The Rn First Assistant

by Rothrock, Jane C.

• ISBN13: 9780781715010
• ISBN10: 0781715016
• Edition: 3rd
• Format: Paperback
• Copyright: 1998-10-01
• Publisher: Lippincott Williams & Wilkins

Summary

This text offers clear, concise, step-by-step guidance on the expanded roles and responsibilities of the RN serving as first assistant in the operating room. Current, readable and well-organized, the text surpasses the limited content in general perioperative books. The author and her contributors -- all leaders in the field -- place emphasis on tissue handling and wound healing, instrument management and suturing. Institutional credentialing and collaborative practice information find application with both nurses applying for practice privileges and hospitals setting up a credentialing process. Hundreds of end-of-chapter review questions make this text the only one to promote and support study for the RN First Assistant role and for national certification. A Brandon-Hill Recommended Title.

Table of Contents

1. History of the RN First Assistant Role	1	(20)
Jane C. Rothrock
Impact of Wartime	2	(6)
The Student Nurse as First Assistant	8	(1)
The Private Duty Nurse as First Assistant	9	(1)
Education of the Nurse for the Operating Room	10	(2)
Factors Influencing the First Assistant Role, 1945 to 1998	12	(3)
Conclusion	15	(2)
Review Questions	17	(1)
Answer Key	18	(1)
References	18	(3)
2. The Nurse Practice Act and Regulation of Nursing Practice	21	(28)
Jane C. Rothrock
Purpose of the Practice Act	22	(1)
Board of Nursing	23	(8)
Beyond the Generalist	31	(6)
Advanced Practice Roles	37	(2)
Institutional Licensure and Expanded Practice	39	(2)
RNFA Initiatives to Influence Practice	41	(1)
Conclusion	42	(1)
Review Questions	43	(3)
Answer Key	46	(1)
References	46	(3)
3. Institutional Credentialing of the RN First Assistant	49	(26)
Nancy B. Davis
Credentialing and Practice Privileges	50	(2)
The Joint Commission on Accreditation of Healthcare Organizations	52	(1)
Credentialing Mechanisms	53	(17)
Conclusion	70	(1)
Review Questions	70	(2)
Answer Key	72	(1)
References	73	(2)
4. Infection Control	75	(30)
Cecil A. King
Nursing Role in the Development of Asepsis	75	(1)
Epidemiology of Surgical Site Infections	76	(2)
Bacterial Microorganisms of Perioperative Importance	78	(4)
Nonantibiotic-Related Risk Factors for SSI	82	(3)
Surveillance Systems	85	(2)
Standards of Perioperative Antibiotic Prophylaxis	87	(2)
Postoperative Indicators of SSI	89	(1)
Treatment of SSI	89	(1)
Implications for the RNFA	90	(7)
Standard Precautions	97	(3)
Summary	100	(1)
Review Questions	100	(3)
Answer Key	103	(1)
References	103	(2)
5. The Diagnostic Process	105	(22)
Jane C. Rothrock
Evaluation for Nonemergency Surgery	106	(1)
Obtaining the History	106	(9)
Performing the Physical Examination	115	(6)
Preoperative Testing	121	(1)
Informed Consent and Patient Self-Determination	121	(1)
Summary	122	(1)
Review Questions	123	(2)
Answer Key	125	(1)
References	126	(1)
6. Perioperative Patient Preparation	127	(26)
Jane C. Rothrock
Perioperative Patient Education	128	(8)
Skin Preparation	136	(6)
Draping the Operative Site	142	(4)
Summary	146
Review Questions	142	(8)
Answer Key	150	(1)
References	150	(3)
7. Anesthesia and Patient Positioning	153	(28)
James E. Rasinsky
Early History	153	(2)
Pre-anesthesia Assessment and Types of Anesthesia	155	(5)
Positioning the Anesthetized Patient	160	(13)
Summary	173	(2)
Review Questions	175	(3)
Answer Key	178	(1)
References	178	(3)
8. Principles of Tissue Handling	181	(20)
Rudolph C. Camishion
Arthur S. Brown
Overview of Wound Healing	182	(1)
Preparation Maneuvers	183	(1)
Surgical Approaches to the Abdomen	184	(3)
Sharp Dissection	187	(3)
Accessories Used in Tissue Handling	190	(2)
Wound Closure	192	(3)
Drains	195	(1)
Dressings	195	(1)
Traumatic Wounds	196	(1)
Summary	197	(1)
Review Questions	198	(1)
Answer Key	199	(1)
References	200	(1)
9. Providing Exposure: Retractors and Retraction	201	(22)
Nancy B. Davis
Nursing Diagnosis: Preventing Injury	201	(2)
Methods of Providing Exposure	203	(16)
Summary	219
Review Questions	213	(7)
Answer Key	220	(1)
References	220	(3)
10. Suturing Materials and Techniques	223	(36)
Nancy B. Davis
Uses and Selection of Sutures	224	(1)
Classification of Sutures	225	(6)
Surgical Needles	231	(3)
Suturing	234	(10)
Suturing Techniques	244	(9)
Preventing Percutaneous Injury	253	(1)
Summary	254	(1)
Review Questions	255	(2)
Answer Key	257	(1)
References	257	(2)
11. Wound Healing	259	(28)
Jane C. Rothrock
Types of Wounds	259	(1)
Physiology of Wound Healing	260	(5)
Metabolic Requirements of Wound Healing	265	(1)
Wound Management	266	(7)
Early Wound Complications	273	(3)
Late Wound Complications	276	(2)
High-Risk Patients	278	(3)
Summary	281	(1)
Review Questions	282	(3)
Answer Key	285	(1)
References	286	(1)
12. Using Grasping Instruments	287	(10)
Sergius Pechin
Hemostasis	287	(3)
Retraction	290	(1)
Thumb Forceps	291	(1)
Summary	292	(1)
Review Questions	293	(1)
Answer Key	294	(1)
References	295	(2)
13. Providing Hemostasis	297	(46)
Nancy B. Davis
Brenda C. Ulmer
Patient Assessment	299	(1)
General Considerations in Hemostasis	300	(2)
Mechanical Means of Achieving Hemostasis	302	(25)
Thermal Means of Achieving Hemostasis	327	(8)
Chemical Means of Achieving Hemostasis	335	(3)
Summary	338	(1)
Review Questions	339	(3)
Answer Key	342	(1)
References	342	(1)
14. The RN First Assistant and Collaborative Practice	343	(22)
Patricia C. Seifert
Definition of Collaborative Practice	344	(1)
Background	345	(2)
Development of Collaborative Practice	347	(9)
Considerations and Implications of Collaborative Practice	356	(2)
Summary	358	(1)
Review Questions	358	(4)
Answer Key	362	(1)
References	362	(3)
15. Clinical Applications	365	(56)
Dale A. Smith
Christine C. Espersen
Barbara M. Wilson
Christopher C. Hlozek
The RN First Assistant in Orthopedic Surgery	365	(12)
The RN First Assistant in Cardiac Surgery	377	(13)
The RN First Assistant in Endoscopic and Minimally Invasive Surgery	390	(11)
The RN First Assistant in Vascular Surgery	401	(9)
Review Questions	410	(7)
Answer Key	417	(1)
References	418	(3)
APPENDIX I AORN Official Statement on RN First Assistants	421	(4)
APPENDIX II AORN Recommended Education Standards for RN First Assistant Programs	425	(5)
APPENDIX III Diagnostic Studies and Their Meaning	430	(35)
INDEX	465