" skipper, " coordinating patient care and case flow of the surgical suite. This role gives nurses autonomy and the opportunity to work with a multidisciplinary team. Other perioperative nurse roles are: certified registered nurse first assistant (CRNFA), specialty service leader, and perioperative nurse specialist. With perioperative nursing, the nursing process is used to assess, plan, and im...

In the course of their daily practice, anesthesiologists are confronted with a number of conventional ethical issues connected to situations ranging from informed consent to endof-life decision making [1]. The specialty of anesthesiology has recently evolved to include not only critical care and pain medicine but also perioperative medicine. The full spectrum of perioperative expertise is manif...

Optimizing perioperative care to provide maximum benefit at minimum cost may be best achieved using a perioperative clinical pathway (PCP). Using our joint replacement surgical home (JSH) model PCP, we examined length of stay (LOS) following total joint arthroplasty (TJA) to evaluate patient care optimization. We reviewed a spectrum of clinical measurements in 190 consecutive patients who under...

When developing a nursing plan of care, a perioperative nurse identifies nursing diagnoses during the preoperative patient assessment. The ability to identify age-specific outcomes (ie, infant/child, adolescent, adult, elderly adult) in addition to those that are universally applicable is a major responsibility of the perioperative RN. Having an individualized plan of care is one of the best wa...

Research has established that health care is not error free. The question facing perioperative units, as well as all health care services, is how to minimize the human factors that impact quality and safety. This two-part series on performance improvement in perioperative services was intended to help answer this question. Achieving performance excellence starts with a supportive work culture. ...

Over the last 20 years, the number of older adults requiring surgical interventions has substantially increased and will continue to escalate as the population ages. Perioperative management of older patients poses challenges not encountered in younger individuals. People over 70 years of age are more likely to have multiple comorbidities, physical and cognitive impairments, and reduced cardiac...

OBJECTIVES To improve surgical outcomes, clinicians must provide optimal perioperative care for comorbidities identified as significant factors in risk models for patients undergoing lung cancer surgery. METHODS We reviewed trends in perioperative care for idiopathic pulmonary fibrosis, cardiovascular diseases, and end-stage renal diseases in patients undergoing lung cancer surgery, as large ...