AORN journal
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Technological advances have changed how traditional surgical procedures are performed. New knowledge and surgical skills are required to effectively monitor the patient and manage fluids administered perioperatively. ⋯ This article provides perioperative nurses with the information needed to evaluate different fluid media and their applications and identify patient care considerations. Possible complications and important postanesthesia care concerns also are discussed.
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Review Case Reports
Do-not-resuscitate. Orders in surgery: decreasing the confusion.
Patients have the right to make decisions regarding their medical care, including the right to refuse treatment or to issue do-not-resuscitate orders as part of an advance directive. Health care providers must comply with the patient's wishes regarding care. ⋯ Surgical team members should consult with the patient and, if necessary, with an ethics expert or committee to determine whether the do-not-resuscitate order is to be maintained or completely or partially suspended during anesthesia and surgery. All surgical departments should have a written policy and procedure concerning the treatment of patients with do-not-resuscitate orders.
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The practice of body piercing is becoming more common worldwide. Surgical patients with body piercings require special preoperative assessment to ensure safety during and after surgery. In a study of Brazilian surgical patients at one facility, only 0.6% had body piercings. An RN or nursing student instructed each patient on piercing removal, and piercings were removed by the patients before surgery.
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Surgical procedures can be unpredictable, and safety-compromising events can jeopardize patient safety. Perioperative nurses should be watchful for factors that can contribute to safety-compromising events, as well as the errors that can follow, and know how to avert them if possible. Knowledge is power and increased awareness of patient safety issues and the resources that are available to both health care practitioners and consumers can help perioperative nurses ward off patient safety problems before they occur.
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Perioperative efficiency is considered a hallmark for physician and patient satisfaction. An OR efficiency program was implemented in a hospital in the northeastern United States in 2005. After one year, improvements were seen in OR schedule adherence, room turnover time, and staff member consistency across all shifts. A well-executed perioperative efficiency program may not only enhance physician and patient satisfaction, but also may improve staff satisfaction and patient safety.