Today's OR nurse最新文献

1. Our clinical service department, perioperative care, had several long-standing issues that needed resolution. Many seemed to revolve around OR delay starts, yet data were necessary to validate the scope of the issue. A systematic program review was planned to evaluate services delivered. 2. A systematic analysis of delay starts revealed that the following factors were involved: anesthesia delays (including insertion of invasive lines), inadequate space or staff to meet needs, incomplete workup or patient preparation, scheduling changes due to incomplete scheduling information or room/equipment not ready, physician not immediately available, patient delays, and emergency cases in progress. 3. An interdisciplinary work team was recruited to assist in resolving this identified factor. The overall issue of delay starts, the focus of the work team, and the plan of approach were reviewed. A problem was identified and corrected. Twelve months later, a formal review of delay starts demonstrated an 80% reduction in delays from scheduling information.

1. With today's emphasis on horizontal and vertical integration of patient care services and the new initiatives prompted by these challenges, OR nurses are considering new methods for managing the perioperative period. One such method is the critical path. 2. A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff members for a particular diagnosis or procedure, designed to better use resources, maximize quality of care, and minimize delays. 3. Hospitals implementing path-based patient care have reported cost reductions and improved team-work. Critical paths have been shown to reduce patient care costs by improving hospital efficiency, not merely by reducing physician practice variations.

1. Perioperative managers have more product choices for gowning and draping materials than ever before. Decision making is more difficult, yet more critical. The product/system selected must meet the patient care, employee protection, and cost expectations of the department. 2. Decision-making should be based on product characteristics, cost considerations, and availability of resources in the institution or service area. 3. Before deciding on any product, a criteria-based evaluation should be conducted. Product, characteristics should be weighed in terms of importance.

1. Professional medical organizations must have a well-defined and properly planned system for rewarding nurses. It must be fair to everyone and reward specific accomplishments. 2. Rewarding OR nurses for working in a highly specialized area and giving them recognition for their contributions and professionalism is important to nurses, patients, and the organization. Such positive reinforcement results in a heightened sense of satisfaction among nurses and loyalty to their organizations. 3. In an era of cost cutting and increased competition among hospitals in employing quality nurses, P*R*A*I*S*E can be an effective method of recruiting and retaining nurses.

1. Laparoscopic gastrostomy or jejunostomy provides a safe and effective method for providing nutritional support to patients who are unable to maintain an adequate intake for metabolic requirements. 2. The advantages of the laparoscopic technique include direct intra-abdominal visualization, a shorter anesthesia time, the decreased need for postoperative narcotics, elimination of the need for endoscopy and suturing, and the prevention of complications associated with open abdominal procedures. 3. The perioperative nurse, who is prepared for and knowledgeable about the nursing implications of the laparoscopic approaches to gastrostomy and jejunostomy, will successfully contribute to an optimal patient outcome.

1. The primary bioethics principles, which are evidenced in the analysis and discussion of organ donation are: autonomy, beneficence, justice, and utility. 2. Organ donation encompasses a variety of ethics-laden issues ranging from invalidation of individual rights to the accepted criteria for donation. However, any of these issues can be categorized as relating to procurement, consent, and allocation. 3. The application of bioethical principles is integral to the decision-making process involved in organ-donation issues. It is the responsibility of nurses, physicians, ethics committees, and organ-procurement organizations, as well as the donors, recipients and their respective relations, to understand and determine which principles support a proposed decision on organ donation or allocation. 4. Human beings must discover and utilize valid principles in order to make effective ethical decisions in difficult or complex situations. By defining and applying the principles of bioethics, individuals can make sense of such painful experiences as those that address organ donation.

1. A successful laparoscopy program requires dedicated personnel, standardized inventory, and ongoing inservice training. Members of the operating team must realize their individual responsibilities and establish accountability while providing safe, efficient care for their patients. 2. A standardized inventory and checklist of all laparoscopic equipment and instrumentation deemed necessary for the procedure by the physician must be maintained and checked on a daily basis. 3. Adequate primary and backup instrumentation must be readily available at all times.

1. Operation Rainbow organizes surgical missions, and "is dedicated to relieving the suffering of the world's forgotten children through service, education and reconstructive surgery." 2. Nurses planning to go on a surgical mission should be prepared to bring all needed supplies. Do not expect any supplies to be at your final destination. 3. Do not impose your culture on local hospital workers. Ethnocentrism (the belief that one's own values are superior to another) is an easy crutch to use when you are uncomfortable because you are in a different culture.