AORN journal
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Epidural or spinal anesthesia-related infections cause serious and devastating morbidity and mortality. The possible infectious complications of neuraxial anesthesia have become better understood in the past 10 years. ⋯ A review of the literature demonstrated that personnel in interdisciplinary specialties use gowns for invasive procedures to prevent infection, and national and international multidisciplinary health care professionals appear to be increasing their use of sterile gowning to prevent infections. We undertook this literature review to explore the incidence of neuraxial infection, provide additional insight into multidisciplinary standards, and evaluate whether the use of sterile gowns while performing neuraxial anesthesia decreases infection rates.
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Pressure injury prevention is essential to patient safety in the perioperative setting. Perioperative nurses should be knowledgeable about the risk factors for pressure injury and the safety precautions that can be taken to prevent this injury from occurring. ⋯ Perioperative patients are at risk for developing pressure injuries because they can experience intense or prolonged pressure during lengthy surgical procedures, may have increased pressure on bony prominences from positioning, are exposed to friction or shear during transfer to the OR bed and positioning, and often have significant comorbidities. This Back to Basics article examines the risk factors for pressure injuries in the perioperative patient population and discusses screening and prevention measures that can be implemented.
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Despite recent advances in perioperative patient care, postsurgical pain continues to be undermanaged. There is increasing acceptance of the concept that effective postsurgical pain management is best achieved through combined use of more than one analgesic agent or technique, and overreliance on opioids produces unwanted side effects limiting their utility. ⋯ The success of ERAS is dependent on nurses and the multidisciplinary team to execute its standardized processes across the care continuum, including patient education, perioperative care, and postsurgical evaluation. Here, we review current concepts related to multimodal analgesia and ERAS regarding care of adult surgical patients and discuss the perioperative nurse's role within this paradigm.
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Preventing unplanned perioperative hypothermia is crucial. Thermal reflective blankets may reduce heat loss, promote normothermia, increase patient comfort, and decrease cotton blanket expenses. Our purpose was to determine whether a thermal reflective blanket plus one warmed cotton blanket provides better temperature control and thermal comfort than warmed cotton blankets only. ⋯ There were no significant differences in patient temperature or comfort between groups. Use of thermal reflective blankets led to significantly reduced use of warmed cotton blankets (t209 = -10.51, P < .001), and a cost threshold for clinical adoption was identified. The hospital opted not to purchase thermal reflective blankets because of equivalent performance and minimal cost savings.