Abstract: Nicholson, Patricia In a landmark publication, 'To Err is Human', experts estimate that as many as 98 000 patients die each year from medical errors, highlighting patient safety as a key area for improvement in health care. This is reinforced in the National Safety and Quality Health Services Standards. Correct patient positioning is a critical part of any surgical procedure yet is often overlooked despite the risk of iatrogenic injuries that are reported as a result of improper positioning. Incorrect patient positioning can have a profound effect on patients, causing postoperative distress and increased morbidity, with nerve injuries the second most common litigation of all anaesthesia-related medico-legal claims reported, according to the ASA Closed Claims Project database.
Abstract: Asdornwised, Usavadee; Pipatkulchai, Daranee; Damnin, Suwat; Chinswangwatanakul, Vitoon; Boonsripitayanon, Mongkol; Tonklai, Sununtha Evidence-based guidelines for the management of surgical smoke and bioaerosols for perioperative nurses are necessary to improve the quality of care for patients and to ensure a safe environment in operating rooms. A survey of 377 operating room (OR) nurses throughout Thailand was used to assess the incidence of health problems related to surgical smoke exposure, as well as the current practices for these substances. A high percentage of OR nurses reported little or no use of smoke evacuation tools such as central smoke evacuation systems (100 per cent), portable smoke evacuation units (82 per cent), wall suction with inline filters (56.5 per cent) or laparoscopic evacuation/ filtration systems (63.7 per cent) during surgery. Most of the perioperative nurses suffered from headaches and/or sore throats. Due to the wide range of deleterious health issues that arise from exposure to surgical smoke, it is critical that perioperative nurses closely adhere to best practice guidelines for minimising this environmental hazard.
Abstract: Bingham, Sharon; Walsh, Kenneth; Ford, Karen An estimated 234 million operations are performed in hospitals each year and complications of surgery are common and often preventable. The rates of complications vary between studies with reports of perioperative death rates of between 0.4 and 0.8 per cent and rates of complications between 3 and 17 percent. Adverse events can lead to patient disability, death, or increased length of stay, imposing a significant burden on the health care system, patients and their families.
Abstract: Wozniak, Beth Innovation, literally, means 'the introduction of something new'. However, the term implies an improvement or change for the better and innovation is important in the medical sector particularly in the field of nursing where so many challenging issues are present. In this article, Beth Wozniak shares her experience of innovation the trials, tribulations and victories on her journey from seeing a need as a graduate nurse to seeing the software system she developed being used in hospitals.
Abstract: The conference program is shaping up to be one of the best with National Standards workshops on the Wednesday followed on Thursday, Friday and Saturday by a plethora of noted plenary and keynote presenters and high quality presentations.
Abstract: Wakefield, Erin The term 'transition shock' is a relatively new concept used to describe the experience of moving from the comfortable and familiar role of the preregistration nursing student to the professional registered nurse (RN). The initial and most dramatic stage in this theory of role adaption occurs over the first four months of professional practice.
Abstract: Watson, Jessica Temperature management within the perioperative environment is an imperative component of and a standard of practice in providing effective patient safety and comfort. This literature review will explore the evidence surrounding the use of active and passive warming mechanisms in the prevention of postoperative hypothermia. Many studies have recognised the adverse consequences of inadvertent postoperative hypothermia, hence the rapid advancement in education about and use of equipment and devices for its prevention. Evidence-based literature was reviewed to provide rationales and recommendations for strategies to prevent postoperative hypothermia. This literature review will potentially guide clinicians through the use of effective devices to allow for informed choices to provide appropriate patient care.
Abstract: Hains, Toni; Turner, Catherine; Strand, Haakan The lines of demarcation between health care professionals were once clear. Gender, education and the ability to prescribe have historically differentiated doctors and nurses. Privileges of medical practice protected by legislation and insurance reimbursement are no longer the sole domain of the medical doctor. A need for 'non-physician practitioners' to meet changes in the health care environment has contributed to less defined lines of demarcation between health care professionals' roles. In the light of alterations to the context of health care and availability of resources, registered nurses (RNs) and allied health professionals are acknowledged as an under-used asset for safe and cost effective health care delivery. Task transfer does not dilute medical care but does strengthen health care.
Abstract: Aleman-Ortega, Heidi; Lee, Rebecca; Shambo, Lyda; Czinn, Edward Epidural or spinal anaesthesia-related infections cause serious and devastating morbidity and mortality. The possible infectious complications of neuraxial anaesthesia have become better understood in the past ten years. We assessed information from published case series, studies, randomised controlled trials and retrospective cohort studies to determine the rate of neuraxial infection and to evaluate iatrogenic causes of infection. The use of sterile gowning appears to be a factor associated with the decreased infection rates noted in some studies. 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 anaesthesia decreases infection rates.
Abstract: Osborne, Sonya Perioperative nursing practice is subject to a number of influences. Some of the significant influences include: the changing shape of Australia's patient and workforce demographics, the shifting boundaries of the environment where the patient undergoes surgical or invasive procedures, innovations in surgical technique and advances in surgical technology. Influences on our practice are constant despite the changing nature of those influences. This requires a constant response to duty of care on our part. The discourse around the need for quality and safety is centred on research and evidence-based practice.
Abstract: Foran, Paula We have been fortunate enough to commence a new stream of webinars where ACORN have joined with some of our trade partners to provide another dimension of education for you, our members. We will continue our Standards webinars and Education webinars but they are now joined by our Trade Partner webinars. The first of these webinars was with one of our oldest trade partners Ansell, a family name in operating suites in Australia. We thank Ansell most sincerely for being the 'first cab off the rank', sponsoring a webinar 'Understanding occupational latex and chemical allergies'. I'm sure you will join me in looking forward to enjoying this type of webinar every few months.
Abstract: Davies, Menna Next time you open an instrument tray or unwrap a sterilised item, consider the process the item has been through to arrive in the operating theatre.
Abstract: Stankiewicz, Monica; Wyland, Michele The use of antiseptics in theatre is mainstay treatment in reducing cutaneous bioburden and, in turn, preventing surgical site infection and sepsis. Typically, aqueous betadine and chlorhexidine in alcohol are preferred. Aqueous betadine is a broad-spectrum antiseptic with a quick kill rate but is deactivated by organic material on the patient's skin. More effective than aqueous betadine is chlorhexidine gluconate - it is also a broad-spectrum antiseptic but is not deactivated by organic compounds on the patient's skin.
Abstract: Tan, Eunice; Russell, Kylie Every year thousands of health care professionals worldwide are exposed to surgical smoke. There is evidence that this smoke consists of toxic gases, pathogens and particulate matter that is a hazard for patients and the perioperative team. Past research indicates that perioperative staff inconsistently comply with smoke evacuation recommendations. The aim of this study was to identify, review and discuss the issues related to surgical plume and its implications for patients and perioperative staff. The findings of this review relate to: surgical smoke content, its risks to the health of the perioperative staff, preventative measures, infection control measures, compliance with smoke evacuation systems, staff knowledge and barriers to implementing smoke evacuation practices. Of particular importance, the literature indicated that strong support from management and the implementation of regular staff education could improve practice for the management of surgical plume in the operating theatre.
Abstract: Watson, Donna S Henrik Kehlet, MD, PhD, a former professor of perioperative therapy and head of the Section for Surgical Pathophysiology at the Rigshospitalet in Copenhagen, Denmark, introduced concepts for Enhanced Recovery After Surgery (ERAS) programs in the mid-1990s. Dr Kehlet stated, 'the key question in our understanding of the pathogenesis of postoperative morbidity is ... related to the pathophysiological role of the various components of the surgical stress response and whether or not a modification of such responses may improve surgical outcomes'. Dr Kehlet challenged traditional standards of care for the patient undergoing colorectal surgery to better understand why a patient could have an unexpected poor outcome when surgery was uneventful and technically proficient. Dr Kehlet shifted patient care management from traditional care ('the way we have always done it') to assessing and modifying various interventions during the perioperative period with the intent of improving patient outcomes. The initial ERAS protocol introduced for patients undergoing colorectal surgery has been adopted in other surgical specialties and successfully implemented in Europe for more than a decade.
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