Effects of Nonpharmacologic Distraction Methods on Children's Postoperative Pain-A Nonmatched Case-Control Study.

PURPOSE: To investigate whether nonpharmacologic distraction as a supplement to conventional pain management can reduce children's assessment of pain in the postanesthesia care unit (PACU), and if parental assessment is a reliable proxy in assessing children's postoperative pain. DESIGN: A nonmatched case-control study. METHODS: The sample included 241 children aged 2 to 7 years assigned to one of five intervention groups or a control group. Children's and parents' assessments of pain were registered on arrival to PACU and repeated after 15, 30, and 45 minutes using the Wong-Baker FACES Pain Rating Scale. FINDINGS: Positive effects of interventions were found in both children's and parental assessments. Results indicate a positive correlation between children's and parental assessments in children older than 3 years (P < .001). CONCLUSIONS: Nonpharmacologic distraction is recommended as a supplement to conventional postoperative pain management. Parental assessment is a reliable proxy in assessing postoperative pain in children younger than 5 years.

Physicians' and Nurses' Attitudes and Actions Regarding Perioperative Medication Management.

PURPOSE: To investigate physicians' and nurses' attitudes and actions related to the prescription and administration of perioperative antibiotics and opioids during a 2-week period. DESIGN: A quantitative descriptive and analytical research design performed at a Danish University Hospital. METHODS: An email survey using an 18-item questionnaire was sent to 163 nurses and physicians involved in the perioperative period. FINDINGS: Of 163 participants, 114 (69.9%) returned the questionnaire. Between 12% and 29% of the respondents reported that they did not correctly manage the medication, although they thought it to be important. Between 41% and 68% of the respondents experienced incorrect medication management with significant differences among professions and specialties. CONCLUSIONS: The study confirms a knowing-doing gap in medication management in perioperative settings, highlighting the need to address this issue, to ensure that physicians and nurses act in accordance with their beliefs and consider the importance of medication safety in interdisciplinary work across specialties.

Quality improvement in documentation of postoperative care nursing using computer-based medical records.

Postanesthesia nursing should be documented with high quality. The purpose of this retrospective case-based study on 49 patients was to analyze the quality of postoperative documentation in the two existing templates and, based on this audit, to suggest a new template for documentation. The audit on the template with quantitative data showed satisfactory documentation of postoperative care nursing in 67% (18% to 92%; mean [min-max]) of the scores. The template for documentation using qualitative descriptions was used by 63% of the nurses, but the keywords were used to a varying degree, that is, from 0% to 63% of records. The analysis also revealed noncompliance with clinical guidelines and multiple duplicate entries. Based on this audit, a new template was constructed, with 10 physiological parameters and drop-down lists with keywords within each parameter. In this way, implicit knowledge could be converted to explicit documentation. Furthermore, the quality of documentation was improved.