Joy Don Baker

Bowel preparation effectiveness: inpatients and outpatients.

This study describes colon visibility and case cancelations of patients taking self-administered outpatient colonoscopy preparation or inpatient preparation at a large north central Texas hospital. The convenience sample of 120 adult patients who were scheduled for a colonoscopy ranged in age from 25 to 88 years. A 33-item investigator-developed questionnaire was used to record patient demographics, type of bowel preparation, signs and symptoms, and colon visualization score obtained during the procedure. On the basis of the visualization scores, there was no significant difference between the outpatient self-administered bowel preparation and the inpatient preparation administered in the hospital setting. There were clinical findings indicating that specific preparation solutions had a slightly higher incidence of nausea or vomiting. Additionally, an opportunity for documentation improvement was identified and reported to the nursing documentation committee for further investigation.

Nursing Education Gets a Second Life

e l o t t a t s c r c m c Second Life® (SL) is a three-dimensional world created by its users who interact with each other online for activities such as nursing education, business meetings or networking, and entertainment (eg, music, art). Each user is represented by an avatar (ie, a digital representation of oneself that is created, customized, and manipulated by the user). Individuals use SL for a variety of reasons. For example, musicians may join SL and put on a concert, which helps increase exposure to their music and boost their careers in SL and in real life. Artists use SL to display their work in virtual art galleries. Perioperative nurses can create poster exhibits, similar to those displayed at AORN Congress, to showcase quality improvement practices and perioperative research (Figure 1). Individuals are able to reach more people in less time using this virtual platform than they would in real life. Business and health care professionals may use SL to establish their brand, share their products and services with users, announce and hold virtual events (eg, fundraising, educational), and conduct business meetings. Using SL as a platform allows businesses and health care providers to extend their reach to potential customers and patients whom they may not have been able to reach using other means. Perioperative nurses also may come to SL as a means for social interaction and entertainment.

Serious Games and Perioperative Nursing

AN OPPORTUNITY FOR PERIOPERATIVE NURSING Overcoming fear and facing sometimes frightening situations is a basic skill needed by all perioperative nurses. Other wise, how could we ever provide the level of care required for our patients? Each day, we assess our pa tients, knowing that we will participate in procedures during which cutting into a human occurs. If a serious game could help nurses overcome fear of new procedures, learn changes in the sequencing of events, reduce the stress of a situation, or help prevent errors, then the patient is the ultimate winner. Nursing practice represents a combination of art and science. Serious games

The Purpose, Process, and Methods of Writing a Literature Review

erioperative nurses are bombarded with an overwhelming volume of nursing and health care publications; however, in-depth literature reviews provide a foundation for consolidating information from myriad publications with the potential to lead to improving clinical practice. Authors write literature reviews to examine previous studies, provide background regarding what is known on a topic, and establish the foundation for a change in practice. Marshall defines a literature review as “a systematic method for identifying, evaluating, and interpreting work produced by researchers, scholars, and practitioners.” Using a culminating clinical literature review on a specific topic aids perioperative nurses and other health care practitioners by providing a way to identify best practices for clinical strategies and therefore maximize their time with patients. Articulating what interventions are successful and unsuccessful is a targeted outcome of systematic literature reviews. This article focuses on four key elements of literature reviews: the purpose, preparation process, types, and methods.

Technology in the OR: AORN Members' Perceptions of the Effects on Workflow Efficiency and Quality Patient Care

This collaborative study sought to describe technology used by AORN members at work, inclusive of radio-frequency identification or barcode scanning (RFID), data collection tools (DATA), workflow or dashboard management tools (DASHBOARD), and environmental services/room decontamination technologies (ENVIRON), and to identify the perceived effects of each technology on workflow efficiency (WFE) and quality patient care (QPC). The 462 respondents to the AORN Technology in the OR survey reported use of technology (USE) in all categories. Eleven of 17 RFID items had a strong positive correlation between the designated USE item and the perceived effect on WFE and QPC. Five of the most-used technology items were found in the DATA category. Two of the five related to Intraoperative Nursing Documentation and the use of the Perioperative Nursing Data Set. The other three related to Imaging Integration for Radiology Equipment, Video Camera Systems, and Fiber-optic Systems. All three elements explored in the DASHBOARD category (ie, Patient Update, OR Case, OR Efficiency) demonstrated approximately 50% or greater perceived effectiveness in WFE and QPC. There was a low reported use of ENVIRON technologies, resulting in limited WFE and QPC data for this category.

Perioperative Nurse Engagement in Lifelong Learning

January is a good time for perioperative nurses to reflect on the previous year’s accomplishments and to set goals for the new year. Building on past learning experiences and engaging in future learning opportunities is a foundational element of the perioperative nurse’s practice, and a commitment to lifelong learning is a requirement for all perioperative nurses. Lifelong learning can be “a critical resilience factor combating fatigue, exhaustion,” and burnout, which can develop as a perioperative nurse progresses in his or her career. The perioperative nurse’s commitment to lifelong learning stems from an insatiable hunger for knowledge, passion for wisdom, and excitement for improved engagement with his or her patients. The perioperative nurse is a lifelong learner who views patients’ problems as hurdles to overcome and opportunities to help improve outcomes rather than insurmountable obstacles. The perioperative nurse meets these challenges with self-discipline, intense curiosity, and self-confidence to achieve the needed result for the patient.

DNP and PhD Options for Perioperative Nurses

W hen perioperative nurses ask me about choosing between a doctorate of nursing practice (DNP) and a doctorate of philosophy (PhD), I tell them the key is to understand the choices. The options are simply different; one degree is not better or worse than the other. In deciding between the two degree options, perioperative nurses should ask themselves two questions: First, what do I want to do after I attain a degree? Second, which of the following two categories am I most interested in pursuing:

Specialty nomenclature: a worthwhile challenge.

The PNDS is currently one of 13 vocabularies recognized by ANA (2004). Other examples include the Nursing Interventions Classification (NIC) system; Nursing Diagnoses, Definitions, and Classification (NANDA); Nursing Outcomes Classification (NOC); and Systemized Nomenclature of Medicine Reference Terminology/Clinical Terms (SNOMED RT/CT). Mapping of the PNDS vocabulary with SNOMED RT/CT (SNOMED, 2004) to assist in communicating the vocabulary to other health disciplines was undertaken as a collaborative agreement in 2003 (Beyea, 2002). This allows translation to and with other health disciplines’ coding systems such as the International Classifications of Diseases (ICD) or Private Communication Technology (PCT) protocol codes used by hospitals and physicians. During the 2003 AORN Congress Technical Exhibit in San Diego, California, 11 software vendors demonstrated products using the PNDS. Partnering with the vendors has been a significant step for the AORN’s implementation process of the PNDS. The software vendors understood the value of the coding process used and have worked with AORN to create useful tools for nursing to evaluate and analyze the outcomes of nursing practice in the perioperative settings. An example of how the coding process can be used in the setting is illustrated by the Cerner Corporation in the Perioperative Documentation screen in Figure 1.The codes can either be visible or not depending on the facility’s preferences. Each element can be tracked and variances in patient outcomes associated with nursing diagnosis and interventions analyzed for effectiveness of practice protocols.

Project Team investigates how the Association's organizational structure can be improved to meet future changes, challenges

The members of the Project Team realize that this is a very different concept than that to which members are accustomed. The details of such a change would be developed with member input, and the new structure would be phased in over a period of several years to be fully implemented by the year 2000.

Succession Planning: A Perioperative Imperative

y 2020, as many as 67,000 nurse manager positions could be vacant, and an insufficient pipeline of prepared leaders could affect the “work environment, quality of care, and patient outcomes.” By that same year, approximately 50% of all nurses will be Millennials (ie, born in the 1980s and 1990s). The mean age of current perioperative nurses is between 50 and 60 years; thus, it is time for all perioperative leaders to commit to succession planning and developing strategies for encouraging their younger prot eg es to enter leadership roles. Baby Boomers in leadership roles must commit to leaving a legacy of wisdom upon which future health care can be based.