Abstracts 2005 Volume 22

ORL – Head and Neck Nursing

Table of Contents
Winter 2005 / Volume 23, Number 1

Departments
Editorial: Changing the Shape of Professional Involvement
Linda K. Clarke, MS, RN, CORLN

Presidential Perspectives: Reflecting on Tomorrow’s Nurses
Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN

Spotlight on Research: Transfusion Prediction in Head and Neck Surgery
Feature Editor: Mary N. Klein, MSN, RN, LNFA
Reviewer: Margaret M. Hickey, RN, MSN, MS, OCN®, CORLN

Media Review: Triage, Staff Development, and Lung Cancer
Mary N. Klein, MSN, RN, LNFA

Patient Education: Taking Allergy Precautions in the Home
Margaret A. Kramper, RN, FNP, CORLN

Products of Interest: Specialized Tracheostomy Tubes
Feature Editor: Cynthia Tucker, BA, RN, RNFA, CNOR, CORLN

Emergency Ventilation of the Tracheostomy Patient, Part I: A Story of Tracheotomy History and Patient Management: Advocating Education for Emergency Resuscitation
Shelia Taylor Myers, RN, PhD
Deidra Sharp, RN, BC, BSN

Abstract
Over a period of 5000 years, dramatic changes have occurred in airway management, tracheotomy procedure terminology, indications, techniques, instruments, settings where procedures are performed, tube design and patient outcomes. Specialized knowledge and skills necessary to safely care for tracheostomy patients and to provide effective respiratory resuscitation are reviewed. The purpose of this paper is to document the history of the tracheotomy as a backdrop for understanding patient management.

Code 99: Extreme Makeover: SOHN Chapter Edition
Cindy J. Dawson, BSN, RN, CORLN
Jeanine C. Whitaker, BS, RN, CORLN

Abstract
Regional Chapters, both old and new, often experience a lack of participation and interest despite large membership numbers. Often, a few overworked members keep the Chapter afloat. This article, co-authored by two Chapter leaders, explores reasons for these changes and offers some tips for an “Extreme Chapter Makeover”.

How I Do It: A Protocol for Diagnostic Nasal Endoscopy
Donald A. Leopold, MD, FACS

Pediatric Upper Airway Endoscopy
Anne DeLeo, MSN, CRNP, CORLN
Paula Dimmitt, RN, MS, CPNP

Departments

Editorial: The Scope of Upper Airway Endoscopy
Susan F. Rudy, MS, CRNP, CORLN

Presidential Perspectives: Helping Patients to Help Themselves
Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN

Patient Education
Adult Nasopharyngolaryngoscopy (English)
Adult Nasopharyngolaryngoscopy (Spanish)

Products of Interest: Laryngeal Examination and Treatment Equipment
Department Editor: Cynthia Tucker, BA, RN, RNFA, CNOR, CORLN

Guidelines for Performing Fiberoptic Flexible Nasal Endoscopy and
Nasopharyngolaryngoscopy on Adults
Patricia Zarnitz RN, RNFA, MSN, BC, CRNP

Abstract
This article presents guidelines for performing two diagnostic skilled examinations; adult fiberoptic flexible nasal endoscopy and nasopharyngolaryngoscopy. These guidelines help to address the paucity of nursing literature on this subject. These procedures previously have been the unique purview of otolaryngologists, but now are being performed by nurse practitioners in otolaryngology specialty practice, as well as by other healthcare providers. All healthcare providers are accountable for seeking appropriate learning resources and clinical supervision in acquiring new procedural skills after graduation and licensure. This article guides learners in acquiring upper airway endoscopy skills, and describes one nurse practitioner’s path to gaining institutional sanction for expanding her scope of practice.

The Risk of Patient Cross-Contamination from Venturi-Principle Atomizers
Timothy R. Wolfe, MD

Abstract
Otolaryngology clinicians care for numerous immunocompetent and immunosuppressed patients with transmissible bacterial, viral and fungal infections, including serious pathogens, such as methicillin resistant Staphylococcus aureus (MRSA), tuberculosis (TB), and human immunodeficiency virus (HIV). In addition, otolaryngology clinicians commonly use a device to deliver topical anesthetics and decongestants to the nose and throat with a known potential to cross-contaminate patients, the air driven
DeVilbiss® atomizer, which operates according to the Venturi principle. This article will review the mechanism of action of the air-driven atomizer and discuss the literature which demonstrates the associated a risk for patient cross-contamination.

Departments

Editorial: Patient Safety: A Renewed Focus
Susan F. Rudy, MSN, CRNP, CORLN

Presidential Perspectives:
Asthma: An Important Comorbidity to Allergic Rhinitis
Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN

Highlights From the Hill:
Creating our Country’s Laws
Linda Miller Calandra, MSN, RN, CPNP, CORLN

Spotlight on Research: Nurses’ Knowledge and Attitudes about Cancer Pain Management
Department Editor: Helene J. Krouse, PhD, APRN, BC, CORLN, FAAN
Reviewer: Hsiao-Lan Wang, MSN, RN

Media Review: Books of Notes
Department Editor: Linda K. Clarke, MS, RN, CORLN
Reviewers: Cindy J. Dawson, BSN, RN, CORLN & Katherine Zimnicki RN, MSN-CS, CWOCN

Products of Intrest: Wound Care Products
Feature Editor: Cynthia Tucker, BA, RN, RNFA, CNOR, CORLN

An Algorithm for Local Non-Surgical Management of Complicated Wounds in Head and Neck Cancer Patients
Sarah H. Kagan, Ph.D., RN, CS, AOCN®
Eric D. Baum M.D., Irene Best BSN, RN
Ara A. Chalian MD, FACS

Abstract
This review paper introduces an algorithm for non-surgical local wound care in head and neck cancer patients who have delayed and complicated wound healing. Wound complications are common in patients undergoing head and neck cancer treatment, regardless of whether their primary treatment modality is surgery or chemoradiation. The risk for complications is compounded by the vital structures in the regional anatomy of these tumors and by the toxicities and long-term consequences of the cancer treatments employed. There is limited empirical and clinical evidence that specifically guides and improves local wound healing outcomes in head and neck cancer patients. The algorithm, based on an analysis of the medical literature, begins with the assessment of five simple wound environment characteristics: exudate volume; slough and eschar; large vessel exposure; proliferation; and systemic nutrition and perfusion. Assessing these wound characteristics is the basis for planning local care. The wound characteristics are discussed in relation to the pertinent literature, product categories, and other known interventions presented herein. Literature was selected, reviewed, and the findings were extrapolated to meet the clinical needs unique to the head and neck cancer patient population. Medical, nursing, and multidisciplinary literature was searched using the Medline®, Cumulative Index for Nursing and Allied Health Literature (CINAHL), and M.D. Consult® databases.
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Practice Management: Ten Tips for Streamlined Surgery Scheduling
Sarah Wiskerchen, MBA, CPC

Abstract
Despite its operational importance, there are few academic references available related to efficient and effective surgery scheduling. This article outlines ten practical tips for streamlining the process of scheduling surgeries.