Journal of Perianesthesia Nursing最新文献

Purpose: This study was conducted to evaluate the Turkish adaptation of the Road to My Surgery Preoperative Checklist.

Design: A methodological, correlational, and comparative study.

Methods: This study was conducted with 125 children between July 2022 and December 2023. Data were collected using an information form and the Road to My Surgery Preoperative Checklist. To evaluate the data, various analyses were performed, including content validity analysis, Kuder-Richardson 20 analysis, intraclass correlation analysis, upper and lower 27% group analysis, and item-total score correlation.

Findings: The Kuder-Richardson 20 reliability coefficient of the Road to My Surgery Preoperative Checklist was 0.715 and the intraclass correlation coefficient was 0.627. The item-total score correlation coefficients of the checklist items were between 0.099 and 0.836. A difference was found between the scale total mean scores of children in the upper 27% group and children in the lower 27% group (P < .005).

Conclusions: The Road to My Surgery Preoperative Checklist is a valid and reliable measurement tool for the Turkish sample.

Purpose: The aim in the present study was to evaluate the effects of chewing postoperative xylitol gum on gastrointestinal functional recovery after laparoscopic cholecystectomy.

Design: A three-arm randomized controlled trial.

Methods: After a baseline assessment, participants were randomly assigned in three groups. The random assignment was performed by using a computer program (Microsoft Excel 2016). Afterward, participants were categorized into three subgroups. Group 3 was the control group that consisted of participants who had no intervention for chewing gum (n = 25). Group 2 was xylitol-free gum chewing group (n = 25), whereas Group 1 was xylitol gum chewing group (n = 24). In later phases, the time to first postsurgical flatus, time to first bowel sound after surgery, time to first postsurgical defecation, time to first mobilization after surgery, and discharge time from hospital were recorded. Nausea and vomiting, which are among the postoperative symptoms, were also evaluated.

Findings: The duration of the control group from the end of surgery to the flatulence and bowel sounds was statistically higher than the xylitol group and xylitol-free group (all P < .05). Also, first postoperative flatulence time of xylitol-free group was higher than the xylitol group (P < .05). The duration from the end of surgery to defecation was longer in the control group compared with the xylitol group and the xylitol-free group, with a statistically significant difference between the groups (P < .05). In this study, a statistically significant difference was observed in terms of the time to first postsurgical flatus, time to first bowel sound after surgery, and time to first postsurgical defecation (all P < .000). No significant difference was found between the xylitol group, xylitol-free group, and control group when discharge from hospital and mobilization times were analyzed (all of them are P > .05).

Conclusions: Chewing xylitol gum facilitates postoperative gastrointestinal recovery after laparoscopic cholecystectomy. Further studies are recommended to confirm these findings and investigate the underlying mechanisms.

Purpose: This study aims to evaluate the effect of acupoint application on the prevention of postoperative sore throat (POST), cough, expectoration, hoarseness, and patient satisfaction after general anesthesia.

Design: Randomized controlled trial.

Methods: A randomized double-blind clinical trial was designed. In total, 112 participants scheduled for gynecology or general surgery under general anesthesia were randomly assigned to 1 of 2 groups. One was the acupoint application group (group A) that received a session of acupoint application over the acupoints of Tiantu (RN22), Neiguan (PC6, bilateral), Zusanli (ST36, bilateral), and Yongquan (KI1, bilateral). The other was the placebo group (group P) and received a session of sham acupoint application in the same acupoints. In virtue of the visual analog scale score, the effects of acupoint application were measured by the incidence of POST, cough, expectoration, and hoarseness before, 24 hours, and 48 hours after the intervention, and patient satisfaction after surgery.

Findings: The incidence of POST was lower in group A versus group P at 24 hours [13 (24.5%) vs 23 (44.2%), P = .033] and at 48 hours [3 (5.7%) vs 15 (28.8%), P = .002]. Compared with group P, the visual analog scale of POST was dramatically lower in group A at 24 and 48 hours (P = .024; P < .001). Group A had a reduced incidence of cough, expectoration, and hoarseness than group P at 48 hours. In addition, patients in group A felt more satisfied postoperatively than patients in group P (96.2% vs 80.8%, P = .013).

Conclusions: Acupoint application effectively relieved POST in adults following general endotracheal anesthesia, reduced the incidence of postoperative cough, expectoration, and hoarseness, as well as improved patient satisfaction.

Purpose: The aim of this study is to observe the effect of music combined with preoperative education on perioperative anxiety in patients undergoing open cardiac surgery.

Design: This was a randomized controlled study.

Methods: A group of 322 patients undergoing elective open cardiac surgery were randomly allocated to receive either music combined with preoperative education (the experimental group) or routine preoperative preparation (the control group). The primary endpoint was perioperative anxiety scores. The secondary outcome measures included length of stay in the intensive care unit, length of hospital stay, perioperative mean blood pressure, heart rate, respiratory rate, and quality of life score measured with the SF-36 subscale scores. This study collected data at the following 6 time points: T0 (preoperative baseline value), T1 (10 minutes after preoperative combined intervention), T2 (after patient extubation), T3 (10 minutes after intensive care unit intervention), T4 (the first day after patient admission), and T5 (1 month after patient discharge).

Findings: The experimental group reported significantly lower anxiety scores than the control group at both T1 and T4 time points. The experimental group had a significantly shorter length of stay in the intensive care unit and length of hospital stay than the control group. Heart rate, mean blood pressure, and respiratory rate were significantly lower in the experimental group at T1, T3, and T4 time points. The mean blood pressure and heart rate were significantly lower in the experimental group at the T2 time point. The SF-36 subscale scores were significantly higher in the experimental group at the T5 time point.

Conclusions: The combination of music and preoperative education provides effective antianxiety and accelerates recovery in patients undergoing open cardiac surgery.

Purpose: This review aims to investigate the effectiveness of nurse-led preoperative visits for the reduction of presurgical anxiety. The review will explore the patterns and mechanisms through which these visits alleviate anxiety, identify the existing practice gaps, and suggest future directions for improvement. The findings will help health care providers choose appropriate visits for their patients.

Design: An integrative review.

Methods: From January 2000 to July 2023, studies on nurse-led preoperative visits were searched in Cochrane Library, Pubmed, Embase, and Web of Science databases. The search only includes English-language full-text entries. Thirteen articles were selected from the 5,741 studies discovered after the quality was rated using the Joanna Briggs Institute appraisal tool. The parameters addressed by the 13 articles chosen for evaluation included, but were not limited to, the type of research done, sample characteristics, and the types of interventions used by the researchers.

Findings: Interviews between nurses and patients are the primary and most prevalent means of exchanging information during nurse-led preoperative visits. These interviews can be classified as structured, with a predetermined set of questions, and unstructured, allowing for flexibility and adaptation based on the patient's responses and needs. Audiovisual materials and written materials were provided to assist with the interview. Nurse-led preoperative visits significantly reduce feelings of anxiety by providing patient education on preoperative procedures and routines, improving trust between patients and caregivers, offering emotional support, and promoting informed decision-making through preoperative education.

Conclusions: In clinical practice, the nurse-led preoperative visit is important for lowering preoperative anxiety. The advantages of these visits may be extended to more patients by incorporating innovative methods such as improving the pattern of preoperative visits, prioritizing the nurse's role in preoperative patient visits, and using emerging technology.

Purpose: Nurses at the study hospitals had implemented aromatherapy as an evidence-based intervention to alleviate nausea, pain, and anxiety in patients in the perioperative setting. Initially, they were approved to administer aromatherapy using large, multidose bottles with gauze as the method of delivery; however, nurses recognized that there were many disadvantages to using this method. This led to a nurse-driven initiative to create a new delivery method for aromatherapy with the aid of the Center for Innovation at the organization. Single, individually wrapped packets were developed to overcome the obstacles faced by using the bottled method in partnership with the industry. The purpose of the study was to evaluate nurses' perceptions of the ease-of-use and preference of delivery method of aromatherapy.

Design: A prospective, comparative, before-and-after observational survey design was used to answer the research question.

Methods: Nurses in 2 perioperative hospital settings in the system used the bottled method for 4 months and completed a System Usability Scale (SUS) survey at the end of that period. The individually wrapped method was then used for the next 4 months, followed by another evaluation using the SUS. Participants were asked to choose which method they preferred and their perception of effectiveness of aromatherapy in the perioperative setting and its use as a good adjunct for patient experience on a 5-point Likert scale.

Findings: Twenty-one nurses participated in the bottled method group (pre) and 30 were in the single-packet group (post). An independent sample t test was used to evaluate the differences in the pre- and post-SUS scores. Mean pre scores were 62.5 (±17.8) with an SUS rating of "D" with marginal acceptance. Mean post scores were 81.8 (±12.5) with an SUS rating of "A" with excellent acceptability and were significantly different (P < .000). Nursing perceptions that aromatherapy is a good adjunct for patient experience were positive (3.97/5) and were effective in use in the perioperative setting (4.4/5). Most nurses indicated that the packet delivery method was preferred over the bottled method.

Conclusions: Nurses' perceptions favored the use of the single-packet delivery method of aromatherapy. A score of 81 on the SUS approximates between the 92nd and 93rd percentile of product use SUS scores. Thus, the findings indicate high ease-of-use for the single-packet version of aromatherapy. Nurse-led innovations, such as this, can impact how care is delivered in the clinical setting.

A spinal epidural hematoma (SEH) is a rare complication of combined spinal epidural anesthesia. The case of a 55-year-old man who underwent orthopedic surgery under combined spinal epidural anesthesia is presented. Flurbiprofen and horse chestnut seed extract that potentially affect coagulation function during the perioperative period were used. The patient developed an SEH, but had normal coagulation function. Due to masking of neurologic symptoms by pain at the surgical site, the diagnosis of the SEH by magnetic resonance imaging was not made until postoperative day 9. Conservative treatment resulted in complete resolution of the SEH. Early, meticulous, and frequent neurologic examinations by anesthesiologists, surgeons, and nurses are crucial in preventing the delayed diagnosis of SEHs.

Purpose: This study was conducted to determine the effect of early mobilization on pain and mobility levels in individuals undergoing total knee arthroplasty.

Design: Randomized controlled clinical trial.

Methods: This study was carried out in the orthopedic and traumatology department of a public hospital in Turkey. The data were collected between September 2022 and June 2023. The study sample consisted of 68 patients, 34 in the intervention group and 34 in the control group. Patient Information Form, Brief Pain Inventory, Patient Mobility Scale, and Observer Mobility Scale were used as data collection tools.

Findings: The decrease in the "current pain" 20th-hour value was significant compared to the "current pain" 8th-hour value in patients in the intervention group. In the control group, the mean value of the Patient Mobility Scale at the 20th hour was significantly higher than the intervention group. In the intervention group, the pain and difficulty measurements during the movements of turning from side to side in the bed, sitting on the edge of the bed, standing up on the edge of the bed, and walking in the patient room at the 20th hour decreased significantly compared to the 8th hour. In the control group, the mean of the Observer Mobility Scale at the 20th hour was considerably higher than the intervention group.

Conclusions: Early mobilization positively affected the patient's pain and mobility levels. An early mobilization protocol should be established and implemented in the postoperative period.

Purpose: Understanding barriers to compliance can aid in mitigation strategies to address them. This study aims to quantitatively and qualitatively assess the relationship between barriers to ERAS recommendations and perceived ability to assure compliance among multidisciplinary team (MDT) members who deliver Enhanced Recovery After Surgery (ERAS) care.

Design: Embedded mixed-methods survey analysis.

Methods: A survey was distributed to ERAS professionals to assess for each recommendation: how much the recommendation was part of their role; how much they felt they could assure compliance with the recommendation; and the primary barrier to compliance. Imputed datasets were created within each MDT role, significant barriers retained, and prediction models developed. Qualitative data were thematically coded and a mind map visualized themes.

Findings: Most respondents were surgeons with greater than 10 years' experience. Surgeons and advanced practice providers reported highest averages of compliance assurance, nurses the lowest. Barriers most reported were patient factors and lack of agreement. Lack of familiarity and motivation predicted statistically significant decreases in compliance with oral carbohydrate loading. Qualitatively, nurses and surgeons reported lack of agreement from colleagues as the biggest barrier, followed by lack of resources and motivation to change. Other themes were the importance of teamwork, data audit, staff education, and informatics.

Conclusions: Standardized data collection and reporting of barriers to ERAS recommendations may help identify barriers and improve compliance in a multidisciplinary context. A rich, mixed-methods analysis revealed key insights into perceptions of barriers and compliance with ERAS.

Purpose: The aim of this study was to assess the correlation between the Visual Analog Scale (VAS), Numeric Rating Scale (NRS), and Verbal Rating Scale (VRS). Additionally, the study aimed to determine NRS threshold values for both mild analgesic administration (= without risk of nausea and vomiting [NV] side effects) and strong analgesic administration (= with risk of NV side effects) in the postanaesthetic care unit (PACU).

Design: Prospective, observational study design.

Methods: The study was conducted between August 2019 and April 2022. Patients scheduled for elective surgery under general anesthesia were included. The primary outcome was the correlation between the VAS, NRS, and VRS, assessed at PACU admission and discharge. Secondary outcomes included pain evolution, desire for analgesic administration with or without risk of NV side effects, and preferred tool for pain assessment.

Findings: VAS, NRS, and VRS were significantly correlated (r = 0.82 to 0.94, P < .001) at both PACU admission and discharge. The median VAS scores significantly improved from 32 (interquartile range [IQR]: 9 to 22) at PACU admission to 27 (IQR: 8 to 39) at PACU discharge (P < .001), while the median NRS scores significantly improved from 3 (IQR: 1 to 6) at PACU admission to 3 (IQR: 1 to 4) at PACU discharge (P < .001). At PACU admission, receiver-operating characteristics curve analysis indicated that an optimal NRS threshold value for the administration of a mild analgesic (= without risk of NV side effects) was greater than 2, and greater than 5 for the administration of a strong analgesic (= with risk of NV side effects). At PACU discharge, patients reported a preferred median NRS score of 5 to be treated with a mild analgesic (= without risk of NV side effects), and a preferred median NRS score of 8 to be treated with a strong analgesic (= with risk of NV side effects).

Conclusions: All three pain assessment tools can be used to evaluate postoperative pain in the PACU setting during the recovery from general anesthesia.