Anaesthetic nurse specialist role in perioperative anaesthetic management of patients who are morbidly obese.

This integrative literature review examined the role of an anaesthetic nurse specialist (ANS) in the perioperative anaesthetic nursing management of morbidly obese patients associated with elective orthopaedic surgery. The responsibility of the ANS is to provide high-quality perioperative anaesthetic care to ensure patient safety. Morbid obesity is increasing globally, with significant implications for healthcare delivery, care and treatment, including perioperative care. The Association of Anaesthetists of Great Britain and Ireland emphasises that the perioperative management of these patients presents significant organisational and practical issues. However, there are limited data or guidelines on whether surgeons, anaesthetists and nurses routinely take special precautions in managing morbidly obesity patients undergoing elective orthopaedic operative procedures. The authors carried out a search of databases, followed by an integrated literature review and synthesis of 11 studies. The main findings revealed significant clinical challenges and resource requirements for perioperative anaesthetic management of this patient group. Recommendations are made to prepare for and manage these surgical patients, from preoperative assessment to postoperative care.

Critical incident analysis: Equip to avoid failure.

This work is set in the context of perioperative practice in difficult airway management. It integrates a root cause analysis and fish bone technique to investigate a critical incident in temporary yet crucial equipment failure. Risk management and incident reporting is analysed alongside human factors in the operating theatre environment. Finally, recommendations for risk reduction, vigilance and checking vital airway equipment are made in anaesthetic practice.

A framework for challenging deficits in compression bandaging techniques.

Northern Irish (and all UK-based) health care is facing major challenges. This article uses a specific theory to recommend and construct a framework to address challenges faced by the author, such as deficits in compression bandaging techniques in healing venous leg ulcers and resistance found when using evidence-based research within this practice. The article investigates the challenges faced by a newly formed community nursing team. It explores how specialist knowledge and skills are employed in tissue viability and how they enhance the management of venous leg ulceration by the community nursing team. To address these challenges and following a process of reflection, Lewin's forcefield analysis model of change management can be used as a framework for some recommendations made.

A mother's journey from the roadside to the operating room.

Sometimes I wonder why I wandered into the nursing profession, but in the past few years it has become clear--I became a nurse to look after my son. As we journey through life we try to predict and plan our future. Life twists and turns in so many ways just like my son's life when one fateful day those plans and predictions were smashed. I recount, as a mother my son's journey into your hands ... the operating room. Some names have been changed.

Service user and carer participation in an endoscopy nursing programme.

This article reports an initiative to improve students' insight into service user and carer experience of endoscopy, particularly those with severe disability, such as spinal cord injury. This insight has the potential to improve the information provided and level of person-centred care in an endoscopy service. It was evident in the feedback from the classroom encounter that the teaching and learning strategy had a positive outcome, which will allow us to integrate the approach into future curriculum development and delivery, bringing the lived experience from the service user and carer perspective into the classroom. Students engaged in discussion and used their reflective skills to develop sensitivity to those with physical disability and complex needs requiring endoscopy procedures.