Periop 101: Improving Perioperative Nursing Knowledge and Competence in Labor and Delivery Nurses Through an Evidence-Based Education and Training Program.

INTRODUCTION: To reach the highest levels of health care quality, all nurses providing intraoperative care to surgical patients should have a firm grasp of the complex knowledge, skills, and guidelines undergirding the perioperative nursing profession. In military treatment facilities, either perioperative registered nurses or labor and delivery (L&D) nurses provide skilled intraoperative nursing care for cesarean deliveries. However, L&D and perioperative nurses occupy vastly different roles in the continuum of care and may possess widely differing levels of surgical training and experience. MATERIALS AND METHODS: The purpose of this project was to improve surgical care quality by standardizing and strengthening L&D nurse perioperative training, knowledge, and competence. Our population, intervention, comparative, and outcome question was, "For labor and delivery nurses of a regional military medical center (P), does implementing an evidence-based training program (I), as compared to current institutional nursing practices (C), increase nursing knowledge and perioperative nursing competence (O)?" We implemented Periop 101: A Core Curriculum-Cesarean Section training for 17 L&D nurses, measured knowledge using product-provided testing, and assessed competence using the Perceived Perioperative Competence Scale-Revised. RESULTS: We found that perioperative nursing knowledge and competence significantly improved and were less varied among the nurses after completing the training program. Nurses demonstrated the greatest knowledge area improvements in scrubbing, gowning, and gloving; wound healing; and sterilization and disinfection, for which median scores improved by more than 100%. Nurses reported significantly greater perceived competence across all six domains of the Perioperative Competence Scale-Revised, with the largest improvements realized in foundational skills and knowledge, leadership, and proficiency. CONCLUSIONS: We recommend that health care leaders develop policies to standardize perioperative education, training, and utilization for nurses providing intraoperative care to reduce clinician role ambiguity, decrease inefficiencies, and enhance care.

A Perioperative Specialty Elective to Address the Perioperative Nursing Shortage: Student Perspectives and Outcomes.

To help solve the perioperative nursing shortage, it is imperative that health care leaders understand why students choose or do not choose to pursue a career in perioperative nursing. In May 2021, we published the results of a specialty elective course evaluation from a leadership and perioperative services personnel perspective; in the current article, we examine the same program from the students' perspective. We distributed survey links to undergraduate nursing students to evaluate their perioperative knowledge before and after completing the course. Students reported large gains in knowledge, critical thinking, teamwork, and confidence at course completion, but the posttest mean number of students with an interest in pursuing perioperative nursing was lower than the pretest mean. This realization is perceived as a positive outcome of the perioperative elective course because it may lead to a decrease in turnover among newly hired perioperative nurses.

Innovative Use of Cadavers in Perioperative Nursing Orientation.

The Periop 101 program administrator at a US Navy medical center worked with personnel in the facility's simulation and bioskills laboratories to develop an innovative perioperative nurse orientation curriculum that included the use of human cadavers during simulation activities. Participants were able to practice common perioperative nursing skills (eg, surgical skin antisepsis) on human cadavers rather than simulation manikins. The orientation program comprises two three-month phases. Participants were evaluated twice during phase 1: at the six-week mark and again six weeks later at the end of the phase. Using the Lasater Clinical Judgment Rubric, the administrator scored participants on their clinical judgment skills; results showed that mean scores increased for all learners between the two evaluation sessions. Practicing skills in a safe environment allows new staff members to learn without fear of causing accidental patient harm, and the additional use of cadavers further increased simulation fidelity and learner satisfaction.

A qualitative study of nurse-perceived barriers to body temperature management in postoperative patients.

Although evidence-based practices exist for preventing hypothermia in patients during surgery, few studies have focused on this concern in postoperative patients. The aim of this qualitative study was to explore the most challenging issues experienced by surgical ward nurses while managing the body temperature of adult surgical patients. To address this research gap, this study used a qualitative descriptive design to document barriers to body temperature management as reported by a sample of 16 perioperative nurses. The semi-structured, face-to-face interviews were digitally recorded, transcribed verbatim and analysed using inductive content analysis. The main barriers fell into three categories: professional nursing ability limitations, unfavourable working conditions and management of human resources. The eight subcategories were disadvantageous professional views, professional knowledge limitations, low motivation to provide nursing care, non-standard treatment environment, inadequate equipment and care protocols, heavy nursing care loads, inadequate staff training and ineffective staff supervision. These findings highlighted the importance of adequate resources, proper education and evidence-based care protocols in the effective delivery of body temperature management to postoperative patients.

Perioperative Nurse Recruitment: An OR Placement Program for Fourth-Year Nursing Students in Ontario.

Nursing associations have predicted a worldwide shortage of perioperative RNs as more nurses reach retirement age. Additionally, the lack of perioperative exposure during undergraduate nursing programs is contributing to the failure to attract recently graduated nurses to this field. In 2019, multiple hospital sites within the St. Lawrence College network in Ontario, Canada, expressed difficulty recruiting perioperative RNs and expressed an interest in collaborating with the college to increase exposure to the perioperative specialty and recruit students to their ORs after graduation. The college has run a successful preceptor-supported OR placement program for fourth-year baccalaureate nursing students since 2019. Eleven out of thirteen students were hired into the OR after their 2020-2021 placement program. This article outlines the steps taken to initiate this program as well as results of a formal program evaluation conducted in 2021, including detailed feedback from participating students, preceptors, and leaders at the involved hospitals.

Observation on the Effect of Intelligent Machine-Assisted Surgery and Perioperative Nursing.

Orthopedic surgery and care during the perioperative period are the key to the treatment of orthopedic diseases, which can quickly and effectively treat orthopedic diseases and can quickly recover during the perioperative period. Therefore, this paper focuses on the observation of the effect of intelligent machine-assisted surgery and perioperative care, combined with smart wearable devices and C-arm camera calibration; the details of the bone surgery are assisted by the machine, and then the recognition ability is accelerated by writing into the digital bone bank. Based on machine vision, CNN training and learning are designed to design a machine-assisted perioperative nursing method. This paper also designed a bone surgery test experiment and perioperative adverse event data analysis, combined with the data obtained from the experiment, designed a comparison experiment with traditional surgery and perioperative nursing. The experimental results show that the success rate of machine-assisted surgery is increased by nearly 2%-15% compared with traditional surgery; and the rehabilitation degree of machine-assisted perioperative nursing is 15.83% higher than that of traditional perioperative nursing.

Sistematização da assistência de enfermagem ao paciente com fratura de colo de fêmur: relato de experiência / Systematization of nursing care for patients with femoral neck fracture: experience report

Objetivo: descrever a aplicação da Sistematização da Assistência de Enfermagem a um paciente com Fratura de Colo de Fêmur no período perioperatório. Metodologia: Relato de experiência realizado no centro cirúrgico de um hospital geral, o qual atende demanda espontânea da capital e do interior do estado da Bahia. O período de realização do estudo foi em agosto de 2019, na cidade de Feira de Santana- BA. Esta experiência foi fruto da vivência de acadêmicos de enfermagem do sexto semestre da Universidade Estadual de Feira de Santana. Foram respeitados os aspectos éticos da Resolução 466/2012. Resultados: Foi aplicada a Sistematização da Assistência de Enfermagem no Perioperatório a paciente idoso com fratura de colo de fêmur, conforme cinco fases do processo de enfermagem: Histórico, Diagnóstico, Planejamento, Implementação e Avaliação. Ressalta-se que o referido caso foi analisado de acordo com as Diretrizes Terapêuticas para Fratura de Colo de Fêmur, que demostraram a importância da aplicação da sistematização para um cuidado diferenciado ao paciente idoso com diagnóstico de fratura de fêmur, considerando que a população idosa cada vez mais vem alcançando a longevidade e as quedas são um dos eventos adversos que mais acometem essa população, seguido pela fratura. Conclusão: Este estudo pretende contribuir como instrumento gerencial e de cuidado relevante para a instituição no centro cirúrgico que visem acelerar o tempo de alta, minimizar o risco de complicações, reduzir os custos e favorecer a qualidade de vida dos pacientes idosos com fratura de fêmur a partir da sistematização da assistência de enfermagem perioperatória.

Objective: Describe the application of Nursing Care Systematization to a patient with a femoral neck fracture during the perioperative period. Methodology: Report of an experience carried out in the operating room of a general hospital, which cares for the spontaneous demand of the capital city and the interior of the state of Bahia. The study was held in August 2019 in the city of Feira de Santana, in the state of Bahia. This was the result of the academic experience of nursing students in the sixth semester at the State University of Feira de Santana. The ethical aspects of Resolution 466/2012 were respected. Results: Perioperative Nursing Care Systematization was applied to an elderly patient with a femoral neck fracture, according to five phases of the nursing process: History, Diagnosis, Planning, Implementation, and Evaluation. It emphasizes whether the case was analyzed according to the Therapeutic Guidelines for Femoral Neck Fractures, which demonstrated the importance of applying systematization for differentiated care for elderly patients diagnosed with femoral fractures, considering that the elderly population is living longer, and falls are one of the adverse events most frequently affecting such population, followed by fracture. Conclusion: This study aims at contributing as a relevant management and care instrument for the institution of any surgical center that aims at speeding up discharge time, minimizing the risk of complications, reducing costs, and favoring the quality of life of elderly patients with femur fracture from the systematization of perioperative nursing care.

Adquisición del conocimiento práctico de las enfermeras de un área quirúrgica / Acquirement of practical knowledge of nurses in a aurgical block

Objetivo principal: Identificar los modos en que las enfermeras quirúrgicas adquieren su conocimiento y competencia. Metodología: Estudio cualitativo descriptivo de carácter exploratorio, mediante entrevistas semiestructuradas a seis enfermeras quirúrgicas. Los datos obtenidos fueron codificados y analizados con el software MAXQDA v.18.1. Resultados principales: La práctica, formación, experiencia, intuición y compañerismo son conceptos relacionados con la adquisición de conocimientos de las enfermeras. El alcance del desarrollo de cada uno de ellos es diferente en relación con el nivel competencial en el que se encuentren las enfermeras, competente, eficiente o experta. Conclusión principal: El proceso de adquisición de conocimientos prácticos en el área quirúrgica es un proceso dinámico y flexible, que se nutre de varias fuentes de conocimiento. Destaca el compañerismo como elemento fundamental en la obtención de información y ayuda en la resolución de problemas, proporcionando la mayor satisfacción. (AU)

Objective: To identify the ways surgical Nurses acquire their knowledge and competence. Methods: Descriptive qualitative study of an exploratory nature, through semi-structured interviews with six surgical nurses. The data gathered were codified and analyzed using MAXQDA v.18.1 software. Results: The practice, training, experience, intuition and fellowship are concepts related to the acquisition of knowledge of the Nurses. The scope of development of each of them is different in relation to the level of competence, competent, efficient or expert. Conclusions: The protocol of acquiring practical knowledge in the surgical block is a dynamical and flexible process, that relies on several sources of knowledge. Fellowship stands out as a key factor of obtaining information, solving problems, and providing the greatest satisfaction. (AU)

Educating Perioperative Nurses About Local Anesthetic Systemic Toxicity Using High-Fidelity Simulation.

BACKGROUND: The rarity of perianesthetic catastrophic events creates a challenge in training support staff in the treatment of emergencies such as local anesthetic systemic toxicity (LAST). Simulation learning offers a unique venue in which to safely encounter rare events. AIMS: This study aimed to evaluate knowledge retention regarding LAST in perianesthetic nursing staff using high-fidelity simulation and a short didactic session. DESIGN: Nurses were recruited from perioperative locations to participate in a simulated scenario of LAST and engage in a short didactic session. SETTINGS: Simulation and education occurred in the high-fidelity simulation center at the University of Wisconsin Hospital. PARTICIPANTS/SUBJECTS: Thirteen nurses from the preoperative, post-anesthesia, and block nursing teams participated in the study. METHODS: Participants completed a pre-test before participating in the simulation, followed by a formal debrief and short lecture. They then completed post-tests and a short survey focused on self-efficacy and review of the simulation experience. RESULTS: Test scores, compared to the pre-test, improved significantly on the immediately-post, 1-month, and 3-month assessments. Participants felt more equipped to handle crisis scenarios. CONCLUSIONS: Experiential learning often results in significant knowledge acquisition and retention. Participants in this study improved their test scores regarding LAST and increased their sense of self-efficacy and ability to handle crisis scenarios after taking part in a high-fidelity simulation.

Práticas educativas no controle da ansiedade de pacientes em pré-operatório de cirurgia cardíaca: revisão integrativa / Educational practices on the anxiety control of patients in pre-operative heart surgery: integration review / Prácticas educativas en el control de la ansiedad de pacientes en preoperatorio de cirugía cardíaca: revisión integrativa

Objetivo: descrever, com base na literatura, as contribuições das práticas educativas para o controle da ansiedade de pacientes em pré-operatório de cirurgia cardíaca. Método: trata-se de uma revisão integrativa realizada no período de novembro a dezembro de 2017 nas Bases de Dados PubMed, Bases de Dados de Enfermagem (BDENF), Biblioteca Regional de Medicina (BIREME), Scientific Electronic Library Online (SCIELO) e Medical Literature Analysis and Retrievel System Online (MEDLINE), com a inclusão de 24 artigos que compuseram esse estudo. Resultados: sobre o diagnóstico ansiedade, os artigos analisados mostraram maior presença no sexo feminino, em diferentes faixas etárias, mas mais prevalente em idades mais avançadas. Educação em saúde tem apresentado excelentes resultados na diminuição da ansiedade, que uma vez realizada pelo enfermeiro, potencializa o cuidado. Conclusão: processos educativos realizados no pré-operatório de cirurgia cardíaca, auxiliam para uma boa recuperação, pois com o envolvimento do paciente no processo, o tornará tranquilo e confortável

Objective: to describe, based on the literature, the contributions of the educational practices to the control of the anxiety of patients in the preoperative period of cardiac surgery. Method: this is an integrative review carried out from November to December 2017 in the PubMed, Bases de Dados de Enfermagem (BDENF), Biblioteca Regional de Medicina (BIREME), Scientific Electronic Library Online (SCIELO) and Medical Literature Analysis and Retrievel System Online (MEDLINE), databases, with the inclusion of 24 articles that composed this study. Results: on the anxiety diagnosis, the articles analyzed showed greater presence in the female sex, in different age groups, but more prevalent at more advanced ages. Health education has presented excellent results in the reduction of anxiety, which once performed by the nurse, potentiates the care. Conclusion: educational processes performed in the preoperative period of cardiac surgery, help to a good recovery, because with the patient's involvement in the process, it will make him calm and comfortable

Objetivo: describir, con base en la literatura, las contribuciones de las prácticas educativas para el control de la ansiedad de pacientes en preoperatorio de cirugía cardíaca. El método: se trata de una revisión integrativa realizada en el período de noviembre a diciembre de 2017 en las Bases de PubMed, Bases de Dados de Enfermagem (BDENF), Biblioteca Regional de Medicina (BIREME), Scientific Electronic Library Online (SCIELO) y Medical Literature Analysis and Retrievel System Online (MEDLINE), con la inclusión de 24 artículos que compusieron ese estudio. Resultados: sobre el diagnóstico ansiedad, los artículos analizados mostraron mayor presencia en el sexo femenino, en diferentes edades, pero más prevalente en edades más avanzadas. La educación en salud ha presentado excelentes resultados en la disminución de la ansiedad, que una vez realizada por el enfermero, potencializa el cuidado. Conclusión: procesos educativos realizados en el preoperatorio de cirugía cardíaca, auxilian para una buena recuperación, pues con la participación del paciente en el proceso, lo hará tranquilo y confortable

Protocolo de actuación de enfermería quirúrgica en cirugía robótica / Surgical nursing intervention protocol in robotic surgery

La aparición de la tecnología robótica ha conllevado la actualización del personal de enfermería tomando un papel fundamental aquellos encargados de la preparación y puesta en marcha del sistema, del instrumental y de la atención de detalles durante el desarrollo de la misma. Describimos el protocolo de actuación de enfermería en cirugía robótica en nuestro hospital. El equipo de cirugía robótica desde la implantación del sistema ha ejercido una actividad asistencial y docente con los profesionales de nueva incorporación. Es importante contar con un personal cualificado y especializado que proporcione un cuidado eficaz de manera eficiente y seguro para el paciente, sin olvidar mantener actualizados los conocimientos e iniciativas que se producen en el campo de la enfermería y la robótica

The appearance of robotic technology has led update nursing professionals, playing a key role those nurse team is responsible for instrumental and robotic system, taking care on all details during surgery. We describe a surgical nursing intervention protocol in robotic surgery in our institution. Since robotic protocol system implementation, robotic surgery team has performed assistant work and training activity of new team or visiting members. Qualified and specialized team is key in order to provide an effective, efficient and safety healthcare to patients. Keep update knowledge in nursing and robotic field is fundamental

Development of an education scheme for improving perioperative nurses' competence in ergonomics.

BACKGROUND: Perioperative nurses have several high-risk tasks. Musculoskeletal disorders (MSDs) are severe problems, while preventive measures are mostly insufficient. The 'Ergonomic patient handling card®' education scheme was introduced in Finland in 2009 aimed at improving both nurses' and patients' safety. Experiences of this multicomponent program from the care units and home care are good; the physical workload and sickness absences due to MSDs are decreasing. As the perioperative nurses' work in operating rooms (OR) varies considerably from the work in care units, a special education scheme needed to be developed. OBJECTIVE: The aim was to plan the 'Ergonomic patient handling card®' perioperative care education scheme [later pCard] and to define competencies, skills, and knowledge levels required to perform perioperative work safely, complying with legislative requirements, OR-safety and care quality. METHODS: Using a focus group and risk assessments in the acute care hospital the most stressful tasks in ORs in Finland were defined. The planning of the pCard content was based on the risk analysis aimed at defining competencies to mitigate the physical risks and on the evaluation of two pilot courses. RESULTS: The requested, approved corrections were incorporated into the new pCard scheme. Practical training emphazises working with safe methods and the safe usage of appropriate equipment.

Addressing the Perioperative Nursing Shortage Through Education: A Perioperative Imperative.

Perioperative nurse leaders are facing an unprecedented nursing shortage. Very few baccalaureate nursing programs in the United States prepare graduates for perioperative nursing, and many current perioperative nurses are retiring from practice or leaving the field for other reasons. It is a challenge for nursing administrators to fill the vacant positions because it takes several months to orient a novice perioperative nurse and it involves significant costs. This article provides current information about perioperative nurse and leader shortages, discusses the effects of the shortages on patient safety and health care facility finances, and reviews the available literature about perioperative nursing education from both an academic and health care facility administrative perspective. In addition, this article presents strategies for addressing the nursing shortage and describes implications for clinical practice, education, and research.

Closing the Gap: A Regional Partnership Model for Perioperative Nursing.

New Jersey is projected to be one of the top three states to experience a nursing shortage. The current practice of health care organizations providing their own education and training in the perioperative setting leads to variability in the degree of staff readiness and competence to address the complexities encountered in this setting. This may result in increased perioperative nursing orientation costs. The Center for Professional Development at Rutgers School of Nursing partnered with members of the region's surgical facilities to design and implement an accelerated immersion perioperative training model. This academic-clinical practice partnership resulted in a model that equips nurses with the competencies to better fulfill workforce demands while reducing costs. [J Contin Educ Nurs. 2019;50(8):363-366.].

Development of the Diverse Standardized Patient Simulation Cultural Competence Education Strategy.

This article describes the development of the diverse standardized patient simulation (DSPS) cultural competence education strategy, which is designed to improve students' knowledge, skills, and attitudes with regard to providing culturally competent care. Development of the DSPS was guided by the Jeffreys' Cultural Competence and Confidence model. As a carefully orchestrated educational intervention utilizing standardized patient pedagogy, the DSPS had content validity review and followed international guidelines and standards for design, implementation, evaluation, and standardized patient training. This strategy was integrated into a nine-credit, 15-week medical-surgical nursing course. A step-by-step description for the development of the DSPS is provided.