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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 mo