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CONTINUING EDUCATION
Clinical Issues
1.4
http://www.aorn.org/CE
MARY J. OGG, MSN, RN, CNOR;
BYRON L. BURLINGAME, MS, BSN, RN, CNOR;
KERRIE CHAMBERS, MSN, RN, CNOR, CNS-CP
Continuing Education Contact Hours
Approvals
indicates that continuing education (CE) contact hours are
available for this activity. Earn the CE contact hours by
reading this article, reviewing the purpose/goal and objectives,
and completing the online Learner Evaluation at http://
www.aorn.org/CE. Each applicant who successfully completes
this program can immediately print a certificate of completion.
This program meets criteria for CNOR and CRNFA recertification, as well as other CE requirements.
Event: #15549
Session: #0001
Fee: Members $11.20, Nonmembers $22.40
The CE contact hours for this article expire December 31,
2018. Pricing is subject to change.
Purpose/Goal
To provide the learner with knowledge of AORN’s guidelines
related to complementary care interventions for pediatric patients, cleaning personal eyewear, education requirements for
advanced practice RN (APRN) first assistants, degree requirements for entrance to an RN first assistant (RNFA)
program, and wearing an arm cast in the perioperative setting.
Objectives
1. Discuss practices that could jeopardize safety in the perioperative area.
2. Discuss common areas of concern that relate to perioperative best practices.
3. Describe implementation of evidence-based practice in
relation to perioperative nursing care.
Accreditation
AORN is accredited as a provider of continuing nursing
education by the American Nurses Credentialing Center’s
Commission on Accreditation.
AORN is provider-approved by the California Board of
Registered Nursing, Provider Number CEP 13019. Check
with your state board of nursing for acceptance of this activity
for relicensure.
Conflict-of-Interest Disclosures
Mary J. Ogg, MSN, RN, CNOR; Byron L. Burlingame, MS,
BSN, RN, CNOR; and Kerrie Chambers, MSN, RN,
CNOR, CNS-CP, have no declared affiliations that could be
perceived as posing potential conflicts of interest in the publication of this article.
The behavioral objectives for this program were created by
Helen Starbuck Pashley, MA, BSN, CNOR, clinical editor,
with consultation from Susan Bakewell, MS, RN-BC, director,
Perioperative Education. Ms Starbuck Pashley and
Ms Bakewell have no declared affiliations that could be
perceived as posing potential conflicts of interest in the publication of this article.
Sponsorship or Commercial Support
No sponsorship or commercial support was received for this
article.
Disclaimer
AORN recognizes these activities as CE for RNs. This
recognition does not imply that AORN or the American
Nurses Credentialing Center approves or endorses products
mentioned in the activity.
http://dx.doi.org/10.1016/j.aorn.2015.10.001
ª AORN, Inc, 2015
660 j AORN Journal
www.aornjournal.org
CLINICAL
ISSUES
1.4
http://www.aorn.org/CE
THIS MONTH
Complementary care interventions for pediatric patients
Key words: pediatric, complementary care, music, hypnosis, acupressure, play therapy, pain, anxiety.
Cleaning personal eyewear
Key words: personal eyewear, eye protection, cleaning, bloodborne pathogen exposure.
Education requirements for advanced practice RN (APRN) first assistants
Key words: advanced practice registered nurse, APRN, registered nurse first assistant, RNFA.
Degree requirements for entrance to an RN first assistant (RNFA) program
Key words: registered nurse first assistant, RNFA, first assistant.
Wearing an arm cast in the perioperative setting
Key words: arm cast, workplace safety, work restrictions, hand hygiene.
Complementary care interventions for pediatric patients
QUESTION:
Are there nonpharmacological ways to reduce pain and
anxiety in pediatric patients undergoing surgery?
ANSWER:
Complementary care interventions such as music, hypnosis,
and play therapy may reduce pain and anxiety in children
undergoing surgery and other invasive procedures. Music is
a complementary approach believed to reduce the amount
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of medications needed to reduce a patient’s pain and anxiety. While surgery is needed to improve the health and
well-being of a child, it may also produce anxiety and pain.1
Causes of preoperative anxiety in children are separation
from parents, being in a strange environment with strange
smells, and the fear of needles and pain.2 A benefit of
decreasing anxiety is increased cooperation from the child.1
Using medications (eg, oral midazolam) for preoperative
anxiety may delay discharge from the postanesthesia care
AORN Journal j 661
Ogg et al
unit (PACU) following a short procedure. However, using
nonpharmacological interventions also may decrease the
child’s anxiety without the potential for a delayed stay in
the PACU.2 In very young children, inadequate pain
control may produce long-term detrimental effects.1
In a systematic review, Klassen et al1 studied the efficacy of
music therapy on pain and anxiety in children undergoing
clinical procedures. These reviewers found 19 randomized
controlled trials (RCTs) that met the inclusion criteria of
music as the intervention and the outcome as measurement
of pain or anxiety. Five of the studies examined music
therapy provided by formally trained music therapists with
structured formalized protocols. Fourteen studies examined
music interventions, also known as music medicine, which are
more passive than active and involve the patient listening to
music made available after admission. The studies included
reading children’s stories and the following types of music:
folk,
upbeat contemporary,
popular,
relaxing,
classical,
lullabies, and
children’s music.1
In three of the studies reviewed, the patient was able to choose
the type of music. The authors concluded that there is evidence
to support the use of music for children undergoing painful or
anxiety-producing procedures. Music interventions were as
effective as active music therapy by a music therapist. The
analysis demonstrated that music as an intervention may be
more effective when part of multifaceted approach to distract
the child from the painful or anxiety-producing procedure.
Kain et al3 studied the effect of interactive music therapy for the
treatment of preinduction anxiety in children undergoing
outpatient surgery under general anesthesia. In this RCT,
researchers assigned children to the music therapy group
(n ¼ 51), the oral midazolam group (n ¼ 34), or the control
group (n ¼ 38). Two music therapists participated in the
study. The music therapy group was divided into the music
therapist 1 group and music therapist 2 group. The patients
in the music therapy group received interactive music therapy
in the preoperative holding area for 20 to 30 minutes. The
assigned music therapist accompanied the child into the OR
and continued the music therapy until induction was
complete. The children in the midazolam group received oral
midazolam, 0.5 mg/kg, 30 minutes before surgery up to a
maximum dosage of 20 mg. The children in the control
662 j AORN Journal
December 2015, Vol. 102, No. 6
group received standard care and did not receive music
therapy or a sedative. All parents accompanied their child to
the OR door, but did not enter the OR. If the attending
anesthesia professional determined the child was exhibiting
extreme anxiety, the parent was allowed into the OR for
induction. The researchers measured anxiety in the holding
area, when the child was separated from parents at the OR
door, at entry into the OR before introduction of the
anesthesia mask, and when introduced to the scented
anesthesia mask used during induction. Children in the
music therapist 2 group and the midazolam group
experienced significantly less anxiety than the control group
and the music therapist 1 group when they were separated
from their parents at the OR door and on entrance into the
OR. When the anesthesia professional first introduced the
mask, the anxiety of the children in the midazolam group was
significantly less than that of the control or music therapy
group. Although both music therapists performed the same
intervention, there was a significant therapist effect when the
child separated from the parents and entered the OR. The
researchers concluded that the effect may be highly
dependent on the individual music therapist’s skills. The
authors emphasized that some, but not all, pediatric patients
may benefit from preoperative interactive music therapy.
Wang et al4 conducted an RCT to determine whether
acupressure at the Extra-1 (Yin-Tang) point located at
the midpoint between the eyebrows would decrease
preprocedual anxiety in children undergoing endoscopic
procedures. Researchers delivered acupressure by attaching
an acupressure bead to self-adhesive tape to secure the bead
in place and created continuous standardized pressure of 1.3
psi as measured by a tonometer. The researchers randomly
assigned intervention groups to the Ex-1 group (n ¼ 26) or
the sham group (n ¼ 26) using a computer-based random
number generator. In the Ex-1 group, the researcher applied
the acupressure bead at the Extra-1 acupoint. In the sham
group, the acupressure bead was applied above the lateral
border of the left eyebrow. Wang et al4 measured
preprocedual anxiety using the State Trait Anxiety Index for
ChildrenTM (STAIC)5 before the interventions to obtain a
baseline assessment and 30 minutes after placement of the
acupressure bead. The STAIC scores of the Ex-1 group
decreased 11% and the STAIC scores of the sham group
increased 2%. The researchers considered the reduction in
anxiety of the Ex-1 group clinically significant.
Hosseinpour and Memarzadeh2 evaluated the efficacy of a
playroom in the preoperative waiting room to reduce preoperative
anxiety in children before surgery in a single-blind RCT. The
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December 2015, Vol. 102, No. 6
Clinical Issues
playroom had age-appropriate colored toys and cars, a television,
and cartoon videos. The children were randomly assigned to the
case group (n ¼ 100) or the control group (n ¼ 100). Personnel
admitted the case group patients to the playroom 30 minutes
before their procedures, and admitted the control group patients
to the preoperative waiting room 30 minutes before their
procedures. Researchers compared the anxiety levels of the
children using the modified Yale Preoperative Anxiety Scale
(m-YPAS).6 The m-YPAS assesses five categories:
CNOR, is a perioperative nursing
specialist in the Nursing
Department at AORN, Inc,
Denver, CO.
activity,
emotional expressivity,
state of arousal,
vocalization, and
use of parents.2
The differences in m-YPAS scores were statistically significant
in the categories of activity, vocalization, emotional expressivity, and use of parents and demonstrated a significant
decrease in the case group’s preoperative anxiety. The authors
conclude that a preoperative playroom is an effective method
to reduce anxiety in children requiring elective surgery.2
In a prospective RCT, Huet et al7 hypothesized that hypnosis
would lower children’s anxiety and pain associated with dental
anesthesia. Children undergoing dental treatment requiring
local anesthesia were randomly assigned to the hypnosis
group (n ¼ 14) or the nonhypnosis group (n ¼ 15). A single
anesthesiologist experienced in hypnosis conducted all
hypnotherapy sessions. The researchers measured the
children’s anxiety using the m-YPAS during an initial
interview, on arrival in the waiting room, in the dental chair,
and at the time of dental anesthesia. Pain was assessed at the
time of anesthesia using the modified objective pain score
(mOPS)8 and after the treatment using the self-assessment
test visual analog scale (VAS).9 The study demonstrated that
hypnosis was effective in reducing the children’s preoperative
anxiety. Children in the hypnosis group showed significantly
lower anxiety scores and significantly lower mean mOPS
scores, and significantly more children in this group reported
not feeling pain. The mean m-YPAS score was 50% lower in
the hypnosis group compared to the nonhypnosis group.
Hypnosis also modified the pain tolerance threshold
evidenced by the mOPS and VAS scores.
Research has demonstrated that various nonpharmacological
interventions (eg, music, play therapy, hypnosis, acupressure)
reduce preprocedual anxiety and pain in children. These
complementary care interventions may be considered for
anxiety and pain reduction instead of medications or as an
adjunct to the use of preoperative sedation.
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Editor’s note: The State Trait Anxiety Score in Children
(STAIC) is a trademark of Charles D. Spielberger, Tampa, FL.
References
1. Klassen JA, Liang Y, Tjosvold L, Klassen TP, Hartling L. Music for
pain and anxiety in children undergoing medical procedures: a
systematic review of randomized controlled trials. Ambul Pediatr.
2008;8(2):117-128.
2. Hosseinpour M, Memarzadeh M. Use of a preoperative playroom to
prepare children for surgery. Eur J Pediatr Surg. 2010;20(6):
408-411.
3. Kain ZN, Caldwell-Andrews AA, Krivutza DM, et al. Interactive
music therapy as a treatment for preoperative anxiety in children:
a randomized controlled trial. Anesth Analg. 2004;98(5):
1260-1266.
4. Wang SM, Escalera S, Lin EC, Maranets I, Kain ZN. Extra-1
acupressure for children undergoing anesthesia. Anesth Analg.
2008;107(3):811-816.
5. Spielberger C, Edwards CD, Lushene R, Montuori J, Platzek D.
STAICTM State-Trait Anxiety Inventory for Children. MHS. http://
www.mhs.com/product.aspx?gr¼edu&prod¼staic&id¼overview.
Accessed August 21, 2015.
6. Wright KD, Eisner A, Stewart SH, Finley A. Measurement of preoperative anxiety in young children: self-report versus observerrated. J Psychopathol Behav Assess. 2010;32(3):416-427.
7. Huet A, Lucas-Polomeni MM, Robert JC, Sixou JL, Wodey E.
Hypnosis and dental anesthesia in children: a prospective controlled
study. Int J Clin Exp Hypn. 2011;59(4):424-440.
8. Wilson GA, Doyle E. Validation of three paediatric pain scores for
use by parents. Anaesthesia. 1996;51(11):1005-1007.
9. Gift AG. Visual analogue scales: measurement of subjective phenomena. Nurs Res. 1989;38(5). 286-286.
Resource
Guideline for complementary care interventions. In: Guidelines
for Perioperative Practice. Denver, CO: AORN, Inc; 2015:455-468.
AORN Journal j 663
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Mary J. Ogg, MSN, RN,
Ogg et al
December 2015, Vol. 102, No. 6
Cleaning personal eyewear
QUESTION:
Should personal eyewear be cleaned?
ANSWER:
The “Guideline for surgical attire”1 addresses the cleaning of
personal eyewear supplemented with solid side shields worn
for eye protection. The guideline recommends personal
eyewear should be cleaned according to the manufacturer’s
instructions for use before and after the health care worker
performs or assists with a procedure. The guideline does not
address personal eyewear when it is not being worn as eye
protection. Similar to other personal items (eg, cell phones,
backpacks) that are taken into the semirestricted or restricted
areas, personal eyewear should be cleaned according to the
manufacturer’s instructions for use before and after going
into the perioperative area.1
Lange2 conducted a hospital study of eyewear use in the OR
to assess infection risk and inform policy development. At
the study hospital, the OR policy for selecting eyewear was
based on the anticipated level of injury, exposure, and
vision needs. The individual could choose whether to wear
disposable or reusable products. Disposable eyewear was to
be immediately discarded after use, and reusable eyewear,
decontaminated after use. During the 30-day study period,
researchers recorded the type of eyewear worn by OR
team members. After prompt removal of the eyewear on
exit from the OR, the researchers cultured all eyewear
twice for organism growth (ie, before and after
decontamination with a germicidal wipe containing a
quaternary/alcohol-based solution). The sample included
315 individual pieces of eyewear, reusable (n ¼ 39) and
disposable (n ¼ 276). Cultures were positive for
contamination on 37.7% of the disposables and on 94.9%
of the reusables. After disinfection, 74.4% of the reusable
eyewear contained microbial growth demonstrating
persistent contamination. The types of microorganisms
cultured were
coagulase-negative Staphylococcus colonies (43.9%),
gram-positive cocci (36.1%),
Bacillus species (10.6%),
diphtheroids (5.6%), and
Micrococcus species (3.5%).
664 j AORN Journal
The author concluded that eyewear can increase crosscontamination and infection risk, especially in high-risk
spray or splash situations. Disposable eyewear can reduce
infection risk from one procedure to the next, if not reused.
Reusable eyewear may pose a risk of carrying ongoing bioburden because all surface details cannot be disinfected. This
poses a risk to the patient and OR team members.
In a study of patterns and prevention of blood exposures in
the OR by Jagger et al,3 a significant finding was that RN
circulators had nearly the same number of eye exposures to
blood as the scrub persons. This finding shows that
circulating nurses have an equivalent risk for blood
exposure of the eyes as scrub nurses. The authors
recommended that all perioperative team members wear
protective eyewear routinely regardless of the distance from
the surgical site.3
The Occupational Safety and Health Administration’s
Bloodborne Pathogen Standard 29 CFR 1910.10304
requires that all health care personnel wear eye protection
when splashes, sprays, splatter, or droplets of blood or
other potentially infectious materials can be reasonably
anticipated. Considering the contamination of eyewear and
the risk for bloodborne pathogen exposure, it is important
to wear and follow cleaning procedures for protective and
personal eyewear.
Mary J. Ogg, MSN, RN, CNOR, is a perioperative
nursing specialist in the Nursing Department at AORN,
Inc, Denver, CO.
References
1. Guideline for surgical attire. In: Guidelines for Perioperative Practice.
Denver, CO: AORN, Inc; 2015:97-119.
2. Lange VR. Eyewear contamination levels in the operating room:
infection risk. Am J Infect Control. 2014;42(4):446-447.
3. Jagger J, Bentley M, Tereskerz P. A study of patterns and prevention of blood exposures in OR personnel. AORN J. 1998;67(5):
979-987.
4. Occupational Safety and Health Standards, Toxic and
Hazardous Substances: Bloodborne Pathogens, 29 CFR
x1910.1030. Occupational Safety and Health Administration.
https://www.osha.gov/pls/oshaweb/owadisp.show_document?
p_table¼standards&p_id¼10051. Accessed August 21, 2015.
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December 2015, Vol. 102, No. 6
Clinical Issues
Education requirements for advanced practice RN (APRN) first
assistants
I am an APRN who has several years of OR experience as a
first assistant. My supervisors say that according to the
AORN Position Statement on Advanced Practice Registered
Nurses in the Perioperative Environment, I must complete
an RN first assistant (RNFA) program to continue to
practice as a first assistant. Is this true?
practice.2 This statement reflects AORN’s intent regarding the
practice of RFNAs, but facility administrators and regulatory
agencies may adopt differing interpretations or more
stringent education and qualification requirements for RNs
and APRNs practicing as first assistants at surgery.
Byron L. Burlingame, MS,
ANSWER:
BSN, RN, CNOR, is a perioperative nursing specialist in the
Nursing Department at AORN,
Inc, Denver, CO.
The AORN Position Statement on Advanced Practice Registered
Nurses in the Perioperative Environment1 provides the following
statement on the educational requirements for the APRN
functioning as a first assistant at surgery.
The APRN practicing in the perioperative environment as a
first assistant at surgery is required, as of January 1, 2016, to
acquire the knowledge and skills needed to provide safe,
competent surgical first assistant services by completing a program that covers the content of the AORN Standards for RN
First Assistant Education Programs, which may be a standalone program or may be a portion of a graduate or postgraduate program (eg, additional coursework included in a
graduate APRN program).1
This education requirement is intended to apply to only the
APRN who has not worked as a first assistant before January 1,
2016. If the APRN is currently functioning (ie, before January
1, 2016) in the role of a first assistant at surgery, he or she is
not expected to complete an RNFA program to continue to
References
1. AORN Position Statement on Advanced Practice Registered Nurses in
the Perioperative Environment. Denver, CO. AORN, Inc. http://www.aorn
.org/WorkArea/DownloadAsset.aspx?id¼26698. Accessed July 17,
2015.
2. Questions and answers about requirements for first assisting.
AORN, Inc. http://www.aorn.org/Clinical_Practice/RNFA_Resources/
Supporting_Documents/RNFAqa.aspx. Accessed August 21, 2015.
Degree requirements for entrance to an RN first assistant (RNFA)
program
QUESTION:
I am currently a nursing student. However, I have many
years of OR experience as a surgical technologist. I
am interested in becoming an RNFA after graduating from
nursing school. Must I have a baccalaureate degree to
become an RNFA and does the degree have to be in nursing?
ANSWER:
Degree requirements are the purview of each RNFA program
and the regulatory agencies that oversee these educational
programs; however, these programs and the regulatory
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agencies frequently look to AORN for guidance when determining the qualifications for admissions. AORN provides this
guidance in the AORN Position Statement on RN First
Assistants,1 which states
The complexity of knowledge and skill required to effectively
care for recipients of perioperative nursing services necessitates
nurses to be specialized and to continue their education beyond
generic nursing programs. Effective January 1, 2020 the
education level for entry into an RNFA program and, subsequently, RNFA practice will be the baccalaureate degree.
AORN recommends that RNs who were practicing as RNFAs
AORN Journal j 665
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QUESTION:
Ogg et al
prior to January 1, 2020 and do not have a baccalaureate
degree be permitted to continue to practice as RNFAs.1
This statement has three components. The first component
states that a baccalaureate degree is required for admission to
an RNFA program. This recommendation from AORN is
consistent with the recommendations in the Institute of
Medicine Future of Nursing report,2 the goal of which is to
increase the proportion of nurses with a baccalaureate degree
to 80% by 2020.
The second component states that a baccalaureate degree
should be obtained to practice as an RNFA after January 1,
2020. Based on this component, an individual without a
baccalaureate degree who has started an RNFA program before
January 1, 2020, but has not completed it by January 2020
would not meet this requirement. Neither of these components specify that the baccalaureate degree be in nursing;
therefore, it is acceptable if a baccalaureate degree has been
obtained in another field and an associate or diploma degree in
nursing has been earned.
The third component covers the person who does not
possess a baccalaureate degree and is currently practicing as
an RNFA. This component states that an individual who
December 2015, Vol. 102, No. 6
does not have a baccalaureate degree and is currently practicing as an RNFA would not have to meet this requirement
in order to continue to practice. As with all AORN position
statements and recommendations, health care institutions,
regulatory agencies, and educational programs may take a
different view and, the reader should consult with the programs in which he or she is interested and current or potential employers to determine their requirements.3
Byron L. Burlingame, MS, BSN, RN, CNOR, is a
perioperative nursing specialist in the Nursing Department at AORN, Inc, Denver, CO.
References
1. AORN Position Statement on RN First Assistants. Denver, CO:
AORN, Inc. http://www.aorn.org/WorkArea/DownloadAsset.aspx?
id¼25934. Accessed September 4, 2015.
2. Committee on the Robert Wood Johnson Foundation Initiative on the
Future of Nursing, at the Institute of Medicine; Institute of Medicine.
The Future of Nursing: Leading Change, Advancing Health.
Washington, DC: The National Academies Press; 2011.
3. RNFA FAQs. AORN, Inc. http://www.aorn.org/Clinical_Practice/
RNFA_Resources/Supporting_Documents/RNFAqa.aspx. Accessed
September 4, 2015.
Wearing an arm cast in the perioperative setting
QUESTION:
One of our circulating nurses fell and broke her arm and
wants to return to work. Is it acceptable to circulate
wearing an arm cast or should the employee have to be on
nonclinical work restrictions?
ANSWER:
The perioperative RN should not perform in the circulating
role or other direct patient care tasks while wearing a cast,
regardless of the type or location of the cast. The nurse may
be given other nonepatient care assignments until the cast is
removed and he or she is cleared to return to full duty according to the health care organization’s employee health
policy. Wearing a cast in the perioperative environment poses
patient and worker safety concerns. The perioperative
setting is a fast-paced, highly technical environment that
poses unique challenges because of the multitude of complex
666 j AORN Journal
procedure-related tasks, lifting and moving of heavy equipment, transferring patients to and from OR beds, and lifting
and holding patients’ extremities. When there is limited use
of only one extremity, even performing nonclinical work, the
perioperative nurse is at risk for potential re-injury and for
the cast to be contaminated. To determine whether the
employee may return to work, an interdisciplinary team (eg,
OR manager, infection preventionist, employee health
personnel) should evaluate the perioperative nurse’s role
versus the limitations that the cast may place on the performance of the employee’s job-related duties. For example,
health care workers should wash their hands on arrival to the
health care facility, before and after patient contact, before
and after donning gloves or other personal protective
equipment, before and after eating or using the bathroom,
and when leaving the health care facility.1,2 When the worker
is wearing a cast, proper hand hygiene cannot be performed
and the cast cannot be cleaned.
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December 2015, Vol. 102, No. 6
Clinical Issues
A cast cannot be contained or confined within scrub attire or
cleaned or disinfected if it becomes contaminated with blood
or other potentially infectious materials. Wearing a glove to
cover the part of the cast that includes the hand is not an
alternative option because hand hygiene should be performed
when removing gloves. Kim et al2 found by observing
participants that contamination of the hands may occur
when wearing gloves with unseen holes or tears, when
wearing gloves from one patient to another, and when
removing gloves. The researchers concluded that wearing
gloves is not a substitute for hand hygiene.
There also are workplace safety concerns when the worker’s
physical ability, task, or workplace environment are not
compatible.3 Activities and movements that may be affected
by wearing a cast include safely transferring patients on and
off OR beds, lifting and holding patients’ extremities, lifting
and moving equipment/instrument trays, and standing for
long periods (ie, if the cast is on the leg).3
Wearing a cast in the perioperative environment poses concerns for both patient and worker safety. Measures should be
taken to evaluate the perioperative nurse’s role and the limitations that the cast may play in the performance of the employee’s job-related duties.
www.aornjournal.org
CNOR, CNS-CP, is a perioperative nursing specialist in the
Nursing Department at AORN,
Inc, Denver, CO.
References
1. Guideline for hand hygiene. In: Guidelines for Perioperative Practice.
Denver, CO: AORN, Inc; 2015:31-42.
2. Kim PW, Roghmann MC, Perencevich EN, Harris AD. Rates of hand
disinfection associated with glove use, patient isolation, and
changes between exposure to various body sites. Am J Infect
Control. 2003;31(2):97-103.
3. AORN guidance statement: safe patient handling and movement in
the perioperative setting. In: Guidelines for Perioperative Practice.
Denver, CO: AORN, Inc; 2015:733-752.
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Kerrie Chambers, MSN, RN,
LEARNER EVALUATION
Continuing Education: Clinical
Issues 1.4
http://www.aorn.org/CE
T
his evaluation is used to determine the extent to
which this continuing education program met
your learning needs. The evaluation is printed
here for your convenience. To receive continuing education credit, you must complete the online Learner Evaluation at http://www.aorn.org/CE. Rate the items as
described below.
5.
To what extent were your individual objectives met?
Low
1.
2.
3.
4.
5.
High
6.
Will you be able to use the information from this article
in your work setting?
1.
Yes
2.
No
7.
Will you change your practice as a result of reading this
article? (If yes, answer question #7A. If no, answer
question #7B.)
7A.
How will you change your practice? (Select all that
apply)
1. I will provide education to my team regarding why
change is needed.
2. I will work with management to change/implement
a policy and procedure.
3. I will plan an informational meeting with physicians
to seek their input and acceptance of the need for
change.
4. I will implement change and evaluate the effect of
the change at regular intervals until the change is
incorporated as best practice.
5. Other: __________________________________
7B.
If you will not change your practice as a result of
reading this article, why? (Select all that apply)
1. The content of the article is not relevant to my
practice.
2. I do not have enough time to teach others about the
purpose of the needed change.
3. I do not have management support to make a
change.
4. Other: __________________________________
8.
Our accrediting body requires that we verify the time
you needed to complete the 1.4 continuing education
contact hour (84-minute) program: _____________
PURPOSE/GOAL
To provide the learner with knowledge of AORN’s guidelines
related to complementary care interventions for pediatric patients, cleaning personal eyewear, education requirements for
advanced practice RN (APRN) first assistants, degree requirements for entrance to an RN first assistant (RNFA)
program, and wearing an arm cast in the perioperative setting.
OBJECTIVES
To what extent were the following objectives of this
continuing education program achieved?
1. Discuss practices that could jeopardize safety in the
perioperative area.
Low
1.
2.
3.
4.
5.
High
2.
Discuss common areas of concern that relate to perioperative best practices.
Low
1.
2.
3.
4.
5.
High
3.
Describe implementation of evidence-based practice in
relation to perioperative nursing care.
Low
1.
2.
3.
4.
5.
High
CONTENT
4.
To what extent did this article increase your knowledge of
the subject matter?
Low
1.
2.
3.
4.
5.
High
668 j AORN Journal
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