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Perioperative Care and Operating Room Management最新文献

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Corrigendum to “The Acero perioperative skin bundle: An intuitive perioperative pressure injury prevention bundle” [Perioperative Care and Operating Room Management 37C, (2024), 100436]
Q2 Nursing Pub Date : 2024-12-01 DOI: 10.1016/j.pcorm.2024.100444
Lilibeth Acero , Mandy Spitzer
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引用次数: 0
Investigating the relationship between awareness, beliefs, and performance of operating room students in hand hygiene with analysis of microbial flora on hands during the COVID-19 pandemic
Q2 Nursing Pub Date : 2024-12-01 DOI: 10.1016/j.pcorm.2024.100430
Tayebeh Arabzadeh , Ahmad Badeenezhad , Nima Daneshi , Zargham Faramarzinia , Mostafa Moazamfard , Jahanbakhsh Vahdatnejad

Background

Hand hygiene compliance among hospital staff has always been recognized as an effective method in controlling and reducing hospital-acquired infections. Since the outbreak of the COVID-19 pandemic, hand hygiene has emerged as one of the effective preventive measures against this disease, leading to increased awareness and concerns. This study aims to examine the awareness, beliefs, and practices of operating room students regarding hand hygiene, by analyzing the microbial flora on their hands during the COVID-19 pandemic. The objective is to assess the level of hand hygiene compliance among students, who will be future hospital employees.

Aim

This study aimed to investigate the correlation between the level of awareness, belief, and performance of operating room students regarding hand hygiene with the analysis of microbial hand flora during the COVID-19 pandemic. The purpose was to examine the compliance with hand hygiene among students, who will be future hospital employees, during this pandemic.

Methodology

The present study included a sample of 92 students majoring in Operating Room who were enrolled in the research through a census. The data collection tool consisted of a questionnaire to assess the students' awareness, beliefs, and performance regarding hand hygiene and analysis of microbial flora on hands. Standard culture media including Blood Agar, Brilliant Green Agar, and Eosin Methylene Blue were used for isolating microorganisms. Microorganism identification was performed using biochemical tests.

Results

The results of this study indicate that out of the participants, 65 were girls and 27 were boys with an average age of 21.9 ± 2.3 years. The mean scores for awareness, belief, and performance were 8.9, 72.3, and 64.2, respectively. Analysis of microbiological flora also revealed that the highest growth microorganisms were epidermidis bacteria (26.6 %), coagulase-negative staphylococci bacteria (22.9 %), and streptococcus bacteria (21.2 %).

Discussion and Conclusion

Based on the results of this study, operating room students have shown a high level of awareness, belief, and performance during the COVID-19 pandemic. Furthermore, the minimal growth of bacteria in the conducted culture samples confirms this finding. Due to the limited availability of studies, it is recommended that further research be conducted in this area.
{"title":"Investigating the relationship between awareness, beliefs, and performance of operating room students in hand hygiene with analysis of microbial flora on hands during the COVID-19 pandemic","authors":"Tayebeh Arabzadeh ,&nbsp;Ahmad Badeenezhad ,&nbsp;Nima Daneshi ,&nbsp;Zargham Faramarzinia ,&nbsp;Mostafa Moazamfard ,&nbsp;Jahanbakhsh Vahdatnejad","doi":"10.1016/j.pcorm.2024.100430","DOIUrl":"10.1016/j.pcorm.2024.100430","url":null,"abstract":"<div><h3>Background</h3><div>Hand hygiene compliance among hospital staff has always been recognized as an effective method in controlling and reducing hospital-acquired infections. Since the outbreak of the COVID-19 pandemic, hand hygiene has emerged as one of the effective preventive measures against this disease, leading to increased awareness and concerns. This study aims to examine the awareness, beliefs, and practices of operating room students regarding hand hygiene, by analyzing the microbial flora on their hands during the COVID-19 pandemic. The objective is to assess the level of hand hygiene compliance among students, who will be future hospital employees.</div></div><div><h3>Aim</h3><div>This study aimed to investigate the correlation between the level of awareness, belief, and performance of operating room students regarding hand hygiene with the analysis of microbial hand flora during the COVID-19 pandemic. The purpose was to examine the compliance with hand hygiene among students, who will be future hospital employees, during this pandemic.</div></div><div><h3>Methodology</h3><div>The present study included a sample of 92 students majoring in Operating Room who were enrolled in the research through a census. The data collection tool consisted of a questionnaire to assess the students' awareness, beliefs, and performance regarding hand hygiene and analysis of microbial flora on hands. Standard culture media including Blood Agar, Brilliant Green Agar, and Eosin Methylene Blue were used for isolating microorganisms. Microorganism identification was performed using biochemical tests.</div></div><div><h3>Results</h3><div>The results of this study indicate that out of the participants, 65 were girls and 27 were boys with an average age of 21.9 ± 2.3 years. The mean scores for awareness, belief, and performance were 8.9, 72.3, and 64.2, respectively. Analysis of microbiological flora also revealed that the highest growth microorganisms were epidermidis bacteria (26.6 %), coagulase-negative staphylococci bacteria (22.9 %), and streptococcus bacteria (21.2 %).</div></div><div><h3>Discussion and Conclusion</h3><div>Based on the results of this study, operating room students have shown a high level of awareness, belief, and performance during the COVID-19 pandemic. Furthermore, the minimal growth of bacteria in the conducted culture samples confirms this finding. Due to the limited availability of studies, it is recommended that further research be conducted in this area.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100430"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143159642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advanced forecasting of emergency surgical case arrivals: Enhancing operating room performance
Q2 Nursing Pub Date : 2024-11-30 DOI: 10.1016/j.pcorm.2024.100451
Hajar Sadegh Zadeh , Lele Zhang , Mark Fackrell , Hamideh Anjomshoa

Background and Objectives

This study, conducted at a major regional hospital in Australia, aims to enhance operating theatre performance by developing a two-step forecasting method for emergency case arrivals. By analysing data from 2018 to 2022, the study seeks to improve operating room efficiency and reduce cancellations through accurate predictions of emergency surgery demands.

Methods

In the first step, several forecasting models, including Prophet, ARIMA, SARIMAX, LSTM, and Agent-Based Simulation, were evaluated for their effectiveness in predicting daily emergency case arrivals. Each model was trained on 80 % and tested on 20 % of data to replicate real-world forecasting conditions. Performance was assessed using error metrics such as Mean Absolute Error (MAE), Mean Squared Error (MSE), and Root Mean Squared Error (RMSE), along with the model's ability to capture monthly seasonality, general trends, and day-of-week patterns. The second step involved using a non-homogeneous Poisson process to provide more precise hourly forecasts for each day.

Results

The SARIMAX model emerged as the most accurate, with the lowest error metrics (MAE: 1.01, MSE: 2.21, RMSE: 1.48), excelling in capturing seasonality, trends, and weekly patterns. It also demonstrated high robustness and scalability, making it the most reliable model. The non-homogeneous Poisson process provided precise hourly forecasts, further improving resource allocation and operating room scheduling.

Conclusions

The two-step forecasting approach, particularly the use of SARIMAX and the non-homogeneous Poisson process, has the potential to significantly enhance operating room performance by reducing cancellations and improving efficiency. This research lays the groundwork for future advancements in operating theatre emergency management through data-driven decision-making.
{"title":"Advanced forecasting of emergency surgical case arrivals: Enhancing operating room performance","authors":"Hajar Sadegh Zadeh ,&nbsp;Lele Zhang ,&nbsp;Mark Fackrell ,&nbsp;Hamideh Anjomshoa","doi":"10.1016/j.pcorm.2024.100451","DOIUrl":"10.1016/j.pcorm.2024.100451","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>This study, conducted at a major regional hospital in Australia, aims to enhance operating theatre performance by developing a two-step forecasting method for emergency case arrivals. By analysing data from 2018 to 2022, the study seeks to improve operating room efficiency and reduce cancellations through accurate predictions of emergency surgery demands.</div></div><div><h3>Methods</h3><div>In the first step, several forecasting models, including Prophet, ARIMA, SARIMAX, LSTM, and Agent-Based Simulation, were evaluated for their effectiveness in predicting daily emergency case arrivals. Each model was trained on 80 % and tested on 20 % of data to replicate real-world forecasting conditions. Performance was assessed using error metrics such as Mean Absolute Error (MAE), Mean Squared Error (MSE), and Root Mean Squared Error (RMSE), along with the model's ability to capture monthly seasonality, general trends, and day-of-week patterns. The second step involved using a non-homogeneous Poisson process to provide more precise hourly forecasts for each day.</div></div><div><h3>Results</h3><div>The SARIMAX model emerged as the most accurate, with the lowest error metrics (MAE: 1.01, MSE: 2.21, RMSE: 1.48), excelling in capturing seasonality, trends, and weekly patterns. It also demonstrated high robustness and scalability, making it the most reliable model. The non-homogeneous Poisson process provided precise hourly forecasts, further improving resource allocation and operating room scheduling.</div></div><div><h3>Conclusions</h3><div>The two-step forecasting approach, particularly the use of SARIMAX and the non-homogeneous Poisson process, has the potential to significantly enhance operating room performance by reducing cancellations and improving efficiency. This research lays the groundwork for future advancements in operating theatre emergency management through data-driven decision-making.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100451"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do the group discussions of the AOTrauma ORP basic course influence operating-room personnel's care approaches?
Q2 Nursing Pub Date : 2024-11-29 DOI: 10.1016/j.pcorm.2024.100448
Sara Cohen , Mor Saban , Rami Mosheiff , Yair Shapira , Yoram A. Weil

Background

Effective communication and collaborative care models are essential for optimizing trauma patient outcomes. However, traditional learning methods can hinder the development of interprofessional care approaches in the operating room (OR).

Objective

This study evaluated an innovative nursing education program aimed at enhancing trauma care through interprofessional group discussions.

Methods

A prospective evaluation was conducted of 268 OR nurses who participated in the Advances in Trauma Care curriculum. The intervention group (n = 147) completed preparatory eLearning and attended group-based sessions as part of the basic trauma care course. The control group (n = 121) did not participate. Trauma care approaches were assessed before and after the program using a 5-item observational scale.

Results

Pre-program baseline scores on the 5-item observational scale ranged from low to medium for both the control and intervention groups. However, post-program, the intervention group showed a significant improvement, with scores rising to the medium to high range. When comparing the two groups, the intervention group scored significantly higher than the control group (t(265)=6.14, p < 0.01). Additionally, scores within the intervention group increased significantly from pre- to post-program (t(146)=-24.93, p < 0.01). Scores improved notably in each participating country after the intervention. Paired t-tests further confirmed a significant difference in the intervention group's score before and after the educational program (t(33)= -11.20, p < 0.01).

Conclusions

Preliminary evidence suggests incorporating interprofessional group discussions within trauma education may positively impact nurses' application of trauma-informed care. This approach could enhance the quality of nursing care, promote evidence-based practice, and support continuous professional development—not only in operating rooms but across various departments. Further research is needed to evaluate the effectiveness and sustainability of collaborative learning models for advancing multidisciplinary trauma care on a global scale.
{"title":"Do the group discussions of the AOTrauma ORP basic course influence operating-room personnel's care approaches?","authors":"Sara Cohen ,&nbsp;Mor Saban ,&nbsp;Rami Mosheiff ,&nbsp;Yair Shapira ,&nbsp;Yoram A. Weil","doi":"10.1016/j.pcorm.2024.100448","DOIUrl":"10.1016/j.pcorm.2024.100448","url":null,"abstract":"<div><h3>Background</h3><div>Effective communication and collaborative care models are essential for optimizing trauma patient outcomes. However, traditional learning methods can hinder the development of interprofessional care approaches in the operating room (OR).</div></div><div><h3>Objective</h3><div>This study evaluated an innovative nursing education program aimed at enhancing trauma care through interprofessional group discussions.</div></div><div><h3>Methods</h3><div>A prospective evaluation was conducted of 268 OR nurses who participated in the Advances in Trauma Care curriculum. The intervention group (<em>n</em> = 147) completed preparatory eLearning and attended group-based sessions as part of the basic trauma care course. The control group (<em>n</em> = 121) did not participate. Trauma care approaches were assessed before and after the program using a 5-item observational scale.</div></div><div><h3>Results</h3><div>Pre-program baseline scores on the 5-item observational scale ranged from low to medium for both the control and intervention groups. However, post-program, the intervention group showed a significant improvement, with scores rising to the medium to high range. When comparing the two groups, the intervention group scored significantly higher than the control group (t(265)=6.14, <em>p</em> &lt; 0.01). Additionally, scores within the intervention group increased significantly from pre- to post-program (t(146)=-24.93, <em>p</em> &lt; 0.01). Scores improved notably in each participating country after the intervention. Paired <em>t</em>-tests further confirmed a significant difference in the intervention group's score before and after the educational program (t(33)= -11.20, <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Preliminary evidence suggests incorporating interprofessional group discussions within trauma education may positively impact nurses' application of trauma-informed care. This approach could enhance the quality of nursing care, promote evidence-based practice, and support continuous professional development—not only in operating rooms but across various departments. Further research is needed to evaluate the effectiveness and sustainability of collaborative learning models for advancing multidisciplinary trauma care on a global scale.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100448"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Topical bupivacaine effect on the response to awake extubation during emergence from general anesthesia in patients undergoing elective thyroidectomy. A randomized controlled study
Q2 Nursing Pub Date : 2024-11-27 DOI: 10.1016/j.pcorm.2024.100449
Shereen E. Abd Ellatif, Asmaa M. Galal Eldin, Rehab A. Wahdan

Background

A desirable combination of smooth extubation, even with prolonged extubation, and an easy maneuver to apply is difficult to achieve. This study aimed to evaluate the efficacy of 0.5% topical bupivacaine for reducing cough, postoperative sore throat, and hemodynamic fluctuations during extubation in patients undergoing thyroidectomy.

Methods

Forty-eight patients scheduled for thyroidectomy were randomly assigned to two equal groups (24 each): group (C) patients received 5 ml of 0.9% normal saline topically, and group (B) patients received 5 ml of 0.5% bupivacaine topically 15 min, around the tracheal tube, before the expected end of surgery, followed by manual ventilation to obtain air bubbles distributed throughout the entire airway mucosa. The primary outcomes were the incidence and grade of cough. The secondary outcomes were the incidence and degree of postoperative sore throat, extubation time, hemodynamic changes during extubation, and side effects.

Results

There was a statistically significant decrease in the incidence and the severity of cough in the bupivacaine group compared to the control group. Moreover, the severity of sore throat, as assessed by the VAS score, was lower in the bupivacaine group up to 12 hours postoperatively. The hemodynamic parameters significantly increased in the control group in the peri-extubation period compared to the bupivacaine group, with no difference in extubation time or side effects.

Conclusion

The use of topical bupivacaine around the ETT significantly reduced the incidence and severity of cough and postoperative sore throat with less hemodynamic fluctuations during the periextubation period in patients undergoing thyroidectomy.
{"title":"Topical bupivacaine effect on the response to awake extubation during emergence from general anesthesia in patients undergoing elective thyroidectomy. A randomized controlled study","authors":"Shereen E. Abd Ellatif,&nbsp;Asmaa M. Galal Eldin,&nbsp;Rehab A. Wahdan","doi":"10.1016/j.pcorm.2024.100449","DOIUrl":"10.1016/j.pcorm.2024.100449","url":null,"abstract":"<div><h3>Background</h3><div>A desirable combination of smooth extubation, even with prolonged extubation, and an easy maneuver to apply is difficult to achieve. This study aimed to evaluate the efficacy of 0.5% topical bupivacaine for reducing cough, postoperative sore throat, and hemodynamic fluctuations during extubation in patients undergoing thyroidectomy.</div></div><div><h3>Methods</h3><div>Forty-eight patients scheduled for thyroidectomy were randomly assigned to two equal groups (24 each): group (C) patients received 5 ml of 0.9% normal saline topically, and group (B) patients received 5 ml of 0.5% bupivacaine topically 15 min, around the tracheal tube, before the expected end of surgery, followed by manual ventilation to obtain air bubbles distributed throughout the entire airway mucosa. The primary outcomes were the incidence and grade of cough. The secondary outcomes were the incidence and degree of postoperative sore throat, extubation time, hemodynamic changes during extubation, and side effects.</div></div><div><h3>Results</h3><div>There was a statistically significant decrease in the incidence and the severity of cough in the bupivacaine group compared to the control group. Moreover, the severity of sore throat, as assessed by the VAS score, was lower in the bupivacaine group up to 12 hours postoperatively. The hemodynamic parameters significantly increased in the control group in the peri-extubation period compared to the bupivacaine group, with no difference in extubation time or side effects.</div></div><div><h3>Conclusion</h3><div>The use of topical bupivacaine around the ETT significantly reduced the incidence and severity of cough and postoperative sore throat with less hemodynamic fluctuations during the periextubation period in patients undergoing thyroidectomy.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100449"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A study of the relationship between professional autonomy and professional quality of life among operating room personnel: A cross-sectional study 手术室人员职业自主性与职业生活质量之间关系的研究:横断面研究
Q2 Nursing Pub Date : 2024-11-20 DOI: 10.1016/j.pcorm.2024.100447
Fatemeh Hasanfard , Camellia Torabizadeh , Zahra Khademian

Background

Healthcare personnel's professional autonomy and professional quality of life can influence the quality of care provided to patients. However, there is scarce and contradictory information available about the relationship between these two factors. The present study aims to investigate the relationship between professional autonomy and professional quality of life among operating room personnel.

Methods

This cross-sectional study was conducted in teaching hospitals in the south of Iran in 2023. The sample consisted of 464 operating room personnel who were selected by quota sampling. Data were collected using Dempster Professional Autonomy Scale and Stamm's Professional Quality of Life Scale. The collected data were analyzed in SPSS v. 24. Level of significance was set at 0.05.

Results

The participants’ professional autonomy mean score was found to be average (92.6 ± 73.32). Among the subscales of professional quality of life, the participants’ highest and lowest mean scores were for compassion satisfaction (35.3 ± 3.75) and secondary traumatic stress (31.2 ± 9.94) respectively. Also, the researchers found a significant inverse correlation between professional autonomy on the one hand and the professional quality of life subscales of burnout (p = 0.017, r = -0.111) and secondary traumatic stress (p = 0.005, r = -0.131) on the other. Moreover, there was a significant correlation between the operating room personnel's employment status on the one hand and professional autonomy (p = 0.004, r = -0.133) and burnout (p = 0.034, r = -0.099) on the other. The results also showed a significant inverse correlation between the subscale of burnout on the one hand and the variables of age (p = 0.021, r = -0.107) and work experience (p = 0.027, r = -0.103) on the other.

Conclusion

In view of the findings of the study, the healthcare system administrators are recommended to adopt effective policies and strategies to promote operating room personnel's professional autonomy and professional quality of life.
背景医护人员的职业自主性和职业生活质量会影响为患者提供的护理质量。然而,关于这两个因素之间关系的信息很少,而且相互矛盾。本研究旨在调查手术室人员的职业自主性与职业生活质量之间的关系。样本包括 464 名通过配额抽样选出的手术室人员。采用 Dempster 职业自主性量表和 Stamm 职业生活质量量表收集数据。收集到的数据使用 SPSS v. 24 进行分析。结果发现,受试者的职业自主性平均得分为(92.6 ± 73.32)。在职业生活质量的分量表中,参与者的同情满意度(35.3 ± 3.75)和继发性创伤压力(31.2 ± 9.94)的平均得分分别最高和最低。研究人员还发现,职业自主性与职业倦怠(p = 0.017,r = -0.111)和继发性创伤压力(p = 0.005,r = -0.131)的职业生活质量分量表之间存在显著的反相关关系。此外,手术室人员的就业状况与职业自主性(p = 0.004,r = -0.133)和职业倦怠(p = 0.034,r = -0.099)之间也存在明显的相关性。结果还显示,职业倦怠的分量表与年龄(p = 0.021,r = -0.107)和工作经验(p = 0.027,r = -0.103)这两个变量之间存在明显的反相关关系。
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引用次数: 0
Postoperative mechanical ventilation after corrective Tetralogy of Fallot surgery in infants: Assessment of perioperative factors and radiographic severity scores 婴儿法洛氏四联症矫正手术后的术后机械通气:围手术期因素和放射学严重程度评分评估
Q2 Nursing Pub Date : 2024-11-16 DOI: 10.1016/j.pcorm.2024.100446
Panop Limratana , Wiriya Maisat , Lee Ferguson , Christopher W. Baird , Koichi Yuki
Early recovery from surgery for congenital heart disease (CHD) is becoming a trend. Tetralogy of Fallot/pulmonary stenosis (TOF/PS) is the most common cyanotic CHD with excellent long-term outcomes. We examined potential factors associated with early extubation in 249 patients who underwent TOF/PS complete repair in a tertiary pediatric medical center from January 2015 to December 2022. Patient demographics, preoperative characteristics, intraoperative variables, postoperative outcomes, surgical type, surgical duration, cardiopulmonary bypass (CPB) time, cross-clamp time, and blood product volumes were acquired from the electronic medical records. Valve sparing repair (VSR) tends to demonstrate earlier recovery profiles than transannular patch repair (TAP) irrelevant of the presence of monocusp valve (P < 0.0001) and the degree of right ventricular outflow pressure drop was significantly correlated with post-operative recovery profile (p = 0.0204). Because of intracardiac shunts and PaO2/FiO2 ratios being poor indicators of lung injury, Brixia scores were also used. Our data suggested that Brixia score could be an excellent alternative to evaluate post-operative lung status.
先天性心脏病(CHD)手术后早期康复已成为一种趋势。法洛氏四联症/肺动脉狭窄(TOF/PS)是最常见的紫绀型先天性心脏病,长期疗效极佳。我们研究了2015年1月至2022年12月在一家三级儿科医疗中心接受TOF/PS完全修复术的249名患者中与早期拔管相关的潜在因素。我们从电子病历中获取了患者的人口统计学特征、术前特征、术中变量、术后结果、手术类型、手术持续时间、心肺旁路(CPB)时间、交叉钳夹时间和血液制品量。与单瓣膜的存在无关,瓣膜疏通修复术(VSR)比经瓣膜修补修复术(TAP)更早显示恢复情况(P < 0.0001),右室流出压下降程度与术后恢复情况显著相关(P = 0.0204)。由于心内分流和 PaO2/FiO2 比值是肺损伤的不良指标,因此还使用了 Brixia 评分。我们的数据表明,Brixia 评分可作为评估术后肺部状况的最佳替代指标。
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引用次数: 0
Compliance evaluation in post-anesthesia care units at teaching hospitals in Alborz Province, Iran 伊朗阿尔伯兹省教学医院麻醉后护理病房的合规性评估
Q2 Nursing Pub Date : 2024-11-13 DOI: 10.1016/j.pcorm.2024.100445
Leila Sadati , Mohsen Khalilnejad , Dorrin Nikbakht , Sahar Karami , Fatemeh Tavakoli , Rana Abjar

Background

The post-anesthesia care unit (PACU) is a critical care unit where postoperative patients are monitored and cared for until full recovery. Evaluating standards in different domains is crucial for providing quality care. This study aims to assess the compliance of design, equipment, drugs, and staff performance standards in PACUs of teaching hospitals of Alborz Province, Iran.

Methods

This cross-sectional study was conducted between January 2023 and September 2023. Data were gathered using a 40-item checklist covering physical structure, equipment/drugs, and staff performance. For the latter, a 360-degree appraisal (self-assessment, internal evaluator, external evaluator) was done.

Results

Among the three standard domains, performance had the highest average compliance at 80.72 %, followed by equipment/drugs at 75.33 %. Design/structure had the lowest compliance at 54 %.

Conclusion

Given the lack of full compliance in PACU design, equipment, and certain aspects of patient care, healthcare managers and policymakers must prioritize improving post-anesthesia care unit infrastructure, equipment provision, and staff training. Implementing continuous education programs with effective teaching methods is crucial for enhancing care quality and preparing future healthcare professionals in these teaching hospitals.
背景麻醉后护理病房(PACU)是一个重症监护病房,术后病人在这里接受监测和护理,直至完全康复。评估不同领域的标准对提供优质护理至关重要。本研究旨在评估伊朗阿尔伯兹省教学医院 PACU 在设计、设备、药物和员工绩效标准方面的达标情况。方法本横断面研究于 2023 年 1 月至 2023 年 9 月期间进行。数据收集采用了一份包含 40 个项目的核对表,内容涵盖物理结构、设备/药品和员工绩效。结果在三个标准领域中,绩效的平均达标率最高,为 80.72%,其次是设备/药品,为 75.33%。结论鉴于 PACU 的设计、设备和患者护理的某些方面未完全达标,医疗管理人员和政策制定者必须优先改善麻醉后护理单元的基础设施、设备供应和人员培训。在这些教学医院中,采用有效的教学方法实施继续教育计划对于提高护理质量和培养未来的医护专业人员至关重要。
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引用次数: 0
Anaesthetic management of caesarean section in a primigravida with pre-eclampsia, pleural effusion, consolidation, and lung collapse – a case report 对一名患有先兆子痫、胸腔积液、合并症和肺塌陷的初产妇进行剖腹产手术的麻醉管理--病例报告
Q2 Nursing Pub Date : 2024-11-02 DOI: 10.1016/j.pcorm.2024.100443
Shilpa A Naik, Prathvi B, Ranjan R K, Angela Abraham
Pregnancy complicated with preeclampsia, pleural effusion and lung infection presents unique challenges to the anaesthesiologist. An enlarged uterus in pregnant women, particularly in the third trimester restricts diaphragmatic movement, raising pleural fluid pressure and facilitating the development of pleural effusion. We present the safe and successful conduct of an emergency lower segment cesarean section (LSCS) in a severe pre-eclamptic patient, with bilateral pleural effusions and collapse and consolidation of the lungs. This was performed under spinal anaesthesia as a valuable alternative to general anaesthesia in the setting of numerous infrastructure constraints.
妊娠合并子痫前期、胸腔积液和肺部感染给麻醉医生带来了独特的挑战。孕妇子宫增大,尤其是在妊娠三个月时,会限制横膈膜的运动,使胸腔积液压力升高,有利于胸腔积液的形成。我们介绍了对一名严重的先兆子痫患者实施紧急下段剖宫产术(LSCS)的安全和成功案例,该患者伴有双侧胸腔积液、肺部塌陷和合并症。该手术是在脊髓麻醉下进行的,这是在众多基础设施限制的情况下替代全身麻醉的重要方法。
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引用次数: 0
The effect of surgical smoke on operating room workers, attitudes towards risks, and the implementation of preventive measures 手术烟雾对手术室工作人员的影响、对风险的态度以及预防措施的实施
Q2 Nursing Pub Date : 2024-10-28 DOI: 10.1016/j.pcorm.2024.100442
Derya Esenkaya , Emine İyigün
Amaç: Bu araştırma, cerrahi dumanın ameliyathane sahipleri üzerinde mevcutlukları, risklere karşı tutumlarını ve para harcamanlarını planlama amacıyla tanımlama olarak yapılmıştır. Gereç ve Yöntem: Kesitsel kalitede bu çalışma, Türkiye'de bir hastanenin ameliyathane ünitesinde Nisan-Mayıs 2022′de kayıtlı süre boyunca devam etmektedir. Araştırmanın boyutları, dahil edilme kriterlerini karşılayan 73 ameliyathane çalışanından oluşuyordu. Araştırmanın verileri Kişisel Bilgi Formu, AORN (Peri-Operatif Kayıtlı Hemşireler Derneği) rehberleri ve ilgili kaynaklarla kırsal Cerrahi Dumanın Ameliyathane Çalışanları Üzerindeki Etkileri, Risklere Yönelik Tutumlar ve Önleyici Tedbirlerin Uygulanması Anketi ile toplanmıştır. Bulgular: Ameliyathane çalışanlarının %91,8′i (n = 67) son beş yıl içerisinde cerrahi dumanla ilgili herhangi bir eğitime katılmadığını belirtti. Bunların %75,3′ü cerrahi dumana maruz kaldıklarını bildirdi. Ameliyathane çalışanlarının yaklaşık %50,7′si (n = 37) lazer dumanı tahliyesi için herhangi bir cihazın kullanılmadığını belirtirken, %39,7′si (n = 29) tahliye dumanı için kullanılan cihazlar hakkında bilgisinin olmadığını belirtti. Ameliyathane çalışanlarının %65,8′inin (n = 48) iş yerlerinde cerrahi dumanla ilgili herhangi bir protokolden haber yoktu. Cerrahi dumana maruz kalmanın sağlık üzerindeki etkilerine, maruziyete dayanıklına süt verdiklerini bildirdiler: sızıntı (%65,8), göz tahrişi (%65,8), gözlerde sulanma (%63,0), göz kuruluğu (%65,8)), uyku bozuklukları (%49,3) %), solunum problemleri (%37,0) ve baş ağrısı (%35,6). Araştırmada ameliyathane çalışanlarının elde edebilecekleri cerrahi dumandan korunmak için kişisel koruyucu önlemlerin alınması. Cerrahi maske (%100), aspirasyon sondası (%60,3), önlük (%41,1) ve gözlük (%35,6) belirlendi. Sağlık çalışanlarının cerrahi dumanın potansiyel tehlikelerine karşı tutumları değerlendirildi. Diğer sağlık çalışanlarının ameliyathane çalışanlarına göre daha fazla kaygı yaşadıkları belirlendi. Sonuç: Araştırmanın düzenine göre ameliyathane çalışanlarının sağlıklı duman tehlikelerine yönelik ilerlemeye yönelik tutumlarını geliştirecek yöntemlerin benimsenmesinin esasları. Ayrıca vakum dumanıyla ilgili tamamlayıcıları önlemek için politikalar ve kılavuzlar iletilmeli ve yöneticilerden uygun ekipman ve destek eğitimi.
目的:本研究旨在描述手术烟雾对手术室所有者的影响,以确定他们的存在、他们对风险的态度以及他们的资金支出计划。材料和方法:这项横断面研究于 2022 年 4 月至 5 月期间在土耳其一家医院的手术室进行。研究对象包括符合纳入标准的 73 名手术室工作人员。研究数据通过个人信息表、AORN(围手术期注册护士协会)指南和相关资源以及农村手术烟雾对手术室工作人员的影响、对风险的态度和预防措施实施情况调查表收集。结果91.8%(n = 67)的手术室工作人员表示在过去五年中没有参加过任何有关手术烟雾的培训。其中 75.3% 的人表示接触过手术烟雾。约 50.7%(n = 37)的手术室工作人员表示没有使用激光排烟装置,而 39.7%(n = 29)的工作人员表示不了解排烟装置。65.8%(n = 48)的手术室工作人员不知道其工作场所有任何与手术烟雾有关的规程。他们报告了接触手术烟雾对健康造成的影响:泄漏(65.8%)、眼睛刺激(65.8%)、眼睛流泪(63.0%)、眼睛干涩(65.8%)、睡眠障碍(49.3%)、呼吸系统问题(37.0%)和头痛(35.6%)。在这项研究中,手术室工作人员采取了个人防护措施,以防止手术烟雾。确定了手术口罩(100%)、吸入探针(60.3%)、围裙(41.1%)和护目镜(35.6%)。评估了医护人员对手术烟雾潜在危害的态度。结果表明,其他医护人员比手术室工作人员更焦虑。结论根据研究结果,必须采取措施改善手术室工作人员对健康烟雾危害的态度。此外,应传达政策和指导方针,以防止与真空烟雾有关的补品,并提供适当的设备和管理人员的支持培训。
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引用次数: 0
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Perioperative Care and Operating Room Management
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