Attendees at the 49th annual AORN C...

Attendees at the 49th annual AORN Congres had a wide variety of education sessions to fix upon from. Topics ranged from evidenced-based practice and plastic surgery to Creutzfeldt-Jakob disease (CJD) Special sessions designed just for managers and pupils also drew large crowds. Following are overviews of just a not many of the exciting sessions currented this year.

EVIDENCE-BASED PRACTICE first note of the scale TO FIGHTING SURGICAL SITE INFECTIONS

As health care workers continue to battle newly resistant and increasingly resistant organisms, they must move round to standard precautions and attract favor toed practices to reduce patient infection rates and their personal risk. That was the message Susan Renee Guerra, RN MN CNAA, CNOR, and Mary Lynne Weemering, RN MSN CNOR, delivered in their presentation titled "Breaking the Chain of Infection in the OR."

Guerra at handed statistics on the growing vexed question of surgical site infections (SSIs). She cited studies that exhibit SSIs may be more prevalent than health care workers believe because many patients are released from health care facilities before infections manifest. Organisms and diseases Guerra singled disclosed for particular attention include Staphylococcus, enterococcus, E coli, tuberculosis, Clostridium difficile, hepatitis, HIV, and CJD

Weemering addressed in what manner to handle the threat from these organisms and diseases in a hospital setting. She discussed the debate about domestic circle laundered scrubs and cited a investigation that found no statistical difference in the amount of bacteria plant on home laundered surgical cleans versus those laundered in a commercial setting.

Weemering also discussed hand hygiene and CDC guidelines upon alcohol-based hand scrubs and brushless scrubbing. According to her, propos CDC guidelines scowl on scrubbing with brushes because it has been institute that regardless of how extended an individual scrubs with a brush, he or she still brings up bacteria from the skin layers.

Weemering encouraged attendees to "make your policy (on hand scrubs) and there urgencys to be monitoring to make never-failing everyone is doing it right."

Weemering also discussed infection have charge of for high-risk patients (eg, patients with CJD) She noted that "people ne to be getting in compliance with the ordinary, everyday things." at following evidence-based practice every day, health care workers can minimize the risk pos by dint of highly infectious organisms, both to themselves and to other patients.

LEGAL AND ETHICAL ISSUES

In the session onward legal and ethical issues for perioperative pampers Thomas Mayo, JD, concentrated in succession four distinct areas, including

* informed consent

* do-not-resuscitate (DNR) orders in the OR,

* off-label uses of US diet and Drug Administration (FDA) approved devices, and

* confidentiality of patient information.

Informed compliance Mayo gave a brief history of the informed harmony process and noted that single of the myths is that informed assent is all about getting a signature forward a form. "Informed consent is a proces not an event" said Mayo, explaining that it is an ongoing relationship. A signature forward a form is mere evidence that the informed concurrence process occurred, and it is not extremely good evidence, said Mayo. Informed concord must pass three tests, including

* the objective "reasonable professional" trial (ie, is the treatment what a reasonable professional would prescribe);

* the objective "reasonable patient" standard (ie, what would a reasonable patient want to know about this treatment); and

* the subjective patient criterion (ie, what does this patient want or ne to know about the procedure)

The next to the first myth of the informed consensus process is that a patient who refuses an indicated surgery is incompetent, still Mayo noted that ethically, a patient's elections should be carried out unles there is an ethically compelling reason not to do in such a manner In addition, a bad decision forward the part of the patient does not mean he or she lacks decision-making ability. Ethically, the following stairs should be taken before deciding whether a patient is convenient to make the decision:

* do not assume incompetency,

* explore the patient's understanding of the treatment and risks of not undergoing treatment,

* explore the patient's evaluative proces and things that might affect the proces (eg beliefs, past experiences), and

* if the patient still refuses, consider initiating a formal consultation.

Do-not-resuscitate orders in the OP Historically, said Mayo, all DNR were suspended in the OR, on the other hand that thinking is changing. Several organizations have issued position statements that reinforce the patient's right to reconsider a DNR order before undergoing surgery Mayo said that this proces is dead to change, and in many hospitals, DNR still are ignored in the OR, which was demonstrated by the agency of a show of hands among audience members.

Off-label uses. According to Mayo, the FDA allows physicians to use approved devices for intentions that have not been approved for marketing. He noted, however, that physicians must be well-informed about the issues of off-label use, base off-label use onward scientific evidence, and maintain records forward the product's use and effect