AORN journal
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OPERATING ROOM MANAGERS are hampered in their efforts to optimize OR efficiency by surgical procedures that last a longer or shorter time than scheduled. The lack of predictability is a result of inaccuracy in scheduling and variability in the duration of procedures. ⋯ MONTE CARLO SIMULATION of ORs scheduled with various combinations of short and long procedures supports this concept's validity. RESULTS INDICATE that scheduling short procedures first can improve on-time performance and decrease staff member overtime expense without reducing surgical throughput.
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A pain management process improvement team was created to develop a unified and consistent way to address pain management for surgical patients. Team members evaluated patient satisfaction ratings, patient and family member education, use of specific pain scales, patient comfort function goals, staff member education, and use of physician standing orders and protocols. Team members were proactive in their efforts to improve pain management outcomes for surgical patients and to improve patient satisfaction. They also integrated protocols to comply with pain management standards established by the Joint Commission on Accreditation of Healthcare Organizations.
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Randomized Controlled Trial Comparative Study Clinical Trial
Using massage and music therapy to improve postoperative outcomes.
An experimental pilot study was conducted to investigate the effects of preoperative massage and music therapy on patients' preoperative, intraoperative, and postoperative experiences. Participants were assigned randomly to one of four groups--a group that received massage with music therapy, a group that received massage only, a group that received music therapy only, or a control group. Hemodynamics, serum cortisol and prolactin levels, and anxiety were measured preoperatively and postoperatively. Postoperative anxiety levels were significantly lower and postoperative prolactin levels were significantly higher for all groups.
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Failure mode and effects analysis (FMEA) (ie, prospective risk analysis) involves close examination of high-risk processes to identify needed improvements that will reduce the chance of unintended adverse events. This risk assessment process is used in other industries (ie, manufacturing, aviation) to evaluate system safety. Health care organizations now are using it to evaluate and improve the safety of patient care activities. The FMEA process promotes systematic thinking about the safety of patient care processes (ie, what could go wrong, what needs to be done to prevent failures.) The steps of the FMEA process are described and applied to a high-risk perioperative process.
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Global environmental problems are connected to patient care issues. The amount and toxicity of medical waste have increased in recent decades. ⋯ Perioperative nurses need to understand how best to segregate waste and take advantage of opportunities for reuse and recycling. There are many ways nurses can contribute to pollution prevention in health care, some of which are detailed in this article.