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Nursing AND Perioperative

Ji Yeong Soh, Se Uk Lee, Inpyo Lee, Ki Sang Yoon, Changho Song, Nam Hun Kim, Tae Sung Sohn, Jae Moon Bae, Dong Kyung Chang, Won Chul Cha
BACKGROUND: An incentive spirometer (IS) is a medical device used to help patients improve the functioning of their lungs. It is provided to patients who have had any surgery that might jeopardize respiratory function. An incentive spirometer plays a key role in the prevention of postoperative complications, and the appropriate use of an IS is especially well known for the prevention of respiratory complications. However, IS utilization depends on the patient's engagement, and information and communication technology (ICT) can help in this area...
February 19, 2019: JMIR MHealth and UHealth
Sasha Vaziri, Joseph M Abbatematteo, Max S Fleisher, Alexander B Dru, Dennis T Lockney, Paul S Kubilis, Daniel J Hoh
OBJECTIVEThe American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) online surgical risk calculator uses inherent patient characteristics to provide predictive risk scores for adverse postoperative events. The purpose of this study was to determine if predicted perioperative risk scores correlate with actual hospital costs.METHODSA single-center retrospective review of 1005 neurosurgical patients treated between September 1, 2011, and December 31, 2014, was performed. Individual patient characteristics were entered into the NSQIP calculator...
February 15, 2019: Journal of Neurosurgery
Victoria M Goode, Brett Morgan, Virginia C Muckler, Michael P Cary, Christine E Zdeb, Michael Zychowicz
Effective pain management for orthopaedic major joint replacement is key to achieving earlier recovery, better functioning, and high rates of patient satisfaction. In an effort to decrease opioid dependency, practitioners are turning to multimodal pain management, which involves the use of multiple analgesic agents and techniques. To utilize this technique, a patient's history of and preoperative consumption of medications to treat pain impacts the success of this regimen. Multimodal pain management involves the use of nonsteroidal anti-inflammatory drugs, acetaminophen, N-methyl-D-aspartate antagonists, gabapentin, serotonin inhibitors, regional techniques, and opioids as needed...
February 12, 2019: Orthopaedic Nursing
David A Edwards, Traci L Hedrick, Jennifer Jayaram, Charles Argoff, Padma Gulur, Stefan D Holubar, Tong J Gan, Michael G Mythen, Timothy E Miller, Andrew D Shaw, Julie K M Thacker, Matthew D McEvoy
Enhanced recovery pathways have quickly become part of the standard of care for patients undergoing elective surgery, especially in North America and Europe. One of the central tenets of this multidisciplinary approach is the use of multimodal analgesia with opioid-sparing and even opioid-free anesthesia and analgesia. However, the current state is a historically high use of opioids for both appropriate and inappropriate reasons, and patients with chronic opioid use before their surgery represent a common, often difficult-to-manage population for the enhanced recovery providers and health care team at large...
February 12, 2019: Anesthesia and Analgesia
Yu-Huan Xie, Hai-Tong Xie, Tian-Shu Wang, Yi-Ping Shu, Xing-Liang Dai
To compare the effect of perioperative holistic care versus conventional care on the levels of anxiety and depression of pituitary tumor patients at a single tertiary care center in China.We enrolled 100 patients who underwent transnaso-sphenoidal microsurgical resection of pituitary tumor at our institution between January 2017 and December 2017. The patients were assigned to the conventional care group (n = 50) and the holistic care group by the order of admission. Patients were evaluated by staff nurses at admission and upon discharge from the hospital using the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS)...
February 2019: Medicine (Baltimore)
Gilda Cinnella, Marco Pavesi, Andrea De Gasperi, Marco Ranucci, Lucia Mirabella
Patient blood management is currently defined as the application of evidence based medical and surgical concepts designed to maintain hemoglobin (Hb), optimize hemostasis and minimize blood loss to improve patient outcome. Blood management focus on the perioperative management of patients undergoing surgery or other invasive procedures in which significant blood loss occurs or is expected. Preventive strategies are emphasized to identify and manage anemia, reduce iatrogenic blood losses, optimize hemostasis (e...
February 13, 2019: Minerva Anestesiologica
Erebouni Arakelian, Lena Nyholm, Caisa Öster
PURPOSE: To study how nurse anesthetists and anesthesiologists assess and handle patients' perioperative anxiety without using a validated instrument. DESIGN: Qualitative study. METHODS: Individual in-depth face-to-face interviews were conducted with nurse anesthetists (n = 9) and anesthesiologists (n = 5) from a university hospital in Sweden. Data were analyzed with thematic analysis according to Braun and Clark. FINDINGS: Two themes were identified: (1) I ask about anxiety, look for visual signs, and observe communication and (2) I handle patients' anxieties individually...
February 7, 2019: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Karin Falk-Brynhildsen, Maria Jaensson, Brigid M Gillespie, Ulrica Nilsson
PURPOSE: To compare perceived competence and self-efficacy (SE) among Swedish operating room (OR) nurses and registered nurse anesthetists (RNAs), and to evaluate the relationship between SE and competence, gender, age, and years of experience. DESIGN: Comparative cross-sectional survey. METHODS: Two validated questionnaires, Perceived Perioperative Competence Scale-Revised and General Self-Efficacy Scale, were sent to members of the Swedish Association of Health Professionals (n = 2,902)...
February 6, 2019: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Juan P Gurria, Heather Nolan, Stephanie Polites, Melody Threlkeld, Katherine Arata, Lisa Phipps, Alison Muth, Richard A Falcone
BACKGROUND: Blood-borne pathogen exposure (BBPE) represents a significant safety and resource burden, with more than 380,000 events reported annually across hospitals in the United States. The perioperative environment is a high-risk area for BBPE, and efforts to reduce exposures are not well defined. A multidisciplinary group of nurses, surgical technologists, surgeons, and employee health specialists created a BBPE prevention bundle to reduce Occupational Safety and Health Administration (OSHA) recordable cases...
February 4, 2019: Joint Commission Journal on Quality and Patient Safety
Mandeep Singh, Reza Askari, Matthias Stopfkuchen-Evans
The incorporation of enhanced recovery after surgery (ERAS) fundamentals into perioperative medicine has improved the patient care experience and hastened recovery time while reducing hospital costs. Research studies have shown that incorporating ERAS principles in the adult or geriatric acute care surgery populations minimizes time to resumption of preoperative activity and reduces hospital length of stay. ERAS principles are widely applicable to these patient cohorts and may be applicable in trauma patients...
March 2019: Anesthesiology Clinics
Jacob Jensen, Rodney W Hicks, Jonathan Labovitz
Tourniquet use during extremity surgery is commonplace and a relatively safe practice. The surgical team's knowledge of the patient history, proper assessment, and indications and contraindications for and risks of tourniquet use can prevent unwanted outcomes. Exploration of these critical areas reinforces perioperative nurses' awareness and understanding of safe tourniquet use. Additionally, a review of the physiological effect of tourniquets on the skin, the body's response to local compression, the risk of vascular compromise, and the effect of the tourniquet on postoperative pain and swelling provides insight into AORN recommended practice guidelines...
February 2019: AORN Journal
Anna Nordström, Monne Wihlborg
In the complex OR environment, perioperative team members need to practice communication and teamwork to ensure safe, high-quality care. A lack of collaboration among professionals in the OR during surgery results in inefficiency, increased tension, and suboptimal patient care. The purpose of this study was to determine how nurse anesthetists and OR nurses experienced their work in the OR. We used a qualitative design with a phenomenographic approach and conducted 12 interviews in two surgical departments in the southern part of Sweden...
February 2019: AORN Journal
Cheryl B Hines, Angela Collins-Yoder
Bone cement implantation syndrome (BCIS) is a potentially fatal complication of orthopedic surgeries that use cement. The symptoms of BCIS occur primarily during femoral fracture repairs, but this complication has been reported in a wide variety of cemented procedures. Clinical presentation of this syndrome begins as a cascade with hypoxia and hypotension; if it is not reversed, it ends with right-sided heart failure and cardiac arrest. This syndrome usually occurs at cementation, prosthesis insertion, joint reduction, or tourniquet deflation, and should be treated with aggressive resuscitation and supportive care...
February 2019: AORN Journal
Mei-Hua Yu, Ting-Ting Lee, Mary Etta Mills
Pathology specimen labeling errors occur for a variety of reasons. We investigated the use of barcode technology as a method to improve the accuracy of pathology specimen labeling and patient safety. We also assessed nurses' perceptions of system quality, information quality, service quality, user satisfaction, and net benefits. Sixty-eight perioperative nurses who work in a teaching hospital in Taiwan completed the survey. Nurses scored net benefits as highly contributing to their satisfaction, whereas system quality contributed most to dissatisfaction...
February 2019: AORN Journal
Mary E Doerner, Constance F Swenty
Health care organizations have tasked nursing education leaders with increasing enrollment and graduating nursing students ready to practice. The purpose of this quality improvement project was to evaluate the effect of a perioperative clinical immersion on the perceptions of readiness for practice held by senior students working toward a bachelor of science in nursing. Seven senior nursing students participated in the perioperative clinical immersion at one midwestern university. At the end of the immersion, the students participated in an interview that was designed to capture their perceptions of the program...
February 2019: AORN Journal
Jeremy E Springer, Aristithes G Doumouras, Sara Lethbridge, Shawn Forbes, Cagla Eskicioglu
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols after colorectal surgery use several perioperative, intraoperative and postoperative interventions that decrease morbidity, length of stay, and improve patient satisfaction. ERAS is increasingly being considered standard of care; however, uptake of formalized protocols remains low. The objective is to characterize the provincial rates of ERAS utilization after colorectal surgery and identify barriers and limitations to ERAS implementation...
March 2019: Journal of Surgical Research
Keetie Kremers, Borg Leijtens, Simone Camps, Alma Tostmann, Sander Koëter, Andreas Voss
BACKGROUND AND PURPOSE: Prosthetic joint infection (PJI) is a serious complication resulting from total knee arthroplasty (TKA) or total hip arthroplasty (THA). In this study, patients with a PJI are compared with patients with an uncomplicated postoperative course to identify relevant risk factors for PJI. METHODS: A matched case-control study was performed with patients undergoing fast-track, elective unilateral TKA or THA. The following data were collected: demographics, surgery-related characteristics (perioperative blood loss, use of cement, body temperature), and postoperative characteristics (hematoma formation, wound leakage, blood transfusion, length of stay [LOS])...
January 11, 2019: Journal of the American Association of Nurse Practitioners
Min Liu, Yao Huang, Yue-Lai Yang, Hong Ruan
PURPOSE: To construct a core training curriculum of inadvertent perioperative hypothermia nursing. METHODS: The content of inadvertent perioperative hypothermia curriculum was developed by brainstorming method and expert consultation method based on literature review and clinical practice guideline. Statistical analysis was implemented using mean and coefficient of variation with SPSS 17.0 software package. RESULTS: We successfully established the content of inadvertent perioperative hypothermia curriculum, including 5 primary dimensions and 12 secondary items...
October 2018: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
Nicholas Mendis, Gavin M Hamilton, Daniel I McIsaac, Dean A Fergusson, Hannah Wunsch, Daniel Dubois, Joshua Montroy, Michaël Chassé, Alexis F Turgeon, Lauralyn McIntyre, Heather McDonald, Homer Yang, Sonia D Sampson, Colin J L McCartney, Risa Shorr, André Denault, Manoj M Lalu
Perioperative intermediate care units (termed surgical special care units) have been widely implemented across health systems because they are believed to improve surveillance and management of high-risk surgical patients. Our objective was to conduct a systematic review to investigate the effects of a 3-level model of perioperative care delivery (ie, ward, surgical special care unit, or intensive care unit) compared to a 2-level model of care (ie, ward, intensive care unit) on postoperative outcomes. Our protocol was registered with PROSPERO, the international prospective register of systematic reviews (CRD42015025155)...
January 21, 2019: Anesthesia and Analgesia
Esmihan Almontaser, Carmel Ritchie, John Madison, Pascal Jabbour
Retinoblastoma (RB) is a rare cancer of the eye, most commonly seen in children. Intra-arterial chemotherapy for RB is a relatively new treatment modality that has gained increasing popularity worldwide. The principal underlying the intra-arterial approach is delivery of chemotherapeutic agents directly to the site of the tumor. This avoids system toxicities normally associated with higher dose of these drugs. The purpose of this continuing education article was to review the features of RB and its treatment, with a focus on the perioperative management of children undergoing intra-arterial chemotherapy at our institution...
January 16, 2019: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
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