Mary W. Stewart

Research News: Perioperative Normothermia

ASPAN published the Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia in late 2009. In that document, the authors described key terms, risk factors for perioperative hypothermia, core versus near-core temperature measurements, and patient assessment and management guidelines. Notably, interventions include both passive and active warming measures. Active warming measures are defined as the ‘‘application of a forced-air convection warming system and circulating-water mattresses, resistive heating blankets, radiant warmers, negative-pressure warming systems, and warmed, humidified, inspired oxygen,’’ (p. 274). Passive warming measures refer to ‘‘the application of warmed cotton blankets, reflective blankets, socks, and head covering, as well as limiting skin exposure to lower ambient room temperature,’’ (p. 274). The following two studies were identified in the medical literature as recent research involving warming devices in the perioperative period, specifically the efficacy of active warming measures on thermoregulation.

Workplace Violence Against Nurses

RESEARCH CAN HELP solve some of our biggest problems, regardless of their domain, for example, personal, professional, or sociopolitical. In this period of global attention to the #MeToo Movement, female empowerment stands at the precipice of revolutionary change. As a traditionally female-dominated profession, nursing can contribute to and benefit from solutions to abuse and violence against women. A team of Chinese researchers gives voice to clinical nurses who endure adverse consequences of workplace violence. Their work sheds light on a topic that, if we are honest, affects nurses internationally.

The Identity Threat of Weight Stigma in Adolescents

Obesity remains a serious public health issue in adolescents, who may be subjected to weight stigma leading to increased stress and poor health outcomes. Stigma can be detrimental to adolescents during self-identity formation. The purpose of this study was to examine weight stigma in adolescents in light of the Identity Threat Model of Stigma. A cross-sectional correlational design was used to examine the relationships among the variables of weight stigma, psychosocial stress, coping styles, disordered eating, and physical inactivity. Regression modeling and path analysis were used to analyze the data. Over 90% of the sample had scores indicating weight stigma or antifat bias. Avoidant coping style and psychosocial stress predicted disordered eating. The strongest path in the model was from avoidant coping to disordered eating. The Identity Threat Model of Stigma partially explained adolescents’ weight stigma. Nursing practice implications are discussed.

Healthcare Quality: A Concept Analysis.

Worsening quality indicators of health care shake public trust. Although safety and quality of care in hospitals can be improved, healthcare quality remains conceptually and operationally vague. Therefore, the aim of this analysis is to clarify the concept of healthcare quality. Walker and Avants method of concept analysis, the most commonly used in nursing literature, provided the framework. We searched general and medical dictionaries, public domain websites, and 5 academic literature databases. Search terms included health care and quality, as well as healthcare and quality. Peer-reviewed articles and government publications published in English from 2004 to 2016 were included. Exclusion criteria were related concepts, discussions about the need for quality care, gray literature, and conference proceedings. Similar attributes were grouped into themes during analysis. Forty-two relevant articles were analyzed after excluding duplicates and those that did not meet eligibility. Following thematic analysis, 4 defining attributes were identified: (1) effective, (2) safe, (3) culture of excellence, and (4) desired outcomes. Based on these attributes, the definition of healthcare quality is the assessment and provision of effective and safe care, reflected in a culture of excellence, resulting in the attainment of optimal or desired health. This analysis proposes a conceptualization of healthcare quality that defines its implied foundational components and has potential to improve the provision of quality care. Theoretical and practice implications presented promote a fuller, more consistent understanding of the components that are necessary to improve the provision of healthcare and steady public trust.

Research News: Postdischarge Nausea and Vomiting

SCANNING THE RESEARCH for studies relevant to the perianesthesia nurse is always considered successful if new information about nausea and vomiting is uncovered! Truly, postoperative nausea and vomiting (PONV) remains a daily concern for us and our patients. A recent study on postdischarge nausea and vomiting (PDNV) reflects the efforts of an interdisciplinary team and adds to our understanding of this common, but important problem.

Safety and Feasibility

An international team of researchers collaborated to investigate the safety and feasibility of a ketamine package to use during emergency and essential surgeries when no anesthetist was available. In developed countries like the United States, we struggle to understand the life-threatening realities facing two-thirds of the globe where anesthesia services are truly scarce. Fortunately, these authors developed an intervention to help address this unmet need in low-income and middle-income countries.

Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing

To determine the effectiveness of using glacial acetic acid (GAA) to convert unsatisfactory bloody ThinPrep (TP) cervical smear test to satisfactory, and identify associated missed diagnoses and high‐risk HPV (hrHPV) genotypes.

Keeping Patients Warm

Skin disinfection agents include iodine, alcohol, and chlorhexidine gluconate. Regardless of type used, their temperature when applied to the patient’s skin can produce hypothermia. Furthermore, conscious patients are aware and often complain about the uncomfortable coolness of the cleaning solution. Using preheated skin disinfectant offers promise of increasing patient comfort, preventing hypothermia, and reducing the risk of surgical site infections.

Research News: Emergency Surgery in Ambulatory Settings

‘‘SAFETYMUST BE the fundamental core value in everyday practice in perianesthesia settings’’ ( p. 385). The American Society of PeriAnesthesia Nurses (ASPAN) enforced nursing’s critical role in safe practice with the development of the Safety Model. The directive is clear for nurses in general, and perianesthesia nurses in particular to uphold the highest standards of patient safety. The ASPAN Safety Model describes multiple considerations for perianesthesia nurses, regardless of the practice setting, to assure safety at the patient, nursing, and organizational levels. The following report addresses a key question of safety for a population that frequents the surgery and anesthesia theater.

What is the Best Way to Follow-up After Pediatric Surgery?

THE PERIANESTHESIA NURSE’S ROLE does not end when the patient is discharged. Rather, we enter and exit the patient’s story, depending on the setting, procedure, and patient needs. In some cases, the same nurse may admit the patient, help prepare them for surgery, care for them in the postanesthesia area, discharge them, and contact them after discharge. This is particularly true in free-standing surgical clinics. For pediatric patients who have undergone general anesthesia, the follow-up procedure has traditionally been a postoperative visit to the surgeon’s office. In the evolving landscape of American health care, where optimal financial and patient outcomes converge, applying best practices in follow-up care is essential. These researchers investigated the efficacy of a nontraditional follow-up routine with positive results.