Pub Date : 2012-05-01DOI: 10.1097/01.ORN.0000412326.57018.05
M. Tinkham
www.ORNurseJournal.com AA history and physical, also known as an H&P, is essential for a complete preoperative evaluation. The H&P gives the surgical team a snapshot of the patient, pointing out preexisting conditions (such as cardiac complications) that may put the patient at risk for operative or postoperative complications. Many postoperative complications, such as delayed wound healing, can be linked to preexisting conditions, such as diabetes. This article provides an overview of the essential components to a successful H&P, alerts to watch for when reviewing the H&P, and recent regulation changes affecting the H&P. Although The Joint Commission (TJC) requires all surgical patients to have an H&P within 30 days before the planned surgery, the exact data and format aren’t specified.1 Many facilities create a form for physicians to fill out; the form provides a framework for obtaining all the necessary information. The preoperative H&P is made up of three main parts: • the complete medical history and review of systems • a detailed head-to-toe physical exam with current vital signs • applicable diagnostic test results. The H&P also includes a listing of the patient’s chief complaint, history of the present illness, surgical plan, and a risks, benefits, and alternatives statement. As with any piece of healthcare information, the H&P form should have the proper patient identification information, including the patient’s name, By Michelle R. Tinkham, MS, BSN, RN, PHN, CNOR, CLNC, RNFA The importance preoperative
{"title":"The importance of the preoperative history and physical","authors":"M. Tinkham","doi":"10.1097/01.ORN.0000412326.57018.05","DOIUrl":"https://doi.org/10.1097/01.ORN.0000412326.57018.05","url":null,"abstract":"www.ORNurseJournal.com AA history and physical, also known as an H&P, is essential for a complete preoperative evaluation. The H&P gives the surgical team a snapshot of the patient, pointing out preexisting conditions (such as cardiac complications) that may put the patient at risk for operative or postoperative complications. Many postoperative complications, such as delayed wound healing, can be linked to preexisting conditions, such as diabetes. This article provides an overview of the essential components to a successful H&P, alerts to watch for when reviewing the H&P, and recent regulation changes affecting the H&P. Although The Joint Commission (TJC) requires all surgical patients to have an H&P within 30 days before the planned surgery, the exact data and format aren’t specified.1 Many facilities create a form for physicians to fill out; the form provides a framework for obtaining all the necessary information. The preoperative H&P is made up of three main parts: • the complete medical history and review of systems • a detailed head-to-toe physical exam with current vital signs • applicable diagnostic test results. The H&P also includes a listing of the patient’s chief complaint, history of the present illness, surgical plan, and a risks, benefits, and alternatives statement. As with any piece of healthcare information, the H&P form should have the proper patient identification information, including the patient’s name, By Michelle R. Tinkham, MS, BSN, RN, PHN, CNOR, CLNC, RNFA The importance preoperative","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"34 1","pages":"40–46"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82513123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-03-01DOI: 10.1097/01.ORN.0000412324.97287.AA
L. Rowen, David G. Hunt, K. Johnson
Currently, approximately one-third of all Americans are categorized as obese.1 On a global level, the World Health Organization estimates that there were approximately 400 million obese adults in 2008, with this number projected to rise to 700 million by 2015.2 Accordingly, it has been noted that the number of bariatric surgical procedures increased from 16,200 in the early 1990s to more than 171,000 in 2005, and an estimated 220,000 procedures performed in 2008.3 Although bariatric surgical procedures are the fastest-growing type of procedure, obesity—in particular, morbid and superobesity—affects the care of all surgical patients, not just those undergoing a weight loss procedure. These patients pose a special set of safety and care challenges for nurses in the OR. Excellence in perioperative nursing means ensuring safe and optimal outcomes for patients undergoing operative and other invasive procedures. Perioperative nurses who care for obese patients must be aware of practice standards related to patient handling and transfers, proper positioning, correct use of appropriate equipment, ensuring adequate body temperature, maintaining skin integrity, and providing an environment of respect and sensitivity. in the OR patients
{"title":"Managing obese patients in the OR","authors":"L. Rowen, David G. Hunt, K. Johnson","doi":"10.1097/01.ORN.0000412324.97287.AA","DOIUrl":"https://doi.org/10.1097/01.ORN.0000412324.97287.AA","url":null,"abstract":"Currently, approximately one-third of all Americans are categorized as obese.1 On a global level, the World Health Organization estimates that there were approximately 400 million obese adults in 2008, with this number projected to rise to 700 million by 2015.2 Accordingly, it has been noted that the number of bariatric surgical procedures increased from 16,200 in the early 1990s to more than 171,000 in 2005, and an estimated 220,000 procedures performed in 2008.3 Although bariatric surgical procedures are the fastest-growing type of procedure, obesity—in particular, morbid and superobesity—affects the care of all surgical patients, not just those undergoing a weight loss procedure. These patients pose a special set of safety and care challenges for nurses in the OR. Excellence in perioperative nursing means ensuring safe and optimal outcomes for patients undergoing operative and other invasive procedures. Perioperative nurses who care for obese patients must be aware of practice standards related to patient handling and transfers, proper positioning, correct use of appropriate equipment, ensuring adequate body temperature, maintaining skin integrity, and providing an environment of respect and sensitivity. in the OR patients","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"102 1","pages":"26–35"},"PeriodicalIF":0.0,"publicationDate":"2012-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79968060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-03-01DOI: 10.1097/01.ORN.0000394308.99541.52
C. Meldrum, R. Reddy
{"title":"Lung Volume Reduction Surgery: A Treatment Option for Severe Emphysema","authors":"C. Meldrum, R. Reddy","doi":"10.1097/01.ORN.0000394308.99541.52","DOIUrl":"https://doi.org/10.1097/01.ORN.0000394308.99541.52","url":null,"abstract":"","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"21 1","pages":"20–27"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75202742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1097/01.ORN.0000390906.35248.96
M. Shermak
20 OR Nurse2011 January www.ORNurseJournal.com Abdominoplasty is the fifth most common plastic surgery procedure performed in the United States, according to the American Society of Plastic Surgeons’ 2009 statistics. The number of abdominoplasty procedures performed annually has risen 84% over the past 10 years, with over 115,000 abdominoplasties performed in 2009.1 This trend is secondary to the growing massive weight loss patient population requiring abdominal reduction and contouring procedures. “Abdominoplasty” broken down into its root terms is exactly defined as “plastic surgery of the abdomen.” Procedures cover a broad spectrum. When thinking about surgical correction of the abdomen, the surgeon will consider issues related to improving the skin, subcutaneous fat layer, musculature, possible hernias, and/or the umbilicus, which also might have an associated hernia. Skin may be lax, redundant, and overhanging. The fat layer may be deflated or thick. The musculature may require approximation centrally due to either diastasis or hernias. The umbilicus may be stretched from significant weight change necessitating shortening.2 The particular steps taken in abdominoplasty consider each patient’s individual physical findings.
{"title":"Abdominoplasty Procedures and perioperative care","authors":"M. Shermak","doi":"10.1097/01.ORN.0000390906.35248.96","DOIUrl":"https://doi.org/10.1097/01.ORN.0000390906.35248.96","url":null,"abstract":"20 OR Nurse2011 January www.ORNurseJournal.com Abdominoplasty is the fifth most common plastic surgery procedure performed in the United States, according to the American Society of Plastic Surgeons’ 2009 statistics. The number of abdominoplasty procedures performed annually has risen 84% over the past 10 years, with over 115,000 abdominoplasties performed in 2009.1 This trend is secondary to the growing massive weight loss patient population requiring abdominal reduction and contouring procedures. “Abdominoplasty” broken down into its root terms is exactly defined as “plastic surgery of the abdomen.” Procedures cover a broad spectrum. When thinking about surgical correction of the abdomen, the surgeon will consider issues related to improving the skin, subcutaneous fat layer, musculature, possible hernias, and/or the umbilicus, which also might have an associated hernia. Skin may be lax, redundant, and overhanging. The fat layer may be deflated or thick. The musculature may require approximation centrally due to either diastasis or hernias. The umbilicus may be stretched from significant weight change necessitating shortening.2 The particular steps taken in abdominoplasty consider each patient’s individual physical findings.","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"1 1","pages":"20–27"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82964128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-01DOI: 10.1097/01.ORN.0000388945.34674.98
Lorraine Bigony
PPerioperative nurses practice in a specialized setting that distinguishes it from other nursing disciplines. A specialized language developed by a professional perioperative nursing organization highlights the vast body of nursing knowledge and critical thinking skills necessary for the delivery of safe, quality surgical care. The Perioperative Nursing Data Set (PNDS) is a communication tool that defines and clarifies the day-to-day practice of perioperative nurses. Effective communication among providers via the patient record, whether paper or electronic, is crucial to patient safety. Yet, documentation omissions and misinterpretations are often the root cause of errors in patient care. The PNDS, validated in 1999 by the American Nurses Association (ANA) and one of only
{"title":"Charting the course with the PNDS","authors":"Lorraine Bigony","doi":"10.1097/01.ORN.0000388945.34674.98","DOIUrl":"https://doi.org/10.1097/01.ORN.0000388945.34674.98","url":null,"abstract":"PPerioperative nurses practice in a specialized setting that distinguishes it from other nursing disciplines. A specialized language developed by a professional perioperative nursing organization highlights the vast body of nursing knowledge and critical thinking skills necessary for the delivery of safe, quality surgical care. The Perioperative Nursing Data Set (PNDS) is a communication tool that defines and clarifies the day-to-day practice of perioperative nurses. Effective communication among providers via the patient record, whether paper or electronic, is crucial to patient safety. Yet, documentation omissions and misinterpretations are often the root cause of errors in patient care. The PNDS, validated in 1999 by the American Nurses Association (ANA) and one of only","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"67 1","pages":"15–21"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84065956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-07-01DOI: 10.1097/01.ORN.0000384191.19127.01
Tiffiny Strever
{"title":"Care of the patient with cervical spine injury","authors":"Tiffiny Strever","doi":"10.1097/01.ORN.0000384191.19127.01","DOIUrl":"https://doi.org/10.1097/01.ORN.0000384191.19127.01","url":null,"abstract":"","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"49 1","pages":"26–33"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87538923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-05-01DOI: 10.1097/01.ORN.0000372497.84385.f3
G. Laustsen
Concerns for global ecosystems and an increase in general ecologic beliefs are becoming more commonplace, both in personal and professional practice. The nursing field is no different, as healthcare facilities are in need of environmentally sound policies. According to the Environmental Protection Agency (EPA), healthcare organizations spend more than $8.5 billion on energy each year to meet patient needs.1 It is also estimated that healthcare facilities create between 2 to 4 million tons of waste in the United States.2 Healthcare facilities and practices contribute to the degradation of healthy environments, which, in turn, can cause more disease in humans. Ecologic behaviors in the nurse’s professional environment can help develop more environmentally friendly, or “green,” nursing practices. This can improve local and global environments by decreasing the amount and costs of waste disposal, as well as reducing potential human or environmental health threats. Ultimately, such activities seek to promote a sustainable human ecosystem. Nurses can play a key role in developing a more environmentally sustainable professional practice. The OR is an area where the use of “greening” ?
{"title":"How green is your OR?","authors":"G. Laustsen","doi":"10.1097/01.ORN.0000372497.84385.f3","DOIUrl":"https://doi.org/10.1097/01.ORN.0000372497.84385.f3","url":null,"abstract":"Concerns for global ecosystems and an increase in general ecologic beliefs are becoming more commonplace, both in personal and professional practice. The nursing field is no different, as healthcare facilities are in need of environmentally sound policies. According to the Environmental Protection Agency (EPA), healthcare organizations spend more than $8.5 billion on energy each year to meet patient needs.1 It is also estimated that healthcare facilities create between 2 to 4 million tons of waste in the United States.2 Healthcare facilities and practices contribute to the degradation of healthy environments, which, in turn, can cause more disease in humans. Ecologic behaviors in the nurse’s professional environment can help develop more environmentally friendly, or “green,” nursing practices. This can improve local and global environments by decreasing the amount and costs of waste disposal, as well as reducing potential human or environmental health threats. Ultimately, such activities seek to promote a sustainable human ecosystem. Nurses can play a key role in developing a more environmentally sustainable professional practice. The OR is an area where the use of “greening” ?","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"31 1","pages":"47–52"},"PeriodicalIF":0.0,"publicationDate":"2010-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89282743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.1097/01.ORN.0000369301.55642.F3
M. Spencer, D. Gulczynski
38 OR Nurse2010 March www.ORNurseJournal.com Asymptomatic colonization with methicillinresistant Staphylococcus aureus (MRSA) and methicillinsensitive Staphylococcus aureus (MSSA) is a risk factor for surgical site infections (SSIs). Identifying S. aureus colonization during the presurgical screening process is important to help reduce infections. In this article, the authors document the effectiveness of preoperative surveillance and topical decolonization in reducing SSI rates. MRSA and MSSA are isolates of S. aureus. MRSA is classified as either healthcare-acquired (HA-MRSA) or community-acquired (CA-MRSA). StopSSIs in their tracks
{"title":"Stop SSIs in their tracks","authors":"M. Spencer, D. Gulczynski","doi":"10.1097/01.ORN.0000369301.55642.F3","DOIUrl":"https://doi.org/10.1097/01.ORN.0000369301.55642.F3","url":null,"abstract":"38 OR Nurse2010 March www.ORNurseJournal.com Asymptomatic colonization with methicillinresistant Staphylococcus aureus (MRSA) and methicillinsensitive Staphylococcus aureus (MSSA) is a risk factor for surgical site infections (SSIs). Identifying S. aureus colonization during the presurgical screening process is important to help reduce infections. In this article, the authors document the effectiveness of preoperative surveillance and topical decolonization in reducing SSI rates. MRSA and MSSA are isolates of S. aureus. MRSA is classified as either healthcare-acquired (HA-MRSA) or community-acquired (CA-MRSA). StopSSIs in their tracks","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"7 1","pages":"38–42"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79014285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-03-01DOI: 10.1097/01.ORN.0000347321.97594.2C
S. Burns, Mary Wojnakowski, Kim D. Cooper
{"title":"Promoting thermal balance","authors":"S. Burns, Mary Wojnakowski, Kim D. Cooper","doi":"10.1097/01.ORN.0000347321.97594.2C","DOIUrl":"https://doi.org/10.1097/01.ORN.0000347321.97594.2C","url":null,"abstract":"","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"95 1","pages":"14–18"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83923713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-01DOI: 10.1007/978-3-540-29805-2_2035
António Pais de Lacerda
{"title":"Intra-operative Awareness","authors":"António Pais de Lacerda","doi":"10.1007/978-3-540-29805-2_2035","DOIUrl":"https://doi.org/10.1007/978-3-540-29805-2_2035","url":null,"abstract":"","PeriodicalId":76746,"journal":{"name":"Today's OR nurse","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51046487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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