ORBIS - training nurses worldwide in ophthalmic care

AORN Journal, Oct, 1998 by Karen Watts, Helen Taylor, Kevin Taylor

The plane program runs from Tuesday through Friday. Screening and patient selection is held at the local hospitals on Mondays. Each Tuesday morning, a nursing orientation workshop is presented by either the nurse educator or float nurse. This workshop is designed to familiarize the nurses with topics such as scrubbing, gowning, gloving, aseptic technique, and standard precautions (Figure 3). The workshop is a nonstressful learning environment that provides an opportunity for discussion; introduces AORN standards, recommended practices, and guidelines that are followed; and allows for an assessment of local nurses' learning needs. All of the nurses are given a brief overview of each area before beginning work in their assigned area.

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The organization prefers to have local nurses spend the entire week in one area to benefit fully and to be able to implement any new ideas that they have learned; however, the schedule frequently is adapted to meet their needs. For example, during the January to March 1997 schedule in Cuba, E1 Salvador, and Trinidad, the nurses' higher knowledge and skill levels, combined with their high interest in all areas, made it feasible for nurses to rotate through each area. Regardless of the nurses' work areas, they are encouraged to spend time in and observe each area. There are monitors located in the PACU and substerile rooms that can be patched to the OR, laser/examination room, or classroom. The nurses then can observe procedures in progress on these monitors. Videotaped in-service programs also can be shown on the monitors.

The PACU has a dual purpose in that it also serves as the preoperative area. The room has a three-bed capacity with suction, oxygen, and patient monitors located at each bed. Standard emergency equipment (eg, crash cart, defibrillator) is present. The two local nurses working with the ORBIS PACU nurse have the opportunity to learn and practice both preoperative and postoperative care of the ophthalmic patient (Figure 4). The role of the nurse in patient education is an important one, so the local nurses become increasingly responsible for patient education throughout the week. Nurses are instructed how to teach patients what to expect preoperatively and postoperatively, proper application of topical eye drops and medications, signs of postoperative symptoms, and activity restrictions. The nurses are encouraged to participate in all aspects of patient care. An ORBIS nurse and translator is present at all times to answer any questions.

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One local nurse works alongside an ORBIS nurse in the substerile room (Figure 5). The proper cleaning, care, and sterilization of microsurgical instruments is emphasized. Methods of sterilization and decontamination often are topics of discussion. Discussions center around common misconceptions concerning relationships between sterilization methods, packaging, and shelf life. During a surgical procedure is an ideal time to discuss a variety of general nursing topics using the mini-lecture format in the substerile room. Each ORBIS nurse is responsible for developing and giving these talks when feasible. In addition, staff members in the nursing and biomedical engineering departments cooperate to give mini-lectures on the use of the ethylene oxide gas sterilizer and its safety precautions.