How to apply Boyer's Scholarship of Practice to Perioperative Nursing?

Applying Boyer's Scholarship of Practice to Perioperative Nursing

Boyer's Scholarship of Practice can be effectively applied to perioperative nursing by implementing evidence-based protocols for patient education, standardizing care pathways, and developing nursing-led research initiatives that focus on improving surgical outcomes and reducing complications.

Understanding Boyer's Scholarship in Perioperative Context

Boyer's model of scholarship includes four domains that can be applied to perioperative nursing:

• Discovery - Conducting original research to identify best practices in perioperative care 1
• Integration - Synthesizing evidence from multiple sources to develop comprehensive care protocols 1
• Application - Implementing evidence-based interventions in clinical practice 2
• Teaching - Educating patients and training nursing staff on perioperative best practices 3

Evidence-Based Preoperative Interventions

Patient Education and Preparation

• Provide detailed preoperative information through multiple formats (written, verbal, and visual) to patients and their caregivers to reduce anxiety and improve postoperative recovery 2
• Implement structured preoperative counseling sessions that include information about the surgical procedure, expected recovery timeline, and self-care techniques 1
• Educate patients on specific techniques like abdominal breathing and coughing to reduce postoperative complications such as pneumonia and arrhythmia 1
• Screen for modifiable risk factors including smoking, alcohol use, undiagnosed hypertension, and nutritional status 2

Surgical Site Infection Prevention

• Apply evidence-based protocols for preoperative skin antisepsis and hair removal to prevent surgical site infections 1
• Implement standardized protocols for removal of nail polish and finger rings before surgery 1
• Provide education on postnatal perineal healing for women undergoing cesarean sections 1
• Ensure proper preoperative bathing or showering with skin antiseptics 1

Intraoperative Nursing Scholarship

• Apply the WHO Surgical Safety Checklist to standardize safety protocols 2
• Maintain normothermia (core temperature ≥36°C) through active warming for operations lasting longer than 30 minutes 2, 3
• Implement opioid-sparing analgesia techniques combined with local and regional blocks when appropriate 2
• Document and monitor key intraoperative parameters to contribute to research databases 4

Postoperative Care Innovations

• Promote early mobilization, with targeted activity goals (30 minutes on day of surgery, 6 hours/day thereafter) 2
• Implement multimodal pain management strategies to reduce opioid requirements 2
• Remove urinary catheters within 24 hours after surgery for most patients to prevent urinary tract infections 2
• Apply evidence-based wound care protocols including appropriate dressing selection 1

Special Considerations for Vulnerable Populations

Elderly Patients

• Implement specialized protocols for elderly patients who are at higher risk for postoperative delirium 1, 2
• Ensure continuity of care through comprehensive information flow between care settings 1, 2
• Provide proactive pain management, especially for cognitively impaired patients who may not effectively communicate pain 1, 2
• Recognize age-related physiological changes that affect medication metabolism and surgical recovery 1

Implementing Boyer's Scholarship Through Nursing Leadership

• Establish perioperative nursing research teams to identify and address knowledge gaps 4
• Create standardized education programs like "Periop 101" to ensure consistent knowledge and competence among perioperative nurses 5
• Develop nursing-led enhanced recovery programs that focus on holistic patient experiences rather than just medical protocols 6
• Implement continuous quality improvement initiatives based on collected data and outcomes 4

Common Pitfalls and Solutions

• Pitfall: Inconsistent application of evidence-based practices

  • Solution: Develop standardized protocols and checklists specific to different surgical procedures 2, 1

• Pitfall: Poor communication during care transitions

  • Solution: Implement structured handover processes between preoperative, intraoperative, and postoperative teams 2

• Pitfall: Inadequate pain management

  • Solution: Use standardized pain assessment tools and multimodal analgesia approaches 2

• Pitfall: Failure to recognize cognitive impairment in elderly patients

  • Solution: Implement routine cognitive screening and specialized care pathways 2

By systematically applying Boyer's Scholarship model to perioperative nursing practice, nurses can contribute to improved surgical outcomes, reduced complications, and enhanced patient experiences while advancing the profession through research and innovation.