AORN journal
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Scalpel injuries can expose surgeons, nurses, and other OR personnel to bloodborne pathogens. Direct and indirect costs of managing exposure include time spent reporting, treating, and following up on the injuries; salaries and benefits for injured staff members; laboratory testing of exposure sources and exposed personnel; and postexposure prophylaxis. Standard precautions, training and awareness for those at risk, the use of neutral passing zones, and safety-engineered devices have helped decrease the incidence of injury for specific categories of sharps. One new safety device is a hand piece that uses electrosurgical plasma induced with pulsed radio-frequency energy to cut tissue.
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Surgical patients have an increased risk for hyperglycemia and its subsequent complications, such as increased risk of infection, morbidity and mortality, and length of stay. Interventional studies indicate that tight glycemic control with intensive insulin therapy improves outcomes. ⋯ Perioperative nurses must be prepared to implement measures to control hyperglycemic for patients with and without diabetes throughout the perioperative process. Perioperative nurses should participate in multidisciplinary efforts to develop evidenced-based glycemic control protocols.
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Pain is a subjective experience that is affected by physical, emotional, and psychological factors, and reliable assessment of pain can be a challenge in the pediatric population. A quality improvement project was conducted at one Canadian health care facility to examine the effectiveness of the postoperative pain management strategy for children admitted to the postanesthesia care unit (PACU). Effective control of postoperative pain involves several preventive strategies that include preoperative analgesia, appropriate use of intraoperative analgesic techniques, and identification of children at risk for significant postoperative pain. Successful implementation of these techniques requires a multidisciplinary team approach involving the patient, the PACU nurses, the anesthesia care provider, and other surgical team members.