ABSTRACT

1. IN THE PAST, rudimentary devices were used to look closely into the chest; currently, advanced video technology, computers, and high-tech electronics are being used to perform many surgical procedures that formerly required a large, open incision.

2. THE GOAL of video-assisted thoracoscopic surgery (VATS) is the same as for comparable open procedures, but it is accomplished with less pain, less patient morbidity, and a shorter hospital stay.

3. IN ADDITION TO EVALUATING and treating thoracic injuries, VATS has demonstrated effectiveness in detecting and managing many other conditions, such as pleural disease, interstitial lung disease, and thoracic malignancies. AORN J 85 (June 2007) 1199-1208. © AORN, Inc, 2007.

ABSTRACT

1. ATRIAL FIBRILLATION (AF) is the most common sustained disturbance of cardiac rhythm, affecting an estimated 2.3 million people in North America and 4.5 million people in the European Union.

2. ALTHOUGH AF IS ASSOCIATED with significant morbidity, mortality, and increased health care costs, more-precise and less-invasive surgical ablation procedures have been developed. Specific cardiac sites emitting the aberrant, premature electrical signals that induce AF are ablated, which results in excellent cure rates and allows normal sinus rhythm to resume.

3. THESE PROCEDURES can be performed with or without the use of cardiopulmonary bypass, through either traditional sternotomy or minimally invasive thoracotomy incisions. AORN J 86 (July 2007) 23-40. © AORN, Inc, 2007.

ABSTRACT

TRANSPOSITION OF THE GREAT ARTERIES is the most common congenital heart defect among the birth defects that present with cyanosis during the early neonatal period.

INFANTS WITH THIS CARDIAC BIRTH DEFECT, in which the aorta originates from the right ventricle and the pulmonary artery originates from the left ventricle, usually do not survive without surgical intervention in the first few days of life.

THE ARTERIAL SWITCH PROCEDURE, performed via a median sternotomy incision during cardiopulmonary bypass, restores the aorta and pulmonary artery to their normal anatomic positions. AORN J 86 (August 2007) 211-226. © AORN, Inc, 2007.

ABSTRACT

ARTHROSCOPIC SURGERY, a minimally invasive, outpatient procedure, is a valuable tool in the diagnosis and treatment of most disorders of the wrist. It offers direct visualization of the structures of the joint anatomy and existing disease processes while causing minimal damage to surrounding soft tissue.

OTHER BENEFITS of arthroscopic treatment compared to traditional open procedures include less postoperative pain, shorter recovery times, and fewer surgical complications. AORN J 86 (August 2007) 181-188. © AORN, Inc, 2007.

ABSTRACT

1. PATIENTS AND HEALTH CARE PROVIDERS alike struggle with alleviating postoperative pain. Patients with unrelieved pain are less likely to cough, breathe deeply, or move easily after surgery, which adversely affects their recovery.

2. INNOVATIONS IN TECHNOLOGY, such as continuous infusion of local anesthetics, have revolutionized postoperative pain management. Technological improvements in needles, catheter insertion techniques, and effortless drug delivery systems are facilitating prolonged analgesia with few adverse effects, increasing patient satisfaction, and expediting postoperative recovery. AORN J 85 (May 2007) 904-914. © AORN, Inc, 2007.

ABSTRACT

1. A CEREBRAL ANEURYSM is a weakening and saccular outpouching of a cerebral artery. This lifethreatening condition affects approximately 10 million to 15 million Americans annually.

2. PERIOPERATIVE NURSES must be aware of the incidence, clinical manifestations, pathophysiology, and treatments for cerebral aneurysm. This article details the perioperative care of patients undergoing craniotomy for surgical clipping or insertion of an endovascular coil.

3. ALTHOUGH ENDOVASCULAR COILING is a relatively new procedure with unknown long-term results, this treatment option offers patients a minimally invasive alternative to craniotomy with a shorter hospital stay and decreased recovery time. AORN J 85 (June 2007) 1172-1182. © AORN, Inc, 2007.

ABSTRACT

1. GUIDELINES FOR MANAGING multidrug-resistant organisms (MDROs) in health care settings were published by the Healthcare Infection Control Practices Advisory Committee (HICPAC) in October 2006.

2. THESE GUIDELINES OUTLINE appropriate strategies to help prevent MDRO cross transmission. Perioperative nurses should be prepared to implement these strategies in an effort to protect their surgical patients from contracting MDRO infections.

3. THE HICPAC RECOMMENDS elevating contact precautions to “intensified interventions” in facilities with endemic outbreaks of MDROs. Perioperative nurses should participate in these efforts by adhering to infection control practices, championing these practices with other health care personnel, and providing clinical support and leadership.

ABSTRACT

1. SLIPS, TRIPS, AND FALLS (STFs)account for about 20% of lost-time injuries for health care personnel. Although the effect that OR layout and equipment choices have on STF risk has not been specifically addressed in the literature, STFs in the perioperative suite are of particular concern because of their potential to cause adverse patient consequences.

2. INCREASED RENOVATION of ORs to include equipment for minimally invasive procedures intensifies the importance of examining best practices in OR layout and equipment choices to reduce the potential for STFs.

ABSTRACT

1. FLASH STERILIZATION was developed for use in the OR for emergent need and immediate use of an instrument that was dropped on the floor, forgotten, or unanticipated.

2. ISSUES AND CONCERNS regarding flash sterilization practice run the gamut from overuse to misuse to increased risk for infection transmission to increased costs for the health care facility.

3. SERIOUS CONSEQUENCES of surgical infection and national demands for patient safety highlight the need for added vigilance in the practices of flash sterilization. Today, state of the art products and equipment can help address some of the challenges historically associated with the flash sterilization process. AORN J 86 (July 2007) 58-68. © AORN, Inc, 2007.

ABSTRACT

EVIDENCE-BASED NURSING PRACTICE incorporates the best research available with clinical expertise. It can be difficult, however, for nurses to integrate use of evidence into their everyday work.

THIS ARTICLE PROVIDES an example of using research findings to implement best nursing practice for patients at risk for venous thromboembolism (VTE). Remaining current on methods to prevent and treat VTE is essential for nurses throughout the hospital but is especially important in the perioperative environment.

NURSES CAN USE THIS EXAMPLE as a basis for establishing evidence-based practice in other patient care situations.