AORN journal
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Fire in the OR is a life-threatening emergency that demands prompt, coordinated, and effective interventions. Specific applications of fire protocols and guidelines for perioperative nurses and their interprofessional colleagues may take several approaches. The perioperative nurse’s role is one that can frequently prevent or ameliorate the damaging thermal effects of a fire. ⋯ In most jurisdictions, any fired--regardless of size--must be reported to the local fire department. Personnel, managers, and administrators should be prepared also for the possibility of participating in postcrisis evaluations by the fire marshal, The Joint Commission, the Occupational Safety and Health Administration, Centers for Medicare & Medicaid Services, and possibly other fire safety-related organizations. Additionally, supplemental information related to investigating a fire is available through the ECRI Institute.28 The ECRI Institute serves as a third-party investigator and can facilitate root-cause analyses, identify whether the crisis ought to be reported and to whom, and assist in restoring clinical operations.
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Perioperative team membership consistency is not well researched despite being essential in reducing patient harm. We describe perioperative team membership and staffing across four surgical specialties in an Australian hospital. ⋯ We found weak but significant correlations between the number of staff (P < .001), procedure start time (P < .001), length of procedure (P < .05), and patient acuity (P < .001). Using mapping, personnel can be identified who may informally influence multiple team cultures, and nurses (ie, the majority of team members in surgery) can lead the development of highly functioning surgical teams.
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The purpose of preemptive analgesia is to reduce postoperative pain, contributing to a more comfortable recovery period and reducing the need for narcotic pain control. The efficacy of preemptive analgesia remains controversial. This systematic review of the literature evaluated the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 (COX-2) inhibitors, and gabapentin as preemptive oral analgesics for surgical patients. ⋯ Research was predominantly conducted outside the United States. Gabapentin and COX-2 inhibitors were found to be the most effective preemptive analgesics for postoperative pain control. As part of a collaborative team, perioperative nurses and certified RN anesthetists are responsible for ongoing pain assessment and management for preemptive analgesic interventions.
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Symptomatic spinal epidural hematoma (SEH) is a rare but serious complication that may occur after lumbar spine surgery. Prompt recognition of this complication depends on the diagnostic skills of perioperative nursing personnel, particularly postanesthesia care unit nurses. ⋯ Clinicians should consider a diagnosis of symptomatic SEH if there is a change in the patient's neurological status during the first several hours after lumbar spine surgery. Suspicion of postoperative symptomatic SEH should prompt clinicians to notify the responsible surgeon without delay.