Pub Date : 2024-12-01DOI: 10.1016/j.jopan.2024.01.002
Zheng Yuan MN , Yali You BN , Xiaofei Song MM , Wenbo Wu MM , Xiaopeng Zhang MD , Guochen Duan MD
Purpose
To construct the comfort status scale for patients with lung cancer after thoracoscopic surgery.
Design
Delphi method inquiry to 15 clinical and nursing experts.
Methods
On the basis of the comfort status scale and the subjective experience and objective symptoms of patients with lung cancer after thoracoscopic surgery, the relevant literature was consulted, semistructured interviews and group discussions were conducted, the pool of items of the postoperative comfort status scale for patients with lung cancer was initially formed, and the postoperative comfort status scale for patients with lung cancer was finally established.
Findings
The positive coefficient of experts was 100%, the coefficient of authority was 0.92 and 0.93, and the Kendal's W was 0.257 and 0.298, the degree of coordination of expert opinions was statistically significant (P < .05). Finally, a total of 28 items in four dimensions were formed to assess the postoperative comfort status of patients with lung cancer after thoracoscopic surgery.
Conclusions
The Delphi method-based comfort status scale for patients with lung cancer after thoracoscopic surgery is scientific and reliable, and can provide a quantitative basis for the evaluation of the comfort status of patients after lung cancer thoracoscopic surgery, to further provide individual comfort care measures.
{"title":"A Delphi Method Comfort Status Scale for Patients With Lung Cancer After Thoracoscopic Surgery","authors":"Zheng Yuan MN , Yali You BN , Xiaofei Song MM , Wenbo Wu MM , Xiaopeng Zhang MD , Guochen Duan MD","doi":"10.1016/j.jopan.2024.01.002","DOIUrl":"10.1016/j.jopan.2024.01.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To construct the comfort status scale for patients with lung cancer after thoracoscopic surgery.</div></div><div><h3>Design</h3><div>Delphi method inquiry to 15 clinical and nursing experts.</div></div><div><h3>Methods</h3><div>On the basis of the comfort status scale and the subjective experience and objective symptoms of patients with lung cancer after thoracoscopic surgery, the relevant literature was consulted, semistructured interviews and group discussions were conducted, the pool of items of the postoperative comfort status scale for patients with lung cancer was initially formed, and the postoperative comfort status scale for patients with lung cancer was finally established.</div></div><div><h3>Findings</h3><div>The positive coefficient of experts was 100%, the coefficient of authority was 0.92 and 0.93, and the Kendal's W was 0.257 and 0.298, the degree of coordination of expert opinions was statistically significant (<em>P</em> < .05). Finally, a total of 28 items in four dimensions were formed to assess the postoperative comfort status of patients with lung cancer after thoracoscopic surgery.</div></div><div><h3>Conclusions</h3><div>The Delphi method-based comfort status scale for patients with lung cancer after thoracoscopic surgery is scientific and reliable, and can provide a quantitative basis for the evaluation of the comfort status of patients after lung cancer thoracoscopic surgery, to further provide individual comfort care measures.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 958-963.e1"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore if cold debriefing, which by definition, occurs days to weeks following the critical event, addresses identified barriers to routine debriefing and results in instituting debriefing as standard practice in the perianesthesia division at the site hospital.
Design
A qualitative descriptive design using case study reviews
Methods
Seven critical events, meeting the criteria of a preproject list, were debriefed by the patient’s primary nurse using a cold debriefing method. Following the debriefing session, the nurse outlining the event, and the staff in attendance were asked to complete a short survey. Knowledge gained or education needed, suggestions for process improvements, and perceived safety of the environment, and feeling safe to provide feedback were assessed.
Findings
Identified barriers were reduced with the institution of cold debriefing. An average of 33% of the working staff were able to attend at least one debriefing session, indicating the barrier of time may be diminished by using cold debriefing. Most staff and debriefers also felt the environment was safe, and feedback provided during the debriefing sessions resulted in identified needed education and process improvement measures.
Conclusions
Implementation of cold debriefing to share and examine information following a critical event may address common barriers, result in process improvement measures, and identify educational needs required by the perianesthesia staff.
{"title":"An Innovative Method to Debrief Critical Events","authors":"Lori Helms DNP, RN, NPD-BC, CPAN, Lori Buzalewski BSN, RN, CPAN, Michelle Pachuilo BSN, RN, CPAN, Ariana Pilat BSN, RN, CCRN, CGRN, Kimberly Reeser MSN, RN, CAPA","doi":"10.1016/j.jopan.2024.01.003","DOIUrl":"10.1016/j.jopan.2024.01.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore if cold debriefing, which by definition, occurs days to weeks following the critical event, addresses identified barriers to routine debriefing and results in instituting debriefing as standard practice in the perianesthesia division at the site hospital.</div></div><div><h3>Design</h3><div>A qualitative descriptive design using case study reviews</div></div><div><h3>Methods</h3><div>Seven critical events, meeting the criteria of a preproject list, were debriefed by the patient’s primary nurse using a cold debriefing method. Following the debriefing session, the nurse outlining the event, and the staff in attendance were asked to complete a short survey. Knowledge gained or education needed, suggestions for process improvements, and perceived safety of the environment, and feeling safe to provide feedback were assessed.</div></div><div><h3>Findings</h3><div>Identified barriers were reduced with the institution of cold debriefing. An average of 33% of the working staff were able to attend at least one debriefing session, indicating the barrier of time may be diminished by using cold debriefing. Most staff and debriefers also felt the environment was safe, and feedback provided during the debriefing sessions resulted in identified needed education and process improvement measures.</div></div><div><h3>Conclusions</h3><div>Implementation of cold debriefing to share and examine information following a critical event may address common barriers, result in process improvement measures, and identify educational needs required by the perianesthesia staff.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 949-954"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141328012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.jopan.2024.02.006
Ping Xue , Qin Zhang , Jueying Xiang , Huan Yang , Dan Wang , Qinghua Jia , Ling Chen , Yiling Liu , Jing Wu
Purpose
To compare the clinical effects of nonpressure and pressure dressings on the postoperative complications of modified Milligan-Morgan hemorrhoidectomy.
Design
Randomized controlled trial.
Methods
A total of 186 patients with grade II to III mixed hemorrhoids who had been excluded from cardiovascular and cerebrovascular diseases and anorectal surgery were included and randomly assigned to the nonpressure dressings group and the pressure dressings group by random number table. The incidence of acute urinary retention and medical adhesive-related skin injury, pain, hemostatic effect, anal distension, anal edema, use of analgesics, length of hospital stay, and hospitalization costs were compared between the two groups. The Consolidated Standards of Reporting Trials checklist for randomized controlled trials was used in this study.
Findings
The incidence of acute urinary retention in both men and women was significantly lower in the nonpressure dressing group (relative risk [RR] = 0.20, 95% confidence interval [CI] [0.13, 0.37], P = .002); (RR = 0.47, 95% CI [0.22, 0.76], P = .015). The postoperative pain at 6 hours/18 hours/25 hours was significantly lower in the nonpressure dressing group (P < .001, P = .004 < 0.05, P = .009). The anal distension at 6 hours and the number of patients who used analgesics were significantly lower in the nonpressure dressing group (P < .001). The incidence of medical adhesive-related skin injuries was significantly lower in the nonpressure dressing group (RR = 0.061, 95% CI [0.020, 0.189], P < .001). No primary bleeding was observed in both groups. However, there were no significant differences between both groups in terms of anal edema scores, length of stay, or hospitalization expenses. No adverse events were reported in either group during the study period.
Conclusions
Nonpressure dressings can effectively reduce the incidence of acute urinary retention and medical adhesion-related skin injury after surgery for grade III to IV mixed hemorrhoids. They can also safely relieve pain and distension.
目的：比较无压敷料和加压敷料对改良米利根-摩根痔切除术术后并发症的临床效果：随机对照试验：方法：纳入186例Ⅱ～Ⅲ度混合痔患者，排除心脑血管疾病和肛门直肠手术，通过随机数字表随机分配到无压敷料组和加压敷料组。比较了两组急性尿潴留和医用粘合剂相关皮肤损伤、疼痛、止血效果、肛门坠胀、肛门水肿、止痛药使用、住院时间和住院费用的发生率。本研究采用了随机对照试验综合报告标准核对表：不加压敷料组男性和女性急性尿潴留的发生率均显著低于加压敷料组（相对风险 [RR] = 0.20，95% 置信区间 [CI] [0.13, 0.37]，P = .002）；（RR = 0.47，95% CI [0.22, 0.76]，P = .015）。无压力敷料组术后 6 小时/18 小时/25 小时的疼痛明显降低（P 结论：无压力敷料可有效减轻术后疼痛：无压敷料可有效降低 III 至 IV 级混合痔术后急性尿潴留和医源性粘连相关皮肤损伤的发生率。它们还能安全地缓解疼痛和胀痛。
{"title":"Effect of Pressure and Nonpressure Dressings on Postoperative Complications in Patients With Mixed Hemorrhoids: A Single-blind Controlled Study","authors":"Ping Xue , Qin Zhang , Jueying Xiang , Huan Yang , Dan Wang , Qinghua Jia , Ling Chen , Yiling Liu , Jing Wu","doi":"10.1016/j.jopan.2024.02.006","DOIUrl":"10.1016/j.jopan.2024.02.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the clinical effects of nonpressure and pressure dressings on the postoperative complications of modified Milligan-Morgan hemorrhoidectomy.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Methods</h3><div>A total of 186 patients with grade II to III mixed hemorrhoids who had been excluded from cardiovascular and cerebrovascular diseases and anorectal surgery were included and randomly assigned to the nonpressure dressings group and the pressure dressings group by random number table. The incidence of acute urinary retention and medical adhesive-related skin injury, pain, hemostatic effect, anal distension, anal edema, use of analgesics, length of hospital stay, and hospitalization costs were compared between the two groups. The Consolidated Standards of Reporting Trials checklist for randomized controlled trials was used in this study.</div></div><div><h3>Findings</h3><div>The incidence of acute urinary retention in both men and women was significantly lower in the nonpressure dressing group (relative risk [RR] = 0.20, 95% confidence interval [CI] [0.13, 0.37], <em>P</em> = .002); (RR = 0.47, 95% CI [0.22, 0.76], <em>P</em> = .015). The postoperative pain at 6 hours/18 hours/25 hours was significantly lower in the nonpressure dressing group (<em>P</em> < .001, <em>P</em> = .004 < 0.05, <em>P</em> = .009). The anal distension at 6 hours and the number of patients who used analgesics were significantly lower in the nonpressure dressing group (<em>P</em> < .001). The incidence of medical adhesive-related skin injuries was significantly lower in the nonpressure dressing group (RR = 0.061, 95% CI [0.020, 0.189], <em>P <</em> .001). No primary bleeding was observed in both groups. However, there were no significant differences between both groups in terms of anal edema scores, length of stay, or hospitalization expenses. No adverse events were reported in either group during the study period.</div></div><div><h3>Conclusions</h3><div>Nonpressure dressings can effectively reduce the incidence of acute urinary retention and medical adhesion-related skin injury after surgery for grade III to IV mixed hemorrhoids. They can also safely relieve pain and distension.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1088-1094"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.jopan.2024.01.015
Mengchao Jiang MMed , Bei Wang MD , Meinv Liu MMed , Huanhuan Zhang MMed , Jianli Li MD
Purpose
Stress response is a common complication during extubation, mainly manifested by dramatic hemodynamic fluctuations. Transcutaneous electrical acupoint stimulation (TEAS) is widely applied in the perioperative period. We performed this meta-analysis to evaluate whether the TEAS could relieve the stress response during extubation in noncardiac surgery patients.
Design
A systematic review and meta-analysis of randomized controlled trials.
Methods
We searched six databases (PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, CNKI, and Wan Fang) for relevant literature. A risk of bias assessment was executed based on the Cochrane Criteria. We applied RevMan5.4.1 software to analyze data. When the χ2 test did not show heterogeneity, we adopted the fixed-effect model. Otherwise, the random-effect model was used.
Findings
ln total, 12 randomized controlled trials with 1,347 participants were enrolled in this meta-analysis. Meta-analysis showed the heart rate and mean arterial pressure of the intervention group were significantly lower than the control group at immediately, 5 minutes, and 10 minutes after extubation. The occurrence rate of emergency agitation (RR 0.39, 95% CI [0.26,0.60]) and postoperative delirium (RR 0.40, 95% CI [0.22, 0.72] were also lower in the TEAS group. The consumption of propofol (standardized mean difference (SMD) 0.47, 95% CI [−0.77, −0.18]) and remifentanil (SMD 1.49, 95% CI [−2.01, −0.96]) of the intervention group were also significantly reduced compared with the control group.
Conclusions
TEAS was beneficial for improving stress response during extubation, emergence agitation, postoperative delirium, and reduced the consumption of intraoperative propofol and remifentanil, but it was necessary to note the limitations of the current evidence.
目的：应激反应是拔管过程中常见的并发症，主要表现为血流动力学的剧烈波动。经皮穴位电刺激（TEAS）被广泛应用于围手术期。我们进行了这项荟萃分析，以评估经皮穴位电刺激是否能缓解非心脏手术患者拔管时的应激反应：设计：对随机对照试验进行系统回顾和荟萃分析：我们检索了六个数据库（PubMed、Web of Science、Embase、Cochrane Library、China National Knowledge Infrastructure、CNKI 和 Wan Fang）中的相关文献。根据 Cochrane 标准进行了偏倚风险评估。我们使用RevMan5.4.1软件分析数据。当χ2检验未显示异质性时，我们采用固定效应模型。结果：本次荟萃分析共纳入了 12 项随机对照试验，共有 1 347 名参与者。荟萃分析表明，干预组在拔管后立即、5 分钟和 10 分钟的心率和平均动脉压均显著低于对照组。TEAS 组的急诊躁动（RR 0.39，95% CI [0.26,0.60]）和术后谵妄（RR 0.40，95% CI [0.22,0.72]）发生率也较低。与对照组相比，干预组的异丙酚用量（标准化平均差（SMD）0.47，95% CI [-0.77，-0.18]）和瑞芬太尼用量（SMD 1.49，95% CI [-2.01，-0.96]）也显著减少：TEAS有利于改善拔管时的应激反应、出现躁动、术后谵妄，并减少术中丙泊酚和瑞芬太尼的用量，但有必要注意目前证据的局限性。
{"title":"Effect of Transcutaneous Electrical Acupoint Stimulation on Extubation-Related Stress Response in Noncardiac Surgery Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Mengchao Jiang MMed , Bei Wang MD , Meinv Liu MMed , Huanhuan Zhang MMed , Jianli Li MD","doi":"10.1016/j.jopan.2024.01.015","DOIUrl":"10.1016/j.jopan.2024.01.015","url":null,"abstract":"<div><h3>Purpose</h3><div>Stress response is a common complication during extubation, mainly manifested by dramatic hemodynamic fluctuations. Transcutaneous electrical acupoint stimulation (TEAS) is widely applied in the perioperative period. We performed this meta-analysis to evaluate whether the TEAS could relieve the stress response during extubation in noncardiac surgery patients.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>We searched six databases (PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, CNKI, and Wan Fang) for relevant literature. A risk of bias assessment was executed based on the Cochrane Criteria. We applied RevMan5.4.1 software to analyze data. When the χ<sup>2</sup> test did not show heterogeneity, we adopted the fixed-effect model. Otherwise, the random-effect model was used.</div></div><div><h3>Findings</h3><div>ln total, 12 randomized controlled trials with 1,347 participants were enrolled in this meta-analysis. Meta-analysis showed the heart rate and mean arterial pressure of the intervention group were significantly lower than the control group at immediately, 5 minutes, and 10 minutes after extubation. The occurrence rate of emergency agitation (RR 0.39, 95% CI [0.26,0.60]) and postoperative delirium (RR 0.40, 95% CI [0.22, 0.72] were also lower in the TEAS group. The consumption of propofol (standardized mean difference (SMD) 0.47, 95% CI [−0.77, −0.18]) and remifentanil (SMD 1.49, 95% CI [−2.01, −0.96]) of the intervention group were also significantly reduced compared with the control group.</div></div><div><h3>Conclusions</h3><div>TEAS was beneficial for improving stress response during extubation, emergence agitation, postoperative delirium, and reduced the consumption of intraoperative propofol and remifentanil, but it was necessary to note the limitations of the current evidence.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 990-998"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.jopan.2024.01.027
Yiting Wang MSCN, SN, Jiaqi Shi MSCN, NP, Yanjun Wei MSCN, SN, Jin Wu MD
Purpose
To summarize the evidence on perioperative nausea and vomiting management in adult patients worldwide.
Design
This is a summary of the best evidence on postoperative nausea and vomiting in adults.
Methods
Databases such as British Medical Journal Best Practice, Cochrane Library, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearing House, Guidelines International Network, American Society of Anesthesiologists (ASA), Association of periOperative Registered Nurses (AORN), Registered Nurses Association of Ontario, PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Yimaitong Clinical Guidelines, China Anesthesia Official website, SinoMed, China National Knowledge Infrastructure, Wanfang, and VIP were searched to collect the relevant guidelines for clinical decision-making, best practices, systematic review, evidence summary, and expert consensus about perioperative nausea and vomiting management. The retrieval time was from the establishment of the database to January 2022. Two authors independently evaluated the quality of the included literature and extracted and summarized the evidence that met the quality criteria.
Findings
A total of 22 studies, including 1 best practice, 2 clinical decision-making articles, 7 evidence summaries, 1 clinical guideline, 9 systematic reviews, and 2 expert consensuses, were included. The summary of 37 pieces of evidence from 7 aspects: risk factors, assessment methods, multimodal prevention strategy, health education, nondrug intervention, drug prevention, postoperative analgesia management strategy, and organization management.
Conclusions
The health care team should select the best evidence according to the characteristics of the department and clinical practice, scientifically manage perioperative nausea and vomiting of patients, reduce the incidence and severity of nausea and vomiting, and promote the accelerated rehabilitation of patients.
{"title":"PONV Management in Adult Patients: Evidence-based Summary","authors":"Yiting Wang MSCN, SN, Jiaqi Shi MSCN, NP, Yanjun Wei MSCN, SN, Jin Wu MD","doi":"10.1016/j.jopan.2024.01.027","DOIUrl":"10.1016/j.jopan.2024.01.027","url":null,"abstract":"<div><h3>Purpose</h3><div>To summarize the evidence on perioperative nausea and vomiting management in adult patients worldwide.</div></div><div><h3>Design</h3><div>This is a summary of the best evidence on postoperative nausea and vomiting in adults.</div></div><div><h3>Methods</h3><div><span>Databases such as British Medical Journal Best Practice, Cochrane Library, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearing House, Guidelines International Network, American Society of Anesthesiologists (ASA), Association of periOperative Registered Nurses (AORN), Registered Nurses Association of Ontario, PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Yimaitong Clinical Guidelines, China Anesthesia Official website, SinoMed, China National Knowledge Infrastructure, Wanfang, and VIP were searched to collect the relevant guidelines for clinical decision-making, best practices, </span>systematic review, evidence summary, and expert consensus about perioperative nausea and vomiting management. The retrieval time was from the establishment of the database to January 2022. Two authors independently evaluated the quality of the included literature and extracted and summarized the evidence that met the quality criteria.</div></div><div><h3>Findings</h3><div>A total of 22 studies, including 1 best practice, 2 clinical decision-making articles, 7 evidence summaries, 1 clinical guideline, 9 systematic reviews, and 2 expert consensuses, were included. The summary of 37 pieces of evidence from 7 aspects: risk factors, assessment methods, multimodal prevention strategy, health education, nondrug intervention, drug prevention, postoperative analgesia management strategy, and organization management.</div></div><div><h3>Conclusions</h3><div>The health care team should select the best evidence according to the characteristics of the department and clinical practice, scientifically manage perioperative nausea and vomiting of patients, reduce the incidence and severity of nausea and vomiting, and promote the accelerated rehabilitation of patients.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1095-1103"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.jopan.2024.01.025
Yi-lin Zeng RN , Li-jun Zhu PhD, RN , Min Lian RN , Hui-ping Ma RN , Hong Cui RN , Yan-e Li RN
Purpose
To explore the optimal plan for the timing of indwelling gastric tube placement in oral and maxillofacial malignant tumor patients.
Design
A prospective randomized controlled trial.
Methods
80 patients with oral and maxillofacial tumor were selected, and 40 patients were Pre-operative group. The remaining 40 patients were the control group, called Postoperative group. The body weight and hospital stay of the two groups were observed before and after surgery. Blood samples were taken before surgery and 1, 3 and 7 days after surgery to detect hemoglobin and plasma albumin.
Findings
The number of postoperative hospitalization days in the pre-operative group was significantly lower than that in the post-operative group; postoperative hemoglobin and plasma albumins were lower in both groups compared with the preoperative level.
Conclusions
Preoperative nasogastric tube ensured early postoperative administration of gastrointestinal nutrition, promoted postoperative plasma albumin recovery, and shortened the days of hospitalization.
{"title":"Comparison of the Efficacy of Indwelling Gastric Tubes in Preoperative and Postoperative Patients With Oral and Maxillofacial Malignancies","authors":"Yi-lin Zeng RN , Li-jun Zhu PhD, RN , Min Lian RN , Hui-ping Ma RN , Hong Cui RN , Yan-e Li RN","doi":"10.1016/j.jopan.2024.01.025","DOIUrl":"10.1016/j.jopan.2024.01.025","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the optimal plan for the timing of indwelling gastric tube placement in oral and maxillofacial malignant tumor patients.</div></div><div><h3>Design</h3><div>A prospective randomized controlled trial.</div></div><div><h3>Methods</h3><div>80 patients with oral and maxillofacial tumor were selected, and 40 patients were Pre-operative group. The remaining 40 patients were the control group, called Postoperative group. The body weight and hospital stay of the two groups were observed before and after surgery. Blood samples were taken before surgery and 1, 3 and 7 days after surgery to detect hemoglobin and plasma albumin.</div></div><div><h3>Findings</h3><div>The number of postoperative hospitalization days in the pre-operative group was significantly lower than that in the post-operative group; postoperative hemoglobin and plasma albumins were lower in both groups compared with the preoperative level.</div></div><div><h3>Conclusions</h3><div>Preoperative nasogastric tube ensured early postoperative administration of gastrointestinal nutrition, promoted postoperative plasma albumin recovery, and shortened the days of hospitalization.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1056-1061"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.jopan.2024.02.003
Lisa Allison Herbinger DNP, CRNA
The use of opioid-sparing and opioid-free strategies in children can provide adequate analgesia while decreasing the risk of adverse events and contributing to the ongoing battle against the opioid crisis. However, every child must be evaluated individually so that a safe and efficacious perioperative pain management plan can be created. A working knowledge of the risks and benefits of opioids, nonopioid adjuncts, and regional anesthesia along with the ethical considerations for balancing stewardship and beneficent care is essential to the success of these strategies. As perioperative practitioners caring for children, we have an obligation to consider opioid-sparing and opioid-free strategies to promote overall best outcomes. We can make a difference, one child at a time.
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The purpose of this study was to understand certified registered nurse anesthetists’ (CRNAs) experiences of nursing in anesthesia care.
Design
An explorative qualitative study was conducted with inspiration from Ricoeur’s hermeneutic phenomenological theory of interpretation.
Methods
Three focus group interviews were carried out with participants representing 5 anesthesiology departments from 3 hospitals in Denmark (a total of 14 participants). The participants were all CRNAs. The transcribed interviews were examined as one coherent text using a Ricoeur-inspired approach, in which the analysis was conducted on three levels: naive reading, structural analysis, and critical interpretation.
Findings
The structural analysis identified three themes relevant to the CRNAs’ experiences of nursing: (1) the relationship with the patient, in which caring and professionalism are equally important; (2) differences between professions when sitting in the operating room; and (3) conflicts between production and caring. The study showed that CRNAs are aware of their professional identities as nurses and view anesthesia nursing as an integration of technical tasks and caring, in which the relationship with the patient and serving as the patient’s representative are central. A major aspect of nursing is performed while the patient is anesthetized, and the CRNA attends to the patient’s basic needs. The study also found that CRNAs find it difficult to define nursing in anesthesia care because of the overlapping tasks and skills between CRNAs and anesthesiologists.
Conclusions
CRNAs are very aware of their professional identities as nurses. The professionalism involved in their relationships with patients is evident in the CRNAs’ representation of the patients themselves.
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Pub Date : 2024-12-01DOI: 10.1016/S1089-9472(24)00540-9
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