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1.
Medicine (Baltimore) ; 98(48): e18132, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770247

RESUMO

BACKGROUND: This study will explore the effects of high-quality nursing care (HQNC) for patients with lung cancer (LC) during the perioperative period (PPP). METHODS: A literature search will be performed at Cochrane Library, MEDLINE, EMBASE, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure since its inception until October 1, 2019. All electronic databases will be searched with no restrictions of language and publication status. Two authors will perform study selection, data collection, and study quality assessment, respectively. We will use RevMan 5.3 software for statistical analysis. RESULTS: This study will summarize the latest evidence on assessing the depression, anxiety, quality of life, and adverse events of HQNC in patients with LC during PPP. CONCLUSION: The results of this study may provide helpful evidence of HQNC on psychological effects in patients with LC during PPP. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019155982.


Assuntos
Neoplasias Pulmonares/enfermagem , Cuidados de Enfermagem/normas , Assistência Perioperatória/enfermagem , Assistência Perioperatória/psicologia , Qualidade da Assistência à Saúde , Ansiedade/etiologia , Depressão/etiologia , Humanos , Neoplasias Pulmonares/psicologia , Neoplasias Pulmonares/cirurgia , Cuidados de Enfermagem/métodos , Cuidados de Enfermagem/psicologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto
2.
Nursing ; 48(11): 24-31, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30286030

RESUMO

This article details the obstacles of implementing a cardiac-specific enhanced recovery after surgery (ERAS) program in a 919-bed not-for-profit community-based health system and the benefits of ERAS programs for different patient populations.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Assistência Perioperatória/enfermagem , Serviços de Saúde Comunitária/economia , Humanos , Pesquisa em Avaliação de Enfermagem , Resultado do Tratamento , Estados Unidos
3.
AORN J ; 108(2): 165-177, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30117542

RESUMO

The perioperative environment is fast paced and complex. Competing responsibilities, noise and distractions, and reluctance of team members to speak up when they are aware of a potential patient safety issue are all barriers to effective communication in the perioperative setting. Communication breakdowns among health care providers can lead to medical errors and patient harm. Accurate and complete communication about the patient and the patient's care can contribute to improved efficiency, better patient outcomes, and fewer adverse events. The new AORN "Guideline for team communication" provides guidance on using standardized processes and tools to improve the quality of team communication. The key points address hand overs between phases of perioperative care; a briefing to share the surgical plan; a time out to verify the correct patient, procedure, site, and side; and a debriefing to discuss what was learned and how to improve. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.


Assuntos
Guias como Assunto , Equipe de Assistência ao Paciente/normas , Segurança do Paciente/normas , Assistência Perioperatória/normas , Enfermagem Perioperatória/normas , Comportamento Cooperativo , Humanos , Erros Médicos/prevenção & controle , Assistência Perioperatória/enfermagem
5.
AORN J ; 108(2): 127-139, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30117551

RESUMO

Perioperative nurses care for patients undergoing a wide range of surgical procedures. One fast-growing surgical specialty is spine surgery performed using minimally invasive techniques. Patients may be candidates for minimally invasive spine surgery based on their presenting signs and symptoms and medical imaging test results. Open anterior and posterior surgical approaches to spine surgery are how surgeons traditionally have performed these procedures. However, new technology has enabled a minimally invasive lateral approach to the spine. This approach minimizes many of the risks and challenges associated with both the anterior and posterior approaches. Minimally invasive lateral interbody fusion requires the perioperative nurse to have a thorough understanding of the necessary patient positioning, spinal anatomy, and OR suite setup to ensure a safe and successful surgical experience for the patient.


Assuntos
Vértebras Lombares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/enfermagem , Assistência Perioperatória/enfermagem , Enfermagem Perioperatória/organização & administração , Complicações Pós-Operatórias/enfermagem , Fusão Vertebral/enfermagem , Humanos , Tempo de Internação , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Fusão Vertebral/métodos
7.
AORN J ; 108(2): 148-153, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30117561

RESUMO

Deep brain stimulation (DBS) is a life-changing surgical treatment. More than 150,000 patients worldwide have been treated with DBS, primarily for Parkinson disease and medically refractory tremor and dystonia. However, the use of DBS has recently expanded beyond traditional movement disorders to include the treatment of obsessive compulsive disorder, epilepsy, and other neurological and psychological diseases. Considering this expanded use of DBS, it is essential to understand the role that each member of the multidisciplinary health care team plays and how to avoid possible complications during this procedure. Proper patient selection, precise anatomical placement of the electrode, and proper programming of the implanted device are key aspects of DBS treatment. It also is valuable to understand how the deep brain stimulator is implanted and functions. Accurate lead placement that results in positive outcomes for patients relies on collaboration from an experienced perioperative team led by the neurosurgeon.


Assuntos
Estimulação Encefálica Profunda/enfermagem , Doenças do Sistema Nervoso/terapia , Assistência Perioperatória/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Encéfalo/cirurgia , Distonia/terapia , Eletrodos Implantados , Humanos , Transtornos dos Movimentos/terapia , Doença de Parkinson/terapia , Tremor/terapia
13.
Worldviews Evid Based Nurs ; 15(2): 127-129, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29485751

RESUMO

This column shares the best evidence-based strategies and innovative ideas on how to facilitate the learning and implementation of EBP principles and processes by clinicians as well as nursing and interprofessional students. Guidelines for submission are available at https://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1741-6787.


Assuntos
Transtorno Autístico/terapia , Enfermagem Baseada em Evidências/educação , Pessoal de Saúde/normas , Assistência Perioperatória/normas , Humanos , Assistência Perioperatória/métodos , Assistência Perioperatória/enfermagem
14.
J Clin Nurs ; 27(1-2): 247-256, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28514534

RESUMO

AIMS AND OBJECTIVES: To explore and explain how nurses minimise risk in the perioperative setting. BACKGROUND: Perioperative nurses care for patients who are having surgery or other invasive explorative procedures. Perioperative care is increasingly focused on how to improve patient safety. Safety and risk management is a global priority for health services in reducing risk. Many studies have explored safety within the healthcare settings. However, little is known about how nurses minimise risk in the perioperative setting. DESIGN: Classic grounded theory. METHODS: Ethical approval was granted for all aspects of the study. Thirty-seven nurses working in 11 different perioperative settings in Ireland were interviewed and 33 hr of nonparticipant observation was undertaken. Concurrent data collection and analysis was undertaken using theoretical sampling. Constant comparative method, coding and memoing and were used to analyse the data. RESULTS: Participants' main concern was how to minimise risk. Participants resolved this through engaging in anticipatory vigilance (core category). This strategy consisted of orchestrating, routinising and momentary adapting. CONCLUSION: Understanding the strategies of anticipatory vigilance extends and provides an in-depth explanation of how nurses' behaviour ensures that risk is minimised in a complex high-risk perioperative setting. This is the first theory situated in the perioperative area for nurses. RELEVANCE TO CLINICAL PRACTICE: This theory provides a guide and understanding for nurses working in the perioperative setting on how to minimise risk. It makes perioperative nursing visible enabling positive patient outcomes. This research suggests the need for training and education in maintaining safety and minimising risk in the perioperative setting.


Assuntos
Teoria Fundamentada , Assistência Perioperatória/enfermagem , Enfermagem Perioperatória/organização & administração , Gestão de Riscos/métodos , Adulto , Idoso , Feminino , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Postgrad Med J ; 94(1109): 143-150, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29122928

RESUMO

INTRODUCTION: Use of the WHO surgical safety checklist is consistently recognised to reduce harm caused by human error during the perioperative period. Inconsistent engagement is considered to contribute to persistence of surgical Never Events in the National Health Service. Most medical and nursing graduates will join teams responsible for the perioperative care of patients, therefore appropriate undergraduate surgical safety training is needed. AIMS: To investigate UK medical and nursing undergraduate experience of the surgical safety checklist training. METHODS: An eight-item electronic questionnaire was distributed electronically to 32 medical schools and 72 nursing schools. Analysis was conducted for the two cohorts, and responses from final year students were included. RESULTS: 87/224 (38.8%) of medical students received teaching on the surgical safety checklist, compared with 380/711 (52.0%) of nursing students. 172/224 (76.8%) of medical students and 489/711 (66.9%) of nursing students understood its purpose and 8/224 (3.6%) medical students and 54/711 (7.4%) nursing students reported never being included in the Time Out. After adjusting for confounding factors, provision of formal teaching in checklist use increased understanding significantly (OR 50.39 (14.07 to 325.79, P<0.001)), as did routine student involvement in time outs (OR 5.72 (2.36 to 14.58, P<0.001)). DISCUSSION: Knowledge of perioperative patient safety systems and the ability to participate in safety protocols are important skills that should be formally taught at the undergraduate level. Results of this study show that UK undergraduate surgical safety checklist training does not meet the minimum standards set by the WHO.


Assuntos
Lista de Checagem , Assistência Perioperatória , Estudantes de Medicina/psicologia , Estudantes de Enfermagem/psicologia , Adulto , Educação de Graduação em Medicina/métodos , Educação em Enfermagem/métodos , Feminino , Humanos , Masculino , Erros Médicos/prevenção & controle , Assistência Perioperatória/educação , Assistência Perioperatória/métodos , Assistência Perioperatória/enfermagem , Gestão da Segurança/métodos , Procedimentos Cirúrgicos Operatórios/métodos , Inquéritos e Questionários , Ensino , Reino Unido
16.
J Clin Nurs ; 27(11-12): 2403-2415, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29149509

RESUMO

AIMS AND OBJECTIVES: To examine the extent to which the findings from an integrative review regarding perioperative patient advocacy could be empirically supported, and to describe Swedish registered nurse anaesthetists' patient advocacy actions and interactions during the perioperative period. BACKGROUND: Patient advocacy is practiced by various healthcare professionals in promoting the well-being of patients. It is complex, and in a general healthcare context, it has been described as supporting the patients both physiologically and psychologically. During general anaesthesia, the patient enters an unconscious state, and the registered nurse anaesthetist safeguards patient privacy and autonomy. DESIGN: Qualitative descriptive. METHODS: Individual, nonparticipant observations (n = 16) with eight registered nurse anaesthetists. The observer followed the nurses unobtrusively by shadowing them during the perioperative phase on two separate occasions. The analysis was conducted with a directed content analysis in the light of four predetermined categories, identified in a previous integrative review of patient advocacy in the perioperative setting: protecting, value preserving, supporting and informing. RESULTS: The predetermined categories were empirically supported. They were further refined by identifying 11 new subcategories leading to a conceptual extension of the theoretical frame. The registered nurse anaesthetists interacted with the patient and all members of the surgical team when practicing perioperative patient advocacy and the actions were mostly initiated by the registered nurse anaesthetists themselves. CONCLUSIONS: The findings offer a new insight into the registered nurse anaesthetist's professional role. The observations deepen the understanding of the registered nurse anaesthetists' perioperative patient advocacy actions and can contribute to a more reflective and theory-oriented view of practice. RELEVANCE TO CLINICAL PRACTICE: The results from this study could be used to help registered nurse anaesthetists and their students understand practice in a more complete and insightful way.


Assuntos
Papel do Profissional de Enfermagem , Defesa do Paciente , Assistência Centrada no Paciente/métodos , Assistência Perioperatória/enfermagem , Humanos , Enfermeiras Anestesistas , Pesquisa Qualitativa , Autocuidado , Suécia
17.
Esc. Anna Nery Rev. Enferm ; 22(3): e20170375, 2018. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-891820

RESUMO

Abstract Objective: To evaluate the intensity and discomfort of perioperative thirst and related factors during anesthesia recovery. Method: This is a quantitative, cross-sectional, descriptive study. Results: Of the 203 participants, 182 (89.6%) reported they were thirsty. The mean intensity of thirst was 6.9 measured using a verbal numerical scale of 0 to 10 and discomfort was 7.3 on a scale of 0 to 14. All attributes evaluated by the scale were cited including dry mouth and desire to drink water (87.3%), dry lips (79.1%), thick tongue feeling (43.4%), thick saliva (56.5%), dry throat (75.2%) and bad taste in the mouth (63.1%). There was a positive correlation between the intensity of thirst and discomfort assessed by the scale (Spearman coefficient: 0.474; p-value: <0.05). No correlation was found between age, length of fasting and use of opioids with the intensity of thirst and discomfort. Conclusion and implication in the clinical practice: Discomfort arising from the attributes of thirst is evidenced as the intensity of thirst increases.


Resumen Objetivo: Evaluar intensidad e incomodidad de la sed perioperatoria y los factores asociados durante la recuperación anestésica. Método: Estudio cuantitativo, transversal, descriptivo. Resultados: De los 203 participantes, 182 (89,6%) sintieron sed. La intensidad media de la sed fue 6,9, evaluada en escala numérica analógica; sus incomodidades, 7,3, en escala de 0 a 14. Todos los atributos evaluados fueron citados: boca seca y ganas de beber agua (87,3%), labios resecados (79,1%), lengua gruesa (43,4%), saliva gruesa (56,5%), garganta seca (75,2%), gusto malo en la boca (63,1%). Se observó correlación positiva entre intensidad de la sed y puntuación de las molestias evaluadas por la escala (Spearman=0,474/p=<0,05). No hubo correlación entre edad, tiempo de ayuno y utilización de opioides con intensidad de sed y sus incomodidades. Conclusión e implicación para la práctica: Incomodidad proveniente de los atributos de la sed se evidencia a medida que la intensidad de la sed aumenta.


Resumo Objetivo: Avaliar a intensidade e o desconforto da sede perioperatória e fatores associados durante a recuperação anestésica. Método: Estudo quantitativo, transversal, descritivo. Resultados: Dos 203 participantes, 182 (89,6%) sentiram sede. A intensidade média da sede foi 6,9, avaliada em escala numérica analógica e a de seus desconfortos, 7,3, em escala de 0 a 14. Todos os atributos avaliados pela escala foram citados: boca seca e vontade de beber água (87,3%), lábios ressecados (79,1%), língua grossa (43,4%), saliva grossa (56,5%), garganta seca (75,2%), gosto ruim na boca (63,1%). Houve correlação positiva entre intensidade da sede e pontuação dos desconfortos avaliados pela escala (Spearman=0,474/p=<0,05). Não houve correlação entre idade, tempo de jejum e utilização de opioides com intensidade de sede e seus desconfortos. Conclusão e implicação para a prática: Desconfortos advindos dos atributos da sede são evidenciados à medida que a intensidade da sede aumenta.


Assuntos
Humanos , Adulto , Unidades de Terapia Intensiva/estatística & dados numéricos , Assistência Perioperatória/enfermagem , Cuidados Pós-Operatórios/estatística & dados numéricos , Sede , Hospitais Universitários/estatística & dados numéricos
18.
Urol Nurs ; 37(1): 9-14, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29240359

RESUMO

Cystectomy is a complex procedure with a tenuous perioperative course. Enhanced recovery programs (ERPs) are bundle strategies, developed to enhance the recovery of surgical patients. This article outlines the components of an ERP for cystectomy patients from a nursing implementation perspective.


Assuntos
Cistectomia/enfermagem , Estomia/enfermagem , Dor Pós-Operatória/enfermagem , Assistência Perioperatória/enfermagem , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/enfermagem , Protocolos Clínicos , Humanos , Tempo de Internação , Manejo da Dor , Neoplasias da Bexiga Urinária/enfermagem
19.
AORN J ; 106(1): 8-19, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28662790

RESUMO

Individuals with debilitating facial injuries and deformities have achieved significant improvement of aesthetic form and function after undergoing a face transplantation. The involvement of surgical technologists and perioperative nurses in the care of the recipient and donor plays a critical role in the success of these procedures. There are unique challenges that staff members may be presented with when caring for a donor and recipient undergoing a face transplantation, including less comfort with and knowledge of the surgical procedure and instrumentation, an increased amount of equipment and personnel in the OR, donor and recipient admission and discharge care, and increased shift length. At New York University Langone Medical Center, New York, we have developed a comprehensive process to prepare staff members to care for patients undergoing face transplantation.


Assuntos
Transplante de Face/enfermagem , Assistência Perioperatória/enfermagem , Enfermagem Perioperatória , Doadores de Tecidos , Humanos , Salas Cirúrgicas/organização & administração , Alta do Paciente , Transplante Homólogo/enfermagem
20.
J Clin Nurs ; 26(23-24): 4246-4254, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28152208

RESUMO

AIMS AND OBJECTIVES: To explore what it means for parents to participate in their children's paediatric perioperative care. BACKGROUND: Allowing parents to participate in paediatric perioperative care can make a major difference for children in terms of their well-being, a decreased need for painkillers, fewer sleeping disorders and a more positive experience for both parties. The nurse anaesthetist should have a holistic view and develop a shared vision for the child, the parents and for themselves to perform successful paediatric perioperative care. DESIGN: Descriptive qualitative study. METHODS: The study was conducted in 2014. Data were collected in 20 narrative interviews with 15 mothers and five fathers who had experience of participating in their child's paediatric perioperative day surgery. The analysis was carried out with qualitative content analysis to describe the variations, differences and similarities in the experiences. RESULTS: The analysis revealed a main category that describes that parental participation in the context of paediatric perioperative care in day surgery meant 'having strength to participate despite an increased vulnerability'. Three generic categories with additional subcategories explained what was essential for the parents to be able to preserve this strength and participate in their child's care despite their increased vulnerability. The generic categories were named, 'gaining information about what will happen', 'being seen as a resource' and 'gaining access to the environment'. CONCLUSION: Efforts should be made to improve parents' roles and opportunities to participate in paediatric perioperative care. RELEVANCE TO CLINICAL PRACTICE: Nurse anaesthetists have a crucial role in enabling parents' participation and need knowledge to develop strategies and nursing interventions that meet parents' needs.


Assuntos
Pais/psicologia , Assistência Perioperatória/enfermagem , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assistência Perioperatória/psicologia , Relações Profissional-Família , Pesquisa Qualitativa
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