AORN journal
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Peripheral nerve blocks are used as part of a preemptive and multimodal analgesic technique to provide safe and effective postoperative pain management with minimal side effects. They are used for a variety of surgical procedures in both inpatient and outpatient settings. Peripheral nerve blocks have resulted in shorter recovery times, decreased anesthesia-related complications, and better postoperative pain management. ⋯ Nerve blocks have allowed procedures previously performed only in hospitals to be performed on an outpatient basis by providing extended surgical area analgesia. The use of peripheral nerve blocks, however, requires skilled and knowledgeable clinicians. This article discusses the mechanism of action and the role of peripheral nerve blocks in multimodal analgesia, as well as perioperative nursing implications and management for upper and lower extremity peripheral nerve blocks.
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Practice Guideline Guideline
Recommended practices for skin preparation of patients.
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This article describes a statistical method used to determine the minimum number of OR teams that should be on call for urgent procedures, in-house versus on standby from home, to minimize labor costs. The OR manager obtains the number of ORs staffed at each hour of the 24-hour period of interest (e.g., 7 AM Saturday to 7 AM Sunday) from the surgical suite's information system. ⋯ This method enumerates all possible combinations of shifts to find the one with the lowest cost, and it ensures a prespecified service level. An example based on 248 weeks of data collected from a large surgical suite is presented, and staffing for emergency procedures is reviewed.
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Political apathy in the nursing profession can be attributed to numerous factors, including a perceived ethical conflict between professional values and political involvement, as well as a lack of strategy for political action. Differences in personal and professional ethics, conflicting loyalties, and a negative image of politics create ethical tension for nurses. Political-ethical conflicts can mean choosing between job, patient care, and personal ideals. ⋯ Many guidelines exist to help nurses understand why they should get involved in the political process. By using these guidelines, nurses can evaluate issues and use a valid method to assess problems, plan for action, and evaluate the effectiveness and benefits of specific strategies. In the second of this two-part series on political involvement in nursing, political-ethical conflict is explored, along with strategies for political action.