The demand for high-quality, cost-effective health care in the United States is growing expeditiously due to the passage of the Affordable Health Care Act in 2010, the lack of physicians specializing in primary care and the shortage of graduate level educated nurses (Watson, 2007). The new expectations for access, quality and affordability within the health care system are creating opportunities for nurse practitioners to expand their roles as advance practice nurse specialists (Watson, 2007). This paper will examine the role of the perioperative nurse practitioner. This examination will define perioperative nursing, give a brief history of operating room nursing, and look closely at the role of the nurse practitioner in pre-operative, intra-operative and post-operative care. This paper will report the evidence-based findings that nurse practitioners in the perioperative setting, when compared to physician-only facilitated care, create an equally therapeutic and healing environment for patients and families, improve the efficacy of surgical procedures and increase patient satisfaction with surgical outcomes. Other topics that will be examined include educational training, the scope of practice for nurse practitioners within the perioperative setting and the application of the holistic nursing approach in perioperative care. The final area this paper will examine is The Institute of Medicine’s (IOM) Report on the Future of Nursing and how it’s recommendations have the potential to change perioperative nursing. What is Perioperative Nursing? Perioperative nursing is a specialized area of practice that works with patients before (preoperative), during (intraoperative) and after (postoperative) surgery (Potter et al., 2013). It is pra... ... middle of paper ... ...ursing still continues to decline today because students do not have access to perioperative education in nursing school and once a new nurse has entered the professional medical field, there are no clear pathways to become a perioperative nurse. Works Cited Battie, R. (2013). The IOM Report on the Future of Nursing: What Perioperative Nurses Need to Know. AORN Journal, 98, 227-234. Potter, P., Perry, A., Stockert, P., Hall, A. (2013). Fundamentals of Nursing, (8th Ed.). St. Louis, MO: Elsevier Mosby. Seliman, D., Andsoy, I. (2011). The Importance of a Holistic Approach During the Perioperative Period. AORN Journal, 93, 482-486. Wade, P. (2012). Historical Trends Influencing the Future of Perioperative Nursing. ORNAC Journal, 30, 22-25. Watson, D. (2007). The Multidimensional Role of the Perioperative Nurse Practitioner. Perioperative Nursing Clinics, 2, 19-21.
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Mr Edward Sales, RN, BSN, is a perioperative nurse in a 6 bed Operating Room unit. He is the Urology Lead RN, Orthopedics/Spine Service Second Lead RN, and also functions as the Acting Unit Flow Coordinator (in the absence of the Unit Coordinator). Over the past several years, Mr. Sales has demonstrated continued leadership in Perioperative Nursing practice. His contributions to this area of practice have positively influenced client care at the nursing service and across the local medical center. Mr. Edward Sales is a role model in the application of the nursing process.
According to agency of health care research and quality it is estimated that almost one third of health care spending is due to inpatient surgical procedures and it also estimates that average hospital costs has been increased from $ 9,100 in 2003 to $11,000 in 2013. [4] Some major reasons for this increase in costs includes lack of coordination, risk associated with complicated surgical procedures, poor patient engagement in decision making, quality requirements and etc. The perioperative surgical homes are very effective in solving these problems and achieve better surgical outcomes as it is a coordinated care which is led by multi specialty physicians who provides continuum of care to patients from the time of decision to 30 days after discharge of the patient i.e., it is incorporated in to include all three phases of surgery; perioperative, intra-operative and postoperative
Ignatavicius, D.D. & Workman, M.L.(2010). Medical-Surgical Nursing: Patient-Centered Collaborative Care. (6th ed.). St. Philadelphia PA: Saunders Elsevier
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Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
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Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).
The sample used for this study was 145 perioperative nurses from the Association of periOperative Registered Nurses (AORN) membership living in New Jersey. Their ages ranged from 31 to 68 with a mean age of 47.7 years and a median age of 46 years. Ninety-eight percent of the study participants were female. Eighty-six percent were Caucasian, 7.6% were Asian/Pacific Islander, 2.1% were African American, and 2.8% listed other ethnic backgrounds or did not answer the question.
Postoperative education is essential to a patient’s recovery after surgery and should be incorporated as part of the discharge process (Bobay et al., 2015). Currently, nurses are challenged in providing timely and relevant discharge teaching. Lack of nursing resources, complex workloads, and insufficient education hinder effective delivery (Cebeci & Celik, 2008).
Perioperative nursing has a high demand among their nursing colleagues. Even though there are departments that are rather demanding mentally or physically, there is pressure to produce quality nursing in surgical services. Surgery has always been a fascination with the general public. However, a worry that most nurses will be concerned with is the lack of personnel.
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.