Journal of Perianesthesia Nursing最新文献

Purpose: This study aims to evaluate the current state of preoperative anxiety and the informational needs of patients undergoing surgery in a preoperative holding area.

Design: Descriptive and Pre post study.

Methods: A total of 655 elective surgery patients awaiting surgery were selected from November 2021 to March 2022. Multiple linear regression analyses were conducted to examine the factors associated with preoperative anxiety and informational needs in patients exhibiting shadow responses.

Findings: The patients' mean anxiety scores were 10.33 ± 3.25. Among them, 51 patients had mean anxiety scores greater than or equal to 12, indicating a state of anxiety. The mean informational needs scores were 7.81 ± 2.66. A total of 71 patients had mean informational needs scores greater than or equal to 5, reflecting a moderate or higher level of informational needs. Multiple linear regression analysis identified gender, age, surgical table, type of surgery, quality of sleep before surgery, surgical experience, and anesthesia experience as the primary factors influencing preoperative anxiety in patients awaiting surgery. Age, surgical experience, and anesthesia experience were identified as the main factors affecting informational needs in the preoperative holding area.

Conclusions: Patients undergoing surgery in the preoperative holding area exhibit heightened levels of anxiety and informational needs. Nurses must provide enhanced psychological support interventions for these patients, particularly focusing on those who are older, female, undergoing repeated operations, gynecological surgeries, experiencing poor sleep quality before surgery, or have had distressing surgical or anesthesia experiences.

Purpose: This quality improvement project aimed to increase goal-directed hemodynamic therapy (GHDT) utilization in adult patients undergoing coronary artery bypass grafts (CABG) by implementing an evidence-based intraoperative GDHT protocol.

Design: A quality improvement project.

Methods: The team implemented a training bundle to raise awareness of complications associated with IOH, educate providers about GDHT benefits, and explain how to incorporate the protocol to guide intraoperative hemodynamic management. The team performed retrospective chart reviews to determine baseline and post-implementation GDHT protocol utilization and IOH incidence.

Findings: After receiving the education and protocol implementation, anesthesia providers began using the GDHT monitors on 100% of CABG procedures at this facility. A total of 60 patient charts were reviewed. Average cumulative hypotensive time decreased by 16.8%, from 26.37 minutes to 21.93 minutes (P = .375, 95% CI [-5.49, 13.35]).

Conclusions: Although there was no significant reduction in IOH, the training bundle and team support increased anesthesia providers' interest in using GDHT monitors. This led to a significant rise in its utilization. A future project is planned to expand the GDHT monitors and protocol to the entire operating room. Post-anesthesia care and intensive care units desiring to increase GDHT use may benefit from similar projects.

Purpose: As no widely accepted recommendations or guidelines on perioperative management for the cannabis-consuming patient exist, this quality improvement project aimed to identify and implement evidence-based recommendations for cannabis-consuming patients throughout the perioperative period. The objectives of this project were (1) to improve anesthesia providers' knowledge on how to care for cannabis-consuming patients, (2) to increase anesthesia providers' self-efficacy in caring for cannabis-consuming patients, and (3) to assess the frequency of utilization of the given evidence-based recommendation.

Design: This quality improvement project incorporated a pretest-posttest design.

Methods: Nurse anesthetists, resident nurse anesthetists, and nurse practitioners (staff) in an urban veteran's hospital participated in the project. Following the Johns Hopkins Evidence-based Practice Model, a literature review was conducted via PubMed, Cochrane Library, and Cumulative Index to Nursing & Allied Health Literature to determine anesthetic considerations for cannabis consumers. Evidence was synthesized and translated into a live educational seminar that was evaluated via an electronic questionnaire before and after (pretest-postest) the seminar. Frequency of education utilization was measured via sticker poster system. Normality tests were conducted using Jamovi computer software. Wilcoxon signed-rank tests were pursued due to the skewed data distribution.

Findings: Results from 22 articles informed content for the live educational seminar; 26 staff participated in the pretest-posttest. Specific preoperative, intraoperative, and postoperative considerations were extracted from the evidence. Questionnaire results showed a 60% increase in self-efficacy (P = .001), a 44% increase in knowledge (P = .001), and a 92% utilization rate (26/28 cannabis-consuming patients) of the recommendations in the clinical setting.

Conclusions: With nearly 20% of veterans indicating use of cannabis, perianesthesia nurses should be aware of the unique preoperative, intraoperative, and postoperative considerations for the cannabis-consuming patient.

Purpose: Thirst during surgical intervention is an important parameter that may affect the clinical course of patients. In this context, although there is a large body of knowledge in the existing literature on thirst during the surgical period, the lack of bibliometric analysis on this subject is striking. This study aims to systematically evaluate scientific publications on thirst during the surgical period, to fill the gaps in the literature, and to provide new perspectives that can guide clinical practice.

Design: Descriptive and bibliometric analyses were used.

Methods: The study universe consisted of 256 articles on postoperative thirst in the SCOPUS database. The study data were analyzed with Excel and they were visualized with VOSviewer and Bibliometrix Package in R software.

Findings: In the study, it was determined that the 256 articles identified were published in 181 different sources between 1969 and 2024, with a total of 1,194 authors contributing to these articles. In this research area, the top 3 publishing countries, China (111) has the highest productivity, followed by the United States (67) and Brazil (52). Most of the articles were published in "Journal of Perianesthesia Nursing," "British Journal of Anesthesia," and "Acta Anaesthesiologica Scandinavica."

Conclusions: The year and forecast analysis show that the number of studies on thirst, which is an important problem among surgical patients, has increased and will increase in the coming years. The increasing interest in thirst as an important problem among surgical patients shows that the interest and demand for research in this field are increasing.

Purpose: The objective of this study was to evaluate the effects of magnetic ball press combined with transcutaneous electrical acupoint stimulation not only on the incidence of postoperative nausea and vomiting (PONV), but also on postoperative pain, comfort, and patient satisfaction in patients undergoing laparoscopic gynecological surgery.

Design: A randomized controlled trial comprising 120 patients undergoing elective gynecological surgery was conducted. These patients were randomly allocated into 3 groups, each consisting of 40 cases.

Methods: The magnetic-electricity-combined group received magnetic ball paste pressure combined with transcutaneous acupoint electrical stimulation, along with standard care. The acupoint pressure group received preoperative acupoint pressure, in addition to conventional care. The no-intervention group received only conventional care. The incidence of PONV, as well as postoperative pain, comfort, and satisfaction, were assessed within the initial 24 hours post surgery using the Visual Analog Scale (VAS) for PONV and pain, the Numerical Rating Scale for pain, the comfort scale, and a patient satisfaction scale.

Findings: The incidence of PONV within 24 hours post surgery was significantly lower in the magneto-electric combination group than in the acupressure and no-intervention groups (5% vs 57.5% vs 57.5%, P < .05). The postoperative pain score (VAS) was significantly lower in the magneto-electric combination group compared with the acupressure and no-intervention groups. The percentage of patients experiencing moderate pain was 12.5% in the magneto-electric group, 77.5% in the acupressure group, and 82.5% in the no-intervention group (P < .05). Furthermore, the magneto-electric combination group exhibited significantly higher comfort scores than the other 2 groups (105.15 ± 5.24 vs 94.65 ± 4.25 vs 91.40 ± 5.29, P < .05). Similarly, the magneto-electric combination group demonstrated significantly higher patient satisfaction scores than the other 2 groups (2.00 ± 0.00 vs 1.57 ± 0.50 vs 1.55 ± 0.50, P < .05).

Conclusions: The combination of magnetic ball compression with transcutaneous electrical stimulation of acupoints significantly reduces the incidence of PONV in patients undergoing gynecological laparoscopic surgery. Furthermore, it mitigates postoperative pain and improves patient comfort and satisfaction, thereby presenting a viable and efficacious approach for postoperative nursing interventions.

Purpose: To increase first-case on-time start (FCOTS) rates at a large New England hospital by optimizing the use of a preoperative (pre-op) push notification system to reduce delays and improve operating room efficiency.

Design: The project employed a quality improvement approach guided by the Model for Improvement from the Institute for Healthcare Improvement.

Methods: A push notification system integrated into the electronic health record was used to enhance communication between surgeons and pre-op nurses across three surgical pavilions. Mandatory education sessions were provided for all enrolled staff, and Plan-Do-Study-Act cycles were conducted to refine processes and monitor outcomes. Data on notification usage and FCOTS rates were tracked from pre implementation (August 2023) through the implementation phase (December 2023).

Findings: Training resulted in 87% (n = 60) of nurses completing the push notification education, and 31% (n = 28) of surgeons confirmed reviewing training materials. Initial implementation increased push notification use among nurses from 26% to a peak of 51% in October 2023, though this later declined to 39% by year-end with net gain of 17%. Among surgeons, push notification usage peaked at 18%, with a net gain of 2% over the baseline. The East pavilion maintained relatively high FCOTS rates, decreasing slightly from 82% in October to 78% by year-end. In the North and South pavilions, increased push notification usage by nurses aligned with gradual FCOTS improvements: the North pavilion rose from 63% to 65%, while the South pavilion experienced fluctuations, ultimately achieving a 12% increase from baseline to reach 57% in December.

Conclusions: These findings suggest that while increased push notification use among nurses helped improve FCOTS in some pavilions, limited surgeon participation may have hindered the overall impact on reducing delays. Future strategies should focus on increasing engagement from all staff, improving workflow integration, and implementing ongoing performance tracking to optimize surgical efficiency across all pavilions. Enhancing FCOTS not only improves the patient experience by reducing wait times and increasing satisfaction, but also benefits staff by streamlining workflows and reducing stress. Ultimately, these improvements support organizational goals for greater efficiency and cost-effectiveness in perioperative care.