Journal of Perianesthesia Nursing最新文献

Purpose: To compare the incidence of puncture site leakage and postoperative analgesia between single-lumen central venous catheter (CVC) and continuous peripheral nerve block (CPNB) catheter for continuous fascia iliaca compartment block analgesia in elderly patients with hip fractures.

Design: A prospective, randomized, parallel-group controlled trial.

Methods: Sixty-four elderly participants (aged 60-75 years, American Society of Anesthesiologists class I-III) scheduled for intramedullary nail internal fixation (PFNA) of femoral intertrochanteric fractures were randomly allocated to two groups: CVC group and Continuous Peripheral Nerver Block catheter (CPNB group). In all patients, the continuous block catheter was inserted into the fascia iliaca compartment above the inguinal ligament under the guidance of ultrasound, and the postoperative analgesic pump was used. Patients in both groups underwent treatment with an ultrasound-guided in-plane approach to the fascia iliaca space via the inguinal ligament, along with the use of a postoperative analgesia pump. The degree of leakage from the two types of catheters was assessed 48 hours postoperatively, with the severity of leakage at the puncture site being qualitatively and quantitatively evaluated based on the color change of a medical-surgical film containing iodophor Secondary outcomes included the time required for puncture and catheterization, visual analog scale pain scores at 6, 24, and 48 hours postoperatively, the success rate of lower limb nerve block, and the incidence of adverse reactions to nerve block.

Findings: In comparison with the CPNB group, the CVC group exhibited a significantly lower incidence of puncture site leakage (96.8% vs 16.1%, P < .001) and a smaller leakage area (19.30 ± 4.64 cm² vs 0.61 ± 0.46 cm², P < .001). However, no significant differences were observed in postoperative analgesic efficacy or other secondary outcomes between the two groups.

Conclusions: In elderly patients with hip fractures, using CVCs for postoperative analgesia is associated with a reduced incidence and extent of leakage at the puncture site during continuous fascia iliaca compartment block.

Purpose: This study aimed to develop and validate a measurement tool to assess attitudes toward mobilization in surgical patients.

Design: In this methodological study, the Mobilization Attitude Scale for Surgical Patients (MASSP) was developed, and its psychometric properties were tested.

Methods: The items for the MASSP were developed based on evidence from the literature and presented to nine experts for evaluation. The scale was administered through face-to-face surveys with patients receiving treatment in the surgical clinics of a university hospital in Turkey. The psychometric properties of the scale, including structural validity, content validity, and internal consistency reliability, were tested. Data from 482 patients were analyzed. Exploratory factor analysis and confirmatory factor analysis were conducted on the collected data.

Findings: The newly developed scale resulted in a structure comprising 36 items and three factors: Avoidance of Mobilization, Readiness for Mobilization, and Motivation for Recovery. In the MASSP, factor 1 (α = 0.932), factor 2 (α = 0.890), and factor 3 (α = 0.822) accounted for 48.704% of the total variance. The entire 36-item acceptability questionnaire demonstrated good internal consistency (α = 0.940). The MASSP was determined to be a valid and applicable measurement tool, confirmed in a Turkish sample of acceptable size.

Conclusions: The findings indicate that the MASSP has acceptable content and structural validity and is reliable for measuring surgical patients' attitudes toward mobilization. Further research in different cultures and geographical regions can enhance the scale's development and strengthen its validity.

Purpose: Early mobility interventions are increasingly recognized as a critical component of postoperative care for cardiac surgery patients. These interventions aim to improve functional recovery, reduce complications, and optimize resource utilization. However, the effectiveness of early mobility programs on outcomes such as the 6-minute walk distance (6-MWD), hospital and intensive care units (ICU) length of stay, and in-hospital mortality remains unclear.

Design: Systematic review and meta-analysis.

Methods: This review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines to evaluate the effectiveness of early mobility interventions in cardiac surgery patients. Relevant studies were identified from PubMed, Scopus, Web of Science, and EMBASE databases. Random-effects meta-analyses were performed to pool standardized mean differences (SMD) or odds ratios with 95% confidence intervals (CIs) for 6-MWD, length of hospital and ICU stay, and in-hospital mortality. Heterogeneity was assessed using the I² statistic.

Findings: Twenty studies including 2,523 participants were analyzed. Early mobility interventions significantly improved 6-MWD (SMD: 1.22; 95% CI: 0.62 to 1.82; P < .001) and reduced hospital (SMD: -0.55; 95% CI: -0.85 to -0.24; P < .001) and ICU (SMD: -0.48; 95% CI: -0.93 to -0.03; P = .036) length of stay. Substantial heterogeneity was observed across studies (I² > 85%). No significant reduction in in-hospital mortality was found (odds ratios: 0.56; 95% CI: 0.13 to 2.42; P = .437).

Conclusions: Early mobility interventions improve functional recovery and reduce hospital and ICU stays in cardiac surgery patients. These findings support the integration of structured mobility programs into postoperative care to optimize outcomes, though further research is needed to address heterogeneity and long-term impacts.

Purpose: This study was conducted to determine the relationship between patient safety attitudes of operating room nurses and their attitudes toward the prevention of pressure injuries.

Design: The study is a descriptive regression study.

Methods: The study data were collected from 102 nurses working in the operating room of a private hospital between September 2 and October 10, 2024. The sample size, which was known before the study, was determined by power analysis. Data were collected using a personal information form, a patient safety attitude scale, and a pressure ulcer prevention attitude scale. Descriptive statistics (frequencies, percentages, means, and standard deviations) were used to analyze the data. Mann-Whitney U test and Kruskal-Wallis test were used to compare groups. The correlational relationship between the patient safety attitude scale and the pressure injury prevention attitude scale was evaluated by Pearson correlation analysis. The predictors of all subdimensions of the nurses' attitudes toward pressure injury prevention scale were evaluated by stepwise multiple linear regression analysis.

Findings: The mean age of the operating room nurses (56.9%) who participated in the study was between 20 and 30 years, 63.7% were female, 77.5% had a bachelor's degree, 39.2% had worked for less than 5 years, and 92.2% were scrub nurses. A high school education and less than 5 years of experience were found to be negative predictors of attitudes toward pressure injury prevention. Working conditions, job satisfaction, and teamwork subdimensions of the patient safety attitude scale were found to be significant predictors of attitudes toward pressure injury prevention.

Conclusions: The findings of the study revealed that operating room nurses' attitudes toward patient safety and the prevention of pressure injuries were significantly related to variables such as educational level, professional experience, job satisfaction, teamwork, and safety climate.

Purpose: To strengthen cooperation, teamwork, and interprofessional relationships among anesthesia care team members and other key stakeholders involved in the operative experience through a shared education program that fosters professional growth, engagement, and camaraderie.

Design: An interdisciplinary task force developed and implemented quarterly educational sessions for the anesthesia care team, progressively expanding participation to include the preadmissions clinic (2023) and Preoperative and PACU staff (2024). These sessions featured journal presentations and discussions in informal, inclusive settings to promote scholarship, engagement, and relationship building.

Methods: Organized by an academic medical center's Anesthesia Care Team Optimization Committee, this initiative engaged certified registered nurse anesthetists, anesthesiologists, student nurse anesthetists, anesthesiology residents, and other perioperative staff. The sessions were held after work at local venues and emphasized shared learning experiences and team cohesion across disciplines. Topics were selected by participants from scholarly journal articles, allowing participants to apply newly acquired knowledge to real-world scenarios.

Findings: In spring 2025, a Qualtrics survey was distributed to 2023 to 2024 Anesthesia Steering Committee meeting attendees. Of 100 invited, 62 responded, primarily certified registered nurse anesthetists (45%) and student nurse anesthetists (24%). Most had over 10 years of experience. While 62% attended 0 to 2 meetings, respondents reported a strong positive impact: 88% noted improved team culture and synergy, 80% felt more engaged, and 96% would recommend Anesthesia Steering Committee meetings. Among those responding to practice-related items, 57% reported changes, including adoption of Enhanced Recovery After Surgery protocols, improved handoffs, expanded use of noninvasive monitoring, and increased interdisciplinary communication. A common barrier was difficulty hearing in the meeting setting.

Conclusions: The shared education program has demonstrated its value in fostering teamwork, enhancing professional development, and promoting a culture of continuous learning and engagement across all departments involved in the operative experience. This model provides a scalable framework for other health care teams aiming to improve interprofessional collaboration and patient outcomes.

Purpose: To develop a valid and reliable scale to assess student nurses' self-efficacy in body temperature management in surgical patients, the Body Temperature Management Self-Efficacy Scale (BTM-SES) was used.

Design: An instrument development and validation study.

Methods: The data of this methodological study were collected between November 2024 and January 2025 in two faculties providing nursing education in the Central Anatolia region of Turkey. The study had a multistage design in accordance with the Consensus-based Standards for the Selection of Health Measurement INstrument checklist. In the first stage, an item pool is created based on a literature review. In Stage 2, the pool aimed to assess content validity, and psychometric properties were evaluated through exploratory factorial analysis. Subsequently, construct validity was tested by confirmatory factor analysis, and reliability and time invariance were simultaneously tested by retest.

Findings: A total of 390 nursing students taking surgical disease nursing courses participated in the study. The content validity index score for the scale items was 0.84. Exploratory factor analysis revealed a three-dimensional factor structure (controlling, recording, informing, evaluating, and prevention) with a cumulative variance contribution rate of 58.03%; the final scale included 21 items. Cronbach's α coefficient of the scale was 0.93. The fit indices for the classes were acceptable.

Conclusions: BTM-SES is a 21-item valid and reliable assessment tool to measure student nurses' self-efficacy in body temperature management in surgical patients. BTM-SES can be used in clinical and educational research.

Purpose: This study aimed to develop a feasible and scientifically grounded protocol for the prevention and management of perioperative hypothermia in neonates.

Design: A Delphi method was used to assess the importance of each item in the developed protocol.

Methods: A comprehensive literature review was conducted to generate a preliminary pool of protocol items. Based on expert feedback, preliminary items were revised, removed, or supplemented to establish a scientifically rigorous and clinically applicable protocol.

Findings: Response rates for the two Delphi rounds were 100% and 94.12% respectively. The authority coefficients were 0.86 and 0.92, with the Kendall's coefficients of concordance being 0.127 (P <.05) and 0.122 (P < .05), respectively. The final protocol included a total of 23 items.

Conclusions: The scientifically developed protocol provides effective guidance for the perioperative temperature management of neonates.

Purpose: This study aimed to compare operation time, vital signs, bleeding tendency, and recovery time according to anesthesia methods in hip surgery patients.

Design: This is a retrospective descriptive study.

Methods: A total of 187 patients were included, with 83 receiving general anesthesia (GA) and 104 receiving spinal anesthesia (SA). Data were collected from electronic medical records of patients aged greater than or equal to 65 years who underwent hip surgery at a single tertiary hospital from March 2023 to February 2024. The collected data were analyzed using SPSS 27.0 (IBM Corp., Armonk, NY), employing descriptive statistics, χ² tests, and independent t tests.

Findings: Significant differences were observed between the two groups with regard to the American Society of Anesthesiologists classification, with 66.3% (55 patients) of the GA group classified as American Society of Anesthesiologists III or higher, compared to 51% (53 patients) in the SA group (t = 4.43, P = .038). There were also significant differences in operation time (t = 2.89, P = .004), postoperative diastolic blood pressure (t = 2.23, P = .027), fluid volume (t = 4.05, P < .001), blood transfusion status (χ² = 5.13, P = .036), transfusion volume (t = 2.80, P = .007), estimated blood loss (t = 7.85, P = .008), bleeding volume (t = 2.27, P = .030), D-dimer (t = -3.09, P = .005), and recovery time (t = -2.10, P = .037) between anesthesia groups. GA patients showed higher average operation time, postoperative diastolic blood pressure, fluid volume, presence of bleeding, bleeding volume, need for transfusion, and transfusion volume. Conversely, SA patients had longer recovery times and higher D-dimer level.

Conclusion: This comparative analysis of patient outcomes based on anesthesia methods in hip surgery provides valuable guidelines for anesthesia care and recovery to perianesthesia nurses in Korea.

Purpose: To systematically assess and quantify the relationship between length of anesthesia time and postoperative cognitive and behavioral changes in children, by combining data from published studies to evaluate possible duration-based effects and to use them to support future clinical recommendations.

Design: The study is a systematic review and meta-analysis conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Methods: The search strategy included a systematic search of Google Scholar, PubMed, Scopus, and Web of Science for publications over the past 15 years. Inclusion criteria included randomized clinical trials and observational studies that included pediatric subjects (0 to 18 years) who underwent surgery under general anesthesia with cognitive or behavioral outcomes reported postoperatively. Studies were placed into groups based on short (<1 hour), moderate (1 to 3 hours), and prolonged anesthesia duration (>3 hours). A random-effects model was utilized for meta-analyses and effect sizes were calculated, heterogeneity was reported using the I² statistic.

Findings: The systematic review and meta-analysis included 15 studies that met inclusion and exclusion criteria. No overall effect of duration of anesthesia was found on verbal, performance, or full-scale intelligence quotient (IQ); however, a significant reduction in verbal IQ was observed in the 1- to 2-hour group (mean difference = -2.00, 95% confidence intervals [CI] = -2.53 to -1.47, P < .00001). Behavior problems were measured by the Child Behavior Checklist total problems score, which showed the strongest increases in failures for the durations of less than 2 hours, while greater durations noted strong associations with attention-deficit hyperactivity disorder (ADHD) (hazard ratio = 1.99, 95% CI: 1.40 to 2.83, P = .0001) and learning disabilities (hazard ratio = 1.71, 95% CI: 1.38 to 2.12, P < .00001). Heterogeneity appeared relatively small across these outcomes, and variability of behaviors was much lower for ADHD and learning disabilities compared with IQ measures and Child Behavior Checklist total problems.

Conclusions: Anesthesia duration has a significant effect on certain cognitive and behavioral outcomes in children. We found that anesthesia exposures of 1 to 2 hours were associated with decreased verbal IQ, and longer durations were associated with ADHD and learning disability. These results demonstrate the importance of planning for anesthesia exposure and standardized approaches in future anesthetic and cognitive studies.