NR 351 Week 5 Discussion Using Evidence-Based Practice to Improve Patient Care (Graded)

Paper Instructions

Discussion

Select a challenging nursing care issue (examples include falls, medication errors, pressure ulcers, and other clinical issues that can be improved by evidence in nursing). Do not select a medical issue (disease, medical treatment). Do not select a workforce issue (staffing, call-offs, nurse to patient ratios). Explain the following for the selected clinical issue;

  • State the issue.
  • Explain the process you would use to search CINAHL for evidence. Include your search terms.

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According to Rowlands, incorrect surgical counts are a common occurrence after surgery. In reviewing incident reports from six hospitals during a three-year period, researchers found that incorrect surgical counts (25%) were the most frequently reported event. Despite the availability of AORN standards and recommended practices and hospital policies, this type of error continues to occur (2012).

Rowlands also states, “the OR is a highly complex, error-prone environment characterized by nonstop activity, specialization, and intricate interdisciplinary processes. The complexity is manifested not only in the patient and his or her condition but also in the sophistication of instrumentation and technology, which may increase the risk for error”. “From the stories of preoperative personnel involved in incorrect surgical counts, three distinct themes emerged bad behavior, general chaos, and communication difficulties”.

Working in the OR first hand I deal with the three themes mentioned. I find it difficult to have everyone participate in the correct sequence as well as visualizing each item counted. When I correct someone, I receive “looks”, hissing and a feeling that I am being too strict while I feel that other are too lax and do not take into consideration that policies dictate our process. The patient and their safety, following policies and maintaining my licensure are the core of my practice.

Recently, I had a surgical technologist berate me for correcting a new surgical technologist in the way they were performing the count. I received attitude from the new employee and was berated by the preceptor during the procedure. I structure my counting based on the policy and so I know that I am performing my count according to AORN standards.

Moving forward in my practice, I will continue my counts as outlined in our policy. I will continue to correct others when necessary and I will hold others accountable to follow the policy. I do not play into unprofessionalism in my OR and I will address each situation as it arises. When others disrupt the OR with unprofessionalism, I simply explain that we can discuss the situation at a later time.

Researching in the Chamberlain Library for information regarding surgical counts, I began my search in the CINAHL complete tab, entered surgical counts on the first line and extended my search further with “risk factors associated with incorrect surgical counts”. I found a great journal article and used it along with my experience to complete my week 5 assignment.

References

  • Hood, L. J. Leddy and Pepper’s Professional Nursing (9th ed.). Philadelphia, PA Wolters Kluwer
  • Rowlands, A. (2012). Risk Factors Associated with Incorrect Surgical Counts.
    https //doi.org/10.1016/j.aorn.2012.06.012Links to an external site.

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