The Peri-operative nurses are the special category which comprises of nurses which work with the patients immediately after operation and other invasive procedures. The perioperative nurses work with the surgeons, anesthetists and the surgical technologists in providing immediate care to the patients after the surgical procedures.
Patients need intense care and support after surgery or operations, which are done by Peri operative nurses. Various activities are performed by the Peri operative nurses like taking patients to the recovery room, ensuring their safety, giving anesthesia, holding bay and much more (Hamlin., Davis, et al., 2016). Along with this, they also help the doctors in addition to educating and evaluating the patients. The role of Peri operative nurses depends on the procedures complexity and type of activity undertaken at a particular moment. In different medical setting and hospitals, they interchangeably use their roles and titles. They have to be always on their foot and proactive in providing services to the patients (Health times, 2017).
Peri operative nursing is not a new term. Its history is as old as the foundation of Australian College of Peri operative nursing. The foundation of Peri operating nursing started way back in 1971 when the meeting of operating nurses was held in Melbourne at RACS (Royale Australian College of Surgeon) to discuss the safety measures taken during operations and considerable differences were seen in the practices and policies existing at that time. Later in 1975, a committee was formed which comprises of one nurse representative from each state to attend and discuss in the nurse conference (Acom, 2017). Following year again a meeting was held by the representatives.
Later in 1978, a conference on the nurse operating room was conducted and was a huge success. It was attended by many delegates from all over the world. In 1980 finally, In Adelaide, another national conference was held which discussed the new regulations and practices along with the rule for operating nurses which were based on the guidelines of 1977 conference. This was the beginning of the Peri operative nursing in Australia. Later, in 1986 a journal was published by different publications like Forceps, Victorian journal, new south Wales journal and it emerged to be national journal named ACORN journal and in December it got published (Acom, 2017).
Roles and Responsibilities of Peri Operative Nursing
The Peri operative Nursing has a vital task to look after the patients and provide them with necessary comfort and medications as and when required during surgery. The foremost responsibility of the peri operative nurses is to see whether the patient is ready for the surgery or not and for this they need to perform certain test to ensure their wellness. Next role is to educate the patients regarding their surgery, which includes explaining them about the operating procedure, medicines, surgery, restrictions, and precaution they need to take after surgery and the time of their discharge. Teaching the patients regarding the surgical procedures is important for the peri operative nurses. The patients are made aware so that they can understand the importance of the surgical procedures and to reduce the resistance of the patients towards complex medication (Sherilyn, 2010).
It helps in reducing the anxiety of the patients and they get mentally prepared for the operation task. Another responsibility is to provide them with proper antibiotics, antiemetics and take their signatures on the documents. Both female and male nurses are also responsible for analyzing the vital sign which may appear as the side effect of medication or surgery. There are various kind of nursing activity conducted by Peri operative nurses and its role is different from the other. The role of Anesthetic nurses is to make sure the patients are safe during anesthetic course (Acorn, 2017). This role may be undertaken by the individuals who are qualified anesthetic technician in Australian heath care system.
Prior to this the role of peri operative nurses were limited to helping the surgeons and performing activities like passing the instrument, maintaining the environment and it includes all non nursing tasks but at present they have special roles to perform which is based on their specialization like advocating patients, caregiver, acting as a leader and teacher. It is their duty to project themselves as a role model for others by motivating them and help them to be proficient in their work (Goodman & Spry, 2016). Their role is both technical and behavioral because along with dealing with the instrument at the time of surgery, it is their role to stable the patients by educating and counseling them.
Review of Expenses and Funds Allocated for Operation Theater
Instead of being an operational process health Care organizations have realized that supply chain processes can turn to be a cost saving strategic tool. In the past years, operating room has been overlooked by the management because it was considered to be the area from where funds were generated and were considered to a well-operating department. Now it is high time that the health care organizations realize that the cost of operating room should be controlled without degrading the quality of care provided to the patients (Pfielder, 2016).
Due to the uprising of certain economic problems the healthcare organizations face the problem of increasing costs. Along with the salary of the nurses, it is also important to consider the rising operation cost. In small facilities where there are ten or less operating rooms, the peri operative nurses earn $64,900 on an average basis and the facilities where there are more than 10 operating rooms the average income of peri operative nurses is $69,600. All those nurses who have an advance skill and knowledge of their profession get good compensation or remuneration. As per AORN survey in a small facility, the lead nurse or an RN assistant can earn up to $73,200 per year and up to $ 77,700 in a larger facility (Tnbutterfly, 2017). In small facility, the nursing supervisor’s average income is $79, 900 and in larger institution, it is $ 84, 900.
It is evident after analyzing the average income of the nurses that funding and budget allocation done for the nurses is good and there is a lot of scope and financial stability in peri operative nursing.
In addition to the expenses incurred on the salary of the nurses there are various kinds of other costs also like fixed cost, variable cost, direct cost, which is incurred during the operating procedure or in maintaining the operation theater. There are certain fixed costs like staffing cost of the operation theater management team (ACI, 2015). In spite of the increase or decrease in the number of operations performed this cost remains fixed. After this, there is variable cost which depends on the type of activity being performed. The staffing cost of the scrub nurse or the cost related to prosthesis depends on the number of operations performed; hence, they are variable.
Then comes direct cost which is directly related to the care provided to the patients after or before surgery (Šárka & Michaela, 2016). This cost is allocated to the patients and is directly associated with the operation theater expenses. Equipment needed for the surgery, wages, and salaries of the nurses will be included in the direct cost. It is not at all advisable for the healthcare organization to increase the operating cost as cost cutting at certain areas would help them in increasing the administrative efficiency. Resources should be used effectively in the hospitals. All those organizations which are able to use their resources effectively without any additional input are efficiently operating (Potter, Perry & Stockert, 2016).
There is a working group, named theater costing whose work is to provide advice on the cost associated with different surgeries, reasonable costing measurement along with measuring the depreciation cost of the operation theaters (Queensland Health, 2017). Although it is difficult to estimate the accurate cost of the operation theater as these include various elements like depreciation in the capital cost, wastage inside the operation theater, staffing costs. The purpose of this group is to identify the discrepancy along with identifying the efficient areas through which operating cost can be minimized.
Another group named as whole of surgery working group is one who advises on the proper collaboration between the clinical staff and the management, and also provide advice about the manner in which patients should be taken care throughout the period. They are also vested with the responsibility of advising about the liability inside the operation theater (ACI, 2017). In order to improve the allocation and collection of operation theater OT standard cost template has been developed.
Current and future developments in Peri operative Nursing
Peri operative nursing is not a new term, its history is extremely old and there is a lot of scope and future in this profession. In Australia, the practice of Peri operative nursing has been in existence since the 1970s and with the evolving time, its practice and performance is getting more advanced (Hamlin et al., 2016).
In relation to the current developments and scope of Peri nursing in Australia, it can be said that it is underdeveloped. No research has been conducted to explore the specialty of the nurses. In order to promote the practice of peri nursing and to enhance their professionalism, AORN provides a platform where ideas and information related to health care of peri operative can be conducted (AORN, 2015). There is a lot of scope and future in peri operative nursing. One who holds specialization in this field can go for the various nursing activity like Holding bay nursing whose prior responsibility is to prepare patients for the surgery and obtaining important medical related information about the patients.
They are also vested with the responsibility of analyzing the patients after and before surgery (Freitas, 2016). Another scope is to go for Anaesthetic nursing. They are vested with the responsibility of giving the anesthetic to the patients as and when needed. Anesthetic is a specialization and one who handles this has the responsibility to look after the condition of the patients after giving anesthetics (Lemons & Peniche, 2016).
In the context of Australia, there is a wide scope in this field as one who has proper technical training about the anesthetic is assumed for this role. Another scope is for circulating nurses whose job is to be alert and attentive, and ensure that all equipment related to the surgery are present at the operation theater. Along with this, they are also vested with the responsibility of managing the documentation needed in the surgical areas. Another field is post operative nursing care which looks after the respiratory status of the patients after surgery (Neil, 2013) Furthermore, there is scope in scrub nursing whose responsibility is to ensure that the equipment used in the operation theater is clean and ready for use.
Thus, it can be seen that there is a lot of scope for Peri operative nursing in Australia; therefore, an extensive research and exploration should be done in this field. It has also been observed that in spite of wide scope and future of peri operative nursing there is a scarcity of qualified person in this field. This shortage can be minimized when the teaching programs and education of this profession is made online or web based (Dumchin, 2010).
Traditional lecture program and tradition based method is not effective as well as they are not applicable in the present environment where technology is moving at a fast pace. The number of individuals will increase when the teaching will be online as it would be easy to access to a wide range of students. It will help in improving and increasing the scope of Peri operative nursing. The future of Peri operative nursing resides in the professional developments of this profession. It is important to attend various conferences and be a part of the committee, which would help in exploration and research. It is advisable for them to attend CPD (Whiteside, 2016). It is a program which helps in identifying new areas of development in this field, planning certain new activities, practices and review new methods of nursing.
It is important to keep up to date with the evolving innovations and technological developments because if it is not so the future of Peri operative nursing will be in dark (Cousley & Martin, 2016). The practitioners find it difficult at times to keep balance between taking care of the patients and technical work. This calls for the requirements of Peri operative nursing to develop their technical and affective skill. The nurses can be provided training to increase their capacity and the efficiency in the work.
This is important because in the present arena Peri operative nursing is recognized as the most diverse area of practice. There has been a major development in this field since its evolvement. Nowadays, sophisticated equipment and procedures are followed to cater to the patients’ need. The present essay reflects that the future in this area is bright (AORN, 2011)
Learning objectives ‘questions’’
Identify the measures and actions which could be taken to improve the nursing education in Australia?
Demonstrate on the importance of educating in the emerging healthcare sector?
The underpinning theory of the chosen area of professional practice
In order to focus on nursing practice, Virginia A. Henderson developed Nursing need theory. According to this theory, the patients should be self-independent as it would help them in speeding up their progress. Long with this theory also focuses that patients have certain basic needs which can be fulfilled by the nurses(s Ahtisham., Jacoline, 2015). There are certain assumption of this theory which states that unless and until the nurses care for themselves they could not care for the patients. Second assumption is that nursing is a profession which seeks to devote themselves to the needs of the patients.
Compare and Contrast Health Care Sectors
There is a great difference between the kind of heath care services provided in rural and metro area. The life expectancy in a rural area is low due to the lesser availability of medical facilities. The life expectancy is also longer for the one living in urban area. On the basis of demographic statistics the life expectancy of females of a rural area in only 0.4 years less than that of females living in an urban area ( Ahtisham, Trickett., et al, 1998). On the basis of health status, it can be observed that death rates of the people living in a remote rural area are always higher than that those living in a capital area.
Emerging trend in Heath care sector
Digitization is something which is seen as an emerging trend in the heath care sector especially in the context of Australia. There is s continuous practice to improve the healthcare sector by the use of new and emerging technologies. Maintaining the records of the patients, using modern technologies in diagnosing the patients are some of the activities which have emerged due to this trend. On the basis of the current statistics, it has been observed that by 2018 the total spending on ICT healthcare will reach up to Aus $ 1.8658 billion (Mukherjee., Ditton,2014).
Gaps in health care and clinical practice
There are relative gaps between the practice and procedures of healthcare practices and to shorten the gap clinical practice guidelines has been developed (Hoesing, 2016). Through CPGs it is ensured that the quality care and high-value services are delivered to the patients. It includes various recommendations, ways to manage different medical conditions and alike. Through this implementation, efforts are being made to shorten the gap between the practices in healthcare services.
Gaps across the health care system
Federal health agencies, physicians and experts on health policies are increasingly focusing towards the disparities and gaps in the current health care practices. Differences in medical care access and differences among the different ethnic and racial groups have been studied as the reason for the same (Riley, 2012). The main drivers which create a gap is the cost of health care services and difficulty in access to primary healthcare which is also a reason for increasing mortality rate.
References
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Acom (2017). Perioperative careers. Retrieved July 14, 2017 from https://www.acorn.org.au/acorn/perioperative-careers/
Acom. (2017). ACORN History. Retrieved July 13, 2017 from https://www.acorn.org.au/acorn/acorn-history/
Ahtisham, Y & Jacoline, S. 2015. Integrating Nursing Theory and Process into Practice; Virginia’s Henderson Need Theory. International Journal of Caring Sciences 2 (8), pp. 443-449
AORN (2011). The Top 10 Areas of Consideration in Product Selection. AORN journal 6s(94),pp. 88- 98
AORN. (2015). Standards Of Perioperative Nursing. Retrieved July 15, 2017 from file:///C:/Users/user/Downloads/II-01_Standards_2015%20(7).pdf
Cousley, A & Martin, D(2016). A Perioperative Model and Framework for Practice. M&K Update Ltd
Dumchin,M.(2010). Redefining the Future of Perioperative Nursing Education: A Conceptual Framework. Aornjournal 1(92), pp. 87-100
Freitas,P.S., Mendas, K,D,S., Galvao,C,M (2017). Surgical count process: evidence for patient safety. Scielo 4(37)
Goodman, T., & Spry, C. (2016). Essentials of Perioperative Nursing. Jones & Bartlett Publishers.
Hamlin, l,T., M, R & Davies, M. Perioperative Nursing – E-Book: Elsevier Health Sciences.
Hamlin,L., Davies,M., Tench,M,R., Fraser,S.S.(2016). Lois Hamlin, Menna Davies, Marilyn Richardson-Tench, Sally Sutherland-Fraser. Elsevier Health Sciences
Heathtimes. (2017). Peroperative Nursing. Retrieved July 14, 2017 from https://healthtimes.com.au/hub/perioperative/46/guidance/nc1/perioperative-nursing/563/
Hoesing, H. 2016. Clinical Practice Guidelines: Closing the Gap Between Theory and Practice. Joint Commission International, pp. 1-12
Lemons,C,D,S & Peniche, A,D,C,D (2016). Nursing care in the anesthetic procedure: an integrative review. Journal of school of Learning 50 (1), pp. 154-162
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Pfeilder. ( 2016). Effective Operating Room Inventory Management. Retrieved July 14, 2017 from https://www.pfiedler.com/ce/1265/files/assets/common/downloads/Effective%20Operating%20Room%20Inventory%20Management.pdf
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Sherilyn, P.(2010). The Nurse ’s Role in the Perioperative Experience, with an Emphasis on Infection control. JCCC Honors Journal,2 (1) pp.1-11
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Whiteside,D.(2016). Perioperative Nurse Leaders and Professionalism. Aorn journal.org. pp.133-144
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