Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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Performing the correct procedure on the correct patient has always been of prime importance to all health care providers. For the past six years, it has been a patient safety initiative priority of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Before JCAHO took the lead in this arena, however, health care facilities handled this issue with individualized policies and procedures. ⋯ It has been a painful process, requiring numerous policy rewrites with updated information as prescribed by JCAHO. Enforcing physician compliance and continually re-educating nurses with each new JCAHO change proved challenging. The marking of surgical sides and verification of all sites, however, has proven to be a collaborative effort with safe patient outcomes as the shared goal.
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Corneal abrasion is the most common ocular injury occurring in the perioperative period. Corneal abrasion may occur during general anesthesia, monitored anesthesia care, regional anesthesia, or in the immediate recovery period. ⋯ Early detection and prompt intervention may help reduce the incidence of ocular morbidity. The purpose of this article is to explore the incidence, mechanism of injury, prevention, recognition, and treatment of perioperative corneal abrasion.
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J. Perianesth. Nurs. · Oct 2006
Comparative StudyEffectiveness of femoral nerve blockade for pain control after total knee arthroplasty.
Control of postoperative pain is a major concern for patients undergoing total knee arthroplasty (TKA). The purpose of this study was to investigate pain control and opioid use, as well as length of stay, ambulation time, antiemetic use, and degree of mobilization for patients undergoing total knee arthroplasty, comparing those receiving femoral nerve block (FNB) to those receiving no femoral nerve block. ⋯ Also noted was a statistically significant reduction in antiemetic use in the FNB compared with the no-FNB group on the day after surgery. This study is in accordance with earlier studies that support continuous FNB as an effective method for achieving postoperative pain control and reducing opioid use for patients undergoing TKA.
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The authors consider methods for determining staffing requirements for a Phase I PACU. Given that the total number of nursing hours per day is limited by budgetary constraints, PACU staffing can be adjusted to minimize the percentage of days that the PACU is full and cannot accept additional patients from the OR. ⋯ In addition, patient acuity must be incorporated into the staffing plan. Methods are described for adjusting staffing requirements when some patient acuities differ from 1 nurse:2 patients, when patients transition from one acuity to another, and when acuity is not known for all patients.