From the Editor

This month’s surgical topic is thoracic surgery, a branch of surgery that includes operations on the heart, lungs, esophagus, and other organs in the chest. Here you will find some news, videos (yes, you will have to create a user name and password, but the site is invaluable for nurses in the perioperative setting) and apps on the topic.

This month’s Graduate in the Spotlight is Enrilen Pioquinto, BSN, CN, CNOR, RNFA.

You’ll also find job openings we’ve collected for you,e5651521-0a79-4662-9408-c8f0e9d97393 along with links to our favorite practice resources.


Patient Safety: Sentinel Event Statistics Released for 2013 

The Joint Commission recently updated its sentinel event statistics with new summary data for January 1 through December 31, 2013. (A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.)

In 2013, 887 sentinel events were reported. Sentinel event outcomes from 2004 through 2013 show that a total of 7,881 patients have been affected by these events, with 4,686 (59.1 percent) resulting in the patient’s death, 752 (9.5 percent) resulting in loss of function, and 2,487 (31.4 percent) resulting in unexpected additional care and/or psychological impact.

Click here for the full story, including a chart showing where surgical procedures ranked.

Thoracic Surgery News
Minimally Invasive Stent Procedure Used for Aortic Aneurysms

Doctors at the Libin Cardiovascular Institute in Calgary are using a specialized stent to repair aortic aneurysms, which averts the need for open-heart surgery and improves patient recovery time, reports Colleen Schmidt of CTV Calgary.

With this technique, incisions are made at the neck and groin; pieces of the stent are guided through arteries to the heart and, once in place, the stent reinforces the aorta wall.

“This is tremendous news for patients. This minimally invasive procedure means we can reinforce the wall of the aorta without having to open their chest and perform invasive surgery,” says AHS cardiac surgeon Dr. Jehangir Appoo. “At the end of the day, for a select group of patients, it’s a much safer operation.”

Click here for the full story.

Major Lung Resection Safest at High-volume Hospitals

A study presented last month at the 94th American Association for Thoracic Surgery Annual Meeting in Toronto, Ontario, Canada, showed that annual hospital volume of major lung operations for cancer had a significant impact on both 30-day and 90-day mortality rates.

“The chance of death was twice as high at hospitals where fewer than 10 major lung cancer resections per year were performed (3.7%), compared to mortality at the busiest hospitals performing more than 90 such operations per year (1.7%),” wrote Kathy Boltz, PhD, in a summary on

Click here for the full story.
Videos offers extensive resources: videos of surgical procedures, lectures, operative techniques, case reports. and interviews with experts. You will need to sign up (at no charge) to get an account the first time you use the site.

Dr. Rivas is one of the leading surgeons using a single-port technique for video-assisted lobectomies for lung cancer. He reports the rationale of this technique.
iPad Apps 
drawMD Thoracic Surgery is a simple tool that enables clinicians to illustrate and modify medical images for the purpose of improving clinician/patient communication. drawMD’s content was developed by physicians to facilitate discussion of the most common conditions and procedures. The draw MD platform allows you to upload your own images and easily annotate any conditions on your images or theirs.

Surgical Anatomy – Student Edition

by Joseph Maclise was originally published in 1859 and is now available on the Mac. This App includes over 180 high quality images from 68 color plates with accompanying annotations and complete text. Illustrations zoom and scroll (like a photo). Recommended for doctors, nurses, students and teachers.
Graduate in the Spotlight
499Name:  Enrilen S. Pioquinto



Student Status: Graduated from NIFA’s RNFA program Dec. 16, 2013

City and State: Clearwater, FL

Current Job:  Surgical Services CN II, Morton Plant Hospital, Clearwater, FL

Why did you want to become an RN? 
In the Philippines at that time students would take tests after high school to help determine their future studies. I passed the aptitude tests for nursing. I thought it sounded like an interesting profession.

Where was your RN training and where did you work afterwards?
I graduated from Western Mindanao State University, Philippines. I went on to work at Zamboanga Doctors Hospital for four years. During two of those years I was also a clinical nurse instructor at Ateneo de Zamboanga University.

When and how did you come over to the US?
In 2006 was working in the OR at the local hospital and saw a newspaper ad for a company that was hiring nurses for the U.S. I took several tests, including two English tests, and passed them all, so the company brought me over at their expense.  I have worked in the OR here ever since. Our hospital has 25 operating rooms.

Why did you decide to become an RNFA?  
From the moment I started working in the operating room, I wanted to first assist. It seemed to be the most fulfilling job as an RN. I get to actively participate in surgery, see firsthand the tissues, organs and the anatomy involved in the procedure. Suturing and leaving no scar behind. To see that the patients recover because of surgical procedures I assisted with is such an achievement. This is far better than circulating and facing the computer.

What is one thing you learned in your RNFA training that you is particularly helpful?
The extreme superiority of the suturing and tying techniques. The proper technique combined with speed in tying is what I learned and love most. This skill, when applied at actual surgery, greatly shortens procedure time, which contributes to positive surgical outcomes.

Job Front

Click here for the RNFA job postings we’ve collected for you this month!

Do you have questions about implementing an RNFA team or becoming an RNFA?
RNFAs, APRNs and Implementing an RNFA Team will answer many of your questions. If you need answers more quickly, please see the links below or just call us at 1-800-922-7747. We will be happy to discuss any questions you may have and discuss the benefits to staff, surgeons and administrators of having an RNFA team at your facility.

Prerequisites for becoming an RNFA

Surgical Skills Workshops   

NIFA Office Hours
Monday-Thursday 7:30am – 5:00pm (Fridays 7:30am – 4:00pm).