AORN journal
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Review Meta Analysis
Risk Factors of Postoperative Delirium in Older Adult Spine Surgery Patients: A Meta-Analysis.
This literature review identifies factors that may place older adult patients at risk for developing delirium after spine surgery. We conducted a meta-analysis according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using a variety of electronic databases, we identified five studies for inclusion that represent 645 patients who were 65 years or older. ⋯ Factors associated with developing postoperative delirium included preoperative opioid use, cervical spine surgery versus lumbar or thoracic spine surgery, spine fusion versus simple spine surgery, hypertension, cerebrovascular disease, pulmonary disease, duration of surgery, and infused IV fluid volume. Nurses who provide perioperative care for older adult patients undergoing spine surgery should be aware of the potential risk factors of delirium to ensure patient safety. Further research is required to clearly delineate the risk factors for postoperative delirium in older adults.
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Surgical counts during a partial cystectomy Key words: partial cystectomy, retained surgical item (RSI), counts, bladder, guidewire. Preparing the OR for patients who require both airborne and contact precautions Key words: airborne precautions, contact precautions, contamination, Coronavirus Disease 2019 (COVID-19), negative pressure. Preoperative transport of patients who require both airborne and contact precautions Key words: preoperative patient transport, hand hygiene, personal protective equipment (PPE), N95 respirator, Coronavirus Disease 2019 (COVID-19). Postoperative transport of patients who require both airborne and contact precautions Key words: postoperative patient transport, hand hygiene, personal protective equipment (PPE), N95 respirator, Coronavirus Disease 2019 (COVID-19).
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Epidural or spinal anesthesia-related infections cause serious and devastating morbidity and mortality. The possible infectious complications of neuraxial anesthesia have become better understood in the past 10 years. ⋯ A review of the literature demonstrated that personnel in interdisciplinary specialties use gowns for invasive procedures to prevent infection, and national and international multidisciplinary health care professionals appear to be increasing their use of sterile gowning to prevent infections. We undertook this literature review to explore the incidence of neuraxial infection, provide additional insight into multidisciplinary standards, and evaluate whether the use of sterile gowns while performing neuraxial anesthesia decreases infection rates.
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This article reviews current literature about the contamination of laryngoscope blades and handles, disinfection practices for laryngoscope blades and handles, and environmental effects and costs of reusable and single-use laryngoscopes. This review shows that inadequately processed rigid laryngoscopes may have the ability to transmit infections to patients and health care personnel. ⋯ Laryngoscope costs are lower for processing reusable laryngoscope handles and blades by HLD and highest for single-use laryngoscopes. Evidence-based guidelines are needed to specify and standardize best practices for processing rigid laryngoscopes.
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Offloading a patient's heels during supine surgical procedures is a common practice to prevent heel pressure injuries. This practice may increase sacral pressure and jeopardize sacral skin integrity, but prophylactic dressings may help protect sacral skin. The purpose of this study was to examine the effects of offloading the heels and of multilayered silicone foam dressings on sacral pressure. ⋯ We used linear mixed-effects modeling to compare the effects of these conditions on sacral pressure. Offloading the heels significantly increased sacral pressure (P < .001), whereas the dressing had no effect on sacral pressure (P = .49). Offloading a patient's heels may increase the risk of sacral pressure injuries.