Recuperación intensificada en cistectomía radical: rol de la enfermera / No disponible

Introducción: La recuperación intensificada en cirugía, Fast-track Surgery o Enhance Recovery After Surgery (ERAS), consiste en la aplicación de una serie de medidas y estrategias pre, intra y posoperatorias con el objetivo de disminuir el estrés secundario a la intervención quirúrgica proporcionando una mejor recuperación del paciente, disminuyendo las complicaciones y la estancia hospitalaria. Las ventajas de la aplicación de programas y protocolos de rehabilitación multimodal han sido ampliamente demostradas en ensayos clínicos y meta análisis. Objetivo: Implementar un programa de recuperación intensificada para cirugía mayor urológica (cistectomía radical) que pretende mejorar la preparación preoperatoria y la recuperación posoperatoria. Material y método: En noviembre de 2016 se creó el programa de rehabilitación multimodal integrado por urólogos, psicólogos, estoma terapeutas, personal administrativo de soporte y la Unidad de Preparación para la Cirugía (UPC),compuesta de anestesiólogos y enfermeras. La muestra estuvo formada por todos los pacientes a los que se les indicó cistectomía radical. Resultados: Los resultados preliminares de una encuesta de satisfacción que cumplimentaron los pacientes un mes después de la cirugía han sido muy satisfactorios. Sobre la información preoperatoria, trato recibido, dolor, alta hospitalaria y satisfacción general se obtuvieron valores altos. Se detectaron aspectos de mejora en la dieta posoperatoria, que fueron evaluados con un menor grado de satisfacción. Se han realizado acciones de mejora que están pendientes de evaluación. Discusión/Conclusión: El éxito del programa está en la participación y estrecha colaboración de las personas implicadas en este proceso: pacientes, familias y/o cuidadores y profesionales del programa de recuperación intensificada. La atención integral, que incluye medidas pre, intra y posoperatorias, y el papel activo de los pacientes que asumen responsabilidades, son claves en la mejora de la preparación y recuperación de la cirugía

Fast-track Surgery or Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach applied to the care of the surgical patient that requires the application of pre-, intra- and post-strategies. This approach has been designed to achieve early recovery after surgical procedures. ERAS protocol has been shown to lead to a reduction in complications and shorter length of hospital stay. Validated data are available from numerous studies to show the benefits of these protocols for patients. Objective: to implement a recovery program for patients undergoing major urologic surgery (radical cystectomy). Objective: to achieve early recovery after surgical procedures and improve and optimize preoperative preparation. Material and method: in 2016 a multimodal rehabilitation program was formed by urologists, psychologists, stoma therapists, administrative staff and surgical preparation unit (SPU) integrated by anesthetists and nursing staff. The study included patients who underwent radical cystectomy. Results: the results of a patient satisfaction survey were satisfactory after the first month of surgery. Regarding preoperative, adequacy of treatment received by patients, pain, discharge from hospital and general satisfaction. Deficiencies detected are pending evaluation. Patients were less satisfied with preoperative dietary information. Conclusion: the success of the program depends on the participation and collaboration of the persons involved in this process: patient, family and/or staff members. A comprehensive approach is the best key to improve the preparation and recovery of the patient before surgery

Abordaje integral de un caso complejo de continuidad de cuidados a un paciente cistectomizado / No disponible

El manejo inefectivo del régimen terapéutico es uno de los diagnósticos que con más frecuencia se le presenta al profesional enfermero durante su desarrollo profesional. Es fundamental que el enfermero desarrolle un plan de cuidados de forma óptima para que el paciente adquiera una correcta adhesión al tratamiento terapéutico y mejore su calidad de vida, así como prevenir las posibles complicaciones ante el no cumplimiento de tal tratamiento. Atendimos en nuestra unidad a un paciente de 56 años con diagnóstico de carcinoma infiltrante de vejiga que iba a ser intervenido de cistectomía. Controla su diabetes sin seguir con el plan terapéutico de su médico de familia, tampoco ha conseguido dejar su hábito tabáquico. Esto nos pone alerta de los posibles problemas posquirúrgicos y al alta

Nursing staff is exposed to ineffective management of therapeutic regimen during their professional development. It is essential for the nursing staff to develop an optimum self-care plan so that the patient can adhere to treatment and improve his quality of life. This will help the patient to anticipate possible complications related to non-compliance for treatment of the disease. A 56 years old patient with an infiltrating bladder cancer was admitted to our unit. The patient poorly controls diabetes, does not follow an appropriate treatment plan and has not stopped smoking. This is putting the patient at great danger due to post-operative complications and problems as a result of discharge from hospital

Perfil del paciente sometido a resección transuretral de neoplasia vesical / No disponible

Antecedentes y objetivos. El cáncer de vejiga es el séptimo tipo de cáncer más frecuentemente diagnosticado en los varones a nivel mundial. Su presentación clínica suele ser con síntomas de hematuria macro o microscópica. La resección endoscópica transuretral (RTU) es el pilar diagnóstico y terapéutico. El objetivo del presente trabajo fue describir el perfil del paciente que ingresa en una unidad de Urología para RTU de vejiga con el fin de detectar los posibles riesgos que puedan presentar. Pacientes y métodos. Estudio retrospectivo transversal descriptivo y analítico que incluyó 108 pacientes atendidos en la Unidad de Gestión Clínica de Urología del Hospital Universitario a los que se practicó RTU vesical a lo largo del año 2016. Los datos fueron obtenidos de las correspondientes historias clínicas electrónicas de urología y anestesia. Se recogieron las siguientes variables: edad, sexo, duración de la hospitalización, peso corporal y altura para obtención del índice de masa corporal (IMC), hábito tabáquico, ingesta habitual de alcohol, diagnóstico previo o tratamiento para hipertensión, dislipemia, diabetes mellitus y antecedentes de cáncer, así como estimación del riesgo anestésico mediante clasificación ASA (American Society of Anesthesiologists) y valoración funcional con escala NYHA (New York Heart Association) y determinaciones analíticas prequirúrgicas de hemograma y bioquímica plasmática. Resultados. El 91,7 por mil de los pacientes sometidos a RTU vesical fueron varones y la edad fue de 69,9 ± 11,3 años. Un 20,4 por mil era fumador. Un 38,0 por mil de los pacientes presentó sobrepeso y un 38,9 por mil obesidad. La prevalencia de hipertensión, dislipemia, diabetes y cáncer previo fue del 63,9 por mil el 40,7 por mil , el 25,9 por mil y el 25,9 por mil , respectivamente. Un 62,0 por mil presentaba un riesgo anestésico ASA de clase II, seguido de un 25,9 por mil que lo presentaba clase III. La valoración funcional mediante escala NYHA más prevalente, 93,5 por mil , fue la de clase I. La cifra media de hemoglobina fue de 12,4 ± 2,2 g/dl. La duración media de hospitalización fue de 2,8 ± 4,4 días. En conclusión, el perfil del paciente sometido a RTU vesical es varón, de edad avanzada, con sobrepeso u obesidad además de elevada prevalencia de otros factores de riesgo cardiovascular como HTA, dislipemia y diabetes, con riesgo anestésico clase II, es decir con enfermedad sistémica leve, controlada y no incapacitante, sin limitación de la actividad física de causa cardíaca y con anemia leve

Background and objectives. Bladder cancer is the seventh most commonly diagnosed cancer in men worldwide. Its clinical presentation is usually with symptoms of macro or microscopic hematuria. Transurethral endoscopic resection (TUR) is the diagnostic and therapeutic mainstay. The objective of the present study was to describe the profile of the patient who enters a urology unit for bladder TUR in order to detect possible risks that they may present. Patients and Methods. A descriptive and analytical cross-sectional retrospective study that included 108 patients treated at the Urology Clinical Unit of the University Hospital, who underwent TUR throughout 2016. The data were obtained from the corresponding electronic medical histories of surgery and anesthesia. The following variables were collected: age, sex, duration of hospitalization, body weight and height to obtain body mass index (BMI), smoking habits, habitual alcohol intake, previous diagnosis or treatment for hypertension, dyslipidemia, diabetes mellitus, cancer, as well as anesthesia risk estimation using the American Society of Anesthesiologists (ASA) and NYHA (New York Heart Association) functional assessment and pre-surgical blood chemistry and biochemical analytical determinations. Results. Ninety-one percent of the patients undergoing bladder TUR were male and the age was 69.9 ± 11.3 years, 20.4 per-mille were smokers, 38.0 per-mille of the patients were overweight and 38.9 per-mille were obese. The prevalence of hypertension, dyslipidemia, diabetes and previous cancer was 63.9 per-mille , 40.7 per-mille , 25.9 per-mille and 25.9 per-mille , respectively. A 62.0 per-mille presented a class II ASA anesthetic risk, followed by 25.9 per-mille that presented class III ASA. The most prevalent NYHA functional assessment, 93.5 per-mille , was class I. The mean hemoglobin level was 12.4 ± 2.2 g / dl. The mean duration of hospitalization was 2.8 ± 4.4 days. In conclusion, the profile of the patient submitted to bladder TUR is a male, elderly with overweight or obesity, as well as a high prevalence of other cardiovascular risk factors such as hypertension, dyslipidemia and diabetes, with a class II anesthesia risk, with mild systemic disease, non-disabling, without limitation of physical activity of cardiac cause and with mild anemia

Pautas prácticas de enfermería en cirugía urológica laparoscópica / No disponible

Hemos realizado una revisión sobre la actividad enfermera intraoperatoria en estos procesos, elaborando una guía práctica de fácil manejo, que ayude a adquirir los conocimientos y habilidades necesarios que capaciten unos cuidados enfermeros de calidad. Principales diagnósticos enfermeros: ansiedad, temor, riesgo de infección, aspiración, lesiones perioperatorias y caídas. 96 cirugías laparoscópicas justifican la necesidad de adquirir los conocimientos y habilidades necesarios para la correcta actuación enfermera. Hemos realizado un plan de cui dados enfermeros estandarizado. La alta especialización de estos procesos precisa un personal altamente cualificado, enfermería es clave en el desarrollo de estas técnicas, pues influye de forma activa en el buen desarrollo de las mismas, favoreciendo el trabajo en equipo, minimizando los tiempos quirúrgicos y asegurando una atención de calidad (AU)

We have carried out a revision about the intraoperatory nurse activity in these processes, elaborating a practical guide of easy handling, which helps to acquire the necessary knowledge and skills that enable quality nurse care. Main nurse diagnoses: anxiety, fear, risk of infection, aspiration, perioperatory injuries and falls. 96 laparoscopic surgeries justify the need to acquire knowledge and necessary skills to the correct nursing performance. We have carried out a standardized nursing care plan. The high specialization of these processes needs highly qualified staff, nursing is key in the development of these techniques as it is influential actively in the correct development of them, favoring the teamwork, minimizing surgical time and guaranteeing attention of quality (AU)

Consulta externa de patología quirúrgica ambulatoria urológica gestionada por el personal de enfermería. Proceso integrado en un plan de calidad total / Outpatient urologic surgery office conducted by nursing staff. A process integrated in a total quality strategy

OBJETIVO: Creación de un proceso pionero de atención a la patología urológica quirúrgica ambulatoria en consultas externas, conducida por el personal de enfermería. MÉTODOS: Nuestro centro presta servicio a 153.266 habitantes. Se ha implementado un subproceso diferenciado para la consulta de patología urológica quirúrgica ambulatoria (“fimosis”, “frenillo corto”, o “solicitud de vasectomía” citados desde Atención Primaria), conducido por personal de enfermería entrenado en el paciente urológico. Se han llevado a cabo las fases de planificación e implementación. Para la fase de control se administró un cuestionario de satisfacción tras la intervención con evaluación de 9 aspectos diferentes del proceso. RESULTADOS: De un total de 224 pacientes atendidos en el periodo del estudio, se recopilaron 175 cuestionarios válidos para el análisis (78,1%). Las intervenciones realizadas fueron circuncisión (11,7%), frenulectomía (14,6%), y vasectomía (73,7%), con una mediana de edad de 36 años. El nivel de satisfacción fue elevado para todos los items del cuestionario, con un 98,2% de los pacientes “muy satisfecho o bastante satisfecho” en la atención global del proceso. Las puntuaciones más bajas se obtuvieron en las preguntas que evaluaron la demora desde la citación hasta la atención en consulta (5,1% de los pacientes “poco o nada satisfechos”), y en la que evaluó la percepción del nivel de información suministrado (2,3% “poco o nada satisfechos”).Se encontró una menor satisfacción (con la demora desde la citación hasta la atención) en los pacientes más jóvenes (p=0,001) y en los sometidos a circuncisión (p=0,004). No se registraron reclamaciones con respecto a este proceso, ni se observaron indicaciones quirúrgicas incorrectas. CONCLUSIONES: La atención en consulta externa del paciente con patología urológica quirúrgica ambulante puede ser realizada, de modo eficaz y seguro, por personal de enfermería entrenado en el paciente urológico sin apreciar disminución en el nivel de satisfacción del usuario. El enfoque de gestión por procesos permite la identificación de áreas de mejora y hacer posible la gestión de la calidad total (AU)

OBJECTIVES: To create an innovative process to care for urological outpatient surgery patients in an outpatient clinic basis conducted by nursing staff. METHODS: Our centre covers a population of 153,266 inhabitants. A differentiated process for urological outpatient surgery patients has been implemented, conducted by nursing staff trained for the attendance of urologic patients (“phimosis”,”short penile frenulum”, and “vasectomy request” sent from Primary Care units). Planning and implementation phases have been carried out. In the control phase, a questionnaire was given after surgical procedures with 9 different items, in order to assess different issues of the process. RESULTS: A total of 224 patients were attended during the study period, and 175 valid questionnaires were collected (78.1%). The procedures performed were circumcision (11.7%), frenuloplasty (14.6%), and vasectomy (73.7%), with a median patient age of 36 years. Satisfaction level was high for all items of the questionnaire, with 98.2% of patients “very satisfied” or “rather satisfied” when asked for the overall quality of attention of the whole process. The lowest scores were obtained in items that assessed delay from the appointment to attendance date (5.1% of patients “little satisfaction or not satisfied”), and the perception of information supplied (2.3% “little satisfaction or not satisfied”). A lower satisfaction score was observed (in the delay from appointment to attendance) in younger patients (p=0.001) and in patients who underwent circumcision (p=0.004). No complaints with regard to this process were collected. No incorrect indications for interventions were observed. CONCLUSIONS: The attendance of urological outpatient surgery patients can be safely and effectively performed by nursing staff trained for the care of urologic patients, without observing a decrease of the level of user satisfaction. Focusing on a process strategy allows the identification of areas for improvement and makes possible total quality management (AU)

Translating an evidence-based algorithm to decrease early post-operative urinary retention after urogynecologic surgery.

The implementation of an evidence-based algorithm along with comprehensive nursing education supports effective clinical decision-making in the prevention of post-operative urinary retention and bladder distention for women who have undergone urogynecologic surgery.

The bedside assistant in robotic surgery--keys to success.

Taking on the position of bedside assistant for a surgical robotic team can be a daunting task. Keys to success include preparation, proper operation set up, effective use of instruments to augment the actions of the console surgeon, and readiness for surgical emergencies. Effective communication, repetitive execution, and readiness facilitate the efforts of the surgical team.

Papel de enfermería en la seguridad del paciente durante el recorrido del paciente quirúrgico urológico / No disponible

La seguridad del paciente se considera una prioridad en la asistencia sanitaria, actividad cada vez más compleja, que entraña riesgos potenciales y en la que no existe un sistema capaz de garantizar la ausencia de eventos adversos. El trabajo que presentamos describe la elaboración de un mapa de riesgo sobre el recorrido del paciente quirúrgico urológico y el importante papel que desempeña la enfermería en las distintas fases del proceso para así reducir los incidentes evitables. El proceso denominado recorrido del paciente quirúrgico urológico incluye desde el momento de la indicación quirúrgica en consultas externas del urólogo hasta la llegada del paciente a la planta de hospitalización una vez intervenido. Para realizar el mapa de riesgos de la unidad se empleó la metodología y matriz de riesgo del modelo de la Agencia Nacional de Seguridad del Paciente del Reino Unido. La priorización de los ítems seleccionados según la matriz de riesgo fue analizada mediante el método de Hanlon adaptado. En el mapa de riesgos se identificaron un total de 30 riesgos específicos. Se realizó la priorización de los distintos ítems según la metodología de Hanlon modificado y tras la misma se describió el papel de enfermería en la seguridad del paciente quirúrgico urológico. El resultado final del mapa de riesgo nos ha mostrado que la mayoría de los problemas son comunes para diferentes áreas de quirófano, así como la necesidad de mantener un personal reciclado en puestos claves, una formación continua y análisis cíclicos de la situación encada momento (AU)

Patient safety is considered a priority in healthcare, increasingly complex activity, potential risks involved and in which no system can guarantee the absence of adverse events. The present paper describes the development of a risk map on urological surgical patient journey and the important role of nursing in the various stages of the process in order to reduce preventable incidents. The process called path includes urological surgical patient from the time of surgical indication in outpatient urologist until the arrival of the patient to the ward once intervened. To make the risk map of the unit was used risk matrix methodology and model of the National Patient Safety in the United Kindong. The prioritization of selected items as the risk matrix was analyzed using the method adapted Hanlon The risk map identified a total of 30 specific risks. We performed the prioritization of the various items according to the methodology of Hanlon modified and after it described the role of nursing in urological surgical patient safety. The outcome of the risk map has shown that most of the problems are common to different areas of theater, as well as the need to maintain a recycling staff in key positions, continuous training and cyclical analysis situation at each moment (AU)

An evidence-based approach to decrease early post-operative urinary retention following urogynecologic surgery.

The Johns Hopkins Nursing evidence-based practice model and guidelines were used to translate evidence into a practice algorithm for the prevention of urinary retention with bladder distention during hospitalization in women having undergone urogynecologic surgery.

Female stress urinary incontinence: office-based urethral bulking agent procedure.

Urethral bulking agents have been used extensively to treat women with stress urinary incontinence due to intrinsic sphincter deficiency. This article presents the authors' experience with one of the currently approved urethral bulking agents, Macroplastique, in a urology office setting.

Using an acuity-adaptable unit for urological services.

The University of Pittsburgh Medical Center--Shadyside Campus uses an acuity-adaptable unit model that has streamlined patient care. Pre-operative preparation and post-operative recovery nursing care on one designated nursing unit provide a less stressful experience for the surgical patient.

Perioperative fluid management.

Technological advances have changed how traditional surgical procedures are performed. New knowledge and surgical skills are required to effectively monitor the patient and manage fluids administered perioperatively. Today, selective fluids are used in a variety of surgical specialties. Complications of fluid therapy can occur that are intrinsic to each procedure within a specialty. This article provides perioperative nurses with the information needed to evaluate different fluid media and their applications and identify patient care considerations. Possible complications and important postanesthesia care concerns also are discussed.

Mixed-sex wards and patient dignity: nurses and patients perspectives.

With the exception of specialized units, adults have historically been cared for in single-sex hospital wards in the UK. However, over the past two decades, concerns about mixed-sex wards have been reported. Respect and dignity are essential to provide high-quality health care. The issue of whether patients' privacy and dignity are compromised by mixed-sex wards is addressed in this article. Qualitative data were obtained from both nurses and patients on a mixed-sex surgical ward specializing in urology, to obtain individual perspectives relating to factors affecting dignity on the ward. Nurses tried hard to keep bays single-sex but, due to bed shortages, they were under continual pressure to mix the bays. Some patients of both sexes and varied ages perceived that a mixed-sex care environment threatened their dignity. They experienced a lack of privacy, worried about bodily exposure and felt uncomfortable. Nurses used various strategies to reduce patients' discomfort. Mixed sex accommodation is an unacceptable solution to bed shortages.

Neurogenic continence. Part 2: Neurogenic bladder management.

This article addresses physical and psychosocial issues in neurogenic bladder management. The impact of neurogenic bladder and its assessment will be discussed. There are a wide range of treatment options available to manage neurogenic bladder dysfunction and this article offers an overview of key management techniques, including non-invasive techniques, self-intermittent and suprapubic catheters, medication and surgical management. The importance of the nursing role in assessment, teaching and supporting patients by enabling them to make informed choices about their bladder management is addressed.

Postoperative pain management - the influence of surgical ward nurses.

AIM: To compare pain levels reported by patients with those documented by ward nurses and to find out to what extent the amount of opioids given correlated with the pain level. Secondly, to study if pain management and nurses' approaches to this task had improved during a two-year period, including an educational pain treatment program for ward staff. BACKGROUND: The management of postoperative pain continues to remain problematic and unsatisfactory and ward nurses play an important role for this task. DESIGN: The study was a cross-sectional, descriptive, two-part study based on survey data from both patients and nurses on two urology surgical wards. METHODS: Part I of the study included 77 patients and 19 nurses. Part II took place approximately two years later and included 141 patients and 22 nurses. Data were collected the day after surgery by asking patients about 'worst pain' experienced. The pain scores given by the patients were compared with those documented in the patients' records and with the doses of opioids administered. Nurses' approaches to pain management were sought after, by using a categorical questionnaire. RESULTS: The nurses' ability to assess pain in accordance with the patients' reports had increased slightly after two years even if and the number of documented pain scores had decreased. Forty per cent of the nurses reported that they did not use visual analogue scale and that they did not assess pain at both rest and activity, neither did one fourth evaluate the effect of given analgesics. CONCLUSION: The study showed a discrepancy in pain scoring between nurses and patients, where active treatment was related to nurses' documentation rather than to patients' scoring. RELEVANCE TO CLINICAL PRACTICE: The study shows a need for more accurate pain assessment, since the patient experiences and suffers pain and the nurse determines upon treatment.

Ansiedad en el paciente urológico quirúrgico / No disponible

Hay un gran numero de pacientes que pueden presentar un cuadro ansioso, acrecentando en el paciente urológico por el síntoma autónomo de la frecuencia miccional. El objetivo es determinar los factores relacionados y las características que originan este diagnostico para, mediante intervenciones de enfermería, disminuir la ansiedad. La variable diagnostico ansiedad al igual que el resultado control de ansiedad seria una constante como objetivo del plan de cuidados, presentando como variables independientes de estudio las intervenciones asociadas a este diagnostico y sus resultados. Una vez conocidas las necesidades aplicamos las siguientes intervenciones: Información escrita y oral al ingreso .Técnicas que aumenten la relajación. Información escrita y oral al alta. La valoración durante la estancia del paciente en planta , acompañada de información continua y personalizada hará que a este le sea mucho mas sencilla su adaptación a un medio que para el resulta «hostil y a la vez necesario» (AU)

There is a great number of patients who can present an anxious profile, increasing in the urological patient for the autonomous symptom of the mictional frequency. The goal is to determine the related factors and the characteristics that originate this diagnose for, through nursing interventions, decreasing the anxiety. The variable diagnose anxiety in the same way as the result of control of anxiety would be a constant as a goal of the cares plan, presenting as independent variables of study the associated interventions to this diagnose and their results. Once the needs are known we apply the following interventions: Written and oral information in the admission. Techniques that increase the relaxation. Written and oral information in the discharge. The appraisal during the stay of the patient admitted, accompanied by continuous and personalized information, will make much more easier the adaptation to a means that for them is «hostile and at the same time necessary» (AU)

De la incontinencia a la continencia / No disponible

La incontinencia urinaria femenina es un problema de salud, consecuencia de la alteración de la fase de llenado vesical, que repercute en el bienestar físico, psicológico, social y económico de la mujer. Cuando no es efectiva la rehabilitación, la solución es quirúrgica. Durante los últimos 25 años en el Servicio de Urología del Hospital Virgen del Camino de Pamplona se han ido utilizando diversas técnicas quirúrgicas para corregir esta alteración, desde la técnica-patrón de Burch hasta el desarrollo de las mallas de prolene suburetrales, que han revolucionado la cirugía de la incontinencia femenina. El presente trabajo es un desarrollo cronológico-descriptivo de las técnicas empleadas en nuestro servicio y la evolución de los Cuidados de Enfermería según la técnica quirúrgica empleada (AU)

The feminine urinary incontinence is a health problem, consequence of the alteration of the phase of filling vesical, that repels in the physical well-being, psychological, social and economic of the woman. When the rehabilitation is not effective the solution is surgical. During last the 25 years in the Service of Urology of the Hospital Virgen del Camino of Pamplona they have been used diverse surgical techniques to correct this alteration, from the technique-pattern of Burch to the development of the suburethrals meshes of prolene, that have revolutionized the surgery of the feminine incontinency. The present work is a chronological-descriptive development of the techniques used in our Service and the evolution of the Cares of Infirmary according to the used surgical technique (AU)

Manejo del dolor posoperatorio en cirugía radical urológica con anestesia epidural / No disponible

La analgesia epidural lumbar posoperatoria es una técnica muy útil en el manejo del dolor posoperatorio (D.P.O.) tras cirugía radical urológica (C.R.U.). Presentamos los resultados del análisis de nuestra experiencia con el manejo de ropivacaína 0,2%, vía epidural, con bomba de perfusión continua. Por el grado de analgesia y confort posoperatorio conseguimos, así como la reducción del trabajo del equipo de enfermería, pensamos que la analgesia posoperatoria epidural con ropivacaína es una técnica idónea y de fácil manejo en planta para la enfermería de urología

No disponible

Patient information at discharge--a study of a combined approach.

OBJECTIVE: To describe patients' perceptions of a new information procedure related to going home after urological surgery. This procedure, developed in an action research project, included a discharge talk with the nurse and an information booklet for the patients to keep. METHODS: A convenience sample of 99 patients responded to a survey sent home 1 week after discharge (return 78.6%). The Patient Information and Nurse Interaction Scale (PINI) was used for data collection. RESULTS: The sample were mostly male (81%), older (mean 71.9 years), and hospitalised on average less than 4 days. Patients who got the booklet had significantly more favourable perceptions on information received (p<0.05) on 11 of 21 items, and 91% said they would not have managed very well at home without it. CONCLUSION: The patients who received the booklet knew more about what might happen to them, were less uncertain and had fewer concerns when going home. PRACTICE IMPLICATIONS: The combination of standardised written information and a talk with the nurse where patients participated in individualising the information appears to have had a significant impact on self-management at home.