Perioperative nurses' attitudes toward the electronic health record.

BACKGROUND: The adoption of an electronic health record (EHR) is mandated under current health care legislation reform. The EHR provides data that are patient centered and improves patient safety. There are limited data; however, regarding the attitudes of perioperative nurses toward the use of the EHR. PURPOSE: The purpose of this project was to identify perioperative nurses' attitudes toward the use of the EHR. DESIGN: Quantitative descriptive survey was used to determine attitudes toward the electronic health record. METHODS: Perioperative nurses in a southeastern health system completed an online survey to determine their attitudes toward the EHR in providing patient care. FINDINGS: Overall, respondents felt the EHR was beneficial, did not add to the workload, improved documentation, and would not eliminate any nursing jobs. CONCLUSIONS: Nursing acceptance and the utilization of the EHR are necessary for the successful integration of an EHR and to support the goal of patient-centered care. Identification of attitudes and potential barriers of perioperative nurses in using the EHR will improve patient safety, communication, reduce costs, and empower those who implement an EHR.

Differences in intraoperative prep solutions: a retrospective chart review.

Surgical site infections (SSIs) are the most common type of health care-associated infection in surgical patients. We wanted to identify which intraoperative prep solution used in our health network for adult open abdominal surgical procedures resulted in the lowest incidence of SSI 30 days after surgery. In addition, we wanted to know specifically how parachoroxylenol compared with chlorhexidine gluconate, povidone-iodine, and 0.7% iodine and 74% isopropyl alcohol as an intraoperative prep solution. We conducted a retrospective medical record review of 162 consecutive patients ages 18 years and older who had undergone elective open abdominal procedures from December 2008 to December 2010 at four acute care community hospitals within an integrated, tertiary health network in the southeastern United States. No SSIs occurred after procedures in which parachoroxylenol intraoperative prep solution was used (n = 71), whereas five SSIs occurred after procedures in which other prep solutions (ie, chlorhexidine gluconate [no SSIs], povidone-iodine [two SSIs], and 0.7% iodine and 74% isopropyl alcohol [three SSIs]) were used (n = 91). A chi-square test indicated a significant difference in the incidence of SSIs among patients prepped with parachoroxylenol intraoperative prep solution compared to patients prepped with the other solutions.

Innovation in engaging hospital staff and university faculty in research.

PURPOSE: The purpose of this article was to describe an innovative faculty-staff engagement dinner that was conducted to enhance collaboration between university faculty and hospital staff. Specific steps used to develop the dinner, as well as outcomes gained, are discussed. BACKGROUND/RATIONALE: Collaborative relationships between academic and clinical nurses may promote nursing research and strengthen mutual interest. Unique stressors and demands of clinical and academic nursing often lead to isolated practice roles. Nursing may require new ways of facilitating collaboration between groups. DESCRIPTION OF THE PROJECT: A dinner supported by a health system was planned for nursing staff interested in conducting research. Faculty at 2 local universities interested in collaborating with nursing staff were invited. Forty participants attended, including 8 faculty from 2 universities, 17 staff nurses, and 16 nurse leaders. Seven collaborative research projects were initiated following the dinner meeting. INTERPRETATION/CONCLUSION: Faculty and nursing staff partnerships were established and led to research projects that focused on themes of improving quality. Faculty and nursing staff expressed enthusiasm for the opportunity to connect over shared research ideas. IMPLICATIONS: Mechanisms for enhancing staff nurse and nurse faculty collaborative relationships are needed to promote nursing research that ensures evidence-based bedside practices. A dinner event was an innovative method to partner nurses at the bedside with faculty with expertise in research methods.

Intraoperative patient skin prep agents: is there a difference?

For health care institutions, intraoperative prep agents are a critical link in combating surgical site infections and the associated economic burden. The question remains, is there an intraoperative prep agent that is truly superior to the others? We conducted a literature review to examine available empirical evidence related to intraoperative prep agents used in our health system for open abdominal, general surgery procedures: povidone-iodine, chlorhexidine gluconate, parachoroxylenol, and iodine povacrylex in 74% isopropyl alcohol. Intraoperative surgical skin prep studies were limited in providing empirical evidence to support one superior prep agent. Each prep agent has a specific mechanism of action along with specific advantages and disadvantages. We concluded that no one perioperative skin prep agent is superior in all clinical situations. Factors to consider when choosing an appropriate intraoperative skin prep agent include contraindications, environmental risks, the patient's allergies and skin condition, the surgical site, the manufacturer recommendations for the prep agent, and surgeon preference.