PRESIDENT’S MESSAGE Our Pursuit of Excellence VICTORIA M. STEELMAN PhD, RN, CNOR, FAAN, AORN PRESIDENT
xcellence is providing high-quality, costeffective care or services based on the best evidence available. Excellence is more than a word or a stationary outcome; it is an ever-changing goal. As new evidence becomes available, expectations change and the bar is raised. It is our continuous pursuit of excellence that is the passion that drives perioperative nursing and allows us to be the best that we can be as individual nurses and collectively as an organization. Many AORN initiatives are planned for 2014 to support our pursuit of excellence, including developing evidence-based clinical practice guidelines, responding to changes in health care and to our patients, enhancing patient safety, and preparing perioperative nurses for the future. EVIDENCE-BASED PRACTICE This year, AORN will further refine our recommended practices (RP) documents to reflect the industry standard for evidence-based practice. AORN Headquarters staff members and the Recommended Practices Advisory Board are scheduled to revise some of the RP documents, including the recommended practices for n
surgical attire, n cleaning and care of instruments and powered equipment, n managing the patient receiving moderate sedation/analgesia and local anesthesia,
preoperative patient skin antisepsis, prevention of unplanned perioperative hypothermia, and n management of specimens. n
This team also will develop a new RP document for autologous tissue management. The RP authors and the Recommended Practices Advisory Board will continue rating the level of supporting evidence to produce documents that will be accepted by the National Guideline Clearinghouse.1 This acceptance ensures that our documents are credible and respected by health care professionals and accrediting agencies. To ensure that these documents are relevant, we rely on your input when draft documents are posted on the AORN web site for public comment. CHANGES IN HEALTH CARE Informational technology plays a key role in health care reform. It is essential that nurses measure the care that we provide, identify opportunities for improvement, and share the knowledge gained. In this way, we demonstrate the value of perioperative nursing. AORN staff members have made significant progress in integrating SyntegrityÒ into health care information systems, but, this year, the Perioperative Nursing Data Set and Syntegrity will be further refined by the AORN staff and the Perioperative Nursing Data Set Committee
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members. The Syntegrity Committee will be moving forward by developing two care plans: “Care of the patient with diabetes” and “Care of the patient with morbid obesity.” We will be showcasing examples of how integration of Syntegrity can and has been used to improve the quality and efficiency of perioperative nursing care. We rely on you to discuss Syntegrity with your information system vendors, which, in turn, helps promote a consumer demand for this product. The Board of Directors also is responding to other evolving changes in health care, one of which is the expectation of active patient involvement in decision-making. The Board of Directors has established a task force to develop a report, Guiding Principles for Perioperative Patient Engagement. This work builds on a recently published white paper from the Nursing Alliance for Quality Care, Fostering Successful Patient and Family Engagement: Nursing’s Critical Role,2 and will reflect the unique nature of perioperative nursing. Other changes in health care are related to technological advances. In collaboration with the Association for Radiologic & Imaging Nursing, the AORN National Committee on Education will be developing competencies for perioperative nursing care of patients who are treated in hybrid ORs. This committee also will be responding to a national epidemic of obesity by continuing their work on an educational module for care of the patient undergoing bariatric surgery. PATIENT SAFETY The cost of health care has driven a change in the locations in which surgery is being performed, resulting in an increase in office-based surgery. To enhance our understanding of safety practices used in office-based surgery, the AORN Nursing Research Committee will be surveying personnel in office settings to identify their familiarity with safety practices and how frequently they use these practices. The knowledge gained will serve as a baseline for identifying what services and products
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PRESIDENT’S MESSAGE AORN might develop in the future to promote patient safety in office-based surgery. We will be promoting patient safety through other initiatives as well. During the past year, we have seen hurricanes, tornadoes, floods, mass shootings, and terrorist activities. We have heard from members that they need additional resources to support management decisions related to these events. Although there are individual reports of how to improve emergency processes published in the AORN Journal,3 AORN is developing targeted resources for perioperative leaders to use in preparing for and responding to emergencies. The members of the newly formed Emergency Preparedness Task Force will assess AORN member needs, determine what resources are already available, and develop these additional resources. Another key component of patient safety is communication. This June, we celebrate the 10th anniversary of National Time Out Day. Building on our success with this collaborative effort, we will focus on fully integrating and improving surgical briefings and debriefings through our Safe Surgery Task Force. From June to December this year, AORN will host a competition on YouTubeÒ, selecting the video clip of the best examples of briefings and debriefings. Stay tuned for more information about this exciting initiative, and plan to showcase work from your facility. FUTURE PERIOPERATIVE NURSES To ensure that we have highly skilled perioperative nurses in the future, the Transition into Practice Task Force will be updating resources for promoting inclusion of perioperative nursing in nursing education programs based on national priorities in health care. The Institute of Medicine report on the Future of Nursing identified nurse residency programs as a key strategy.4 This task force also will be developing perioperative case studies for use in these nurse residency programs. Education is also changing, with new technology and techniques that have been demonstrated to
enhance learning. The Simulation Task Force will be developing a template for multidisciplinary simulations and an initial set of simulations on high-priority topics that perioperative educators can use to teach these concepts to perioperative team members.
health record and electronic perioperative record solutions, please contact the AORN Syntegrity team via e-mail at [email protected]
. AORN Syntegrity is a registered trademark of AORN, Inc, Denver, CO. YouTube is a registered trademark of Google, Inc, Mountain View, CA.
CONCLUSION As perioperative nurses, our pursuit of excellence will never end. I have shared some of the work that will be undertaken this year in support of this pursuit. It takes all of us working together to ensure that our products and services are relevant and respected, and that they reflect the best evidence available. On behalf of the AORN Board of Directors, I thank all of the volunteers and staff members who dedicate their time to providing you with the resources that you need to provide excellent patient care, and all of you who share our pursuit of excellence.
Editor’s notes: The second edition of the Perioperative Nursing Data Set (PNDS) was superseded by the third edition (PNDS 3) in 2011. The PNDS 3 terminology is only distributed through AORN and AORN Syntegrity licensed vendors. For questions about PNDS 3 implementation into the electronic
1. National Guideline Clearinghouse. Agency for Healthcare Research and Quality. http://www.guideline.gov. Accessed January 21, 2014. 2. Sofaer S, Schumann MJ. Fostering Successful Patient and Family Engagement: Nursing’s Critical Role. Silver Spring, MD: Nursing Alliance for Quality Care; 2013. http://www.naqc.org/WhitePaper-PatientEngagement. Accessed January 21, 2014. 3. Hemingway M, Ferguson J. Boston bombings: response to disaster. AORN J. 2013;99(2):277-288. 4. National Research Council. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press; 2011.
Victoria M. Steelman, PhD, RN, CNOR, FAAN, is the AORN president and an assistant professor at The University of Iowa College of Nursing, Iowa City. Dr Steelman has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article.
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