Validation of the data elements for the health system domain of the PNDS.

This research study established the data elements for the health system domain in the Perioperative Nursing Data Set. A sample of AORN members were asked to confirm the clarity, necessity, measurability, and accuracy of each proposed data element. As a result of this study, the health system domain contains 114 data elements with definitions. When integrated into an electronic health record, data elements can be used to identify, compare, and evaluate the context in which patient care is delivered across settings.

AORN Ergonomic Tool 5: Tissue Retraction in the Perioperative Setting.

Manual retraction, a task performed to expose the surgical site, poses a high risk for musculoskeletal disorders that affect the hands, arms, shoulders, neck, and back. In recent years, minimally invasive and laparoscopic procedures have led to the development of multifunctional instruments and retractors capable of performing these functions that, in many cases, has eliminated the need for manual retraction. During surgical procedures that are not performed endoscopically, the use of self-retaining retractors enables the assistant to handle tissue and use exposure techniques that do not require prolonged manual retraction. Ergonomic Tool #5: Tissue Retraction in the Perioperative Setting provides an algorithm for perioperative care providers to determine when and under what circumstances manual retraction of tissue is safe and when the use of a self-retaining retractor should be considered.

AORN Ergonomic Tool 3: lifting and holding the patient's legs, arms, and head while prepping.

Lifting the arms, legs, or head of a patient while prepping these areas for surgery can exert strong forces on the muscles and joints of the shoulders and backs of perioperative team members who perform this task, which may lead to work-related musculoskeletal disorders. AORN Ergonomic Tool 3: Lifting and Holding the Patient's Legs, Arms, and Head While Prepping provides scientifically based determinations of the amount of weight perioperative personnel can safely lift and hold manually for up to one, two, and three minutes using one hand or both. If these weight limits are exceeded, additional staff members or assistive devices are needed to help with the task.

AORN ergonomic tool 2: positioning and repositioning the supine patient on the OR bed.

Positioning or repositioning a patient on the OR bed in preparation for a surgical procedure presents a high risk for musculoskeletal disorders, such as low-back and shoulder injuries, for perioperative personnel. Safe patient handling requires knowledge of current ergonomic safety concepts, scientific evidence, and equipment and devices to ensure that neither the patient nor the caregiver is at risk for injury. AORN Ergonomic Tool 2: Positioning and Repositioning the Supine Patient on the OR Bed provides guidelines that enable perioperative personnel to determine safe methods for positioning and repositioning a patient in the semi-Fowler, lateral, or lithotomy position in preparation for surgery.

Evolution and revision of the Perioperative Nursing Data Set.

The Perioperative Nursing Data Set (PNDS) is a nursing language that provides standardized terminology to support perioperative nursing practice. The PNDS represents perioperative nursing knowledge and comprises data elements and definitions that demonstrate the nurse's influence on patient outcomes. Emerging issues and changes in practice associated with the PNDS standardized terminology require ongoing maintenance and periodic in-depth review of its content. Like each new edition of the Perioperative Nursing Data Set, the third edition, published in 2010, underwent content validation by numerous experts in clinical practice, vocabulary development, and informatics. The goal of this most recent edition is to enable the perioperative nurse to use the PNDS in a meaningful manner, as well as to promote standardization of PNDS implementation in practice, both in written documentation and the electronic health record.

Prevalence of psychiatric and substance use disorders among single mothers nearing lifetime welfare eligibility limits.

CONTEXT: In the 1990s, US welfare reform legislation imposed a 5-year lifetime limit on financial support for low-income families with young children (younger than 18 years). With increasing numbers of single mothers and their children reaching the end of their welfare eligibility, there is concern about potentially high rates of untreated psychiatric and substance use disorders in this population. OBJECTIVE: To determine the prevalence, correlates, and likelihood of treatment for mental and substance use disorders in a population of urban single mothers receiving Temporary Assistance for Needy Families (TANF). DESIGN: In-person diagnostic assessments were conducted from November 1, 2003, to October 31, 2004. SETTING: Cook County, Illinois. PARTICIPANTS: Female TANF recipients and residents of Cook County (N = 333) who were randomly sampled during the final 24 months of their eligibility for TANF. MAIN OUTCOME MEASURE: Prevalence rates of DSM-IV mental and substance use disorders using the World Health Organization's Composite International Diagnostic Interview. RESULTS: Lifetime prevalence of Composite International Diagnostic Interview disorders was 61.0% (95% confidence interval [CI], 55.7%-66.3%); 12-month prevalence was 46.8% (41.5%-52.2%). Lifetime prevalence of mental disorders was 53.2% (95% CI, 47.8%-58.5%); 12-month prevalence was 44.1% (38.8%-49.5%). Lifetime prevalence of substance use disorders was 29.1% (95% CI, 23.9%-33.8%); 12-month prevalence was 9.0% (6.8%-12.0%). Lifetime prevalence of comorbid mental/substance use disorders was 21.3% (95% CI, 16.9%-25.7%); 12-month prevalence was 6.3% (3.7%-8.9%). Only 21.7% (95% CI, 14.8%-28.5%) of participants with 12-month mental disorders received treatment for mental disorders; 41.4% (22.3%-60.4%) of participants with 12-month substance abuse disorders received treatment for substance use disorders. CONCLUSIONS: Despite the high prevalence of psychiatric and substance use disorders in this population, many remain untreated. The consequences of terminating welfare assistance are worthy of further investigation, given the potential for adverse effects on both mothers and their young children.

Validation of concept mapping between PNDS and SNOMED CT.

The perioperative nursing data set (PNDS) is a structured vocabulary developed by AORN to help document perioperative nursing practices. The PNDS has been mapped to the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) reference terminology model to support the electronic exchange of nursing data. This study validates the concept mapping between the PNDS and SNOMED CT, supporting an equivalent meaning of concepts between the two terminology systems.

Multi-society guideline for reprocessing flexible gastrointestinal endoscopes. Society for Healthcare Epidemiology of America.

Flexible gastrointestinal endoscopy is a valuable diagnostic and therapeutic tool for the care of patients with gastrointestinal and pancreaticobiliary disorders. Compliance with accepted guidelines for the reprocessing of gastrointestinal endoscopes between patients is critical to the safety and success of their use. When these guidelines are followed, pathogen transmission can be effectively prevented. Increased efforts and resources should be directed to improve compliance with these guidelines. Further research in the area of gastrointestinal endoscope reprocessing should be encouraged. The organizations that endorsed this guideline are committed to assisting the FDA and manufacturers in addressing critical infection control issues in gastrointestinal device reprocessing.