Journal of Perianesthesia Nursing最新文献

{"title":"Discharge Under Sedated Status can Decrease Postoperative Emergence Agitation in Pediatric Patients Undergoing Strabismus Surgery: A Prospective Randomized Controlled Trial","authors":"Fang Tan PhD, MD ,&nbsp;Weisha Lu RN ,&nbsp;Shuangshuang Li PhD, MD ,&nbsp;Jing Chen RN","doi":"10.1016/j.jopan.2024.01.014","DOIUrl":"10.1016/j.jopan.2024.01.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Emergence agitation (EA) is a frequent complication during emergence. The researchers aimed to investigate whether discharged pediatric patients from the postanesthesia care unit (PACU) to wards under sedated status could reduce the incidence of EA.</div></div><div><h3>Design</h3><div>Prospective randomized controlled study.</div></div><div><h3>Methods</h3><div>This study was conducted in 4 to 6 year old patients who had undergone strabismus surgeries. There were 100 patients randomly assigned to a sedated group who were discharged from PACU to the ward under a sedated state and regained consciousness accompanied with their parents (Group P, n = 50) and the control group who were fully awake when discharged (Group C, n = 50). The primary outcome was the incidence of EA. The secondary outcomes included rescue measure, discharge time, hemodynamic parameters at the point of discharge, 1 and 2 hours after extubation, and the parental satisfaction score.</div></div><div><h3>Findings</h3><div>The incidence of EA in Group P was significantly reduced compared to Group C (<em>P</em> = .023). The number of patients who needed rescue measures was higher in Group C than in Group P (<em>P</em> = .041). The PACU discharge time in Group P was significantly shorter than in Group C (<em>P</em> &lt; .001). The heart rate of the pediatric patients in Group P was significantly lower than in Group C at the point of discharge from PACU to the ward (<em>P</em> = .003), while the oxygen saturation (SpO₂) and the mean arterial blood pressure were comparable between the two groups (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Pediatric patients discharged to their parents under sedated status could reduce the incidence of EA undergoing strabismus surgery.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 985-989"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279911","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}

{"title":"Malignant Hyperthermia in the Perioperative Setting","authors":"Maggie Thompson DNP, APRN, AGACNP-BC, CNE,&nbsp;Angela D. Pal PhD, APRN, ACNP-BC, CHSE","doi":"10.1016/j.jopan.2024.08.020","DOIUrl":"10.1016/j.jopan.2024.08.020","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1104-1105"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511185","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}

{"title":"Does Postanesthesia Forced-Air Warming Affect Emergence Delirium in Pediatric Patients Receiving Daily Anesthesia?","authors":"Elizabeth Henry BSN, RN, CPN ,&nbsp;Mei Lin Chen-Lim PhD, RN, CCRC","doi":"10.1016/j.jopan.2024.01.021","DOIUrl":"10.1016/j.jopan.2024.01.021","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine if postanesthesia forced–air warming as a nonpharmacologic intervention for emergence delirium (ED)/emergence agitation (EA) decreased the incidence and severity of ED in children aged 18 months to 6 years old.</div></div><div><h3>Design</h3><div>Prospective nonrandomized controlled trial.</div></div><div><h3>Methods</h3><div><span><span>Participants included children aged 18 months to 6 years old receiving general anesthesia within a </span>radiation oncology<span> setting. Status of ED/EA was based on the participants’ Pediatric Anesthesia<span><span> Emergence Delirium (PAED) scale score (two consecutive scores greater than 10 out of 20) or inconsolable agitation behaviors post computed tomography simulation (day 0). </span>Interrater reliability was conducted among the center’s perianesthesia care nurses. Participants who scored positive for ED/EA received a forced-air warming blanket for the remainder of treatment with data collection 1 to 14 days postanesthesia. Non-ED/EA participants were followed for 14 days and provided forced-air warming if ED/EA occurred. Data consisted of daily PAED scores and self- or parent-report on the anxiety scale. If the participants received forced-air warming, nurses’ </span></span></span>clinical observations and parent satisfaction surveys were collected 3 times during the 14-day study period.</div></div><div><h3>Findings</h3><div><span>A total of 59 participants completed the study (mean age 3.43 years; 60% male; 63% non-Hispanic White); 16 were identified with ED or EA (mean age 3.56 years; 50% male; 69% non-Hispanic White) with an incidence rate of 28%. For the 16 participants with ED/EA, the primary diagnosis consisted of solid tumors and an American Society of Anesthesia Classification III to IV. Prior to the forced-air warming intervention, all 16 participants exhibited inconsolable ED/EA behaviors, including 8 who had PAED scores greater than 10. ED/EA behaviors expressed included inconsolability, confusion, thrashing, and combativeness. Within the 14-day period, 3 participants received forced-air warming on day 1, while the other 13 received an average of 4.23 days of treatment (range 1 to 11 days; mode 1 day; median 4 days). Comparison of PAED scores pre (mean 4.4) and post (mean 1.8) indicated that the use of forced-air warming was statistically significant (</span><em>P</em> = .001). ED/EA behaviors and PAED scores after the forced-air warming period decreased in all but one participant. Some agitation behaviors were not captured within the PAED score.</div></div><div><h3>Conclusions</h3><div>Forced-air warming impacted PAED scores and agitation behaviors for studied participants, offering a safe, nonpharmacological nursing intervention that may be an effective tool for helping to manage this baffling condition.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1026-1033.e1"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293857","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}

{"title":"The Effect of Virtual Reality, Music Therapy, and Stress Ball Application on Pain and Anxiety During Outpatient Gynecological Procedures: A Randomized Controlled Trial","authors":"Tuğba Öz PhD ,&nbsp;Nurdan Demirci PhD","doi":"10.1016/j.jopan.2024.01.022","DOIUrl":"10.1016/j.jopan.2024.01.022","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to determine the effect of virtual reality, music therapy, and stress ball applications, which are methods of distraction, on pain, anxiety, and patient satisfaction during outpatient gynecological procedures.</div></div><div><h3>Design</h3><div>This study was a randomized controlled trial with control and intervention groups, pre-test and post-test.</div></div><div><h3>Methods</h3><div>The study was conducted with 200 women who underwent gynecological surgical procedures without sedation in a state hospital on the European side of Istanbul between October 2022 and March 2023. There were four groups in the study: Virtual Reality (n = 50), Music Therapy (n = 50), Stress Ball (n = 50), and Control group (n = 50). Data were collected using a Descriptive Information Form, Visual Analog Scale, State-Trait Anxiety Inventory, Life Information Follow-up Form, and Patient Satisfaction Evaluation Form. The scales were completed separately by the investigator before the procedure, 10 minutes after the procedure, and 1 hour after the procedure.</div></div><div><h3>Findings</h3><div>A statistically significant difference between the intervention groups and control groups of women who underwent a gynecological procedure at the 10th minute after the procedure (<em>P</em>=.000) and at the 1st hour after the procedure (<em>P</em>=.000) was significant. State-Trait Anxiety Inventory of women by groups decreased after the procedure and showed a statistically significant difference (<em>P</em> =.000). Satisfaction scores of the women with the intervention according to the groups also showed a significant difference (<em>P</em> =.000). When the satisfaction scores of the women with the intervention were compared by groups, the satisfaction scores ranged from the highest to the lowest, as virtual reality, music therapy, and stress ball application, respectively.</div></div><div><h3>Conclusions</h3><div>Virtual reality, music therapy, and stress ball applications, which are methods of distraction during the outpatient gynecological procedure, were effective in reducing anxiety and pain and increasing patient satisfaction.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1034-1041"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097199","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}

{"title":"Every Second Patient Does Not Fully Understand Written Preprocedure Information: An Explorative Study About Functional Health Literacy","authors":"Emelie Janmyr CRNA, MSN ,&nbsp;Benjamin Grossmann CRNA, PhD ,&nbsp;Andreas Nilsson CRNA, PhD","doi":"10.1016/j.jopan.2024.02.004","DOIUrl":"10.1016/j.jopan.2024.02.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the self-perceived functional health literacy (FHL) of patients who underwent advanced endoscopic treatment, explore whether FHL could explain aspects of patients' perioperative experiences, and determine whether patients read the provided patient information.</div></div><div><h3>Design</h3><div>A prospective cross-sectional explorative study.</div></div><div><h3>Methods</h3><div>One hundred patients who underwent endoscopic bile duct intervention were enrolled and asked to answer the Swedish version of the FHL Scale and their perioperative experiences of the intervention. Along with procedural data, all data were analyzed for group comparisons; high or low FHL.</div></div><div><h3>Findings</h3><div>The study included a total of 100 patients, with half of them rating their FHL as problematic or inadequate (low FHL). Among those who perceived their FHL as inadequate, a majority had not read the provided information before the procedure. Patients with problematic or inadequate FHL experienced perioperative anxiety and pain more frequently than those with sufficient FHL (high FHL).</div></div><div><h3>Conclusions</h3><div>This study supports previous research on the association between low FHL and patients' well-being. To better meet patients' information needs, it is crucial for nurse anesthetists and other health care providers to have knowledge about FHL. Additionally, the study highlights the importance of using alternative and more effective means of delivering information to patients.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1075-1078"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493955","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}

{"title":"Potential Artificial Intelligence Patient Safety Concerns in Health Care","authors":"Jacqueline Ross RN, PhD","doi":"10.1016/j.jopan.2024.08.018","DOIUrl":"10.1016/j.jopan.2024.08.018","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1106-1107"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299339","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}

{"title":"Care of the Patient Having Local-Only Procedures","authors":"Theresa Clifford DNP, RN, CPAN, CAPA, FASPAN, FAAN","doi":"10.1016/j.jopan.2024.08.019","DOIUrl":"10.1016/j.jopan.2024.08.019","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1111-1112"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511183","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}

{"title":"Design Specifications for an Automated System to Deliver Instructions About Preprocedure Fasting","authors":"Kristina Chang MScN, RN-EC, NP-PHC ,&nbsp;Amanda Matthews RN ,&nbsp;Sheryl Alexandre MScN, CCCN(c), RN ,&nbsp;Julie Vizza MHSc ,&nbsp;Aaron Conway BN (Hons), PhD","doi":"10.1016/j.jopan.2024.02.001","DOIUrl":"10.1016/j.jopan.2024.02.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Many patients undergoing surgical and other medical procedures requiring sedation or anesthesia receive standardized “no eating or drinking after midnight” instructions. This “standardized” instruction does not change regardless of potential alterations in scheduling that result in significant delays in procedure start times. As a result, the duration of preprocedure fasting often far exceeds recommended requirements. A technological solution that automates the delivery of preprocedure fasting instructions to patients would likely improve the patient experience. The purpose of this study was to determine design specifications for the delivery of notifications to patients as part of an automated system.</div></div><div><h3>Design</h3><div>A qualitative study was conducted with 14 adult participants using the persona-scenario method.</div></div><div><h3>Methods</h3><div>Participants worked in groups to create realistic but fictitious personas and scenarios that described how individuals like themselves would interact with an automated preprocedure fasting instruction system. Data generated through the development of the scenarios were analyzed to first identify important themes, which were then interpreted into design specifications.</div></div><div><h3>Findings</h3><div>Seven women and seven men, aged 25 to 75, developed 9 persona-scenarios, which captured outpatient and inpatient preprocedure fasting experiences, as well as perspectives of individuals who were not comfortable with technology, or those for which English was not the primary spoken language. Most scenarios described preprocedure fasting instructions delivered by an automated bidirectional short message service system. Two major themes were identified as patient priorities, including: (1) enhancing communication between patients and healthcare providers; and (2) the importance of using simple technology so that a greater number of patients with varying degrees of comfort and capabilities would be able to use the system confidently. A corresponding set of proposed design specifications was devised.</div></div><div><h3>Conclusions</h3><div>The results of this study provide actionable ways to operationalize patient-centered ideas in the design of an automated preprocedure fasting instruction system.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1069-1074"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181366","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}

{"title":"Cross-sectional and Correlational Examination of Patients’ Preoperative Anxiety, Information Need, and Health Literacy in a Presurgical Consultation","authors":"Patrick Teixeira Machado MscN ,&nbsp;Claudia Lecoultre MscN ,&nbsp;Cécile Courbon MD","doi":"10.1016/j.jopan.2024.01.020","DOIUrl":"10.1016/j.jopan.2024.01.020","url":null,"abstract":"<div><h3>Purpose</h3><div>This study elucidates the preoperative anxiety (PA), information need (IN), and health literacy (HL) levels of an elective preoperative sample in Switzerland and examines the possible associations between PA and the patients’ characteristics. By knowing these patient dimensions, which can influence perioperative outcomes, one can tailor individualized nursing interventions to improve patients’ surgical experience.</div></div><div><h3>Design</h3><div>This was a cross-sectional and correlational study.</div></div><div><h3>Methods</h3><div>The sample consisted of 88 patients who underwent a preoperative consultation at a Swiss tertiary hosptial. Patients’ PA and IN were assessed using the Anxiety Preoperative and Information Scale, and their HL was measured using the Functional, Communicative, and Critical Health Literacy Scale. Data on other patient characteristics were collected from the patients, physicians, and electronic patient records. Association tests, as well as univariate regressions, were performed on PA, IN, HL, and patient characteristics.</div></div><div><h3>Findings</h3><div>Among participants, 40.91%, 78.41%, and 59% reported having PA, IN, and low HL, respectively. Finally, PA was associated with IN, HL, solitary living, and the American Society of Anesthesiology score.</div></div><div><h3>Conclusions</h3><div>A high proportion of patients scheduled for presurgical consultation were found to be anxious. They presented high IN and low HL. An examination of patients’ PA–associated characteristics can help improve their surgical experience. More studies should examine PA–associated characteristics.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1019-1025"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960462","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}

{"title":"A Christmas Wish for Measuring Nursing Care Effectiveness","authors":"Jan Odom-Forren PhD, RN, CPAN, FASPAN, FAAN","doi":"10.1016/j.jopan.2024.10.009","DOIUrl":"10.1016/j.jopan.2024.10.009","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 935-936"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757058","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}