High prevalence of burnout syndrome in orthopedic nurses in Italy.

BACKGROUND: Recent studies reported particularly high levels of burnout in nurses working in Orthopedic and Trauma departments. OBJECTIVE: The objectives of the present study were to evaluate the estimated prevalence of burnout and psychiatric morbidity in a population of nurses that work in Italian orthopedic and traumatology departments and to reveal eventual correlations between socio-demographic factors, stress factors, and satisfaction at work. METHODS: Nurses, employed in orthopedics and traumatology departments, were asked to complete an anonymous questionnaire including: a section on demographic data, the Maslach Burnout Inventory, the Short-Form 12, a section on personal and social life, work conditions, and feelings about the work. RESULTS: A high emotional exhaustion (EE) value was present in 35 nurses (66%), a high depersonalization (DP) value in 44 nurses (83%), and a low personal accomplishment (PA) value in 47 nurses (88%). High levels of burnout (EE and DP) were strongly correlated to nurses' perception of health-related quality of life (in the Mental Component Summary-12). CONCLUSION: The average subscales of burnout were remarkably high among Italian orthopedic nurses, suggesting the need of further studies for obtaining a more exact prevalence of this phenomenon.

Caregivers' knowledge and practice toward pressure ulcer prevention in national orthopedic hospital, Enugu, Nigeria.

INTRODUCTION: Globally, nurses are known to care for hospitalized patients and the presence or absence of pressure ulcers is being regarded as a performance measure of quality nursing care. The study aims to determine the knowledge and practice of caregivers towards pressure ulcer prevention for hospitalized patients in National Orthopaedic Hospital, Enugu. METHOD: A cross sectional descriptive survey design was adopted among eighty-five (85) caregivers who met the inclusion criteria and participated in the study. Ethical approval and informed consent of participants was obtained before data collection using a pre-tested semi-structured questionnaire and checklist. Descriptive analysis and Chi-square statistical test was used to test for association between variables. RESULT: Results revealed poor knowledge 67.3% of pressure ulcer prevention among caregivers. Inadequate staffing 93.5%, heavy workload 92.9%, were highest perceived barriers to pressure ulcer prevention. The test of hypothesis showed that there is a significant relationship between years of service of caregivers and knowledge of pressure ulcer P = 0.000. CONCLUSION: It was concluded that in-service training, recruitment of more staff and ensuring availability of the necessary equipment are some of the important steps to improve nurses' knowledge and practice regarding prevention of pressure ulcer.

Pain Management by Nurses in Level 2 and Level 3 Hospitals in China.

BACKGROUND: Pain management practice differs among hospitals in China; however, no studies have examined the association between hospital level and nursing practice of pain management. AIMS: To evaluate the nursing practice of pain management in orthopedics wards of level 3 and 2 hospitals and compare the differences in pain management regulations, policies, and perceived barriers. DESIGN: This was a cross-sectional descriptive study. SETTING: This study was conducted during the 10th International Congress of the Chinese Orthopedic Association, November 19-22, 2015. PARTICIPANTS: Subjects: The sample included 121 nurses from China. METHODS: Quantitative research methods were used to assess pain management practice by 121 Chinese nurses as well as barriers to nursing practice. RESULTS: Nurses in level 3 hospitals were more likely to evaluate patients' pain intensity (85.23% vs. 65.38%, p < .05) and quality (77.27% vs. 53.85%, p < .05) than those in level 2 hospitals. Compared with level 2 hospitals, level 3 hospitals were more likely to participate in the Painless Orthopedics Ward program (53.41% vs. 23.08%, p < .01), conduct pain management knowledge training (88.64% vs. 69.23%, p < .05), and establish pain management regulations (68.18% vs. 34.62%, p < .01). Level 2 hospital nurses reported a higher score for barriers than level 3 hospital nurses (3.27 vs. 2.45, p < .05). CONCLUSIONS: Nurses from level 2 hospitals received less education on pain management and also paid less attention to and faced more restrictions for pain management than nurses from level 3 hospitals.

Identification of factors influencing patient satisfaction with orthopaedic outpatient clinic consultation: A qualitative study.

BACKGROUND: In recent years, new models of health service delivery in orthopaedic outpatient clinics, including physiotherapists working in orthopaedic triage roles, have become increasingly common. Evaluation of patient satisfaction with orthopaedic clinic services is dependent on an understanding of factors influencing patient satisfaction in this clinical context. OBJECTIVES: The objective of this study was to identify the factors influencing patient satisfaction with orthopaedic outpatient clinic services. STUDY DESIGN: A cross-sectional, qualitative design including focus groups and interviews. METHODS: Interviews and focus group sessions were undertaken with 36 participants representing patients, health professionals and clinical support staff in an orthopaedic outpatient clinic. Interviews and focus groups provided a rich narrative which was subjected to a process of thematic analysis. RESULTS: The analysis identified seven themes influencing patient satisfaction with orthopaedic clinic assessment. These themes were clinic waiting time, clinical contact time, trust, empathy, communication, expectation and relatedness. CONCLUSIONS: Understanding factors influencing patient satisfaction is important to inform organisational and clinical processes that aim to foster high levels of patient satisfaction. Clinician awareness of the interpersonal issues which dominate stakeholders' perspectives of patient satisfaction may improve the patient experience and potentially foster patient behaviours toward a therapeutic advantage. An understanding of these factors in the context of orthopaedic clinics is also important in the development of questionnaires designed to evaluate patient satisfaction with health service delivery.

Análise do registro e conteúdo de checklists para cirurgia segura / Analysis of the registration and content of surgical safety checklists

Analisar e relacionar o registro de informações e conteúdo dos checklists com os objetivos do Programa Cirurgias Seguras Salvam Vidas. Métodos: Pesquisa documental com 257 checklists de cirurgias ortopédicas realizadas de 2011 a 2012 em hospital brasileiro. Os 12.629 itens relativos à segurança cirúrgica alimentaram planilha do programa Excel e foram analisados com auxílio do programa Statistical Package for the Social Sciences. Resultados: 99,8% dos itens do checklist foram verificados e o teor dos registros evidenciam não garantia, por meio da checagem documental, de elementos de segurança relativos ao local cirúrgico certo (objetivo 1), perdas sanguíneas (objetivo 4), reação alérgica (objetivo 5), retenção de instrumentais/compressas (objetivo 7), identificação de espécimes cirúrgicos (objetivo 8) e comunicação (objetivo 9). Conclusão: A alta adesão ao preenchimento do checklist permitiu identificar potenciais riscos cirúrgicos decorrentes de ações de segurança não confirmadas, exigindo ações em busca da qualificação da assistência...

Necessidades de cuidados realizados pelo cuidador ao idoso submetido à cirurgia ortopédica: um estudo Enfermagem Traumato-Ortopédica / Care needs carried out by the older caregiver submitted to orthopedic surgery: a traumato-ortopedic nursing study

O envelhecimento populacional é uma realidade e como consequência dessa longevidade, patologias específicas inerentes à idade aparecem, como as ortopédicas. O idoso com distúrbio ortopédico apresenta por um período curto ou longo de tempo dependendo da sua patologia, comprometimento funcional que demanda orientações, informação e apoio de todos os profissionais capacitados da área de saúde, e é essencial a elaboração de um plano de cuidados voltado para as necessidades individuais. Este estudo foi realizado em uma Enfermaria de Ortopedia de um Hospital Universitário no Município do Rio de Janeiro. A pesquisa teve como objetivos: caracterizar as condições socioeconômicas e cirúrgicas do idoso submetido à cirurgia ortopédica e discutir as demandas de necessidades de cuidados realizados pelo cuidador do idoso no pré e pós-operatório de cirurgia ortopédica. O estudo foi realizado de outubro de 2011 à novembro de 2012. Trata-se de um estudo exploratório ­ descritivo com abordagem quantitativa; tipo Survey. O instrumento de coleta de dados compreendeu as variáveis: idade, gênero, estado civil, profissão/ocupação, dependência econômica, participação na renda familiar, causas da internação e relação entre cuidadores e os indivíduos da pesquisa. A maioria dos participantes da pesquisa possuía idade entre 60 e 89 anos, sendo a média 69,6 anos, eram aposentados (60,0%), casados(56,7%), do gênero feminino (66,3%%), participantes ativos na renda familiar (69,2%) e economicamente dependentes (53,34%). As causas da internação foram variadas com destaque para as: fraturas de fêmur e quadril (12,0%), fraturas do rádio (6,40%), afecções articulares (12,8%), próteses de quadril e joelho (7,2%), lesões na coluna (1,6%) entre outras. Os dados apontaram que foram os familiares (90,0%) que representaram a figura de cuidador durante o período de hospitalização, seguidos dos amigos (6,7%). A pesquisa apontou ainda que, para as atividades: administrar medicamentos, realizar tarefas domiciliares, vestir-se, realizar higiene corporal, realizar atividades fora do lar, à demanda de necessidades de cuidadores dos idosos submetidos á cirurgia ortopédica aumentou. Constatou-se ainda que, o distúrbio traumato-ortopédico provoca uma incapacidade temporária, o que pode causar depressão e afastamento social desses idosos. Dessa forma, a presença do cuidador/familiar durante o processo de hospitalização e recuperação desses indivíduos, é importante fonte de ajuda e conforto e contribuem na manutenção da capacidade funcional desses indivíduos.(AU)

Orthopaedic nurses' knowledge about pressure ulcers in Iran: a cross-sectional study.

OBJECTIVE: To assess nurses' knowledge about pressure ulcers in an Iranian orthopaedic ward. METHOD: A cross-sectional, self-report questionnaire study using Pieper's Pressure Ulcer Knowledge Test (PUKT). Orthopaedic nurses' knowledge about pressure ulcers was examined in two teaching hospitals in Iran. The questionnaire consisted of 41 true or false assertions, categorised according to pressure ulcer classification and onset, wound characteristics and preventive measure. RESULTS: Of 68 nurses, 57 participated in this study (response rate of 84%); of the respondents, 68%(n=39) were women and 32% (n= 18) were men. Mean age of participants was 30.2 ± 5.1 years and mean years of experience was 6.9 ± 4.6 years. The overall rate of correct responses by nurses was 70.1%.Nurses had the highest level of knowledge in the pressure ulcer prevention category and the lowest in the pressure ulcer categorisation and onset section. No relationship was found between level of knowledge and nurses' years of experience. CONCLUSION: Pressure ulcer prevention is one of the most important roles of nurses in an orthopaedic setting. The results of this study suggest that orthopaedic nurses in Iran were not sufficiently knowledgeable about pressure ulcers. Therefore, there is a need to improve their knowledge with some targeted, educational programmes.

A informação como instrumento da assistência em artroplastia total de quadril: um estudo de enfermagem traumato-ortopédica / The degree of importance given by patients in perioperative period of Total Hip Arthroplasty

A Artroplastia Total de Quadril (ATQ) é uma cirurgia de substituição da articulação do quadril e é um tratamento eficaz para doenças degenerativas articulares e fraturas nessa região e tem como objetivo primordial, restabelecer a função coxofemural e melhorar a qualidade de vida. Esta pesquisa tem como objeto a informação como parte da assistência, recebida ou não, pelo paciente no período pré, intra e pós-operatório de Artroplastia Total de Quadril. Os objetivos deste estudo são: identificar as informações recebidas e não recebidas, pelo paciente, relacionadas ao período pré, intra e pós-operatório de Artroplastia Total de Quadril e classificar essas informações quanto ao grau de importância atribuído pelos pacientes no período perioperatório de Artroplastia Total de Quadril. Trata-se de um estudo de abordagem quantitativa, transversal e do tipo Survey. Os dados para esta pesquisa foram coletados em três hospitais de esferas diferentes de governo: um hospital federal (HF), um hospital estadual (HE) e um hospital municipal (HM), no período de outubro de 2010 a outubro de 2011, com o intuito de identificar os pacientes submetidos ou a se submeterem à Artroplastia Total de Quadril. Dos 73 pacientes que participaram desta pesquisa, 24 eram do hospital federal, 7 do hospital estadual e 42 do hospital municipal. Desses, 43 (69%) encontravam-se no período pré-operatório e 30 (41%) no período pós-operatório. Com relação ao sexo dos pacientes que participaram desta pesquisa, 43 eram do sexo feminino (59%) e 30 eram do sexo masculino (41%), mostrando uma prevalência de mulheres com indicação para a cirurgia de ATQ. A idade dos pacientes variou de 29 a 92 anos. A maior frequência dos pacientes do sexo feminino estava na faixa de 50 a 89 anos de idade (88,3%) e do sexo masculino, entre 40 e 89 anos (96,7%).Com relação à causa de indicação para a Artroplastia Total de Quadril, os dados desta pesquisa apontam: fratura, necrose avascular, coxortrose, infecção e revisão...

Low back problems and possible improvements in nursing jobs.

AIM: This paper reports a study that aimed to evaluate the workload, to identify problems leading to the higher incidence rate of work-related low back injury among nurses in the orthopaedic and intensive care unit departments of the hospital, and to gather information about improvements that the nurses would like in the workplace. BACKGROUND: The literature shows that low back injuries are common among nurses, and intervention programmes are needed to address this problem. METHOD: The hospital injury records were examined in a retrospective study. In addition, a validated questionnaire was administered between January and May 2005 to 47 nurses (23 orthopaedic and 24 intensive care nurses). The questionnaire contained questions on workload, history of back injuries, problems, possible solutions and psychophysical measures of exertion. FINDINGS: The life-time incidence and point prevalence of low back pain were 65% and 30%, respectively, in orthopaedic nurses, and 58% and 25%, respectively, in the intensive care nurses. The mean weight handled was reported to be 47 +/- 30 kg by the orthopaedic nurses and 26 +/- 10 kg by the intensive care nurses. The low back scored highest for body-part discomfort - 4.6 and 4.0, respectively, on a 10-point scale. The rate of perceived job exertion was 6.7 +/- 1.8 (very strong), and 5.8 +/- 1.9 (strong) on Borg's 10-point scale. The total effort required by the job, rated on Visual Analogue Scales, was 67 +/- 14% and 68 +/- 15% of the maximum, respectively. The Borg scores and the total effort according to the Visual Analogue Scale, and the Borg scores and force effort on the Visual Analogue Scale were moderately correlated (r = 0.53, P < 0.01 for both comparisons). CONCLUSION: The methodology proposed here is practical for job evaluation and to design a participatory ergonomic intervention aiming at reducing low back injuries in nursing jobs. There are workload differences between nursing jobs. Lifting devices, biomechanical training, bigger rooms, adequate set-up and additional staff are suggested improvements.

Restraint reduction in orthopaedics.

Restraint reduction is a challenge, especially when working with an elderly population. This article describes one orthopaedic unit's successful restraint reduction program. The role of the nurses on the unit is discussed, along with forms that were helpful and the fact that the reduction program fit into the Performance Improvement Plan for the institution. The most frequently used and successful alternatives are discussed. A restraint/seclusion data collection form has been highlighted. Finally, areas for additional research are suggested.

[Patient satisfaction--a study of patients' assessment of the treatment at a department of orthopedic surgery]. / Patienttilfredshed--en undersøgelse af patienters vurdering af behandlingen på en ortopaedkirurgisk afdeling.

A study among day-case and inpatients on an orthopaedic ward has been carried out to assess patient satisfaction. A single-page questionnaire were mailed to 445 patients, 388 (87.2%) returned the questionnaire. Three hundred and fifty five (79.8%) answers were usable. We found an overall rate of satisfaction with the given treatment of 71.3%, 20.3% were dissatisfied. We found the group of day-case patients more satisfied than the group of inpatients. The group of patients who underwent arthroscopic surgery were identified as being the most dissatisfied. There were among all patients a large group who were dissatisfied with the amount of perioperative information and especially the amount of postoperative out-patient control. We recommend a higher degree of written information including information about risk of complications and failures.