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J Cardiothorac Surg ; 15(1): 5, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915020


BACKGROUND: The saphenous vein is the most commonly used conduit for coronary artery bypass grafting (CABG). Wound healing complications related to saphenous vein harvesting are common, with reported surgical site infection rates ranging from 2 to 20%. Patients' risk factors, perioperative hygiene routines, and surgical technique play important roles in wound complications. Here we describe the perioperative routines and surgical methods of Swedish operating theatre (OT) nurses and cardiac surgeons. METHODS: A national cross-sectional survey with descriptive design was conducted to evaluate perioperative hygiene routines and surgical methods associated with saphenous vein harvesting in CABG. A web-based questionnaire was sent to OT nurses and cardiac surgeons at all eight hospitals performing CABG surgery in Sweden. RESULTS: Responses were received from all hospitals. The total response rate was 62/119 (52%) among OT nurses and 56/111 (50%) among surgeons. Chlorhexidine 5 mg/mL in 70% ethanol was used at all eight hospitals. The OT nurses almost always (96.8%) performed the preoperative skin disinfection, usually for three to 5 minutes. Chlorhexidine was also commonly used before dressing the wound. Conventional technique was used by 78.6% of the surgeons, "no-touch" by 30.4%, and both techniques by 9%. None of the surgeons used endoscopic vein harvesting. Type of suture and technique used for closing the wound differed markedly between the centres. CONCLUSIONS: In this article we present insights into the hygiene routines and surgical methods currently used by OT nurses and cardiac surgeons in Sweden. The results indicate both similarities and differences between the centres. Local traditions might be the most important factors in determining which procedures are employed in the OT. There is a lack of evidence-based hygiene routines and surgical methods.

Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Veia Safena/transplante , Coleta de Tecidos e Órgãos/métodos , Procedimentos Cirúrgicos Vasculares/métodos , Ponte de Artéria Coronária , Estudos Transversais , Humanos , Enfermagem de Centro Cirúrgico/métodos , Assistência Perioperatória/métodos , Padrões de Prática Médica , Fatores de Risco , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Inquéritos e Questionários , Técnicas de Sutura , Suturas , Suécia , Coleta de Tecidos e Órgãos/efeitos adversos , Procedimentos Cirúrgicos Vasculares/efeitos adversos
Nurse Educ Today ; 79: 153-160, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31132727


BACKGROUND: Virtual Reality (VR) simulation has recently been developed and has improved surgical training. Most VR simulators focus on learning technical skills and few on procedural skills. Studies that evaluated VR simulators focused on feasibility, reliability or easiness of use, but few of them used a specific acceptability measurement tool. OBJECTIVES: The aim of the study was to assess acceptability and usability of a new VR simulator for procedural skill training among scrub nurses, based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model. PARTICIPANTS: The simulator training system was tested with a convenience sample of 16 non-expert users and 13 expert scrub nurses from the neurosurgery department of a French University Hospital. METHODS: The scenario was designed to train scrub nurses in the preparation of the instrumentation table for a craniotomy in the operating room (OR). RESULTS: Acceptability of the VR simulator was demonstrated with no significant difference between expert scrub nurses and non-experts. There was no effect of age, gender or expertise. Workload, immersion and simulator sickness were also rated equally by all participants. Most participants stressed its pedagogical interest, fun and realism, but some of them also regretted its lack of visual comfort. CONCLUSION: This VR simulator designed to teach surgical procedures can be widely used as a tool in initial or vocational training.

Competência Clínica , Aprendizagem , Treinamento por Simulação/métodos , Realidade Virtual , Adulto , Craniotomia , Educação em Enfermagem/métodos , Feminino , Humanos , Masculino , Enfermagem de Centro Cirúrgico/métodos , Reprodutibilidade dos Testes , Interface Usuário-Computador
Nurse Educ Today ; 73: 13-16, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30472404


BACKGROUND: Orthopedic operating room (OR) nurses entail specialized skills and training, which are not part of the regular curricula at most nursing college. Instead, many nursing students' exposure to orthopedic care in the orthopedic range is limited to occasional observational assignments. Additionally, teamwork is an important factor affecting the performance of the orthopedic OR nurses. This results in a knowledge gap in clinical nursing education. Problem and scripting based learning (PSBL) method is a crucial tool of pre-operative prepared improvement. It is easy for surgeon to record surgical video from his own field of vision by wearable technology (WT). Nevertheless, few studies related to combine WT and PSBL been done to investigate features underlying efficiency in training of novice orthopedic OR nurses. OBJECTIVE: This study aimed to evaluate the feasibility of combining WT with PSBL in training of novice orthopedic OR nurses. METHODS: 20 operating room post-graduate-year-1 nurses from the First Hospital of China Medical University were randomly divided into two groups ("conventional training (CT)" group and "WT combining with PSBL" group). Initially the superior orthopedic operating room nurses who immediately followed each procedure filled out a feedback questionnaire of the novice nurses. After finished procedure, novice nurses had a basic understanding of each training method benefits and then filled out the questionnaires. Statistical analysis of the results was performed. RESULTS: Novice nurses of WT&PSBL Group got the better score in most of the preparedness and performance feedback statement. Mean scores of overall total preparedness and performance feedback statement of WT&PSBL Group was higher than CT Group (P ≤ 0.05). Based on summarizing the questionnaires, the novice nurse in WT- PSBL Group also made significantly better total score than "Conventional training" Group (P ≤ 0.05). CONCLUSIONS: WT&PSBL method, as a crucial tool for improving pre-operative preparedness and intra-operative performance, can cultivate novice orthopedic operating room nurses' ability to use prior knowledge and cognitive frameworks flexibly to deal with problems during performance. It plays a crucial role in training confident and safe orthopedic operating room nurses. DESIGN: Randomized controlled trial (RCT).

Enfermagem de Centro Cirúrgico/métodos , Ortopedia , Aprendizagem Baseada em Problemas/métodos , Estudantes de Enfermagem , Dispositivos Eletrônicos Vestíveis , China , Competência Clínica/normas , Currículo , Educação em Enfermagem , Humanos , Inquéritos e Questionários
Gynecol Oncol ; 152(2): 298-303, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30527338


OBJECTIVE: Quantifying non-routine events (NREs) assists with identify underlying sociotechnical factors that could lead to adverse events. NREs are considered any event that is unusual or atypical during surgical procedures. This study aimed to use prospective observations to characterize the occurrence of non-routine events in gynecological surgeries. METHODS: Observational data were collected prospectively within one surgical gynecology department over a five month period. Researchers captured NREs in real time using a validated tablet PC-based tool according to the NRE type, impact, whom was affected, and duration. Researchers also noted what surgical approach (i.e. open, laparoscopic, robotic) was used. RESULTS: Across 45 surgical cases, 554 non-routine events (M = 12.31 NREs per case, SD = 9.81) were identified. The majority of non-routine events were external interruptions (40.3%), teamwork (26.7%), or equipment (21.3%). The circulating nurse was most frequently affected by NREs (43.2%) followed by the entire surgical team (13.7%). There was no statistically significant difference in non-routine events based on surgical approach. CONCLUSION: Non-routine events are prevalent in the gynecological surgical setting. Identifying the sociotechnical factors that influence non-routine events are important in determining interventions that will combat the associated risks. Interventions focusing on teamwork, managing external interruptions, and coordinating equipment may have the greatest impact to reduce or eliminate NREs in gynecological surgeries.

Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Feminino , Procedimentos Cirúrgicos em Ginecologia/métodos , Procedimentos Cirúrgicos em Ginecologia/enfermagem , Procedimentos Cirúrgicos em Ginecologia/normas , Humanos , Laparoscopia/métodos , Laparoscopia/enfermagem , Laparoscopia/normas , Laparoscopia/estatística & dados numéricos , Enfermagem de Centro Cirúrgico/métodos , Enfermagem de Centro Cirúrgico/normas , Enfermagem de Centro Cirúrgico/estatística & dados numéricos , Equipe de Assistência ao Paciente/organização & administração , Projetos Piloto , Estudos Prospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/enfermagem , Procedimentos Cirúrgicos Robóticos/normas , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos
HERD ; 11(3): 124-138, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29355033


AIM: To assess how the adjacencies of functionally different areas within operating rooms (ORs) can influence the circulating nurse's (CN) workflow patterns and disruptions. BACKGROUND: The CN plays a significant role in promoting patient safety during surgical procedures by observing, monitoring, and managing potential threats at and around the surgical field. Their work requires constant movement to different parts of the OR to support team members. The layout of the OR and crowded and cluttered environment might impact the CN's workflow and cause disruptions during the surgery. METHOD: A convenience sample of 25 surgeries were video recorded and thematically coded for CN's activities, locations, and flow disruptions. The OR layout was categorized into transitional zones and functional zones (workstations, supply zones, support zones, and sterile areas around the surgical table). CN's activities were classified into patient-, equipment-, material-, and information-related activities. Flow disruptions included those related to environmental hazards and layout. RESULTS: The CN traveled through multiple zones during 91% of the activities. The CN's workstation acted as a main hub from which the CN made frequent trips to both sides of the surgical table, the foot of the OR table, supply zones, and support zones. Transitional zones accounted for 58.3% of all flow disruption that the CN was involved in whereas 28% occurred in areas surrounding the OR bed. CONCLUSION: The similarity of the movement and flow disruption patterns, despite variations in OR layout, highlighted the adjacencies required between major zones that CNs regularly visit. These optimum adjacencies should be considered while designing ORs such that they are more efficient and safer.

Arquitetura Hospitalar , Enfermagem de Centro Cirúrgico/métodos , Salas Cirúrgicas/organização & administração , Planejamento Ambiental , Humanos , Enfermeiras e Enfermeiros , Segurança do Paciente , Gravação em Vídeo , Fluxo de Trabalho , Local de Trabalho
J Biol Regul Homeost Agents ; 31(3): 659-665, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28954456


Operating room (OR) nursing previously referred to patient care provided during the intra-operative phase and the service provided within the OR itself. With the expansion of responsibilities of nurses, OR nursing now includes pre-operative and post-operative periods, therefore peri-operative nursing is accepted as a nursing process in OR in the contemporary medical literature. Peri-operative nurses provide care to the surgical patients during the entire process of surgery. They have several roles including those of manager or a director, clinical practitioner (scrub nurse, circulating nurse and nurse anesthetist), educator as well as researcher. Although, utmost priority is placed on insuring patient safety and well-being, they are also expected to participate in professional organization, continuing medical education programs and participating in research activities. A Surgical Patient Safety Checklist formulated by the World Health Organization serves as a major guideline to all activities in OR, and peri-operative nurses are key personnel in its implementation. Communication among the various players of a procedure in OR is key to successful patient outcome, and peri-operative nurses have a central role in making it happen. Setting up of OR in military conflict zones or places that suffering a widespread natural disaster poses a unique challenge to nursing. This review discusses all aspects of peri-operative nursing and suggests points of improvement in patient care.

Cuidados Intraoperatórios , Enfermagem de Centro Cirúrgico , Segurança , Feminino , Humanos , Cuidados Intraoperatórios/métodos , Cuidados Intraoperatórios/estatística & dados numéricos , Cuidados Intraoperatórios/tendências , Masculino , Enfermagem de Centro Cirúrgico/métodos , Enfermagem de Centro Cirúrgico/normas , Enfermagem de Centro Cirúrgico/tendências , Guias de Prática Clínica como Assunto
Orthop Nurs ; 36(2): 124-130, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28358775


The anterior, anterolateral, direct lateral, transtrochanteric, and posterior techniques have historically been the surgical approach to a total hip arthroplasty; however, a forthcoming technique called the direct anterior approach has been demonstrated to produce many patient and physician quality outcomes. These favorable outcomes can include shorter hospital stay, earlier mobility and functionality, decreased medical costs, and increased patient satisfaction scores. Appropriate nursing care during the preoperative, intraoperative, and postoperative phases is essential. The purpose of this article is to describe the nursing care for a patient undergoing a direct anterior approach to hip arthroplasty.

Artroplastia de Quadril/métodos , Artroplastia de Quadril/enfermagem , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Papel do Profissional de Enfermagem , Humanos , Tempo de Internação , Enfermagem de Centro Cirúrgico/métodos , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Recuperação de Função Fisiológica
Curationis ; 39(1): e1-e10, 2016 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-27796105


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.

Adaptação Psicológica , Terapia por Estimulação Elétrica/normas , Enfermeiras e Enfermeiros/normas , Enfermagem de Centro Cirúrgico , Terapia por Estimulação Elétrica/psicologia , Terapia por Estimulação Elétrica/estatística & dados numéricos , Humanos , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermagem de Centro Cirúrgico/métodos , Enfermagem de Centro Cirúrgico/estatística & dados numéricos , Psicometria/instrumentação , Psicometria/métodos , Psicometria/estatística & dados numéricos , Inquéritos e Questionários , Recursos Humanos
Enferm. glob ; 15(43): 228-239, jul. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-153689


Se objetivó caracterizar las hospitalizaciones ocurridas en la Clínica Quirúrgica de un hospital universitario del Centro Oeste de Brasil. Estudio descriptivo, retrospectivo, transversal, realizado a través de los registros en un total de 750 admisiones. La colecta fue de enero a mayo de 2011, con instrumento estructurado y validado. Se realizó análisis estadístico descriptivo. Se encontró que la mayoría de los ingresos fue electiva (82,1%), con duración de la estancia hospitalaria entre dos y ocho días para el 82,2% de los ingresos. Al menos una intervención quirúrgica se registró en 85,9% de las hospitalizaciones y los médicos fueron los profesionales con una mayor participación en la evolución del paciente, mientras que la enfermera presentó registro de evaluación en 19,2% de las hospitalizaciones. Destaca la necesidad de los profesionales de repensar sus acciones a través de la atención de la salud y que las instituciones realicen la sistematización del proceso de evaluación de los indicadores clínicos en busca de la calidad y seguridad del paciente en la práctica clínica (AU)

Este objetivou caracterizar as internações ocorridas na Clínica Cirúrgica de um hospital universitário do Centro Oeste do Brasil. Estudo descritivo, retrospectivo, de delineamento transversal, realizado por meio de prontuários em um total de 750 internações. A coleta foi de janeiro a maio do ano de 2011, com instrumento estruturado e validado. Realizada análise estatística descritiva. Constatou-se que a maioria das admissões foi eletiva (82,1%), com tempo de internação entre dois e oito dias para 82,2% das internações. Pelo menos uma intervenção cirúrgica foi registrada em 85,9% das internações e os médicos foram os profissionais com maior participação na evolução do paciente, enquanto que o enfermeiro apresentou registro de avaliação em 19,2% das internações. Evidencia-se a necessidade dos profissionais repensarem suas ações frente ao cuidado em saúde e que as instituições realizem a sistematização do processo de avaliação dos indicadores da assistência, em busca de qualidade e segurança do paciente na prática clínica (AU)

This study aimed to characterize the hospitalizations occurred in the Surgical Clinic of a university hospital in the Midwest of Brazil. Descriptive, retrospective, cross-sectional study, carried out based on medical records for a total of 750 admissions. Collection of data took place from January to May of 2011 with aid of a structured and validated instrument. Descriptive statistical analyses were carried out. It was found that most admissions were elective (82.1%), with length of stay between two and eight days for 82.2% admissions. At least one surgery was recorded in 85.9% of the hospitalizations and doctors were professionals with high participation in the evolution of the patient, while the nurse presented evaluation record in 19.2% of the admissions. This highlights the need for professionals to rethink their actions in the health care and for the institutions to perform the systematization of the process of evaluation of clinical indicators, searching for quality and safety of the patient in the clinical practice (AU)

Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Cuidados de Enfermagem/organização & administração , Cuidados de Enfermagem/normas , Cuidados de Enfermagem/tendências , Cuidados Críticos/organização & administração , Enfermagem de Centro Cirúrgico/métodos , Enfermagem de Centro Cirúrgico/organização & administração , Enfermagem de Centro Cirúrgico/normas , Enfermagem de Centro Cirúrgico/estatística & dados numéricos , Enfermagem de Centro Cirúrgico/tendências , Qualidade da Assistência à Saúde/organização & administração , Avaliação de Processos e Resultados (Cuidados de Saúde)/métodos , Garantia da Qualidade dos Cuidados de Saúde , Avaliação de Processos (Cuidados de Saúde)/organização & administração
ENFURO: Rev. Asoc. Esp. A.T.S. Urol ; (130): 12-16, feb. 2016. graf
Artigo em Espanhol | IBECS | ID: ibc-150318


La seguridad de la cirugía es una prioridad de salud pública. Nuestro objetivo: confirmación de las prácticas seguras en quirófano. Hemos revisado numerosos documentos sobre medidas de prácticas quirúrgicas seguras. Tras analizar estas recomendaciones, las hemos comprobado con nuestras actuaciones diarias en todas las intervenciones programadas que se han realizado en el quirófano de urología en 2014 en el Hospital Valme, Sevilla. Los puntos que hemos detectado con áreas de mejora son: prevención de la infección de la herida quirúrgica, lavado quirúrgico de manos y mantenimiento de la normotermia. Los puntos de actuación correcta son: profilaxis antibiótica, prevención TEV, aspectos derivados de la anestesia, listado verificación quirúrgica, medicamentos de aspecto o nombres parecidos y realización del procedimiento correcto en el lugar correcto del cuerpo. Hemos detectado áreas de mejora, que nos han planteado revisión de protocolos y sesiones. Tenemos importantes líneas de investigación futuras. Concluimos que nuestros quirófanos son seguros

The safety of surgery is a public health priority. Objective: confirmation of safe practices in the operating room. We have reviewed several documents about safety measures in surgery practice. After analyzing these recommendations we have compared with our daily practice in all programmed interventions that have been performed in the urology operating room in 2014 at hospital Valme, Seville. The main areas we have detected for improvement are: prevention of infection of the surgical wound, surgical hand washing and maintenance of normothermia. The correct action points are: antibiotic prophylaxis, VTE prevention, issues arising from anesthesia, surgical check list, drugs with similar appearance or name and achievement of the right procedure at the right place in the body. We have identified areas for improvement, and as a consequence we have reviewed protocols and sessions. We have important future research. We conclude that our operating rooms are safe

Humanos , Salas Cirúrgicas/estatística & dados numéricos , Gestão da Segurança/métodos , Infecção Hospitalar/prevenção & controle , Enfermagem de Centro Cirúrgico/métodos , Segurança do Paciente/estatística & dados numéricos
Health Informatics J ; 22(4): 1101-1110, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-26635321


This article reports the results of a case study of the consequences of mobile device use for the work practices of operating room nurses. The study identifies different patterns of mobile technology use by operating room nurses, including both work-related and non-work-related use. These patterns have multiple consequences for nurses, such as improvements in information access, e-learning and work-related communication, as well as a perceived increase in distractions from the collaborative work. We conceptualize these consequences in terms of three level effects and explain how we find both positive and negative consequences on the third level. On the positive side, improvements were found in how nurses spent their unoccupied time during the stable parts of operations, contributing to their well-being and job satisfaction. A negative consequence was the perceived increase in distraction from the collaborative operating room work practices.

Atitude do Pessoal de Saúde , Telefone Celular/normas , Papel do Profissional de Enfermagem , Enfermagem de Centro Cirúrgico/métodos , Salas Cirúrgicas , Telefone Celular/ética , Comunicação , Hábitos , Humanos , Relações Interprofissionais , Salas Cirúrgicas/organização & administração , Gerenciamento do Tempo/psicologia , Recursos Humanos
Comput Inform Nurs ; 33(8): 335-8, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26018576


In order to facilitate assists in surgical procedure, it is important for scrub nurses to understand the operation procedure and to share the operation status with attending surgeons. The potential utility of head-mounted display as a new imaging monitor has been proposed in the medical field. This study prospectively evaluated the usefulness of see-through-type head-mounted display as a novel intraoperative instructional tool for scrub nurses. From January to March 2014, scrub nurses who attended gasless laparoendoscopic single-port radical nephrectomy and radical prostatectomy wore the monocular see-through-type head-mounted display (AiRScouter; Brother Industries Ltd, Nagoya, Japan) displaying the instruction of the operation procedure through a crystal panel in front of the eye. Following the operation, the participants completed an anonymous questionnaire, which evaluated the image quality of the head-mounted display, the helpfulness of the head-mounted display to understand the operation procedure, and adverse effects caused by the head-mounted display. Fifteen nurses were eligible for the analysis. The intraoperative use of the head-mounted display could help scrub nurses to understand the surgical procedure and to hand out the instruments for the operation with no major head-mounted-display wear-related adverse event. This novel approach to support scrub nurses will help facilitate technical and nontechnical skills during surgery.

Apresentação de Dados , Enfermagem de Centro Cirúrgico/métodos , Interface Usuário-Computador , Desenho de Equipamento/instrumentação , Humanos , Japão , Informática em Enfermagem , Estudos Prospectivos
J Perioper Pract ; 25(3): 37-8, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26016279


This simple quality initiative won the best innovation in clinical practice at the recent CEO healthcare awards gala event in the North West of Ireland. It demonstrated how a simple collaborative idea led to improving the quality and safety of care in the operating room. As practitioners we have a huge contribution to make in providing quality and safe care to our patients. It is crucial that we share knowledge and have our input recognised.

Distinções e Prêmios , Enfermagem de Centro Cirúrgico/história , Enfermagem de Centro Cirúrgico/métodos , Inovação Organizacional , Segurança do Paciente/história , Melhoria de Qualidade/história , Qualidade da Assistência à Saúde/história , Comunicação , Comportamento Cooperativo , Equipamentos e Provisões , História do Século XXI , Humanos , Irlanda , Estudos de Casos Organizacionais
Enferm. clín. (Ed. impr.) ; 25(2): 64-72, mar.-abr. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-138397


Objetivos: Evaluar las percepciones, opiniones y conductas que tienen enfermeros y auxiliares de enfermería sobre seguridad del paciente en el servicio quirúrgico de un hospital público del Sistema Nacional de Salud español. Describir fortalezas y debilidades/oportunidades de mejora según criterios de la Agency for Healthcare Research and Quality y conocer el número de incidentes de seguridad notificados. Método: Estudio observacional, transversal, llevado a cabo utilizando la versión española del cuestionario Hospital Survey on Patient Safety Culture. La muestra estuvo constituida por profesionales de enfermería que aceptaron participar en el estudio voluntariamente y cumplían los criterios de selección. Se realizó un análisis descriptivo e inferencial en función de la naturaleza de las variables y las condiciones de aplicación de los test estadísticos. Significación p < 0,05. Resultados: Respondieron 74 profesionales de enfermería (63,2%). No se encontró ninguna fortaleza en el servicio quirúrgico, y las áreas principales que necesitan mejora corresponden a «Dotación de personal» (64,0%) y «Apoyo de la gerencia del hospital en materia de seguridad del paciente» (52,9%). El 52,3% (n = 65) califica el grado de seguridad del paciente entre 7 y 8,99 (en una escala de 10); el 79,7% (n = 72) no notificó ningún incidente durante el último año. La varianza total explicada por el modelo de regresión fue 0,56 para «Frecuencia de eventos notificados» y 0,26 para «Percepción de seguridad». Conclusiones: Percepción más positiva sobre cultura de seguridad del paciente a nivel de unidad/servicio. Las debilidades identificadas pueden servir para diseñar actividades concretas de intervención para mejorar la cultura de seguridad del paciente en otros servicios quirúrgicos del entorno (AU)

Objectives: To assess nursing professionals and health care assistants’ perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. Method: A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. Results: In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for “Frequency of incident reporting” and 0.26 for “Overall perception of safety”. Conclusions: There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres (AU)

Humanos , Gestão da Segurança/organização & administração , Salas Cirúrgicas/normas , Cultura Organizacional , Segurança do Paciente/normas , Enfermagem de Centro Cirúrgico/métodos , Auxiliares de Cirurgia/estatística & dados numéricos , Estudos Transversais
J Wound Ostomy Continence Nurs ; 42(2): 138-44, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25473881


PURPOSE: To assess the incidence of hospital-acquired, surgery-related pressure injury (ulcers) and identify risk factors for these injuries. DESIGN: We used a prospective cohort study to investigate the research question. SUBJECTS AND SETTINGS: The study was conducted at a major metropolitan hospital in Brisbane, Australia. Five hundred thirty-four adult patients booked for any surgical procedure expected to last more than 30 minutes were eligible for inclusion. METHODS: Patients who provided informed consent for study participation were assessed for pressure ulcers, using the European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel Guidelines, before entering the operating room and again in the post-anesthetic care unit (PACU). Research nurses and all PACU nurses were trained in skin assessment and in pressure ulcer staging. Patients were not assessed again after their discharge from the PACU. RESULTS: Seven patients (1.3%) had existing pressure injuries (ulcers) and a further 6 (1.3%) developed a surgery-related pressure ulcer. Risk factors associated with surgery-related pressure injuries were similar to non-surgically related risks and included older age, skin condition, and being admitted from a location other than one's own home. Length of surgery was not associated with pressure ulcer development in this cohort. CONCLUSION: Perioperative nurses play an important role in identifying existing or new pressure injuries. However, many of these nurses are unfamiliar with pressure ulcer classification, so education in this area is essential. Although the incidence of surgically acquired pressure ulcers was low in this cohort, careful skin inspection before and after surgery provides an opportunity for early treatment and may prevent existing lesions progressing to higher stages.

Doença Iatrogênica/epidemiologia , Lesão por Pressão/epidemiologia , Lesão por Pressão/etiologia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Adulto , Idoso , Austrália , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Enfermagem de Centro Cirúrgico/métodos , Enfermagem de Centro Cirúrgico/normas , Lesão por Pressão/prevenção & controle , Estudos Prospectivos , Fatores de Risco , Higiene da Pele/normas
Enferm. glob ; 13(35): 326-337, jul. 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-123978


Mediante la revisión sistemática de artículos relacionados con los cuidados de enfermeria en pacientes sometidos a procesos quirúrgicos, se clasifican por niveles de evidencia; con base en la teoria de sintomas desagradables de Elizabeth Lenz en la que mediante sus tres componentes: síntomas, factores influyentes y resultados de desempeño y además cuatro dimensiones: la angustia, la calidad, la duración y la intensidad de los síntomas, se argumenta la importancia de los cuidados de enfermería basado en la teoría de rango medio: síntomas desagradables de Elizabeth Lenz y colaboradores, para ser aplicada en el contexto del cuidado de pacientes en proceso de intervención quirúrgica, de tal forma que disminuyan los efectos de los sìntomas en el posoperatorio (AU)

Through systematic review related to nursing care for patients undergoing surgical procedures articles, classified by levels of evidence; based on the theory of unpleasant symptoms Elizabeth Lenz in which by its three components: symptoms, influencing factors and performance outcomes while four dimensions: anxiety, quality, duration and intensity of symptoms, argue the importance of nursing care based on the mid-range theory: unpleasant symptoms of Elizabeth Lenz et al, to be applied in the context of the care of patients undergoing surgical intervention, so as to decrease the effects of symptoms in the postoperatively (AU)

Humanos , Enfermagem de Centro Cirúrgico/métodos , /enfermagem , Complicações Intraoperatórias/enfermagem , Enfermagem Baseada em Evidências , Teoria de Enfermagem , Fatores de Risco
Rev. Rol enferm ; 37(1): 42-50, ene. 2014. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-119191


Se describe el proceso de implantación de mejoras para la seguridad del paciente en la administración de medicamentos, en quirófano. Objetivos. Conocer los puntos débiles del quirófano que pueden contribuir a que se produzca un incidente en torno a la medicación y la administración de líquidos intravenosos en aquel, y establecer estrategias de mejora para reducir o prevenir los errores a partir de las experiencias de las enfermeras. Método. Cualitativo de consenso mediante grupo de enfermeras expertas y cuestionario sobre los niveles de riesgo que estas atribuyen a cada una de las categorías de análisis. Se exploran sus experiencias sobre la seguridad en quirófano y sus propuestas para el control de los errores de medicación. Resultados. Se identifican como áreas de mayor riesgo los proveedores y la prescripción y el procesamiento, los puntos débiles de la cultura profesional sobre la seguridad del paciente y las propuestas de mejora (AU)

This bibliographic study describes the aspects of bonding that a pediatric nurse must know to foster the emotional attachment between a mother and her baby in the maternity hospital setting. It describes the theoretical models of bonding based on a review of the literature and research on this subject. It also discusses the origins of the bonding theory and the characteristics, types, benefits and consequences that this attachment has on the child’s physical, emotional and social development. Finally, it summarizes the nurse’s role in strengthening mother-child duality, assisting with baby care and supporting the family environment. The qualitative protocol of Kitchenham (2005) was used to extract the relevant information. Conclusion: The results of this review highlight the key role of nurses in promoting mother-child bonding despite political structures in maternity and pediatric centres (AU)

Humanos , Enfermagem de Centro Cirúrgico/métodos , Salas Cirúrgicas/métodos , Gestão da Segurança , Conduta do Tratamento Medicamentoso , Segurança do Paciente/normas , /prevenção & controle
AANA J ; 82(6): 431-6, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25842641


This article discusses the anesthetic management and implications of 2 pediatric patients with a diagnosis of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis. Anti-NMDA receptor encephalitis has been described as an immune-meditated syndrome that triggers the production of antibodies to the NMDA receptor: a site of action for many commonly used anesthetic agents. Symptoms of this disease can be autonomic, neurologic, and psychological in nature. This disease process can pose a challenge to the anesthesia provider during all stages of the anesthetic. Thus, the anesthesia provider must incorporate an understanding of the administered anesthetic agent's potential pharmacologic effect on the affected NMDA receptor when formulating the patient's anesthetic plan.

Anestesia/métodos , Anestésicos/administração & dosagem , Encefalite Antirreceptor de N-Metil-D-Aspartato/enfermagem , Encefalite Antirreceptor de N-Metil-D-Aspartato/cirurgia , Enfermagem de Centro Cirúrgico/métodos , Complicações Pós-Operatórias/prevenção & controle , Adolescente , Feminino , Humanos , Guias de Prática Clínica como Assunto