The Oak October 2024
ACORN’s 2024 conference is in a few weeks! It’s great to see groups of colleagues registering and using this opportunity to upskill and network. We have decided to offer the early registration price for a while longer so register now to take advantage of the very reasonable price point.
It is bound to be an exciting conference. As well as an inspiring educational program, we have John Mangos as master of ceremonies, Julia Baird as keynote speaker and our own Phyllis Davis AM presenting the Judith Cornell Oration. And we are thankful for the support of our excellent industry partners Ansell, Halyard, Multigate and Solventum, and conference sponsors B Braun, Aspen Surgical Australia, Cooper Surgical, Hitrak, Mölnlycke and Cardinal Health.
Perioperative Nurses Week 2024 (PNW) is also very soon. Please join us online and share your PNW fun. Once again, we are thrilled to have Multigate as the G.L.U.E award sponsor. We are hoping to have a few special people and industry friends of ACORN support the week of celebrations with competitions. The ACORN team will also be visiting our local hospitals and thanking perioperative nurses for their valuable work.
Apart from PNW and the conference we are busy reviewing and updating The New ACORN Standards, re-writing contracts and models of service delivery to our clients, creating the annual report, organising governance and compliance activities, fulfilling our external and internal obligations, onboarding new specialist team members including three board members and saying farewell to Carla Smith our operations manager since July last year. Carla was with us in a temporary capacity and has now resumed her studies in social work.
ACORN’s core team currently comprises Education Officer, Angela Jarkey; Clinical Excellence Coordinator, Edwina Eaton; Community Engagement Officer, Sarah Wylie, and Publications Officer, Eleanor Tan who works closely with our Journal Editor, Professor Jed Duff. I thank my small but talented team for managing all the activity at ACORN.
I am also very grateful to ACORN’s wonderful volunteers who support our work – members of the Education Committee, the Standards Working Party, the Research Committee and the Events Committee. We very much appreciate their input and support. In particular I thank Ruth Hibberd who volunteered to create an asset register and archive of all ACORN’s wonderful historical material. As you can imagine, since ACORN began in 1977 there is a lot of material to catalogue, digitise and archive. Thanks to Ruth, you will all be able to view some of ACORN’s historical collateral at the ACORN stand at the conference. I look forward to seeing you there.
Diane Harapin OAM
ACORN CEO
With the conference just weeks away, our dedicated operations and events teams are applying the final touches to the trade show and educational program. We are excited to create an environment that fosters connection and intra-professional learning for delegates from Australia, the Asia-Pacific region and beyond. If you haven’t registered yet, now is the time – our early registration deadline has been extended! Join us in Sydney as we unite and ignite our passion for perioperative nursing.
Additionally, Perioperative Nurses Week is just around the corner, and I am eager to see how perioperative and procedural suites across the country will come together to celebrate the professionalism, care and innovation that both enrolled and registered perioperative nurses bring to their diverse workplaces. For ideas on how to participate, visit ACORN PNW 2024.
ACORN’s engagement with our community is a vital avenue for supporting perioperative nurses though education, connection and the provision of evidenced-based resources such as the ACORN Standards to enhance their practice, providing safe, quality perioperative care to the general public. I’m very much looking forward to meeting with you and hearing from our community over the next few months.
Caroline Johnson
ACORN Board Chair
Prevalence of pre-operative anxiety among adult patients undergoing elective surgery: A prospective observational single-centre study
Salihah Asiri, Jed Duff, Jane Currie and Michelle Guilhermino
The effects of an abdominal vibration stimulation program on the quality of bowel preparation in patients undergoing screening and surveillance colonoscopy: A general surgeons blinded, randomised controlled trial
Waraporn Sansaard, Usavadee Asdornwised, Rattima Sirihorachai and Varut Lohsiriwat
Nurses’ perceptions of artificial intelligence (AI) integration into practice: An integrative review
Lester Lora and Paula Foran
Enhanced Recovery After Surgery (ERAS)
- Understanding enhanced recovery after surgery (ERAS) in perioperative nursing (AORN research) Enhanced Recovery After Surgery (ERAS) is a patient-centred, evidence-based approach to achieve the best surgical outcomes by enhancing the recovery process. Originally developed for colorectal surgeries, ERAS protocols have expanded across various surgical specialties and most ERAS principles can be safely implemented with most perioperative patients. The goal of ERAS is to minimise the physiological and psychological stress of surgery – promoting faster recovery, reducing complications, and shortening hospital stays.
- Enhanced recovery after surgery programs: How much do perioperative nurses know? Enhanced recovery after surgery (ERAS) protocols have been shown to improve recovery and reduce patients’ risk of morbidity and mortality. Australian research used an online survey to describe and compare surgeon, anaesthetist, perioperative nurse and surgical ward nurse perceptions of ERAS protocols.
- ERAS Society recommendations for neonatal perioperative care Neonates requiring surgery are often cared for in neonatal intensive care units (NICUs). Despite a breadth of surgical pathology, neonates share many perioperative priorities that allow for the development of unit-wide evidence-based ERAS recommendations. Despite varied pathology, neonatal perioperative care within NICUs allows for unit-based ERAS recommendations independent of the planned surgical procedure. The 16 recommendations within this ERAS guideline are intended to be implemented within NICUs to benefit all surgical neonates.
Research
- Developing the green operating room: exploring barriers and opportunities to reducing operating room waste This narrative review in the Medical Journal of Australia reports on the challenges of reducing operating theatre waste and emissions. Many health systems are looking at how to reduce impacts and waste and be more sustainable. The authors report that ‘The waste reduction strategies focused on avoidance of high carbon products; correct waste segregation and reduced overage; reusing, reprocessing, and repurposing devices; and improved recycling.’
- Patient falls in the operating room: Why is this still a problem in 2024? Despite advances in patient safety, perioperative patient falls continue to be a persistent and preventable harm. Patient falls in procedural areas have been associated with multiple post-operative complications such as additional falls, functional decline and hospital readmissions. Although fall-related databases exist, the specific number of periprocedural falls is difficult to ascertain, and the causes of such falls also remain elusive.
- Impact of a daily huddle on safety in perioperative services A recent study found that implementing the morning safety huddle contributed to a reduction in the rate of SSEs without introducing delays to first case start-times. Following the implementation of huddles, there were no SSEs for more than 900 days (2.0 SSEs/year preintervention vs. 0.0 SSEs/year postintervention). The first SSE during the postintervention period occurred in March 2023. Huddle compliance was consistently > 95%. No delays were observed in first case on-time starts postintervention. The huddle is now SOP for all general OR teams and interventional radiology.
- Capability as a concept in advanced practice nursing and education: A scoping review Capability was used as a concept and framework to describe advanced practice nursing within complex practice environments that necessitate flexible approaches. Capability frameworks were applied holistically and to specific areas of practice or education, including in pre-graduate and postgraduate advanced practice nursing education. Strategies for teaching and learning capability focused on flexibility, student-directed learning and development of flexible learning pathways.
- Human factors in the perioperative environment Human factors in surgery relate to the environmental, organisational and human factors that can impact performance in the operating theatre. This study assesses whether various factors such as music, counting backwards and attempting to do simultaneous tasks impact surgical time and performance.
- Operating theatre efficiency optimisation Research looking at indicators and metrics for the perioperative environment. The Getting It Right First Time (GIRFT) programme has set targets to achieve 85% touch time utilisation by 2024/25. Touch time utilisation is a measure of theatre productivity, defined as the time from the start of anaesthesia to the time a patient leaves the theatre for all cases on a defined theatre list as a percentage of total available theatre time. No published evidence examines touch time utilisation as a measure of theatre efficiency and its correlation with surgical cutting time. This study aims to determine if there is a statistical relationship between touch time utilisation and surgical cutting time, and whether the use of touch time utilisation is sufficient to inform about surgical productivity.
Regulatory body reports, reviews and frameworks
- Victorian Clinical Governance Framework: Safer Care Victoria Safer Care Victoria has published their revised Victorian Clinical Governance Framework.
- Safer Care Victoria report: Sentinel events 245 sentinel or ‘harm events’ were uncovered in the 12 months to the end of June 2023, according to a Safer Care Victoria report, up two per cent on the previous year. Fatal medication errors killed 18 patients and four died or were seriously harmed after objects were left inside their bodies after surgery. The report said most errors were due to staff changing over during surgery, when a procedure involved two stages or when a dressing was modified. Surgery or invasive procedures were performed on the wrong side of a patient’s body three times while one person underwent the wrong procedure. Results of the report were covered in The Age, The Guardian and Yahoo News.
- SA Health Clinical Governance Framework was recently published. The framework ‘seeks to ensure the delivery of safe, high-quality care across South Australia, aligned to the SA Health Charter of Responsibility, by defining clinical governance roles and responsibilities across the SA Health system and the methods by which regulatory mechanisms are implemented and continually improved.’
- Workforce and patient safety: Temporary staff – integration into health care providers The Health Services Safety Investigations Board (HSSIB) in the UK has published their latest investigation report. This investigation ‘explored the challenges of integrating temporary clinical staff (bank only staff, agency staff and locum doctors) into health care providers. Integration is important because temporary staff coming into a new health care setting may be unfamiliar with its systems, processes and patient groups, which can pose a risk to patient safety’. The report includes several findings, observations and recommendations. Among the findings was that discrimination against temporary staff in the National Health Service creates a culture of fear that stops them speaking up about patient safety.
- Updated ANZCA pre-operative fasting guideline 2024
In the media
- Call for national standardised nursing terminology According to the World Health Organization, clinical standardised terminology is a ‘compilation of terms used in the clinical assessment, management and care of patients, which includes agreed definitions that adequately represent the knowledge behind these terms and link with a standardised coding and classification system’. The ACN have released a media statement advocating for standardised nursing terminology that will enable nursing's contribution to the health care system to be more visible and to generate fresh insights, which will lead to best practices and increase the body of knowledge of nursing.
- Wrong site surgery (United States of America) A patient died in Florida recently after the surgeon removed their liver instead of spleen.
- Body roundness index (BRI) is showing promise where body mass index (BMI) failed. The formula was developed by Diana Thomas, a mathematician and professor at the United States Military Academy in West Point, New York. She first described the metric in a 2013 paper published in the journal Obesity. BRI measures how round a person is using a formula that considers height and waist, instead of weight. The formula, which ranks subjects on a scale of 1 to 15, may provide a better estimate for centre-body obesity and abdominal fat, which is linked to increased risks of Type 2 diabetes, hypertension and heart disease.
- Transorbital brain surgery – surgical technique innovation (United States of America) Clinicians in a clinic in Cleveland, Ohio, recently performed brain surgery through a patient's eyelid. The surgery is a minimally invasive approach that features a tiny incision above the eye. Most patients are discharged the day after their operation.
- Potential new perioperative role – Endoscopy technicians (United States of America) The need for trained technicians in being met by standardised endoscopy technician programs.
ACORN Queensland state conference
25–26 October, Marcoola, Queensland
Perioperative Nurses Week 2024
10–16 November 2024
ACORN 2024 International Conference
28–30 November, ATC, Randwick, Sydney