Myrna Mamaril

ASPAN's Delphi study on national research: priorities for perianesthesia nurses in the United States.

Prudent nursing practice mandates the best, scientific evidence available. The complexity of perianesthesia practice, management, and education, coupled with required competencies within these domains, generate problems demanding answers. ASPANs financial and human resources, however, are limited. Therefore, ASPAN must be able to articulate research priorities. The purpose of this study was to identify and prioritize the research questions related to perianesthesia practice, management, and education. A three-round Delphi study conducted with perianesthesia nursing experts determined research priorities for perianesthesia nursing practice. Research problems were identified and refined into research questions. Questions were ranked for their priority. Research priorities focused on the following themes: evidence supporting ASPAN standards, staffing ratios, nurse fatigue, adverse patient outcomes, patient care issues related to intensive care unit (ICU) overflow, obstructive sleep apnea, pain management, glycemic control, and clinical critical care competencies. This study advances the mission of ASPAN by identifying the top national perianesthesia research priorities related to practice, management, and education, and should guide researchers in their continued exploration of the science of perianesthesia nursing.

Perianesthesia nursing advocacy: an influential voice for patient safety.

Perianesthesia nurses are called to advocate for their patients, promote a safe work environment, and contribute to the continued advancement of the nursing profession. Nurses must demonstrate vigilance in their nursing care to protect patients from harm. It is an ethical and legal responsibility to request physicians to review with patients their informed consents when they report they do not understand or have questions about the surgical procedure. Likewise, nurses need to alert managers and administrators when they experience unsafe work environments, such as actual or potential nurse staffing issues, unsafe nurse-to-patient ratios, medication errors, and nurse fatigue. This article focuses on the valuable role perianesthesia nurses play in patient advocacy by: (1) speaking out on behalf of the patient, (2) assuring a safe work environment, (3) assessing for nurse fatigue, and (4) advocating patient safety for the global nursing profession.

Speak Out for Patient Safety: Guest Editorial

THE DRUMS OF HEALTH CARE REFORM are once again sounding throughout the United States, but this time the impact of federal mandates threatens severe cost-containment initiatives, with renewed scrutiny directed at nurse staffing ratios. Hospitals across the country are beginning to look at labor costs with special attention to nursing, which comprises one of the largest components. Nurse managers are therefore charged with reducing operational costs, while concurrently expected to meet productivity goals, ensure quality imperatives, and foremost, keep patients safe. Clearly, this is the ‘‘perfect storm’’ of conflicting demands. As the winds of change have intersected with the hurricane forces of the Affordable Care Act, hospitals must look to reposition themselves to serve patients well. No one really knows the true ramifications and full consequences of the coming changes. We hear daily about the severe effects of budgetary sequestration impacting reimbursement and program availability, the need to change significantly the delivery of health care, and eliminate entitlements. These issues are hotly debated from Washington, DC, to the kitchen table. It is during these adverse times that the profession of nursing needs to unite its members, speak with one voice, and be recognized. The effect of changes in health care in the high acuity and physically demanding environment of perianesthesia nursing can be detrimental to the workforce and recipients of care. Likewise, perianesthesia nurse managers covering preadmission, same-day surgery, phase I, phase II, and extended care units must be aligned with that