AORN journal
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Review Case Reports
Counting difficulties: retained instruments, sponges, and needles.
Patients in whom a sponge or instruments is left after surgery may suffer complications including pain, infection, abscess, or intestinal obstruction. Consequences or retained items for surgical team members may include malpractice lawsuits and adverse actions from the National Practitioner Data Bank and state licensing board. Adherence to AORN recommended practices for counting and facility counting policies can protect both patients and practitioners.
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This study compared the effectiveness of an Internet-based method with a standard method for preparing adolescent patients scheduled for out-patient tonsillectomy procedures. A two-group experimental design compared adolescents' state anxiety, knowledge acquisition, postoperative pain intensity, and satisfaction with the method of preoperative preparation. Parents' state anxiety and satisfaction with their child's preparation method also were compared. Data analysis revealed significantly increased knowledge acquisition and satisfaction among adolescents who were assigned to the Internet method of preparation and increased satisfaction among their parents.
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Hypothermia, a common problem for patients having surgery, adversely affects multiple organ systems and physiologic functions. Research indicates that maintaining normothermia can reduce infection rates, operative blood loss, and length of hospital stay. ⋯ In addition, inconsistent practices and lack of guidelines may affect team members' efforts. Surgical team awareness, education, and understanding of the effects of hypothermia are necessary components to enhance the ways clinicians provide quality, cost-effective patient care.
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Electronic documentation can improve organizational processes in health care settings and may be of particular benefit to ambulatory surgery centers. A decision support system (DSS) can be integrated with an electronic documentation system. ⋯ Barriers to implementation of a DSS include practitioner noncompliance with alerts and limitations in system design. Nurses can be instrumental in overcoming the barriers that prevent some clinicians from adopting these useful information systems.
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Beginning in 2005, the aorn foundation and Safer Healthcare implemented a human factors program based on Crew Resource Management training in five diverse surgical facilities across the United States. Highly interactive, customized training sessions were designed to help clinicians standardize communication, enhance teamwork, implement preprocedure briefings and postprocedure debriefings, maintain situational awareness, and recognize red flags in the workplace. Pretraining and post-training surveys were used to determine the effectiveness of the program. Brief overviews from the participating facilities detail specific issues encountered in each setting.