Música como promotora da saúde na sala de espera de cirurgia: percepções de acompanhantes / Music as a health promoter in the surgery waiting room: companions' perceptions / La música como promotora de salud en la sala de espera de cirugía: percepciones de los acompañantes

Objetivo: compreender as percepções dos acompanhantes que aguardam notícias de seus entes queridos que estão em cirurgia, sobre a utilização da música como estratégia para promover saúde no hospital. Método: estudo descritivo, exploratório, qualitativo, fundamentado nos pressupostos teóricos da Promoção da Saúde, com a participação de 15 acompanhantes que aguardavam notícias de seus entes queridos em uma sala de espera no ambiente hospital. Realizaram-se entrevistas semiestruturadas e os dados foram organizados e analisados conforme análise de conteúdo. Resultados: os participantes destacaram algumas possibilidades para promover saúde na sala de espera de cirurgia do hospital, como a música, a qual proporciona distração da realidade preocupante, felicidade, vida, alegria, esperança, sensações boas, ânimo e tranquilidade. Considerações finais: a música destaca-se como tecnologia para promover saúde, despertando sentimentos positivos durante as intervenções musicais no hospital. Portanto, faz-se necessário ampliar a discussão e utilização da música como estratégia para promover saúde no âmbito hospitalar

Objective: to understand the perceptions of companions awaiting news from their loved ones who are undergoing surgery, about the use of music as a strategy to promote health in the hospital. Method: a descriptive, exploratory, qualitative study, based on the theoretical assumptions of Health Promotion, with the participation of 15 companions who were waiting for news from their loved ones in a waiting room in the hospital environment. Semi-structured interviews were carried out and the data were organized and analyzed according to content analysis. Results: the participants highlighted some possibilities to promote health in the hospital surgery waiting room, such as music, which provides distraction from the worrying reality, happiness, life, joy, hope, good feelings, cheer and tranquility. Final considerations: music stands out as a technology to promote health, arousing positive feelings during musical interventions in the hospital. Therefore, it is necessary to expand the discussion and use of music as a strategy to promote health in the hospital environment

Objetivo: comprender las percepciones de acompañantes en espera de noticias de sus seres queridos que están siendo operados, sobre el uso de la música como estrategia de promoción de la salud en el hospital. Método: estudio descriptivo, exploratorio, cualitativo, basado en los presupuestos teóricos de la Promoción de la Salud, con la participación de 15 acompañantes que esperaban noticias de sus seres queridos en una sala de espera del ambiente hospitalario. Se realizaron entrevistas semiestructuradas y los datos fueron organizados y analizados según el análisis de contenido. Resultados: los participantes destacaron algunas posibilidades para promover la salud en la sala de espera de cirugía hospitalaria, como la música, que proporciona distracción de la realidad preocupante, alegría, vida, alegría, esperanza, buenos sentimientos, alegría y tranquilidad. Consideraciones finales: la música se destaca como tecnología para promover la salud, despertando sentimientos positivos durante las intervenciones musicales en el hospital. Por lo tanto, es necesario ampliar la discusión y el uso de la música como estrategia de promoción de la salud en el ámbito hospitalario

Leveraging Academic-Clinical Partnerships to Create an Operating Room Nurse Pipeline.

This article describes an academic-clinical partnership program between a school of nursing and an American Nurse Credentialing Center Magnet®- and National Cancer Institute-designated Comprehensive Cancer Center based on a shared vision and multifaceted for optimal new graduate operating room (OR) recruitment and use of clinical partner resources. The program, now in its 3rd year, has a 100% retention rate among the cohorts. Implementing a multifaceted OR partnership program based on nursing theory is a strategy for workforce development to increase retention of new graduate OR nurses.

Perception of care quality and ethical sensitivity in surgical nurses.

BACKGROUND: It is stated that high ethical sensitivity positively affects the quality of nursing care. However, the relationship between nursing care quality and ethical sensitivity has not been clearly demonstrated in researches. AIM: This study was carried out to determine the relationship between surgical nurses' care behaviors and their ethical sensitivity. METHOD: The sample of this cross-sectional, descriptive-correlational study consists of 308 nurses who worked at the surgical departments in four Turkish hospitals. The data were collected using the "Nurse Description Form" developed by the researcher, "Caring Behaviours Inventory-24" and "Ethical Sensitivity Questionnaire." Data were evaluated by the Mann Whitney U test, Kruskal Wallis one-way analysis of variance and Spearman correlation analysis. ETHICAL CONSIDERATIONS: The study was approved by the ethics committee. Verbal and written consent was received from the nurses. RESULTS: It was found in the study that nurses' Caring Behaviours Inventory-24 total score median was 5.25 (4.83-5.58), nurses' perception level of caring quality was high, median of Ethical Sensitivity Questionnaire total score was 89.00 (75.00-101.00) and nurses' ethical sensitivity was moderate. A negative significant relation was found between nurses' Caring Behaviours Inventory-24 total score and Ethical Sensitivity Questionnaire total score (r = -0.162; p = 0.009). A negative relation was also detected between nurses' working period at the current clinic and providing benefit (r = -0.147; p = 0.012), holistic approach (r = -0.139; p = 0.018) and orientation (r = -0.175; p = 0.003) scores of Ethical Sensitivity Questionnaire sub-scales. CONCLUSION: Nurses' perception levels of caring quality were high and their ethical sensitivity levels were moderate. It was found out that nurses' ethical sensitivity increased together with their perception of caring quality, and as their working period at the current clinic increased, the ethical sensitivity also increased in terms of the sub-scales of providing benefit, holistic approach, and orientation. The factors that adversely affect the quality of nursing care and ethical sensitivity should be examined and attempts should be made to improve the working environment.

Bacteremia in the red blood cells obtained from the cell saver in patients submitted to heart surgery / Bacteremia nos glóbulos vermelhos obtidos do "cell saver" em pacientes submetidos a cirurgia cardíaca / Bacteriemia en los glóbulos rojos obtenidos del "cell saver" en pacientes intervenidos de cirugía cardíaca

Objective: to determine the microbiological characteristics of the red blood cells obtained with the cell saver in heart surgery patients on an extra-body circuit. Method: a cross-sectional and descriptive study conducted with 358 patients scheduled for heart surgery where the saver was used. Sociodemographic variables were collected, as well as from the saver and of the microbial identification in the re-infusion bag proceeding from the cell saver. Informed consent performed. Results: of the 170 GRAM+ bacteria isolations, the most frequent species were Staphylococcus epidermidis in 69% (n=138) of the cases and Streptococcus sanguinis with a report of 10% (n=20). Significant differences were found in the Staphylococcus epidermidis strain in patients with a Body Mass Index ≥25 (p=0.002) submitted to valve surgery (p=0.001). Vancomycin was the antimicrobial which resisted the Staphylococcus epidermidis strain with a minimum inhibitory concentration of >16 µg/ml. Conclusion: the microbiological characteristics of the red blood cells obtained after processing autologic blood recovered with the cell saver during heart surgery are of GRAM+ bacterial origin, the most isolated species being Staphylococcus epidermidis. Consequently, in order to reduce the presence of these GRAM+ cocci, an antibiotic should be added to the cell saver reservoir, according to a previously established protocol.

Objetivo: determinar as características microbiológicas dos glóbulos vermelhos obtidos com o "cell saver" em pacientes submetidos à cirurgia cardíaca em circuito extracorpóreo. Método: estudo descritivo transversal com 358 pacientes de cirurgia cardíaca em que o "cell saver" foi utilizado. Foram coletadas variáveis sociodemográficas e identificação microbiana da bolsa de reinfusão do "cell saver". Foi confirmado o Termo de Consentimento. Resultados: das 170 baterias isoladas GRAM+, as mais frequentes foram Staphylococcus epidermidis em 69% (n=138) dos casos e Streptococcus sanguinis com um registro de 10% (n=20). Diferenças significativas foram encontradas na cepa Staphylococcus epidermidis em pacientes com índice de massa corporal ≥25 (p=0,002) submetidos a cirurgia valvular (p=0,001). A vancomicina foi o antimicrobiano resistente à cepa Staphylococcus epidermidis com uma concentração inibitória mínima >16 µg/ml. Conclusão: as características microbiológicas dos glóbulos vermelhos obtidas após o processamento do sangue autólogo recuperado com o "cell saver" em cirurgia cardíaca são de origem bacteriana GRAM+, sendo a espécie mais isolada o Staphylococcus epidermidis. Portanto, para reduzir a presença desses cocos GRAM+, um antibiótico deve ser adicionado ao "cell saver", de acordo com um protocolo previamente estabelecido.

Objetivo: determinar las características microbiológicas de los glóbulos rojos obtenidos con el "cell saver" en el paciente de cirugía cardíaca bajo un circuito extracorpóreo. Método: estudio descriptivo transversal con 358 pacientes programados para cirugía cardíaca donde se utilizó el "cell saver". Se recogieron variables sociodemográficas e identificación microbiana de la bolsa de reinfusión procedente del "cell saver". Consentimiento informado realizado. Resultados: de 170 aislamientos de bacterias GRAM+, las especies más frecuentes fueron el Staphylococcus epidermidis en el 69% (n=138) de los casos y el Streptococcus sanguinis con un reporte del 10% (n=20). Se encontraron diferencias significativas en la cepa Staphylococcus epidermidis en pacientes con índice de masa corporal ≥25 (p=0,002) sometidos a cirugía valvular (p=0,001). La vancomicina fue el antimicrobiano resistente a la cepa Staphylococcus epidermidis con una concentración mínima inhibitoria >16 ug/ml. Conclusión: las características microbiológicas de los glóbulos rojos obtenidos tras el procesamiento de sangre autóloga recuperada con el "cell saver" en cirugía cardíaca son de origen bacteriano GRAM+ siendo la especie más aislada el Staphylococcus epidermidis. Por ello, con el fin de reducir la presencia de estos cocos GRAM+ se debería añadir un antibiótico en el reservorio del "cell saver", según un protocolo previamente establecido.

Vivências de famílias de crianças em intraoperatório: a arte como possibilidade de cuidado / Experiences of families of children in intraoperative period: art as a care option / Vivencias de familias de niños en intraoperatorio: el arte como posibilidad de cuidado

Objetivo: compreender as vivências de famílias de crianças em período intraoperatório, participantes de oficina de biscuit. Método: pesquisa qualitativa, modalidade fenomenológica, realizada em um hospital público, de ensino, localizado no estado de São Paulo, com 13 famílias de crianças em período intraoperatório, após aprovação do comitê de ética, parecer número 2253964. Resultados: as famílias revelaram que o período intraoperatório é o mais crítico, repleto de expectativas sobre o sucesso e/ou insucesso da cirurgia. No entanto, ao participarem da oficina de biscuit, as famílias perceberam novos sentimentos, como calma, tranquilidade, relaxamento, distração e troca de experiências entre as famílias. O uso da arte foi considerado um modo de cuidado à família e seu reconhecimento mobilizou sentimento de gratidão nessas famílias. Conclusão: a oficina de biscuit possibilitou a manifestação de sentimentos positivos, além do reconhecimento desta intervenção como sendo um modo de cuidado à família.

Objective: to understand the experiences of the families of children in the intraoperative period, who were participating in a cold porcelain workshop. Methodology: this phenomenological, qualitative study was conducted at a public teaching hospital in São Paulo state with 13 families of children in the intraoperative period, after research ethics committee approval (Opinion No. 2253964). Results: the families revealed that the intraoperative period is the most critical, and full of expectations about the success and/or failure of surgery. However, by participating in the cold porcelain workshop, the families perceived new feelings of calm, tranquility, relaxation, distraction and sharing of experiences among families. Using art was considered a way of caring for the family, and recognition of that brought out a feeling of gratitude in these families. Conclusion: the cold porcelain workshop allowed people to express good feelings, as well as the acknowledgement that this was a way of caring for the family.

Objetivo: comprender las vivencias de familias de niños en periodo intraoperatorio, participantes de taller de biscuit. Metodología: investigación cualitativa, modalidad fenomenológica, realizada en un hospital público, de enseñanza, localizado en el estado de São Paulo, con 13 familias de niños en periodo intraoperatorio, después de aprobación del comité de ética, dictamen número 2253964. Resultados: las familias revelaron que el periodo intraoperatorio es el más crítico, repleto de expectativas sobre el éxito y/o fracaso de la cirugía. Sin embargo, al participar del taller de biscuit, las familias percibieron nuevos sentimientos, como calma, tranquilidad, relajación, distracción e intercambio de experiencias entre las familias. El uso del arte fue considerado un modo de cuidado a la familia y su reconocimiento ocasionó un sentimiento de gratitud en esas familias. Conclusión: el taller de biscuit posibilitó la manifestación de sentimientos positivos, además del reconocimiento de esta intervención como siendo un modo de cuidado a la familia.

O enfermeiro está preparado frente às complicações ocasionadas pela ventilação mecânica? / Is the nurse prepared for complications caused by mechanical ventilation? / El enfermero está preparado frente a las complicaciones ocasionadas por la ventilación mecánica?

Avaliar o conhecimento de enfermeiros sobre as complicações relacionadas à Ventilação Mecânica. Método: Estudo descritivo, exploratório e de abordagem quantitativa. A coleta de dados foi realizada por meio questionário aplicado a enfermeiros de um hospital de nível terciário no município de Fortaleza/CE, entre fevereiro e julho de 2017 e os resultados foram submetidos à análise estatística simples. Resultados: Dos enfermeiros entrevistados, 50% era especialista, 86,36% informou não ter recebido durante a academia informações suficientes para cuidar de um paciente sob ventilação mecânica e 77,52% dos pesquisados alegou não saber reconhecer as complicações relacionadas à Ventilação Mecânica. Conclusão: Infere-se a necessidade de capacitação e treinamento dos profissionais enfermeiros sobre as complicações relacionadas à ventilação mecânica, para que assim, esses profissionais participem efetivamente da construção do seu processo de práticas baseada em evidências, propagando um cuidado seguro e holístico ao paciente.(AU)

To evaluate nurses' knowledge regarding complications related to mechanical ventilation. Method: Descriptive, exploratory study and using a quantitative approach. The data collection was performed through a questionnaire applied to nurses of a tertiary level hospital in the city of Fortaleza/CE, between February and July 2017 and the results were submitted to simple statistical analysis. Results: Of the nurses interviewed, 50% were specialists, 86.36% reported not having received enough information during college to care for a patient under mechanical ventilation, and 77.52% of the participants claimed that they would not know the complications related to mechanical ventilation. Conclusion: It is inferred the need for training of nurses on complications related to mechanical ventilation, so that these professionals effectively participate in the construction of their process of evidence-based practices, propagating a safe and holistic care to the patient.(AU)

Evaluar el conocimiento de enfermeros sobre las complicaciones relacionadas a la ventilación mecánica. Método: Estudio descriptivo, exploratorio y de abordaje cuantitativo. La recolección de datos fue realizada por medio de un cuestionario aplicado a los enfermeros de un hospital de nivel terciario en el municipio de Fortaleza / CE, entre febrero y julio de 2017 y los resultados fueron sometidos al análisis estadístico simple. Resultados: De los enfermeros entrevistados, 50% eran especialistas, 86,36% informaron no haber recibido durante la academia informaciones suficientes para cuidar de un paciente bajo ventilación mecánica y el 77,52% de los encuestados alegaron que no sabían reconocer las complicaciones relacionadas a la Ventilación Mecánica . Conclusión: Se infiere la necesidad de capacitación y entrenamiento de los profesionales enfermeros sobre las complicaciones relacionadas con la ventilación mecánica, para que así, participen efectivamente de la construcción de su proceso de prácticas basada en evidencias, propagando un cuidado seguro y holístico hacia el paciente.(AU)

The effect of an empathy role-play program for operating room nursing students.

PURPOSE: The purpose of this research was to investigate the effect of a role-playing training program for empathetic communication with patients on empathy scores of operating room nursing students. METHODS: This clinical trial was carried out on 77 operating room nursing students from the first to the fourth years studied in the School of Nursing and Midwifery at Isfahan University of Medical Sciences in the academic year 2017-2018. The intervention administered on the experimental group included a 12-hour training program with the theme of expressing empathy to patients using a role-playing technique. The Jefferson Scale of Empathy-Health Profession Students' Version was completed before, immediately after, and one month after the intervention by the samples. Comparison analysis was done among three stages. RESULTS: Comparing the total mean empathy scores before intervention in the control group and the experimental one did not reveal a significant difference (P=0.50); however, the total mean empathy scores in the experimental group, immediately after and one month after the intervention, was higher than that in the control group (P<0.001). CONCLUSION: Empathy training through a role-playing technique was effective on improving the empathy scores of operating room nursing students and it also highlighted the fact that empathy could be promoted by education. Making changes in educational curriculum of operating room nursing students was indispensable in order to make them familiar with the concept of empathy in operating room.

Sistematização da assistência de enfermagem perioperatória na segurança do paciente: revisão integrativa / Systematization of perioperatory nursing assistance in patient safety: an integrative review / Sistematización de la asistencia de enfermería perioperatoria en la seguridad del paciente: revisión integrativa

Objetivo: Conhecer a abordagem de artigos científicos sobre a sistematização da assistência de enfermagem perioperatória relacionada à segurança do paciente. Método: Revisão integrativa com buscas nas bases de dados da Biblioteca Virtual em Saúde, da National Library of Medicine (PubMed) e dos periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). Artigos avaliados conforme o nível de evidência utilizando o instrumento de avaliação proposto pela Joanna Briggs Institute (JBI). Resultados: Identificaram-se dez artigos, sendo oito publicados em periódicos nacionais e dois em internacionais. Os estudos foram classificados conforme níveis de evidência (NE): três com NE 5 e sete com NE 6. Conclusões: Consideram-se poucas as publicações sobre sistematização da assistência de enfermagem perioperatória relacionada à segurança do paciente. Os artigos selecionados apresentam baixo nível de evidência e a abordagem direciona-se à segurança do paciente, restringindo-se à utilização do checklist e implementação da sistematização da assistência de enfermagem perioperatória

Objective: To know the approach of scientific articles on the systematization of perioperative nursing care related to patient safety. Method: Integrative review with searches in the databases of the Virtual Health Library, National Library of Medicine (PubMed), and the journals of the Coordination of Improvement of Higher Education Personnel (CAPES). Articles were evaluated according to the level of evidence, using the evaluation tool proposed by the Joanna Briggs Institute ( JBI). Results: Ten articles were identified, of which eight were published in national journals, and two in international journals. The studies were classified according to levels of evidence (LoE): three with LoE 5 and seven with LoE 6. Conclusions: There are few publications on the systematization of perioperative nursing care related to patient safety. The articles selected present a low level of evidence and the approach is directed towards patient safety, being restricted to the use of the checklist and implementation of the systematization of perioperative nursing care

Objetivo: Conocer el enfoque de los artículos científicos sobre la sistematización de la atención de enfermería perioperatoria relacionada con la seguridad del paciente. Método: Revisión integradora con búsquedas en las bases de datos de la Biblioteca Virtual en Salud, la Biblioteca Nacional de Medicina (PubMed) y las revistas de Coordinación de Mejora del Personal de Educación Superior (CAPES). Los artículos fueron evaluados según el nivel de evidencia, utilizando la herramienta de evaluación propuesta por el Instituto Joanna Briggs ( JBI). Resultados: se identificaron diez artículos, de los cuales ocho se publicaron en revistas nacionales y dos en revistas internacionales. Los estudios se clasificaron según los niveles de evidencia (levels of evidence ­ LoE): tres con LoE 5 y siete con LoE 6. Conclusiones: Existen pocas publicaciones sobre la sistematización de la atención de enfermería perioperatoria relacionada con la seguridad del paciente. Los artículos seleccionados presentan un bajo nivel de evidencia y el enfoque se dirige hacia la seguridad del paciente, y se limita al uso de la lista de verificación y la implementación de la sistematización de la atención de enfermería perioperatoria.

The effects of an empathy role-playing program for operating room nursing students in Iran / 보건의료교육평가

PURPOSE: The purpose of this study was to investigate the effects of a role-playing training program conducted among operating room nursing students on empathetic communication with patients through measurements of empathy scores. METHODS: This study was carried out among 77 operating room nursing students from the first to the fourth years studying at the School of Nursing and Midwifery of Isfahan University of Medical Sciences in the academic year 2017–2018. The intervention administered to the experimental group included a 12-hour training program on expressing empathy to patients that incorporated role-playing. The Jefferson Scale of Empathy-Health Profession Student version was completed by the participants before, immediately after, and 1 month after the intervention. A comparative analysis of these 3 time points was conducted. RESULTS: No significant difference was found in the total pre-intervention mean empathy scores before the intervention between the control group and the experimental group (P=0.50). However, the total mean empathy scores in the experimental group immediately after and 1 month after the intervention were higher than those in the control group (P<0.001). CONCLUSION: Empathy training through a role-playing technique was effective at improving the empathy scores of operating room nursing students, and this finding also underscores the fact that empathy can be promoted by education. Changing the educational curriculum of operating room nursing students is suggested in order to familiarize them with the concept of empathy in the operating room.

Efetividade da massagem com aromaterapia no estresse da equipe de enfermagem do centro cirúrgico: estudo-piloto / Efectividad del masaje con aromaterapia en el estrés del equipo de enfermería del quirófano: estudio piloto / Effectiveness of aromatherapy massage on the stress of the surgical center nursing team: a pilot study

RESUMO Objetivo Verificar a efetividade do uso da aromaterapia com óleos essenciais de lavanda (Lavandula angustifolia) e gerânio (Pelargonium graveolens) associado à massagem para alívio do estresse de uma equipe de Enfermagem do centro cirúrgico por meio da avaliação de parâmetros biofisiológicos e psicológicos. Método Estudo-piloto do tipo ensaio clínico controlado e randomizado, realizado com a equipe de enfermagem de um centro cirúrgico de um hospital escola do interior do estado de São Paulo. A intervenção foi composta de seis massagens com aromaterapia com os óleos essenciais diluídos em creme neutro na concentração de 1% cada. A frequência cardíaca e a pressão arterial foram verificadas antes e após cada massagem e a Escala de Estresse no Trabalho e a Lista de Sintomas de Stress foram aplicadas antes e ao final da intervenção. A análise estatística foi realizada com o teste t pareado e qui-quadrado, intervalo de confiança de 95% e p<0,05. Resultados Houve diminuição com significância estatística da frequência cardíaca e pressão arterial após as sessões de massagem. Conclusão O uso da aromaterapia demostrou efetividade na diminuição de parâmetros biofisiológicos da equipe de enfermagem do centro cirúrgico. Registro Brasileiro de Ensaios Clínicos: RBR-6mgqn3.

RESUMEN Objetivo Verificar la efectividad del empleo de la aromaterapia con aceites esenciales de lavanda (Lavandula angustifolia) y geranio (Pelargonium graveolens) asociado con el masaje para alivio del estrés de un equipo de Enfermería del quirófano mediante la evaluación de parámetros biofisiológicos y psicológicos. Método Estudio piloto del tipo ensayo clínico controlado y randomizado, realizado con el equipo de enfermería de un quirófano de un hospital escuela del interior del Estado de São Paulo. La intervención estuvo compuesta de seis masajes con aromaterapia utilizándose los aceites esenciales diluidos en crema neutra en la concentración del 1% cada. La frecuencia cardiaca y la presión arterial fueron verificadas antes y después de cada masaje y la Escala de Estrés Laboral y la Lista de Síntomas de Estrés fueron aplicadas antes y al final de la intervención. El análisis estadístico se llevó a cabo con la prueba t pareada y chi cuadrada, intervalo de confianza del 95% y p<0,05. Resultados Hubo disminución con significación estadística de la frecuencia cardiaca y presión arterial luego de las sesiones de masaje. Conclusión El uso de la aromaterapia demostró efectividad en la disminución de parámetros biofisiológicos del equipo de enfermería del quirófano. Registro Brasileño de Ensayos Clínicos: RBR-6mgqn3.

ABSTRACT Objective To verify the effectiveness of aromatherapy with essential oils of lavender (Lavandula angustifolia) and geranium (Pelargonium graveolens) associated with massage for stress relief of a nursing staff of the surgical center through evaluation of biophysiological and psychological parameters. Method Pilot study, controlled and randomized clinical trial performed with the nursing team of a surgical center of a teaching hospital in the interior of the state of São Paulo. The intervention comprised six aromatherapy massages with essential oils diluted in neutral cream at concentration 1% each. Heart rate and blood pressure levels were measured before and after each massage session. The Work Stress Scale (WSS) and the List of Stress Symptoms (LSS) were applied before and at the end of the intervention. Statistical analysis was performed with the paired t-test and chi-square test, 95% confidence interval and p <0.05. Results There was a statistically significant reduction in heart rate and blood pressure levels after massage sessions. Conclusion The use of aromatherapy has demonstrated effectiveness for lowering biophysiological parameters of the surgical center nursing staff. Brazilian Registry of Clinical Trials: RBR-6mgqn3.

The effectiveness of sensory stimulation therapy to strengthen the resilience of operating room nurses.

BACKGROUND: Operating room (OR) nurses need to be resilient in order to cope with extreme demands in their workplace. This research focused on the effectiveness of sensory stimulation therapy (SST) to strengthen the resilience of nurses in the OR of a private hospital in the North West Province. PURPOSE: The purpose was to determine the effectiveness of SST as an intervention to strengthen the resilience of OR nurses. DESIGN: A quasi-experimental design was used. METHOD: The population consisted of OR nurses and ICU nurses at private hospitals in the North West Province. All-inclusive sampling was used. Forty-one OR nurses formed the intervention group. A pilot group (8 subjects, OR nurses), as well as a comparison group (23 subjects, ICU nurses), was also sampled. An intervention, namely SST, was implemented with the intervention group. The resilience of the intervention group, pilot group and comparison group was measured before and after the implementation of the SST by means of Wagnild and Young's resilience questionnaire. The intervention group also completed a self-report questionnaire on their needs and suggestions for SST and wrote short narratives on their experience of SST. Data were analysed using descriptive and inferential statistics, and by thematic coding. RESULTS: Results indicated a significant statistical increase in the intervention group's resilience levels. Results from the narratives confirmed that the intervention group's resilience may have been strengthened through SST. CONCLUSION: SST has potential to strengthen the resilience of OR nurses.

The Effect of an Interdisciplinary QI Project to Reduce OR Foot Traffic.

We instituted a multidisciplinary educational and operational quality improvement initiative to assess the effect of process interventions on reducing OR door openings and, by extension, surgical site infections. From 2009 to 2012, we conducted an initial trial to gather information and identify reasons for door openings followed by a three-phase investigation that evaluated a total of 102 orthopedic hip and knee procedures in which we counted door openings from the time of incision to the closing of the capsule. We analyzed the effectiveness of door opening deterrents (eg, a pull shade, magnetic yellow caution tape across the door frame) and changes in traffic processes (eg, clear-covered implant carts). The interventions and process changes showed a 50% reduction in door openings compared to the baseline.

Enhancing midwives' scope of practice: an innovative educational program for delivery suite operating rooms.

BACKGROUND: This retrospective study examined the enhancement of practice, knowledge, and skill of delivery suite midwives undertaking the circulating and instrument roles during emergent caesarean sections following a tailored educational program implemented to the benchmark standard. METHOD: All midwives who attended the educational program were invited to participate (N = 48); a total of 20 responses were received. Descriptive data analysis of the bivariate nominal data was performed. RESULTS: Clinically significant outcomes were noted across all theme areas: knowledge of the Australian College of Operating Room Nurses standards, competence and knowledge of the main roles during a caesarean section, knowledge of policies and procedures, and patient safety. An improved working relationship between the perioperative and delivery ward staff also was identified. CONCLUSION: An educational program for midwives on the instrument and circulating roles for caesarean sections provides the knowledge and skill development required for clinically safe practice.

Repercussões do uso de fitoterápicos no processo anestésico-cirúrgico: uma revisão integrativa / Repercussions of the use of herbal medicines in the surgical anaesthetic process: an integrative review

O estudo teve por objetivo analisar a produção científica sobre complicações perioperatórias relacionadas ao uso de fitoterápicos. Adotou-se como método a revisão integrativa de literatura com artigos publicados de 1966 a 2010, com levantamento de dados nas bases: PUBMED, BVS, CINAHL, SciVerse Scopus Database e EMBASE. Identificaram-se 1.043 artigos e foram selecionados 29 deles para fazerem parte da amostra do estudo...

Estratégias lúdicas na assistência ao paciente pediátrico: aplicabilidade ao ambiente cirúrgico / Playful strategies in pediatric patient care: applicability to surgical environment

Trata-se de uma pesquisa de revisão de literatura com o objetivo de realizar um levantamento das estratégias de humanização utilizadas pela equipe de saúde com o paciente pediátrico no contexto hospitalar, e apontar a aplicabilidade dessas técnicas ao bloco cirúrgico. Foram encontradas as estratégias da Brincadeira Terapêutica, Musicoterapia, Biblioterapia, Arteterapia, Ambiente Decorado e Terapia Assistida por Animais. ...

Measuring nursing competencies in the operating theatre: instrument development and psychometric analysis using Item Response Theory.

BACKGROUND: Concern about the process of identifying underlying competencies that contribute to effective nursing performance has been debated with a lack of consensus surrounding an approved measurement instrument for assessing clinical performance. Although a number of methodologies are noted in the development of competency-based assessment measures, these studies are not without criticism. RESEARCH AIM: The primary aim of the study was to develop and validate a Performance Based Scoring Rubric, which included both analytical and holistic scales. The aim included examining the validity and reliability of the rubric, which was designed to measure clinical competencies in the operating theatre. RESEARCH METHOD: The fieldwork observations of 32 nurse educators and preceptors assessing the performance of 95 instrument nurses in the operating theatre were used in the calibration of the rubric. The Rasch model, a particular model among Item Response Models, was used in the calibration of each item in the rubric in an attempt at improving the measurement properties of the scale. This is done by establishing the 'fit' of the data to the conditions demanded by the Rasch model. RESULTS: Acceptable reliability estimates, specifically a high Cronbach's alpha reliability coefficient (0.940), as well as empirical support for construct and criterion validity for the rubric were achieved. Calibration of the Performance Based Scoring Rubric using Rasch model revealed that the fit statistics for most items were acceptable. CONCLUSION: The use of the Rasch model offers a number of features in developing and refining healthcare competency-based assessments, improving confidence in measuring clinical performance. The Rasch model was shown to be useful in developing and validating a competency-based assessment for measuring the competence of the instrument nurse in the operating theatre with implications for use in other areas of nursing practice.

Assessment of surgical and obstetrical care at 10 district hospitals in Ghana using on-site interviews.

BACKGROUND: For most of the population in Africa, district hospitals represent the first level of access for emergency and essential surgical services. The present study documents the number and availability of surgical and obstetrical care providers as well as the types of surgical and obstetrical procedures being performed at 10 first-referral district hospitals in Ghana. MATERIALS AND METHODS: After institutional review board and governmental approval, a study team composed of Ghanaian and American surgeons performed on-site surveys at 10 district hospitals in 10 different regions of Ghana in August 2009. Face-to-face interviews were conducted documenting the numbers and availability of surgical and obstetrical personnel as well as gathering data relating to the number and types of procedures being performed at the facilities. RESULTS: A total of 68 surgical and obstetrical providers were interviewed. Surgical and obstetrical care providers consisted of Medical Officers (8.5%), nurse anesthetists (6%), theatre nurses (33%), midwives (50.7%), and others (4.5%). Major surgical cases represented 37% of overall case volumes with cesarean section as the most common type of major surgical procedure performed. The most common minor surgical procedures performed were suturing of lacerations or episiotomies. CONCLUSIONS: The present study demonstrates that there is a substantial shortage of adequately trained surgeons who can perform surgical and obstetrical procedures at first-referral facilities. Addressing human resource needs and further defining practice constraints at the district hospital level are important facets of future planning and policy implementation.

Perioperative blood transfusion: the role of allogenous and autologous transfusions, and pharmacological agents.

The decision to transfuse patients perioperatively is made on an individual basis and should consider factors such as duration and severity of anaemia, symptoms, physiological parameters and comorbidities. Autologous blood transfusion has the benefit of avoiding some of the immunological and infective complications associated with allogenic blood transfusion. Pharmacological agents as well as anaesthetic and surgical techniques have a role in avoiding the need for blood transfusion.

Regional anaesthesia: back to basics.

Regional anaesthesia has become more popular in recent years with an emphasis on cost effectiveness, bed occupancy, and reduction in hospital acquired infections (HAls). Anaesthesia is a worrying time for any patient, but now the emphasis is to encourage patient empowerment by involving patients in their own care throughout their holistic journey. This article explores patient selection for regional anaesthesia, and the different types of central and peripheral blocks in line with national policies. The equipment required, pharmacology, toxicity of local anaesthetics, and their physiological effects on the cardiovascular, respiratory, and gastrointestinal systems of the body will also be discussed.