Use of Mentholated Popsicle in the Management of the Elderly Patient's Thirst in the Immediate Postoperative Period: A Randomized Controlled Trial.

PURPOSE: This study aimed to compare a mentholated popsicle with usual care (absolute fasting) in the change in thirst intensity and discomfort in elderly patients in the immediate postoperative period (IPP). DESIGN: A randomized controlled trial. METHODS: The sample consisted of 50 elderly patients (60 years or older) in the IPP who were randomly assigned to two groups: experimental group (20 mL mentholated popsicle) and control group (usual care). The outcomes, thirst intensity and discomfort, were assessed at baseline and 20 minutes after the intervention. FINDINGS: The mentholated popsicle presented a statistically significant (P < .001) decrease in thirst intensity and discomfort by 5.0 in the median and a Cohen's r large effect size for both outcomes. There were no adverse events or side effects. CONCLUSIONS: The use of a mentholated popsicle decreased the intensity and discomfort of the elderly patient's thirst in the IPP.

The use of mentholated popsicle to reduce thirst during preoperative fasting: A randomised controlled trial.

AIMS AND OBJECTIVES: To compare mentholated popsicle with usual care (absolute fasting) in the change of thirst intensity and discomfort of patients in the preoperative fasting. BACKGROUND: Thirst is defined as the desire to drink water, and it is considered to be a multifactorial symptom. In the preoperative fasting, the patient may experience intense thirst, often for a long time, that can lead to feelings of suffocation, desperation, fear and anxiety. DESIGN: A randomised controlled trial. METHODS: Forty patients, aged between 18-60 years, were randomised to mentholated popsicle group or absolute fasting group (twenty in each). The primary outcomes were thirst intensity, evaluated by a numeric scale ranging from 0 (no thirst)-10 (the worst possible thirst), and discomfort from thirst (evaluated by the Perioperative Thirst Discomfort Scale), both measured twice (baseline and after 20 min of intervention). The CONSORT checklist was used to report this study. RESULTS: Mean age was similar in both groups (38 years in the mentholated popsicle group and 39 in the absolute fasting group). At baseline, the mentholated popsicle group had higher median for the scales of intensity (6.5) and discomfort (7.5) from thirst than the absolute fasting group (5.0 and 5.0, respectively). At the end of 20 min, the popsicle group had a statistically significant decrease in intensity and discomfort from thirst (median decreases of 5.0 and 7.0 points, respectively) when compared to the absolute fasting group (median increases of 0.5 and 1.0 points, respectively). CONCLUSIONS: The use of mentholated popsicle decreased the intensity and discomfort from thirst, and it is a viable strategy for the management of thirst in the preoperative fasting. RELEVANCE TO CLINICAL PRACTICE: In the preoperative fasting, making mentholated popsicles available to patients is an easy strategy to manage thirst, which might lead to better care.

A systematic review on the effectiveness of prewarming to prevent perioperative hypothermia.

AIMS AND OBJECTIVES: To analyse available research on the effectiveness of prewarming to prevent perioperative hypothermia and identify knowledge gaps for future research. BACKGROUND: Perioperative hypothermia is common and causes complications, such as coagulation and platelet function abnormalities; increased cardiac morbidity, surgical site infection, and pressure ulcer incidence levels. In this context, several methods have been investigated to prevent perioperative hypothermia, including prewarming. Prewarming is defined as the warming of peripheral tissues or the skin surface before anaesthetic induction and may consist of an active cutaneous warming system or the preoperative administration of vasodilation drugs. DESIGN: Systematic review. METHODS: We searched CINAHL, EMBASE, Cochrane Register of Controlled Trials and Medline (January 1990-November 2011) for randomised controlled trials on the effectiveness of prewarming for prevention of perioperative hypothermia, published in English, Spanish and Portuguese, and involving elective surgery patients aged 18 years or older. RESULTS: Of 730 identified studies, only 13 met the inclusion criteria. After hand-searching the reference lists of included studies, an additional study was identified for a total sample of 14 studies. The results suggest that forced-air warming system is effective to reduce hypothermia when applied for the prewarming of surgical patients. CONCLUSION: Prewarming patients with the forced-air warming system might be effective to reduce perioperative hypothermia, and new studies are needed to examine the use of carbon fibre technology. RELEVANCE TO CLINICAL PRACTICE: Nurses can use this review to inform decision-making on a prewarming programme in the perioperative period. They can also develop research on strategies to put in practice prewarming in the surgical context.

A systematic review of the effectiveness of cutaneous warming systems to prevent hypothermia.

AIMS: To retrieve and critique recent randomised trials of cutaneous warming systems used to prevent hypothermia in surgical patients during the intraoperative period and to identify gaps in current evidence and make recommendations for future trials. BACKGROUND: Hypothermia affects up to 70% of anaesthetised surgical patients and is associated with several significant negative health outcomes. DESIGN: Systematic review using integrative methods. METHODS: We searched CINAHL, EMBASE, Cochrane Register of Controlled Trials and Medline databases (January 2000-April 2007) for recent reports on randomised controlled trials of cutaneous warming systems used with elective patients during the intraoperative period. Inclusion criteria. We included randomised control trials examining the effects of cutaneous warming systems used intraoperatively on patients aged 18 years or older undergoing non-emergency surgery. Studies published in English, Spanish or Portuguese with a comparison group that consisted of either usual care or active cutaneous warming systems without prewarming were reviewed. RESULTS: Of 193 papers initially identified, 14 studies met the inclusion criteria. There was moderate evidence to indicate that carbon-fibre blankets and forced-air warming systems are equally effective and that circulating-water garments are most effective for maintaining normothermia during the intraoperative period. Few trials reported costs. CONCLUSIONS: Carbon-fibre blankets and forced-air warming systems are effective and circulating-water garments may be preferable. Future research should measure the direct and indirect costs associated with competing systems. RELEVANCE TO CLINICAL PRACTICE: Nurses can use this review to inform their selection of warming interventions in perioperative nursing practice. They can also assess other factors such as nursing workload, staff training and equipment maintenance, which should be incorporated into future research.

Avaliaçäo de indicadores do controle da contaminaçäo ambiental da sala de operaçäo: um estudo piloto / An evaluation of control indicators of environmental contamination in the operating room: a pilot study

O controle da contaminaçäo ambiental, na sala de operaçäo, é uma das medidas de prevençäo da infecçäo do sítio cirúrgico. Assim, o presente estudo teve como objetivo identificar se os padrões mínimos para o controle da contaminaçäo ambiental estäo sendo considerados pelos profissionais de saúde que atuam na unidade de Centro Cirúrgico. A investigaçäo foi desenvolvida em um hospital geral, público; a coleta de dados realizou-se através de observaçäo das cirurgias, utilizando instrumentos previamente elaborados, na especialidade de ginecologia e obstetrícia, no mês de janeiro de 2000, perfazendo um total de 23 procedimentos anestésico-cirúrgicos observados. Realizamos uma análise descritiva e matemático-estatística, utilizando freqüência absoluta e porcentagem. Ao analisarmos o conjunto de itens do Padräo 1, que retrata a limpeza e montagem da sala de operaçäo, e do Padräo 2, relativo aos princípios de assepsia cirúrgica, constatamos que a maioria dos procedimentos foi realizada pelos profissionais que atuavam na unidade, da forma preconizada pela literatura, entretanto, alguns itens avaliados evidenciaram a necessidade de reavaliaçäo das práticas desenvolvidas pela equipe de saúde em relaçäo ao controle da contaminaçäo ambiental, bem como a atualizaçäo sobre os avanços técnico-científicos para o controle da infecçäo do sítio cirúrgico

O esperado e o praticado pelo enfermeiro em relacao a lideranca no ambiente hospitalar: visao do atendente de enfermagem / Expected and Delivered Behavior of Nurses Regarding Leadership in Hospital Settings - the View of Nurses Aids

Partindo da compreensao de que o trabalho profissional do enfermeiro tem privilegiado o exercicio administrativo, e que esta administracao pressupoe o uso de lideranca, o objetivo dos autores nesta pesquisa foi verificar e analisar, a luz das teorias Grid, o esperado e o praticado pelo enfermeiro em relacao a lideranca na visao do atendente de enfermagem. O trabalho foi realizado em quatro unidades de internacao de um hospital-escola. A coleta de dados se processou atraves da aplicacao de instrumentos denominados Instrumento Grid & Lideranca em Enfermagem, de Trevizan, os quais destinam-se a averiguar os comportamentos ideal e real. Os resultados indicaram que tanto em relacao ao comportamento ideal do enfermeiro, como o real, o estilo Grid 9,9 foi o que obteve o maior numero de pontos. Os autores discutem os resultados e enfatizam a necessidade do desenvolvimento de lideranca na enfermagem