Inadvertent hypothermia caused by redistribution of core heat after anesthesia induction is a common perioperative complication. This randomized controlled trial evaluated whether brief (five-minute) limb-focused warming added to whole-body prewarming improves efficiency and attenuates redistribution hypothermia during general anesthesia. Eighty-two adults undergoing laparoscopic lower gastrointestinal surgery were randomly assigned to a prewarming group (n = 41) or control group (n = 41). The intervention combined standard whole-body prewarming with targeted warming of both forearms and lower legs for five minutes before anesthesia induction. Core temperature, peripheral temperature, and perfusion index were recorded at baseline and peri-induction intervals. At 30 minutes after induction, the prewarming group had a higher median core temperature (36.8 °C versus 36.5 °C [98.2 °F versus 97.7 °F]; P = .046) and a smaller decline from baseline (P < .001), as well as higher peripheral temperature. This brief nurse-led approach provides efficient thermal protection without delaying anesthesia induction.

Patients undergoing procedures with local-only anesthesia experience a unique wide-awake approach to perioperative care, often without an anesthesia professional present. Implementing recommended practices can strengthen perioperative safety and support patient care goals. The recently updated AORN "Guideline for care of the patient receiving local-only anesthesia" provides perioperative nurses and clinical teams with background information on administration of local anesthetics and effective methods for providing patient care when an anesthesia professional is not present. This article provides an overview of the guideline and discusses recommendations for preoperative assessment and individualized plan of care, local anesthetic administration and intraoperative care, postoperative care and discharge planning, adverse reactions, education, and policies and procedures. It also includes a scenario describing specific concerns associated with monitoring the patient receiving local-only anesthesia. Perioperative nurses should review the guideline in its entirety and apply the recommendations when caring for patients who are undergoing procedures with local-only anesthesia.

The cardiac catheterization laboratory (CCL) is a highly specialized procedural environment that requires an effective orientation process for nurses and radiology technologists. Leaders at a health care network identified the need for a standardized CCL orientation program when high turnover rates and staff shortages created a need to hire nurses and radiology technologists with no CCL work history. A group of CCL leaders and perioperative educators collaborated to create and implement a network-wide CCL orientation program. The program is an instructor-led course conducted over three eight-hour days with a cumulative exam at the conclusion. Content includes evidence-based best practices for procedural areas and CCL-specific content. Over two cohorts, there were a total of eight participants. Initial evaluations of the CCL orientation program indicated that a standardized orientation program in the health care network was feasible and beneficial for novice nurses and radiology technologists in the catheterization laboratory practice setting.

Intraoperative hand offs are prone to communication breakdowns that can diminish nurses' self-efficacy and satisfaction, thus compromising patient safety. In this study, a descriptive cross-sectional design was used to examine the relationships between hand-off self-efficacy, satisfaction, and communication competence among OR nurses. Eighty nurses at a South Korean tertiary hospital completed a validated questionnaire for self-efficacy, sending and receiving hand-off satisfaction, and 10 subdomains of communication competence. Canonical correlation analysis identified two significant variates. Higher self-efficacy and both sending and receiving satisfaction were strongly associated with interaction management, social appropriateness, efficiency, and expressiveness. Receiving hand-off satisfaction was also linked to immediacy. These findings indicate that specific communication skills are key to building confidence and satisfaction with intraoperative hand offs. Incorporating these competencies into continuing-education curricula may enhance hand-off quality and contribute to improved surgical patient safety.