AORN journal
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As we reflect on the concept of critical thinking in perioperative nursing practice, we should ask ourselves whether we think critically. If not, we must learn the principles of critical thinking and apply them in our clinical practice settings. Our perioperative nurse managers and directors must demonstrate critical thinking in leading other nurses in the delivery of quality, cost-effective, service-oriented patient care. They also must identify peers who use critical thinking skills to support and sustain them in their quest.
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Study results are only as meaningful as the research questions they answer. Good research ideas often emerge from clinical practice situations, but they need to undergo development and refinement to become researchable nursing research questions.
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Stereotactic biopsy procedures, in which a computer-based, three-dimensional-image-guided system accurately locates patients' brain tumors, are relatively new diagnostic methods. Complications from stereotactic biopsy procedures are minimal compared with open craniotomy procedures because they are performed with local anesthesia. Perioperative nurses should have knowledge of and be trained in stereotactic biopsy procedures to ensure optimal care for patients undergoing these procedures.
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Patients undergoing cardiac surgery have increased risks for developing pressure ulcers. The researchers conducted this study to identify preoperative, intraoperative, and postoperative factors associated with the development of pressure ulcers among patients undergoing cardiac surgery at the Cleveland Clinic Foundation. The significant factors associated with pressure ulcer development in the study patients were presence of diabetes mellitus and other significant comorbid conditions; low preoperative Braden Risk Assessment Scale scores; lower preoperative hemoglobin, hematocrit, and serum albumin levels; presence of intraaortic balloon pumps in the postoperative period; being turned less often; and more rapid returns to preoperative body temperatures. By incorporating vigilant observation and timely nursing interventions throughout patients' surgical experiences, perioperative nurses can help prevent the development of pressure ulcers and promote optimal patient outcomes.
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When predicting staffing requirements for postanesthesia care units (PACUs), nurse managers are expected to satisfy standards, meet patient care needs, staff PACUs to accommodate surgeons' and facilities' needs, and contain costs. The authors present a statistical method that offers reliability and accuracy in forecasting future patient numbers and related PACU staffing requirements. Nurse managers can use this method to decide how frequently they will satisfy staffing standards, how many shifts of RNs to schedule each day, and how many months in the future to schedule staff members. Future peak numbers of patients for each daily shift are based on previous daily peak numbers of patients, and staffing requirements can be planned from these predicted peak numbers of patients, using a facility's PACU staffing standards.