Code Status Limitations
WHAT DO WE DO when a patient with a do not resuscitate (DNR) order comes into our care for a palliative care procedure? Do we simply ignore it until the procedure has been completed? Do we avoid any attempts to intubate the patient who unexpectedly becomes oversedated and hypoxic? Physicians and researchers from two American academic hospitals explored current adoption of standing guidelines for situations like this. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Authors: Mary W. Stewart Tags: Research News Source Type: research

Celebrate Strengths: Elevate Practice
IT IS WITH GREAT HONOR and privilege that I have  been chosen to serve this amazing organization—the American Society of PeriAnesthesia Nurses (ASPAN). For a long time, I have appreciated how vital ASPAN is to my perianesthesia practice and have aspired to lead this group of professionals. Having the support and backing of our premier organizat ion that seeks and uses evidence to support practice gives me the strength to advocate for safe patient care and fuels my passion for this wonderful specialty. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Authors: Amy Dooley Tags: The President's Page Source Type: research

The Dark Side of Systems Thinking
I RECENTLY ENROLLED in a professional and organizational development program. My first assignment was to answer the following questions: is systems thinking a modern clich é or a fad that will soon pass? Or, is systems thinking a method of change to support sustainability and viability within a health care system? I labored over my response for several weeks before I could construct my reply. Certainly there have been fads in nursing over the years, right? Who does n ot remember primary nursing? It was here to stay! Then came team nursing. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Authors: Theresa Clifford Tags: The Back Page Source Type: research

Exploring New Horizons, Empowering Global Practice
A DECADE HAS PASSED since the goal emerged to expand global professional connections across our specialty practice. The path to establishing a formal professional specialty organization began by holding an inaugural international perianesthesia nursing conference in 2011. Ten years and four successful biennial international conferences later, the International Collaboration of PeriAnaesthesia Nurses, Inc (ICPAN) will host its 2019 conference in beautiful Cancun, Mexico (Figure  1). Over the past 10 years, a steady progression has occurred in the collective aim to facilitate sharing of perianesthesia nursing exper...
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Authors: Joni M. Brady Tags: Global Connections Source Type: research

What Do We Do? Ensuring Patient Safety Through Teamwork
In my February  editorial,1 I focused on what it means to be a nurse and the many opportunities that the role provides. In this issue, I would like to focus on what it is that perianesthesia and perioperative nurses do, and most importantly, the team environment in which we work on a daily basis. Nurses across al l areas of the surgical continuum are charged, above all else, with ensuring the safe traversal of the patient through every phase of the surgical experience. Preoperatively, to include preadmission testing and preoperative holding, we coordinate the early assessment, education, and preparation of t he patien...
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Authors: Vallire Hooper Tags: Editorial Opinion Source Type: research

Information for Readers
(Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Source Type: research

Editorial Board
(Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Source Type: research

Table of Contents
(Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Source Type: research

Effect of Listening to Music on Postoperative Cognitive Function in Older Adults After Hip or Knee Surgery: A Randomized Controlled Trial
This study aimed to assess the effect of listening to music on postoperative cognitive function in older adults after hip or knee surgery. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 31, 2019 Category: Nursing Authors: Funda Çetinkaya Tags: Original Article Source Type: research

Peripheral Nerve Blocks and Immediate Postoperative Recovery: A Single-Institution Survey of Perianesthesia Nurses' Preferences and Opinions.
CONCLUSIONS: The perianesthesia nurses surveyed felt PNBs improved pain control and patient recovery despite a perceived risk of falling for lower extremity TJR, and they preferred PNB when considering TJR surgery for themselves. PMID: 31153776 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - May 29, 2019 Category: Nursing Authors: McClain RL, Porter SB, Scott CL, Mazer LS, Robards CB Tags: J Perianesth Nurs Source Type: research

Peripheral Nerve Blocks and Immediate Postoperative Recovery: A Single-Institution Survey of Perianesthesia Nurses' Preferences and Opinions
To ascertain the preferences of perianesthesia nurses regarding peripheral nerve blocks (PNBs) and their impact on patient recovery after total joint replacement (TJR). (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 29, 2019 Category: Nursing Authors: Robert L. McClain, Steven B. Porter, Courtney L. Scott, Laura S. Mazer, Christopher B. Robards Tags: Original Article Source Type: research

Key Factors for Successful General Anesthesia of Obese Adult Patients.
CONCLUSIONS: Knowledge of key factors that facilitate and improve the anesthesia care of obese patients is important to provide safe and quality anesthesia to this patient group as obese patients often have small margins and urgent situations can quickly arise. This knowledge enables the nurse anesthetist to be one step ahead and to be ready to take action if complications occur. PMID: 31151885 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - May 28, 2019 Category: Nursing Authors: Larson F, Nyström I, Gustafsson S, Engström Å Tags: J Perianesth Nurs Source Type: research

Key Factors for Successful General Anesthesia of Obese Adult Patients
To study nurse anesthetists' experiences of key factors for successful airway management in general anesthesia of adult obese patients. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 28, 2019 Category: Nursing Authors: Fanny Larson, Ingela Nystr öm, Silje Gustafsson, Åsa Engström Tags: Original Article Source Type: research

Essential Oils to Reduce Postoperative Nausea and Vomiting.
CONCLUSIONS: Aromatherapy demonstrated a statistically significant (P
Source: Journal of Perianesthesia Nursing - May 27, 2019 Category: Nursing Authors: Fearrington MA, Qualls BW, Carey MG Tags: J Perianesth Nurs Source Type: research

Essential Oils to Reduce Postoperative Nausea and Vomiting
The purpose of this study was to determine if using essential oil products for adult patients reduced the need for antiemetics for postoperative nausea and vomiting (PONV). (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - May 27, 2019 Category: Nursing Authors: Maxine A. Fearrington, Brandon W. Qualls, Mary G. Carey Tags: Original Article Source Type: research

Adverse Events in Anesthesia: An Integrative Review.
CONCLUSIONS: Care planning, efficient communication, and teamwork are critical to prevent adverse events in anesthesia. PMID: 31005390 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - April 17, 2019 Category: Nursing Authors: de Santana Lemos C, de Brito Poveda V Tags: J Perianesth Nurs Source Type: research

Adverse Events in Anesthesia: An Integrative Review
This study conducted an integrative review of the literature in a search for scientific evidence related to the occurrence of perioperative adverse events resulting from anesthesia. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - April 17, 2019 Category: Nursing Authors: Cassiane de Santana Lemos, Vanessa de Brito Poveda Tags: Original Article Source Type: research

Nurse Anesthetists' Communication in Brief Preoperative Meeting With Orthopaedic Patients-An Interview Study.
CONCLUSIONS: The Preoperative meetings need to be developed and structured to improve communication. A way to assess the results of this conversation should be developed. Other recommendations include finding a way to improve patient involvement in this dialogue and development of skills of NAs to enhance the meeting for patients. PMID: 30952583 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - April 2, 2019 Category: Nursing Authors: Krupic F Tags: J Perianesth Nurs Source Type: research

Nurse Anesthetists' Communication in Brief Preoperative Meeting With Orthopaedic Patients —An Interview Study
To explore the experience of preoperative communication of nurse anesthetists (NAs) in brief meetings with patients in an orthopaedic setting. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - April 2, 2019 Category: Nursing Authors: Ferid Krupic Tags: Original Article Source Type: research

A Culture of Safety-Whose Responsibility?
PMID: 30914134 [PubMed - in process] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 29, 2019 Category: Nursing Authors: Odom-Forren J Tags: J Perianesth Nurs Source Type: research

Be Aware of Health Technology Hazards.
PMID: 30914135 [PubMed - in process] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 29, 2019 Category: Nursing Authors: Ross J Tags: J Perianesth Nurs Source Type: research

Antithrombotic Therapy and Regional Anesthesia.
PMID: 30914136 [PubMed - in process] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 29, 2019 Category: Nursing Authors: Wolfe RC, Evans T Tags: J Perianesth Nurs Source Type: research

Considering the Control Group.
PMID: 30914137 [PubMed - in process] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 29, 2019 Category: Nursing Authors: Fetzer SJ Tags: J Perianesth Nurs Source Type: research

Leaving a Legacy of Caring.
PMID: 30914138 [PubMed - in process] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 29, 2019 Category: Nursing Authors: O'Brien DD Tags: J Perianesth Nurs Source Type: research

Antithrombotic Therapy and Regional Anesthesia
THE AMERICAN SOCIETY OF REGIONAL Anesthesia and Pain Medicine, in conjunction with the European Society of Anaesthesiology, published updated guidelines on antithrombotic therapy in the patient receiving neuraxial and peripheral regional anesthesia.1 These guidelines aim to resolve international differences in the management of antithrombotic agents for neuraxial and peripheral nerve procedures and to incorporate new information and medications that have become available since the last guidelines were published in 2010. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Authors: Rachel C. Wolfe, Tayler Evans Tags: Pharmacology Facts Source Type: research

Considering the Control Group
The “gold standard” of research designs is the randomized control trial (RCT). When proposing an RCT the researcher divides patients into at least two groups of participants or subjects. The three defining features of an RCT include manipulation, control, and randomization.1 Manipulation involves th e researcher “doing something” to some of the subjects; these subjects are referred to as the treatment or intervention group. The control group comprises participants who do not get the intervention. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Authors: Susan J. Fetzer Tags: Research for Practice Source Type: research

Leaving a Legacy of Caring
Over the past few years I have watched as perianesthesia and other nursing colleagues have retired. The number of years worked varies. The reasons for retirement are multifactorial. Common themes include the desire to travel when healthy, the need to care for a family member, the wish to grow hobbies and interests into full time practices, and occasionally because of illness or loss. Of course, a few people are just tired …tired of the pace, the pressures, and the changes in health care, seemingly occurring on a daily basis. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Authors: Denise D. O'Brien Tags: The Back Page Source Type: research

Be Aware of Health Technology Hazards
PATIENT SAFETY IS PARAMOUNT in health care. Various agencies provide guidance to providers on alerts for patient safety hazards in the health care arena. One of those groups is the ECRI Institute, whose mission is to protect patients from unsafe and ineffective medical technologies and practices. The ECRI Institute makes recommendations based on patient safety events. To advise health care facilities, the ECRI Institute provided a top 10 list of 2019 health technology hazards that include important safety issues. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Authors: Jacqueline Ross Tags: Patient Safety Source Type: research

A Culture of Safety —Whose Responsibility?
WE KNEW AS EARLY as 1998 when the Institute of Medicine report, To Err Is Human: Building a Safer Health System was published that up to 98,000 patients die each year in the United States as the result of preventable medical error.1 Fifteen years later, the National Patient Safety Foundation's report, Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err Is Human, found that despite some improvement in patient safety in the US, the improvement has been slow and limited. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Authors: Jan Odom-Forren Tags: Editorial Opinion Source Type: research

Information for Readers
(Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Source Type: research

Editorial Board
(Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Source Type: research

Table of Contents
(Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Source Type: research

JOPAN Editorial Staff 2018-2019
(Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Tags: Editorial Staff Photos Source Type: research

Congratulations New CPANs and CAPAs!
ON BEHALF OF the American Board of PeriAnesthesia Nursing Certification, I would like to extend our congratulations to the following nurses who have achieved CPAN ® or CAPA® certification during the Fall 2018 examination cycle. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 24, 2019 Category: Nursing Tags: Membership Source Type: research

Implementation of Vulnerable Elders Survey-13 Frailty Tool to Identify At-Risk Geriatric Surgical Patients.
CONCLUSIONS: A detailed and comprehensive preoperative assessment remains the most efficient way to identify frail geriatric surgical patients. PMID: 30910510 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 22, 2019 Category: Nursing Authors: Vernon TL, Rice AN, Titch JF, Hill BF, Muckler VC Tags: J Perianesth Nurs Source Type: research

Implementation of Vulnerable Elders Survey-13 Frailty Tool to Identify At-Risk Geriatric Surgical Patients
The primary purpose of this project was to preoperatively identify frail and vulnerable geriatric patients aged 65 or older using the Vulnerable Elders Survey (VES-13) tool, and to use those scores to assist with perioperative decision-making. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 22, 2019 Category: Nursing Authors: Tedrick L. Vernon, Andi N. Rice, J. Frank Titch, Brandyce F. Hill, Virginia C. Muckler Tags: Original Article Source Type: research

Educating Patients About Opioid Disposal: A Key Role for Perianesthesia Nurses.
CONCLUSIONS: Patients often have excess prescribed opioids after laparoscopic cholecystectomy, and they do not understand proper disposal of unused medications. Education about proper disposal of unused opioids medications is a key role of perianesthesia. PMID: 30894293 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 17, 2019 Category: Nursing Authors: Merrill KC, Haslam VC, Luthy KEB, Nuttall C Tags: J Perianesth Nurs Source Type: research

Reducing Preventable Surgical Cancellations: Improving the Preoperative Anesthesia Interview Process.
Abstract PURPOSE: Thorough and accurate preoperative anesthesia interviews may help improve perioperative efficiency by reducing unnecessary preoperative testing and preventable surgical cancellations, both of which create financial burdens. Standardized anesthesia preoperative interview guidelines and online educational modules for registered nurses (RNs) conducting preoperative interviews may improve this process. DESIGN: Predesign and postdesign, retrospective chart review. METHODS: Online educational modules and standardized preoperative anesthesia interview guidelines were developed for RNs conducti...
Source: Journal of Perianesthesia Nursing - March 17, 2019 Category: Nursing Authors: Leite KA, Hobgood T, Hill B, Muckler VC Tags: J Perianesth Nurs Source Type: research

Educating Patients About Opioid Disposal: A Key Role for Perianesthesia Nurses
To examine opioid prescription practices, patient use of opioids after laparoscopic cholecystectomy, and patient knowledge about disposal of unused medication. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 17, 2019 Category: Nursing Authors: Katreena C. Merrill, Valynn Christina Haslam, Karlen E. (Beth) Luthy, Craig Nuttall Tags: Original Article Source Type: research

Reducing Preventable Surgical Cancellations: Improving the Preoperative Anesthesia Interview Process
Thorough and accurate preoperative anesthesia interviews may help improve perioperative efficiency by reducing unnecessary preoperative testing and preventable surgical cancellations, both of which create financial burdens. Standardized anesthesia preoperative interview guidelines and online educational modules for registered nurses (RNs) conducting preoperative interviews may improve this process. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 17, 2019 Category: Nursing Authors: Kirsten A. Leite, Todd Hobgood, Brandy Hill, Virginia C. Muckler Tags: Original Article Source Type: research

Mirtazapine for Postoperative Nausea and Vomiting: Systematic Review, Meta-analysis, and Trial Sequential Analysis.
CONCLUSIONS: This meta-analysis suggests that mirtazapine reduces PONV overall versus placebo. We found evidence of reduction in preoperative anxiety, although mirtazapine increased the risk of sedation. PMID: 30879907 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 14, 2019 Category: Nursing Authors: Bhattacharjee D, Doleman B, Lund J, Williams J Tags: J Perianesth Nurs Source Type: research

Evaluation of Warming Effectiveness on Physiological Indices of Patients Undergoing Laparoscopic Cholecystectomy Surgery: A Randomized Controlled Clinical Trial.
CONCLUSIONS: Both interventions had similar effects on physiological indices. Therefore, the recommendation is to use the warming method according to patient's other conditions. PMID: 30879908 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 14, 2019 Category: Nursing Authors: Baradaranfard F, Jabalameli M, Ghadami A, Aarabi A Tags: J Perianesth Nurs Source Type: research

Mirtazapine for Postoperative Nausea and Vomiting: Systematic Review, Meta-analysis, and Trial Sequential Analysis
Patients rank postoperative nausea and vomiting (PONV) as the most undesirable outcome of anesthesia. Mirtazapine is hypothesized to be effective in PONV prophylaxis via 5HT3 receptor antagonism. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 14, 2019 Category: Nursing Authors: Debamita Bhattacharjee, Brett Doleman, Jonathan Lund, John Williams Tags: Original Article Source Type: research

Evaluation of Warming Effectiveness on Physiological Indices of Patients Undergoing Laparoscopic Cholecystectomy Surgery: A Randomized Controlled Clinical Trial
The present study aimed to evaluate the impact of warming on  physiological indices of patients undergoing laparoscopic cholecystectomy. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 14, 2019 Category: Nursing Authors: Fereshteh Baradaranfard, Mitra Jabalameli, Ahmad Ghadami, Akram Aarabi Tags: Original Article Source Type: research

Music as a Postoperative Pain Management Intervention.
PMID: 30872013 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 11, 2019 Category: Nursing Authors: Poulsen MJ, Coto J, Cooney MF Tags: J Perianesth Nurs Source Type: research

Music as a Postoperative Pain Management Intervention
PAIN IS A COMMON and frequently reported effect of surgical intervention. The World Health Organization estimates 266 to 360 million surgeries are performed yearly.1 Studies have shown that 40% to 65% of postoperative patients report moderate to severe pain.1 The most common treatment for moderate to severe pain continues to be opioid medications because of immediate effects, multiple delivery forms, and ease of administration. The US Department of Health and Human Services has concerns with increasing opioid-related deaths and opioid use disorder, causing the medical community to rethink the approach to pain management re...
Source: Journal of PeriAnesthesia Nursing - March 11, 2019 Category: Nursing Authors: Michael J. Poulsen, Jeffrey Coto, Maureen F. Cooney Tags: Pain Care Source Type: research

Laboratory Monitoring and Transfusion Guidelines to Influence Care in Patients Undergoing Multilevel Spinal Fusion Surgery.
CONCLUSIONS: Through the use of the protocol, laboratory value monitoring provided quantitative data to aid and improve clinical decision making for practitioners in the perioperative period. PMID: 30853328 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 7, 2019 Category: Nursing Authors: Hollis C, Rice AN, Gupta DK, Goode V Tags: J Perianesth Nurs Source Type: research

Effects of Vibration and Cold Application on Pain and Anxiety During Intravenous Catheterization.
CONCLUSIONS: Vibration and cold gel pack application is suggested to relive pain during IV catheterization in adults. PMID: 30853329 [PubMed - as supplied by publisher] (Source: Journal of Perianesthesia Nursing)
Source: Journal of Perianesthesia Nursing - March 7, 2019 Category: Nursing Authors: Pakiş Çetin S, Çevik K Tags: J Perianesth Nurs Source Type: research

Laboratory Monitoring and Transfusion Guidelines to Influence Care in Patients Undergoing Multilevel Spinal Fusion Surgery
The purpose of this project was to determine whether the use of the modified Northwestern high risk spine protocol in patients undergoing multilevel spinal fusion surgery would result in improved transfusion practices. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 7, 2019 Category: Nursing Authors: Colby Hollis, Andi N. Rice, Dhanesh K. Gupta, Victoria Goode Tags: Original Article Source Type: research

Effects of Vibration and Cold Application on Pain and Anxiety During Intravenous Catheterization
To determine the effects of vibration and cold gel pack application on pain and anxiety levels of patients undergoing intravenous (IV) catheterization. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - March 7, 2019 Category: Nursing Authors: Sevgi Paki ş Çetin, Kıvan Çevik Tags: Original Article Source Type: research