Amber Wood

AORN’s Revised Model for Evidence Appraisal and Rating

AORN perioperative practice specialists responsible for authoring the Guidelines for Perioperative Practice have spent several years using evidence-based practice tools adapted from other organizations. AORN now has its own evidence appraisal tools and model for evidence-based practice that can be used by nurses and students to appraise research and nonresearch articles and assign an evidence rating to help inform perioperative practice decisions. The new and revised tools include a new evidence rating model, hierarchy of evidence, and expanded appraisal tools.

Back to Basics: Environmental Cleaning

The need for a clean perioperative environment is a basic principle for all perioperative team members. Recent evidence suggests that the environment plays a role in the occurrence of health care-associated infections (HAIs), including surgical site infections. Frequently cleaning high-touch surfaces helps prevent the spread of infections, and routinely cleaning and disinfecting the patients environment can reduce the level and frequency of contamination and the risk of HAIs. Perioperative personnel should use a bundled approach to perform a standardized cleaning routine and implement a successful monitoring program.

Clinical Issues—September 2017

Performing Staphylococcus aureus decolonization for urgent procedures Key words: decolonization, Staphylococcus aureus, MRSA, MSSA, mupirocin. Hand hygiene before donning gloves Key words: hand hygiene, glove, personal protective equipment. Hand hygiene before skin prep Key words: hand hygiene, skin prep, sterile task, aseptic task. Scrubbing by stroke versus timed method Key words: surgical hand rub, surgical scrub, stroke method, timed method.

Clinical Issues—February 2017

Implementing surgical smoke evacuation practices Key words: surgical smoke, compliance, health effects, smoke evacuators. Surgical smoke evacuation policies and procedures Key words: surgical smoke, smoke evacuation, policy, procedure. Measuring compliance with surgical smoke evacuation practices Key words: surgical smoke, smoke evacuation, compliance. Patient safety and hand hygiene Key words: hand hygiene, hand wash, hand rub, patient safety, point of use.

Clinical Issues—January 2016

Use of count boards Key words: count, retained surgical item, RSI, count board, whiteboard, dry erase board. Subtracting items from the count Key words: count, retained surgical item, RSI, subtract, remove. Counting miscellaneous items for gynecological procedures Key words: count, retained surgical item, RSI, bulb syringe, cervical cup, vagina. RN first assistants (RNFAs) performing initial count Key words: count, retained surgical item, RSI, RNFA, first assistant.

Clinical Issues‐October 2015

Personnel wearing hijabs in the OR Key words: hijab, head covering, hair covering, Muslim, Islam. Isolation precautions for perioperative patient visitors Key words: isolation, contact, droplet, airborne, visitor.

Clinical Issues‐June 2016

Use of alcohol (ethanol)-based hand rubs (ABHRs) during pregnancy Key words: alcohol, ethanol, hand rub, ABHR, hand sanitizer. Working when experiencing a shingles infection Key words: shingles, varicella, zoster, employee health. Cleaning rigid containers Key words: rigid container, container, instrument pan.

Clinical Issues‐December 2016

Head coverings Key words: head cover, bouffant, skull cap, hair, scalp. Skin preps Key words: skin preps, antiseptics, cesarean delivery, surgical site infections, abdomen. Pediatric surgical counts Key words: pediatrics, counts, surgical, retained surgical items, policy. Sterile set up Key words: sterile table, sterile set up, covering, monitoring, contamination. Surgical hand antisepsis Key words: surgical hand rub, application, surgical scrub, scrubbed areas.