Transforming Nursing Education Through Interprofessional Collaborative Innovation: A Project Story.

This project story is about transforming nursing education through interprofessional collaborative innovation to develop and use a complement of technology-based portable simulation devices collectively known as the Healthcare Education Simulation Station. This collection of inexpensive, simulated point-of-care instruments controlled wirelessly by an instructor or simulation operator were developed and field tested by an interdisciplinary team to enhance learning experiences in several configurations, including those using standardized patients and those using static and low-, mid-, and high-fidelity manikins. The core feature of this project story is the collaboration of students and faculty from two unrelated disciplines, nursing and engineering. The story includes a description of the development, field testing, and initial deployment of a simulated pulse oximeter, capnograph, automated sphygmomanometer, cardiac monitor, thermometer, and fetal monitor. Underpinning this project story is Rogers' Diffusion of Innovation theory and how the characteristics of the innovation, the personnel, and the environment worked together to enable this project and the innovation's subsequent diffusion into nursing education. The aspiration to improve learning experiences for students in multiple disciplines was paramount. The desire to acquire high-quality, dynamic educational tools for nursing educators, coupled with an environment that encourages collaboration, led to an innovation that can transform nursing preparation and ultimately improve patient care, while minimizing cost.

Do-not-resuscitate. Orders in surgery: decreasing the confusion.

Patients have the right to make decisions regarding their medical care, including the right to refuse treatment or to issue do-not-resuscitate orders as part of an advance directive. Health care providers must comply with the patient's wishes regarding care. Automatic suspension or continuation of a do-not-resuscitate order for a patient undergoing surgery cannot be justified. Surgical team members should consult with the patient and, if necessary, with an ethics expert or committee to determine whether the do-not-resuscitate order is to be maintained or completely or partially suspended during anesthesia and surgery. All surgical departments should have a written policy and procedure concerning the treatment of patients with do-not-resuscitate orders.

Nursing shortages in the OR: solutions for new models of education.

The professional literature predicts worldwide perioperative nursing shortages. Compounding this is the absence of perioperative curricula in most nursing programs, which reduces new graduate interest in and awareness of employment opportunities in the OR environment. Educators at a university and a large hospital system formed an innovative partnership to create a pilot undergraduate nursing course to better prepare nurses for the surgical setting. The course was offered in a condensed-semester format and included online activities, simulation experiences, classroom discussions, and clinical experiences in a small group setting. Two of the four nursing students in the course were hired directly into the perioperative setting after graduation, decreasing hospital costs related to recruitment and orientation. The success of the course led to its integration into the undergraduate curriculum, thus providing a valuable elective option for junior and senior nursing students, as well as achieving a new model for perioperative nursing education.

Multi-society guideline for reprocessing flexible gastrointestinal endoscopes. Society for Healthcare Epidemiology of America.

Flexible gastrointestinal endoscopy is a valuable diagnostic and therapeutic tool for the care of patients with gastrointestinal and pancreaticobiliary disorders. Compliance with accepted guidelines for the reprocessing of gastrointestinal endoscopes between patients is critical to the safety and success of their use. When these guidelines are followed, pathogen transmission can be effectively prevented. Increased efforts and resources should be directed to improve compliance with these guidelines. Further research in the area of gastrointestinal endoscope reprocessing should be encouraged. The organizations that endorsed this guideline are committed to assisting the FDA and manufacturers in addressing critical infection control issues in gastrointestinal device reprocessing.

Deep vein thrombosis and airline travel--the deadly duo.

A number of deaths from pulmonary embolism caused by deep vein thrombosis (DVT) have been attributed to long-distance airplane travel. Although airplanes provide the most convenient means of long-distance travel, the aircraft environment can take a physical toll on passengers. This article describes the causes and risk factors for discusses preventive strategies, and offers recommendations for making air travel safer.

BSN in 10: what is your opinion?

The purpose of this project was to elicit the opinions of members of AORN of Central Ohio regarding Ohio's BSN-in-10 initiative. Using a focus group, we sought to answer the following question: is there a need to legislate that newly licensed RNs in Ohio obtain a bachelor's degree in nursing (BSN) within 10 years? Participants valued higher education but were not informed about the need for more BSN-prepared nurses. They also were not aware of the professional and financial effects of obtaining a baccalaureate degree, the available resources to assist them in obtaining one, or collaborative nursing association partnerships that advocate for BSN-in-10 legislation. The results suggest that health care policy advocates need to find alternative means to communicate essential information to RNs.

Compliance with surgical smoke evacuation guidelines: implications for practice.

Surgical smoke presents a serious health hazard, but perioperative nurses' compliance with smoke evacuation recommendations is not consistent. I investigated key indicators for compliance with electrosurgical smoke evacuation recommendations based on nurses' individual innovativeness characteristics, perceptions of the attributes of smoke evacuation recommendations, and organizational innovativeness characteristics. The study findings provide implications for improving nurses' compliance with smoke evacuation recommendations. Individual innovativeness characteristics, including nurses' knowledge and training, were most strongly linked to smoke evacuation compliance. The key indicators that promote surgical smoke evacuation can provide direction to guide the content of education programs and help identify the personnel and settings that are most in need of this information. Barriers to compliance included lack of equipment, physician resistance, noise, and staff member complacency. Vendor demonstrations on the ease of smoke evacuation device use can show nurses that smoke evacuation is compatible with nursing practice. Facility leaders should provide smoke evacuation policies that are easy to understand and should enforce these policies.

Surgical smoke evacuation guidelines: compliance among perioperative nurses.

More than 500,000 health care workers are exposed to surgical smoke every year. Toxic gases create an offensive odor, small particulate matter causes respiratory complications, and pathogens may be transmitted in the surgical smoke to the surgical team. Previous research notes that perioperative nurses do not consistently follow smoke evacuation recommendations. The purpose of this study was to determine key indicators that are associated with compliance with smoke evacuation recommendations. Data from a web-based survey completed by 777 nurse members of AORN were analyzed to examine the relationship between the key indicators and compliance with smoke evacuation recommendations. Major findings were that specific key indicators influencing compliance include increased knowledge and training, positive perceptions about the complexity of the recommendations, and increased specialization, interconnectedness, and leadership support in larger facilities. Education programs can be developed that directly address these key predictors so that a surgical environment free from surgical smoke is promoted.

Compliance with surgical smoke evacuation guidelines: implications for practice.

Surgical smoke presents a serious health hazard, but perioperative nurses' compliance with smoke evacuation recommendations is not consistent. I investigated key indicators for compliance with electrosurgical smoke evacuation recommendations based on nurses' individual innovativeness characteristics, perceptions of the attributes of smoke evacuation recommendations, and organizational innovativeness characteristics. The study findings provide implications for improving nurses' compliance with smoke evacuation recommendations. Individual innovativeness characteristics, including nurses' knowledge and training, were most strongly linked to smoke evacuation compliance. The key indicators that promote surgical smoke evacuation can provide direction to guide the content of education programs and help identify the personnel and settings that are most in need of this information. Barriers to compliance included lack of equipment, physician resistance, noise, and staff member complacency. Vendor demonstrations on the ease of smoke evacuation device use can show nurses that smoke evacuation is compatible with nursing practice. Facility leaders should provide smoke evacuation policies that are easy to understand and should enforce these policies.

The enigma of the H1N1 flu: are you ready?

This flu season, health care providers must be prepared to treat patients who have the seasonal flu and also those who have contracted a novel strain of the H1N1 influenza virus. Although H1N1 flu is sometimes incorrectly called "swine flu," the virus is transmitted from person to person; it cannot be contracted from pigs or from eating pork products. Symptoms of the H1N1 flu include fever, chills, nausea, vomiting, body aches, lethargy, and fatigue, which usually appear in rapid succession. People at high risk include children, pregnant women, and those with certain medical conditions. The most common cause of death from the virus is respiratory failure, but other causes of mortality include sepsis, dehydration, and electrolyte imbalance. The first line of defense against H1N1 flu is vaccination. Treatment includes use of antiemetics, antipyretics, and respiratory support.