Journal of PeriAnesthesia Nursing RSS feed: Current Issue. The Journal of PeriAnesthesia Nursing provides original, peer-reviewed research for a primary audience that includes nurses in perianesthesia settings, including ambulatory surgery, preadmission testing, postanesthesia care (Phases I and II), extended observation, and pain management. The Journal provides a forum for sharing professional knowledge and experience relating to management, ethics, legislation, research, and other aspects of perianesthesia nursing.http://www.jopan.org/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. Journal of PeriAnesthesia Nursing1089-9472254August 2010 © 2010 Published by Elsevier Inc. healthpermissions@elsevier.comhttp://www.jopan.org/article/PIIS1089947210002546/abstract?rss=yesDecember 1, 2009 was the tenth anniversary of To Err is Human, the Institute of Medicine (IOM) report on medical errors in the health care system. Dr. Wachter notes that this report “arguably launched the modern patient-safety movement.” In an updated analysis, Wachter looks at the progress that has been made since that initial report and also gives an in-depth description of the gaps that are still present.Patient Safety—Ten Years LaterJan Odom-Forren10.1016/j.jopan.2010.06.002Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Editorial Opinion209211http://www.jopan.org/article/PIIS1089947210002534/abstract?rss=yesIN THIS ISSUE of the Journal of PeriAnesthesia Nursing (JoPAN), Corbett and colleagues investigated the anti-inflammatory effects of ellagic acid using an established rodent animal model. Ellagic acid is a major component of pomegranate juice, an increasingly popular dietary supplement used by the American adult population. How pomegranate juice and other over-the-counter dietary supplements interact with anesthesia and affect a patient’s recovery from surgery is largely unknown. Although it is rare for JoPAN to publish nursing research involving animal (ie, preclinical) models, such studies may significantly influence the clinical practice of perianesthesia nurses. For example, Pierce and Clancy found that hypoxia-induced diaphragm fatigue was not caused by a decrease in neuromuscular excitation of the diaphragm in anesthetized rats, but rather by decreased oxygen availability caused by low arterial blood oxygen content. These authors concluded that tidal volume might not be a reliable index of diaphragm fatigue, because a patient could be using their accessory muscles to maintain adequate tidal volume.Integrating Animal Model Research Into Perianesthesia Nursing PracticeAutumn M. Schumacher10.1016/j.jopan.2010.06.001Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Article Commentary212213http://www.jopan.org/article/PIIS108994721000242X/abstract?rss=yesFew studies have investigated the anti-inflammatory properties of ellagic acid and no published studies have examined the effects of ellagic acid in combination with anesthetic adjuvants. In this study, 54 Sprague-Dawley rats were assigned to one of six groups: (1) vehicle; (2) ketorolac and vehicle; (3) meloxicam and vehicle; (4) ellagic acid and vehicle; (5) ellagic acid, ketorolac, and vehicle; and (6) ellagic acid, meloxicam, and vehicle. Groups 5 and 6 investigated interactions between ellagic acid and cyclooxygenase inhibitors. Paw inflammation was induced with 3% carrageenan and was measured with a plethysmometer at 30 minutes and 4, 8, and 24 hours after intraperitoneal injection. All rats received one intraperitoneal injection of equivalent volumes according to group assignment. Analysis of covariance followed by post hoc analysis determined that ketorolac was the only compound to significantly reduce paw edema at 4 hours (P = .019); ellagic acid alone (P = .038) and the combination of ellagic acid and ketorolac (P = .038) were the only compounds to significantly reduce paw edema at 8 hours. At 24 hours, only ellagic acid was effective (P = .01). Our findings suggest that ellagic acid may be effective against inflammation, may have a prolonged onset and duration of action, and may interact with known cyclooxygenase inhibitors.Evaluation of the Anti-inflammatory Effects of Ellagic AcidStephanie Corbett, Janice Daniel, Rachael Drayton, Melanie Field, Rebecca Steinhardt, Normalynn Garrett10.1016/j.jopan.2010.05.011Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Original Articles214220http://www.jopan.org/article/PIIS1089947210002431/abstract?rss=yesThis article presents a case report of a 52-year-old female patient with lung cancer presenting with Raynaud’s phenomenon during thoracic surgery. Experiences and lessons learned from this case are presented. The classification, pathogenesis, and perianesthesia management of Raynaud’s phenomenon are discussed.Perianesthesia Management of Raynaud’s Phenomenon—A Case ReportYong X. Liang, Miao N. Gu, Shi D. Wang, Hai C. Chu10.1016/j.jopan.2010.05.012Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Original Articles221225http://www.jopan.org/article/PIIS1089947210002406/abstract?rss=yesUndergoing a procedure that requires anesthesia can be anxiety provoking. Anxiety is associated with increases in heart rate and blood pressure and other changes that can have a negative impact preoperatively; during the induction, maintenance, and emergence phases of anesthesia; and postoperatively. Music therapy is a nonpharmalogical intervention that has the ability to reduce anxiety levels in some patients. This review presents research studies that have been conducted on the effects of music therapy for patients in different clinical settings. In general, the majority of the published articles reviewed revealed that listening to music was beneficial to the patient no matter the setting. Offering a music selection to patients before anesthesia could enhance its positive effect. Perianesthesia nurses could easily develop a protocol for different situations where patients will be exposed to interventions where the use of general or local anesthesia is expected.The Efficacy of Music TherapyJudith H. Wakim, Stephanie Smith, Cherry Guinn10.1016/j.jopan.2010.05.009Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Original Articles226232http://www.jopan.org/article/PIIS1089947210002418/abstract?rss=yesNurse-to-nurse hostility (NNH) is an emotional challenge within a group and has a negative impact on performance, nurse satisfaction/retention, health, and patient safety. The purpose of this study was to explore confrontational anxiety scores (CAS) of acute care nurses, including perianesthesia nurses, resulting from NNH by asking: In combined groups, will high levels of individual emotional intelligence (EI) and group emotional competence (GEC) be associated with low CAS and will there be a difference in CAS between military and civilian nurses? Data were gathered from two valid and reliable self-report questionnaires. Participants rated confrontational anxiety from 1 to 5, yielding the CAS. The hypotheses were tested via t test with alpha set at 0.05 and 0.9 powered for combined groups testing. The study was underpowered for individual groups. Statistical significance (P = .02) was found in subscales “Regulation of Emotion,” “Norms for Confronting Members,” and “Team Self-evaluation.” No statistically significant difference in CAS was found between the two populations. The results support the need to improve EI and GEC to achieve constructive and appropriate member behavior during interactions (ie, reduce anxiety and occurrence of NNH) to preserve group trust, effectiveness, and collaboration, therefore positively impacting performance, nurse satisfaction/retention, health, and patient safety.Nurse-to-Nurse Hostility, Confrontational Anxiety, and Emotional Intelligence: An Integral, Descriptive Pilot StudyTommie L. Jones, Daniela Argentino10.1016/j.jopan.2010.05.010Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Original Articles233241http://www.jopan.org/article/PIIS108994721000239X/abstract?rss=yesTraumatic brain injury (TBI) affects approximately 1.4 million individuals and has a mortality rate greater than 30% in the first 72 hours after injury. The patient with TBI can present a significant challenge for the perianesthesia nurse in the acute care setting. Increased intracranial pressure is a common consequence of TBI and the rapid assessment and management can affect the long term outcome of the patient with TBI. New monitoring modalities have been developed to monitor cerebral blood flow and nutritional supply to neurologic tissues. A case scenario will be used to identify priorities for the perianesthesia nurse caring for this challenging patient.Traumatic Brain Injury and Increased Intracranial PressureKim A. Noble10.1016/j.jopan.2010.05.008Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Continuing Education242250http://www.jopan.org/article/PIIS1089947210002388/abstract?rss=yesTHERE IS NO DOUBT in the minds of nurses who work in the ambulatory surgery setting that the more they know about their patients, the better equipped they are to care for and anticipate potential problems. The depth and breadth of that knowledge is provided by the astute assessment skills of the registered nurse (RN) throughout the continuum of care for the perianesthesia patient. This assessment begins in the preadmission/operative evaluation service and continues through the postdischarge follow-up phone calls. Understanding the impact of historical data on the current presentation of the patient provides the avenue for critical thinking and complex problem solving and mediates crisis management when a complication occurs. This two-part column will explore the historical assessment and its impact throughout the perianesthetic continuum of care. Case studies involving untoward outcomes will be reviewed regarding the impact of this historical assessment and its predictive value in managing the patient’s outcomes.Filling in the Lines: Historical Assessments and Their Prevention of Untoward Outcomes in the Day-Surgery PatientSarah M. Cartwright10.1016/j.jopan.2010.05.007Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Ambulatory Surgery251254http://www.jopan.org/article/PIIS1089947210002352/abstract?rss=yesAN UPDATED VERSION of the ASPAN Standards will be available in a few months. The recommended changes from the Standards Committee meeting in October 2009 were approved by the Representative Assembly at the ASPAN National Conference on April 18, 2010. The direction of the new standards is truly remarkable and is a major step in identifying ASPAN as the premier organization for perianesthesia nursing.Why Should We Care About the Standards?Barbara Godden10.1016/j.jopan.2010.05.004Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Clinical Clips255257http://www.jopan.org/article/PIIS1089947210002364/abstract?rss=yesOPIOIDS ARE POTENT analgesics and the mainstay of treatment for moderate to severe postoperative pain. The most commonly used intravenous (IV) opioids in the postanesthesia care unit are morphine, fentanyl, and hydromorphone. All of these agents are potent agonists at the mu-opioid receptor and, when administered in comparable doses, analgesic and adverse effects are similar. Clinicians are quite aware of variability in patient response to what is considered an appropriate dose of an IV opioid. If adequate analgesia is not achieved, increasing the dose and/or frequency of administration (to increase the plasma level) of the opioid does not always improve pain relief and could increase adverse effects. Furthermore, the relationship between opioid dose and pain intensity (using the visual analog scale) is not linear. Opioids have a narrow therapeutic index, necessitating patient-specific opioid therapy with frequent and responsive nurse monitoring to prevent serious events.OpioidsJulie Golembiewski, Andrei M. Rakic10.1016/j.jopan.2010.05.005Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Pharmacology Facts258260http://www.jopan.org/article/PIIS1089947210002510/abstract?rss=yesIn the original article, “The Impact of Music on the PACU Patient's Perception of Discomfort” by Easter et al, (2010;25:79-87), reference number 6 was cited incorrectly. The correct citation is Fredriksson AC, Hellström L, Nilsson U. Patients' perception of music versus ordinary sound in a postanaesthesia care unit; a randomised crossover trial. Intensive & Critical Care Nursing. 2009;25:208-213.Erratum10.1016/j.jopan.2010.05.014Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Pharmacology Facts260260http://www.jopan.org/article/PIIS1089947210002340/abstract?rss=yesIN THIS EDITION of the Practice Corner, the issues surrounding orientation needs of the new PACU nurse will be explored. Questions: Are there guidelines for previous clinical experience required when hiring new nurses in the PACU? Is it possible to hire a new graduate nurse to work in the Phase I PACU? What resources can ASPAN offer to support orientation program development?Orientation of New NursesTheresa Clifford10.1016/j.jopan.2010.05.003Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Practice Corner261262http://www.jopan.org/article/PIIS1089947210002376/abstract?rss=yesETHICS IS DEFINED AS “the principles of conduct governing an individual or a group.” Authenticity and truthfulness are the ethical cornerstones of publication. Authors, editors, and publishers are responsible for presenting readers with original ideas, unsullied research with accurate data, and previously unpublished work. Ethical practices apply to all publications, whether in print or on a Web site.Publication Ethics: Conflicts, Copyright, Permission, and AuthorshipKathlyn Carlson, Jacqueline Ross10.1016/j.jopan.2010.05.006Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3Writing for Publication263271http://www.jopan.org/article/PIIS1089947210002558/abstract?rss=yesTHIS EDITORIAL PRESENTS the last in a series examining the challenges and goals established by the National Priorities Partnership (NPP), which is charged with developing a vision for world-class, affordable health care. The NPP’s final priority concerns the elimination of overuse while ensuring the delivery of appropriate care.National Priorities Partnership: Eliminating OveruseVallire D. Hooper10.1016/j.jopan.2010.06.003Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3The Back Page275277http://www.jopan.org/article/PIIS1089947210002583/abstract?rss=yesMasthead10.1016/S1089-9472(10)00258-3Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3FrontmatterA1A1http://www.jopan.org/article/PIIS1089947210002595/abstract?rss=yesEditorial Board10.1016/S1089-9472(10)00259-5Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3FrontmatterA2A2http://www.jopan.org/article/PIIS1089947210002601/abstract?rss=yesTable of Contents10.1016/S1089-9472(10)00260-1Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3FrontmatterA3A4http://www.jopan.org/article/PIIS1089947210002613/abstract?rss=yesInformation for Contributors10.1016/S1089-9472(10)00261-3Journal of PeriAnesthesia Nursing 25, 4 (2010)2010-08-01Journal of PeriAnesthesia Nursing2010-08-01254S1089-9472(10)X0005-3FrontmatterA6A6