Pain Management for Orthopedic Patients; Closing the Gap.

Total joint replacement (TJR) is one of the most commonly performed and painful surgeries in the United States. Over the past few decades, regulatory changes increased the use of oral narcotics as a first-line treatment of this population. In the current opioid crisis, new pain management techniques and therapies have emerged. Research of current therapies, their effectiveness, and emerging best practices are discussed. Clear, thoughtful, and thorough education is an essential next step for closing the gap of the pain experience. Specifically, education of the frontline nurses, patients, and their caregivers on pain reduction techniques is essential.

Implementing a Perioperative RN Training Program for Recent Graduates.

In 2010, nurse educators at one health care facility implemented a new program that emphasized placing new graduates in specialty areas, including the hemodialysis unit, the gastroenterology unit, and the OR. Managers in the OR faced staffing challenges because of the difficulty in recruiting and retaining experienced perioperative nurses and the expected retirement of a significant number of staff members. Surgical services managers agreed to participate in the new graduate program and decided to use AORN's Periop 101™ course and a series of monthly simulation training sessions to supplement the program and provide recently graduated nurses with a strong perioperative nursing foundation. In three years, a total of nine newly graduated RNs successfully completed the program. The three-year retention rate was 78%.

Using simulation training to improve perioperative patient safety.

Simulation learning provides medical and nursing personnel with the opportunity to develop and refine their skills without putting patients at risk. Faced with ensuring the competence of a large number of new staff members, the management team at one facility implemented a simulation training program. Surgical team members are able to participate in an ongoing program of simulated scenarios involving surgical drape fires and airway fires, cardiac arrest of patients in the supine position and prone position, respiratory depression in the postanesthesia care unit, and malignant hyperthermia. The simulations help OR staff members identify problems that can happen during real emergencies and help them work as a team to prepare for events that may represent life-threatening situations for patients.