Assent in Pediatric Patients.

AIM: To report an analysis of the concept of pediatric assent. BACKGROUND: The concept of assent is poorly defined in current literature which may lead to potentially flawed practices in obtaining pediatric assent. DESIGN: The Walker and Avant (2011) method is used to provide clarity to the concept of pediatric assent. DATA SOURCES: Data were collected from PubMed, Academic Search Premier, PhilPapers, Wikipedia, and Google. REVIEW METHODS: Data were collected from 2014 to 2015. Twenty-three sources published between 2011 and 2015, nine sources published between 2003 and 2009, the Belmont Report (1979), and the American Academy of Pediatrics' report (1995) were included for pertinent contributions to this multidisciplinary concept analysis. RESULTS: Elements of assent include a patient's thoughtful review of the proposed treatment and rational decision in choosing the best course of action. There may be social, familial, and cognitive development factors influencing this process. CONCLUSION: This framework uses nurses' knowledge of cognitive development and ethics to inform practice. Assent is respectful of minor patients and ensures their rights are protected. Policies and procedures can be developed to incorporate assent, researchers have a stronger conceptual base, and educators can train nurses to help pediatric patients develop medical decision making skills.

Implementing AORN recommended practices for electrosurgery.

Technology is constantly changing, and it is important for perioperative nurses to stay current on new products and technologies in the perioperative setting. AORN's "Recommended practices for electrosurgery" addresses safety standards that all perioperative personnel should follow to minimize risks to both patients and staff members during the use of electrosurgical devices. Recommendations include how to select electrosurgical units and accessories for purchase, how to minimize the potential for patient and staff member injuries, what precautions to take during minimally invasive surgery, and how to avoid surgical smoke hazards. The recommendations also address education/competency, documentation, policies and procedures, and quality assurance/performance improvement. Perioperative nurses should consider the use of checklists and safety posters to remind staff members of the dangers of electrosurgery and the steps to take to minimize the risks for injury.

Implementing AORN recommended practices for surgical attire.

Surgical attire is intended to protect both patients and perioperative personnel. AORN published the "Recommended practices for surgical attire" to guide perioperative RNs in establishing protocols for selecting, wearing, and laundering surgical attire. Perioperative RNs should work with vendors and managers to ensure appropriate surgical attire is available, model the correct practices for donning and wearing surgical attire, and teach team members about evidence-based practices. The recommendation that surgical attire not be home laundered is supported by evidence that perioperative nurses can share with their colleagues and managers to help support appropriate practices. Hospital and ambulatory surgery center scenarios have been included as examples of appropriate execution of these recommended practices.