Dissertations / Theses: 'Operating Room and Surgical Nursing'

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Eakin, Sherri. "Operating room nurses and surgical technologists perceptions of job satisfaction in the operating room environment." Thesis, University of Phoenix, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10024192.

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The predicted future operating room nurse and surgical technologist shortages may have significant implications for the healthcare industry. Improving the job satisfaction of operating room personnel could promote retention and provide adequate staffing in operating rooms. The job satisfaction of operating room nurses and surgical technologists can result in positive or negative work environments. The purpose of the qualitative phenomenological study was to explore the perceptions of job satisfaction of operating room nurses and surgical technologists to discover how job satisfaction influences the intent to leave or remain in the work environment of the operating room. A purposive selection was made of 12 registered nurses and 12 surgical technologists who had varying degrees of experience in the healthcare field, and were working part time or full time in the operating room of a pediatric medical center in North, Texas. Interviews were audio-recorded and the seven steps were used from Moustakas van Kaam analysis to reveal themes and patterns from the research data. Six themes emerged from the research study that included teamwork, recognition from surgeon, working with pediatric patients and their families, staff appreciation, work environment, and executive leadership. Based on the findings, further research is needed to ascertain strategies that would improve operating room registered nurses and surgical technologists’ job satisfaction and retention.

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Opadotun, Olukemi. "Infection control practices for the prevention of surgical site infections in the operating room." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1017195.

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Infections are a major cause of morbidity and mortality during the post-operative phase of patients’ recovery. Wound infections are the second most commonly encountered type of nosocomial infection. Because wound infections can be introduced by not applying infection control measures and sterile technique principles in the operating room, the implementation of infection control principles is an imperative. The aim of this study was to explore and describe infection control practices related to the prevention of Surgical site infections in the operating rooms in a public health care sector in the Nelson Mandela Bay Municipality. The findings were compared with practices, as indicated in an evidence-based guideline. The research design was quantitative, explorative, descriptive, comparative-descriptive and contextual in nature. The research sample consisted of all the professional nurses, in the operating room. The data were collected by means of a self-administered questionnaire. Descriptive statistics was used to present the data in the form of tables and graphs. Based on the analysis of the data, some recommendations were made for the implementation of infection control practices, in order to prevent Surgical site infections in the operating room.

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Hilton, George Leslie. "SENSORY REGRESSION TIME FROM SUBARACHNOID BLOCK WITH HYPERBARIC 0.75% BUPIVACAINE IN THE OBESE PATIENT." VCU Scholars Compass, 1989. http://scholarscompass.vcu.edu/etd/5067.

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The purpose of this study was to determine if obese patients have a different sensory regression time from subarachnoid block than non-obese patients using hyperbaric 0.75% bupivacaine. A quasi-experimental design was used. Twenty patients were separated into two groups; one group was classified as obese, and the other group was classified as non-obese. The data consisting of age, height, weight, sex, and surgical procedure were recorded preoperatively. All the patients received hyperbaric 0.75% bupivacaine via subarachnoid puncture. The levels of spinal anesthesia were recorded at the highest level achieved. The injection time was also recorded. When the surgery was completed, the patient was transferred to the recovery room and levels of sensory blockade were checked by pin-prick with an 18-gauge needle every 10 minutes until complete recovery from the spinal anesthesia had been achieved. The hypothesis, there will be no difference in sensory regression time from SAB with hyperbaric 0.75% bupivacaine between obese and non-obese patients, failed to be rejected. No statistically significant difference, using linear regression analysis, was found in mean regression time between groups (obese versus non-obese).

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Hudalla, Christa Choate. "The Effect of Tourniquet Application On Systemic Coagulation." VCU Scholars Compass, 1992. http://scholarscompass.vcu.edu/etd/5073.

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Seven orthopedic surgery patients requiring the use of a tourniquet were studied. The hypothesis stated that tourniquet application does not affect coagulation. A total of 5 blood samples were drawn perioperatively (preoperative, 5 minutes after induction of anesthesia, 30 minutes after tourniquet inflation, 2 - 5 minutes after tourniquet deflation, and 30 minutes after tourniquet deflation. For each sample, TEG parameters (R, R + k, MA and α) were measured. The value for each TEG parameter was compared by analysis of variance (ANOVA), then the samples were contrasted and examined by repeated measures ANOVA. None of the TEG parameters showed a statistically significant difference in the blood samples before, during or after tourniquet application. The hypothesis could not be rejected at the α = .05 level of significance. A t test was used to examine the effect of anesthesia on coagulation. The TEG parameters indicated a significant relationship between the TEG values R and R + k, and a near significant relationship between TEG values MA and a and the administration of anesthesia. It was concluded that tourniquet use does not effect coagulation when applied 2 hours or less. However, anesthesia had a significant effect on TEG parameters R and R + k. The clinical significance of this effect was questionable since the type of anesthesia varied in some patients, and none of the patients in the study demonstrated symptoms of coagulopathy.

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Gosse, C. Suzanne. "Critical thinking skills : a comparative analysis of experienced operating room and medical-surgical registered nurses." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/958783.

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Critical thinking skills have emerged as a vital tool for the professional nurse confronting an explosion of technology and compressed plans of treatment. The purpose of this research was to compare the critical thinking skills of experienced registered nurses from two practice settings: the operating room and general medical-surgical floors. Critical thinking was defined as a "composite of attitudes, knowledge, and skills" (Watson-Glaser, 1980, p. 1).The research of Benner (1984) provided the foundation for this research. Benner documented the development of knowledge and skill in nursing practice. Nurses at the proficient and expert stages of development were the focus of this research.A non-random, convenience sample containing fifty one nurses was drawn from two Midwestern hospitals. Demographic data was gathered to further describe the sample. Participation in the study was voluntary and anonymity of subjects was assured.The Watson-Glaser Critical Thinking Appraisal (WGCTA) (1980) was the instrument utilized to measure the critical thinking skills of the experienced nurses. This tool has established validity and reliability and is considered a benchmark for measuring critical thinking ability.Analysis of the WGCTA (1980), results revealed a mean of 54.29, SD 9.66 for the total group of experienced registered nurses (N=5 1). For the operating room nurses (n=28) a mean of 52.71 with a SD of 9.41 was obtained. Among the medical-surgical nurses (n=23), the mean score was 56.21 with a SD of 9.81. T-test and MANOVA analysis was carried out. No significant statistical differences were found between the means in either the total scores of the WGCTA or on the five sub-tests for the two groups. The data submitted for analysis reflected a very experienced group (51 % with > 15 years nursing experience) and predominate Associate and Diploma preparation (61 %). Norming information available for the WGCTA indicated the scores obtained in this research were comparable to much larger samples drawn from nursing students and police officers.A conclusion of this research is that critical thinking, as measured by the WGCTA (1980), develops uniformly across diverse practice areas. An examination of the usefulness of the WGCTA to accurately measure the process of critical thinking in experienced nurses is recommended. More research into the important issues of critical thinking and experienced nursing practice is recommended.
School of Nursing

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Bull, Rosalind Margaret. "Theatre wear must be worn beyond this point : a hermeneutic ethnographic exploration of operating room nursing." Title page, table of contents and abstract only, 2002. http://web4.library.adelaide.edu.au/theses/09PH/09phb9355.pdf.

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Paterson, Robyn A. "Preoperative predictors of postoperative pain." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1993. https://ro.ecu.edu.au/theses/1142.

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The purpose of this study was to investigate five factors, which have been identified in the literature as having influence on the experience of postoperative pain. (1) Patient satisfaction with preoperative information, (2) Anticipated postoperative pain, (3) General self-efficacy, (4) Age, (5) Gender. These variables were examined to determine their relationship, if any with postoperative pain. Any relationship between these variables was also examined. Review of the literature revealed considerable research on pain, and that much of that research has been directed at the treatment of, rather than prediction of postoperative pain. Also, these studies have focused on patients who are receiving analgesia via traditional methods. No work has been reported on preoperative estimation of postoperative pain on those patients using Patient Controlled Analgesia as a single method of pain control. For this reason the study group consisted of patients who have undergone abdominal surgery, and have used the Patient Controlled Method of postoperative pain control. One Independent variable, self-efficacy, was shown to be significantly correlated to postoperative pain scores and to contribute to the preoperative prediction of how much postoperative pain an Individual may experience. Weak but significant correlations were also noted between satisfaction with preoperative Information, age and expectation of postoperative pain. The results also demonstrated a significant lack of specific preoperative information of pain and pain control methods amongst the subjects. There were large inconsistencies noted between how much pain subjects experienced and how much pain they had expected to experience. The results are of particular importance to nurses as they affect the nature of preoperative teaching, patient assessment and the provision of effective postoperative pain control, all of which are significant nursing responsibilities.

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Cosgrove, Marianne S. "PERCEIVED IMPACT OF AMBIENT OPERATING ROOM NOISE BY CERTIFIED REGISTERED NURSE ANESTHETISTS." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5963.

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It is widely acknowledged that elevated levels of noise are commonplace in the healthcare environment, particularly in high acuity areas such as the operating room (OR). Excessive ambient noise may pose a threat to patient safety by adversely impacting provider performance and interfering with communication among perioperative care team members. With respect to the certified registered nurse anesthetist (CRNA), increased ambient OR noise may engender distractibility, diminish situation awareness and cause untoward health effects, thereby increasing the possibility for the occurrence of error and patient injury. This research project analytically examines the perceived impact of ambient noise in the operating room by CRNAs. Findings from this study reveal that CRNAs perceive elevated noise to be regularly present in the OR, specifically during the critical emergence phase of the anesthetic. However, CRNAs feel that increased noise only occasionally limits their ability to perform procedures, concentrate and communicate with the perioperative team. OR noise rarely interferes with memory retrieval. CRNAs perceive that noise is sometimes a threat to patient safety but infrequently engenders adverse patient outcomes. CRNAs do not perceive noise in the OR to be detrimental to their health but strongly agree that excessive noise can and should be controlled. Increased ambient OR noise is a veritable reality that may pose a potential threat to patient safety. Further research to identify elevations in noise during critical phases of the anesthetic and delineation of significant contributors to its genesis is warranted.

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Berry, Judith. "Pressure ulcer prevention in the perioperative environment." Title page, table of contents and overview only, 2004. http://hdl.handle.net/2440/37709.

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There are many terms used to describe pressure ulcers: pressure sores, decubitus ulcers, bedsores, and pressure necrosis or ischaemic ulcers. Essentially they all describe damage to the patient's skin and underlying tissue. The nursing literature abounds with information about the risk, grading, prevention and treatment of pressure ulcers. These ulcers are a problem in hospital and long term care facilities, and are a major cause of morbidity. In the hospital setting they contribute to an extended length of stay and by doing so 'block' the bed for use by another patient. The ulcers are difficult to treat, are an ongoing cause for pain and discomfort for the patient and can be a strain on hospital finances. Pressure ulcers are not unique to modern times, as they have been discovered on the remains of an Egyptian mummified body (Armstrong & Bortz 2001). This would suggest that the problem dates back to the Pharoahs, and has continued to be a challenging problem throughout the centuries (Bridel 1992). The escalating costs of treating these ulcers today, has brought about an emphasis on the risk factors, prevention and the appropriate interventions, rather than an acceptance of these ulcers as a tolerable ondition (Bridel 1992). In the operating room, nurses are faced with unique challenges when caring for their patients. This is due to difficulty in caring for patients under the influence of the anaesthesia required for surgery, long periods of forced immobility and the inability of the patient to perceive pain and discomfort from the pressure of the hard surface of the operating room table. These problems are increased by nurses' inability to gain access to the patient because of the sterile drapes required to cover the patient for surgery. Armstrong and Bortz (2001) present information from one study in which it is stated that surgical patients have 90% greater chance of developing pressure ulcers than medical patients. One reason for this may be due to the limited information available in regard to the most effective support surface to place on top of the operating room table. This gap in information is problematic for operating room nurses as it limits their ability to select the most effective item of equipment, and determine if the chosen equipment reduces pressure on tissue intra- operatively. The most effective operating room table mattress used and the skills and knowledge of the operating room nurse about the aetiology and prevention of pressure ulcer prevention, are important aspects of nursing care and can influence patient outcomes. The potential for complications to occur may be dependent on single or combined factors such as the patient's age, disease processes, nutritional status and mobility. Preparatory and supportive nursing interventions for surgical procedures based on best available evidence, nursing experience and patient preference, can reduce the incidence of pressure ulcer development in the perioperative environment. This doctoral portfolio contains four separate sections related and linked together by a common theme - pressure ulcer prevention in the perioperative environment. This first section of the portfolio situates the topic and provides a brief overview of the portfolio. The second section is a critical review of the literature pertaining to the most commonly used operating room table mattresses, and the effectiveness of these mattresses in the prevention of pressure ulcer development. This review highlighted a lack of quality research in this area, and while many evaluations have been undertaken to determine the effectiveness of perating room table mattresses, the results are contradictory concerning the patients, exposures and interventions. Because of issues related to the methodological quality of published research in this area a systematic review using meta- analysis was not possible rather a critical review of the research literature is used. The third section of the portfolio reports on a hermeneutic ethnography of the perceived skills and knowledge of nurses in the prevention of pressure ulcer development in the perioperative environment. This study was designed to determine if pressure ulcer prevention forms an aspect of the everyday practice of perioperative nurses. This review has highlighted the need for operating room nurses to review practices when caring for patients in the perioperative environment particularly in respect of pressure ulcer prevention. The fourth and final section of the portfolio summarises the research and provides recommendations for nursing practice and further research in the area of pressure ulcer prevention in the perioperative environment.
Thesis (D.Nurs.)--Department of Clinical Nursing, 2004.

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Forren, Jan Odom. "POST DISCHARGE NAUSEA AND VOMITING IN AMBULATORY SURGICAL PATIENTS: INCIDENCE AND MANAGEMENT STRATEGIES." Lexington, Ky. : [University of Kentucky Libraries], 2009. http://hdl.handle.net/10225/1141.

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Thesis (Ph. D.)--University of Kentucky, 2009.
Title from document title page (viewed on May 12, 2010). Document formatted into pages; contains: vii, 166 p. : ill. Includes abstract and vita. Includes bibliographical references (p. 141-157).

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Mitchell, Lucy. "Development of a behavioural rating system for scrub nurses' non-technical skills." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=167786.

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In the first study, a literature review and semi-structured interviews with experienced scrub nurses (n=25) and consultant surgeons (n=9), identified ‘communication’, ‘teamwork’, ‘situation awareness’ and ‘coping with stress’ skills as important skills for scrub practitioners. The second study used focus groups (n=4 groups) of experienced scrub nurses (total n=16 participants) to sort and label the extracted non-technical skill data, from study 1, into skill categories and underlying elements. The focus groups also generated ‘behavioural markers’ describing good and poor performance of those elements. This preliminary taxonomy contained eight categories with 28 underlying elements. An expert panel, comprising two psychologists and a subject matter expert used an iterative process, with reference to the system design guidelines, to refine the taxonomy. The resulting prototype was called the Scrub Practitioners’ List of Intraoperative Non-Technical Skills (SPLINTS) system which had three skill categories – ‘Situation awareness’; ‘Communication and teamwork’; ‘Task management’, each of which had three underlying elements. The third study tested the psychometric properties of the prototype SPLINTS system. Scrub practitioners (n=34) attended a single-day evaluation session where they received training (5 hours) and practice (1 hour) using the SPLINTS system before rating the scrub practitioner’s behaviour seen in standardized surgical video scenarios (n=7) (1 hour). Within-group agreement was acceptable (r_wg >.7) for the three skill categories and for six of the nine elements. Future work will assess the usability of SPLINTS system in the operating theatre environment. This project has provided scrub practitioners with a structured method for training and assessing an important aspect of performance, which could help to reduce adverse events in the operating theatre.

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Ellis, Anna K., and L. Lee Glenn. "Challenges in Staging of Transient Pressure Ulcers Following Urologic Surgery." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7514.

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Austin, Erin, and L. Lee Glenn. "Online and Face-To-Face Orthopaedic Surgery Education Methods." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7497.

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Ramdas, Leonard Harichand. "Strategies to Prevent the Unintentional Retention of Foreign Objects in Surgical Patients." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1656.

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The Institute of Medicine's report in 2000, To Err Is Human: Building a Safer Health System, highlighted the seriousness of medical errors in the U.S. health care system. The unintentional retention of foreign objects in surgical patients is one of those errors. At the time of this study, there was no standardized counting policy and process across operating rooms in the United States. The purpose of this project was to develop a best practice educational counting program to help prevent the unintentional retention of foreign objects in surgical patients. The Logic Model was used to guide the design of the educational program and expected learning outcomes. A draft of the educational program was distributed to 10 perioperative stakeholders for an initial formative review. Changes were incorporated into the program and it was distributed to 6 perioperative experts for an additional summative assessment and content validation utilizing the AGREE II Instrument. The overall quality evaluation of the educational program was 85%, indicating that it was of high quality. Four of the respondents recommended the educational program for implementation without any changes and 2 recommended it for implementation with some minor modifications related to rewording of one question in the pretest-posttest. There were no recommended modifications in the content of the educational program. As a result, the project was recommended for adoption as a best practices-based educational program to prevent the unintentional retention of foreign objects in surgical patients. The study promotes positive social change by providing suggestions to improve the provision of safe care to surgical patients and decrease health care costs.

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Paqueo, Mariefel Casino. "Low Health Literacy and Preoperative Instruction Compliance Among Patients Undergoing Surgical Procedures." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4318.

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In addition to cancelations and delays of needed surgical procedures, serious or fatal complications can occur when patients with low health literacy do not comply with preoperative instructions. The purpose of this quality improvement project was to provide more insight about ways to decrease on cancelled and delayed surgical procedures in low health literacy patients' due to noncompliance with preoperative fasting instructions. The project was informed by the reach, effectiveness, adoption, implementation, and maintenance model (King, D. K., Glasgow, R. E., and Leeman-Castillo, B. (2010). The project question centered on whether health literate preoperative fasting instructions could decrease cancellations and delays of surgical procedures in low health literate patients. The project setting was conducted at a doctor's office. Interventions and changes to the preoperative instruction sheet were evaluated by using the preoperative communication checklist (POCC) which was developed for this project study. A 3-month pre-post POCC intervention design was used to evaluate changes in the numbers of cancelled and delayed surgical cases among 30 low health literate patients at a local community physician's office. The Newest Vital Sign which is a health literacy skill level assessment tool developed by Pfizer (2012), was used to assess patient health literacy. 30 (13 women and 17 men) who were aged 17-75 were enrolled. Pre-intervention, the and cancellation rate was 16.67%. Post intervention, there was a zero percent cancellation rate. This project has potential to produce positive social change by empowering patients with health literacy instructions for better understanding of what is being asked of them when having surgical procedures. This knowledge may result in better patient outcomes.

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Patterson, Michele M. Tervo. "Adolescent Experience with Trauma and Orthopedic External Fixation: A Dissertation." eScholarship@UMMS, 2007. https://escholarship.umassmed.edu/gsn_diss/7.

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Over 13 million adolescents sustain traumatic injuries yearly, resulting in functional disability, disfigurement, psychosocial problems and fractures. These fractures are increasingly being treated with orthopedic external fixation devices (EFDs). The purpose of this study was to describe the experience of traumatically injured adolescents treated with EFDs. The 4 aims of the study focused on the circumstances leading to the traumatic event, experiences following the traumatic event, the impact of EFD treatment, and adolescents’ role in pin-care self-management, which is crucial to preventing infection. This longitudinal, qualitative descriptive study used purposive sampling to recruit 5 male and 4 female adolescents, 13-20 years old, from a New England level-1 trauma center. Participants were injured in motor vehicle crashes (including an all-terrain vehicle), falls, by gunshot, trampoline and football trauma. Interview questions were framed by two themes from a study of adult recovery from physical injury, i.e., the event and fallout. Participants were interviewed within days of the injury, 2 weeks after returning home, and within one month of EFD removal. Data were coded from verbatim transcripts using NVIVO and organized into themes guided by the principles of qualitative analysis. An overarching theme of “old self no more; forever changed” emerged from 26 interviews. The participants’ experience affected all tasks of adolescence: independence from parents, accepting body image, peer relations, and forming an identity. Major themes included “what risk?”, regarding circumstances leading to the traumatic event, mastering the environment, was 2 part first, processing the event, where determining fault and realizing everything has changed, they were ambivalently lucky, and not invincible. Secondly “suck it up and deal with it”, where strategies to deal with traumatic injury emerged (i.e. medication, channeling outlets, and slow caution). EFD experience revealed “Space age robot” and “they’ll do it themselves” as emergent themes. EFDs were described as painless, robotic, no big deal and necessary. One draining pin-site was noted. Findings related to use of self-administered analgesics, information technology, recall of detail, and gender differences in coping may lead to future interventions. These findings lay the groundwork for future studies that may improve care of adolescents during acute recovery from traumatic injury.

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Yackzan, Susan G. "FACTORS INFLUENCING PREFERENCE FOR SURGICAL CHOICE AMONG WOMEN WITH EARLY STAGE BREAST CANCER." UKnowledge, 2017. https://uknowledge.uky.edu/nursing_etds/34.

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Breast cancer is the most common cancer among women in the United States with over 60% of cases diagnosed as early stage disease. For those women without prohibiting clinical or cosmetic concerns, a choice between breast-conserving surgery and mastectomy can be made. Either choice confers equivalent survival. The decision-making process also involves consideration of recurrence risk as well as management of the unaffected, contralateral breast for both future surveillance and risk reduction. In recent years, increasing rates of mastectomy with contralateral prophylactic mastectomy have been reported among women with unilateral, early stage breast cancer. If eligible for a choice among surgical options, a woman’s decision becomes one of personal preference. The decision-making process is complex and involves consideration of potential benefits and harms with each option. The purpose of this dissertation was to: 1) analyze the psychometric properties of the Anxiety Subscale of the Depression Anxiety Stress Scale, 2) critically review Decisional Conflict Scales and 3) prospectively identify demographic, clinical, cognitive and affective factors influencing a woman’s decision to choose either breast conserving surgery or mastectomy with contralateral prophylactic mastectomy and to identify self-reported sources of information in the surgical decision-making process. Three manuscripts make up the dissertation. A secondary data analysis was conducted to test the psychometric properties of the Anxiety Subscale of the Depression Anxiety Stress Scale (DASS). The results of this analysis supported the reliability and validity of the DASS anxiety subscale. A critical review of decisional conflict measures for use with early stage breast cancer patients making surgical treatment decisions was conducted. The results of this review supported the use of Decisional Conflict Scales from a clinical and research perspective. Existing Decisional Conflict Scales show moderate to acceptable reliability. The first two manuscripts provided background and support for the use of scales included in the research study described in the third manuscript. This study was a prospective, exploratory, cross-sectional, mixed-methods study describing factors influencing preference for surgical choice among women with early stage breast cancer. A sample of 78 participants enrolled in the study, 47 who chose breast conserving surgery and 31 who chose mastectomy with contralateral prophylactic mastectomy. Differences were tested between the groups. Women who chose mastectomy with contralateral prophylactic mastectomy were younger, more likely to work full or part-time, had larger tumors and participated in preoperative genetic counselling. Women who chose breast conserving surgery were more likely to have participated in preoperative breast magnetic resonance imaging. Overall, women choosing either surgery were not experiencing severe levels of distress, depression, anxiety or stress although there were individual variations. Women choosing mastectomy with contralateral prophylactic mastectomy were more anxious and had more frequent intrusive thoughts about the diagnosis. They also had less decisional conflict as compared to women choosing breast conserving surgery. Information sources were similar but the most influential information source differed among the two groups. In both groups, intention for surgical choice was matched by the final decision. There are many factors influencing surgical choice among women with early stage breast cancer. Previous work has focused on clinical, demographic and diagnostic processes influencing the decision. With this study, evidence regarding the influence of cognitive and affective factors is described.

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Vitori, Tracey. "PSYCHOLOGICAL DISTRESS AND CARDIAC DISEASE." UKnowledge, 2016. https://uknowledge.uky.edu/nursing_etds/26.

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The purpose of this dissertation was to evaluate the association of psychological distress with cardiac disease, events, and mortality. Specific aims were to: 1) to evaluate the association between hostility level and recurrence of acute coronary syndrome (ACS) and all-cause mortality in patients with coronary heart disease (CHD); 2) to evaluate the psychometric properties of the Brief Symptom Inventory (BSI) hostility and anxiety subscales in a group of incarcerated participants at high risk of cardiovascular disease; and 3) to evaluate the association of patient and caregiver psychological state with quality of life in both patient and caregiver, and postoperative complications after cardiac surgery. Specific aim one was addressed through a secondary analysis of data collected during the Patient Response to Myocardial Infarction following a Teaching Intervention Offered by Nurses trial to determine whether hostility was a predictor of ACS recurrence and mortality. Hostility was common after ACS and predicted all-cause mortality. Hostility did not predict recurrent ACS. Specific aim 2 was addressed in a secondary analysis of baseline data from a randomized controlled trial in male prisoners. Participants completed the BSI at baseline prior to the intervention. Internal consistency reliability was good for both subscales (Cronbach’s alpha - hostility 0.83, anxiety 0.81). Items from the two dimensions were analyzed together using exploratory factor analysis with varimax rotation. Two dimensions, anxiety and hostility, were identified. Construct validity was supported; those with high anxiety and hostility reported a greater number of days where their self-reported health was rated as fair or poor. Those prisoners with less perceived control had higher levels of anxiety and hostility. Specific aim 3 was addressed through a prospective, descriptive correlational study that measured patient and caregiver anxiety, hostility and depressive symptoms, at baseline to determine whether these predicted quality of life using a multilevel dyadic analysis; and to evaluate the association of baseline anxiety, hostility and depressive symptoms and quality of life with postoperative complications and mortality. Anxiety, hostility, and depressive symptoms were common in both cardiac patients and their caregiver. Psychological state influenced quality of life in both dyad members, but was not associated with complications.

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Camargo, Tamara Carolina de. "Avaliação da esterilização a vapor do instrumental laparoscópico montado: abordagem laboratorial." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-20092013-153759/.

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Esta pesquisa avaliou a segurança microbiológica da esterilização a vapor do instrumental laparoscópico reutilizável montado. Foram selecionados dois tipos de instrumental laparoscópico reutilizável: trocarte e pinça de dissecção de 5mm. Considerando a eficácia da limpeza como pré-requisito essencial para o processo de esterilização, a PRIMEIRA ETAPA da pesquisa, avaliou 66 instrumentos laparoscópicos, sendo 33 pinças e 33trocartes, submetidos a diferentes métodos de limpeza, avaliando como desfecho os resíduos orgânicos de proteína, hemoglobina e carboidrato, após contaminação intencional com sangue de placenta humana. Os métodos de limpeza testados foram: (1) limpeza manual com enxágue em água potável; (2) limpeza manual com enxágue em água potável, seguida de limpeza ultrassônica sem enxágue; (3) limpeza manual com enxágue em água potável, seguida de limpeza ultrassônica com enxágue em água potável e (4) limpeza manual com enxágue em água potável, seguida de limpeza ultrassônica com enxágue em água potável e último enxágue em água destilada esterilizada. Os experimentos foram acompanhados pelos grupos controle Positivo (sem limpeza) e Negativo, composto por instrumental laparoscópico novos sem contaminação intencional, avaliados após os procedimentos de limpeza (1) e (4). Para avaliação dos resíduos orgânicos, utilizou-se o kit Quantipro BCA para dosagem de proteínas, TMB One para hemoglobina, fenol 5% e ácido sulfúrico para carboidrato, todos com leitura por espectrofotometria. O grupo controle Positivo evidenciou níveis médios de 332µg/cm2 proteína, 30µg/cm2 carboidrato e 417µg/cm2 hemoglobina. Conforme esperado, o método de limpeza (4) apresentou desempenho superior quando comparado com o método (1), reduzindo 92% a mais de µg/proteína/pinça e 60% a mais de µg/carboidrato/pinça e por trocarte, embora esta superioridade não tenha sido observada de uma forma uniforme em todo o experimento. No grupo controle Negativo, os níveis máximos de proteína detectados foram 1,70µg/cm2 e de carboidrato de 1,07µg/cm2, não sendo detectada hemoglobina. A SEGUNDA ETAPA, avaliou a esterilização do instrumental laparoscópico reutilizável montado com contaminação desafio de três vezes 106 esporos Geobacillus stearothermophillus ATCC 7953, impregnados em suporte de papel filtro extraídos do indicador biológico comercialmente disponível para monitoramento da autoclavação. Os experimentos microbiológicos foram acompanhados dos grupos controle Positivo (suporte do indicador biológico não submetido à esterilização) e controle Negativo (instrumentos laparoscópicos esterilizados desmontados com contaminação desafio). Como grupo Experimental, foram analisados 370 instrumentos laparoscópicos esterilizados montados, sendo 185 pinças e 185 trocartes. Três suportes de papel impregnados com os esporos foram introduzidos no interior de cada instrumento laparoscópico, precedidos de limpeza tipo (4), embalados em papel grau cirúrgico e submetidos à esterilização a vapor saturado sob pressão (134oC por 5 minutos). Com técnica asséptica, cada suporte de papel foi inoculado em meio de cultura de Tryptic Soy Broth (TSB), incubado a 56oC por 21 dias. Não sendo observado crescimento, as amostras foram submetidas a um choque térmico a 80oC, por 20 minutos, para estimular a germinação, com reincubação por mais 72 horas. Não houve crescimento microbiano algum nas amostras do grupo Experimental. Os resultados dos grupos controles foram satisfatórios. O controle Positivo confirmou o desafio imposto aos experimentos e o controle Negativo apresentou resultados esperados de ausência de crescimento. Este estudo forneceu fortes evidências científicas para os Centros de Material e Esterilização sustentarem a segurança microbiológica da prática de esterilização do instrumental laparoscópico montado
This study evaluated the microbiological safety of steam sterilization, the reusable laparoscopic instrument assembled. We selected two types of reusable laparoscopic instrument: trocar and dissecting forceps 5mm. Considering the efficacy of cleaning as an essential prerequisite for the sterilization process, the FIRST STEP evaluated 66 laparoscopic instruments, 33 trocars and 33 dissecting forceps, subjected to different cleaning methods evaluating outcome as organic waste protein, hemoglobin and carbohydrate after intentional contamination with blood from human placenta. Cleaning methods were tested: (1) manual cleaning rinse with potable water, (2) manual cleaning with rinsing in clean water, then cleaning ultrasonic without rinsing, (3) manual cleaning with rinsing in clean water, then cleaning ultrasonic rinse with potable water and (4) manual cleaning rinse with potable water, followed by ultrasonic cleaning with potable water rinse and final rinse in sterile distilled water. The experiments were accompanied by positive control groups (without cleaning) and negative, composed of laparoscopic instruments again without intentional contamination, assessed after the cleaning procedures (1) and (4). For evaluation of organic waste is used Quantipro BCA kit for the determination of protein, TMB One to hemoglobin, 5% phenol and sulfuric acid of carbohydrate with any read by spectrophotometry. The positive control group showed average levels of 332µg/cm2 protein, carbohydrate 30µg/cm2 and 417µg/cm2 hemoglobin. As expected, the cleaning method (4) superior performance when compared with the method (1), reducing 92% more µg/protein/forceps and more than 60% µg/carbohydrate/forceps and trocar, although this superiority has not been observed in a uniform manner throughout the experiment. In the negative control group maximum levels of protein detected were 1.70 µg/cm2 and 1.07 µg/cm2carbohydrate was not detected hemoglobin. The SECOND STEP evaluated the sterilization of reusable laparoscopic instruments assembled with contamination challenge 3 times 10 Geobacillusstearothermophillus spores ATCC 7953, impregnated strips filter paper extracted from commercially available biological indicator for monitoring steam sterilization. The experiments were accompanied microbiological positive control groups (biological indicator spore strips non-sterile) and negative (laparoscopic instruments sterilized contamination disassembled challenge). As experimental group were analyzed 370 laparoscopic instruments sterilized assembled, 185 dissecting forceps and 185 trocars. Three spore strips of paper impregnated were introduced in laparoscopic instrument within each preceded by cleaning type (4), packed in surgical paper and subjected to saturated steam sterilization under pressure (134oC for 5 minutes). With aseptic technique, each paper spore strip was inoculated into culture medium Tryptic Soy Broth (TSB) and incubated at 56oC for 21 days. No growth was observed, they were subjected to heat shock at 80oC for 20 minutes to stimulate germination, with more reincubation for 72 hours. There was no microbial growth in some samples of the experimental group. The results of the control groups were satisfactory. The Positive Control confirmed the challenge posed to experiments and the negative control presented results expected from the absence of growth. This study provides strong scientific evidence for the Centers for Material and Sterilization sustain the microbiological safety of the practice of sterilization of laparoscopic instruments assembled.

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Ekman, Jakob, and Benjamin Bernroth. "Liten tuva stjälper ofta stort lass : Bakteriell kontamination över tid av operationsinstrument vid öppen neurokirurgi." Thesis, Umeå universitet, Institutionen för omvårdnad, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-115892.

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Bakgrund: Postoperativa sårinfektioner orsakar lidande för den drabbade patienten och kostnader för patienten, vården och samhället. Intraoperativ kontamination av operationsinstrumenten är en av källorna till dessa infektioner. Operationssjuksköterskan är ansvarig för aseptiken och operationsinstrumenten. Syfte: Syftet med denna pilotstudie var att mäta graden av bakteriell kontamination över tid på operationsinstrument som används vid öppen neurokirurgi samt observera utvalda källor till kontamination under samma tid. Metod: Denna studie designades som en kvantitativ icke-experimentell observationsstudie. Datainsamlingen skedde under hösten 2015 och bestod av omhändertagandet av specifika instrument som använts av operatören under operationen efter förutbestämd åtgången knivtid. Bakterieodlingar på dessa instrument skedde sedan på laboratorium enligt en förutbestämd metod och graden av kontamination mättes genom observation av mängden colony forming units (CFU). Resultaten presenteras i form av förändringar av mängden CFU. Resultat: Fem operationer observerades och tio odlingar utfördes på tio instrument. Totalt tio CFU registrerades under samtliga observationer. Ingen signifikant ökning av antal CFU kunde observeras från en till två timmars knivtid (P=0,156). Antal dörröppningar ökade från 3,4 till 9,0 och antal personer på operationssalen ökade från 5,4 till 5,8. Slutsats: Trots det ringa antal observationer som ingick i denna studie tyder resultaten på god aseptik och minimal bakteriell kontamination på operationsinstrumenten under operationens två första timmar. Ytterligare forskning med längre observationer, fler observationer och observationer kring annan typ av kirurgi behövs.
Background: Post-operative surgical site infections (SSI) cause suffering for the afflicted patient and is a great cost for the patient, the health care system and society. Intra-operative contamination of surgical instruments is one of the sources of these infections. The operating room nurse is responsible for preventing infections. Purpose: The purpose of this pilot-study was to measure the degree of bacterial contamination over time on surgical instruments used in open neurosurgery as well as to observe specific sources of contamination during this time. Method: The design was a quantitative nonexperimental observational study. The data collection took place during autumn 2015 and consisted of the sampling of specific instruments used by the surgeon during surgery after preset elapsed operating times. Bacterial culturing on these instruments was then carried out at a laboratory according to a preset routine and the degree of contamination was measured by observing the amount of colony forming units (CFU). The results are presented as changes in CFU. Results: Five operations were observed and ten bacterial culturings were conducted on ten instruments. A total of ten CFU was registered during all observations. No significant increase in the number of CFU could be observed from one to two hours of elapsed surgery (P=0,156). The amount of door openings increased from 3,4 to 9,0 and the number of personnel in the operating room increased from 5,4 to 5,8. Conclusion: Despite the small number of observations included in this study the results indicate good aseptics and minimal bacterial contamination on the surgical instruments during the first two hours of surgery. Further research with longer observations, more observations and observations on other forms of surgery is needed.

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Heriot, Jody L. "Implementation of a Beta Blocker Protocol." UNF Digital Commons, 2012. http://digitalcommons.unf.edu/etd/415.

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Background: Beta blockers are recommended by the American College of Cardiology/American Heart Association Guidelines for high and intermediate-risk cardiac patients undergoing non-cardiac surgery. Beta blockers are a class of drugs that moderate the effects of increased catecholamine levels on the heart by selectively blocking beta receptors in the heart and blood vessels, resulting in a lower heart rate and blood pressure. Beta blocker use perioperatively has been shown to reduce the risk of ischemia and infarction. Purpose: The purpose of this project is to address beta blocker use in a group of anesthesia providers who routinely attend to high-risk and intermediate-risk cardiac patients undergoing non-cardiac surgery in a medium-sized private hospital in suburban South Florida. There are barriers to the implementation of the published guidelines for beta blocker administration, including lack of awareness of the best current practice and a lack of a formal beta blocker protocol at the institutional level. Methods: A simple and inexpensive beta blocker protocol was implemented and evaluated by various means. Beta blocker administration practices were examined and documented prior to and after protocol implementation. Beta blocker usage was examined prior to and after protocol implementation Findings/Implications: It was hypothesized that increased anesthesia provider awareness would lead to increased administration of perioperative beta blockers to high-risk and intermediate-risk cardiac patients undergoing non-cardiac procedures. Although there was a knowledge increase related to the new beta blocker protocol, no change in practice was observed.

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Mattia, Ana Lucia De. "Utilização das horas de enfermagem em salas de operações, segundo a complexidade do paciente e do procedimento anestésico-cirúrgico." Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/7/7136/tde-06052009-101000/.

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Esta pesquisa é um estudo de caso, com natureza exploratória, descritiva e comparativa de campo, transversal e com abordagem quantitativa. Tem como objetivo classificar as cirurgias em categorias, segundo a necessidade de horas de enfermagem em salas de operações, subsidiando o dimensionamento de pessoal de enfermagem em centro cirúrgico. Foi realizada em um Hospital geral, de grande porte, da rede privada da cidade de São Paulo. A amostra foi constituída de 140 pacientes, divididos em 14 grupos, sendo 10 pacientes em cada grupo. Para a formação dos grupos foi considerado a condição física do paciente, segundo Americam Society of Anestesiologists (ASA), o porte anestésico segundo a Associação Médica Brasileira (AMB), o tipo de procedimento anestésico-cirúrgico, invasivo ou minimamente invasivo (MI) e cirurgias eletivas. Quanto à condição física do paciente, os grupos foram formados com ASA1, ASA2 e ASA3; a ASA4 foi excluída por não apresentar casos, ASA 5 e 6 foram excluídos por serem cirurgias de urgência ou emergência. Quanto ao porte anestésico, as cirurgias foram classificadas em pequeno porte, médio porte, grande porte e porte especial. Desta forma os grupos ficaram simbolizados como: 1P, 1M, 1G, 1E, 2P, 2M, 2G, 2E, 3M, 3G, 3E, 1PMI, 1MMI e 2MMI. A coleta de dados foi realizada dentro das salas de operações, por meio de observação estruturada, a qual foi utilizado um roteiro com itens referentes à caracterização da cirurgia, recursos humanos, condição física do paciente e procedimentos anestésicos-cirúrgicos. O tratamento dos dados foi feito segundo a caracterização do paciente cirúrgico, horas utilizadas pelos recursos humanos e pelo paciente, procedimentos realizados e recursos materiais utilizados. Na comparação entre os grupos, a caracterização do paciente cirúrgico permitiu os seguintes resultados: quanto ao sexo, 83 (59,29%) do sexo feminino e 57 (40,71%) masculino, a maior frequência de idade foi entre 30 e 40 anos, em 34 (24,29%) dos pacientes. As especialidades cirúrgicas de maior frequência foram otorrinolaringologia em 23 (16,43%), ginecologia e obstetrícia 21 (15%) e ortopedia e traumatologia 21 (15%). A anestesia geral prevaleceu com 75 (53,58%) dos pacientes. Quanto aos distúrbios sistêmicos que caracterizaram a ASA, as doenças cardiovasculares prevaleceram em 52 (65%) dos pacientes, sendo 40 (50%) com hipertensão arterial sistêmica e 16 (20%) com diabetes Mellitus. Quanto às horas utilizadas, as média das horas utilizadas por paciente foram: 3,40 horas de enfermagem (HE); 0,10 horas de enfermeira (HEn); 3,28 horas de técnico/auxiliar de enfermagem (HT/A); 6,14 horas da equipe médica (HEM); 1,12 horas de cirurgia (HC); 1,95 horas de salas de operações (HSO); 0,21 horas de preparo para anestesia (HPA) e 0,16 horas de preparo para cirurgia (HPC). Para uma hora de cirurgia (HC), as médias de horas utilizadas em cada paciente foram: 3,54 HE; 0,14 HEn; 3,40 HT/A; 5,77 HEM e 1,90 HSO. Para uma hora de sala de operações (HSO), as médias de horas utilizadas em cada paciente foram: 1,81 HE; 0,06 HEn; 1,75 HT/A; 3,08 HEM e 0,54 HC. Quanto aos procedimentos realizados, as médias dos invasivos foi de 2,04 procedimentos e não invasivos de 5,70 procedimentos; com total de 7,74 procedimentos. A média de recursos materiais utilizados para anestesia foi de 4,19 equipamentos e para a cirurgia de 2,76 equipamentos; com total de 6,95 equipamentos. Na análise estatística dos grupos, referentes às ASA, segundo os portes anestésicos; os resultados demonstraram que os portes anestésicos pequeno e médio não diferiram significativamente entre si, sendo inferiores aos portes grande e especial, nas variáveis HE, HT/A, HEM; quanto aos portes anestésicos, segundo às ASA; os resultados demonstraram que quase não houve diferenças entres as ASA. Os grupos de cirurgias minimamente invasivas, houve diferença apenas nos recursos materiais, sendo superiores conforme o porte anestésico e a análise entre os grupos de cirurgias invasivas e minimamente invasivas, com portes anestésicos e ASA semelhantes, os resultados demonstraram que os grupos de cirurgias invasivas apresentaram - se significativamente inferiores nas variáveis estudadas em relação aos grupos de cirurgias minimamente invasivas. Desta forma, conclui-se com este estudo, que as HE estão relacionadas aos portes anestésicos, onde quanto mais complexo o procedimento anestésico-cirúrgico, mais horas de enfermagem são utilizadas, não foi observado relação das HE utilizadas com a condição física do paciente. Assim, foi elaborado uma classificação das cirurgias em categorias, segundo a necessidade de horas de enfermagem, para uma hora de sala de operações, sendo: cuidados padrão de enfermagem, com 1,41 horas; cuidados complexos de enfermagem, com 1,99 horas e cuidados diferenciados de enfermagem, com 1,78 horas
This is a case study with exploratory character, descriptive and comparative, and a fieldwork with a quantitative approach. It aims to classify the surgeries in categories according to the number of nursing hours in operating rooms, subsidizing the dimensioning of the nursing staff in operating rooms. It was performed in a large general private Hospital in São Paulo. The sample was constituted of 140 patients, divided into 14 groups, 10 patients on each group. To organize the groups it was taken on account the patient\'s physical condition, according to the American Society of Anesthesiologists (ASA), the anesthetic complexity, according to the Brazilian Medical Association (BMA), the sort of surgical anesthetic procedure: invasive, or minimally invasive (MI) and elective surgeries. According to the patient\'s physical condition, groups were constituted with ASA1, ASA2 and ASA3. ASA 4 was put away because there were no cases, and ASA 5 and ASA 6 were put away because they were urgency or emergency surgeries. As to the anesthetic complexity, surgeries were classified as presenting small complexity, mean complexity, large complexity and special complexity. Therefore groups were symbolized as: 1S, 1M, 1L, 1S, 2S, 2M, 2L, 2S, 3M, 3L, 3S, 1SMI, 1MMI AND 2AMI. Data were collect inside the operating rooms, by means of organized observation, according to a guide presenting items referring to the surgery characteristics, human resources, patient\'s physical condition and surgical anesthetic procedures. Data analysis was performed according to the surgical patient\'s characteristics, hours taken by human resources and by the patient, procedures and material resources employed. In the comparison among groups, the characterization of the surgical patient led to the following results: as to gender, 83 (59,29%) female and 57 (40,71%) male, the higher age frequency was between 30 and 40 years in 34 (24,29%) of the patients. The most frequent surgical specialties were otorhinolaryngology and traumatology in 23 (16,43%), gynecology and obstetrics in 21 (15%) and orthopedics and traumatology in 21 patients (15%). General anesthesia prevailed in 75 (53,58%) of the patients. Concerning the systemic disorders that characterize the ASA, cardiovascular disorders prevailed in 52 (65%) of the patients, 40 (50%) presenting systemic arterial hypertension and 16 (20%) presenting diabetes Mellitus. As to the hours taken, the average hours taken by patients was: 3,40 hours of nursing (NH); 0,10 hours of nurse (NeH); 3,28 hours of nursing assistant (NaH); 6,14 hours of medical staff (MSH); 1,12 hours of surgery (SH), 1,95 hours of operating room (ORH); 0,21 hours of anesthetic preparation (APH) and 0,16 hours of surgery preparation (SPH). For one SH, the average hours taken for each patient was: 3,54 NH; 0,14 NeH; 3,40 NaH; 3,08 MSH and 0,54 SH. Concerning to the procedures taken, the average of invasive procedures was 2,04 and non-invasive procedures 5,70; total procedures 7,74. The average material resources used for anesthesia was 4,19 equipment and for surgery 2,76 equipment; total 6,95 equipment. In the statistical analysis of groups referring to the ASA, according to the anesthetic complexity, results evidenced that small and mean anesthetic complexity presented no significant difference, and were inferior to large and special complexity in variables NH, NaH and MSH; as to the anesthetic complexity according to the ASA the results evidenced that there were almost none difference among the ASA. In the group of minimally invasive surgeries, there was difference only in the material resources, that were superior according to the anesthetic complexity and in the analysis comparing groups of invasive and minimally invasive surgeries with similar anesthetic complexity and ASA the results evidenced that groups of invasive surgeries were significantly inferior in the studied variables in relation to groups of minimally invasive surgeries. Therefore, this study concludes that the NH are related to the anesthetic complexity, and the more complex the anesthetic surgical procedure, the more nursing hours are taken. The relation of NH taken with the patient\'s physical condition was not observed. Thus a classification of surgeries in categories was done, according to the necessary nursing hours for one hour of operating room, that is: standard nursing cares, 1,41 hours; complex nursing cares, 1,99 hours and differentiate nursing cares, 1,78 hours

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Machan, Melissa Dawn. "Emerging Evidence in Infection Control Effecting Change." UNF Digital Commons, 2011. http://digitalcommons.unf.edu/etd/385.

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Current procedures for cleaning anesthesia airway equipment have been reported to be ineffective. The potential for cross-contamination from some airway equipment to a patient has been documented in several studies. In order to prevent potential infections, it should be ascertained as to why all anesthesia providers are not using disposable laryngoscope blades. The purpose of this evidence based project is to determine the perceptions of anesthesia providers regarding the use of disposable laryngoscope blades. Their frequency of use, their evaluation of ease of use, and any complications encountered when using the disposable blade before and after an in-service program designed to increase the use of disposable blades will be determined. Once Institutional Review Board (IRB) approval and written consent were obtained, anesthesia providers were asked to complete an anonymous one page questionnaire on their knowledge and practice regarding disposable laryngoscope blades. Immediately following the completion of the questionnaire, participants were given an investigator developed article to read. Participants completed the same anonymous questionnaire 3 months following the pre-intervention questionnaire. Inventory of the disposable laryngoscope blades were collected at the start of the project, at one month, and then again at three months. A total of 12 anesthesia providers participated in the evidence based practice project. An increased number of providers stated that they felt disposable laryngoscope blades were easy to use at the completion of the project and there was an increased use of disposable laryngoscope blades. At post-intervention, anesthesia providers described performance (25%) as their reason for not using the disposable laryngoscope blade which was down from the start of the project (60%). A single proportion Z-Test showed that the 23% increase in use of disposable laryngoscope blades after the intervention was statistically significant (Z=2.046, p=0.041). This evidence based project has shown that despite initial apprehension, a change in practice was evident after dissemination of the best and most recent clinical evidence regarding laryngoscope blades which should translate to improved patient outcomes.

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Camargo, Tamara Carolina de. "Eficácia da esterilização a vapor de instrumental laparoscópico montado versus desmontado: um estudo experimental." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-20042007-140745/.

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A vídeo-laparoscopia é uma inovação tecnológica que trouxe indiscutíveis vantagens e também novos desafios, incluindo nestes, as diretrizes para o reprocessamento adequado dos instrumentais e seus acessórios. A autoclavação dos instrumentais laparoscópicos desmontados é mais segura, uma vez que a condução térmica é facilitada. No entanto, são artigos complexos, compostos por múltiplas peças e a sua remontagem no momento da cirurgia traz transtornos às equipes cirúrgicas, correndo o risco do não funcionamento ou de danos às peças pela montagem inadequada. Existe um arraigado conceito, entre os profissionais da saúde, que para o sucesso da esterilização ser alcançado, é necessário o contato direto do vapor com todas as superfícies dos materiais submetidos à autoclavação sem considerar também o raciocínio do calor latente. A destruição microbiana por meio da esterilização pelo vapor está essencialmente relacionada ao calor latente, gerado pela condensação deste em contato com a superfície fria do material, promovendo a termocoagulação das proteínas microbianas. É uma prática comum nos hospitais brasileiros a realização da autoclavação de instrumentos previamente montados, apesar de não haver comprovação científica consistente dessa prática. Isto posto, esta investigação teve o objetivo de avaliar a eficácia do processo de esterilização a vapor dos instrumentais laparoscópicos previamente montados, comparando os seus resultados com os desmontados, considerada neste estudo a melhor prática. Tratou-se de uma pesquisa experimental, laboratorial, com abordagem quantitativa. Foram selecionados dois modelos de maior complexidade dentre os instrumentos laparoscópicos para realização do estudo, sendo eles: trocarte com válvula tipo janela rosqueada de 5mm, composto por cinco peças desmontáveis e pinça para dissecção de 5mm, composta por quatro peças desmontáveis. Cada peça dos instrumentais foi considerada como uma unidade amostral na análise microbiológica. Este estudo teve então como Grupo Montado: instrumentais laparoscópicos montados; Grupo Desmontado: instrumentais laparoscópicos desmontados; Grupo Contagem Microbiana: instrumentais laparoscópicos submetidos aos procedimentos de contaminação desafio, encaminhados diretamente para o teste de contagem microbiana. O inóculo para a contaminação desafio constitui-se de suspensão do Geobacillus stearothermophilus, na forma esporulada, acrescido de sangue de carneiro desfibrinado esterilizado. Todos os instrumentais foram contaminados desmontados com o inóculo desafio. Os grupos Montado e Desmontado foram submetidos aos processos de limpeza manual, complementada pela limpeza automatizada em lavadora ultra-sônica com retrofluxo, enxágüe em água corrente e sob pressão. Por fim, foi realizado o enxágüe com água destilada esterilizada e secagem com ar comprimido medicinal. Na seqüência, foi realizado sorteio para composição dos Grupos Montado e Desmontado. Os instrumentais foram embalados individualmente em papel grau cirúrgico e submetidos à esterilização a vapor em autoclave com pré-vácuo. Após a esterilização, os instrumentais foram avaliados quanto à eficácia da esterilização, por meio dos resultados dos testes de cultura microbiológica, utilizando o método de inoculação direta. No Grupo Montado foram recuperados os microrganismos teste em três peças de uma mesma pinça (3/48) e em três peças de um mesmo trocarte (3/60), enquanto que no Grupo Desmontado o microrganismo teste não foi recuperado nas unidades amostrais estudadas. Nas condições desse experimento, os resultados obtidos refutaram a hipótese inicial da pesquisa quanto à segurança da autoclavação das pinças e dos trocartes utilizados em cirurgia laparoscópica previamente montados
The video laparoscopy is a technological innovation that brought unquestionable advantages and, also, new challenges, like: the policies for the adequate reprocessing of the instruments and its permanent accessories. The steam sterilization of disassembled laparoscopic instruments is much safer, once that the thermal conduction is facilitated. However, laparoscopic instruments are quite complex articles; they are composed by many parts and the reassemblage in site at the moment of the surgery brings many inconveniences to the surgical team, like the possibility of the instruments malfunctioning or non functioning at all, or even damages to the instruments due to inadequate assembling. There is a strong belief among the Healthcare Professionals about the necessity of the direct contact of the steam with all the surface of the materials submitted to the steam sterilization, which is correct, however it doesn´t consider the latent heat assumption as well. The destruction of the microbiological material throughout the steam sterilization is essentially related to the latent heat, created by the vapor condensation when in contact with the instrument´s cold surface, promoting the thermal-coagulation of microbiological proteins. Many hospitals use the steam sterilization of previously mounted instruments, although there´s not any consistent scientific evidence about the efficiency of this practice. Once stated this point, this investigation´s aim was: evaluate the effectiveness of the steam sterilization process of the previously mounted, permanent laparoscopic instruments. It was an experimental laboratorial research, using a quantitative approach. Two models of permanent laparoscopic instruments of major complexity were chosen for the experiments: a trocar with a 5mm screw window valve, composed by five dismountable parts and a 5mm dissection clamp, composed by four dismountable parts. Each part of the instruments was considered as a sample unit on the microbiological analysis. This study it had the Assembled Group was: mounted laparoscopic instruments; the Disassembled Group was: disassembled laparoscopic instruments; the Microbiological Counting Group was: laparoscopic instruments submitted to the - challenge contamination - procedures, being directed straight to the test of microbiological counting. The inoculants material used for the challenge contamination consisted on the suspension of the Geobacillus stearothermophilus, in its spore form, plus defibrinated and sterilized sheep blood. All the instruments were contaminated, disassembled with the challenge inoculants material. The Assembled and Disassembled groups were submitted to the manual cleaning processes, enhanced by the automatic cleaning in an ultrasonic washer with retro-flux, rinsed in running and under pressure water. At last, a rinsing with distilled water was performed; the drying process was made with medicinal compressed air. Then, a sorting was performed to decide about the composition of the Assembled and Disassembled groups. The instruments were individually packed in surgical paper and submitted to the steam sterilization in a pre-vacuum sterilizer machine. After the sterilization, the instruments were evaluated according to sterilization effectiveness throughout the microbiological culture test´s results, using the straight inoculation method. In the Assembled Group the microorganism´s tests were recovered in three parts of one same clamp (3/48) and in three parts of the same trocar (3/60), in the Disassembled Group the test microorganism wasn´t recovered in any of the sample unities. The results, under the conditions of the experiment, refuted the hypothesis of safety in the usage of the steam sterilization in previously mounted used clamps and trocar in laparoscopy

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Elam, Charles R. IV. "Predicting Arterial Oxygen Desaturation Events Via Patient Journal and Pulse Oximetry Data in Postoperative Ambulatory Surgery Patients." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5649.

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Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical. Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity and mortality is on the horizon unless aggressive measures are taken at mitigating risk. Similarly, as the obesity epidemic expands, obesity-related comorbid conditions including obstructive sleep apnea (OSA) are likely to grow. The purpose of this research was to explore the relationship between ambulatory orthopedic patient-reported activities (quality of life metrics) and diagnostic factors (physical and perioperative care data) in the immediate postoperative period that are predictive of arterial oxygen desaturation. Data was obtained using a novel patient journal exploring sleep, pain, nausea, tobacco use, alcohol use, and appetite in conjunction with a valid and reliable portable, wrist-worn pulse oximeter. Additional assessment data was taken from the preanesthetic assessment. All participants were scored according to the STOP-Bang questionnaire, an accepted survey of OSA risk. Patients were recruited from a busy metropolitan ambulatory surgery center in Richmond, Virginia that sees approximately 500 cases monthly, and a 309-bed tertiary care hospital in West Burlington, Iowa. The target sample included 52 individual patients with data collected over the first two post-operative nights following discharge. Two patients were excluded. Negative binomial regression, log10 transformation, and least-squares regression examined the relationships the STOP-Bang questionnaire, quality of life data, and physical perioperative data had on postoperative desaturation events. Results suggested the STOP-Bang score predicted desaturation events and that age and BMI were significant individual predictors. Opiate pain medication treatment, a happy mood, and home CPAP use were associated with decreased events. This study provided a unique perspective in patient safety research, relating human behaviors and experiences with postoperative oxygen desaturation. Future research projects aligned with postoperative monitoring, pulse oximetry, patient safety, and obstructive sleep apnea are potential following the findings of this study.

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Taylor, Andrew. "Effect of a Self-Care and Self-Awareness Education Program on Resilience to Burnout and Depression in Clinically Experienced Nursing Students." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/honors/637.

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The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these hazards. The educational intervention had a strong positive effect on resilience scores (effect size of r=72%; p < 0.05). Eighty-six percent of the participants believed that the intervention increased their capabilities for self-care, especially in sleep, spending time outside, hydration, nutrition, and physical stretching exercises but not in journaling. Eighty-one percent stated that they would be likely to seek professional help if needed. Although this study must be repeated in other samples before it be implemented with full confidence, the standardized, high intensity, short duration, resilience training session can be recommended to nursing programs just prior to graduation and to hospitals for nurse orientation programs.

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Macedo, Rolanda. "Integração de Enfermeiros no Bloco Operatório: O Primeiro Passo para Cuidados de Excelência." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2015. http://hdl.handle.net/10400.26/10454.

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Relatório de Trabalho de Projeto apresentado para cumprimento dos requisitos à obtenção do grau de Mestre em Enfermagem Médico-Cirúrgica
O presente Relatório de Trabalho de Projeto surge no âmbito do 3º Curso de Mestrado em Enfermagem Médico-Cirúrgica da Escola Superior de Saúde do Instituto Politécnico de Setúbal e a sua construção, apresentação e discussão pública visam a obtenção do grau de Mestre nesta área científica. Os objetivos deste relatório passam por apresentar o PIS – Projeto de Intervenção em Serviço e o PAC – Projeto de Aprendizagem Clínica, e descrever e analisar o desenvolvimento das competências adquiridas como Enfermeira Especialista e Mestre em Enfermagem Médico-Cirúrgica. No âmbito dos estágios realizados no Bloco Operatório do Centro Hospitalar X foram desenvolvidos, segundo a metodologia de trabalho de projeto, dois projetos: um Projeto de Intervenção em Serviço sobre “Integração de Enfermeiros no Bloco Operatório – O Primeiro Passo para Cuidados de Excelência”, cuja realização nos permitiu criar e implementar um programa de integração de novos enfermeiros no Bloco Operatório, com o objetivo de melhorar a qualidade e a segurança das integrações, sendo que foi um contributo para uma eficaz integração, facilitadora e potenciadora de uma prestação de cuidados de excelência; e um Projeto de Aprendizagem Clínica, centrado no desenvolvimento dos domínios nas áreas da prevenção e controlo de infeção, da resposta na catástrofe e emergência multivítima e do cuidar da pessoa em situação crítica e em situação crónica e paliativa. Ambos os projetos contribuíram para o desenvolvimento das competências comuns e específicas do Enfermeiro Especialista em Enfermagem Médico- Cirúrgica, designadamente em Enfermagem em Pessoa em Situação Crítica e em Pessoa em Situação Crónica e Paliativa, bem como as competências de Mestre em Enfermagem Médico-Cirúrgica. Ao longo do Relatório, descrevemos o percurso efetuado no Curso e respetivos estágios, analisando os seus aportes no desenvolvimento de competências especializadas e de mestre em enfermagem, contribuindo para a melhoria contínua da qualidade dos cuidados prestados, dentro do alvo desejável da excelência na profissão de Enfermagem.
Abstract: This Project Work Report comes out as part of the 3rd edition of the Medical- Surgical Nursing Master’s degree in the School of Health, Polytechnic Institute of Setúbal. Its construction, presentation and public discussion aims the achievement of a Master’s degree in this scientific area. The objectives of this report are to present the IPS – Intervention Project in Service – and the CLP – Clinic Learning Project – and describe and analyze the development of skills acquired as Specialist Nurse and Master in Medical-Surgical Nursing. Two projects were carried out during the internship: an Intervention Project in Service entitled as "Integration – The First Step to Excellence Care", which allowed us to create and implement a program for the integration of new nurses in the operating room, which has been a contribution to an effective integration, promoting and enabling the provision of a care of excellence; and a Clinic Learning Project, aimed at developing the skills of a Specialist Nurse regarding the prevention and control of infections, the answer in disaster situations and multi victim emergencies, and the care of someone in critical and in chronic and palliative situations. Both projects contributed to the development of the common and specific skills of the Specialist Nurse in Medical-Surgical Nursing, namely in the care to the Patient in Critical Situation or in Chronic and Palliative Situation, as well as the development of the skills of Master in Medical-Surgical Nursing. Throughout the Report, we will describe the route followed during the Course and respective internships, analyzing their contributions to the development of expertise and mastership in Nursing, and to the continuous improvement of the quality of care provided within the desirable goal of excellence in the Nursing profession.

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Balfour, Lindsay E. "Hospital Loneliness and the Patient-Physician Relationship: A Preliminary Analysis of Associations with Recovery in Bone Marrow Transplant Patients." UNF Digital Commons, 2012. http://digitalcommons.unf.edu/etd/336.

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The purpose of the present study was to examine general loneliness, hospital loneliness, and the patient-physician relationship in regards to their associations with Bone Marrow Transplant (BMT) recovery outcome variables (days until engraftment and quality of life). Fifteen (66.7% female, 33.3% male; 93.3% white, 6.7% Black/African American; average age 61.73) individuals who had an allogeneic or autologous BMT at The Mayo Clinic of Jacksonville completed the FACT-BMT, UCLA-Loneliness Scale Version 3, the CARE Measure, and provided disease and treatment information at the 6 month posttransplant date (+/- 30 days). Patients recovering from BMT indicated significantly higher scores of hospital loneliness in comparison to their general loneliness scores. This increase is believed to represent the outcome of experiencing hospital isolation during the post-transplant recovery process. Increases in hospital loneliness were marginally significant in predicting decreases in the patients overall quality of life. The patient physician consultational relationship was found to have a significant relationship with the number of days until engraftment, however the direction of the relationship was opposite the hypothesized direction. This may suggest that engraftment influences the quality of the relationship instead of vice versa. These results imply that there is a relationship between hospital isolation and increases in the amount of loneliness experienced during recovery from a BMT. Loneliness has been found to have a negative relationship with a number of physiological and quality of life outcomes. The present study also elucidates possible correlates with the patient-physician relationship.

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Ogunjulugbe, Jacqueline P. "Decreasing Operating Room Delays for Surgical Orthopedic Patients." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6078.

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The operating room (OR) at the project site was experiencing surgical delays for orthopedic surgical patients due to unavailable instruments, which led to a decrease in the efficiency of OR utilization. The purpose of this project was to decrease operating room delays for the orthopedic surgical patients. The practice-focused question explored whether a multidisciplinary approach to the procurement of instruments and supplies for the orthopedic surgical patient would help to ensure an on-time surgery start, resulting in increased efficiency in the utilization of the OR from 42% to 65% within a 9-month period. Lewin's change model was used to guide the project. Data analysis was conducted using a t test to compare the changes in the mean scores of the OR utilization rate before and after the involvement of a multidisciplinary team. An independent samples t test found no significant effect of the intervention, t (13) = 0.74, p > .05. Because the t test results were not significant at the Î± = .05 level, results showed no evidence that the multidisciplinary team affected the OR utilization rate. Decreasing surgical delays can have the potential implication for positive social change at the organization level, because delays hinder optimal patient flow, increase anxiety for patient and families, and have a significant negative economic impact on hospitals.

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McWhirter, Lynn. "Novel Oral Anticoagulants: Bedrest and Bleeding in Patients Undergoing Atrial Fibrillation Catheter Ablation." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/520.

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Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and sometimes arterial, sheath removal and hemostasis. Limited research is available on the appropriate duration of bedrest to minimize bleeding complications associated with AF ablation in patients who use NOACs. The purpose of this quality improvement project was to compare and evaluate the effect of bedrest duration on post-procedure bleeding outcomes, urinary complaints, and back pain among patients taking NOACs while undergoing AFCA. Thirty patients undergoing elective AFCA on NOACs were orally consented to participate in the study and placed on shortened (8 hours) or prolonged (>8 hours) bedrest following vascular hemostasis. Outcome measurements included bleeding after ambulation, back pain, and urinary complaints. Fifteen patients (50%) were on shortened bedrest and 15 (50%) were on prolonged bedrest. No statistically significant difference in bleeding, urinary complaints, or back pain were found. Since there is no clear advantage to prolonged bedrest for patients on NOACS after an AFCA procedure, clinicians should consider this when deciding on bedrest duration for their patients.

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Kingdon, Brenda. "Effects of Provider Education on Documentation Compliance in the O.R." UNF Digital Commons, 2009. http://digitalcommons.unf.edu/etd/310.

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Knowledge of The Joint Commission's National Patient Safety Goals and an effective provider cooperative practice involving communication and teamwork are essential for the delivery of safe and compliant patient care in the surgical setting. The purpose of this study was to assess the impact of an educational intervention for physicians and nurses designed to increase documentation of compliance with national patient safety standards. As events of noncompliance have impacted patient safety at the hospital where this project was conducted, measures were needed to assess barriers to compliance with standards of practice and to focus educational session plans on identified knowledge-base needs. The goal of this project involved bringing all surgical team members together for educational sessions on safety standards. Pre-intervention and post-intervention assessments of knowledge were administered to study participants. Additionally, random chart documentation audits were conducted before and after the intervention to assess the effectiveness of the education sessions on documentation compliance with the targeted standards. Outcomes of this study included improved knowledge of, and compliance with, national patient safety goals. Results may improve safe patient care at this hospital, reduce costs, and create mutual respect and teamwork, all contributing to the successful achievement of the organization's quality improvement goals.

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Taylor, Leah Kristine. "Objective measures of operating room wire navigation performance." Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/5656.

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There is no widely accepted tool to assess an orthopedic surgeon’s technical skill in the operating room. With changes in surgical education, simulators are being investigated for learning and assessing technical skills, but a link between the actual operating room is needed to ensure they are effective. Hip fracture surgery is a good starting point to develop these measures because hip fractures are common and fixation is a difficult task. Resident orthopedic surgeons wore a head-mounted video camera during hip fracture surgery. Data collected included: duration, number of x-ray images, the supervising surgeon intervention, and tip-apex distance (TAD, a measure of how accurate the implant is placed). To determine the reliability of these measurements, four raters performed them for two cases. Ten raters measured the tip-apex distance (TAD) on 7 cases. These performance metrics for 15 cases were compared to experience of the residents, both point in residency and number of previous cases. A composite performance score was computed using the four metrics. The metrics were also compared to two practicing surgeons’ assessment of skill. The inter-rater reliability of the performance metrics was high (0.97-0.99) showing these measures are consistent between different raters and useful for assessment. There was a significant relationship between resident experience and the metrics of duration and TAD. Expert opinion was related to duration. These metrics provide objective assessment of resident technical performance in the operating room by a non-expert, an important step towards competency based education. Their validity is shown with correlation to surgical experience.

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Seneca, Martha E. "Improving Anesthesia Professional Adherence to Hand Hygiene." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/502.

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Performance of hand hygiene is among the most effective means of preventing healthcare associated infections (HAI) among patients. Deaths resulting from HAIs are one of the top ten leading causes of death in the United States. Any improvement in the frequency of hand hygiene among healthcare professionals may have a direct impact on patient mortality and associated costs. While anesthesia professionals have been found to have low rates of hand hygiene adherence, few targeted studies seeking to improve hand hygiene adherence among this group exist. Studies conducted to improve hand hygiene among health care professionals have reported limited improvement, with overall inconclusive recommendations for improving prolonged hand hygiene adherence rates. The purpose of this project was to improve anesthesia professionals’ hand hygiene through encouragement of performance and education on the current state of research in the area of anesthesia associated HAIs. Hand hygiene rates were evaluated through measuring the amount of hand sanitizer used at eleven anesthesia workstations in the main operating room of a hospital. Measurements were taken at baseline and continued for three months after the educational program was implemented.

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Prince, Jacqueline Yvonne. "Operating room nursing science learning programmes in South Africa." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/594.

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Operating room nurses form the corner-stone of the operating room because perioperative care of the patient rests mainly in the hands of the nursing personnel. Unique challenges face nurses functioning in the stressful surgical environment where anticipation to prevent or cope with life-threatening situations is the order of the day. The operating room nurse must be knowledgeable, skilled and alert, as he/she is held accountable for all acts of commission and omission. To ensure that nurses are appropriately educated and trained and able to keep trend with the changing technology in the operating room, it is essential that learning programmes meet the minimum standards for registration as prescribed by the South African Nursing Council. Reviewing and evaluating learning programmes on a regular basis by specialist nursing educationists, are therefore essential to ensure that the standards of education and training are maintained and upgraded if required. The aim of this study is to explore and describe the various Operating Room Nursing Science Learning Programmes offered at accredited Higher Education Institutions, utilized for the education and training of the operating room nursing students in South Africa. The proposed research is based on a qualitative paradigm and the theoretical grounding is found in Bergman’s model for professional accountability (Bergman, 1982:8). A document analysis of five approved comprehensive Operating Room Nursing Science Learning Programmes from higher education institutions in South Africa (nursing colleges and universities) was carried out, together with a sixth programme, the Operating Theatre Learning Programme, as suggested by the Standard Generating Body. Requests for permission were forwarded to the management of the selected colleges or universities for inclusion of the respective programmes in the study. The researcher formulated and utilized thirty-four essential criteria derived from three documents, the first being a document entitled “Proposed Standards for Nursing and Midwifery Qualifications” submitted to the SANC and SAQA by the SGB for Nursing and Midwifery (2001-2004). The second document entitled the Public and Private Higher Education Institutions format template for criteria for the Generation and Evaluation of Qualifications and Standards within the National Qualifications Framework was also utilized (SAQA, 1430/00) and thirdly the researcher included the most relevant criteria from the list of criteria for curriculum development as indicated by the South African Nursing Council. Various tables were compiled, to reflect the findings of the document analysis according to the thirty-three criteria indicated above, to provide a clear and broad overview of the specific data in the respective six Operating Room Nursing Science Learning Programmes utilized in the study. In conclusion recommendations for a broad macro-curriculum were made to facilitate formulation of programmes in Operating Room Nursing Science relevant to the South African context.

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Levesque, Marie-Julie. "Interprofessional Collaboration in the Operating Room: A Nursing Perspective." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42751.

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The aim of this thesis was to examine the contribution of nurses to interprofessional collaboration (IPC) in the operating room (OR) guided by the Interprofessional Education Collaborative Patient Care Practice (IECPCP) framework. First, a secondary analysis of interviews with 19 registered nurses was conducted. Twenty emergent themes were identified. The most prevalent of the four dimensions (internalization; shared goals and vision; governance; and formalization) consisted of the internalization dimension relating to human interaction and sense of belonging within the interprofessional team. A scoping review then identified 20 studies evaluating four interventions (briefings, checklists, team training, and debriefings) used to improve IPC in the OR. Despite weak study designs, these interventions showed improvements in communication, teamwork, and safety outcomes. OR nurses contribute mainly through interactional processes and they require organizational support to foster their efforts in IPC. Nurse are involved in all IPC interventions and their contribution is important to support IPC in the OR.

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Gillespie, Brigid Mary, and N/A. "The Predictors of Resilience in Operating Room Nurses." Griffith University. School of Nursing and Midwifery, 2007. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20070824.123750.

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The nursing workforce has experienced considerable change during the previous decade, resulting in a chronic shortage of nurses. Issues such as economic rationalism, increased workloads, changes in nursing education and the advancing age of the current nursing workforce are the chief contributors to this shortage (Australian Institute of Health & Welfare, 2005b; Buerhaus, Staiger, & Auerbach, 2000b). Operating room (OR) nursing is a primary specialty area that has been especially affected by rising nurse attrition and a reduction in nurse recruitment (Australian College of Operating Room Nurses, 2003; Australian Health Workforce Advisory Committee, 2002). Accordingly, the loss of skilled nurses from the OR specialty compounds the negative effects on morale for those who remain in the environment, as they struggle to provide safe patient care while concomitantly being responsible for the clinical development of neophyte and inexperienced nurses (Australian Health Workforce Advisory Committee, 2002; Arndt, 1998). In the midst of working in the OR environs where the nature of the associated stressors is unique, resilient qualities may assist nurses to meet and overcome these challenges. If there is to be a continued nursing presence in the OR, it is essential that nurses be given the opportunity to develop resilience. At this time when nurse retention rates are continuing to decline steadily, there is a compelling need to identify and describe the relationship between resilience and its predictors in the context of the OR. To date, little is known about predictors of resilience and their potential to ameliorate the effects of workplace stress in the OR. The overall purpose of this study was to identify and describe the predictors of resilience in OR nurses. A literature review and concept analysis of resilience was initially conducted. Hope, self-efficacy, coping and personal characteristics were identified as defining characteristics of resilience. Next, the research was conducted as a mixed method phased study that was underpinned by the pragmatist paradigm, and employed a sequenced combination of qualitative followed by quantitative inquiry (Morgan, 1998). The first phase used a mini-ethnography to identify and describe the components of workplace culture in an OR in relation to their potential impact on nurses ability to adapt in this culture. A triangulated approach was used involving participant observation, a reflective journal, field notes and interviews. This phase revealed that competence, knowledge, collaboration, peer support and the ability to manage challenges were central components of OR workplace culture. From these categories, three themes were abstracted and subsequently developed into constructs that were measured and validated in the larger second phase. The second phase used a predictive correlation survey to describe empirically the relationship between resilience and its hypothesised predictors in a systematic random national sample of nurses who were members of the Australian College of Operating Room Nurses (ACORN), and a combined sample of hospital nurses purposively drawn from two similar hospital sites. The survey included scales measuring perceived competence, collaboration, managing stress, self-efficacy, hope, coping, and resilience, as well as gathering information about the demographic characteristics of nurse respondents. Out of a total potential sample of 1,730 OR nurses, the overall response rate was 51.7% (n = 896). Differences between the ACORN and hospital samples were found in age, years of experience, education and years of employment; therefore, the national and hospital samples findings were analysed separately. Five independent variables hope, self-efficacy, coping, managing stress and competence predicted resilience in the larger sample of ACORN respondents (n = 772). For the substantially smaller sample of hospital respondents (n = 124), hope, self-efficacy and managing stress predicted resilience. Given that the smaller hospital sample resulted in a similar model, this consistency lends strength and weight to the revised resilience model. Over 60% of the variance in resilience was explained by the independent variables in each model. Given the dearth of literature describing the efficacy of resilience in ameliorating stress in OR contexts, the results of this study have extended the theoretical application of the resilience concept to include a nursing context. There is a need to implement resilience-building strategies that address the culture of the OR, both at the departmental and organisational levels. Strategies that provide a supportive workplace environment in relation to goal-orientation, the provision of stress management and education programs, and strategies that facilitate cultural assimilation may improve resilience, and hence retention and recruitment rates in the OR. The findings of this study support the need for further research not only to test the stability of the proposed model among other groups of nurses but also to explore further predictors of resilience in the OR setting.

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Theron, Margot Cecile. "Nursing care practice related to patient safety in the operating room." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1017197.

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Patient safety is a primary concern of members of the surgical team. Professional nurses working in the operating room play a vital role in the safety of the patients from the moment the patient enters the operating room to the discharge of the patient to the unit. Quality nursing care is of the utmost importance and therefore it is the responsibility of a professional nurse to ensure patient safety during the peri-operative period. Team work and good communication in the operating room are essential in order to ensure patient safety. Nursing care practices related to patient safety should be a key aspect to consider in rendering care to the surgical patient and professional nurses should perform their duties to the best of their ability despite lack of resources and shortage of staff. The main purpose of the study was to explore and describe nursing care practice related to patient safety in the operating room at hospitals in the Nelson Mandela Metropolitan area. Once this was established recommendations on how to enhance nursing care practice related to patient safety in the operating room were made. This study is based on a quantitative, explorative, descriptive and contextual design. Convenient sampling was used in this study. Data were collected by means of a self-administered questionnaire. Descriptive and inferential statistics were used to analyse the data. Ethical considerations were adhered to and the findings of the research will be disseminated appropriately. Recommendations based on the findings that emerge from the data, as well as the literature review, will be offered to enhance nursing care practice related to patient safety in the operating room.

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Sadeghian, Parastoo. "A new generation of hospital operating room ventilation." Licentiate thesis, KTH, Hållbara byggnader, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-284542.

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Surgical site infection is responsible for 38 percent of reported infections after surgery. This infection increases mortality and treatment costs, and prolongs the hospitalization of patients. Bacteria-carrying particles are the main cause of surgical site infection and one of the main sources of these particles is skin fragments released from the surgical personnel during an ongoing surgery. Ventilation systems reduce the concentration of bacteria-carrying particles by supplying clean air in the operating room. The performance of operating room ventilation systems is affected by internal disruptions such as medical equipment, surgical lamps, number of staff and their behaviour during the surgery. Using computational fluid dynamics, this thesis investigates the airflow behaviour and distribution of the contamination in the operating room under the presence of various internal disruptions. In this regard, three common ventilation systems are considered: laminar airflow, turbulent mixing and temperature-controlled airflow ventilations. This study tries to overcome the weaknesses of the ventilation systems by providing sustainable solutions and continuously being in contact with design companies. It is common to use warming blankets to prevent reduction in the core body temperature of the patient during major surgeries. However, there is a major concern that these blankets disrupt the supplied airflow, which results in rising contaminant concentration. Most of the studies about warming blankets are clinical works and it is still not clear whether or not these blankets should be used. The results of the present study show that using warming blankets had no impact on increase of contamination level at the surgical zone. However, one common type of warming blanket – a forced-air warming blanket – can considerably increase the concentration of bacteria-carrying particles at the wound area if it becomes contaminated. The simulated results of the airflow field and particle tracking showed that the laminar airflow ventilation system was disturbed more easily by the local heat loads than overall heat loads in the operating room. Surgical lamps are considered as an obstacle in the supplied airflow path. These lamps create a stagnant area above the operating table and increase the contamination level. In this regard, a novel design of surgical lamp, a fan-mounted surgical lamp, was introduced to operating rooms.This device was used in the operating rooms equipped with laminar airflow and mixing ventilation system. The simulated results revealed that this lamp significantly reduced the contamination level at the operating table. Visualization techniques were adopted to teach and improve the understanding of surgical personnel about transmission of contaminated particles in operating rooms. Here, a virtual and augmented reality interface was used to visualize the impact of differences in ventilation principle, surgical staff constellation and work practice.
Infektioner relaterade till kirurgiskt ingrepp utgör 38 % av rapporterade infektioner efter operation. Dessa infektioner ökar dödligheten och behandlingskostnaderna samt förlänger patienternas sjukhusvistelse. Bakteriebärande partiklar är den främsta orsaken till infektion vid kirurgi. Huvudkällan till dessa partiklar är hudfragment som frigörs från kirurgisk personal under en pågående operation. Genom att tillföra ren luft via ventilationssystemet kan koncentrationen av baktebärande partiklar i operationssalen minskas. Ventilationssystemets förmåga att ventilera salen påverkas av föremål som stör luftströmmen, som exempel medicinsk utrustning, kirurgiska lampor samt av närvarande personal och deras beteende under operationen. Med avancerade numeriska strömningsberäkningar undersöks i denna avhandling luftflöden och fördelningen av föroreningar i operationssalen under inverkan av sådana störningar. Tre olika ventilationssystem inkluderas. Ett för laminärt luftflöde, ett för turbulent omblandning och ett för temperaturreglerad luftströmning. I studien kartläggs ventilationssystemens funktion och relevansen prövas i ett kontinuerligt samarbete med tillverkande industri. Användning av värmefiltar förekommer under större operationer för att hålla patientens kroppstemperatur stabil. Det finns emellertid en stor oro för att dessa filtar stör det tillförda luftflödet och därmed ökar föroreningsnivån. En vanlig typ av värmefilt med forcerad varmluft kan om den är förorenad avsevärt öka koncentrationen av bakteriebärande partiklar i sårområdet. De flesta undersökningar om värmande filtar är kliniska studier och det är fortfarande inte helt klarlagt i vilken mån och hur dessa filtar skall användas. Denna studie visar emellertid att användning av värmefiltar inte påverkar föroreningsnivån i den kirurgiska zonen. Gjorda datorsimuleringar av luftflödesfältet och partikelspårning visar att det laminära ventilationsflödet lättare störs av lokala värmebelastningarna än av generella värmebelastningar i operationssalen. Kirurgiska lampor betraktas som hinder i en planerad luftflödesväg. Lampor kan skapa en stillastående luftmassa ovanför operationsbordet och därmed öka föroreningsnivån. För detta introduceras en ny design av kirurgisk lampa, en fläktmonterad kirurgisk lampa för operationsrum, utrustade med laminärt luftflöde och omblandning. Simulerade resultat visar att denna nya kirurgiska lampa signifikant minskar föroreningsnivån vid operationsbordet. Visualiseringsteknik användes i denna studie för att förbättra förståelsen hos kirurgisk personal om hur förorenade partiklar kan spridas i operationssalen. Med ett virtuellt och förstärkt gränssnitt visualiserades föroreningshalter i rumsluften då olika typer av ventilationssystem användes. Visualiseringen visar också hur kirurgigruppens storlek och arbetsställning under operation påverkar spridningen av föroreningar.

QC 20201103

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Siegel, Hugh Andrew. "Subjectivity Of Estimating Blood Loss Among Health Care Providers In The Operating Room." VCU Scholars Compass, 1993. https://scholarscompass.vcu.edu/etd/5263.

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This research utilized a descriptive study to establish a relationship between educational background and accuracy of estimating blood loss. The null hypothesis, that the educational background of health care providers in the operating room has no effect on the accuracy of estimating blood loss , was tested. Ten nurse anesthesia students, 8 certified registered nurse anesthetists, 16 operating room registered nurses, 12 anesthesiologists, and 9 surgeons were included in the sample population. A number of different protocols were utilized to assess the relative accuracy of blood volumes estimates. The study was separated into four stations. Station 1 consisted of three tables, each with different sizes and types of sponges with varying amounts of blood placed on them. Four estimates were required at each table, for a total of 12 estimates. Stations 2-3-4 contained different aggregates of blood-soaked materials, requiring a single estimate at each station. Repeated measures analysis of variance (ANOVA) revealed that the means across all groups in Station 1 reached statistical significance beyond p = .05 (< .001), and the hypothesis is rejected for equal group means. However, the results for Stations 2-3-4 for equal group means did not reach statistical significance ( p = .136), therefore, do not reject the null hypothesis of equal group means.

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Brinkman, Mary Adams. "A focused ethnography| Experiences of registered nurses transitioning to the operating room." Thesis, Widener University School of Nursing, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3570586.

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The operating room (OR) is a unique setting and specialty area of nursing practice that requires optimal orientation and education to render safe and efficient patient care. Unfortunately, there will be a significant shortage of nurses in the operating room in the next five to ten years. The need for new nurses in the operating room is essential as many OR nurses in the workforce will retire within the next five years. Currently, most nursing programs no longer offer perioperative courses in their curriculum. Subsequently, this trend has led to the need for hospitals to educate and orient new nurses to their operating rooms. As hospitals educate their own OR nurses, retention following orientation becomes a priority.

The purpose of this study was to explore nurses' experiences as they transition to a new area of nursing practice, the operating room. A qualitative focused ethnography was conducted using Leininger's ethnonursing research method. Fourteen RNs transitioning to the OR agreed to participate in this study. The OR was a first time experience for the RNs. The setting was a large teaching hospital located in an urban area. Observations and interviews were conducted with the RNs to explore their experiences as they transitioned in the OR.

The RNs' transition included learning the didactics of OR nursing through the web-based AORN Nursing 101 online computer course, practicing skills learned in a simulation laboratory, and rotating through surgical specialty areas under the supervision of an RN preceptor. Influences that facilitated the RNs transition to the OR were the

positive learning experience, perception of belonging and acceptance into the OR culture, stimulating environment, supportive personnel, collegiality among peers, and presence of nursing in the OR. Influences that hindered the RNs' transition to the OR were inconsistency in precepting, being in a hostile environment, limited exposure to the OR prior to the RNs' transition, and an overwhelming environment. Meleis' Transition model emerged in the RNs' experiences of transitioning to the OR.

The need to educate nurses in the operating room is essential to assure safety and positive outcomes for the surgical patient. Structured perioperative courses implemented by hospitals or with partnerships with nursing programs can enhance the education, transition, and retention of nurses new to the OR. The importance of a nurse educator having an advanced degree with experience in the OR specialty was essential in coordinating and mentoring nurses transitioning to this new practice area. RNs who are prepared to precept were vital in the education and retention of these RNs. The need for consistent preceptors was recognized as an essential factor to the RNs' successful transition. The findings contribute to evidence-base practice for the design and implementation of perioperative programs for new nurses.

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Alexander, Sherly Bejoy. "An Effective Succession Planning Educational Program for Operating Room Nurses." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2950.

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The current nationwide shortage of registered nurses is a growing problem impacting patient care and hospital operations. The operating room is the area most affected by the nursing shortage. Reasons cited for this shortage include ineffective nursing orientation programs and a decline in job satisfaction. The purpose of this project was to develop a best practice succession planning educational program to provide novice operating room nurses with an introduction to the operating room. The Dreyfus model of skills acquisition and Benner's novice to expert theory guided this project. A 2-step process was used to assess and validate the content and quality of the educational program. In Phase 1, the educational program was distributed to 10 operating room nurse stakeholders for formative review. There was agreement from these reviewers that the educational program covered key concepts important for novice operating room nurses. Two recommendations were made for additional clarification. In Phase II, the educational program was revised and distributed to a group of 10 perioperative professionals for summative review using the AGREE II instrument. The summative review group found the educational program to be clear and concise. The overall summative approval of 100% and recommendations of both review groups guided the final development of the best practice educational module. This best practice educational module will provide a standardized program for educating novice operating room nurses. This project will contribute to positive social change by empowering these nurses while supporting safe care for all surgical patients. Dissemination will occur first within the organization and then to local and national organizations targeting operating room nurses.

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McGarvey, Helen Elizabeth. "The operating department : investigating the role of the nurse." Thesis, University of Ulster, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326331.

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Makeleni, Nontsokolo Sylvia. "The effectiveness of surgical face masks in the operating room : a systematic review / Nontsokolo Sylvia Makeleni." Thesis, North-West University, 2012. http://hdl.handle.net/10394/9781.

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Surgical face masks have been designed to protect health care professionals from the splashes of the patients’ blood or body fluids and also to minimise the transmission of oro- and nasopharyngeal bacteria from the surgical team to the patient’s wounds, thereby decreasing the likelihood of postoperative surgical site infections during a surgical procedure. However, there are several ways in which surgical face masks could potentially contribute to contamination of the wound during a surgical procedure in the operating room. The objectives of this study were to explore and describe the effectiveness of surgical face masks as a protective barrier during a surgical procedure in the operating room in the public hospitals in the North West Province, South Africa and to formulate recommendations regarding surgical face masks worn by health care professionals during a surgical procedure in the operating rooms. A systematic review was conducted, followed by a quantitative, explorative, descriptive and contextual approach. The motivation for a systematic review was to search evidence on surgical face mask efficiency. A search strategy was conducted in February and March 2012 and the total initial search was 9,933 research articles. Screening of articles on effectiveness of surgical face masks during a surgical procedure was done. After six months the search was updated and the final sample of six relevant articles (n=6) was obtained. Studies that met the inclusion criteria were critically appraised based on the scores using standardised critical appraisal tools. The findings of this research project were synthesised and evaluated in order to come to conclusions. Conclusions were integrated and synthesised as the basis of developing a clear overview of the best quality empirical evidence about effectiveness of surgical face masks during a surgical procedure in the operating room. Recommendations were formulated for the nursing practice, education and research focussing on wearing a surgical face mask during a surgical procedure in the operating room. Reviewer’s conclusion: From the limited results it is unclear whether wearing surgical face masks during a surgical procedure in the operating room serve as a protective device for both surgical team and the patient. There is a need for further research.
Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

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Meyer, Rhoda. "Students perceptions of the operating room as a clinical learning environment." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/95860.

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Thesis (MPhil)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room, for example, is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite the numerous studies that have been undertaken in this field, few studies that have investigated the operating room as a clinical learning environment in the South African healthcare system have been published. The aim of this study was to determine students’ perceptions of the operating room as a clinical learning environment in a private hospital context. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Data was collected from nursing students undertaking their training at a private nursing education institution. Ten nursing students participated in an open-ended questionnaire (N=10), and twelve students participated in the focus group discussion (N=12). From the results, four themes emerged, namely, ‘interpersonal factors’, ‘educational factors’, ‘private operating room context’, and ‘recommendations’. This study has highlighted some of the challenges experienced by students in the private sector operating room context. Despite the potential learning opportunities, the key findings reveal negative perceptions of students regarding learning experiences. However, the opinion that the operating room offers an opportunity to gain skills unique to this context, as well as facilitates the integration of theory and practice, was also expressed. Some students reported that the emphasis on profitability and cost to patient, and the lack of a mentoring process in this context posed a constraint to learning. Exploration into the specific preparatory needs of students specific to learning outcomes before operating room placement should be considered. It would also be necessary to improve collaboration between lecturers, mentors and theatre managers so that a structured teaching programme may be developed for students entering the perioperative environment.
AFRIKAANSE OPSOMMING: Studente onderneem hul kliniese plasing in verskeie kliniese omgewings vir die blootstelling aan en aanleer van vaardighede wat verband hou met daardie spesifieke konteks. Die operasiesaal, byvoorbeeld, is ’n kliniese omgewing wat die geleentheid bied om kritiese vaardighede te ontwikkel wat verband hou met die perioperatiewe versorging van die pasiënt. Ten spyte van die talle studies wat in die operasiesaal onderneem was, het slegs ’n paar studies uit ’n Suid-Afrikaanse gesondheidsorg oogpunt, die operasiesaal as ’n kliniese opleidings omgewing ondersoek. Die doel van hierdie studie was om studente se persepsies van die operasiesaal as ’n kliniese omgewing in ’n privaat hospitaal konteks te bepaal. ’n Ondersoekende, verklarende en beskrywende ontwerp wat kwalitatiewe data genereer, is gebruik. Data is ingesamel van verpleegstudente wat hul opleiding by ’n privaat verpleegonderrig instelling ontvang. Tien verpleegstudente (N=10) was genooi om ’n onbepaalde vraelys te voltooi en twaalf student (N=12) het aan die fokusgroep bespreking deelgeneem. Vier temas het na vore gekom, naamlik ‘interpersoonlike faktore’, ‘opvoedkundige faktore’, ‘privaat-operasiesaal konteks’, en ‘aanbevelings’. Hierdie studie het ’n paar van die uitdagings uitgelig wat die studente in ’n privaat sektor operasiesaal ondervind. Ten spyte van die potensiële leergeleenthede teenwoordig in die privaat sektor operasiesaal, toon die belangrikste bevindings egter die negatiewe persepsies van studente jeens hierdie kliniese omgewing. Die opinie is egter ook uitgespreek dat hierdie omgewing ook ’n geleentheid aanbied om unieke vaardighede aan te leer. Dit bied ook ’n geleentheid om teorie en praktiese kundigheid te integreer. Sommige studente rapporteer dat die klem op winsgewendheid en koste vir die pasiënt, asoók die gebrek aan mentorskap in hierdie kliniese omgewing ’n beperking plaas op die leerproses. Die spesifieke voorbereidings behoeftes van studente insake leeruitkomste voordat plasing in die operasiesaal omgewing geskied, moet eers deeglik ondersoek word. Dit is ook nodig om die nodige samewerking tussen dosente, mentors en operasiesaal bestuurders te verbeter sodat ’n gestruktureerde onderrig program ontwikkel kan word vir studente wat die perioperatiewe omgewing betree.

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Jay, Rita A. "Relationship of organizational work climate to nurse turnover in operating room settings." Thesis, Capella University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3724927.

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Organizational work climates in healthcare organizations were described in the literature using a social framework of structured interactions, defined roles, and behavioral responses between team members of physicians and nurses. It was hypothesized that the characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy in socially complex work settings have relationships to turnover intent in nurses who work in operating room settings. In an era of nursing shortages the challenge of nurse retention and the evidence of challenging work climate become even more critical for healthcare organizations. This research study examined a gap in knowledge regarding the extent to which aspects of organizational work climate predict nurse turnover in operating room work settings. A quantitative correlational study using three work climate characteristics of physician-nurse collaboration, physician dominance, and nurse autonomy was conducted using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (Hojat & Herman, 1985, Developing an Instrument to Measure Attitudes toward Nurses: Preliminary Psychometric Findings) and the Anticipated Turnover Scale (Hinshaw & Atwood, 1983, Nursing Staff Turnover, Stress, and Satisfaction: Models, Measures, and Management). Responses from 322 Operating Room staff nurses who were members of a national professional nursing organization were examined in the analyses. The study concluded that the independent variables of collaboration, dominance, and autonomy were not significant in predicting turnover among nurses in the operating room setting.

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Long, Steven A. "Orthopaedic surgical skills: examining how we train and measure performance in wire navigation tasks." Diss., University of Iowa, 2019. https://ir.uiowa.edu/etd/6795.

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Until recently, the model for training new orthopaedic surgeons was referred to as “see one, do one, teach one”. Resident surgeons acquired their surgical skills by observing attending surgeons in the operating room and then attempted to replicate what they had observed on new patients, under the supervision of more experienced surgeons. Learning in the operating is an unideal environment to learn because it adds more time to surgical procedures and puts patients at an increased risk of having surgical errors occur during the procedure. Programs are slowly beginning to switch to a model that involves simulation-based training outside of the operating room. Wire navigation is one key skill in orthopaedics that has traditionally been difficult for programs to train on in a simulated environment. Our group has developed a radiation free wire navigation simulator to help train residents on this key skill. For simulation training to be fully adopted by the orthopaedic community, strong evidence that it is beneficial to a surgeon’s performance must first be established. The aim of this work is to examine how simulation training with the wire navigation simulator can be used to improve a resident’s wire navigation performance. The work also examines the metrics used to evaluate a resident’s performance in a simulated environment and in the operating room to understand which metrics best capture wire navigation performance. In the first study presented, simulation training is used to improve first year resident wire navigation performance in a mock operating room. The results of this study show that depending on how the training was implemented, residents were able to significantly reduce their tip-apex distance in comparison with a group that had received a simple didactic training. The study also showed that performance on the simulator was correlated with performance in this operating room. This study helps establish the transfer validity of the simulator, a key component in validating a simulation model. The second study presents a model for using the simulator as a platform on which a variety of wire navigation procedures could be developed. In this study, the simulator platform, originally intended for hip wire navigation, was extended and modified to train residents in placing a wire across the iliosacral joint. A pilot study was performed with six residents from the University of Iowa to show that this platform could be used for training the other applications and that it was accepted by the residents. The third study examined wire navigation performance in the operating room. In this study, a new metric of performance was developed that measures decision making errors made during a wire navigation procedure. This new metric was combined with the other metrics of wire navigation performance (tip-apex distance) into a composite score. The composite score was found to have a strong correlation (R squared = 0.79) with surgical experience. In the final study, the wire navigation simulator was taken to a national fracture course to collect data on a large sample of resident performance. Three groups were created in this study, a baseline group, a group that received training on the simulator, and a third group that observed the simulator training. The results of this study showed that the training could improve the overall score of the residents compared to the baseline group. The overall distribution from resident performance between groups also shows that a large portion of residents that did not receive training came in below what might be considered as competent performance. Further studies will evaluate how this training impacts performance in the operating room.

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Lalys, Florent. "Automatic recognition of low-level and high-level surgical tasks in the Operating Room from video images." Phd thesis, Université Rennes 1, 2012. http://tel.archives-ouvertes.fr/tel-00695648.

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La besoin d'une meilleure intégration des nouveaux systèmes de chirurgie assistée par ordinateur dans les salles d'opération à récemment été souligné. Une nécessité pour atteindre cet objectif est de récupérer des données dans les salles d'opérations avec différents capteurs, puis à partir de ces données de créer des modèles de processus chirurgicaux. Récemment, l'utilisation de vidéos dans la salle d'opération a démontré son efficacité pour aider à la création de systèmes de CAO sensibles au contexte. Le but de cette thèse était de présenter une nouvelle méthode pour la détection automatique de tâches haut niveaux (i.e. phases chirurgicales) et bas-niveaux (i.e. activités chirurgicales) à partir des vidéos des microscopes uniquement. La première étape a consisté à reconnaitre automatiquement les phases chirurgicales. L'idée fut de combiner des techniques récentes de vision par ordinateur avec une analyse temporelle. Des classifieurs furent tout d'abord mis en œuvre pour extraire des attributs visuels et ainsi caractériser chaque image, puis des algorithmes de classification de séries temporelles furent utilisés pour reconnaitre les phases. La deuxième étape a consisté à reconnaitre les activités chirurgicales. Des informations concernant des outils chirurgicaux et des structures anatomiques furent détectées et combinées avec l'information de la phase précédemment obtenu au sein d'un système de reconnaissance intelligent. Après des validations croisées sur des vidéos de neurochirurgie et de chirurgie de l'œil, nous avons obtenu des taux de reconnaissance de l'ordre de 94% pour la reconnaissance des phases et 64% pour la reconnaissance des activités. Ces systèmes de reconnaissance pourraient être utiles pour générer automatiquement des rapports post-opératoires, pour l'enseignement, l'apprentissage, mais aussi pour les futurs systèmes sensibles au contexte.

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McDonald, Cynthia J. "Assessment of self-esteem in first semester students in the surgical technologist program at Northeast Wisconsin Technical College." Online version, 1999. http://www.uwstout.edu/lib/thesis/1999/1999mcdonaldc.pdf.

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Liechty, Elizabeth. "Values and perceptions of caring by perioperative nurse associates." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/958799.

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Caring is emerging as an important concept for the nursing profession especially within the perioperative arena (Bickler, 1994; McNamara, 1995; Rawnsley, 1990). The purposes of this study were to investigate: (a) the relationship between perioperative nurse associates' values and caring behaviors; and (b) the relationship between perioperative nurse associates' perceptions of own demonstrated caring behaviors to demonstrated caring behaviors of nurse managers.The study was based upon Watson's (1985) model of Human Caring. The instruments used were Staub's (1989) Values Questionnaire and Nkongho's (1990) Caring Ability Inventory. A demographic profile of study participants was obtained. The population included all nurses (48,000) who were members of the Association of Operating Room Nurses (AORN). The sample consisted of 300 randomly selected non-managerial perioperative nurse associates obtained from the membership list of AORN.A cover letter explaining the study along with a demographic questionnaire and three survey instruments were mailed to the 300 perioperative associates at their home address. The surveys were returned to the investigator by mail in a furnished self-addressed stamped envelope (n=96). Procedures for human subject protection were followed.A descriptive correlation design and descriptive statistics were used for data analysis. Perioperative nurses identified three recurring themes as suggestions for incorporating caring behaviors by nurse managers; (a) improved communication skills; (b) increased accessibility; and (c) empowerment of nurses. Findings showed a moderately positive and significant relationship between values and caring behaviors supporting Watson's Theory of Human Care (1985). Results showed no relationship of caring behaviors between nurse associates and nurse managers. However, the data did reveal that nurse associates perceived themselves as more caring than the nurse managers.
School of Nursing

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Boson, Maria, and Linda Smedman. "Operationssjuksköterskans upplevelse av sin yrkesroll : -en kvalitativ intervjustudie." Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-13527.

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Abstract:

Bakgrund Yrket som operationssjuksköterska är idag den äldsta sjuksköterskespecialiteten men förblir främst en dold yrkesroll på grund av att det utövas bakom stängda dörrar. Yrkesrollen skildrades som komplex och kretsade omkring patienten, samarbetet och den tekniska utrustningen Patricia Benners teorier om sjuksköterskans yrkesutveckling användes som teoretisk förankring i studien. Syfte Studiens syfte var att belysa hur operationssjuksköterskan upplever sin yrkesroll. Metod Studien genomfördes med en kvalitativ ansats och tio semistrukturerade intervjuer utfördes med operationssjuksköterskor från två sjukhus i Sverige under våren 2011. Alla intervjuer spelades in och transkriberades ordagrant. Insamlat data analyserades med kvalitativ innehållsanalys. Resultat I textanalysen identifierades tolv subkategorier och fyra kategorier; rollen som omvårdnadsansvarig, upplevelsen av vad som gör operationssjuksköterskan trygg i sin yrkesroll, betydelsen av att vara medarbetare i arbetet på operationssalen och synen på den egna professionen. Operationssjuksköterskorna beskrev sitt arbete som patientfokuserat och möjligheten att hjälpa medförde känslan av att göra skillnad. Erfarenhet och uppskattning gav ett självförtroende som resulterade i att operationssjuksköterskorna blev trygga i sin yrkesroll. Operationssjuksköterskorna beskrev kommunikation på salen som essentiellt för ett fungerande samarbete och menade att de anpassade sig efter sina medarbetare. Operationssjuksköterskorna upplevde sin yrkesroll både som osynlig och utvecklande. Citat från informanterna presenterades i texten för att tydliggöra resultatet. Slutsats Studien visade att operationssjuksköterskorna har en central roll för omvårdnaden på operationsavdelningen och för patienten. Operationssjuksköterskans närvaro och kompetens vid operationer var oersättlig men ständigt beroende av teamet omkring sig.
Background The profession of operating room nurse is now the oldest nursing specialty, but remains primarily a hidden profession because it is exercised behind closed doors. The professional role were described as complex and revolved around the patient, cooperation and the technical equipment. Patricia Benners theories on the nurses’ professional development were used as a theoretical basis in the study. Aim The study aimed to elucidate how the operating room nurse perceives the professional role. Method The study was conducted with a qualitative approach and ten semi-structured interviews were carried out with operating room nurses from two hospitals in Sweden in spring 2011. All interviews were recorded and transcribed verbatim. To analyze the collected data content analysis with an inductive approach was used. Result In the text analysis twelve subcategories and four categories were identified: the role as being responsible of nursing, the experience of what makes the operating room nurse safe in the professional role, the meaning of being a co-worker during the work on the operating room and the view on the own profession Quotes from the informants were presented in the text to clarify the result. Conclusion The study showed that the operating room nurse has a central role for nursing in the surgical ward and the patient. The operating room nurse presence and expertise in operations was irreplaceable, but always dependent of the team around him/her.

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Dissertations / Theses on the topic 'Operating Room and Surgical Nursing'

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