A Nurse-Led Implementation Science Specialist Program.

A well-known challenge in health care is integrating evidence into practice. Implementation science (IS) is a growing field that promotes the sustainable application of evidence-based practice (EBP) to clinical care. Health care organizations have an opportunity to support sustainable change by creating robust IS infrastructures that engage nurses in the clinical environment.

Growing Novice Nurses to Perianesthesia Care: Formation of a Post-Anesthesia Care Unit (PACU) Fellowship.

Purpose: To provide a proof of concept of a structured, replicable perianesthesia fellowship program for nurses with less than 2 years of experience and new graduate nurses.

Design: An immersive learning experience was implemented as a pilot quality improvement project using the Plan-Do-Study-Act method.

Methods: This 24-week fellowship program used blended learning approaches and the Tiered Skill Acquisition Model (TSAM) to develop foundational Post Anesthesia Care Unit (PACU) skills.

Thoracic enhanced recovery with ambulation after surgery: a 6-year experience.

Objectives: Our institution implemented a protocol known as thoracic enhanced recovery with ambulation after surgery (T-ERAS) in thoracic operations. The objective was early ambulation starting in the postoperative ambulatory care unit.

Methods: Video-assisted thoracoscopic surgery lobectomy patients are placed on a chair in the preoperative area and then walked to the operating room.

Interrater Reliability of Hospital Readmission Evaluations for Surgical Patients.

Value-based purchasing initiatives have helped shift attention to the accuracy of hospital readmission information at the most clinically detailed level. The purpose of this study was to determine the interrater reliability (IRR) of surgical experts in assessing surgical inpatient readmissions for categorical causes, relation to index procedure, and potential preventability. Cases were selected from the American College of Surgeons National Surgical Quality Improvement Program local database.

Top 10 patient safety issues: what more can we do?

A 2012 survey of AORN members identified the top 10 safety issues reported by perioperative nurses. These nurses are in a unique position to understand the errors and the unreported near misses that occur in the OR. For each of the top-rated safety issues that RNs identified, we discuss the evidence of risk and contributing factors and make targeted recommendations for further improvement in perioperative safety with the goal of mitigating risk and improving patient outcomes.

Effectiveness of 2% CHG cloth bathing for reducing surgical site infections.

We conducted a prospective cohort study on the effectiveness of preoperative bathing with chlorhexidine gluconate (CHG) cloths for reducing surgical site infections. We hypothesized that use of CHG cloths as an adjunct to surgical prep would significantly reduce the endogenous flora of surgical patients and therefore reduce surgical site infections. Data from a control group of patients who had undergone general, vascular, and orthopedic surgery were used for comparison.

Priority patient safety issues identified by perioperative nurses.

Much of the work done by perioperative nurses focuses on patient safety. Perioperative nurses are aware that unreported near misses occur every day, and they use that knowledge to prioritize activities to protect the patient. The purpose of this study was to identify the highest priority patient safety issues reported by perioperative RNs.

A pragmatic and successful approach to treating nonsmall-cell lung carcinoma.

Lung cancer is the single leading cause of cancer deaths for men and women combined. Nonsmall-cell lung carcinoma (NSCLC), which results largely from smoking tobacco, accounts for 87% of all lung cancer cases. Methods of patient selection, preoperative and intraoperative care, and postoperative outcomes for patients with NSCLC who were treated from 1991 through 2003 at Inova Fairfax Hospital are discussed.