Sustaining Nursing Grand Rounds Through Interdisciplinary Teamwork and Interorganizational Partnership.

: In 2017, Navy Nurse Corps executives launched a new nursing professional practice model that promotes operational readiness, professional development, and transformational leadership. This directive prompted nursing leadership at Naval Hospital Jacksonville (NH JAX) to conduct a needs assessment survey to determine what kind of educational initiative nursing staff members would most welcome in support of the goals of the new practice model. Survey respondents favored case studies presented in a nursing grand rounds format. Our change implementation team designed and executed the grand rounds program, offering lunchtime presentations every other month. Topics included a wide range of "high-risk/low-volume" procedures-those infrequently performed at participants' clinical sites. Ten months after the initiation of grand rounds, surveys were distributed to NH JAX participants to assess their perceptions of the value of the sessions in terms of professional development, interdisciplinary teamwork, and strengthened institutional partnerships.Of the 161 nursing grand rounds participants, 41 (25%) responded to the postimplementation survey. Responses indicated that participants valued nursing grand rounds in enhancing clinical knowledge (83% agreed), discussing research and evidence-based practices (71% agreed), supporting professional development (88% agreed), improving interdisciplinary teamwork (83% agreed), and solidifying interorganizational partnerships (73% agreed). This article presents the implementation of the NH JAX grand rounds program and demonstrates how nursing grand rounds can serve as an excellent forum in which to develop knowledge, showcase research and evidence-based practices, support professional growth, improve collaboration, and strengthen partnerships.

Implementing AORN recommended practices for product selection.

This article focuses on the revised AORN "Recommended practices for product selection in perioperative practice settings." Hospitals and ambulatory surgery facilities should have protocols in place for product evaluation that includes a multidisciplinary team approach. The process for product evaluation and selection includes gathering information; establishing consistent requirements for product evaluation; performing a financial impact analysis; investigating a plan to standardize products; conducting an environmental impact analysis; determining whether to purchase single-use, reposable, or reusable products or reprocess single-use devices; developing an evaluation process based on objective criteria; and developing and implementing a comprehensive plan to introduce and use new products. Use of an evaluation tool that is based on objective criteria is one way to obtain valuable input during product evaluations. Because of varied roles and experiences, the perioperative RN is an integral member of the product selection committee.

Determining the state of knowledge for implementing the universal protocol recommendations: an integrative review of the literature.

The purpose of this study was to determine the current state of knowledge concerning the implementation of the Joint Commission's Universal Protocol. We conducted an integrative review of the literature through a systematic search of the National Library of Medicine (ie, PubMed) database to identify empirical and theoretical documents that discussed the implementation process for the Universal Protocol. The current state of knowledge varies from facility to facility, and we noted significant trends, gaps, and areas of concern in the implementation process. Successful implementation of the Universal Protocol has the following elements: a multidisciplinary team approach, active staff/patient participation, supportive hospital administration/leadership, and active communication that promotes a healthy work environment.

Reducing medical waste.

Medical waste is a necessary by-product of any hospital environment; however, the majority of regulated medical waste is produced in the OR from the use of disposable surgical supplies (eg, drapes, gowns, basins, gloves, sponges). We conducted a concept comparison project in the ORs of two large medical centers in Bethesda, Maryland, and Washington, DC, to evaluate the effects of using reusable surgical basins, gowns, and table and Mayo stand covers in place of disposable products. Survey results indicated that surgeons and surgical technologists found the reusable products to be preferable to the disposable products currently in use. In addition, using reusable products provided a means to decrease regulated medical waste generated in the OR by an average of 65% as well as reduce the cost of waste disposal. AORN recommends evaluating the environmental effects of using reusable, reposable, and disposable products; our findings provide evidence that may be useful to surgical facilities that seek to adopt a "green" approach.