Surgical smoke: articulating the problem.

This six-part series focuses on surgical smoke evacuation legislation and policy. It provides answers to important frequently asked questions (FAQs) about surgical smoke from policymakers and people not working in perioperative services and suggests resources and tools to help you become a strong advocate for surgical smoke evacuation. The FAQs and legislative checklists that will be shared will cover the basics of surgical smoke and its harmful effects, strategies and solutions for eradicating surgical smoke in the OR, the role of regulatory agencies, and how to lay the groundwork for successful state legislation on your own and in tandem with AORN's Government Affairs Department.

Perianesthesia Nursing Malpractice: Reducing the Risk of Litigation.

Nursing malpractice claims are escalating, which equates to a higher risk of being named in a lawsuit and possibly defending one's actions in court. The perianesthesia nurse is at particular risk because of patient involvement before, during, and after surgical procedures. To minimize this risk nurses should have a clear understanding of how a malpractice claim proceeds and the common incidents involved. Three perianesthesia case studies are presented that identify potential nursing litigation threats and strategies to reduce those threats.

La enfermera en el área quirúrgica. Prevención de complicaciones e implementación de intervenciones / The nurse in the surgical area: prevention of complications and implemention of intervention in patient care

La aportación de la enfermera quirúrgica es fundamental para garantizar la seguridad de la persona que se somete a una intervención; además de acompañarla, este profesional especializado trabaja para garantizar que la persona se encuentre en las mejores condiciones físicas y psíquicas para afrontar un procedimiento de estas características. Frecuentemente, el cuidado enfermero en el bloque quirúrgico se halla descrito desde el enfoque biomédico puesto que se centra en el tipo de cirugía o en la técnica quirúrgica, perspectiva que puede ser insuficiente y obsoleta a la hora de identificar las áreas de intervención profesional y de clarificar los objetivos del equipo enfermero en el área quirúrgica. Se describen en este trabajo las intervenciones enfermeras, como el apoyo emocional, la potenciación de la seguridad y la prevención de la infección; y se identifican también las complicaciones potenciales más prevalentes en las diferentes etapas del proceso quirúrgico, como la hemorragia, la hipoxia o la hipotermia, entre otras, desarrollado todo ello a partir de la estructura de razonamiento enfermero y poniendo énfasis, desde una visión humanizadora de los cuidados, en la persona. La especificidad del área quirúrgica demanda a un profesional enfermero preparado y competente en el acompañamiento y el apoyo emocional de la persona y su familia, que demuestre conocimientos y habilidades en el manejo técnico e instrumental asociado a cada tipo de cirugía; y, también, competente en el diagnóstico de las complicaciones potenciales y en el desarrollo de actividades dirigidas a su prevención, detección precoz y tratamiento(AU)

The contribution made by the surgical nurse is essential to ensure the security of the patient who is subjected to surgery, as well as accompany this specialized professional work to ensure that the patient is in the best physical and mental condition to deal with procedures of these characteristics. Nurse care in the surgical area is frequently described from a biomedical approach as it focuses on the type of surgery or the surgical technique, a perspective that might be inadequate and obsolete in identifying the areas of professional intervention and in clarifying the objectives of the nursing staff in the surgical area. In this paper, nursing interventions such as emotional support, enhanced security and the prevention of infection are described as well as the identification of potential complications more prevalent in the different stages of surgical procedure, such as bleeding, hypoxia or hypothermia, among others, all these different points are developed from a rationalistic nursing approach with emphasis on a humanistic vision of patient care. The specificity of the surgical area demands a prepared and competent professional nurse in the emotional support of the patient and his or her family, as well as the demonstration of knowledge and skills in technical management and instruments associated with each type of surgery. It also requires competence in the diagnosis of potential complications and the development of activities designed to the prevention, early detection and treatment of potential health problems(AU)

Legal, professional and ethical considerations of advanced perioperative practice.

Advances within the NHS have recognised nurses in roles that go beyond the historical parameters of their initial training and role characteristics (DH 1999, DH 2000). Working within such a role creates added responsibilities of advancing practice and the continuing development of knowledge and skills. Nurses working at a higher level of practice will require an understanding of not only the professional and legal implications that new roles create, but also an awareness of the ethical dilemmas that will undoubtedly become increasingly complex (Bartter 2002). This article examines the professional, legal and ethical implications of advanced perioperative practice through the author's role as a surgical care practitioner (SCP).

[Retained foreign bodies from the point of view of the jurist]. / Belassene Fremdkörper--aus der Sicht des Juristen.

Civil processes and criminal procedures against physicians and/or medical assistants due to retained foreign bodies following surgery are not uncommon within the framework of the booming liability disputes in hospitals. As the protection and safety of the patient is the highest priority, the physician must take all feasible and reasonable precautions against such a possibility during both in- and outpatient operations.These include clear, written instructions for the assisting medical personnel in relation to count control, its documentation, final revision and specification in the surgical report. The delegation of swab and instrument counts to reliable OP nurses and other personnel is juristically possible and leads to their own responsibility, based on principle of basic trust, i.e. the physician can rely on the correct count of abdominal sponges, swabs etc. If an error does occur, the organizational liability does not fall on those responsible for the operation.