Journal of Perianesthesia Nursing最新文献

Purpose: The purpose of this meta-analysis is to measure the effectiveness of penehyclidine hydrochloride hydrate (PHC)-an antimuscarinic drug-in preventing postoperative nausea and vomiting (PONV) for different surgeries.

Design: Meta-analysis.

Methods: According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we conducted an online literature search using PubMed, Web of Science, Scopus, and Embase databases. Randomized control trials comparing PHC with placebo or any other standard treatments were included.

Findings: Our systematic review screened 54 articles, and four randomized control trials with 766 patients were included. There was no significant difference between PHC and the control group for the prevention of postoperative vomiting (risk ratio [RR] = 0.43). However, the subgroup analysis showed some promise. At 24 hours, PHC significantly decreased the incidence of postoperative nausea (RR = 0.31), postoperative vomiting (RR = 0.17), and PONV (RR = 0.33). While at 48 hours, PHC showed nonsignificant results for the same outcomes. PHC did not result in significantly higher rates of analgesia use, headache, dizziness, longer durations of stay in the postanesthesia care unit, or longer duration for extubation, but it showed significantly lower results for the use of antiemetics. Furthermore, PHC showed higher rates of dry mouth.

Conclusions: The findings suggest that PHC offers a promising option for PONV prophylaxis, particularly in surgical settings where early PONV are prevalent, with an acceptable safety profile. Further research is recommended to optimize dosing strategies and compare PHC with established antiemetics.

Purpose: To provide a structured macroscopic overview of the characteristics and advances in research related to the Enhancing Recovery after Surgery (ERAS) protocol.

Design: A bibliometric analysis.

Methods: Web of Science was selected as the search engine for the bibliometric analysis study, and data up to January 25, 2024 were included in the scan. The analysis was conducted using the "biblioshiny" application available in the Bibliometrics R package.

Findings: A total of 769 studies were included in the review between 1991 and 2024. China produced the most publications on the subject, while the United States received the highest number of citations. A total of 213 global collaborations were identified, with the most frequent collaboration being between the United States and Canada (8 collaborations). The author Li K. contributed the most papers and the Journal of Perianesthesia Nursing published the most nursing papers on the topic. "Enhanced recovery" was the most frequently used keyword in the articles. In addition, China led in the number of publications, while the United Kingdom, China, Canada, and Sweden had the highest number of citations of all countries.

Conclusions: This bibliometric study provided comprehensive information on global trends and hotspots in ERAS protocol care research. Developed countries were the most productive in this area of research. It was noted that publications in this study area did not meet the Lodka and Bradford laws.

Purpose: This original study aimed to examine the relationship of emotional intelligence and passion to decision-making in surgical nurses.

Design: It is a descriptive, relational study.

Methods: This study was conducted with 166 surgical nurses. Data for the study were collected using the Descriptive Characteristics Form, Passion Scale, Emotional Intelligence Scale, and Nurse Decision-Making Scale.

Findings: The decision-making level of 85.6% of the surgical nurses was found to be at the third level. There was a 0.265 U increase in decision-making score for a 1 U increase in nursing experience. A 1 U increase in the standard deviation of the Emotional Intelligence Scale increased the standard deviation of the Nursing Decision-Making Scale by 0.322 U, and a 1 U increase in the standard deviation of the Passion Scale increased the standard deviation of the Nursing Decision-Making Scale by 0.268 U.

Conclusions: Surgical nurses' passion, emotional intelligence, and decision-making levels were found to be high. A positive relationship was also found between the passion and emotional intelligence levels of surgical nurses and their decision-making. Decision-making is crucial in nursing, particularly in the surgical setting where passion and emotional intelligence play a significant role. This study highlights how passion, associated with professional growth and emotional intelligence and empathy and situational awareness, influence surgical nurses' decision-making processes.

Purpose: This report details the recommendations of a Nursing Best Practice Working Group, which aims to advance best practice in the use of 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) in patients with high-grade glioma (HGG).

Design: Quality Improvement Project.

Methods: These recommendations were gathered during a meeting of a Nursing Best Practice Working Group comprising expert nurses and practice administrators from five US centers of excellence in the management of HGG. Ahead of the meeting, a survey was taken to evaluate the views of each expert and surgical teams, patients and institutions on current benefits, challenges and practices associated with the use of 5-ALA FGS in HGG. The Nursing Best Practice Working Group then met to share their experiences, explore where consensus exists, and identify opportunities for enhanced patient management.

Findings: The advisors made recommendations to support improvements across a range of areas associated with multidisciplinary team delivery of 5-ALA FGS. These included specific issues surrounding the administration of 5-ALA, photosensitivity and low-light precautions, and key aspects relating to protocol development, content features, format and accessibility, and updates and education of both the multidisciplinary team and patients. Guidance was also gathered on a flowchart to support the practical delivery of patient care and detail roles, responsibilities, and timings.

Conclusions: This guidance provides direction for the development of practical, evidence-based protocols and educational approaches for multidisciplinary teams and patients. Such approaches can improve best practice in 5-ALA FGS in all institutes, irrespective of size, and when developed collaboratively provide the means to share best practice across institutes and reach consensus on patient care.

Brachial plexus block is the predominant anesthetic method used for upper-limb surgical procedures in pregnant patients. The innovative method of brachial plexus block in the costoclavicular space has shown enhanced reliability and effectiveness for postoperative analgesia. We report a case of a pregnant woman who underwent surgery for a humeral fracture. Continuous costoclavicular brachial plexus block was successfully employed to facilitate the reduction and stabilization of the humeral fractures. This case report serves as an initial assessment of the efficacy of the costoclavicular brachial plexus block in arm surgery, which also underscores the crucial role of perianesthesia nurses in performing a continuous brachial plexus block.

Purpose: neuromuscular blockade (NMB) remains a significant risk for patients after anesthesia. This study examines the confidence and knowledge of the use and side effects of NMB and associated reversal agents amongst postanesthesia care unit (PACU) nurses caring for the postanesthesia surgical population. Retrospective data on the incidence and demographics of patients who underwent general anesthesia with NMB were also examined.

Design: The design was an educational intervention with a pre and post-test, which assessed knowledge and confidence scores of PACU nurses. The nurses completed a demographic, confidence, and knowledge survey before participating in an educational session.

Methods: Analysis of the preintervention and postintervention scores was compared using a Wilcoxon signed-rank test. Retrospective data on the incidence of patients who received general anesthesia with NMB were analyzed from February 2023 to July 2023.

Findings: PACU nurses had scores of strong confidence in their ability to care for postoperative patients, and our educational intervention found a statistically significant (P ≤ .05) increase in knowledge for nurses regarding the use of neuromuscular blocking agents. The mean preintervention knowledge score of the participants was 8.0 (SD 1.6), and the mean postintervention knowledge score was 9.18 (SD 0.66).

Conclusions: An educational intervention on the use and side effects of neuromuscular blocking agents and reversal agents improved PACU nurse knowledge. This allows for increased patient outcomes regarding PACU recovery and discharge of our surgical patient population.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome, a common cause of recurrent fever in childhood, presents a challenge in both diagnosis and management. While initially considered a monogenic disorder, recent research has highlighted its complex genetic underpinnings, involving noncoding genome regions and immune-mediated cytokine dysregulation. This complexity underscores the need for comprehensive perioperative management strategies, particularly in surgical interventions such as tonsillectomy and adenoidectomy. This article presents two cases of PFAPA syndrome undergoing surgical procedures and outlines their perioperative management. Emphasizing meticulous preoperative assessment, including medication adjustments and fasting protocols, underscores the importance of multidisciplinary collaboration in tailoring individualized care plans. In this context, perioperative nurses play a crucial role in caring for pediatric patients diagnosed with PFAPA syndrome, contributing significantly to preoperative preparation, intraoperative monitoring, and postoperative recovery, ensuring patient safety and optimizing outcomes. Furthermore, the article discusses emerging prophylactic and therapeutic modalities, such as colchicine and interleukin-1 inhibitors, offering insights into potential avenues for optimizing patient outcomes. We present our article to improve care for PFAPA patients and contribute to nurses, residents, and anesthesiologists by explaining the basics and sharing our clinical experiences.

Purpose: This study aimed to investigate the effect of preoperative tele-nursing counseling on anxiety and patient satisfaction in day surgery.

Design: Randomized controlled study design was employed.

Methods: The study was conducted in a city hospital and a university hospital in Istanbul between July 2022 and May 2023 with patients who met the study criteria. The sample consisted of 160 patients in the experimental (n = 80) and control (n = 80) groups. In the first interview, the patients who came to be examined (experimental and control groups) were given the Descriptive Information Form and the Surgery-specific Anxiety Scale. The patients in the experimental group were given a training booklet and counseling with tele-nursing practice the day before the surgery, and the patients in the control group were given routine clinical follow-up and a training booklet. The patients (experimental and control) were given the Surgery-specific Anxiety Scale on the day they came for surgery before they were taken into surgery. After the surgery, the Patient's Perception of Nursing Care Scale was applied to the patients. The patients in the experimental group were also given the Tele-nursing Evaluation Form.

Findings: As a result of the study, the patients in the experimental group who received tele-nursing counseling had lower levels of surgery-specific anxiety than the control group. Patients in the experimental group were statistically significantly more satisfied with nursing care.

Conclusions: Providing preoperative tele-nursing counseling to patients scheduled for day surgery contributed to the reduction of anxiety and worry of the patients and increased the satisfaction of the patients.

Purpose: Health literacy is a complex issue that affects the health outcomes of surgical patients. This study aimed to determine the health literacy of general surgery patients.

Design: A descriptive cross-sectional study.

Methods: The sample of the descriptive study consisted of 420 patients who applied to the general surgery outpatient clinic of the hospital between December 2019 and April 2020. Research data were collected using the "Patient Information Form" and "Health Literacy Index" prepared by the researchers in line with the literature. The score ranges of the Health Literacy Index are a minimum of 5 and a maximum of 25. Data were analyzed by number and percentile distribution, mean, standard deviation, t test, and one-way analysis of variance.

Findings: The mean age of the participants in the study was 47.58 ± 14.92 years and 56.2% of them were women. Participants' Health Literacy Index total score average was determined as 101.33 ± 18.56. Individuals received a maximum score of 25 points in access to information and a minimum score of 7 points in understanding the information from the subindices. There was a statistically significant difference between the demographic characteristics (eg, age, marital status, gender, education level, occupation, place of residence) of the participants and their health literacy levels.

Conclusions: The health literacy levels of the participants in the research are adequate and at a good level. We recommend evaluation of health literacy levels in surgical patients to reduce complications and enable patients to participate effectively in care.

Purpose: Cardiovascular diseases are a leading cause of morbidity and mortality worldwide. Clinically, various techniques are used to diagnose coronary artery diseases. Coronary angiography is considered the gold standard for the diagnosis of coronary artery disease. The aim of this study is to determine the effect of cold spray applied before local anesthesia on pain and anxiety during coronary angiography procedures.

Design: The study was designed as a randomized controlled trial.

Methods: The study was conducted in the angiography unit of a training and research hospital between January and March 2023. Data collection tools included a patient information form, Visual Analog Scale, and State-Trait Anxiety Inventory.

Results: When the total mean scores of the Visual Analog Scale of the individuals in the intervention and control groups were examined, a statistically significant difference was found between the mean scores of the patients in the intervention group and the control group (P < .05). A significant difference was found between the individuals in the intervention and control groups in terms of the total scores of the state anxiety scale after cold spray (P < .001), with the mean scores of the control group higher than the intervention group.

Conclusions: The application of cold spray before local anesthesia in coronary angiography significantly reduced pain and anxiety levels.