Establishing safety standards in liver transplantation operating room nursing care

ObjectiveThe liver transplant operation is a lengthy procedure where the operating room (OR) nurse is expected to maintain adequate safety measures to protect the patient from physical injuries such as hypothermia, position-related injuries and thermal-related injuries from electrocautery. Our aim is to review the effectiveness of our perioperative patient care precautions.MethodsA retrospective review of all perioperative liver transplant records from January 2006 to December 2008 of recipients and live liver donors was performed. From January 2007 onwards, a standardized nursing care protocol designated for liver transplant-related patients was developed by the nursing department. Perioperative injuries related to poor nursing preparation were recorded.ResultsA total of 462 patients were included. There were a total of 13 (13.5%) perioperative nursing complications which included 7 skin integrity defects, 3 temporary nerve injuries, and 3 hypothermia episodes below 36 °C. All these injuries (13 out of 96 patients) were seen from January to December 2006 prior to the implementation of a standardized perioperative nursing protocol. From 2007 onwards, physical facilities׳ improvement was instituted with the acquisition of leg compression cuffs and silicon-based cushions. The OR air conditioning was improved by self-adjusting monitoring devices to keep the OR temperature and humidity at 24 °C and 50%, respectively. There has been no reported complication from January 2007 to December 2008.ConclusionThe establishment of objectively assessable perioperative OR nursing care standards in liver transplantation operation is important to avoid installation-related complications.