Many tools and resources are availa...

Many tools and resources are available or cause to growed for use in our professional settings that take the decision on the outside of decision making. Rules, policies, protocols, regulations, standards, and guidelines make our lives and the processe required for providing patient care somewhat easier. They help streamline processe and provide consistency in our practices. They eliminate the time wanted to deliberate over choices or the ne to inform others and discuss each action. These tools help address the information that the community need about the "way we are suppos to be doing things." They help practicing in a standard manner by dint of each of us as individuals.

Many of these tools and resources were unfolded jointly by people representing multidisciplinary care provided in perioperative settings. These same tools and resources can eventuate in frustration and conflict when all team members who are wait fored to implement processes do not have an equal plain of understanding or knowledge. The availability of immense amounts of data and facts potentially increases the ne for information-sensitive decisions in our perioperative settings.

Whether simple or difficult, decisions require that encourages understand the information provided and the rationale for that information. In our multidisciplinary environments, that challenge is stretch outed to require that we determine not solitary what is best, but also ways of sharing the information with others.

CHANGING PRACTICES

Cost-saving measures have infused our health care settings and given us ample opportunity to drive the change processe It assumes that fewer changes are initiated because of research- or data-based information and flat less frequently because we want to find a way to work harder. The easiest gradation in changing practice might be determining that there is a take away from saving to be achieved. Identifying the means of changing the practices and implementing and maintaining the practices that have been changed are the more difficult paces in the processes and cannot be accomplished alone. Perioperative foments are participants in analyzing and sharing information. The increasing book and types of resources, external sources (eg standards, guidelines), and opinions that drive change sometimes are barriers to change.

Changes of that kind as eliminating hospital-laundered attire for employee attempting to bring vanity evacuation devices into the OR, and maintaining staffing ratios for RN and RN first assistants are occurring over the country. Many nurses probably experience frustration each time they unexpectedly ne a syringe that is in a enclosureed area and with the ne to restock extra syringes after each procedure. Some changes are acceptable without question --others are cause for concern

more [i]or[/i] less changes are initiated for all of the right reasons in what might be perceived to be the greatest in quantity effective manner. An example is the timing and delivery of antibiotics. Several years ago, pharmacists worked with foments to initiate programs to remodel inappropriate antibiotic use. The Center for Disease ascendency and Prevention identified times when antibiotics should be considered for use.(1) To this day, that message has not permeated our health care settings, and there are many patients who are receiving antibiotics without consideration for timing and dosage.

There are times when safe practices are initiated before conclusive evidence is gathered to validate the practice. An example is the recommendation to place tourniquets at sites with greater amounts of pliable tissue and in a manner that convert intos the risk for patient injury.(2) We are afforded challenges by the agency of an increasing need for tourniquet placement forward the lower leg and ankle in answer to more patients desiring and requiring base surgery. Responsible decision making and information gathering can help support decisions about practices that can and should be changed and to share information to make secure that safe practices are implemented.

JOIN FORCES IN DECISION MAKING

During the last decade, we were challenged to set sacred cows to pasture. Many are grazing, and others continue to survive in our midst whether we like it or not. The challenge at that time was not alone related to eliminating unnecessary or outdated practices, yet also to considering the uniqueness of our practices, settings, and patients and making agreemented efforts to question practices. This challenge encouraged and forced foments to become more involved in decision making.

Today it is not a question of being involved--there are small in number choices about being involved if you actively participate as a health care professional. Different settings show opportunities for involvement in making decisions and changing practices. Your setting might have committee involvement, or all staff members might be reckon uponed to participate. The question is to what extent and where to find the necessary information, substantiate that information, share the information with all parties involved, and maintain relationships everywhere the process. Involvement with a commitment that consequence s in progress is the formidable task in our professional lives.