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 © 2009 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved. Journal of PeriAnesthesia Nursing1089-9472246December 2009 © 2009 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.jopan.org/article/PIIS1089947209004419/abstract?rss=yesI JUST RETURNED FROM a speaking engagement in Nelson, New Zealand, where I spoke to nurses attending the Perioperative Nurses College of New Zealand Nursing Organisation's annual meeting. The theme of the conference was “Life in Balance in Life.” You can actually see the balance of the words in the phrase. I have been thinking quite a bit about balance in life lately. When I was in school and working on my doctorate, I was initially able to keep balance in my life juggling classes, children, husband, home, church, work, exercise, and relaxation. But at some point during the process, the juggling became an erratic and hectic process. I suppose it could have been when I agreed to co-author a book while I was writing my dissertation!Balancing LifeJan Odom-Forren10.1016/j.jopan.2009.10.015Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Editorial Opinion341342http://www.jopan.org/article/PIIS1089947209003918/abstract?rss=yesSurgery can be a confusing and traumatizing experience for the patient with Alzheimer's Disease (AD). The perianesthesia nurse can better care for the AD patient by acquiring knowledge of the symptoms and stages of the disease, communication skills specific to AD patients, and techniques useful in dealing with AD behaviors. An understanding of AD factors related to anesthesia administration, pain and pain management, as well as general post-operative care, is necessary to create a plan of care that focuses on the AD patient's unique needs. It is important that there be thorough communication along the continuum of care. The health care professional, using well-established nursing skills, paired with Alzheimer's Disease educational resources, can make the challenge of caring for the AD surgical patient less stressful and, hopefully, more satisfying for both the AD patient and the nurse.Perianesthesia Care of the Alzheimer's PatientAnnette S. Williams10.1016/j.jopan.2009.10.001Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Original Articles343347http://www.jopan.org/article/PIIS108994720900392X/abstract?rss=yesPreoperative anxiety is prevalent in surgical patients who may require anxiety medications, thus impacting preoperative teaching and patient satisfaction. No studies were found in a comprehensive search on the effect of essential oils on anxiety in the preoperative setting. The purpose of this experimental study was to investigate whether the essential oil lavandin is more effective than standard care in reducing preoperative anxiety. A convenience sample of 150 adult patients were randomly assigned to either control (standard care), experimental (standard care plus essential oil lavandin), or sham (standard care plus jojoba oil) groups. Visual analog scales were used to assess anxiety on admission and OR transfer. Controlling for baseline anxiety and pain, the lavandin group had significantly lower anxiety on OR transfer, suggesting that lavandin is a simple, low-risk, cost-effective intervention with the potential to improve preoperative outcomes and increase patient satisfaction. Future studies should test the effects of lavandin in the postoperative phase and in specific populations with documented high anxiety.The Use of the Essential Oil Lavandin to Reduce Preoperative Anxiety in Surgical PatientsRebecca Braden, Susan Reichow, Margo A. Halm10.1016/j.jopan.2009.10.002Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Original Articles348355http://www.jopan.org/article/PIIS1089947209003967/abstract?rss=yesRecommended staffing standards were developed by ASPAN to guide decisions for optimal outcomes and efficiency in a PACU. In the midst of a nursing shortage, providing optimal staffing can be challenging. Licensed practical nurses can be educated to meet evidence-based standards for optimal patient recovery. Determining critical skills and competencies and performing a thorough interview assists in selecting suitable licensed practical nurse candidates. Supplying a high-quality orientation contributes to team success. High-performing teams promote greater efficiency in patient care and consequently improve quality of care and staff morale. This article provides details of a model of care that includes licensed practical nurses in the nurse staff mix. Suitability qualities, orientation program, and scope of practice of licensed practical nurses will be discussed. Improved patient experience and efficiency can be successfully achieved with mixed registered and licensed practical nurse PACU staffing.Licensed Practical Nurses in the PACULori DeWitt10.1016/j.jopan.2009.10.004Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Original Articles356361http://www.jopan.org/article/PIIS1089947209004043/abstract?rss=yesPatients with diabetes often have impaired wound healing and an increased rate of postoperative complications with surgery. Most research has focused on the effect of hyperglycemia in the postoperative period, but there is limited evidence to guide blood glucose (bG) control throughout the perioperative period. This retrospective study explored the effect of hyperglycemia in the PACU on postoperative complications, length of stay (LOS), and in-hospital mortality in patients with diabetes undergoing spine, colon, or joint surgery. Findings revealed that the total LOS for patients with a PACU bG >200 mg/dL was significantly longer than for patients with a maximum bG of 140 to 200 mg/dL. Further, the rate of total complications increased significantly as bG levels increased. More prospective, controlled studies on the management of perioperative hyperglycemia are recommended for consideration.A Study of Perioperative Hyperglycemia in Patients With Diabetes Having Colon, Spine, and Joint SurgeryD. Kristin Smith, James Bowen, Linda Bucher, Teresa Hawkins, Claudine Jurkovitz, James Reed, Susan Volk10.1016/j.jopan.2009.10.011Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Original Articles362369http://www.jopan.org/article/PIIS1089947209004067/abstract?rss=yesThe purpose of this systematic review was to examine the effect of music on postoperative pain. A search for scientific articles was conducted using online databases. Included were quantitative studies published from 1998 through 2007 that considered the effect of music interventions on postoperative pain in adult patients. After the search and appraisal of quality, 18 studies were included in the review. The results in 15 of the studies included indicated a significant positive effect of music on postoperative pain. Four studies found that the use of analgesics was lower for the intervention groups. The patients in the studies were scheduled for different kinds of surgery and assessments and the interventions were performed at different times. Various types of music were used, mostly chosen by the researchers. The conclusion is that music can be used as an adjuvant for the relief of postoperative pain.Music as a Nursing Intervention for Postoperative Pain: A Systematic ReviewMargaretha Engwall, Gill Sörensen Duppils10.1016/j.jopan.2009.10.013Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Original Articles370383http://www.jopan.org/article/PIIS1089947209003955/abstract?rss=yesDiabetes mellitus (DM) has reached epidemic proportions globally, and its incidence continues to rise. Considering the increasing number of patients diagnosed with diabetes and the associated complications, such as cardiovascular and renal disease, the complexity of care for this population can be very challenging. In addition, specific postoperative complications, such as delayed wound healing, infections, and cardiac dysrhythmias, are more likely to occur in the presence of perioperative hyperglycemia. Recognition of the presence of diabetes and implementation of a diabetic management protocol will optimize patient outcomes by providing guidelines for avoiding such complications. Although comparative studies of the current published protocols are limited, there is agreement that health care facilities must have a protocol in place that considers the individual's health history, planned surgery, and glycemic control to guide management of diabetes.Glycemic Control and Surgery—Optimizing Outcomes for the Patient With DiabetesHeather Ead10.1016/j.jopan.2009.10.003Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Continuing Education384395http://www.jopan.org/article/PIIS1089947209004006/abstract?rss=yes“REIMBURSEMENT” and “wasted time” are buzzwords floating through the OR suites. Beyond the words lie complex issues, where the real impact of change in public health policy is felt as increased demands with decreased reimbursement threaten the functionality of surgical services. As health industries in general struggle to fulfill mandates for change within health care delivery systems, specialty areas with high costs are deeply impacted by the shortage of funding from all sectors. As perianesthesia nurses, our role in identifying issues preoperatively that may impact the rate of day-of-surgery cancellations is tantamount. As the first-line care providers, we have a unique opportunity to identify, triage, and communicate patient issues and promote continuous throughput.What's All the Fuss About? Day-of-Surgery Cancellations and the Role of Perianesthesia Nurses in PreventionSarah M.I. Gillen, Karen Catchings, Leslie Edney, Rhonda Prescott, Susan M. Andrews10.1016/j.jopan.2009.10.008Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Ambulatory Surgery396398http://www.jopan.org/article/PIIS1089947209004018/abstract?rss=yesPRE-PRINTED ORDERS are often used in the PACU setting to allow for timely intervention in treating postoperative pain. These orders are intended to provide safe and efficient care in a specialty unit by providing specific orders from physicians to the nursing staff who are appropriately assessing patients' needs for management and treatment of pain.Pre-printed Opioid Medication OrdersEllen E. Sullivan10.1016/j.jopan.2009.10.009Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Clinical Clips399400http://www.jopan.org/article/PIIS1089947209003372/abstract?rss=yesTHE RAPID ANALYSIS, interpretation, and treatment of abnormal lab values is imperative for all perioperative patients, and this is especially true for the critically ill patient in the Phase I PACU. Because arterial blood gas (ABG) analysis is the most frequently performed laboratory testing in critically ill patients, the ability to accurately interpret and report abnormal results is required by the PACU nurse. This column begins with a case study of a fictitious patient with abnormal ABG results, followed by a description of normal acid base balance, forms of compensation, and common abnormalities associated with blood gas derangement.THE ABCs of Arterial Blood GassesKim A. Noble10.1016/j.jopan.2009.08.005Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Patho Corner401405http://www.jopan.org/article/PIIS1089947209003992/abstract?rss=yesTHE CENTERS FOR Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) implemented the Surgical Infection Prevention (SIP) project in August 2002. A panel of experts developed three measures for national surveillance and quality improvement: (1) prophylactic antibiotic received within one hour before surgical incision, (2) prophylactic antibiotic is consistent with currently published guidelines, and (3) prophylactic antibiotic is discontinued within 24hours after the end of surgery. The goal of the SIP project was to reduce morbidity and mortality from postoperative surgical site infections (SSIs), which account for 14 to 16% of all hospital-acquired infections.Surgical Antibiotic Prophylaxis—Focus on DosingJulie Golembiewski10.1016/j.jopan.2009.10.007Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Pharmacology Facts406408http://www.jopan.org/article/PIIS1089947209003980/abstract?rss=yesIN THIS EDITION of the Practice Corner, the clinical practice questions were chosen due to their direct relationship to the ASPAN 2008-2010 Standards of Perianesthesia Nursing Practice.Practice CornerTheresa Clifford10.1016/j.jopan.2009.10.006Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Practice Corner409410http://www.jopan.org/article/PIIS1089947209003979/abstract?rss=yesMOST MODERN health care facilities now use disposable plastic bedpans, urinals, wash basins, and other products. Although these items are for one patient only, they are usually used by the patient many times during the hospital stay and disposed of when the patient is discharged. For those of us who remember scrubbing and disinfecting the old stainless steel versions of these products, the plastic disposable version was a welcome change. Plastic bedpans are usually rinsed off with a spray wand located on the back of a toilet or hopper. Splatter from the spray can contaminate not only the toilet and surrounding walls, but often the scrub clothes and skin of the caregiver. It is not unusual to see a bedpan sitting on the floor in the bathroom or in the patient's room. Eventually, bedpans go back to the patient's bed and can deposit bacteria picked up from the floor, as well as spread bacterial contamination from previous use.Using Environmentally Green Bedpans and Other Health Care Products to Decrease Health Care–Acquired Infections and to Lessen the Amount of Medical Waste Deposited in LandfillsDebbie Sandlin-Leming10.1016/j.jopan.2009.10.005Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7Resource Center411413http://www.jopan.org/article/PIIS1089947209004407/abstract?rss=yesTHIS EDITORIAL PRESENTS a return to the fifth in a continuing series of editorials 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 has identified six priorities that they believe, if addressed, will have a significant impact on improving health care at the national level. The third of these priorities is focused on improving the safety and reliability of the nation's health care system.National Priorities Partnership: Improving the Safety and Reliability of America's Health Care SystemVallire D. Hooper10.1016/j.jopan.2009.10.014Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7The Back Page421422http://www.jopan.org/article/PIIS1089947209004092/abstract?rss=yesMasthead10.1016/S1089-9472(09)00409-2Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7FrontmatterA1A1http://www.jopan.org/article/PIIS1089947209004109/abstract?rss=yesEditorial Board10.1016/S1089-9472(09)00410-9Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7FrontmatterA2A2http://www.jopan.org/article/PIIS1089947209004110/abstract?rss=yesTable of Contents10.1016/S1089-9472(09)00411-0Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7FrontmatterA3A4http://www.jopan.org/article/PIIS1089947209004122/abstract?rss=yesInformation for Contributors10.1016/S1089-9472(09)00412-2Journal of PeriAnesthesia Nursing 24, 6 (2009)2009-12-01Journal of PeriAnesthesia Nursing2009-12-01246S1089-9472(09)X0006-7FrontmatterA6A6