Journal of Perianesthesia Nursing最新文献_第8页

Bridging the Gap: When Leadership Lacks Perianesthesia Roots 弥合差距：当领导缺乏麻醉周围的根基

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.08.007

Amy Berardinelli DNP, APRN, FNP-C, NE-BC, CPAN, CAPA, FASPAN

引用次数: 0

Influence of Breathing Training Based on Multimedia Education Combined With CICARE Communication Mode on Patients With Coronary CTA 基于多媒体教学的呼吸训练结合CICARE通讯模式对冠状动脉CTA患者的影响。

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.02.011

Hongfang Huang , Guanzhen Zeng , Xiuzhen Chen, ChenHui Li, XiPin Pan, Ying Dou, Junli Liang

Purpose

Coronary computed tomography angiography (coronary CTA) is an important examination method for diagnosing coronary artery disease. This study aims to explore the effect of multimedia education–based breathing training combined with Connect, Introduce, Communicate, Ask, Respond, Exit (CICARE) communication mode on patients with coronary CTA.

Design

Randomized Control Trial.

Methods

The control group received routine inspection and education, whereas the intervention group underwent intervention with multimedia education and the CICARE communication mode. The operation time, physiological reactions, psychological state, incidence of adverse reactions caused by the iodine contrast agent, and image quality after examination were compared between the two groups. A total of 120 patients who underwent coronary CTA for suspected coronary artery disease in our hospital between May 2022 and May 2023 were selected, and the patients were divided into the intervention group and the control group using the random number method (60 cases in each group).

Findings

The intervention group had a significantly shorter operation time compared with the control group (P < .05). While both groups showed an increase in systolic and diastolic blood pressure and heart rate 15 minutes before the examination, the intervention group exhibited lower increases (P < .05). Additionally, the incidence of adverse reactions to iodine contrast agents, as well as Hamilton Anxiety Scale and Hamilton Depression Scale scores, were lower in the intervention group (P < .05). The intervention group also had a higher qualified rate of imaging quality (P < .05).

Conclusions

Breathing training based on multimedia education combined with the CICARE communication mode is more effective than the conventional approach in shortening examination operation time, alleviating patients’ nervousness and anxiety, reducing the incidence of adverse reactions to iodinated contrast agents, and improving image quality.

目的：冠状动脉ct血管造影（冠脉CTA）是诊断冠状动脉疾病的重要检查方法。本研究旨在探讨基于多媒体教育的呼吸训练结合Connect， Introduce, communication, Ask, response, Exit （CICARE）沟通模式对冠状动脉CTA患者的影响。设计：随机对照试验。方法：对照组采用常规检查教育，干预组采用多媒体教育和CICARE沟通方式进行干预。比较两组手术时间、生理反应、心理状态、碘造影剂不良反应发生率及检查后影像质量。选取2022年5月至2023年5月在我院行疑似冠状动脉病变冠脉CTA的患者120例，采用随机数法将患者分为干预组和对照组，每组60例。结果：干预组手术时间明显短于对照组(P)。结论：基于多媒体教育的呼吸训练结合CICARE沟通模式在缩短检查手术时间、缓解患者紧张焦虑、降低碘造影剂不良反应发生率、提高影像质量等方面均优于常规方式。

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引用次数: 0

“Who Does the Operating Room Resuscitation?” Experiences of Operating Room Nurses and Anesthesia Technicians Regarding Intraoperative Cardiopulmonary Resuscitation: A Qualitative Study “谁做手术室复苏？”手术室护士和麻醉技术人员术中心肺复苏经验的定性研究。

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.06.004

Ozlem Sahin Akboga PhD, RN , Esra Ozbudak Arıca PhD, RN , Rukıye Hobek Akarsu PhD, RN , Betul Unsal PhD, RN

Purpose

This study aimed to determine the opinions, experiences, and recommendations of operating room (OR) nurses and anesthesia technicians in intraoperative cardiopulmonary resuscitation (IO-CPR) management.

Design

A qualitative design was used in the present study.

Methods

This study was conducted using in-depth interviews with OR nurses (n = 8) and anesthesia technicians (n = 7) working in the OR unit of a tertiary hospital in Türkiye. The analysis and synthesis of the data were conducted through the use of an inductive thematic approach.

Findings

As a result of the data analysis, three main and eight subthemes were identified: (1) information insufficiency (insufficient knowledge about the patient and the surgical process, the management of the IO-CPR process), (2) roles related to the IO-CPR management process (not being involved in process management, conveniences, and challenges), and (3) recommendations for IO-CPR management (preoperative evaluation, intraoperative monitoring, and training and cooperation of the OR team).

Conclusions

The OR nurses did not actively participate in the process of IO-CPR management and only observed the general condition of the patient during the CPR management process. Anesthesia technicians played an active role in the management of IO-CPR and often took the lead in coordinating the actions of the OR team. A comprehensive review of the roles and responsibilities of OR nurses during intraoperative cardiac arrest is warranted, with the aim of informing appropriate structural and procedural revisions to enhance team performance and patient outcomes.

目的：本研究旨在了解手术室（OR）护士和麻醉技术人员对术中心肺复苏（IO-CPR）管理的看法、经验和建议。设计：本研究采用定性设计。方法：对云南省某三级医院手术室护士（n = 8）和麻醉技术人员（n = 7）进行深度访谈。数据的分析和综合是通过使用归纳专题方法进行的。结果：通过数据分析，确定了三个主要主题和八个副主题：(1)信息不足（对患者和手术过程的了解不足，IO-CPR过程的管理），(2)与IO-CPR管理过程相关的角色（不参与过程管理，便利和挑战），以及(3)IO-CPR管理的建议（术前评估，术中监测，以及手术室团队的培训和合作）。结论：手术室护士没有积极参与IO-CPR管理过程，在CPR管理过程中仅观察患者的一般情况。麻醉技术人员在IO-CPR的管理中发挥了积极的作用，经常带头协调手术室团队的行动。有必要对术中心脏骤停期间手术室护士的角色和职责进行全面审查，目的是告知适当的结构和程序修改，以提高团队绩效和患者预后。

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引用次数: 0

Operating Room Black Box Technology to Mitigate Local Anesthetic Systemic Toxicity Risk Associated With Liposomal Bupivacaine Administration 手术室黑匣子技术减轻布比卡因脂质体给药引起的局麻全身毒性风险。

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.02.016

Gyuhyun Lee DNP, CRNA , Barbara S. Turner PhD, RN, FAAN , Jessica D. Szydlowski DNP, CRNA, ACNP, CHSE , Virginia C. Simmons DNP, CRNA, CHSE-A, FAANA, FAAN

Purpose

This quality improvement project used operating room black box (ORBB) technology to evaluate adherence to liposomal bupivacaine (LB) administration protocols, specifically to identify obstacles to compliance with these protocols to mitigate the risk of local anesthetic systemic toxicity (LAST).

Design

The team conducted a retrospective chart review of surgical cases using ORBB technology in two robotic operating rooms at a tertiary academic medical center.

Methods

The project included 39 patients who received intraoperative LB between November 2022 and February 2024. Data were collected from the ORBB recordings and electronic medical records, focusing on provider adherence to LB administration protocols, such as conducting LB time-outs, applying LB alert wristbands, discontinuing lidocaine infusions, and following a 2:1 admixture ratio of LB with bupivacaine hydrochloride.

Findings

Chart review indicated 25 (64%) cases completed the LB time-out, 24 (62%) applied the LB wristband intraoperatively, 23 (59%) included a wristband check, and 14 (36%) incorporated lidocaine infusion checks during the LB time-out. One case failed to stop the lidocaine infusion and 3 cases failed to follow the correct 2:1 admixture ratio; however, no LAST cases were reported.

Conclusions

These findings underscore the potential of ORBB technology in improving adherence to LB administration protocols, reducing the incidence of LAST (10.2%), and enhancing patient safety. Challenges such as blind zones in ORBB coverage, the Hawthorne effect, and potential litigation risks are acknowledged. Information and training about ORBB technology, sharing ORBB reports with staff, and cross-referencing ORBB data with electronic medical records are recommended to optimize patient outcomes.

目的：本质量改进项目使用手术室黑匣子（ORBB）技术评估布比卡因脂质体（LB）给药方案的依从性，特别是确定遵守这些方案的障碍，以减轻局麻全身毒性（LAST）的风险。设计：研究小组对一家三级学术医疗中心的两个机器人手术室中使用ORBB技术的手术病例进行了回顾性图表回顾。方法：该项目纳入了2022年11月至2024年2月期间接受术中LB治疗的39例患者。从ORBB记录和电子医疗记录中收集数据，重点关注提供者对LB给药方案的依从性，例如进行LB暂停，使用LB警报腕带，停止利多卡因输注，并按照2:1的LB与盐酸布比卡因的混合比例使用LB。结果：图表回顾显示25例（64%）完成LB暂停，24例（62%）术中使用LB腕带，23例（59%）包括腕带检查，14例（36%）在LB暂停期间纳入利多卡因输注检查。1例未停止利多卡因输注，3例未按照正确的2:1掺量比例使用；但未见LAST病例报告。结论：这些发现强调了ORBB技术在提高对LB给药方案的依从性、降低LAST发生率（10.2%）和提高患者安全性方面的潜力。承认了ORBB覆盖的盲区、霍桑效应和潜在的诉讼风险等挑战。建议提供有关ORBB技术的信息和培训，与员工共享ORBB报告，以及将ORBB数据与电子医疗记录交叉引用，以优化患者的治疗效果。

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引用次数: 0

Risk-Outcome Relationship in Perioperative Care: A Complex Research Affair! 围手术期护理的风险-结局关系：一个复杂的研究事件！

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.07.006

Rohan Magoon MD, DM, Varun Suresh MD, DM, DNB, MNAMS

引用次数: 0

Response to the Letter to the Editor “Health Literacy and Early Postoperative Symptoms: A Clarifying Response” 对致编辑信“健康素养与术后早期症状：澄清性回应”的回应

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.08.002

Kezban Koraş Sözen PhD, Nesibe Sultan Çinaroğlu PhD

引用次数: 0

Relationship Between Perioperative e-Health Literacy and the Quality of Bowel Preparation: A Propensity Score–matched, Retrospective, Observational Study 围手术期电子健康素养与肠道准备质量的关系：一项倾向评分匹配的回顾性观察性研究

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.03.004

Liangyu Fang RN , Xiaoxuan Zhou RN , Meifeng Wu RN , Peipei Wang RN , Yinchuan Xu MD, PhD

Purpose

To analyze the correlation between perioperative electronic health literacy (e-health literacy) and the quality of bowel preparation based on investigating the risk factors associated with inadequate bowel preparation in colonoscopy patients.

Design

A prospectively observational study conducted at three tertiary endoscopy centers in China.

Methods

In total, 9,618 patients who underwent their first colonoscopy scanning from July 2023 to June 2024 were collected. Logistic regression analysis was used to identify independent risk factors for bowel preparation failure, while 1:1 propensity score matching was employed to compare the quality of bowel preparation based on different e-health literacy levels.

Findings

About 24.55% of patients were experiencing inadequate bowel preparation. Moderate-to-severe anxiety, male, primary school education level, nondigestive endoscopy specialist prescribing, more than 7 days between prescription and treatment time, and low perioperative e-health literacy levels were the independent risk factors for inadequate bowel preparation (P < .05). Inadequate bowel preparation in patients with low perioperative e-health literacy group was predominantly seen in the right and left colon and the proximal colon.

Conclusions

Perioperative e-health literacy is an independent risk factor for the quality of bowel preparation. The results highlight the need for developing a customized education intervention program that can improve perioperative e-health literacy for successful preoperative preparation.

目的：通过对结肠镜检查患者肠准备不足相关危险因素的调查，分析围手术期电子健康素养（e-health literacy）与肠准备质量的相关性。设计：一项在中国三所三级内镜中心进行的前瞻性观察研究。方法：收集2023年7月至2024年6月首次结肠镜扫描的9618例患者。采用Logistic回归分析确定肠道准备失败的独立危险因素，采用1:1倾向评分匹配方法比较不同电子卫生素养水平的肠道准备质量。结果：约24.55%的患者出现肠道准备不足。中重度焦虑、男性、小学文化程度、非消化内窥镜专科处方、处方至治疗时间间隔大于7天、围手术期电子健康素养低是肠准备不足的独立危险因素(P)。结论：围手术期电子健康素养是肠准备质量的独立危险因素。研究结果强调，需要制定定制的教育干预计划，以提高围手术期电子健康素养，为成功的术前准备做好准备。

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引用次数: 0

Management of Patients With AIDS and Retroperitoneal Calcified Fibrosis During the Perioperative Period: A Case Report 围手术期艾滋病合并腹膜后钙化纤维化患者的处理：1例报告。

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.02.013

Haibin Zhang , Di Meng , Jing Zhang

This case report details the perioperative management of a 27-year-old male patient with AIDS and a rare giant retroperitoneal calcifying fibrous tumor. The tumor's surgical removal posed high risk due to its proximity to vital structures and the patient's human immunodeficiency virus infection. The report highlights the importance of multidisciplinary collaboration in managing such complex cases. Key nursing considerations included providing psychological support to mitigate the stigma associated with AIDS, adhering strictly to infection control and disinfection protocols, closely monitoring for postoperative hypovolemic shock, and managing complications such as gastric motility disorders and renal infarction. Integrating traditional Chinese medicine with Western treatments for gastrointestinal issues proved beneficial. The patient's recovery, achieved through coordinated care, underscores the significance of personalized nursing interventions to optimize patient outcomes. This report provides valuable insights for clinical practice, particularly in handling similar cases of human immunodeficiency virus with complex comorbidities.

本病例报告详细介绍了一个27岁男性艾滋病患者和一个罕见的巨大腹膜后钙化纤维肿瘤的围手术期处理。由于肿瘤靠近重要结构，且患者感染人类免疫缺陷病毒，手术切除肿瘤的风险很高。该报告强调了多学科合作在管理此类复杂病例中的重要性。关键的护理考虑包括提供心理支持以减轻与艾滋病相关的耻辱，严格遵守感染控制和消毒方案，密切监测术后低血容量性休克，以及管理胃动力障碍和肾梗死等并发症。西医结合中医治疗胃肠疾病被证明是有益的。患者的康复，通过协调护理实现，强调个性化护理干预的重要性，以优化患者的结果。本报告为临床实践提供了有价值的见解，特别是在处理具有复杂合并症的人类免疫缺陷病毒的类似病例方面。

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引用次数: 0

Scoping Review of Psychological Therapies in Acute Pain Relief—To Whom, From Who, and Which Channels 心理治疗在急性疼痛缓解中的范围综述-从谁，从谁，和哪些渠道。

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.03.005

Kevin Efrain Tololiu MAPN , Arie Arizandi Kurnianto PhD , Ikhwan Yuda Kusuma M.Sc , Jessica Siska Ehlers MA , Anita Deak PhD , Ferenc Kocsor PhD, Habil , Krisztina Csokasi PhD

Purpose

Chronic pain remains a worldwide burden. This prolonged pain arises from acute pain, especially prolonged postoperative pain. Although there are available psychosocial interventions, the investigation of these interventions in an acute health care setting is underrated. This study aimed to examine existing literature addressing the providers, recipients, and media of psychological interventions in acute pain management.

Design

A scoping review.

Methods

Five databases (PubMed, Scopus, Web of Science, Cochrane Library, and Embase) were used via access from the University of Pecs, University of Szeged, and the Queensland University of Technology. Inclusion criteria covered studies published from 2013 to 2022 on patients receiving psychological intervention to relieve acute pain. This review excluded studies conducted in pediatrics, reviews, nonexperiments, and study protocols.

Findings

Twenty eligible randomized controlled trials applied psychological interventions in alleviating acute pain, including psychoeducation, hypnosis, music therapy, cognitive behavioral therapy, emotion regulation, and humanistic approach. The studies had varying characteristics in terms of the type of psychological intervention, the media the interventions are used, the actors performing those, and the setting where the intervention is delivered.

Conclusions

Although most studies showed a decrease in mean pain scores, the results were statistically significant only in a subset of studies. Appropriate psychological interventions help reduce acute pain in both surgical and procedural settings. Music therapy serves as the most easy-to-use intervention, while hypnosis has more flexibility of delivery media. All psychological interventions can be delivered by health care professionals with training.

目的：慢性疼痛仍然是世界范围内的负担。这种延长的疼痛源于急性疼痛，尤其是术后延长的疼痛。虽然有可用的社会心理干预措施，但在紧急卫生保健环境中对这些干预措施的调查被低估了。本研究的目的是检查现有的文献解决提供者，接受者和媒体的心理干预在急性疼痛管理。设计：范围审查。方法：通过Pecs大学、seeged大学和昆士兰科技大学的检索，使用PubMed、Scopus、Web of Science、Cochrane Library和Embase 5个数据库。纳入标准涵盖2013年至2022年发表的关于接受心理干预以缓解急性疼痛的患者的研究。本综述排除了儿科研究、综述、非实验研究和研究方案。结果：20项符合条件的随机对照试验应用心理干预措施缓解急性疼痛，包括心理教育、催眠、音乐治疗、认知行为治疗、情绪调节和人本主义方法。这些研究在心理干预的类型、干预使用的媒介、实施干预的演员以及实施干预的环境等方面都有不同的特点。结论：虽然大多数研究显示平均疼痛评分降低，但结果仅在一小部分研究中具有统计学意义。适当的心理干预有助于减少外科和手术环境中的急性疼痛。音乐治疗是最容易使用的干预手段，而催眠在传递媒介上具有更大的灵活性。所有心理干预均可由受过培训的卫生保健专业人员提供。

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引用次数: 0

Fospropofol Disodium Combined With Sufentanil Impact on the Endotracheal Intubation--Induced Cardiovascular Response: A Dose-Finding Study 磷丙酚二钠联合舒芬太尼对气管插管诱导的心血管反应的影响：一项剂量研究

IF 2 4区医学 Q2 NURSING

Journal of Perianesthesia Nursing

Pub Date : 2025-12-01 DOI: 10.1016/j.jopan.2025.02.017

Li-Qin Cheng MM , Yu-Lian Zhang BS , Hong-Xia Leng BS , Chun-Hua Hu BS , Hai-Xia Gong MM

Purpose

The objective of this study is to ascertain the 95% effective dose (ED95) of fospropofol disodium for injection (fospropofol_FD) combined with sufentanil for the attenuation of cardiovascular reactions to endotracheal intubation, to determine the optimal dosage of fospropofol disodium for clinical safe medication use in different populations.

Design

This study employed a biased coin design (BCD)-based up-and-down sequential allocation trial method.

Methods

Eighty surgical patients who received fospropofol disodium combined with sufentanil for general anesthesia induction at the First Affiliated Hospital of Nanchang University between March and September 2023 were enrolled. Participants were stratified into two cohorts: middle-aged group (18 to 59 years, n=40, Group A) and elderly group (60 to 89 years, n=40, Group O). The fospropofol disodium dosage was titrated according to the preceding patient's cardiovascular response, with dose increments set at 0.5 mg/kg. Positive cardiovascular response was defined as heart rate or blood pressure fluctuations exceeding 20% from baseline. Furthermore, isotonic regression analysis was implemented to calculate the 95% effective dose (ED95).

Findings

The ED95 of fospropofol_FD combined with 0.4 mcg/kg sufentanil for anesthesia induction to mitigate cardiovascular responses was determined to be 13.8 mg/kg (95% CI: 13.57 to 14.1 mg/kg) for Group A and 9.89 mg/kg (95% CI: 9.84 to 9.90 mg/kg) for Group O, with no overlap in confidence intervals between the two groups, indicating a significant difference (p<0.01).

Conclusions

The ED95 differed between patients aged 18 to 59 years and those aged 60 to 89 years, yielding values of 13.8 mg/kg and 9.89 mg/kg, respectively, with the older group demonstrating heightened sensitivity to fospropofol_FD. Pruritus and paresthesia were the primary adverse reactions observed in the study.

目的：本研究旨在确定注射用磷丙酚二钠（fopropofolfd）联合舒芬太尼对气管插管后心血管反应衰减的95%有效剂量（ED95），确定不同人群临床安全用药的最佳磷丙酚二钠用量。设计：本研究采用基于偏置硬币设计（BCD）的上下顺序分配试验方法。方法：选取南昌大学第一附属医院2023年3 - 9月应用磷异丙酚二钠联合舒芬太尼全麻诱导的手术患者80例。参与者被分为两组：中年组（18 ~ 59岁，n=40， A组）和老年组（60 ~ 89岁，n=40， O组）。根据前述患者的心血管反应滴定磷异酚二钠的剂量，剂量增量设定为0.5 mg/kg。心血管反应阳性定义为心率或血压波动超过基线的20%。采用等渗回归分析计算95%有效剂量（ED95）。结果：A组的ED95为13.8 mg/kg (95% CI: 13.57 ~ 14.1 mg/kg)， O组的ED95为9.89 mg/kg (95% CI: 9.84 ~ 9.90 mg/kg)，两组间的置信区间无重叠，差异有统计学意义(p)。18 - 59岁患者和60 - 89岁患者的ED95值不同，分别为13.8 mg/kg和9.89 mg/kg，老年人对氟异丙酚fd的敏感性更高。瘙痒和感觉异常是研究中观察到的主要不良反应。

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引用次数: 0