Perspectives is committed to providing timely and relevant information on postoperative recovery strategies. Our articles focus on the continuum of care from operating room to recovery room, ward, or home. Perspectives strives to provide pertinent, pragmatic information, continuing education, and gudelines to maximize nurses' ability to enhance patient outcomes and minimize secondary (iatrogenic) problems. Our articles are authored by nurses, who have in depth knowledge and experience in a broad range of clinical specialties, and are reviewed by our advisory board. We welcome opinions and suggestions from our readers. In each issue, we will provide our readers with an opportunity to earn continuing education credits.

Postoperative recovery in elderly patients: Implications for respiratory care
by Helen M. Sorenson, MA, RRT, CPFT, FAARC

Surgical intervention for a variety of medical conditions has a role in treating geriatric patients. Cardiopulmonary disease, cancer, gastrointestinal disorders, and age-associated diseases can be effectively treated or alleviated with surgery. Given the increased population of older adults and newer technology available in hospitals, attitudes toward subjecting the elderly to surgical procedures have become more liberal. While survival may be the ultimate goal, improving quality of life and functional capacity may be far more important to the elderly. Preoperative screening can identify potential age-associated problems, allowing a plan to be put in place to address them should they arise during or after surgery. Attention to some of the details covered in this article may make a difference in the percentage of older adults who both survive and thrive after an operation.

Using an Evidence-Based Framework for Preventing Unplanned Extubation
by Jan Foster, PhD, RN, CNS, CCRN

Unplanned extubation (UE) can be a devastating event for critically ill patients, with potentially life threatening complications including airway trauma, bronchospasm, severe hypoxemia, and cardiac arrest. UE can lead to an increased number of ventilator days, resulting in excessive resource use for patients, and increased risk of litigation for healthcare professionals. Methods to protect against UE include education, quality improvement processes, sedation protocols, physical restraints, and tube securing methods.

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