bluuebunny/crossref_metadata_2025 huggingface dataset:
Two Gloves or Not Two Gloves: That is the Question
Authors: Bernthal Liz
Published: December 2017

Surgical gloves were first introduced in 1889, when Halstead wanted to protect his scrub nurse from dermatitis caused by contact with mercuric chloride (Dodds et al 1990). The use of gloves then became more widespread, principally to protect surgical teams whilst operating on infected patients (Dodds et al 1990). Later, focus changed to protecting the wound from microbial contamination (McLoed 1989).
Library Resources and Getting the Best Out of Them
Authors: Thomas Judy
Published: December 2017

Nurses are required to undertake professional updating, PREP (UKCC, 1994), and are increasingly under pressure to ensure that they provide evidence-based healthcare (DoH, 1996). Proliferation of the literature, the move from printed to electronic sources of information and shortage of time may all be seen as barriers to nurses who wish to gain access to information to support these activities. Libraries are important gateways to this information and this article is a brief guide to making the most of library resources.
Beating Heart Coronary Artery Bypass Grafting: A Theatre Nurse's Perspective
Authors: Spence Mark
Published: December 2017

Coronary artery bypass graft (CABG) surgery has been going through a time warp. The development of cardiopulmonary bypass (CPB), together with continuing advances in equipment and refinement of techniques, introduced a high level of safety for CABG operations. Recently, however, with pharmacological and technological advances, surgeons have been able to ‘go back in time’ and undertake complex CABG surgery without CPB.
Morale within Operating Departments
Authors: Livesley Mandy , Williams Marilyn , County Bernadette
Published: December 2017

Perioperative nurses spend so much time taking care of the needs of their patients that their own needs can be neglected. The amount of work done every day in operating departments means that there is often little or no time given to looking after staff. The morale within a department is not usually a high priority - until there is a crisis, or staff start leaving. Mandy Livesley's article presents the results of a survey of staff morale in an operating department. Some of the findings will not surprise you; others may stimulate debate…
Future Practitioners…: Advancing Nursing Practice in the Perioperative Setting
Authors: Mehigan Sinêad
Published: December 2017

The aim of this article is to consider how perioperative nursing practice may be advanced in the future. Imagine a new operating department, in a brand new hospital, where you have been given the task of finding and developing a team of perioperative nurses. Where will they come from, and how will they be developed? It is hoped that the remainder of this article may give some answers to these questions before providing some food for thought as to how nursing practice may advance.
Latex Allergy Awareness and Protocol
Authors: Rhodes Anne
Published: December 2017

My first encounter with a latex-sensitised client occurred some eight years ago. Since then I have become aware of an increase in the number of clients presenting for surgery who have hypersensitive reaction to latex. This realisation was the impetus to undertake the following research.
The Wearing of Facial Protection in High-Risk Environments: The Non-Compliance of Healthcare Workers with Universal Precautions
Authors: Pearson Tina
Published: December 2017

The term Universal Precautions (UP) originates from the Centre for Disease Control (CDC) in Atlanta (Taylor 1993). The precautions recognise that it is safer for all patients to be treated as potentially infective, whatever their status in life. The basic aim of UP is to lower the level of contact with blood or body fluids. This reduces the risk to all personnel of contact with blood born viruses and pathogenic organisms carried in other body fluids (Wicker 1991). The precautions recognise that there are high risk environments rather than high risk patients.
Adult Hypoxaemia in the Perioperative Period: A Review of the Literature
Authors: O'reilly Denise , Williams Marilyn , County Bernadette
Published: December 2017

As a group of academic skills, learning to search for, obtain, read and critically review literature represents a considerable achievement. For the many perioperative nurses who may never be able to pursue their own research project, reading literature reviews is an excellent alternative which enables individuals to become better and more critically informed. A review of the available literature may provide answers to questions or indicate where a subject is in need of further research. In this article by Denise O'Reilly, perioperative hypoxaemia is defined and a range of literature about the subject is critically reviewed.
Making a Difference: Nursing and Midwifery Education
Authors: Milburn Alan , Williams Marilyn
Published: December 2017

Continuing our new series on the politics of the health service, the following article contains extracts from the keynote speech by Alan Milburn, Secretary of State, on 22 November 1999, Since then, of course, we've had the budget, with its promise of significantly more funding for the NHS. Is this Government at last about to deliver on its manifesto pledges? It is clear from this article, and from Government pronouncements since, that they believe nurses can make a difference, and that education is a key factor in this. As a Senior Lecturer, I would not argue with that, but knowing as we all do the pressures on the service at present, is education an appropriate place to start the change process? Put your politics on hold for a while and read what Alan Milburn has to say, then reach for your pen or computer and let us know via Open Forum what you think
Anaesthetic Drugs
Authors: Griffiths Rachelle , Plowes Dina
Published: December 2017

A mere glance at a BNF will demonstrate the huge variety of drugs which are now available to us. In this piece, Rachelle Griffiths takes us step by step through the basics of anaesthetic drugs. I am very aware of the enormity of this topic, and would recommend that you take the time to consider carefully the information provided in this piece. There will be further articles on drugs and their effects in this series.
Call us First - We'll Fix it: How a Day Case Unit Plays a Vital Role through Teamwork
Authors: Lang Bobbie
Published: December 2017

Clinical effectiveness can be defined as ‘the extent to which specific clinical interventions, when deployed in the field for a particular patient or population, do what they are intended to do… maintain health and secure the greatest possible health gain from the available resources.’ (NHS Executive 1996) 3M/NATN Award winner for 1999 Bobbie Lang describes how her Day Case Unit has become the central focus for the co-ordination of such procedures - offering clinical effectiveness for a particular patient group.
Reducing Patient Stress in Theatre
Authors: Welsh Joan
Published: December 2017

For most patients, admission to hospital for surgery can be very stressful. It is well recognised that stress, created by prolonged anxiety, can produce harmful effects and may even delay a patient's recovery following surgery. This article, submitted for the 1999 Alison Bell award (sponsored by NATN and Regent Medical), looks at key ways to reduce the effects of such stress.
The past as Prologue to the Future
Authors: Nightingale Kate
Published: December 2017

Kate Nightingale is well known to NATN, in particular as a previous Editor of the British Journal of Theatre Nursing. This article reproduces in full the Daisy Ayris Lecture that Kate gave at NATN's 1999 Annual Congress in Harrogate…
Antiseptic Skin Preparation Revisited
Authors: Kent Sally , Williams Marilyn , County Bernadette
Published: December 2017

Preparing the operation site by painting a solution of something onto the skin is one of the best preserved rituals in surgery. There appears to be something really satisfying about this precursor to the main event, and if the solution used is brightly coloured, or stains the skin, then so much the better - you can actually see where you've been! I hope than no-one is under the illusion that because the whole leg (or arm, or abdomen or anywhere else) is now a sickly shade of brown or alarmingly pink, that no pathogenic organisms can possibly have survived the onslaught. In this comprehensive review of the literature and practice audit, Sally Kent revisits the reasons for skin preparation, and recommends the use of well proven research to determine correct practice.
Using the Internet to Enhance Evidence-Based Practice
Authors: Orson Judy
Published: December 2017

Evidence-based healthcare requires reliable and validated research findings to aid improved clinical practice. The Internet, with its growing medical resources, is an invaluable tool for busy healthcare workers. However, as more material becomes available on the web, the quality and reliability of various information sites is a worry for many practitioners. The ability to evaluate web sites is becoming increasingly important and as a novice user, I was interested to discover the extent to which the Internet could assist me researching a specific topic. This article describes the process of conducting an Internet search, on a topic relevant to theatre nursing, and considers how the resources might best be evaluated.
Theatre Nursing in Finland
Authors: Lipp Allyson
Published: December 2017

As part of the Socrates exchange system three students from the School of Care Sciences, University of Glamorgan visited Finland for a 15-week placement. They were based in two areas Hameenlinna and Kuopio. As part of the exchange I visited the students, did some teaching and observed some of the clinical areas.
Nursing: Image, Politics and the Media
Authors: Doolan Ed , Williams Marilyn
Published: December 2017

This is the final article in the series on nursing and politics. It examines one person's perspective on the image of nursing as portrayed in the media, and the place of nursing in political debate. The series has presented a variety of views: from political correspondents, from Government or Opposition spokesmen. This final article offers the views of Ed Doolan, a journalist and BBC broadcaster who is also a member of an NHS Trust Board. The article is based on an interview which took place at the BBC Pebble Mill studios in Birmingham in February this year. Ed Doolan has not been paid a fee for the interview; instead, NATN have made a contribution to the Children's Hospital, Birmingham.
Verbal Abuse
Authors: Howells-Johnson Jan
Published: December 2017

The Health and Safety Executive includes verbal abuse in its definition of work-related violence (HSE 1997). Verbal abuse is ‘any remark made to or about a client which may reasonably be perceived to be demeaning, disrespectful, humiliating, intimidating, racist, sexist, homophobic, ageist or blasphemous’. Examples include making sarcastic remarks, using a condescending tone of voice or using excessive and unwanted familiarity (UKCC 1999).
Infection Control Issues in the Orthopaedic Theatre Environment
Authors: Hughes Angharad
Published: December 2017

This article is the First Prize winning entry in the Essay Section of the Alison Bell Memorial Writer's Award 2000, sponsored by NATN and Regent. It is based on an essay submitted for the Evidence Based Practice Module of the post-graduate programme in Health Promotion and Health Studies at Bath Spa University College, Bath.
The Use of Touch for a Patient Experienccing Laryngospasm
Authors: Engelhardt Gabi
Published: December 2017

This article is based on a course work assignment for the Welsh National Board Certificate Level Module in Operating Department Practice (Recovery Branch). The article uses a critical incident reflective approach to explore the issues of using touch in caring for a patient, experiencing laryngospasm following a general anaesthetic. A literature review will explain the mechanisms of laryngospasm and will discuss the use of different forms of touch. Conclusions and recommendations will be drawn from the issues discussed.
Principles of Bone Cement Mixing
Authors: Eveleigh Rebecca , Sellek Guy
Published: December 2017

This is the first in a series of four consecutive articles on bone cement mixing. It aims to bring to the perioperative practitioners’ attention, all of the factors that will influence the quality and reproducibility of the bone cement they produce. The series will demonstrate how perioperative practitioners can have a direct influence on the successful long-term result of a hip or knee replacement.
Interprofessional Working and Learning in a UK Operating Department
Authors: Hind Martin , Williams Marilyn , County Bernadette , Andrews Clive , Galvin Kathleen , Jackson Dawn , Platt-Mellor Susan
Published: December 2017

Developing a seamless team of operating department staff is an ideal to which most departments aspire. Matching skills and knowledge, however, does not necessarily create an efficient or cohesive team who work happily together. Speculation about what makes for successful interprofessional working and learning will not provide answers. In this research study, Martin Hind and his colleagues explore some of the issues and offer some suggestions for a better integrated workforce, working and learning together.
Effective Management: What is it?
Authors: Westwood Fiona
Published: December 2017

The first article in this series looked at the importance of reconciling the professional and commercial aspects of our organisations. We found that it is important to develop a better understanding of both by working together to share information and expertise. In this article we will consider what management means in practice and how we can help or hinder its effectiveness.
Mixing Systems: and the Effects of Vacuum Mixing on Bone Cement
Authors: Eveleigh Rebecca
Published: December 2017

This third article in our series on bone cement mixing covers the effect that modern vacuum mixing techniques and the design of the mixer can have on improving the mechanical properties of the bone cement. This will ultimately lead to a better long-term outcome for the patient.
Leadership and Communication: What Really Works?
Authors: Westwood Fiona
Published: December 2017

In her previous article, Fiona Westwood looked at effective management and what this means in practice in our organisations. This article develops these themes by considering the role of leadership and the importance of open and honest communications.
Latex Allergy within the Perioperative Area
Authors: Clancy John , McVicar Andrew , Cox Janet
Published: December 2017

Latex allergy is a subject which is causing concern both amongst healthcare workers and in the Department of Health, with reports that significant numbers of NHS staff may have latex hypersensitivity. With this informative article, Janet Cox joins John Clancy and Andrew McVicar to explain the mechanisms that underlie latex hypersensitivity and to make recommendations about how hospitals can deal more effectively with it. The article is based on the text, Physiology and Anatomy, a homeostatic approach, 2nd ed, John Clancy and Andrew McVicar, Arnold, London (in print September 2001).
Lies, Damned Lies and Statistics
Authors: Campbell Libby
Published: December 2017

Readers may remember Jim Miller's introductory article in this series (Miller 2001), where lessons learnt from the Titanic disaster were related to lessons to be learnt in the NHS today. Unfortunately many of those lessons are yet to be learnt by some of our organisations or, certainly, lessons which need to be applied consistently. One of those lessons related to the need for accurate data and using it to inform action and priorities. This article identifies some of the data requirements, where they might be obtained and the need for a systematic process to inform strategy.
Nurse Education in the New Millennium a Review of Current Reports
Authors: Tanner Judith , Girot Elizabeth A
Published: December 2017

With the publication of a number of recent reports (eg: DOH 1999a, UKCC 1999a), the National Executive meeting of the National Association of Theatre Nurses seems a timely opportunity to gaze into the crystal ball of nurse education in the next millennium. In particular, as a supporting paper to the above meeting, it offers a valuable chance to explore the implications of some of the recommendations for theatre nurses.
An Analysis of Perioperative Care
Authors: Williams Marilyn , O'reilly Denise
Published: December 2017

The word ‘routine’ and surgical shorthand such as ‘TAH’ on an operating list belie the scope of perioperative nursing. The pressure to treat more patients, reduce waiting lists and maximise the use of resources allows us no time to consider the enormity of surgery as an experience for the patient and an exercise in nursing expertise. In this article, Denise O'Reilly takes a critical and analytical look at a common procedure, hysterectomy. Her analysis is astute and well supported, taking into account both ideology and reality. We could all do better if we tried, and this article may prompt you to think about some of those ‘routine’ operations you helped with today …
Influencing without Authority
Authors: Westwood Fiona
Published: December 2017

In the first article in her new series on effective management, Fiona Westwood looked at the effect of conflict within our organisations. Whilst some conflict is good, too much conflict can be damaging, with a great deal of time and energy taken up managing people who are the source of these tensions. This second article looks at ways of becoming more proactive - of dealing with the sources of conflict before they become entrenched or break out into open war.
Clean/Dirty Scrub Technique: Is it Worth the Effort?
Authors: Williams Marilyn , Bruen Elizabeth
Published: December 2017

Asepsis is a vital underlying practice for any surgical procedure and it is part of every perioperative nurse's responsibility to participate actively in incorporating the principles of aseptic technique into surgical practice. Not to do so exposes the patient to a risk that could have been avoided. The following literature review of the practice of clean and dirty technique in bowel surgery indicates that it may play a vital role in the prevention of postoperative wound infections.
Doing Deals
Authors: Westwood Fiona
Published: December 2017

In the previous two articles in this series, Fiona Westwood looked at the importance of managing conflict positively and influencing people without the use of direct authority. We now move on to the next management tool – the ability to ‘do deals' with people.
Eye Catching?
Authors: Waller Frank
Published: December 2017

Decontamination has moved into the top ranks of healthcare issues. In this article, Frank Waller highlights the need for strict adherence to decontamination and sterilisation procedures at all perioperative levels. He demonstrates how apparently minor operations can have serious consequences for both the patient and for perioperative staff where decontamination and sterilisation are inadequate.
Postoperative Nausea and Vomiting in the Perioperative Setting
Authors: Arnold Agnes
Published: December 2017

Postoperative nausea and vomiting (PONV) is reported to occur in up to 92% of surgical cases. In this article, Agnes Arnold defines the terms, identifies a range of therapies and risk factors, examines the dangers and discusses the management of PONV. The article was originally produced as a study for ENB 183.
Instrument Reprocessing in Theatres Drivers for Change
Authors: Miller Jim
Published: December 2017

It is well known that long-term exposure to chemical disinfectants can have adverse effects on an individual, and can even result in ill health requiring premature retirement. Jim Miller highlights some of the dangers of chemical disinfectants and reports on the relative merits of newer technologies, including low temperature hydrogen peroxide.
Law and Professional Practice Accountability and Implications
Authors: Hughes Suzanne , Tanner Judith
Published: December 2017

It seems that every week there are new examples of hospital patients or their families seeking legal redress against hospital trusts and healthcare practitioners for some kind of injury. While an inadequate standard of care cannot be condoned, healthcare professionals in the perioperative setting need to know what is meant by an ‘adequate standard’ and what the implications of failing to meet this standard might be for them. In this article (adapted from a course assignment for the BSc in Professional Practice for Nurses), Suzanne Hughes looks at the meaning of the term ‘accountability’ and at the legal and professional implications for the practitioner of failing to achieve the accepted standard.
The Hazards of Surgical Smoke Not to be Sniffed At!
Authors: Biggins Jill , Renfree Steve
Published: December 2017

This article is based on a presentation given at Congress 2001 in Harrogate. It focuses on the risks to perioperative team members arising from the production of smoke during electrosurgical and laser procedures. It identifies the sources and nature of the risks, the failure of masks to provide adequate protection and suggests the standards that need to be set to reduce the risks.
Recruiting Students to Your Theatres
Authors: Tanner Judith
Published: December 2017

This article is based on a paper presented at the National Association of Theatre Nurses Congress and Exhibition in October 2001. In it, Judith Tanner asks why it is so difficult to recruit students to theatres, identifies some reasons given by students for not going into theatres, as well as their reasons for going into theatres, and gives advice on how perioperative departments can become more student-friendly.
Changing the Workforce
Authors: Moore Sally , Tanner Judith
Published: December 2017

New working practices are being developed throughout the NHS. Much of this work is being carried out at the level of local NHS Trusts. Sally Moore reports, in this article, on how changes in one NHS Trust have given staff at support levels greater opportunities for training, and increased their participation in patient care.
The Role of the Rnsa in Colorectal and General Surgery
Authors: Biggins Jill
Published: December 2017

More nurses are taking on the role of Surgical Assistant. In this article, Jill Biggins reports on her own experience of becoming a Registered Nurse Surgical Assistant in colorectal and general surgery. Jill explains how the role was developed, its tasks and responsibilities, the response of other perioperative practitioners to the role and how further development of the role might be achieved.
Research Fraud
Authors: Timmons Stephen , Williams Marilyn
Published: December 2017

Readers will be well aware of the importance attached to research or other convincing evidence to underpin nursing practice. Much excellent research has been and is still being done by nurses, with the intention of improving practice and establishing a knowledge base for nursing. The medical profession holds its powerful position primarily by virtue of an extensive and largely research supported knowledge base. This important article by Stephen Timmons takes a constructively critical look at research fraud, so that we may be aware that not all published research is quite what it seems.
DVT Prophylaxis in the Perioperative Setting
Authors: Arnold Agnes
Published: December 2017

This is the first of a two-part article in which Agnes Arnold examines the role of the perioperative nurse in the prophylaxis of lower limb deep vein thrombosis (DVT). This part discusses the pathophysiology of DVT and the methods of assessing an individual's risk of developing the disorder. Part 2, which will appear in the September edition of BJPN, will deal with prophylaxis of DVT. It will critically analyse the research, cost-effectiveness, side-effects and target patient population of each prophylactic regimen.
The Benefits of E-Learning
Authors: Hoyle Robin
Published: December 2017

Everything has ‘e’ in front of it these days – and training and education is no different. The growth of information technology and especially the web has led to us doing all sorts of different activities via our computers. There is now a plethora of e-learning opportunities – from helping your children prepare for their GCSEs to degree courses on line. So why have NATN decided to invest in e-learning for the members?
Theatre Nursing in Portugal
Authors: Lipp Allyson
Published: December 2017

A recent opportunity to visit Porto, in Portugal, allowed Allyson Lipp to observe operating department nursing in that city. In this article, Allyson explains the background to her visit, identifies some of the practices observed and compares the operating department she visited in Portugal, and nursing in that country, with their counterparts in the UK.
Anastasis Revisited
Authors: Steele Frances
Published: December 2017

This article describes some more of its author's experiences of serving on the mercy ship Anastasis. Frances Steele previously reported on the vessel's activities in an article published in the January 1998 BJPN, with which she won the runner-up award in the Alison Bell Memorial writer's competition, 1997. In this article, Frances describes some of the cases she dealt with during her second visit onboard the ship.
Elective Placement United Hospitals Network, Toronto
Authors: Kear Carolyn
Published: December 2017

This article reports on an ERFF-funded visit by a member of NATN to hospitals in Toronto, Canada. The visit provided an opportunity for the author to compare the organisation and practices of healthcare services in Toronto with those of her own Trust.
Are Perioperative Nurses Really Patient Advocates?
Authors: Farrell Jane
Published: December 2017

The debate regarding the nurse as patient advocate continues to evoke strong feelings. This article will explore the concept of advocacy, where the notion originated, the qualities needed to be a patient advocate and whether nurses in the perioperative environment do advocate for their patients.
A Year in Whangarei
Authors: Macdonald Margaret
Published: December 2017

Ever felt like spreading your wings and exploring nursing in a place or culture very different from your own? Margaret Macdonald shows us that it can be done and that many worthwhile experiences can be obtained, allowing a fresh perspective on our own healthcare system.
Quantitative and Qualitative Research
Authors: Bassett Chris , Bassett Jane , Tanner Judith
Published: December 2017

The two previous parts of this research series looked at the reasons for creating a research basis for nursing and considered the benefits that may be achieved for the patient by using research to support nursing practice. This article discusses the next thing that helps the nurse understand research application better - an appreciation of the differences between quantitative and qualitative research. These similar sounding terms describe the two overarching approaches to research, designed to explore two very different aspects of healthcare.
Reading and Critiquing Research
Authors: Bassett Chris , Bassett Jane , Tanner Judith
Published: December 2017

Previous articles in this series have looked at the reasons for creating a research basis for nursing, considered the benefits to the patient from using research to support nursing practice, and provided a comparison of quantitative and qualitative research. This fourth article is very much about helping you get to grips with published research articles and papers, enabling you to understand them and helping you decide if their methods and recommendations are worthy of trying out in your workplace.
Being Bullied What An Insight
Authors: Hughes Angharad
Published: December 2017

Bullying and harassment have occupied a prominent position in NATN workshops and publications recently. Challenging Behaviours in the Perioperative Environment identifies practices that fall within the definition of these socially and legally unacceptable activities, and provides advice and guidance to victims and those who use bullying or violent behaviours. In this article, the author draws on her own experience of being a victim and provides advice on how to identify and deal with bullying.
Assistants in Surgical Practice What's in a Name?
Authors: Thatcher Janet
Published: December 2017

There has been much discussion in operating theatre corridors and literature (Beesley 2002) about this apparently new breed of practitioner. What is the difference between a First Assistant and a Surgical Assistant? Which term incorporates a laparoscopic nurse specialist? Perhaps more appropriately: Why is there such lack of clarity? How does it benefit the patient? This article attempts to unravel some of the issues underlying these questions.
Short-Term Ventilation of Critically Ill Patients in Recovery
Authors: Ryan David , Tobin Gillian
Published: December 2017

There is often a shortfall of critical care facilities which can result in a number of patients who need management in intensive care units (ICUs) being treated in a recovery unit prior to being found an ICU bed. This article describes a study which examined this situation. The patients’ origins, durations of stay in recovery, outcomes and final destinations are discussed. The authors conclude that recovery provides a hidden resource to supplement the lack of intensive care beds and suggest ways that the problem might be addressed.
Fighting Aids Stigma Caring for All
Authors: Woodhead Kate
Published: December 2017

The International Council of Nurses (ICN) chooses a theme each year to heighten awareness of an issue facing nurses working all over the world, and uses International Nurses Day, 12 May, to focus attention on the plight of patients’ suffering. This year's theme is Fighting AIDS stigma: caring for all. This article looks at the current situation with regards to HIV/AIDS and how it affects the public, patients and healthcare staff.
Percutaneous Endoscopic Gastrostomy Procedure in Practice
Authors: Lee Alex Ch , Carter Helen P , Crabbe David
Published: December 2017

Percutaneous endoscopic gastrostomy (PEG) is a relatively common procedure used in the treatment of children. As with all procedures, it must be used with care and only after taking careful account of circumstances and likely responses of the individual patient. This first of two articles on the procedure discusses the indications and contraindications for PEG insertion in children and then focuses on the procedure itself. The second article will discuss the role of the nurse as surgeon's assistant in the application of this procedure to children.
Recruitment and Retention the Derby Theatre Project Experience
Authors: Ainsworth David
Published: December 2017

The National Theatre Project was set up in March 2001 by the Modernisation Agency to improve the patient and carer experience, improve employee satisfaction, optimise theatre utilisation and reduce cancelled operations. This is the second article in the series where David Ainsworth, manager of a pilot site project in Derby, describes issues around the Theatre Project. This month the focus is on recruitment, retention and staff morale.
Desert Theatre Rats
Authors: Carey-Harris Jane , Coombs Mandy , Neilson Pauline
Published: December 2017

We are pleased to bring you this fascinating insight, from three theatre nurses, into life in a 200-bedded field hospital in Iraq. In February 2003 NATN members Jane Carey-Harris, a major in the Territorial Army, Mandy Coombs, a captain in the Territorial Army, and Pauline Neilson, a captain in the regular Army, were all called up. They tell us some of their story.
Introduction to Pulse Oximetry
Authors: Wright James , Johnson Melody
Published: December 2017

James Wright, now a qualified ODP, wrote this article while a trainee. He shares with us the history of pulse oximetry. This article in our student series describes the theoretical knowledge behind pulse oximetry and highlights its value in safely monitoring patients both pre- and postoperatively, as well as the need for proper daily calibration. He also describes the associated problems with movements of patients. He concludes that ‘pulse oximetry is one of the greatest advances in anaesthetic safety’.
A Discharge Protocol for the Postanaesthetic Recovery Unit
Authors: Swatton Sharon
Published: December 2017

Despite guidelines from the Royal College of Anaesthetists, some hospitals still do not have a formal discharge policy. The author of this article works within an operating department in the dual role of anaesthetic and recovery sister and has a particular interest in discharge criteria for postanaesthetic recovery patients. She suggests that a discharge protocol, developed in a multidisciplinary setting, should be in place in the postanaesthetic recovery unit.
Use of Leg Positioning Holders
Authors: Richardson Caroline
Published: December 2017

Direct Placement Leg Holders (DPLHs) have improved patient care in our hospital for those people requiring lower limb internal fixation for fractures. This brief history of how and why their potential use in orthopaedic trauma came about will describe the benefits for patient care and how they can improve patient positioning. Further suggestions include added benefits for practitioners acting as surgical or first assistants to the surgeon, including highlighting the benefits of preventing back injury to staff.
New Ways of Working in Anaesthesia
Authors: Lipp Allyson
Published: December 2017

Change and the NHS are synonymous; it is inevitable that new ways of working are explored to ensure an effective service. This article explores the possibility of using non-medically trained anaesthetists in the operating theatre. It examines a current pilot being undertaken by the NHS Changing Workforce Programme (DoH 2002a) and discusses how much impact this is likely to have in theatre.
Developing the First Assistant Course at the Countess of Chester Hospital
Authors: Owen-Jones Brenda
Published: December 2017

First assistant or advanced scrub practitioner roles have been undertaken by nurses since Florence Nightingale. Recently, theatre practitioners have undertaken this role as a matter of course, regardless of skill level. The Countess of Chester Hospital Theatres has produced the IS3 110 operating theatre first assistant module at level three. This runs alongside an in-house pathway of rapid evaluation of competence. Both are undertaken as work-based learning.
Opening Doors of Perception Creativity, Learning and Developing Practice
Authors: McCormack Brendan
Published: December 2017

The notion of ‘intelligence and humane choice’ is addressed in this article. The only way nursing can be influential in the world of healthcare is questioned by looking at a commitment to learning, development and research. The article aims to challenge issues about nurse education and explore ways in which the nursing profession can move debates about the values underpinning the preparation of undergraduate nurses.
Fibres Found during Cataract Surgery
Authors: Pisani Sandra
Published: December 2017

Unwanted fibres found in the operative site during phacoemulsification of cataract surgery may lead to infection, endophthalmitis, blindness and even loss of an eye. This article describes a study to identify the source of these unwanted fibres using scientific investigations. Recommendations for practice are made, based upon the findings.
Childhood Obesity
Authors: Lawrence Justin
Published: December 2017

There has been much public debate over the increasing global problem of obesity. The rise in obesity is not just confined to the adult population, childhood obesity is also on the increase. This article will highlight some of the issues contributing to the recent rise in childhood obesity and its associated health consequences. As healthcare professionals it is essential that we identify how the health-related factors of childhood obesity impact upon the care given in the perioperative environment.
European Working Time Regulations Implications for Practice
Authors: Beesley John
Published: December 2017

The European Working Time Regulations (EWTR) have implications for all NHS and independent sector employees. The aim of the EWTR is to protect employees’ health and safety by encouraging improvements in the working environment.
The Changing Face of Surgery Using Systematic Reviews
Authors: Richardson-Tench Marilyn , Pearson Alan , Birks Michelle
Published: December 2017

Three systematic reviews relating to pre-admission procedures, admission procedures and staffing policies were undertaken to establish evidence to develop best practice guidelines for day surgery units. Results revealed that a pre-admission intervention can improve patient and surgery outcomes, although the most effective type of intervention should be further investigated. It was also found that distraction can reduce patient preoperative anxiety, and there is no high quality evidence relating skill mix, staffing levels and desired health outcomes in day surgery units. Recommendations for areas of future research are presented.
Series Editor: Felicia Cox Obstetric Haemorrhage in the Perioperative Environment
Authors: Wilde Sarah
Published: December 2017

Massive haemorrhage remains a serious complication of childbirth despite advances in knowledge and surgical technique, with the number of mothers dying in the UK from haemorrhage appearing to be on the increase.
Preoperative Fasting Revisited
Authors: Mardell Andy , Bothamley Janet
Published: December 2017

Fasting patients prior to their surgical procedures is accepted practice. Although the latest research shows that it is safe for most patients to drink clear fluids 2–3 hours before a general anaesthetic many key staff are not aware of these findings. This article discusses preoperative fasting and describes an audit which culminated in a change in practice in a large district general hospital.
Mentoring Opens Doors
Authors: Allen Sheila
Published: December 2017

This article is based on the Daisy Ayris lecture given at the 2003 Congress by Sheila Allen, former Association of Perioperative Registered Nurses president. In it she explores the history and definition of mentoring. Mentors may be persons of rank, achievement and prestige, or they may be a knowledgeable colleague or teacher. They serve as a catalyst to transform as they instruct, counsel, guide and facilitate the development of others.
Walk or be Driven? A Study on Walking Patients to the Operating Theatre
Authors: Keegan-Doody Mary
Published: December 2017

The objective of this study was to determine patients' perception on the possibility of changing a tradition-based practice to a more patient-empowering service, thus demonstrating that nurses can make a difference in providing a more patient-centred environment. The study revealed that the patients themselves wanted to be included in the decision-making process and actively embrace change.
The Need for Accurate Records
Authors: Pirie Susan
Published: December 2017

Dear AfPP

I have recently obtained a senior post in a hospital that is in a different part of the UK in relation to where I have always worked. I have become aware of differing practices, many of which are improving patient care. However, I am concerned that in this perioperative environment, there is no permanent record of items used during each case. The only records of the items used in any one case are those that are recorded on the swab board and the signatures of the staff who undertake the final count in the theatre register. In some of my previous jobs, we have recorded the count on a separate sheet that was then filed in the patients' notes by the scrub practitioner of the case, thus providing a permanent record of the count in the patients' notes. Can AfPP advise on whether a record in the patients' notes is necessary?

Concerned from County Armagh
Introducing Student Nurses to Operating Department Nursing
Authors: Sampson Heather
Published: December 2017

The shortage of nurses is a major problem faced by the National Health Service. This also impacts on the shortage of theatre nurses where lack of recruitment and retention are threatening their existence (Montgomery 1997). Recruitment has not previously posed a problem in the operating department where the author works, due to pre-registration diploma nurses (PRDN) being allocated to the department as part of their critical care placement. Many of these students have been appointed to work in the operating theatre once qualified. However, due to changes in nurse education, students are now able to choose their placement.
Nursing Ethics in Practice: Issues for Perioperative Nursing
Authors: Richardson-Tench Marilyn , Brookes Alison , Hardley Andrew
Published: December 2017

Consent is a concept inherent in any nurse-patient relationship and provides nursing with both theoretical and practical challenges. Within the perioperative area written informed consent is obtained for surgical and anaesthetic interventions. Consent is not formally negotiated for the multitude of interventions undertaken to facilitate the most straightforward of surgical procedures. An explorative, qualitative research project was undertaken to explore the processes used by perioperative nurses for negotiating such consent. Data was collected from perioperative nurses working in an acute teaching hospital using ‘consent episodes’ as units of data focusing on daily tasks of perioperative patient care. Findings indicate there is a dominant discourse of implied consent in which perioperative nursing practice is located.
Preoperative Assessment and Intraoperative Care Planning
Authors: Hurley Ciarán , McAleavy Janet
Published: December 2017

We interviewed ten theatre nurses about their contribution to patient care. Their assessment strategy usually involved meeting patients on arrival in the department and did not include accessing the Trust's preoperative assessment document. In this paper we discuss the nursing assessment of surgical patients in the context of the nursing process as it was described in our research interviews.
Dissecting the Myths of Day Surgery: The Anaesthetist's View
Authors: Smith Ian
Published: December 2017

Although day surgery is now well established, its practice varies enormously between various parts of the country and even between different practitioners (Audit Commission 2001). Some of these differences may be explained by a number of lingering myths which persist from the earlier, pioneering days of day surgery. The purpose of this short review is to discuss some of these myths from an anaesthetist's perspective and to try to dispel them using the available evidence.
A New Vision for Day Surgery
Authors: Baskerville Paul
Published: December 2017

The premise that underlines this article (based on a presentation delivered at AfPP's Annual Congress in October 2006) is that all elective surgery performed in this country should be day surgery. This should eventually include patients undergoing hip replacements, radical prostatectomies, aortic aneurysm repair and hepatectomies, to name a few. All of these procedures we should perform, safely and well, under the British definition of day surgery as ‘going home at the end of the day’.
Operating Department Support Level 2 Nvq: Some Perceptions
Authors: McAleavy Janet
Published: December 2017

New roles for support staff are emerging and registered practitioners are now being asked to devolve key aspects of patient care. This study explores some of the background issues relating to these developments and provides evidence regarding the inevitability but also benefits, if managed well, of these changes. The experience of both support staff who have undertaken the Operating Department Support National Vocational Qualification Level 2 (ODS NVQ) and their managers was examined using a phenomenological approach. Data was obtained on the perceived value of this qualification and training and how it affected the working lives and career development of support staff.
Waste Responsibility: Or Wasted Opportunity?
Authors: Cunnington Jannice
Published: December 2017

This article will seek to identify, within the generic role of the theatre practitioner (TP), how effective waste management is crucial to patient care. Its place in infection control will also be discussed, along with issues of health and safety in the workplace. The ramifications of waste disposal are managed by legislation and therefore levels of responsibility, within the healthcare setting, will be explored. Potential difficulties arising from discrepancy between policy and practice will be examined, with a rationale presented for the TP's personal responsibility to keep abreast of changes. Finally, conflicting obligations that impinge on the economics of waste management will be adjudged, along with their implications for patient care now and in the future.
Holby City: Fact or Fiction?
Authors: Knobel Johann
Published: December 2017

The following article is based on a presentation given at AfPP's Annual Congress in October 2005. The author, a producer of BBC television's ‘Holby City’ drama series, discusses the making of the programme and gives an insight into how storylines and ‘realism’ are imported from real-life situations.
Cultural Considerations and Surgical Consent
Authors: Creedon Rena
Published: December 2017

The Irish healthcare system is failing to meet the needs of minority ethnic groups. This is a factor that has been attributed to communication barriers and lack of cultural awareness between healthcare providers and recipients of care (O'Connor 2005a). Moreover, with increasing diversity in Ireland, encounters between the healthcare professional and patients from ethnic minorities are becoming more common. Patients bring to the medical encounter different languages, explanatory models concerning treatment and illness, religious beliefs, and ways of understanding the experience of suffering. Thus the risk of misunderstanding and inability to complete appropriate assessments surrounding care and in particular the consent process is a growing concern.
Preparing a Patient Information Leaflet
Authors: Brown Valerie
Published: December 2017

As a student of operating department practice, I was asked to produce a patient information leaflet that helped to prepare patients for a surgical procedure. In addition, I had to write a paper highlighting the issues involved in effectively communicating with vulnerable patients. The relevance of communication and information giving is vital in all aspects of healthcare but even more so in theatre where the patient must be informed to give consent.
Bangladesh: An Exceptional Experience
Authors: Truscott Gillian
Published: December 2017

Last summer a consultant colleague approached me and asked if I would accompany him on a two week working trip to Bangladesh. Without even stopping to consider the proposal I heard myself answering ‘yes’ and, a few months later, I found myself being steered through the VIP zone of Dhaka airport into a captivating world alive with vibrant activity, beguiling all the senses.
Post Anaesthetic Care Units in the Republic of Ireland: A Survey of Discharge Criteria
Authors: Hegarty Josephine , Burton Aileen
Published: December 2017

Discharge readiness of patients from the post anaesthetic care unit (PACU) is often determined by specific discharge criteria. This quantitative, descriptive national study aimed to survey discharge criteria used in the PACU. Data from 45 hospitals nationally with a response rate of 77.8% (n=35) was gathered. Specific discharge criteria were used by 71.4% (n=25) of the PACUs in the determination of fitness of patients for discharge from the PACU.
Avoiding the Use of Agency Staff in the Operating Department
Authors: Gee Alison
Published: December 2017

In January 2006 the BBC reported NHS trust debts of £1.07 billion in England (BBC 2006a). In April 2006 it reported that 7,000 job losses had already been confirmed (BBC 2006b) – although this figure could rise to as many as 13,000. Clarke (2006) identifies that many hospitals are now reducing their use of agency staff as one method of controlling unfunded expenditure. This makes economic sense: Clarke (2004) reported that the 2003–4 spend on agency staff for the whole of the UK was £1.64 billion.