AORN journal
-
Preparing for surgical separation of conjoined twins involves coordination, communication, and multidisciplinary planning by several specialties. This article discusses the embryology, etiology, and incidence of conjoined twins and provides a historical perspective of the different types of conjoined twins. A case study describes the perioperative management of conjoined twins at Texas Children's Hospital's, Houston. Team members' roles are discussed, and the perioperative care of conjoined twins detailed.
-
During the 2007 meeting of the Child Health Corporation of America Operating Room Director's Forum, members identified two major discrepancies in surgical count policies among the member hospitals: variations for instrument counts in pediatrics and exceptions to radiographic verification when needle counts were incorrect. The group agreed to collaboratively develop a pediatric count policy based on directors' expertise and current literature to help improve count practices. ⋯ The project exemplifies a successful nurse-led, national group effort. The outcome is a policy that represents best practice in pediatrics and is a first step toward future opportunities to improve patient safety.
-
Successful surgery depends on collaboration and mutual trust among interdisciplinary team members. We compared teamwork quality as perceived by surgeons, anesthesia care providers, and perioperative nurses using two surveys in the same hospital. The general survey sent to the homes of the OR personnel revealed teamwork climate scores in the medium to high range. ⋯ A second single-item survey administered immediately after elective open abdominal surgical procedures also showed relatively high satisfaction with teamwork. Results of the second survey, however, showed that attending surgeons were significantly less satisfied than the members of all the other professions, and perioperative nurses were significantly more satisfied than the members of all the other professions. We conclude that general surveys about teamwork quality among members of surgical teams may not necessarily reflect teamwork quality during actual surgical procedures.
-
Review Case Reports Randomized Controlled Trial Clinical Trial
Effects of warming therapy on pressure ulcers--a randomized trial.
Postoperative pressure ulcers are a common and expensive problem. Intraoperative hypothermia also is a common problem and may have a connection with impaired tissue viability. Researchers in this study hypothesized that intraoperative control of hypothermia may reduce the incidence of postoperative pressure ulcers. ⋯ Results indicated an absolute risk reduction in pressure ulcers of 4.8% (i.e., 10.4% to 5.6%) with a relative risk reduction of 46% in patients who received warming therapy. Although not reaching statistical significance, the clinical significance of almost halving the pressure ulcer rate is important. A correlation between body temperature and postoperative pressure ulcers was established.
-
Comparative Study
Comparing new-technology passive warming versus traditional passive warming methods for optimizing perioperative body core temperature.
Hypothermia puts surgical patients at risk for adverse outcomes. Traditional passive warming methods are mostly ineffective in reducing hypothermia. New-technology passive warming holds promise as an effective method for promoting and sustaining normothermia throughout surgery. ⋯ The traditionally warmed cohort had no change in temperature (35.9° C ± 0.6° C presurgery vs 35.9° C ± 0.7° C postsurgery; t = 0.47; P = .66). The intervention cohort showed a significant increase in temperature (35.75° C ± 0.52° C presurgery vs 36.30° C ± 0.53° C postsurgery; t = 4.64; P < .001). A repeated-measure analysis of variance adjusting for surgery duration and fluid administration confirmed the significance (F = 17.254; P < .001), suggesting that new-technology passive warming may effectively complement active warming to reduce perioperative hypothermia.