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Authors: Beyea SC.
Title: Best practices for safe medication administration.
Source: AORN Journal. 81(4):895-8, 2005 Apr.

Authors: Bishop P.
Title: Bipolar transurethral resection of the prostate--a new approach.
Source: AORN Journal. 77(5):979-83, 2003 May.
Abstract
Benign prostatic hyperplasia (BPH) is a common problem among older men. Transurethral resection of the prostate (TURP) is a common surgical procedure for treatment of BPH. Typically, TURP is performed using monopolar electric current and a wire electrode; however, the irrigating solution used during this procedure has the potential to cause transurethral resection (TUR) syndrome. A new technology uses bipolar electrosurgery, which creates less risk of electrical shock, and saline irrigation, which eliminates the risk for TUR syndrome.

Author: Ferguson RT.
Title: Case commentary. Involving family members in a thyroplasty procedure.
Source: AORN Journal. 2003 Feb; 77(2): 418-20. (11 bib)

Authors: Sherwood GD. McNeill JA. Starck PL. Disnard G.
Title: Changing acute pain management outcomes in surgical patients.
Source: AORN Journal. 77(2):374, 377-80, 384-90 passim, 2003 Feb.
Abstract
Patient outcome studies indicate that patients accept pain as part of hospitalization. The majority of hospitalized patients who report experiencing pain are recovering from surgical intervention. To achieve successful outcomes, a comprehensive multidisciplinary effort must begin preoperatively and continue through discharge. The perioperative period is an essential link in effective pain management, and perioperative nurses are key in helping direct the care of surgical patients before, during, and after surgical procedures. Pain relief and the patients satisfaction with care frequently are used to measure pain management outcomes. This article examines the results of a secondary analysis of a subset of surgical patients drawn from a larger data set that was collected during two studies in urban and rural hospitals. It focuses on two outcomes, namely characteristics of pain and patient satisfaction with pain management after surgery. These outcomes were measured using the American Pain Society patient outcome questionnaire and the pain management index. Correlational, descriptive, and regression analyses indicate that postoperative management of patients' pain in these studies was less than optimal. From this new understanding, strategies for effective pain management of surgical patients are recommended.

Author: Collette CL.
Title: Clinical exemplar. Understanding patients' needs is the foundation of perioperative nursing.
Source: AORN Journal. 2000 Mar; 71(3): 629-30. (1 ref)
Abstract
As I reflected on Mrs L's procedure, I realized the importance of my role. I coordinated the efforts of the radiologist, radiological technologist, surgeon, pathologist, and nurses to provide Mrs L with a positive surgical experience, and I collaborated with Mrs L and her husband to make them as comfortable and relaxed as possible. I connected with Mrs L and her husband--they knew I would help them in any way to make this a positive experience. In addition, I collected data about Mrs L's perception and satisfaction with her experience to explore her response to her stereotactic surgical biopsy procedure experience. Perioperative nurses are important to patients and their family members. By listening to patients' needs, planning for their individual care, and being present, perioperative nurses help patients through difficult situations. I use my experience and knowledge to serve as a role model for breast imaging personnel, nurses, and other coworkers, and to improve each patient's perioperative experience.

Author: Brunges M. Avigne G.
Title: Clinical innovations. Music therapy for reducing surgical anxiety.
Source: AORN Journal. 2003 Nov; 78(5): 816-8. (6 ref)

Authors: Norred CL.
Title: Complementary and alternative medicine use by surgical patients.
Source: AORN Journal. 76(6):1013-21, 2002 Dec.
Abstract
This national multisite study examined complementary and alternative medicine (CAM) use by surgical patients during the two weeks preceding their surgery. A simple descriptive design consisting of anonymous self-report questionnaires was used to measure CAM use and determine participant demographics. A purposive sample of adult, English-speaking, elective outpatients from 16 hospitals representing seven US regions was used. Data were collected randomly at each site. Sixty-seven percent of participants disclosed use of all types of CAM; 27% consumed herbs, 39% used dietary supplements, 54% took vitamins, and 1% reported use of homeopathics. Thirty-four percent of participants reported using CAMs that potentially can interact with anesthetics and inhibit coagulation. The results of this study suggest that perioperative nurses should encourage patients to disclose CAM use and should educate patients about anesthetic interactions that may contribute to bleeding.

Authors: Capasso VA. Munro BH.
Title: The cost and efficacy of two wound treatments.
Source: AORN Journal. 77(5):984-92, 995-7, 1000-4, 2003 May.
Abstract
Using the physiology of moist wound healing as the framework, this nonexperimental, retrospective chart review compared the rate of wound healing and cost of wound care associated with wet-to-dry normal saline gauze dressings to the rate of wound healing and cost of wound care associated with amorphous hydrogel dressings for patients with infrainguinal arterial disease and diabetes. These patients were discharged from the hospital to home care for management of perioperative arterial surgical wound dehiscence and nonhealing ulcerations. The sample included 25 patients who used wet-to-dry normal saline gauze dressings and 25 patients who used amorphous hydrogel dressings. Repeated measures of analysis of covariance revealed a similar rate of wound healing in the two groups. The overall cost of wound care was significantly higher (P = .006) for patients in the normal saline group, with a higher number and cost of home nursing visits. The cost of supplies was not significantly different between groups, although amorphous hydrogel dressings cost an average of dollar 50 more than wet-to-dry normal saline gauze dressings. The two treatments are equally efficacious in promoting wound healing, but amorphous hydrogel dressings are significantly more cost effective and, thus, a better value for the home care dollar.

Authors: Ball K.
Title: Deep vein thrombosis and airline travel--the deadly duo.
Source: AORN Journal. 77(2):346-54, 357-8, 2003 Feb.
Abstract
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.

Authors: Martin JH. Haynes LC.
Title: Depression, delirium, and dementia in the elderly patient. [Review] [18 refs]
Source: AORN Journal. 72(2):209-17; quiz 218-21, 223, 225-6, 2000 Aug.
Abstract
Perioperative nurses commonly care for patients with changes in mental status, especially elderly patients. Three common mental status disorders in the elderly are delirium, depression, and dementia. Each of the disorders can have similar clinical presentations. Despite similarities, the appropriate nursing interventions may vary significantly. Interventions discussed in this article focus on the etiology of the presenting problem and the nursing interventions that will promote the most positive outcome for the patient. [References: 18]

Authors: Schrecengost A.
Title: Do humorous preoperative teaching strategies work?
Source: AORN Journal. 74(5):683-9, 2001 Nov.
Abstract
Incorporating humor into preoperative teaching may improve patients' ability to recall pertinent instruction. This article describes a study in which an experimental, two-group, pretest/posttest design was used to determine whether there was a significant difference in the amount of knowledge patients recalled after receiving a teaching booklet either with (i.e., experimental) or without (i.e., control) humor. The sample included 50 patients undergoing open-heart surgery. Results indicate that there was no significant difference (F1, 48 = .07, P > .05) between the groups in the amount of knowledge gained related to postoperative pulmonary exercises. Both groups, however, had a statistically significant increase in the amount of knowledge gained from pretest to posttest (F1, 48 = 39.16, P < .05). Before humorous teaching strategies can be recommended for use in preoperative teaching, further research about the relationship between preoperative instruction, humor, and knowledge retention is necessary.

Authors: Yellen EA. Ricard R.
Title: The effect of a preadmission videotape on patient satisfaction.
Source: AORN Journal. 81(4):831-42, 845, 2005 Apr.
Abstract
The effect of a preadmission videotape presentation on patient satisfaction in an outpatient surgery department was explored in this research study. A sample of 141 Caucasian and Hispanic patients took part in the study. Results indicated that patients who viewed the preadmission patient videotape did not differ significantly in their report of satisfaction from those who did not view the videotape. The study also found that the satisfaction of nurses in the project varied significantly during the study period.

Authors: Mok E. Wong KY.
Title: Effects of music on patient anxiety.
Source: AORN Journal. 77(2):396-7, 401-6, 409-10, 2003 Feb.
Abstract
Undergoing surgery with local anesthesia is stressful because patients often are aware of their surroundings. This study investigated music as a method of reducing patients' anxiety during minor surgery with local anesthesia. For this study, researchers assessed the effectiveness of music as a relaxation modality by measuring patients' vital signs and self-reported anxiety before and after surgery. Study results indicate that patients who listened to their choice of music during surgery experienced significantly lower anxiety levels, heart rates, and blood pressure than patients who did not listen to music.

Authors: Scott EM. Leaper DJ. Clark M. Kelly PJ.
Title: Effects of warming therapy on pressure ulcers--a randomized trial. [Review] [77 refs]
Source: AORN Journal. 73(5):921-7, 929-33, 936-8, 2001 May.
Abstract
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. A randomized clinical trial (n = 338) was used to test the effects of using forced air warming therapy versus standard care. 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. [References: 77]

Author: Wendel I.
Title: Elder care. A case study of postoperative delirium.
Source: AORN Journal. 2002 Mar; 75(3): 595-600. (17 ref)

Author: Larsen PD.
Title: Elder care. Effective pain management in older patients.
Source: AORN Journal. 2000 Jan; 71(1): 205-8. (31 ref)

Author: Moore LW. Amburgey LB.
Title: Elder care. Older adults and HIV.
Source: AORN Journal. 2000 Apr; 71(4): 873-6. (26 ref)
Abstract
As the number of older Americans grows, perioperative nurses increasingly will be called on to provide services to older adults infected with HIV. To provide quality patient care, perioperative nurses must understand the facts about HIV and aging individuals. Finally, perioperative nurses must realize the best defense against exposure to bloodborne pathogens (e.g., HIV) is compliance with standard precautions while caring for all patients, from newborns to older adults. [References: 22]

Author: Tappen RM. Muzic J. Kennedy P.
Title: Elder care. Preoperative assessment and discharge planning for older adults undergoing ambulatory surgery.
Source: AORN Journal. 2001 Feb; 73(2): 464, 467, 469-70 passim. (17 ref)
Abstract
Based on this survey, the prevalence of chronic illness and disability in older adult patients with respect to current ambulatory surgery practices is worrisome, especially the fragmentation of patients' care as they progress from the decision to undergo procedures, to preoperative assessment, to postoperative discharge. Ambulatory surgery unit nurses, case managers, surgeons, and office staff members must work together to better optimize time and resources. As baby boomers age, the number of older adults undergoing ambulatory surgery will increase. It is essential for ASU staff members to be cognizant of the special needs of older adult patients. Timeliness, patient education, and appropriate coordination and follow-up of care are important ingredients to successfully plan care for older adult patients undergoing ambulatory surgery. Nurses can play a pivotal role in this success.

Authors: Seifert PC.
Title: Ethics in perioperative practice--commitment to the patient.
Source: AORN Journal. 76(1):153-60, 2002 Jul.
Abstract
Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this fourth of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the second statement, which emphasizes commitment to the patient.

Authors: Schroeter K.
Title: Ethics in perioperative practice--principles and applications.
Source: AORN Journal. 75(4):818-24, 2002 Apr.
Abstract
Though often difficult, ethical decision making is necessary when caring for surgical patients. Perioperative nurses have to recognize ethical dilemmas and be prepared to take action based on the ethical code outlined in the American Nurses Association's (ANA's) Code of Ethics for Nurses with Interpretive Statements. In this first of a nine-part series that will help perioperative nurses relate the ANA code to their own area of practice, the author looks at the first statement, which emphasizes respect for people.

Author: Allen G.
Title: Evidence for practice. Effect of vitamin D3 supplementation.
Source: AORN Journal. 2003 Nov; 78(5): 852, 854.

Author: Leske J.
Title: Evidence for practice. Older adult patients' perceptions of hospital care.
Source: AORN Journal. 2004 Nov; 80(5): 945, 947.

Author: Leske J.
Title: Evidence for practice. Older adult patients' quality of life.
Source: AORN Journal. 2004 Nov; 80(5): 944.

Author: Allen G.
Title: Evidence for practice. Serum vitamin A concentration and hip fractures in women.
Source: AORN Journal. 2005 Jan; 81(1): 221-2.

Author: Allen G.
Title: Evidence for practice. Smoking cessation in patients with coronary heart disease.
Source: AORN Journal. 2005 May; 81(5): 1084, 1086.

Author: Allen G.
Title: Evidence for practice. Surgery for older adults.
Source: AORN Journal. 2004 Oct; 80(4): 754.

Authors: Drake C.
Title: Finding Internet resources about geriatric issues.
Source: AORN Journal. 72(2):300-2, 2000 Aug.

Authors: Watson DS.
Title: First, do no harm.
Source: AORN Journal. 76(5):752-5, 2002 Nov.

Authors: Clausing SL. Kurtz DL. Prendeville J. Walt JL.
Title: Generational diversity--the Nexters.
Source: AORN Journal. 78(3):373-9, 2003 Sep.
Abstract
For the first time in recent history, the workforce includes four generations of employees--Veterans, Baby Boomers, Generation Xers, and Nexters. These generations share some common values and beliefs, but they also exhibit differences stemming from the experiences of their eras. Understanding and appreciating these differences will help decrease generational conflict and support all generations in welcoming diversity. The Nexter generation includes more than 81 million people, approximately 30% of the current population. Nexters will enter the workforce in large numbers and will influence changes in the work environment just as Baby Boomers did.

Authors: Foltz P. Wavrin C. Sticca R.
Title: Heated intraoperative intraperitoneal chemotherapy--the challenges of bringing chemotherapy into surgery. [Review] [8 refs]
Source: AORN Journal. 80(6):1055-63; quiz 1065-8, 2004 Dec.
Abstract
Heated intraoperative intraperitoneal chemotherapy (HIIC) was introduced at Altru Health System in August 2003 to offer the community a different treatment option for intraperitoneal carcinomatosis. The closed technique is performed to eliminate the risk of aerosolization and direct contact of the toxic chemotherapeutic agent with staff members. Implementing the HIIC procedure resulted in the creation of a comprehensive policy on chemotherapy precautions in surgery, which was the catalyst for implementing quality improvement initiatives throughout Altru Health System. [References: 8]

Authors: Roeder RA. Geddes LA. Corson N. Pell C. Otlewski M. Kemeny A.
Title: Heel calf capillary-support pressure in lithotomy positions.
Source: AORN Journal. 81(4):821-7, 830, 2005 Apr.
Abstract
A three-part analysis was undertaken to increase understanding of the occurrence of pressure ulcers in lithotomy positions. An innovative measuring device was used to determine capillary pressure. Ankle blood pressure was measured compared to ankle height in 11 participants. Ankle systolic and diastolic pressure decreased approximately 20 mmHg per foot of elevation. Calf and heel capillary-support pressures were measured in 15 participants in the standard lithotomy position. Capillary-support pressure for the calf was substantially less than for the heel. Heel capillary-support pressures were measured in 16 participants in the high lithotomy position. As heel height increased, capillary-support pressure also increased.

Author: Brumley C.
Title: Herbs and the perioperative patient.
Source: AORN Journal. 2000 Nov; 72(5): 783, 785-6, 788-94 passim. (32 ref)
Abstract
Herbs are claimed to cure or correct many ills, and in the United States, they are classified as dietary supplements. The Federal Trade Commission, rather than the US Food and Drug Administration, has primary responsibility for dietary supplements, so companies may make claims about herbs that are unsubstantiated by research. Perioperative nurses should be aware of herb usage, interactions with other traditional medications, and herbs effects on perioperative patients.

Author: Payer M. Youngberg B. Pfister S.
Title: Home study program. Panniculectomy -- an option for people who are morbidly obese.
Source: AORN Journal. 2003 Apr; 77(4): 780, 782-92, 794-5 passim. (7 ref)
Abstract
Obesity is becoming a major health issue across the nation. Surgical procedures to alleviate problems of severely limited ambulation, development of open wounds, and overeating may be an option for people who are morbidly obese. A gastric bypass procedure and panniculectomy are among the surgical options available. In this article, the preoperative, intraoperative, and postoperative care of a patient undergoing a panniculectomy are presented. A safe, complication-free procedure can be performed with preplanning; a precise, detailed team effort; and an informed, motivated patient.

Author: Branson JJ. Goldstein WM.
Title: Home study program. Primary total hip arthroplasty.
Source: AORN Journal. 2003 Dec; 78(6): 946-53, 956-9, 961-9 passim. (24 ref)
Abstract
TOTAL HIP ARTHROPLASTY (THA) has been proven to decrease a patient's pain and improve function and quality of life. This procedure has been performed in the United States since 1960. Follow-up data suggest long-term success with a decreasing rate of complications and low rate of revision. MORE THAN 168,000 THA procedures are performed in the United States every year. There is an 80% chance these hip replacements will last at least 20 years. CURRENT IMPROVEMENTS in hip designs, surgical techniques, fixation methods, prophylactic therapies, preadmission education, and rehabilitation have contributed to improved patient outcomes. [References: 24]

Author: Brown C.
Title: Home study program. Surgical treatment of trigeminal neuralgia.
Source: AORN Journal. 2003 Nov; 78(5): 743-4, 746, 748-50 passim. (9 ref)

Authors: Dunn H.
Title: Horizontal violence among nurses in the operating room.
Source: AORN Journal. 78(6):977-88, 2003 Dec.
Abstract
MANY NURSES report that sabotage is a common event in the OR, and the level of sabotage present in the OR may have an effect on overall job satisfaction among perioperative nurses. THIS STUDY looked at the relationship between the presence of sabotage in the OR and job satisfaction levels reported by a group of perioperative nurses in New Jersey. STUDY RESULTS found that although sabotage is reported as common in the OR, the presence of sabotage is not significantly associated with reported job satisfaction.

Authors: McNamara SA.
Title: Incorporating generational diversity.
Source: AORN Journal. 81(6):1149-52, 2005 Jun.

Authors: Yellen E.
Title: The influence of nurse-sensitive variables on patient satisfaction.
Source: AORN Journal. 78(5):783-93, 2003 Nov.
Abstract
A DESCRIPTIVE STUDY was conducted in an ambulatory surgical unit to explore the influence of selected nurse-sensitive variables on patient satisfaction and compare the reliability and validity of existing instruments that measure patient satisfaction. STUDY RESULTS indicate that age, gender, culture, pain control, and communication affect patient satisfaction in ambulatory care. A reliable tool to measure patient satisfaction is needed to promote improvements in care.

Authors: Mordiffi SZ. Tan SP. Wong MK.
Title: Information provided to surgical patients versus information needed.
Source: AORN Journal. 77(3):546-9, 552-8, 561-2, 2003 Mar.
Abstract
The importance of providing preoperative information to patients has been reiterated in many research studies; however, the delivery is based on health care providers' view of what information should be included. An analysis of studies on the type of preoperative information given to patients confirms the lack of patient focus when delivering such information. In this study, a multifaceted approach was used to determine patients' and health care providers' perceptions about preoperative information. Importance was placed on information about the details of anesthesia by all three cohorts (ie, patients, nurses, physicians). A gap in information provided about the details of anesthesia and the OR environment was found. Further analysis seems to attribute the inadequate information received by patients to health care providers' misunderstanding regarding the information patients want.

Authors: Floryan KM. Berghoff WJ.
Title: Intraoperative use of autologous platelet-rich and platelet-poor plasma for orthopedic surgery patients. [Review] [18 refs]
Source: AORN Journal. 80(4):668-74, quiz 675-8, 2004 Oct.
Abstract
As use of autologous platelet-rich plasma (PRP) and platelet-poor plasma (PPP) increases for intraoperative care of a variety of patients, it is important for perioperative nurses to recognize their benefits. Autologous PRP may decrease postoperative drainage, reduce narcotic requirements, and facilitate an early return to mobility. Postoperatively, patients should experience fewer complications, recover more rapidly, and have a reduced hospital stay. This article defines autologous PRP and PPP, describes processing and application of PRP and PPP, and reports clinical outcomes of the use of platelet concentrate for a group of patients who underwent total knee arthroplasty. [References: 18]

Author: Panagiotis K. Maria P. Argiri P. Panagiotis S.
Title: Is postanesthesia care unit length of stay increased in hypothermic patients?
Source: AORN Journal. 2005 Feb; 81(2): 379-80, 382, 385-8 passim. (33 ref)
Abstract
* INADVERTENT HYPOTHERMIA is one of the most common complications experienced by surgical patients who are transferred to the postanesthesia care unit (PACU).

* APPROPRIATE PACU LENGTH OF STAY (LOS) is defined as the time required for a patient to achieve a physiologically stable condition after anesthesia administration. In studies measuring appropriate LOS, patients who arrived hypothermic in the PACU had longer stays than those who arrived normothermic.

* THE AIMS OF THIS STUDY were to deter-mine whether the actual and appropriate LOS in the PACU differs between hypothermic and normothermic patients and to identify differences between subgroups of patients according to age, gender, and type of anesthesia administered.

Authors: Murphy EK.
Title: Judicial recognition of nursing as a unique profession.
Source: AORN Journal. 80(5):924-7, 2004 Nov.

Authors: Epps CD.
Title: Length of stay, discharge disposition, and hospital charge predictors.
Source: AORN Journal. 79(5):975-6, 979-81, 984-97, 2004 May.
Abstract
THIS STUDY EXPLORED the effect of patient, clinical, and treatment factors on length of stay (LOS), discharge disposition, and total acute care hospital charges for older adults undergoing elective total hip arthroplasty or total knee arthroplasty. A CAUSATIVE RETROSPECTIVE DESIGN was used, and data analysis included descriptive statistics, multiple regression, and logistic regression. SIGNIFICANT DIFFERENCES in predictor variables (ie, age, gender, living arrangement, comorbidities, postoperative complications) were found between patients who were discharged to home and those who were discharged to another facility. Only postoperative complications contributed significantly to LOS. Total surgical time and postoperative complications contributed significantly to hospital charges.

Authors: Costa MJ.
Title: The lived perioperative experience of ambulatory surgery patients.
Source: AORN Journal. 74(6):874-81, 2001 Dec.
Abstract
Understanding patients' perspectives is central to providing appropriate nursing care. The purpose of this study was to explore ambulatory surgery patients' perceptions and views of the perioperative experience. A phenomenological study was conducted that included 16 patients who underwent abdominal surgical procedures in the ambulatory surgery center of a large teaching hospital in the northeastern United States. Intensive semistructured interviews were used to collect data. Patients were interviewed one week after surgery. Data analysis was aimed at gaining understanding of the lived experience of ambulatory surgery patients. Themes identified included fear, knowing, and presence. Results indicate that patients in this study were not prepared adequately for the perioperative experience, suffered needlessly due to inadequate pain management, and did not achieve discharge readiness.

Authors: Hohler SE.
Title: Minimally invasive total hip arthroplasty. [Review] [18 refs]
Source: AORN Journal. 79(6):1243-58; quiz 1259-62, 2004 Jun.
Abstract
Total hip arthroplasty procedures relieve patients' arthritic hip pain. Since the first procedure was performed in the 1960s, surgeons and implant companies have worked to improve prosthesis design, composition of implants, and the mechanisms for holding the implants in place. Recently, surgeons have focused on minimizing the surgical incision. Smaller incisions have resulted in smaller scars and faster recoveries. This article presents a brief historical overview of, as well as current trends in, minimally invasive total hip arthroplasty. All aspects of care for a patient undergoing total hip arthroplasty are discussed. [References: 18]

Authors: Killen AR.
Title: Morality in perioperative nurses.
Source: AORN Journal. 75(3):532-3, 537-41, 545-6 passim, 2002 Mar.
Abstract
This study examined nurses' moral motivation, character, and action using a Model of Morality for Perioperative Nurses. Influences on moral actions and selected outcomes for surgical patients and perioperative nurses were examined. Results indicate that motivation and character are related directly to the moral actions of perioperative nurses (R = .13 to .31, P < .001). Fourteen percent of the variance in action was explained by motivation, character, self-perceived level of practice, and ethics education. Results suggest that current models do not describe the moral behavior of perioperative nurses adequately. Future research should examine constructs that explain the moral actions of nurses in the perioperative setting.

Author: Letvak S.
Title: Myths and realities of ageism and nursing.
Source: AORN Journal. 2002 Jun; 75(6): 1101-4, 1106-7. (40 ref)
Abstract
Ageism is pervasive throughout society, and it is an especially important issue for nurses because the nursing workforce is aging rapidly. This article explores ageism as it applies to women and nurses, along with the myths and realities about this prevalent attitude. It also presents strategies for managing and educating the aging nursing workforce.

Authors: Hommelstad J. Ruland CM.
Title: Norwegian nurses' perceived barriers and facilitators to research use.
Source: AORN Journal. 79(3):621-34, 2004 Mar.
Abstract
A descriptive study was conducted to examine perioperative nurses' perceptions of barriers and facilitators to the use of research findings in nursing practice. The study's findings indicate that the most important barriers are research literature not being compiled in one place, lack of time to read research articles and to implement research findings, uncooperative physicians, insufficient resources, and lack of access to information. The nurses had a positive attitude toward research, but they lacked the competence to assess research findings. Study days, education programs, and research nurses in clinical practice are recommended to remove these obstacles.

Authors: Letvak S.
Title: Nurses as working women.
Source: AORN Journal. 73(3):675-8, 680-2, 2001 Mar.
Abstract
Women today make up nearly half of the nation's workforce. A number of these women have children at home, and women also often are responsible for providing care to older adult family members or friends. The different roles assigned to women in today's society are burdensome, particularly for nurses who deal with the stress of managed care, downsizing, the nursing shortage, caring for increasingly ill patients, long and irregular hours, and daily crises. There are ways that nurses can modify their work situation, however, to help them cope with the rigors of the workplace and the home.

Title: Older adults prefer choosing physicians to saving money.
Source: AORN Journal. 2005 Sep; 82(3): 496.

Author: Dorin AF.
Title: Opinion. Working together to ensure quality patient care.
Source: AORN Journal. 2004 Jan; 79(1): 17-8. (1 ref)

Author: Todd S. Corsnitz D. Ray S. Nassar J.
Title: Outpatient laparoscopic Nissen fundoplication.
Source: AORN Journal. 2002 May; 75(5): 955-6, 959, 961 passim. (9 ref)
Abstract
Gastroesophageal reflux disease affects more than 40% of Americans, causing heartburn and reflux of gastric contents into the esophagus when bending or lying down. Lifestyle modification, such as weight loss and a diet rich in protein and low in fat and glucose, should increase the patient's resting lower esophageal sphincter pressure. Avoiding exacerbating substances, such as mint, chocolate, alcohol, and tobacco, also may reduce symptoms. Medications may be prescribed to reduce persistent symptoms, although no medication currently available cures the disease process. Patients who need antireflux medication regularly for four to six weeks or more may be candidates for laparoscopic Nissen fundoplication. Patients who do not want to take antireflux medication for the rest of their lives, cannot afford the medication for an extended period of time, or suffer significant side effects from the medication also are candidates. This article describes performing Nissen fundoplication laparoscopically on an outpatient basis. The average length of hospital stay has been decreased to two to three hours when performed laparoscopically on an outpatient basis from 10 days for the open procedure and two to three days when performed laparoscopically on an inpatient basis. The incidence of recurrent heartburn is less than 2% when the procedure is performed laparoscopically and does not appear to be clinically significant.

Authors: Boyle HJ.
Title: Patient advocacy in the perioperative setting.
Source: AORN Journal. 82(2):250-62, 2005 Aug.
Abstract
A descriptive study was undertaken to define patient advocacy and perioperative nurses' role as advocates and to investigate perioperative nurses' perceptions of behaviors that represent advocacy in the perioperative setting. A purposive sample of 163 perioperative RNs from upstate New York was invited to participate in the study. A total of 57 responses were returned, and 33 individuals participated in audiotaped interviews. The four overarching themes that emerged from the interviews include protection, communication/giving voice, doing, and comfort and caring. These interrelated, overlapping themes represent nurses' definition, role, and experiences of patient advocacy in the perioperative setting.

Author: Bailes BK.
Title: Perioperative care of the elderly surgical patient.
Source: AORN Journal. 2000 Aug; 72(2): 185-96, 198, 200 passim. (45 ref)
Abstract
Elderly surgical patients undergo approximately 20% or more of all surgical procedures in acute care hospitals across the country. Elderly people also are more at risk for surgical intervention because of age-related system changes and comorbid conditions. In recent years, greater knowledge about aging and advanced surgical, anesthetic, and monitoring technology has made it possible for many elderly people to undergo surgery without significant mortality. This article is intended to increase the ability of perioperative nurses to anticipate, plan, and provide care for their elderly surgical patients.

Author: Madick S.
Title: Perioperative care of the patient with Zenker's diverticulum.
Source: AORN Journal. 2001 May; 73(5): 902, 904-13, 915-7 passim. (16 ref)
Abstract
There are a variety of surgical approaches to treat the symptomatic patient with a Zenker's diverticulum. Approaches to treat Zenker's diverticula include external excision (i.e., diverticulectomy) with or without myotomy; diverticulopexy, an endoscopic approach; or cricopharyngeal myotomy alone. This article discusses esophageal diverticula, treatment modalities, and the perioperative care of patients with Zenker's diverticula.

Authors: Newhouse RP. Johantgen M. Pronovost PJ. Johnson E.
Title: Perioperative nurses and patient outcomes--mortality, complications, and length of stay.
Source: AORN Journal. 81(3):508-9, 513-22, 525-8, 2005 Mar.
Abstract
THE PURPOSE OF THE STUDY described in this article was to identify the relationship between RN staffing factors in the OR and surgical patient outcomes. THE STUDY ADDRESSED two main questions: whether the level of RN staffing in the OR is related to postoperative complications, mortality, and length of stay (LOS) and whether certification, RN agency use, 24-hour staffing, and the performance of multidisciplinary code drills are related to complications, mortality, and LOS. ACCORDING TO THIS STUDY, selected organizational factors in ORs had a significant influence on patient outcomes.

Author: Miller J. Ingram L.
Title: Perioperative nursing and animal-assisted therapy.
Source: AORN Journal. 2000 Sep; 72(3): 477-9, 481-3. (7 ref)
Abstract
Interacting with animals has been shown to reduce blood pressure and cholesterol, decrease anxiety, and improve a person's sense of well being. Animal-assisted therapy (AAT) can be incorporated into the care of perioperative patients. Some of the goals that can be met by using trained and certified therapy animals are reducing stress preoperatively, motivating patients to have a positive attitude, promoting postoperative activity, and reducing the need for pain medication. Infection control, immunosuppressed patients, and research are issues regarding AAT in the hospital setting that must be covered by policy and procedure. Suggestions for setting up an AAT program are discussed.

Author: Shelswell NL.
Title: Perioperative patient education for retinal surgery.
Source: AORN Journal. 2002 Apr; 75(4): 801-7. (11 ref)
Abstract
Anticipation of retinal surgery and fear of permanent vision loss can be stressful for patients. When patients first are diagnosed with retinal problems and informed that ocular surgery is required, they may not be psychologically or emotionally ready to absorb the information needed to prepare them for the postoperative recovery phase. Perioperative nurses have an opportunity to affect patient outcomes by providing information to patients before, during, and after surgery. Well-educated patients have the necessary knowledge to maximize compliance and afford themselves an optimal surgical outcome.

Authors: Fox VJ. Schira M. Wadlund D.
Title: The pioneer spirit in perioperative advanced practice--two practice examples.
Source: AORN Journal. 72(2):241-53, 2000 Aug.
Abstract
Perioperative nurses have options in advanced practice instead of leaving the acute care setting. One of the newest advanced practice roles is the acute care nurse practitioner (ACNP). This role may be ideal for perioperative nurses who want to remain in perioperative practice and grow clinically by pursuing advanced practice. This article presents two collaborative practice examples for the ACNP in the perioperative setting. The authors describe new frontiers in advanced perioperative practice and analyze the emerging advanced practice role of the ACNP. This challenging and exciting role is well suited to perioperative practice in a general and trauma surgery practice. The academic preparation, certification, and credentialing necessary to practice as an ACNP are explained.

Title: Postoperative cognitive decline seen in older adults.
Source: AORN Journal. 2005 May; 81(5): 1086.

Authors: Kiernan PD. Graling PR. Hetrick VL. Vaughan BE. Sheridan MJ. Lee JK.
Title: A pragmatic and successful approach to treating nonsmall-cell lung carcinoma. [Review] [33 refs]
Source: AORN Journal. 80(5):840-57; quiz 859-62, 2004 Nov.
Abstract
Lung cancer is the single leading cause of cancer deaths for men and women combined. Nonsmall-cell lung carcinoma (NSCLC), which results largely from smoking tobacco, accounts for 87% of all lung cancer cases. Methods of patient selection, preoperative and intraoperative care, and postoperative outcomes for patients with NSCLC who were treated from 1991 through 2003 at Inova Fairfax Hospital are discussed. All patients were treated with surgery, some selectively and progressively with a combination of preoperative neoadjuvant therapy, to try to downstage the disease to make complete resection feasible. Outcomes from this data collection period match or exceed the best results for treatment of late-stage (ie, III and IV) disease reported anywhere to date. [References: 33]

Author: Segal CG. Anderson JJ.
Title: Preoperative skin preparation of cardiac patients.
Source: AORN Journal. 2002 Nov; 76(5): 821-8. (35 ref)
Abstract
Nurses at a large southwestern hospital undertook an initiative to optimize the preoperative skin preparation of patients undergoing open heart surgery. After an extensive review of the literature, a proposal was submitted to and accepted by the surgeons and internal review board of the hospital. High-risk patients were identified before surgery and randomized into groups to receive one of four different skin preps. The incidence of infection was lower in the two groups of patients who were prepped with insoluble iodine, indicating that the type of surgical skin prep could affect whether patients develop surgical site infections. The clinical practice of skin preparation in this hospital changed based on the results.

Author: Hammarsten R. Hammarsten J. Jemsby P.
Title: Preoperative skin testing of materials used in surgical procedures.
Source: AORN Journal. 2003 Apr; 77(4): 762, 764, 766 passim. (15 ref)
Abstract
Postoperative skin complications increase health care costs and cause patient suffering. In the OR, patients are exposed to materials with adhesive substances that have the potential to cause allergic or toxic effects on the skin. Intraoperatively and postoperatively, these reactions can result in skin complications. The objective of this study was to investigate the incidence of skin reactions in connection with the application of different materials. Skin reactions after preoperative skin testing occurred in 3% to 50% of patients with atopic or contact eczema, allergy, or asthma in their medical history.

Authors: Bernier MJ. Sanares DC. Owen SV. Newhouse PL.
Title: Preoperative teaching received and valued in a day surgery setting.
Source: AORN Journal. 77(3):563-72, 575-8, 581-2, 2003 Mar.
Abstract
This study examined the congruence between the preoperative teaching received and valued by patients undergoing same day surgery. A convenience sample of 116 patients was interviewed using the 26-item preoperative teaching interview guide, which explores five dimensions of preoperative information, including situational/procedural information, sensation/discomfort information, patient role information, psychosocial support, and skills training. The correlation between preoperative teaching received and valued was r = 0.34, P < or = .01. Significant relationships were observed between income level and preference for situational/procedural information and between gender and preference for psychosocial support information. The findings are being used to frame a program of research in perioperative nursing and to restructure preoperative teaching in one facility.

Author: Watson DS.
Title: President's message. The perfect storm.
Source: AORN Journal. 2002 Jun; 75(6): 1068, 1070-1. (7 ref)

Authors: Beyea SC.
Title: Preventing fires in the OR.
Source: AORN Journal. 78(4):664-6, 2003 Oct.

Author: King CA.
Title: Research reviews.
Source: AORN Journal. 2002 Jun; 75(6): 1183-4.

Author: Calvin RL.
Title: Research reviews. Commentary on Patient satisfaction with an outpatient endoscopic service.
Source: AORN Journal. 2000 Apr; 71(4): 901.

Author: Pease G. Ruschak A. Mathis MG. Wellman D.
Title: Reviews. Access device guidelines; employee retention; pain relief for older adults; starter kit for new managers.
Source: AORN Journal. 2005 Sep; 82(3): 493-4, 496.

Author: Mandell DL. Claypool ML. Kay DJ.
Title: Superstitions among perioperative nurses.
Source: AORN Journal. 2005 May; 81(5): 971-2, 974, 977-80 passim. (11 ref)
Abstract
A DESCRIPTIVE STUDY was conducted using a mailed questionnaire to determine the prevalence of work-related superstitions among perioperative nurses.

DATA ANALYSIS included the two-sample t test for continuous data and the two-sided Fisher's exact test for binary data.

STUDY RESULTS indicate that although only 23% of respondents view themselves as "generally superstitious," specific work-related superstitions are widespread. Belief in specific superstitions was not statistically related to age or number of years as a perioperative nurse.

AN ANALYSIS of the literature on medical workplace superstitions helps to elucidate possible underlying explanations for the phenomenon of nursing superstitions.

Authors: Brown C.
Title: Surgical treatment of trigeminal neuralgia. [Review] [9 refs]
Source: AORN Journal. 78(5):744-58; quiz 759-62, 2003 Nov.
Abstract
TRIGEMINAL NEURALGIA, which is unilateral electric shock or knifelike pain occurring in one or more branches of the trigeminal nerve, is evoked by stimulation of the face, lips, or gums caused by activities such as shaving, brushing the teeth, or moving trigger zones. IT GENERALLY IS ACCEPTED that classic trigeminal neuralgia is a consequence of vascular compression and demyelination of the trigeminal nerve. Although medical therapy is available, it gradually becomes less effective because of the progressive nature of trigeminal neuralgia. MICROVASCULAR DECOMPRESSION of the trigeminal nerve to treat trigeminal neuralgia is discussed in this article. Perioperative care, expected course of recovery, and potential complications are described. [References: 9]

Authors: Hammarsten R. Hildingh C.
Title: Swedish patients' perceptions of a preoperative skin test.
Source: AORN Journal. 81(3):531-8, 541-6, 549-52, 2005 Mar.
Abstract
PREOPERATIVE PREPARATION is an important aspect of creating a safe and pleasant hospital experience for surgical patients. Evaluating patient satisfaction, however, also depends on determining patients' perceptions of the care they receive. THIS STUDY used a descriptive, qualitative method with a phenomenographic approach to determine how patients perceived undergoing a preoperative skin test that was developed to ascertain what substances might result in intraoperative reactions in patients with allergies, asthma, or eczema. OVERALL, the patients had positive perceptions of the skin test; however, the results indicate a need for improved and individualized preoperative instruction that focuses on patients from a holistic perspective.

Authors: Beyea SC.
Title: Systems that reduce the potential for patient identification errors.
Source: AORN Journal. 76(3):504-6, 2002 Sep.

Authors: Heckman R.
Title: Ultrasound use in cardiothoracic surgery. [Review] [15 refs]
Source: AORN Journal. 73(1):144-65; quiz 167-72, 2001 Jan.
Abstract
With the advent of minimally invasive surgical techniques, patients in the United States currently are undergoing safer, more comfortable surgical procedures than in the past. Traditionally, saphenous vein harvesting techniques involved open surgical techniques that could become sources of postoperative complications, including pain, poor wound healing, increased length of hospital stay, and higher costs for the patient and hospital. These complications were the impetus for developing minimally invasive techniques for vein harvesting. Minimally invasive saphenous vein harvesting is performed through small incisions and subcutaneous tunnels. The procedure offers an atraumatic conduit for the coronary artery bypass procedure and decreases the number of leg wound complications. Ultrasound devices currently offer a quick, accurate method for locating veins before harvest, thereby avoiding wound complications and injuries. [References: 15]

Authors: Haynes LC. Martin JH. Endres D.
Title: Use of nontraditional therapies--implications for older adults.
Source: AORN Journal. 77(5):913-7, 920-2, 2003 May.
Abstract
Using nontraditional therapies to replace traditional medical treatment is becoming more popular in the United States. Nurses in the twenty-first century are faced with the challenge of broadening their view of health care and discovering the benefits of nontraditional, often ancient, health care principles and practices. Health care professionals and patients need to understand, however, that although a nontraditional therapy may be natural or noninvasive, it is not necessarily safe and without consequences. This article discusses the increased use of nontraditional therapies among older adults with a focus on the use and perioperative implications of botanical, herbal, and nutritional supplements.

Authors: Domanovic MA. Ouzidane M. Ellis RJ. Kinsella TJ. Beddar AS.
Title: Using intraoperative radiation therapy--a case study.
Source: AORN Journal. 77(2):412-7, 2003 Feb.
Abstract
The introduction of a mobile linear accelerator in the OR has made intraoperative radiation therapy (IORT) more plausible. An IORT treatment can deliver a single high dose of radiation to a tumor or tumor bed after surgical resection or surgical exposure of high risk areas. This article details a case study in which IORT was used on a patient with sigmoid carcinoma and the procedure outcomes.

Authors: McRee LD. Noble S. Pasvogel A.
Title: Using massage and music therapy to improve postoperative outcomes.
Source: AORN Journal. 78(3):433-42, 445-7, 2003 Sep.
Abstract
An experimental pilot study was conducted to investigate the effects of preoperative massage and music therapy on patients' preoperative, intraoperative, and postoperative experiences. Participants were assigned randomly to one of four groups--a group that received massage with music therapy, a group that received massage only, a group that received music therapy only, or a control group. Hemodynamics, serum cortisol and prolactin levels, and anxiety were measured preoperatively and postoperatively. Postoperative anxiety levels were significantly lower and postoperative prolactin levels were significantly higher for all groups.

Authors: Chappy SL.
Title: Women's experience with breast biopsy.
Source: AORN Journal. 80(5):885-901, 2004 Nov.
Abstract
The purpose of this study was to obtain descriptions of the perioperative experiences of women who underwent breast biopsies with local anesthesia. Twenty-two participants were interviewed, and open-ended questions were used to allow the women to describe their experiences. Data analysis revealed three major themes--certitude, care, and justice. The women's most pervasive need was to have the biopsy results as soon as possible. They viewed the surgical phase of the biopsy as a stepping-stone to achieving certitude associated with having the pathology results. The surgical phase of the biopsy did not hold as much significance for the women as the researcher had anticipated.

Authors: Hastings DP. Kantor GK.
Title: Women's victimization history and surgical intervention. [Review] [44 refs]
Source: AORN Journal. 77(1):163-8, 170-1, 173-4 passim, 2003 Jan.
Abstract
Research suggests that women who are abused use health care services at higher rates than those who are not abused. Few studies have examined the association between women's history of victimization and surgical intervention. A secondary analysis of quantitative data obtained originally from primary care practice records of 110 women was conducted. The relationship between women's history of victimization and the likelihood that these women had undergone surgery was examined statistically. Findings reveal that women who had experienced childhood abuse, abuse as an adult by an intimate partner, or both underwent a significantly higher number of surgeries and more major surgeries than women with no history of abuse. Screening for victimization history is recommended in perioperative settings to facilitate appropriate intervention. [References: 44]