Sharon A. Van Wicklin

Implementing a research utilization plan for prevention of deep vein thrombosis

Ensuring use of best practices is crucially important in todays health care system. Nurses can identify research results that offer promising new treatment options for their patients and should have a plan for implementing research findings. The perioperative education coordinator at one facility identified the occurrence of deep vein thrombosis as a significant problem. She conducted a literature review, created an education program for nurses, and implemented an evidence-based practice change. This article describes the steps in this process. Now, patients at the facility consistently are assessed for deep vein thrombosis and receive appropriate preventive treatment.

Implementing AORN Recommended Practices for Hand Hygiene

This article focuses on implementing the revised AORN Recommended practices for hand hygiene in the perioperative setting. The content of the document has been expanded and reorganized from the previous iteration and now includes specific activity statements about water temperature, water and soap dispensing controls, the type of dispensers to use, paper towel dispenser requirements, placement of soap and rub dispensers, and regulatory requirements for products and recommendations for hand hygiene practices. A successful hand hygiene program allows end users to have input into the selection and evaluation of products and should include educating personnel about proper hand hygiene, product composition and safety, and how and when to use specific products. Measures for competency evaluation and compliance monitoring include observations, quizzes, skills labs, electronic monitoring systems, handheld device applications, and data collection forms.

Implementing AORN Recommended Practices for Prevention of Deep Vein Thrombosis

One to two people per 1,000 are affected by deep vein thrombosis (DVT) or pulmonary embolism in the United States each year. AORN published its new Recommended practices for prevention of deep vein thrombosis to guide perioperative RNs in establishing organization-wide protocols for DVT prevention. Strategies for successful implementation of the recommended practices include taking a multidisciplinary approach to protocol development, providing education and guidance for performing preoperative patient assessments and administering DVT prophylaxis, and having appropriate resources and the facilitys policy and procedure for DVT prevention readily available in the practice setting. Hospital and ambulatory patient scenarios have been included as examples of appropriate execution of the recommended practices.

Developing effective drills in preparation for a malignant hyperthermia crisis.

A malignant hyperthermia (MH) crisis is a medical emergency. To give the patient the best possible chance for a successful outcome, a swift, coordinated, multidisciplinary team response is necessary. Malignant hyperthermia occurs infrequently and, as such, details about its diagnosis, treatment, and management must be reviewed and reinforced during periodic education sessions. An MH response plan should be developed to guide a multidisciplinary team during an MH crisis. This plan should be tailored to the needs of the individual health care organization and practiced and refined during periodic simulations of MH episodes, such as MH mock drills.

Clinical Issues—January 2012

n This Monthn n n Venous thromboembolism prophylaxis in pediatric patientsn n Key words: pediatric patients, venous thromboembolism, prophylaxis.n n n The Centers for Disease Control and Prevention surgical wound classification systemn n Key words: surgical wound, wound classification, clean wound, clean-contaminated wound, contaminated wound, dirty infected wound.n n n Using the Surgical Wound Classification Decision Tree tooln n Key words: surgical wound, wound classification, clean-contaminated wound, contaminated wound.n n n Using cotton surgical masksn n Key words: allergy, cotton surgical masks, fabric surgical masks, disposable surgical masks.n n n Using povidone-iodine solution for surgical skin antisepsis before thyroid proceduresn n Key words: povidone iodine, thyroid, surgical skin antisepsis.n n n

Clinical Issues‐May 2016

Variations in documenting surgical wound classification Key words: surgical wound classification, clean, clean-contaminated, contaminated, dirty. Wearing long-sleeved jackets while preparing and packaging items for sterilization Key words: long-sleeved jackets, organic material, sterile processing. Endoscopic transmission of prions Key words: prions, high-risk tissue, low-risk tissue, Creutzfeldt-Jakob disease (CJD), variant Creutzfeldt-Jakob disease (vCJD). Wearing gloves when handling flexible endoscopes Key words: gloves, low-protein, powder-free, natural rubber latex gloves, latex-free gloves.

Clinical Issues—August 2017

Caring for patients with tattoos undergoing magnetic resonance imaging (MRI) procedures Key words: magnetic resonance imaging, tattoos. Reducing slips, trips, and falls caused by electrical cords on the procedure room floor Key words: slips, trips, falls, electrical cords, equipment booms. Classifying surgical limb amputation wounds Key words: wound classification, documentation, amputation. Preventing postoperative pressure alopecia Key words: alopecia, occipital neuropathy, scalp massage. Using prophylactic dressings to prevent pressure injury Key words: prophylactic dressings, silicone foam dressings, sacral dressings, heel dressings, pressure injury.