By Christina Orlovsky, contributor
August 12, 2010 - Nursing has come a long way since Florence Nightingale’s day, with ever-evolving technology that helps improve efficiency and safety and makes the demands on today’s nursing professionals a little less daunting.
One specific area that has seen numerous implementations of technology over the past several years is the operating room (OR). Nurses and other OR personnel have the benefits of a multitude of new devices and procedures to help improve both patient and workplace safety and improve patient outcomes. From robotic surgery to electrosurgery and lasers, the technology used by perioperative nurses is some of the most advanced in the hospital setting.
“High-technology OR suites may be described as integrated or digital ORs,” explained Bonnie Denholm, RN, MS, CNOR, a perioperative nursing specialist with the Association of periOperative Registered Nurses (AORN). “An integrated OR is equipped with technology that centralizes control of audio-video equipment and information systems and is capable of controlling a variety of equipment and activities within the surgical suite.”
According to Denholm, hybrid ORs are another example of how advanced surgical technology benefits both the patient and the health care professional.
“Interventional radiology/cardiac catheter laboratories and hybrid operating rooms are other trends that reflect technological advances relating to minimally invasive surgical access to the patient,” she said. “A hybrid OR is designed with numerous imaging technologies, such as 3D angiography, computed tomography, magnetic resonance imaging, positron-emission tomography and intravascular ultrasound to support surgical procedures that require multiple care providers with varied expertise to provide patient care in one location.”
In and out of the OR many other technologies have made the job safer and easier for nurses of all specialties. One such technology is bar-coding, which is used in multiple settings to prevent medication errors, assist in patient identification, track inventory and more.
A recent study published in the May 2010 issue of the New England Journal of Medicine highlighted the importance of bar-code verification technology within an electronic medication administration system, or bar-code eMAR. After reviewing more than 14,000 medication administrations and more than 3,000 order transcriptions, researchers concluded that, “Use of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events,” calling it “an important intervention to improve medication safety.”
Bar-code technology also has its place in the operating room, where it can be used to track surgical equipment, helping perioperative nurses count objects used during a procedure to reduce the risk of leaving something inside a patient. One such system is manufactured by SurgiCount Medical, Inc. The Temecula, California-based medical device company designed the Safety-Sponge System to help nurses count and document surgical sponges labeled with a unique serial number. By not allowing a sponge to be counted more than once, this system helps improve accuracy and reduce the number of retained foreign bodies in the surgery setting.
According to Denholm, reducing the risk of retained foreign objects—including surgical instruments other than sponges—is one important area of focus for future technology in the OR.
“AORN just released an updated document, entitled Recommended Practices for Prevention of Retained Surgical Items, which highlights examples of technologies that directly impact what the perioperative registered nurse is responsible for in the operating room,” she said. “At this time, there are adjunct technologies designed to supplement the manual process of counting soft goods, such as sponges. In the future, we hope to have technologies that supplement the manual process of counting instruments, including the detection of instruments that might be retained.”
Of course, technology is not the panacea to all the potential risks in an OR setting – or any other nursing setting. Sometimes it’s safer to rely on the fundamentals that surely were present in Florence Nightingale’s day.
“Surgery is a complex environment with many variables and teams of professionals to coordinate to achieve a safe environment for both the patient and the health care workers,” Denholm concluded. “Key components to a safe environment include communication, collaboration and competency.”
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