Canadian operating room nursing journal最新文献

Current nursing issues such as the nursing shortage, recent changes to basic nursing education, and ongoing fiscal restraints have had consequences for operating room nursing education. The purpose of this article is to discuss approaches for lessening the negative effects that current nursing issues may have on perioperative nursing education in Canada. The delivery of this specialty education should be reviewed to determine if it is fully addressing the issues facing the nursing profession as a whole. The resulting negative impact on recruitment and retention in perioperative programs, on generalist and specialty training, and on funding levels require careful examination and supportive solutions. Establishing the best responses to these challenges will require further discussion of perioperative nursing education delivery.

Background: Perioperative hypothermia is physiologically stressful because it elevates blood pressure, heart rate and plasma catecholamine concentration that may increase the risk of cardiac complications, bleeding, wound infection, and post-anaesthesia care unit stay. This study was designed to evaluate the effects of warming intravenous fluids on perioperative hemodynamic situation, post-operative shivering and recovery in orthopaedic surgery patients.

Methods: Perioperative pulse rate, blood pressure, intraoperative esophageal and skin temperature were measured in sixty patients undergoing orthopaedic surgery that were randomly divided into two groups according to intraoperative IV fluids management. In 30 patients (hypothermia group) all IV fluids infused were at room temperature. In the other 30 patients (normothermia group) all IV fluids were warmed using a dry IV fluid warmer.

Results: The core and skin temperatures of the hypothermia and normothermia groups decreased significantly between the induction of anesthesia and the end of surgery, but the drop was greater in the hypothermia group (P < 0.005). Postoperative mean arterial blood pressure (non-invasive) increased significantly more in the hypothermia group versus normothermia group (p < 0.005). Shivering was observed in 21 of 30 in the hypothermia group and 11 of 30 in the normothermia group (p < 0.005) and recovery time was significantly lower in the normothermia group (36 +/- 5 vs. 26 +/- 3 min, p < 0.005).

Conclusion: Intraoperative IV fluid warming reduces perioperative changes to the hemodynamic situation, post-operative shivering, and recovery time.

A request to the International Federation of Perioperative Nurses (IFPN), by some nurses in Papua New Guinea led to Kate Woodhead and Phyllis Davis running a workshop in Port Moresby, Papua New Guinea. They set out to help the perioperative nurses establish their own organisation to advise the government on policy which affected their service, and to serve as a forum for perioperative education and motivation. This article describes the process, the enthusiasm which greeted them and the mechanisms by which the Papua New Guinea Perioperative Nurses Association came into being.

The author discusses horizontal and vertical violence as they have existed in nursing for many years but are only recently beginning to be discussed and dealt with. The article will consider some of the issues from examples around the world and how they impact on perioperative nurses.

The author explores the history and definition of mentoring. Mentors may be persons of rank, achievement and prestige, or they may be a knowledgeable colleague or teacher. They serve as a catalyst to transform as they instruct, counsel, guide and facilitate the development of others.

This article is based on a presentation given by the authors at the 42nd Congress of the Association for Perioperative Practice (AfPP), October 2006, in the United Kingdom. The conference theme was Circles of Influence and the Congress also hosted an International Federation of Perioperative Nurses (IFPN) Study Day featuring a safety theme. This article contains a brief review of the influence of infection control practices on perioperative practice and surgical outcome. It reviews the Principles of Asepsis and accepted infection control practices. Patient safety is more closely monitored today than ever before--not only by hospitals but also by consumers, health care reformers, governments and patients. The Canadian Institute for Health Information, (CIHI) shows one in nine Canadian adults acquire a hospital infection and that one in nine receives an incorrect medication or medication dosage. Our rates of patient deaths following an adverse event are higher than the combined death rates for Canadians involved in motor vehicle accidents, suffering from breast cancer, and HIV Positive. Each perioperative practitioner must use all available resources to assist in the safety of everyone involved in surgical interventions.

Performance appraisals affect everyone. Perioperative nurses often participate in staff orientations and act as preceptors for other learners. Nurses also participate in their own performance appraisal process. This article discusses performance appraisal forms and performance interview processes. Examples of a performance appraisal form design and performance indicators for perioperative nurses are included. Potential problems with performance appraisals are identified and the impact of Canadian law on performance appraisals is discussed.

The author discusses laparoscopic radical prostatectomy from the perspective of patient assessment/selection, approach, patient perioperative experience, and a partial comparison between open and laparoscopic prostatectomy.

During the delivery of health care, ethical-legal problems are not uncommon and can be defined as situations that have potential legal consequences when equally compelling ethical reasons for and against a particular course of action are recognized and a decision must be made. Ethical-legal repercussions may occur when obtaining surgical consent from a younger teenager (defined as dependant and/or under 18 years of age). An ethical-legal dilemma arising from the case of a 14-year-old, run away girl, who had signed her own surgical consent for a cholecystectomy is analyzed. The concept of consent is discussed and related to an actual case study. The elements of a valid informed consent are identified, discussed and related to the case study. Using the MORAL model for ethical decision-making the ethical implications of this case are analysed. Possible legal repercussions are addressed and a risk management strategy (suggested policy and documentation protocols for the consent process) is proposed and evaluated.