Application of enhanced recovery after surgery in perioperative nursing care of elderly patients with hip and knee arthroplasty: A systematic review and meta-analysis.

BACKGROUND: To collect data from randomized controlled trials (RCTs) to evaluate the effects of enhanced recovery after surgery on postoperative recovery of elderly patients who underwent hip or knee arthroplasty. METHODS: The search was limited to studies published prior to January 1, 2023, in the electronic databases of Cochrane, Embase, Ovid Medline, Proquest, PubMed, Scopus, Web of Science, and Chinese databases, including China National Knowledge Internet (CNKI) and SinoMed. All relevant data were collected from the studies that met the inclusion criteria. The outcome variables were recovery of joint function and incidence of complications. STATA software (version 14.0) was used for the meta-analysis. RESULTS: A total of 44 published studies met the inclusion criteria. The cumulative data included 2203 cases receiving enhanced recovery after surgery (ERAS), and 2173 cases receiving traditional recovery after surgery (non-ERAS). The meta-analysis showed that the VAS score was significantly lower in the ERAS group than in the non-ERAS group (P < .01), and there were fewer incidences of complications in the ERAS group than in the control group (P < .01). CONCLUSIONS: ERAS significantly reduced pain and the incidence of complications in elderly patients who had undergone joint replacement surgery.

Effects of operating room nursing intervention on wound infection in patients undergoing ovarian cysts surgery: A meta-analysis.

We conducted this study aimed to explore the effect of operating room nursing intervention on wound infection in patients undergoing ovarian cysts surgery. A computer system was used to search PubMed, Web of Science, EMBASE, Cochrane Library, Wanfang, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure databases, from database inception to October 2023, for randomised controlled trials (RCTs) on the application of operating room nursing intervention to ovarian cyst surgery. Literature that met the requirements was independently screened by two researchers, and data were extracted and assessed for literature quality. RevMan 5.4 software was applied for data analysis. Fifteen RCTs involving 1187 patients were finally included. The analyses revealed that, compared with routine nursing, the implementation of operating room nursing intervention had a significant advantage in reducing the incidence of wound infections (1.17% vs. 5.44%, odds ratio [OR]: 0.30, 95% confidence interval [CI]: 0.15-0.58, p = 0.0004) and postoperative complications (6.34% vs. 25.17%, OR: 0.20, 95%CI: 0.13-0.29, p < 0.00001), as well as being able to shorten the operative time (standardised mean difference [SMD]: -3.93, 95%CI: -5.67 to -2.20, p < 0.00001), hospital length of stay (SMD: -2.54, 95%CI: -3.19 to -1.89, p < 0.00001) and gastrointestinal recovery time (SMD: -1.61, 95%CI: -2.24 to -0.98, p < 0.00001) in patients undergoing ovarian cysts surgery. This study confirmed by meta-analysis that the operating room nursing intervention can significantly reduce the incidence of wound infection and complications, shorten the operative time, gastrointestinal recovery time, and hospital length of stay after ovarian cyst surgery.

Systematization of perioperative nursing care in robotic surgery: instrument validation.

OBJECTIVE: To develop and validate an instrument to assist in the systematization of perioperative nursing care in robotic surgery. METHODS: Methodological study developed in four phases: content survey; textual elaboration; content validation by the group of expert judges and target audience; and elaboration of the electronic instrument layout. RESULTS: Eleven expert judges and seven evaluators of the target audience participated. For validation, the Content Validity Index (CVI) was used with a 0.78 cutoff point. The instrument total CVI after evaluation was 0.90 by the expert judges and 0.88 by the target audience. CONCLUSION: The tool built was proved satisfactory for the systematization of perioperative nursing care. The instrument construction was based on the updated scientific literature and validated by the expert judges and target audience.

Pacientes em pós-operatório imediato: recepção na unidade clínico-cirúrgica / Patients in the immediate postoperative period: admission to the clinical and surgical unit

Objetivo: Analisar a demanda de enfermagem nos cuidados de pacientes em pós-operatório imediato, desde sua recepção do centro cirúrgico até sua acomodação ao leito na unidade de internação. Métodos: Estudo prospectivo e analítico. A população foi constituída por pacientes adultos, egressos do centro cirúrgico. A amostra foi calculada considerando-se que o serviço realiza uma média de 118 cirurgias ao mês. Considerando que a amostra mínima seria de 91 pacientes com um intervalo de confiança de 95%, optou-se por trabalhar com amostra de 100 pacientes. Os dados foram coletados no momento em que os pacientes eram recebidos da SRPA. Resultados: Os grupos cirúrgicos Angiologia, Coloproctologia, Otorrinolaringologia e Urologia demandaram no máximo dois profissionais de enfermagem. Os grupos de Cirurgia de Cabeça e Pescoço, Cirurgia Plástica, Nefrologia e Ortopedia demandaram pelo menos dois profissionais. O grupo da Coloproctologia teve maior média de tempo de acomodação ao leito. Cerca de 15% dos pacientes demandaram oxigenoterapia, quase 50% receberam analgésicos e 34% estavam usando cateter vesical de demora. Conclusão: O tempo destinado à acomodação dos pacientes variou de 5 a 30 minutos, com média de 15,19 ± 4,7. Não há indícios de que mais ou menos profissionais atuando juntos alterem o tempo de acomodação do paciente. Descritores: Admissão do paciente; Transferência do paciente; Cuidados de enfermagem; Enfermagem perioperatória.

Objective: To analyze the nursing demand in the care of patients in the immediate postoperative period, from their admission to the surgical center to their accommodation in bed in the admission unit. Methods: Prospective and analytical study. The population consisted of adult patients, discharged from the surgical center. The sample was calculated considering that the service performs an average of 118 surgeries per month. Considering that the minimum sample would be 91 patients at a 95% confidence interval, we chose to work with a sample of 100 patients. Data were collected at the time patients were received from the PACU. Results: The Angiology, Coloproctology, Otorhinolaryngology and Urology surgical groups required a maximum of two nursing professionals. The Head and Neck Surgery, Plastic Surgery, Nephrology and Orthopedics groups required at least two professionals. The Coloproctology group had a higher average time of accommodation in bed. About 15% of the patients required oxygen therapy, almost 50% received analgesics and 34% were using an indwelling urinary catheter. Conclusion: The time allocated to the accommodation of patients ranged from 5 to 30 minutes, with an average of 15.19 ± 4.7. There are no indications that a greater or lesser number of professionals acting together alter the accommodation time of the patient. Descriptors: Patient admission; Patient transfer; Nursing care; Perioperative nursing.

Risco de Desenvolvimento de Lesão em Decorrência de Posicionamento Cirúrgico: Estudo Observacional / Risk of Injury Development Due to Surgical Positioning: an Observational Study / Riesgo de Desarrollo de Lesiones Debido al Posicionamiento Quirúrgico: Estudio Observacional

Objetivo:Classificar o risco de desenvolvimento de lesão por posicionamento cirúrgico. Método: Estudo observacional, longitudinal, prospectivo, de abordagem quantitativa realizado em hospital público, com 135 pacientes submetidos à cirurgia eletiva. Utilizaram-se instrumentos contendo caracterização sociodemográfica, clínica e cirúrgica e escala de avaliação de risco para desenvolvimento de lesões decorrentes do posicionamento cirúrgico. Empregaram-se análise descritiva, teste exato de Fisher ou teste χ2 e a medida de associação odds ratio, conforme apropriado. Resultados: A maioria dos participantes era do sexo masculino (51,11%), adulta (52,59%) e foi classificada como maior risco para o desenvolvimento de lesões por posicionamento cirúrgico (51,85%). Ser idoso, hipertensão, diabetes mellitus e cirurgias urológicas foram estatisticamente significativos (p < 0,05) para maior risco de desenvolvimento de lesões. A incidência de lesão por pressão foi de 0,74%, com observação apenas na região sacra. Conclusão: Verificou-se maior risco para desenvolvimento de lesão em decorrência do posicionamento cirúrgico e baixa incidência de lesão por pressão. A enfermagem perioperatória deve incorporar à prática assistencial ferramentas validadas de mensuração de risco para um cuidado seguro, individualizado e de qualidade aos pacientes cirúrgicos.

Objective:To classify the risk of developing injury due to surgical positioning. Method: Observational, longitudinal, prospective study with a quantitative approach carried out in a public hospital, with 135 patients undergoing elective surgery. Instruments containing sociodemographic, clinical, and surgical characteristics and a risk assessment scale for the development of injuries due to surgical positioning were used. Descriptive analysis, Fisher's exact test or χ2 test and odds ratio association measure were used as appropriate. Results: Most participants were male (51.11%), adults (52.59%) and were classified as having a higher risk for developing injuries due to surgical positioning (51.85%). Elderly, hypertension, diabetes mellitus and urological surgeries were statistically significant (p < 0.05) for a higher risk of developing lesions. The incidence of pressure injuries was 0.74%, with observation only in the sacral region. Conclusion: There was a greater risk of developing lesions due to surgical positioning and low incidence of pressure injury. Perioperative nursing should incorporate validated risk measurement tools into care practice for safe, individualized and quality care for surgical patients,

Objetivo:Clasificar el riesgo de desarrollar lesión por posicionamiento quirúrgico. Método: Estudio observacional, longitudinal, prospectivo, con abordaje cuantitativo, realizado en un hospital público, con 135 pacientes sometidos a cirugía electiva. Se utilizaron instrumentos que contenían características sociodemográficas, clínicas y quirúrgicas y una Escala de Evaluación de Riesgo para el Desarrollo de Lesiones por Posicionamiento Quirúrgico. Se utilizó el análisis descriptivo, la prueba exacta de Fisher, o chi-cuadrado y la medida de asociación odds ratio, según corresponda. Resultados: La mayoría de los participantes eran hombres (51,11 %), adultos (52,59 %) y se clasificaron con mayor riesgo de desarrollar lesiones debido al posicionamiento quirúrgico (51,85 %). Ancianos, hipertensión, diabetes mellitus y cirugías urológicas fueron estadísticamente significativos (p ˂ 0,05) para mayor riesgo de desarrollar lesiones. La incidencia de lesiones por presión fue del 0,74%, observándose solo en la región sacra. Conclusión: Hubo un mayor riesgo de desarrollar lesiones debido al posicionamiento quirúrgico y una baja incidencia de lesión presión. La enfermería perioperatoria debe incorporar herramientas validadas de medición del riesgo en la práctica asistencial para una atención segura, individualizada y de calidad a los pacientes quirúrgicos.

Validación clínica de la propuesta diagnóstica de enfermería de sed perioperatoria / Clinical validation of the nursing diagnostic proposition perioperative thirst / Validação clínica da proposição diagnóstica de enfermagem sede perioperatória

Objetivo: verificar la validez clínica de la proposición de un nuevo diagnóstico de enfermería denominado sed perioperatoria, basado en la precisión diagnóstica de sus indicadores clínicos, incluyendo la magnitud del efecto de sus factores etiológicos. Método: estudio de validación clínica diagnóstica con 150 pacientes quirúrgicos en un hospital universitario. Se recogieron variables sociodemográficas e indicadores clínicos relacionados con la sed. Se utilizó la técnica de análisis de clases latentes. Resultados: se propusieron dos modelos de clases latentes para las características definitorias. El modelo ajustado en el preoperatorio incluía: labios resecos, saliva espesa, lengua espesa, ganas de beber agua, informe del cuidador, garganta seca y deglución constante de saliva. En el postoperatorio: sequedad de garganta, saliva espesa, lengua espesa, constante deglución de saliva, ganas de beber agua, mal gusto en la boca. Los factores relacionados "temperatura ambiente elevada" y "sequedad de boca" se asocian a la presencia de sed, así como las condiciones asociadas "uso de anticolinérgicos" e "intubación". La prevalencia de sed fue del 62,6% en el preoperatorio y del 50,2% en el postoperatorio inmediato. Conclusión: la proposición diagnóstica de la sed perioperatoria mostró buenos parámetros de precisión de sus indicadores clínicos y efectos etiológicos. Esta propuesta en una taxonomía de enfermería permitirá una mayor visibilidad, apreciación y tratamiento de este síntoma.

Objective: to verify the clinical validity of the proposition of a new nursing diagnosis called perioperative thirst, based on the diagnostic accuracy of its clinical indicators, including the magnitude of effect of its etiological factors. Method: clinical diagnostic validation study with a total of 150 surgical patients at a university hospital. Sociodemographic variables and clinical indicators related to thirst were collected. The latent class analysis technique was used. Results: two models of latent classes were proposed for the defining characteristics. The model adjusted preoperatively included: dry lips, thick saliva, thick tongue, desire to drink water, caregiver report, dry throat and constant swallowing of saliva. In the postoperative period: dry throat, thick saliva, thick tongue, constant swallowing of saliva, desire to drink water, bad taste in the mouth. The factors related to "high ambient temperature" and "dry mouth" are associated with the presence of thirst, as well as the associated conditions "use of anticholinergics" and "intubation". The prevalence of thirst was 62.6% in the pre and 50.2% in the immediate postoperative period. Conclusion: the diagnostic proposition of perioperative thirst showed good accuracy parameters for its clinical indicators and etiological effects. This proposition in a nursing taxonomy will allow greater visibility, appreciation and treatment of this symptom.

Objetivo: verificar a validade clínica da proposição de um novo diagnóstico de enfermagem denominado sede perioperatória, com base na acurácia diagnóstica de seus indicadores clínicos, incluindo a magnitude de efeito de seus fatores etiológicos. Método: estudo de validação clínica diagnóstica com 150 pacientes cirúrgicos em um hospital universitário. Foram coletadas variáveis sociodemográficas e indicadores clínicos relacionados à sede. Empregou-se a técnica de análise de classe latente. Resultados: dois modelos de classes latentes foram propostos para as características definidoras. O modelo ajustado no pré-operatório incluiu: lábios ressecados, saliva grossa, língua grossa, vontade de beber água, relato do cuidador, garganta seca e constante deglutição de saliva. No pós-operatório: garganta seca, saliva grossa, língua grossa, constante deglutição de saliva, vontade de beber água, gosto ruim na boca. Os fatores relacionados Temperatura do ambiente elevada e Boca seca estão associados à presença de sede, assim como as condições associadas Utilização de anticolinérgicos e Intubação. A prevalência de sede foi de 62,6% no pré-operatório e 50,2% no pós-operatório imediato. Conclusão: a proposição diagnóstica de sede perioperatória apresentou bons parâmetros de acurácia de seus indicadores clínicos e efeitos etiológicos. Essa proposição em uma taxonomia de enfermagem permitirá maior visibilidade, valorização e tratamento desse sintoma.

Guidelines in Practice: Medication Safety.

Medication errors are preventable events that health care professionals, consumers, and medication manufacturers report to the US Food and Drug Administration. The agency receives more than 100,000 medication-related reports each year, and some reports involve patient death. A variety of sources provide perioperative nurses with information on interventions and practices to prevent medication errors, including the US Pharmacopeia, The Joint Commission, medication manufacturers' instructions for use, safety data sheets, and the updated AORN "Guideline for medication safety." This article provides an overview of the guideline and discusses recommendations for organizational oversight, procurement and storage, retrieval and preparation, labeling, and hazardous medications. It also includes a scenario that illustrates perioperative nursing practices for administering an antineoplastic medication intraoperatively. Perioperative nurses should review the guideline in its entirety and implement recommendations in operative or procedural settings.

Effectiveness of perioperative family-centered educational interventions in the anxiety, pain and behaviors of children/adolescents and their parents: Systematic Review Protocol / Eficacia de las intervenciones educativas perioperatorias familiares centradas en la ansiedad, el dolor y las conductas de las personas menores y adolescentes y de sus progenitores: protocolo de revisión sistemática

Introduction: Every year, millions of children and adolescents undergo surgery, 50%-75% of them experience fear and anxiety. Children are particularly susceptible to stress and anxiety surrounding surgery as a result of their cognitive development, previous experiences, and knowledge about healthcare; this leads to additional interventions to prevent and reduce these symptoms. Objective: To evaluate the effectiveness of family-centered educational interventions in the children's and adolescents' anxiety, pain, and behaviors and their parents' anxiety during the perioperative period. Methods: This review will follow the Joanna Briggs Institute guidelines for systematic reviews of effectiveness and will consider those studies (experimental and quasi-experimental) in which perioperative educational interventions have been applied to children and adolescents and their parents; these studies measured children and adolescents' pain, anxiety, and behaviors, as well as their parent's anxiety. An initial search of MEDLINE and CINAHL will be followed by a second search for published and unpublished studies from January 2007 on, available in English, Spanish and Portuguese. After all full texts are retrieved, the methodological quality assessment and data extraction will be independently and critically evaluated by two reviewers, and the data will then be presented in a tabular format. An explanatory synthesis will accompany the results. Whenever possible, a meta-analysis will be performed, and a Grading of Recommendations, Assessment, Development, and Evaluation Summary of Findings will be presented. Expected Results: This review will provide guidance on how family-centred educational interventions can be used as a resource to manage anxiety, pain, and behavior in children, adolescents and their relatives during the perioperative processes.

Introducción: Cada año, millones de personas menores y adolescentes se someten a cirugía, de las cuales entre el 50-75 % experimenta miedo y ansiedad. Las niñas y los niños son particularmente susceptibles al estrés y la ansiedad que rodea a la cirugía, como resultado de su desarrollo cognitivo, experiencias previas y conocimiento de la salud, lo que requiere intervenciones para prevenir y reducir estos síntomas. Objetivo: Esta revisión tiene como objetivo evaluar la efectividad de las intervenciones educativas familiares centradas en la ansiedad, el dolor y los comportamientos de las personas menores y adolescentes y de sus progenitores en el período perioperatorio. Métodos: Esta revisión seguirá las pautas del Instituto Joanna Briggs para revisiones sistemáticas de efectividad y considerará estudios experimentales y cuasiexperimentales en los que las intervenciones educativas perioperatorias para medir el dolor, la ansiedad y los comportamientos en niñas, niños y adolescentes y la ansiedad de sus progenitores. Se ha realizado una búsqueda inicial limitada de MEDLINE y CINAHL. Además, una segunda búsqueda de estudios publicados y no publicados de enero de 2007 disponibles en inglés, español y portugués. Una vez recuperados los textos completos, dos revisores evaluarán críticamente, de forma independiente, la calidad metodológica y la extracción de datos y se presentarán en forma de tabla. Una síntesis narrativa acompañará a los resultados y, si es posible, se realizará un metanálisis y se presentará un Grading of Recommendations, Assessment, Development and Evaluation. Resultados esperados: Esta revisión brindará orientación sobre cómo las intervenciones educativas centradas en la familia pueden usarse como un recurso para controlar la ansiedad, el dolor y el comportamiento en niñas, niños, adolescentes y sus familias en el contexto perioperatorio.

Introdução: Todos os anos, milhões de crianças e adolescentes são submetidos a cirurgias e 50-75% apresentam medo e ansiedade. Crianças/adolescentes são particularmente suscetíveis ao stress e ansiedade em torno da cirurgia devido ao seu desenvolvimento cognitivo, experiências anteriores e conhecimento que possuem sobre os cuidados de saúde, necessitando de intervenções para a prevenção/redução destes sintomas. Objetivo: Avaliar a eficácia de intervenções educacionais centradas na família na ansiedade, dor e comportamentos de crianças/adolescentes e ansiedade dos pais no período perioperatório. Métodos: Esta revisão seguirá a metodologia do Instituto Joanna Briggs para revisões sistemáticas de eficácia e considerará estudos (experimentais e quase-experimentais) em que as intervenções educacionais perioperatórias tenham sido aplicadas a crianças/ adolescentes e seus pais e avaliadas a dor, ansiedade e comportamento em crianças/adolescentes e ansiedade dos pais como resultados. Uma pesquisa inicial limitada de MEDLINE e CINAHL foi realizada. Será seguida por uma segunda busca por estudos publicados e não publicados de janeiro de 2007 disponíveis em inglês, espanhol e português. Após a recuperação dos textos completos, a avaliação da qualidade metodológica e a extração de dados serão avaliadas de forma crítica e independente por dois revisores e apresentadas em forma de tabela. Uma síntese narrativa acompanhará os resultados e, se possível, uma meta-análise será realizada e um resumo das Grading of Recommendations, Assessment, Development and Evaluation apresentado. Resultados esperados: Esta revisão fornecerá orientações sobre como as intervenções educativas centradas na família podem ser utilizadas como um recurso para gestão da ansiedade, dor e comportamento em crianças, adolescentes e suas famílias no contexto perioperatório.

Pain Management Knowledge and Attitudes for Surgical Nursing Students.

BACKGROUND: Pain is considered as one of the most common factors that cause people to seek medical care. An important responsibility of health professionals is to manage pain, and nurses play a crucial role in it. Therefore, nursing students must have pain management knowledge and skills to fulfill this role. AIM: The objective of the study was to examine pain management knowledge and attitudes of nursing students who had taken a surgical nursing course. METHODS: This descriptive, cross-sectional study was conducted with volunteer second-year undergraduate nursing students (n = 260) from two universities in Turkey. The Knowledge and Attitudes Survey Regarding Pain and a student demographic information form were used for data collection. Data were analyzed with descriptive statistics, t test and variance analysis. RESULTS: The mean score on the Knowledge and Attitudes Survey Regarding Pain was 6.78 ± 2.23. Of all the students, 48.8% reported that they only preferred pharmacologic treatments for pain management. The mean score on the Knowledge and Attitudes Survey Regarding Pain significantly differed in terms of the type of high school (p = .044) and the unit for clinical education (p = .025). CONCLUSIONS: The students had a moderate mean score on the Knowledge and Attitudes Survey Regarding Pain. The students who graduated from high school and those who received their clinical education in cardiovascular and thoracic surgery units had significantly higher mean scores on pain management knowledge and attitudes.

Estratégias para melhorar a segurança do paciente cirúrgico / Strategies to improve surgical patient safety

Objetivo: O presente estudo objetiva refletir sobre quais estratégias melhoram a segurança do paciente cirúrgico. Método: Revisão narrativa, realizada em janeiro de 2023 com base em artigos publicados em periódicos e documentos de órgãos oficiais dos anos de 2010 a 2022. Os dados foram categorizados pela análise temática de Bardin. Resultados: organizados em três categorias: O primeiro deles abordou-se "Eventos Adversos e as Práticas Cirúrgicas", no segundo, a "Segurança do Paciente", e por último foi abordado "Lista de verificação de segurança cirúrgica e sistematização de assistência de enfermagem como estratégias de segurança do paciente". Conclusão: As ferramentas investigadas são inerentes à atuação da enfermagem cirúrgica que contribuem com a prática acadêmica ao reforçar a importância da aplicação de instrumentos que contemplem a segurança do paciente, sobretudo na conjuntura atual(AU)

Objective: This study aims to reflect on which strategies improve surgical patient safety. Method: Narrative review, carried out in January 2023 based on articles published in journals and documents from official bodies from 2010 to 2022. Data were categorized using Bardin's thematic analysis. Results: organized into three categories: The first of them addressed "Adverse Events and Surgical Practices", in the second, "Patient Safety", and finally, "Checklist of surgical safety and systematization of nursing care as patient safety strategies. Conclusion: The investigated tools are inherent to the performance of surgical nursing that contribute to academic practice by reinforcing the importance of applying instruments that address patient safety, especiall in the current situation(AU)

Objetivo: Este estudio pretende reflexionar sobre qué estrategias mejoran la seguridad del paciente quirúrgico. Método: Revisión narrativa, realizada en enero de 2023 a partir de artículos publicados en revistas y documentos de organismos oficiales de 2010 a 2022. Los datos fueron categorizados mediante el análisis temático de Bardin. Resultados: organizados en tres categorías: la primera de ellas abordó "Eventos Adversos y Prácticas Quirúrgicas", en la segunda, "Seguridad del Paciente", y finalmente, "Lista de verificación de seguridad quirúrgica y sistematización de los cuidados de enfermería como estrategias de seguridad del paciente. Conclusión: Las herramientas investigadas son inherentes al desempeño de la enfermería quirúrgica que contribuyen a la práctica académica al reforzar la importancia de aplicar instrumentos que aborden la seguridad del paciente, especialmente en la situación actual.(AU)

Perioperative Fast-Track Surgery Nursing Intervention for Patients with Kidney Stone Disease under Computed Tomography Imaging.

This research aims to analyze the clinical intervention effect of perioperative fast-track surgery (FTS) nursing on patients with kidney stone disease (KSD) under computed tomography (CT) imaging. One-hundred KSD patients were selected as research objects and grouped after CT examination. These objects were randomly divided into a research group (FTS nursing intervention, n = 50) and a control group (general routine nursing intervention, n = 50). The preoperative psychological status of patients was compared between the two groups, using Self-rating Anxiety Scale and Self-rating Depression Scale. The hunger and thirst situations were compared using Numerical Rating Scale; postoperative recovery time, incidence of complications, and nursing satisfaction were also compared. The high-density shadow could be clearly observed in the right kidney of the patients in the CT imaging examination. The nursing outcomes suggested that there was no notable difference in hunger between the two groups, and anxiety, depression, and thirst in the research group were highly better than those in the control group (P < 0.01). The time of the first exhaust, the time of body temperature returning to normal, the time of getting out of bed, and the length of hospital stay in the research group were all shorter than those in the control group (P < 0.05). The total postoperative satisfaction of the research group (98.00%) was greatly better than the 88.00% in the control group (P < 0.05). As the FTS concept was applied in the perioperative nursing of KSD patients under CT imaging, the preoperative and postoperative negative emotions of patients could be improved. Thereby, the postoperative recovery rate of patients was promoted, postoperative complications and patients' pain were reduced, and the postoperative quality of life of patients was also improved.

Perioperative Nursing Role in Robotic Surgery: An Integrative Review.

PURPOSE: Robotic surgery is an increasingly popular approach across surgical specialties in several countries. Nurses embedded in this highly technological environment, however, could excessively center their attention to the robot, deviating their focus from the patient. The Perioperative Patient Focused Model is proposed as a theoretical framework to guide nursing perioperative care toward a patient-centered approach based on 4 dimensions: Health System, Safety, Behavioral Responses and Physiological Responses. This review aimed to understand the role of perioperative nursing in robotic surgery according to the Perioperative Patient Focused Model. DESIGN: An integrative review. METHODS: The Whittemore and Knafl methodology guided this review. The following databases were searched: PubMed, Cochrane Library, ProQuest, Scielo, and LILACS. The keywords used were "Robotic Surgical Procedures" and "Nursing" and their equivalents in Spanish, Portuguese, and French, using the Boolean operator "AND," within the time frame of 2010-2021. FINDINGS: A total of 1,695 articles were retrieved, of which 26 were retained for the final analysis. The majority (n = 17) were written in English, with a level of evidence between 4 and 5. The main actions performed by nursing professionals were retrieved in the Health Systems, Safety, and Behavioral Responses dimensions, focusing on the intraoperative and postoperative period. However, most of the patient's responses were presented in the postoperative stage, even after discharge. Encompassing these findings, a theoretical framework is proposed. CONCLUSIONS: Nursing professional duties are diverse within the course of robotic surgery. It is necessary to expand the Perioperative Nursing specialty toward an extended care, encompassing even the community settings.

Perianesthesia Nursing.

These nurses care for patients before and after surgery.

Desafios para implementação da SAE perioperatória em pacientes do centro cirúrgico / Challenges for implementing perioperative SAE in surgical center patients / Retos para la implantación del SAE perioperatorio en pacientes de centros quirúrgicos

Introdução: A Sistematização da Assistência de Enfermagem Perioperatória (SAEP) é o alicerce que fornece sustentação nas ações de enfermagem, na promoção de saúde e prevenção de complicações de clientes cirúrgicos. Objetivo: este estudo teve como objetivo conhecer a percepção dos enfermeiros, que assistem pacientes cirúrgicos, sobre a SAEP dentro do contexto da sua prática profissional. Metodologia: Trata-se de uma pesquisa de revisão de literatura de caráter descritiva que implicou na busca de arti- gos científicos de 2012 a 2022, que abordassem as dificuldades que a enfermagem en- contra para a execução da SAEP. Desta forma, foram utilizados apenas publicações que estivessem nas bases de dados SciELO, LILACS, LATINDEX, MIAR. Resultados: Fo- ram identificados inicialmente 414 artigos, após a aplicação dos critérios propostos nove artigos foram selecionados para a amostra. Conclusão: As dificuldades encontradas no exercício profissional da enfermagem no centro cirúrgico estão relacionadas a não com- preensão e a aplicabilidade da SAEP, e também pela falta de recursos humanos, tecnoló- gicos e assistenciais.

Introduction: The Systematization of Perioperative Nursing Care (SAEP) is the foundation that provides support in nursing actions, in health promotion and prevention of complications in surgical clients. Objective: this study aimed to know the perception of nurses, who assist surgical patients, about SAEP within the context of their professional practice. Methodology: This is a descriptive literature review research that involved the search for scientific articles from 2012 to 2022, which addressed the difficulties that nursing encounters in the implementation of SAEP. In this way, only publications that were in the SciELO, LILACS, LATINDEX, MIAR databases were used. Results: Initially, 414 articles were identified, after applying the proposed criteria, nine articles were selected for the sample. Conclusion: The difficulties encountered in the professional practice of nursing in the surgical center are related to the lack of understanding and applicability of the SAEP, and also to the lack of human, technological and assistance resources.

Introducción: La Sistematización de los Cuidados de Enfermería Perioperatoria (SAEP) es el fundamento que proporciona apoyo en las acciones de enfermería, en la promoción de la salud y prevención de complicaciones en los clientes quirúrgicos. Objetivo: este estudio tuvo como objetivo conocer la percepción de las enfermeras, que asisten pacientes quirúrgicos, sobre la SAEP en el contexto de su práctica profesional. Metodología: Se trata de una investigación de revisión bibliográfica descriptiva que implicó la búsqueda de artículos científicos desde 2012 hasta 2022, que abordaran las dificultades que la enfermería encuentra en la implementación del SAEP. De esta forma, sólo se utilizaron publicaciones que estuvieran en las bases de datos SciELO, LILACS, LATINDEX, MIAR. Resultados: Inicialmente, se identificaron 414 artículos, después de aplicar los criterios propuestos, se seleccionaron nueve artículos para la muestra. Conclusiones: Las dificultades encontradas en la práctica profesional de enfermería en el centro quirúrgico están relacionadas con la falta de comprensión y aplicabilidad del SAEP, así como con la falta de recursos humanos, tecnológicos y asistenciales.

A qualitative study of nurse-perceived barriers to body temperature management in postoperative patients.

Although evidence-based practices exist for preventing hypothermia in patients during surgery, few studies have focused on this concern in postoperative patients. The aim of this qualitative study was to explore the most challenging issues experienced by surgical ward nurses while managing the body temperature of adult surgical patients. To address this research gap, this study used a qualitative descriptive design to document barriers to body temperature management as reported by a sample of 16 perioperative nurses. The semi-structured, face-to-face interviews were digitally recorded, transcribed verbatim and analysed using inductive content analysis. The main barriers fell into three categories: professional nursing ability limitations, unfavourable working conditions and management of human resources. The eight subcategories were disadvantageous professional views, professional knowledge limitations, low motivation to provide nursing care, non-standard treatment environment, inadequate equipment and care protocols, heavy nursing care loads, inadequate staff training and ineffective staff supervision. These findings highlighted the importance of adequate resources, proper education and evidence-based care protocols in the effective delivery of body temperature management to postoperative patients.

The Relationship Between Perioperative Care Quality and Postoperative Comfort Level in Patients With Hip Replacement Surgery.

PURPOSE: To examine the relationship between perioperative care quality and postoperative comfort level of patients undergoing hip replacement surgery. DESIGN: This is a descriptive study. METHODS: This study was conducted with 90 patients between February and September 2021 in a training and research hospital in Turkey. Data were collected from Information Form, the Good Perioperative Nursing Care Scale (for Patients) (GPNCS), and the Post Hip Replacement Comfort Scale (PHRCS). FINDINGS: The mean age of the patients was 65.58 ± 15.10 years. The mean total scores of the patients in GPNCS and PHRCS were 134.61 ± 16.29 and 3.58 ± 0.40, respectively. In the correlation analysis, a statistically significant and positive weak relationship was determined between GPNCS and PHRCS, and as the quality of care during the surgery increases, the postoperative comfort levels increase (r = 0.253, P < .05). CONCLUSIONS: Ensuring the comfort of patients during the surgery as well as in the pre-, intra- and postoperative period is necessary and important for the quality of care. In addition, since the quality of the care during surgery is effective on the postoperative comfort levels of the patients, quality nursing care is required pre-, intra-, and postoperative periods.

Effect of Roy's Adaptation, Model-based, Perioperative Nursing Service on Patients: A Clinical Observational Study.

Context: Surgery for early-stage lung carcinoma (LC) is invasive and most patients will experience psychological disorders, such as depression and anxiety. Accumulating evidence has shown that a nursing intervention can exert significant improvements in clinical efficacy for perioperative patients. Objective: The study intended to investigate the clinical value during the perioperative period of a nursing service based on Roy's Adaptation Model (RAM), for patients undergoing radical resection for early-stage LC, to provide accurate guidance and reference for a future clinical nursing intervention for LC patients. Design: The research team designed a retrospective analysis, controlled study. Setting: The study took place at Jiangsu Cancer Hospital in Nanjing, Jiangsu, China. Participants: Participants were 69 patients with early-stage LC who had been admitted to the hospital between March 2018 and March 2020. Intervention: The research team assigned participants to an intervention or a control group, with 42 participants in the intervention group receiving RAM nursing during hospitalization, and 27 participants in the control group receiving routine nursing care. Outcome Measures: The study measured the alterations in pulmonary function (PF) pre- and postoperatively and assessed the incidence of complications postintervention. At baseline and postintervention, the research team also assessed participants' psychological states using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) and their pain levels using a visual analogue scale (VAS). Postintervention, participants competed a nursing satisfaction survey. At baseline and postintervention, the participants completed the Karnofsky Performance Status (KPS) scale for functional status, the Self-Perceived Burden Scale in Cancer Patients (SPBS-CP), the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the WHO-QOL-BREF questionnaire. Results: Postoperatively, the PF indexes had decreased significantly for both groups, but the intervention group's value were significantly higher postoperatively than those in the control group (P < .05). No differences existed in the incidence of adverse reactions between the groups (P > .05). The intervention group had significantly lower SAS and SDS scores, pain scores, and SPBS-CP scores than the control group postintervention but had significantly higher KPS scores (all P < .05). The intervention group significantly higher nursing satisfaction, sleep quality, and quality of life than the control group did (P < .05). Conclusions: RAM nursing can significantly protect the PF of patients with early-stage LC who are undergoing a radical resection and can effectively improve patients' psychological states, sleep quality, and nursing satisfaction, which makes it worthy of clinical reference and popularization.

Transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program prevents subsyndromal delirium in older patients after joint replacement.

OBJECTIVES: This study aimed to develop transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program and evaluate its effects on preventing subsyndromal delirium (SSD) and postoperative delirium (POD) in older patients after joint replacement surgery. METHODS: Participants were randomly divided into two groups, the experimental group (n = 48) was given transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program based on the routine care of the control group (n = 49). The incidence of SSD and POD in a week after surgery was recorded. Assessments of delirium severity, cognition, anxiety, and depression were also conducted at baseline and on postoperative day 7. RESULTS: The findings indicate that the intervention program had significant advances in alleviating the severity of delirium, cognitive impairment, anxiety, and depression but failed to reduce the incidence of SSD and POD. CONCLUSIONS: Our study indicated that TEAS combined with an integrated perioperative nursing program has a beneficial effect on alleviating symptoms of delirium, cognitive dysfunction, anxiety, and depression in older adults after joint replacement surgery.