AORN journal
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Nursing leaders at one facility challenged staff nurses in the postanesthesia care unit (PACU) to implement a modified process of shared governance, a model that allows staff nurses to influence their practice. As a result of this initiative, PACU nurses were able to collaborate with other perioperative staff members, ultimately increasing patient safety. Successes included increased staff nurse participation in educational projects; increased interdisciplinary collaboration; personal and professional development for the nurses involved; and recognition from a highly esteemed, national organization.
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Patients and health care providers alike struggle with alleviating postoperative pain. Patients with unrelieved pain are less likely to cough, breathe deeply, or move easily after surgery, which adversely affects their recovery. Innovations in technology, such as continuous infusion of local anesthetics, have revolutionized postoperative pain management. Technological improvements in needles, catheter insertion techniques, and effortless drug delivery systems are facilitating prolonged analgesia with few adverse effects, increasing patient satisfaction, and expediting postoperative recovery.
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Postoperative hypothermia (ie, a core temperature lower than 96.8 degrees F [36 degrees C]), is a problem frequently seen in surgical patients, especially those undergoing total joint replacement. Patients who experience hypothermia may have increased recovery times and postoperative complications. A team of clinical staff members and personnel from the performance improvement (PI) department of a hospital used a PI model to incorporate use of preoperative forced-air warming blankets that resulted in improved postoperative core temperatures.
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One of the aspects of OR service that is most important to surgeons is quick OR turnaround times. Perioperative staff members and one orthopedic surgeon at the Community Hospital, Munster, Ind, have developed an innovative approach to the OR turnaround process that considerably increases efficiency and reduces average turnaround times. By assigning specific tasks to each perioperative team member, scheduling surgical procedures in order based on type of procedure, and drawing on individual team members' traits, the orthopedic surgeon is able to perform more procedures than other orthopedic surgeons in that facility in the same amount of time, which increases revenue for the hospital.
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Medication errors involving pediatric patients in the postanesthesia care unit may occur as frequently as one in every 20 medication orders and are more likely to cause harm when compared to medication errors in the overall population. Researchers examined six years of records from the MEDMARX database and used consecutive nonprobability sampling and descriptive statistics to compare medication errors in the pediatric data set to those occurring in the total population data set. Nineteen different causes of error involving 28 different products were identified. The results of the study indicate that an organization can focus on causes of errors and products involved in errors to mitigate future error occurrence.