PERSONAL DIGITAL ASSISTANTS (PDAs), are handheld minicomputers used for tasks such as referencing, documentation, and data storage and retrieval. THESE DEVICES can help perioperative nurses solve problems associated with updating, maintaining, and retrieving surgical preference cards and accessing treatment and medication references. CHOOSING A PDA and accessories, finding ...

(including resuscitation and perioperative care), and anaesthesia for acute and chronic pain management

In 2007, a steering committee at West Virginia University Hospitals, Morgantown, began a three-year, accelerated design, computer implementation project to institute an automated perioperative record. The process included budgeting, selecting a vendor, designing and building the system, educating perioperative staff members, ...

Perioperative hypertension is commonly encountered in patients that undergo surgery. While attempts have been made to standardize the method to characterize the intraoperative hemodynamics, these methods still vary widely. In addition, there is a lack of consensus concerning treatment thresholds and appropriate therapeutic targets, making absolute recommendations about ...

, anesthesiologists, and surgeons), nurses (nurse practitioners and other registered nurses), and physician assistants

disciplines, nursing and paramedic studies. � Current experience in peri-operative care, resuscitation and

... Abstract : A major goal of anesthesia practitioners is to ... Elective surgery patients are acquiring greater expectations regarding the perioperative care ...

Headlines -- May 22, 2008 Perioperative Nursing Perioperative Nursing Same Day Surgical Unit staff nurse 22, 2008 -- Caring Headlines -- Page 11 Surgical NursingSurgical Nursing Staff nurse, Josephine e n e r a l H o s p i t a l May 22, 2008 Headlines 20082008Staff nurse, Mary Anne Malloy, RN, cares

Learning pharmacology is a critical element of any health care practitioner's education to ensure quality and safety in perioperative care. The medication-use process and safe medication use are two important principles that contribute to the safe use of pharmacological agents in perioperative clinical practice. ...

Drug administration errors are a major cause of morbidity and mortality in hospitalized patients. These errors result in major harm and incur dramatic costs to the delivery of health care. This article highlights this problem, especially as it deals with patients in the perioperative setting. PMID:21295758

The perioperative environment generates large amounts of waste, which negatively affects local and global ecosystems. To manage this waste health care facility leaders must focus on identifying correctable issues, work with relevant stakeholders to promote solutions, and adopt systematic procedural changes. Nurses and managers can moderate negative ...

Advances in liver resection surgery have lead to reductions in both mortality and morbidity. However morbidity remains high so effective multidisciplinary teamwork is essential to optimise the perioperative care of this patient group. In this article we review the current literature on the perioperative management of patients ...

In the current health care environment, buzzwords such as redesign, reengineering, restructuring, right-sizing, customer service, diversity, quality, multiskilled workers, and unlicensed assistive personnel conjure up many notions about how perioperative nurses can meet the needs and wants of their patients. Unlicensed assistive personnel are becoming ...

Call staffing and the associated long work hours can be challenging for both perioperative staff members and the health care organization. A change in culture is needed to recognize exhaustion as an unacceptable risk to patients and perioperative personnel safety. Perioperative health care ...

... primary subspecialty in any of several critical care nursing areas, peri-operative (operating room) nursing, or emergency/trauma nursing. ...

... While cardiovascular complications remain a leading cause of perioperative morbidity ... patients with a history of insulin-dependent diabetes (-4.0, P ...

Every perioperative department could benefit from having an information system that facilitates managerial function and improves efficiency in the OR. The Patient Advancement Monitoring System-Surgical implemented in a hospital in Taipei, Taiwan, is one such a system that uses radio-frequency identification technology for tracking perioperative ...

... 8-98) Prescribed by ANSI Std Z39-18 Page 4. ... generally evenly represented, with critical care, perioperative, and nurse practitioner specialties ...

Treating patients with Hutchinson-Gilford progeria syndrome (HGPS) are based on the abnormalities of accelerated aging that affect the healing processes, combined with a fragile cardiovascular status. A classic HGPS case is presented, of Korean ancestry, who was treated for severe coxa valga with bilateral varus osteotomies using blade plate fixation. Complications over the ...

Treatment of patients with Hutchinson-Gilford progeria syndrome (HGPS) is based on the abnormalities of accelerated aging that affect the healing processes, combined with a fragile cardiovascular status. A classic HGPS case, of Korean ancestry, previously treated for severe coxa valga with bilateral varus osteotomies using blade plate fixation is presented. Complications over ...

The burden of tobacco dependence can be measured in premature deaths due to accelerated atherosclerotic disease and cancer, and economic costs of lost productivity and intensified medical care. Smoking cessation efforts have benefited from continued pharmacologic developments, increased public awareness of stop-smoking programs, aggressive ...

Objectives. The global obesity epidemic poses many challenges to clinical endocrinologists and has fomented a coordinated effort among specialists to revolutionize management paradigms. The emerging roles of bariatric surgery and clinical endocrinology will be discussed within the context of obesity and diabetes comprehensive care plans and cost-effective strategies.Methods. ...

Nursing? Close faculty supervision in clinical courses. For all direct care experiences, clinical groups Primary Care as Nurse Practitioners Public Health Research Managing Clinical Trials Leadership and Management as Clinical managers and Directors of Nursing Peri-operative care as Nurse Anesthetists and RN

BackgroundHypothermia, defined as a core body temperature less than 36�C (96.8�F), is a relatively common occurrence in the unwarmed surgical patient. A mild degree of perioperative hypothermia can be associated with significant morbidity and mortality. A threefold increase in the frequency of surgical site infections is reported in colorectal surgery patients who ...

Perioperative nursing is practiced in a technologically advanced, fast-paced environment, and there is a continuing shortage of qualified and competent perioperative nurses. The expansion of nursing education programs into web-based environments has the potential to address this shortage. Online learning is both effective and efficient and particularly ...

Research related to perioperative care requires advanced training and is well suited to take place at a research-intensive university. A recent research alliance established between AORN and the University of Michigan School of Nursing, Ann Arbor, uses the strengths of both a robust perioperative professional organization and a ...

Nearly 60% of the Dutch population undergoing surgery is aged 65�years and over. Older patients are at increased risk of developing perioperative complications (e.g., myocardial infarction, pneumonia, or delirium), which may lead to a prolonged hospital stay or death. Preoperative risk stratification calculates a patient's risk by evaluating the presence and extent of ...

ABSTRACT: Strokes and TIAs, with their high cumulative mortality and morbidity rates, are occurring with increasing frequency in western population 14. As such, it is vital for clinicians to provide optimal medical management in the perioperative period for those patients with this common neurological problem. This review aims to highlight the importance of the ...

Simulation in perioperative anesthesia training is a field of considerable interest, with an urgent need for tools that reliably train and facilitate objective assessment of performance. This article reviews the available simulation technologies, their evolution, and the current evidence base for their use. The future directions for research in the field and potential ...

Several medications used in clinical perioperative medicine are currently cited on the national shortage list. Medication shortages may be attributed to lack of raw materials, manufacturing issues, and discontinuation of production. Medication shortage has a substantial impact on patient care, and is responsible for creating an environment conducive to an ...

Neurologic injury in patients with congenital heart disease remains an important source of morbidity and mortality. Advances in surgical repair and perioperative management have resulted in longer life expectancies for these patients. Current practice and research must focus on identifying treatable risk factors for neurocognitive dysfunction, advancing methods for ...

Perioperative hyperglycemia is a common phenomenon affecting patients both with and without a known prior history of diabetes. Despite an exponential rise in publications and studies of inpatient hyperglycemia over the last decade, many questions still exist as to what defines optimal care of these patients. Initial enthusiasm for tight glycemic control ...

Increasing numbers of children with congenital and chronic diseases are surviving beyond adolescence. Consequently, arrangements must be put in place to ensure that these groups of patients continue to receive high-quality care into adulthood. Although some medical disciplines have reacted positively to this growing challenge, perioperative ...

Shortened hospital stays, expectations of quick recovery, and rapid turn-around times in surgical services challenge perioperative nurses to be creative and innovative providers of essential and appropriate patient education. Nurses need approaches that enable them to meet these challenges. One such approach is the adaptation of a clinical care map to the ...

The perioperative period is a time of thermal instability for older surgical patients. Beyond the elder persons vulnerability to intraoperative heat loss and hypothermia, the surgical procedure initiates host responses that affect body temperature. Technology and drug therapies often deliberately or inadvertently alter thermal balance. Alterations range from mild hypothermia ...

Accurate assessments of intravascular fluid status are an essential part of perioperative care and necessary in the management of the hemodynamically unstable patient. Goal-directed fluid management can facilitate resuscitation of the hypovolemic patient, reduce the risk of fluid overload, reduce the risk of the injudicious use of vasopressors and ...

Accurate assessments of intravascular fluid status are an essential part of perioperative care and necessary in the management of the hemodynamically unstable patient. Goal-directed fluid management can facilitate resuscitation of the hypovolemic patient, reduce the risk of fluid overload, reduce the risk of the injudicious use of vasopressors and ...

An increasing number of pediatric patients with permanent pacemakers and implantable cardioverter defibrillators (ICDs) require cardiac and noncardiac surgery. It is critical that the anesthesiologist caring for these patients understands the management of the device and the underlying heart disease. Children with these devices are more vulnerable to lead failure and ...

We experienced anesthesia and perioperative management for hysterectomy in a patient with acquired angioedema. Angioedema due to C1 esterase inhibitor (C1-INH) deficiency (loss or dysfunction of C1-INH) is one of the rarest diseases, and is characterized by recurrent episodes of regional hard edema and ascites induced by mechanical stimuli or mental stress. Edema spreads to ...

Hypertrophic cardiomyopathy with or without left ventricular outflow tract obstruction is characterized by asymmetric hypertrophy of the interventricular septum causing intermittent obstruction of the left ventricular outflow tract. Because Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease, it may present to the anesthesiologist more often than anticipated, sometimes in ...

New developments in deoxyribonucleic acid (DNA) technology are increasing understanding of the role of genetics in health and disease. This kind of health information requires that perioperative nurses develop new skills and roles that will enhance the quality of genetic health care they provide to patients, particularly with regard to managing genetic ...

heart rates before surgery and during the perioperative period than did those given standard care (Table VASCULAR SURGERY THE EFFECT OF BISOPROLOL ON PERIOPERATIVE MORTALITY AND MYOCARDIAL INFARCTION IN HIGH-RISK PATIENTS UNDERGOING VASCULAR SURGERY DON POLDERMANS, PH.D., ERIC BOERSMA, PH.D., JEROEN J. BAX, PH.D., IAN

SummaryTRALI is a rare but fatal complication of blood transfusion usually under diagnosed and under reported. An interesting case of hemolysis and lung injury developing in a single patient following blood transfusion during perioperative period is reported hereby. Great amount of suspicion about TRALI and supportive care such as mechanical ventilation ...

Children are not just 'small adults'. They have specific physical, psychological and social requirements that must be identified and addressed to optimise their well-being in the perioperative period. The healthcare practitioner should be trained to understand the needs of the paediatric patient in hospital, including the ever increasing need to take into account cultural ...

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) has become an important tool in the management of patients with peritoneal malignancies. It is a complex surgical procedure with significant fluid loss during debulking leading to relevant pathophysiological alterations and therefore a challenge for anesthesiologists and critical care physicians. This ...

As you read this issue of the Journal and celebrate OR Nurse Week, think about your daily opportunities to practice the principles of international nursing. Look for chances to appreciate cultural values different from your own as you provide patient care and interact with visiting international colleagues. Adopt a global perspective to perioperative ...

Information technology has the potential to provide a tremendous step forward in perioperative patient safety. Through automated delivery of information through fixed and portable computer resources, clinicians may achieve improved situational awareness of the overall operation of the operating room suite and the state of individual patients in various stages of surgical ...

We developed a 21-item questionnaire to evaluate the effectiveness of nursing care provided in an outpatient surgery center. The four constructs of the instrument for measuring patient satisfaction are caring, continuity of care, competence of nurses, and education of patients and family members. Content validity and test-retest ...

The concept of information literacy may be new to some perioperative nurses; however, embracing this concept will help nurses identify situations that necessitate gaining more information, locate and access information sources, evaluate and analyze data, and cite information in compliance with copyright and fair use laws. The culture of health care is ...

: Hermitage Medical Clinic Ensuring the quality of health care among mothers and children: maternal and child into the perioperative workplace setting Theresa Cummins: Evidenced-based nursing practice outcomes in prevention

The Public Health Service Policy on Humane Care and Use of Laboratory Animals states that procedures on animals that may cause more than momentary or slight pain or distress should be performed with appropriate sedation, analgesia or anesthesia.

. Perioperative care of patients with obstructive sleep apnea � a survey of Canadian anesthesiologists. Can J suspended marketing aprotinin in Canada until data analysis is completed. Currently, aprotinin is available the administration device affect the quality of patient-controlled analgesia? A randomized controlled trial" Jeremi

This book contains 32 chapters. Come of the chapter titles are: Imaging; Urinary tract infections; Calculus formation; Perioperative care; Renal injuries; Kidney stone surgery; Trauma to the lower urinary tract; renel cystic disease; Bladder cancer; and The ureter.

Results of current research into perioperative medication errors have revealed that more than half of medication errors occur during the administration phase of the medication-use process. The administration phase is the point at which the medication and the patient intersect and the medication imposes its pharmacological effect. During this phase, the only safety net between ...

Strokes and TIAs, with their high cumulative mortality and morbidity rates, are occurring with increasing frequency in western population [1,4]. As such, it is vital for clinicians to provide optimal medical management in the perioperative period for those patients with this common neurological problem. This review aims to highlight the importance of the ...

Non-ketotic hyperglycinemia (NKGH) is an autosomal recessive disorder of glycine metabolism. Defective glycine cleavage results in elevated concentrations of glycine in plasma, urine and cerebrospinal fluid. The accumulation of glycine, an inhibitory neurotransmitter, leads to a clinical presentation of apnea, lethargy, hypotonia, seizures, and severe psychomotor retardation. There are four ...

Factor XIII (F XIII) is an essential parameter for final clot stability. The purpose of this study was to determine the impact of the addition of factor (F)XIII on clot stability as assessed by Rotation Thromboelastometry (ROTEM). In 90 intensive care patients ROTEM measurements were performed after in vitro addition of F XIII 0.32 IU, 0.63 IU, 1.25 IU and compared to diluent ...

Obesity is a worldwide epidemic with increasing importance in both industrialised and developing countries. Anaesthesiologists will be increasingly challenged by the care for morbidly and super-obese patients. Prerequisites for an optimal perioperative care are a suitable and adapted environment both on the ward and in the operating ...

This article discusses the data collection tool developed to investigate how patient flow is affected by the delivery of different types of care within Perioperative Services. To better understand the Perioperative Services processes, this study tracked staff members as they perform their activities. A challenging aspect of documenting ...

When we join perioperative nursing we enter the swinging doors of the operating suite and never leave. Have we come home? Are we drawn by--Student experience? A job to go to by random assignment? A long desire to work in the OR? For a career change? Regardless of the reason for our arrival, many things keep us in the OR including the teamwork, friendships formed, the ...

The purpose of this study was to examine the near-miss experiences of RNs working in perioperative services to understand their perception of the causes of near misses. The setting was a multi-facility health care system in the mid-Atlantic region of the United States. The study design was descriptive, using a survey of perioperative ...

The above description of the circulating Registered Nurse is only a brief over view of the detailed and complex world of perioperative nursing. Unveiling the vital, "well kept secret", of the need for a Registered Nurse, circulating at all times throughout the surgical procedure, is critical for safe patient care. The health care ...

Numerous advances in technology during the past decade require that nurses not only be knowledgeable in nursing science but that they also become educated in information technology (IT). Perioperative IT has the potential to improve the quality of health care, reduce costs, decrease medication administration errors, reduce time spent on paperwork, increase ...

Laryngotracheal reconstruction (LTR) involves surgical correction of a stenotic airway with cartilage interpositional grafting, followed by either placement of a tracheostomy and an intraluminal stent (two-stage LTR) or placement of an endotracheal tube with postoperative sedation and mechanical ventilation for an extended period of time (singlestage LTR). With single-stage repair, there may be ...

Growing evidence demonstrates the link between the quality of care nurses provide, patient outcomes, and nurses' level of qualification and expertise. Little attention has been given to measuring the influence of experience and education on nurses' perceptions of their perioperative competence. To describe the influence of years of OR experience and ...

As techniques become more advanced, perioperative nurses in all surgical specialties must increase their knowledge to provide safe patient care. Cardiopulmonary bypass for cardiac surgery demands special knowledge and skills. Knowledge of the principles of CPB allows the nurse to give excellent nursing care and to function as an ...

Aim:? To evaluate the efficacy of 'the perioperative dialogue (PD)' by analyzing salivary cortisol, in 5- to 11-year-old children undergoing day surgery. Background:? To deal with anxiety prior to investigations and/or procedures, children need to be confident and informed about what is going to happen. Therefore, intervention strategies should be initiated before admission to ...

If patients being treated with anticoagulants need to undergo an operation then physicians need to consider whether to suspend the use of this medication or to allow its use to be continued. Suspending the use of anticoagulants increases the risk of thrombosis, whereas continued use may cause bleeding complications. No evidence-based scientific research has been carried out regarding best practice ...

The current traditional apprenticeship model in healthcare is no longer meeting the needs of our learners. This model requires learners to master various core skills, carry out a procedure under supervision, and relate simultaneously to other staff in the complex operating room. The approach of "see one, do one, teach one" is considered, by some, to no longer be acceptable. ...

Formal post-registration continuing professional education (CPE) has been explored previously, however, not from the perspectives of perioperative nurses. Using a descriptive qualitative approach, interviews were conducted with 23 perioperative nurses who had recent experience of formal university-based study. Analysis of interview transcripts revealed the ...

Every perioperative transoesophageal echo (TEE) study should generate a written report. A verbal report may be given at the time of the study. Important findings must be included in the written report. Where the perioperative TEE findings are new, or have led to a change in operative surgery, postoperative care or in prognosis, it is ...

Research supports the practice of preprocedure warming as a method to prevent the development of unplanned perioperative hypothermia. ASPAN defines hypothermia as a core temperature lower than 36�C. The purpose of this quality improvement project was to explore the idea that preprocedure warming maintains perioperative normothermia. Information was ...

Pheochromocytomas (PHEO) and paragangliomas (PGL) are tumors derived from the sympathetic and parasympathetic nervous system. The parasympathetic-associated paragangliomas arising in the neck are usually non-functioning and are rarely encountered by general and visceral surgeons. The sympathetic-associated PHEO and PGL are usually functioning and most often arise in the abdomen. Because they ...

Previous studies have demonstrated that preoperative haemoglobin concentration and female gender are related to an increased need for perioperative allogeneic transfusions in cardiac surgery. Hence, urgent cardiac surgery presents a dilemma for female patients who are Jehovah's Witnesses, because of their refusal of allogeneic transfusion. This report describes the management ...

HoLRP is a technique which produces a defect in the prostatic fossa analogous to TURP but does so with significantly less blood loss. The perioperative outcome was assessed in a randomized clinical trial. The patients in the HoLRP arm (61 patients) had a longer resection time when compared to the TURP group (59 patients) but had less nursing contact time, shorter catheter time ...

The 2004 Canadian Adverse Events Study estimated up to 23,750 potentially preventable in-hospital deaths occur annually; 51.4% of adverse events occurred with surgical care delivery. An integrated peri-operative quality management program has been implemented at The Ottawa Hospital using the American College of Surgeons National Surgical Quality ...

Actively engaging in perioperative research lays a framework for stimulating interest in future research possibilities and provides students and graduate nurses with challenges to keep them interested as their careers progress. In this article, former honors students and a faculty researcher share their perceptions of participating in perioperative ...

A small group of patients account for the majority of peri-operative morbidity and mortality. These 'high-risk' patients have a poor outcome due to their inability to meet the oxygen transport demands imposed on them by the nature of the surgical response during the peri-operative period. It has been shown that by targeting specific haemodynamic and oxygen ...

Manual retraction, a task performed to expose the surgical site, poses a high risk for musculoskeletal disorders that affect the hands, arms, shoulders, neck, and back. In recent years, minimally invasive and laparoscopic procedures have led to the development of multifunctional instruments and retractors capable of performing these functions that, in many cases, has eliminated the need for manual ...

Perioperative coagulation monitoring is the rational diagnostic basis for pro- and anti-thrombotic interventions in patients undergoing emergency and elective surgery. The main goal of perioperative monitoring of haemostasis is to increase safety of patients undergoing surgical procedures. Currently, there is a change in paradigm with (1) increasing ...

Undocumented traditions in perioperative care after total hip and knee arthroplasty are passed on as gold standard. However, evidence-based medicine may interfere with traditions. It is therefore essential to revisit traditions or routines once in a while and re-evaluate current practice according to existing evidence. Fast track surgery is an example of ...

The population of children with end-stage heart failure requiring mechanical circulatory support is growing. These children present for diagnostic imaging studies, various interventions and noncardiac surgical procedures that require anesthetic care. This article is a review of the population demographics of children on mechanical cardiac support, the alternative devices ...

Hyperglycemia in the surgical population is a recognized risk factor for postoperative complications; however, there is little literature to date regarding the management of hyperglycemia in the perioperative period. Here, we detail the strategies that our institutions have employed to identify and treat hyperglycemia in patients with diabetes who present for surgery. Our ...

Background: Most anesthesiologists will experience at least one perioperative catastrophe over the course of their careers. Very little, however, is known about the emotional impact of these events and their effects on both immediate and long-term ability to provide care. In this study, we examined the incidence of perioperative ...

IntroductionHomozygous sickle cell carriers have an increased perioperative mortality. Some indications may justify an exchange blood transfusion to reduce the proportion of haemoglobin S. The advantages of general blood transfusion in a perioperative setting have not been proven and thus remain controversial. It is not clear whether reducing the ...

Surgical site infections (SSIs) occur in approximately 2%-5% of patients undergoing surgery in the acute care setting in the United States. These infections result in increased length of stay, higher risk of death, and increased cost of care compared with that in uninfected surgical patients. Given the inclusion of maintenance of ...

Holism is the philosophy of understanding people by addressing factors that affect people in all situations. The goal of holistic nursing is to help patients integrate appropriate self-care into their lives. By providing holistic care, the perioperative nurse can help surgical patients experience fewer problems (eg, surgical trauma, ...

Providing perioperative care for patients with hip fractures can present major challenges for the anaesthesiologist. These patients often have multiple comorbidities, the deterioration of any one of which may have precipitated the fall. A careful balance has to be achieved between minimising the time before operation and spending time ...

Facts and evidence have been negated or lost by the inexperience of health care professionals who are not cognizant of the legal requirements concerning potential criminal cases. In the perioperative setting, policy and procedure should provide guidelines for potential criminal cases based on the key concepts and principles of forensic science. Potential ...

The nursing profession has worked with unlicensed assistive personnel (UAP) for decades; however, with the budget cuts resulting from health care redesign, some health care providers have expressed apprehension about UAP roles (eg, nurse aides, orderlies, unit clerks). Staff members in the perioperative services department at ...

BackgroundGiven the complexity of surgical care, perioperative patients are at high risk of opioid-related adverse drug events. Existing methods of detection, such as trigger tools and manual chart review, are time-intensive which makes sustainability challenging. Using strategic rule design, computerized surveillance may be an efficient, pharmacist-driven ...

There is a continuous increase in the proportion of elderly patients undergoing surgical procedures. This review will concentrate on selected topics related to elderly care that represent current unresolved and relevant issues for the care of the elderly surgical patient including: aging related organ dysfunction, perioperative risk ...

As our elderly population increases, theatre staff are frequently presented with the challenges of caring for patients with co-morbidities who are undergoing surgery. This article aims to educate the reader about Parkinson's disease, and suggest interventions that perioperative practitioners may want to consider in order to improve the patient's experience ...

ObjectiveDevelop and evaluate a risk-adjusted perioperative morbidity model for vaginal hysterectomy.Study DesignMedical records of women who underwent vaginal hysterectomy during 2004 and 2005 were retrospectively reviewed. Morbidity included hospital readmission, reoperation, and unplanned medical intervention or intensive care unit admission; urinary ...

Perioperative hypothermia is a common and serious complication of anesthesia and surgery. Core body temperature, which is normally regulated to within a few tenths of a degree centigrade, can fall by as much as 6 degrees C during anesthesia. The combination of anesthetic-induced impairment of thermoregulatory control and exposure to a cool operating room environment causes ...

Surgery is performed in patients with liver disease more frequently now than in the past, in part because of the long-term survival of patients with cirrhosis. Recent work has focused on estimating perioperative risk in patients with liver disease. Hemodynamic instability in the perioperative period can worsen liver function in patients with liver disease. ...

Protocols for prevention of cerebral ischemic attacks caused by hyperventilation resulting from crying, as observed in perioperative pediatric moyamoya patients, were evaluated. The first protocol involved the use of sedation when staff were setting up the intravenous lines, performing neuroimaging studies, and controlling postoperative pain. The second involved the use of ...

OPINION STATEMENT: It has been demonstrated that patients undergoing surgical procedures are at increased risk for complications if they have obstructive sleep apnea. It is believed that this increase in risk is related to more difficult intubations, use of ventilatory depressant medications, and perhaps body positioning. Although identifying patients with a preexisting diagnosis of sleep apnea is ...

Musculoskeletal injuries can occur when the physical work demanded by a job exceeds a worker's ability to respond safely. In perioperative nursing, and nursing in general, patient handling and movement demands commonly lead to injury and are considered high-risk activities. In 2005, the AORN Workplace Safety Task Force was charged with identifying high-risk tasks performed in ...

IntroductionTo evaluate and compare the peri-operative and postoperative complications of the two most frequently used percutaneous tracheostomy techniques, namely guide wire dilating forceps (GWDF) and Ciaglia Blue Rhino (CBR).MethodsA sequential cohort study with comparison of short-term and long-term peri-operative and postoperative complications was ...

The delivery of culturally sensitive care by perioperative nurses is an essential element of patient advocacy. To provide culturally astute care, nurses must familiarize themselves with the world's religious and ethnic groups. Islam is a worldwide religion and, like all religions, is practiced along a spectrum ranging from very ...

Since the 1970s outpatient surgery has become increasingly popular as a mechanism for reducing hospitalizations and allowing patients to recuperate in their own homes. Advanced nursing care, improved surgical procedures, and modern pharmaceuticals and anesthetic techniques increase the rate and quality of patient recovery and allow the patient to enter the hospital, undergo ...

OBJECTIVES: Perioperative handoffs are a particularly high-risk period given patients' postprocedural physiology, their physical transport through the hospital, and the triad transfer of personnel, information, and technology. The authors piloted a new perioperative handoff process to guide patient transfers from the cardiac operating room (OR) to the ...

For many years, computers have supported complex clinical ancillary functions such as the laboratory, radiology, endoscopy, and others. Digital computers have been successfully incorporated into specialized clinical instruments to offer advanced digital devices such as fetal monitors, heart monitors, and imaging equipment. But these devices are often not fully integrated with clinical management ...

It is ethically and legally important, when providing care to our patients, to respect their autonomy and dignity, to act in their best interests and avoid doing harm. Advance care planning is essential to achieving this by giving patients the opportunity to tell us what they would want us to do if they became seriously unwell and could no longer ...

Purpose:Delayed gastrointestinal (GI) recovery after bowel resection is associated with longer hospital stays and increased health care costs. Alvimopan (Entereg), a peripherally acting mu-opioid receptor antagonist, accelerates GI recovery after bowel-resection surgery. We undertook a study to evaluate the economic impact of alvimopan in clinical ...

Despite remarkable improvements in perioperative care, adverse neurobehavioral outcomes following neonatal and infant cardiac surgery are commonplace and are associated with substantial morbidity. It is becoming increasingly clear that complex congenital heart disease is associated with both abnormalities in neuroanatomic development and a delay in fetal ...

Aminoglycosides are used to treat aerobic gram-negative infections and can be administered with other antibiotics to treat resistant gram-positive infections. Aminoglycosides are most often administered topically or parenterally. During the surgical period, surgeons may use aminoglycosides to irrigate wounds or may apply them directly to surgical incisions. Because aminoglycosides are excreted ...

Communication is of the utmost importance for effective teamwork, yet promoting effective communication and overcoming the cultural belief that conflict is "bad" are key challenges for leaders. To provide optimal patient care, perioperative nurse leaders should assess the culture in which they work and develop strategies to build solid credible ...

Results of the Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial, intensive insulin therapy (IIT), and use of a continuous glucose sensor in intensive care units (ICU) were analyzed. The NICE-SUGAR trial was unable to determine if optimal intensive insulin therapy decreases mortality. Continuous ...

Nuclear cardiology including single photon emission computed tomography (SPECT) and positron emission tomography (PET) can play important roles as myocardial viability assessment and perioperative cardiovascular evaluation for noncardiac surgery. Increasing prevalance of coronary artery disease (CAD) is associated with an increasing number of patients with heart failure ...

BackgroundConcomitant treatment in addition to intervention may influence the primary outcome, especially in complex interventions such as surgical trials. Evidence-based standards for perioperative care after distal pancreatectomy, however, have been rarely defined. This study's objective was therefore to identify and analyse the current basis of evidence ...

OBJECTIVE: The authors review the historical basis for the provision of perioperative glucocorticoid coverage, and detail the evolution in the understanding of the role of the hypothalamic-pituitary-adrenal cortical (HPA) axis in response to physical stressors. New recommendations are proposed for glucocorticoid-dependent patients who require anesthesia and surgery. SUMMARY ...

BACKGROUND: The combined treatment of cytoreductive surgery (CRS) and perioperative chemotherapy (PIC) for colorectal peritoneal carcinomatosis (PC) is a rigorous surgical treatment most suited for fit and young patients. With technical maturity and improved perioperative care, we examined the outcomes of elderly patients undergoing ...

The indications for continuous nerve blocks for the perioperative pain management in hospitalized and ambulatory patients have extended well beyond orthopaedics. These techniques are not only used to control pain in patients undergoing major upper and lower extremity surgery, but also to provide perioperative analgesia in patients undergoing abdominal, ...

One of the key aspects of successful collaborative working is the relevant and effective exchange of information between professionals. Boundaries exist not only between health and social care in a community setting, but also in acute care between and within departments and professions. Patients continuously cross these boundaries during transfers and ...

Match Acceleration Traces to Cedar Point Rides. C. D. National Aeronautics and ... ride is different, but the acceleration pattern may look similar. Think carefully ...

The arrival of work-based learning awards in professional education offers an alternative route for healthcare professionals looking to undertake post-registration education. The unique way that work-based learning integrates individual learning needs with that of role requirements makes the award an ideal choice for the advanced perioperative practitioner (APP) who wishes to ...

Current nursing shortages along with unsuccessful nursing orientation programs have been a major concern for the past decade because they result in poor retention, reduced quality of patient care, decreased job satisfaction and high financial costs to the organization. Specialty areas, such as the Operating Room (OR), are even more vulnerable due to the stressful working ...

Surgical instruments, whether single use or reusable, are defined by the University of Newcastle's Online Medical Dictionary as 'Hand held tools or implements used by health professionals for the performance of surgical tasks' (CancerWEB 1998). This definition, in its broadest terms, recognises that the inter-professional team (health professionals) are involved in the use, ...

The personal and financial consequences of avoidable infection are enormous in personal and global terms (DH 2003, Stone, Larson & Kawar 2002). Patients expect to be treated and cared for in clean conditions, and not be exposed to the risks of acquiring an infection by poor practice on the part of healthcare workers (DH 2005, Health Care Commission ...

The quality of teamwork among health care professionals is known to affect patient outcomes. In the OR, surgeons report more favorable perceptions of communication during procedures and of teamwork effectiveness than do nurses. We undertook a quality improvement project in the Veterans Health Administration to confirm reported teamwork differences between ...

Multiple missions are assigned to the Bagram Airfield in Afghanistan, including providing combat medical and medical support services to US and coalition forces and providing resources to strengthen security and build a solid health care infrastructure. Craig Joint Theater Hospital located at Bagram Airfield is staffed primarily with Air Force personnel serving a six-month ...

The alarms of medical devices are a matter of concern in critical and perioperative care. The frequent false alarms not only are a nuisance for patients and caregivers but can also compromise patient safety and effectiveness of care. The development of alarm systems has lagged behind the technological advances of medical devices over ...

The Japanese who are in a hospice or a palliative care ward recently, and pass away are increasing in number. However, the present condition is that most pass away in a general ward. In Japan, since a surgeon is concerned in many cases to terminal care, in addition to the operation method and perioperative management, has to learn the ...

Traditionally, Scandinavian anaesthesiologists have had a very broad scope of practice, involving intensive care, pain and emergency medicine. European changes in the different medical fields and the constant reorganising of health care may alter this. Therefore, the Board of the Scandinavian Society of Anaesthesiology and Intensive ...

The present invention relates, in general, to perioperative bleeding and, in particular, to methods of identifying individuals at risk of perioperative bleeding. The present invention relates, in general, to perioperative renal dysfunction and, in particular, to methods of identifying individuals at risk of ...

as deemed safe by the anesthesiologist. During the first two hours of recovery, oxygen at the specified an oxyhemoglobin satu- ration of more than 92 percent. The anesthesiologists who cared for the patients were aware by the American Society of Anesthesiologists (on which a preop- erative score of 1 indicates that the patient

For many years, clonidine, an ?2-adrenergic receptor (?2-AR) agonist, has been widely used as an analgesic adjuvant in perioperative conditions and pain therapy. Dexmedetomidine (DMET) is currently the most potent ?2-AR agonist available and was first approved as a sedative agent for use in the intensive care unit. However, DMET has recently been ...

Health care vendors (ie, industry) can be credited with developing products and medications that improve perioperative clinician and patient safety. The role of the medical science liaison in industry is to provide education about these products and facilitate research partnerships between clinicians and industry that can result in new products and ...

We report the case of a 76-year-old man of the Jehovah's Witness faith who had a giant abdominal aortoiliac aneurysm that was successfully operated on using an aortoiliac Y-graft bypass technique, without the use of stored allogenic blood. Cell saver technique and recombinant human erythropoietin (epoetin beta) were used during the perioperative period. The patient had good ...

OPINION STATEMENT: Complete surgical repair of tetralogy of Fallot (TOF) around 3�months of age is the commonly undertaken management strategy in many centers and has excellent outcomes. Intervention at an earlier age, including the newborn period, may be required for children with symptoms. Early extubation from mechanical ventilation where possible may help improve outcomes for children ...

Inadvertent hypothermia is a condition prevalent within the perioperative setting, since it has been estimated that as many as 70% of surgical patients suffer some degree of hypothermia (Litwack 1995, cited in Arndt 1999). This article will focus primarily on increasing the practitioner's awareness of patient risk and will discuss preventative measures. It will also provide ...

traumatic epidural and sub- dural hematomas along the anterior bifrontal convexities. These particular the neurointensive care unit. Only frontal epidural or subdural hemorrhages with large enough absorbance to prevent, perturbations in cortical metabolic rate, ICP, arterial inflow, or venous drainage may also complicate the rela

As accelerator beam intensity increases, loading of the RF system becomes a serious problem. Typical solutions include careful accelerating cavity design and active feedback schemes. Since the goal is to provide a low accelerating gap impedance, it is pos...

weeks) Nurse 467 Management of Critical & Emergent Care 5 Summer Semester Year 2: 12 hours Nurse 462 Special Topics in Hlth Care 2 Nurse 468 Effectiveness in ComplexMajor Map: Bachelor of Science In Nursing: Accelerated Track

The National Coalition on Health Care (NCHC) and the Institutes for Healthcare Improvement (IHI) launched a joint initiative entitled 'Accelerating Change Today-for America's Health' to feature exemplary cases of quality improvement in health care and to ...

The prevalence of diabetes is rising and diabetics may soon represent more than 5% of the world population. The type 2 diabetes is a major independent risk factor for coronary artery disease. The screening for silent myocardial ischemia (IMS) must be systematic. The autonomic dysfunction and the cardiac microcirculatory disorders are at risk of hypotension and hypothermia during anesthesia. After ...

The importance of partial liver resection as a therapeutic option to cure hepatic tumors has increased over the last decades. This has been influenced on the one hand by advances in surgical and anesthetic management resulting in a reduced mortality after surgery and on the other hand by an increased incidence of hepatocellular carcinoma. Nowadays, partial resection of the liver is performed ...

The prevalence of hypertension is high in the surgical population. Differing practices and the absence of consensus among physicians involved in caring for hypertensive patients has made it one of the most frequent reasons for cancelling scheduled surgery. The aim of this consensus statement is to outline a practical approach to managing the hypertensive surgical patient. ...

The ASA classification is an assessment of the patient�s preoperative physical status. On its own, the ASA classification of physical status is not a predictor of operative risk. Operative risk is a combination of: the physical status of the patient; the physiological derangement that the procedure will cause; the skill and experience of the operator; the skill and experience of the anaesthetist ...

Ornithine transcarbamylase deficiency (OTCD) is the most common inborn error of the urea cycle. Several specific factors require care during anesthesia in patients with this condition to avoid metabolic decompensation with acute hyperammonemia and encephalopathy. We report monozygous twins with severe neonatal-onset OTCD undergoing general anesthesia twice each, with ...