Surgical site infection and prevention guidelines: a primer for Certified Registered Nurse Anesthetists.

Each year 500,000 surgical site infections occur in the US. Surgical site infections are the second most common healthcare-associated infections resulting in readmissions, prolonged hospital stays, higher medical costs, and increased morbidity and mortality. Surgical site infections are preventable in most cases by following evidence-based guidelines for hand hygiene, administration of prophylactic antibiotics, and perioperative patient temperature management. As attention to issues of healthcare quality heightens, the demands for positive surgical patient outcomes are intensifying. The Certified Registered Nurse Anesthetist can provide transparent high-quality care by implementing evidence-based guidelines for timely and appropriate antibiotic use, maintenance of normothermia, and hand washing.

Objective Structured Clinical Examination as an educational initiative for summative simulation competency evaluation of first-year student registered nurse anesthetists' clinical skills.

The use of simulation to imitate real-life scenarios reaches back many centuries. In the last decade, the use of simulation in healthcare has gained acceptance as a valuable tool for teaching and learning technical and nontechnical skills in healthcare. The use of simulation technology has moved medical education from the standard of pen and paper examinations to the assessment of clinical competency before caring for patients. The old thinking of "see one, do one, teach one" is behind us as healthcare works to create a culture of safety that holds healthcare personnel accountable. A current use of testing clinical competence is the use of Objective Structured Clinical Examination (OSCE) by physician training programs. As a testing tool, the OSCE has great potential to assess the clinical competence of students before they enter the clinical setting. The nurse anesthesia program at the authors' university has moved toward creating a formal assessment to ensure clinical competence of their student registered nurse anesthetists. In this article, we describe the development and implementation of an OSCE to ensure clinical competence of first-year student registered nurse anesthetists before they begin their clinical training.

Pulseless electrical activity in a pediatric patient: a case report and review of causative factors and treatment.

Pulseless electrical activity, an arrhythmia that leads to cardiac arrest, is defined as the presence of organized electrical activity without a palpable pulse or arterial blood pressure. When this arrhythmia presents during anesthesia, it has become routine practice to initiate advanced cardiac life support according to the American Heart Association guidelines. This arrhythmia is usually associated with a poor prognosis unless a reversible cause is investigated and treated immediately. The purpose of this article is to summarize the causative factors of pulseless electrical activity and its treatment modalities. This case report describes the successful resuscitation of a pediatric patient who presented with pulseless electrical activity during anesthesia for a rigid bronchoscopy.