AORN journal
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Postoperative delirium is one of the most common adverse outcomes in elderly patients undergoing surgery and is associated with increased morbidity, length of stay, and patient care costs. The purpose of this quality improvement project was to evaluate the effectiveness of a multicomponent strategy to identify and treat general surgical patients 65 years of age or older at risk for and who develop postoperative delirium at Cape Cod Hospital, a community hospital in southern New England. We evaluated 96 patients using the Mini-Cog assessment tool preoperatively and the Confusion Assessment Method (CAM) delirium screening tool or CAM-Intensive Care Unit (CAM-ICU) assessment tool postoperatively. ⋯ The results showed an association between compliance and outcomes. High compliance with implementation of CAM and CAM-ICU assessment tools resulted in increased identification of postoperative delirium in the older surgical population. The use of screening tools helped facilitate early identification of postoperative delirium in elderly surgical patients.
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Disasters disrupt everyone's lives, and they can disrupt the flow and function of an OR as well as affect personnel on a professional and personal level even though perioperative departments and their personnel are used to caring for trauma patients and coping with surprises. The Boston Marathon bombing was a new experience for personnel at Massachusetts General Hospital, Boston. This article discusses the incidents surrounding the bombing and how personnel at this hospital met the challenge of caring for patients and the changes we made after the experience to be better prepared in the event a response to a similar incident is needed.
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Nearly half of all surgical complications are considered preventable. Early research regarding preprocedural surgical safety checklist briefings revealed that this process led to improved surgical complication rates. We conducted a literature search to gather evidence regarding compliance in conducting briefings, outcomes of briefings, and surgical team members' perceptions toward the use and efficacy of checklist briefings. ⋯ The studies used a variety of methodologies and outcome measures. Common themes in the studies included enhanced patient safety, improved compliance over time, and increased communication among team members when checklists were used. As research continues on surgical safety checklists and briefings, a great opportunity exists for perioperative nurses to make contributions to the evidence.