Perioperative Care and Operating Room Management最新文献_第7页

Operationalising the right to refuse treatment: karnataka’s 2025 response to the 2023 Order 实施拒绝治疗的权利：卡纳塔克邦2025年对2023年法令的回应

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-22 DOI: 10.1016/j.pcorm.2025.100557

Uzodinma Yurriens Ezenduka, Debarati Halder

Background

Indian law recognises refusal of life-sustaining treatment and accepts advance directives. The order of 24 January 2023 sets attestation before a notary or a Gazetted Officer, allows authenticity checks through digital health records or named public custodians, and assigns activation to Primary and Secondary Medical Boards. This study asks whether Karnataka’s 2025 measures supply the required custody route and how hospitals can record cross-district verification within existing law.

Methods

Doctrinal analysis of national rules and Karnataka’s 2025 instruments; review of professional guidance on end-of-life decisions and Do-Not-Attempt-Resuscitation (DNAR); and use of migration data to frame document reach. From these sources, a concise verification workflow and audit checks were derived.

Findings

Karnataka names the Joint Commissioner in each Bruhat Bengaluru Mahanagara Palike zone and the Executive Officer of each taluk panchayat as custodians, and standardises Secondary Medical Boards from existing practitioner pools, with judicial acknowledgment of compliance. A three-channel method suits high mobility: consented access to a personal health record, contact with persons named in the directive, and written confirmation from the identified custodian. The file then carries an authenticity note recording version, attestation, source, and times, plus time-stamped minutes from both Boards. Treating authenticity as reach and version control improves reliability across districts and yields clear audit points, including time to first verified copy and concordance across versions.

Conclusions

Karnataka’s measures answer the custody question in the affirmative and allow verification within the national scheme. With attested directives, named contacts, reachable custodians, DNAR where relevant, and brief reasoned minutes, hospitals can produce a reviewable record that supports timely decisions while respecting autonomy and privacy.

印度法律承认拒绝维持生命的治疗，并接受预先指示。2023年1月24日的命令将证明交给公证人或宪报官员，允许通过数字健康记录或指定的公共保管人进行真实性检查，并指定初级和二级医疗委员会启动。本研究询问卡纳塔克邦2025年的措施是否提供了所需的监护路线，以及医院如何在现有法律范围内记录跨地区核实。方法对国家规定和卡纳塔克邦2025文件进行理论分析；审查关于临终决定和不尝试复苏（DNAR）的专业指导；并利用迁移数据来框定文档到达。从这些来源，得出了一个简明的验证工作流程和审计检查。《卡纳塔克邦调查报告》任命布鲁哈特·班加罗尔Mahanagara paralike区的联合专员和每个塔鲁克村务委员会的行政官员为监管人，并从现有的执业人员中对二级医疗委员会进行标准化，并司法确认其遵守情况。三渠道方法适合高流动性：经同意查阅个人健康记录，与指令中指定的人员联系，以及获得已确定的监护人的书面确认。然后，该文件带有记录版本，证明，来源和时间的真实性说明，以及两个董事会的时间戳分钟。将真实性视为范围和版本控制，可以提高跨区域的可靠性，并产生明确的审计点，包括首次验证副本的时间和跨版本的一致性。结论卡纳塔克邦的措施肯定地回答了监护问题，并允许在国家计划内进行核查。有了经过认证的指令、指定的联系人、可联系的监护人、相关的DNAR和简短的推理分钟，医院可以生成可审查的记录，在尊重自主权和隐私的同时支持及时决策。

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引用次数: 0

A comparison of spinal Anaesthesia in traditional sitting position versus cross-legged sitting position in Parturients undergoing elective caesarean section—a Randomised controlled trial 选择性剖宫产产妇传统坐姿与盘腿坐姿脊柱麻醉的比较——一项随机对照试验

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-22 DOI: 10.1016/j.pcorm.2025.100556

S. Podder , I.A. Khan , L Shenoy , A. Satish , M. Kulkarni , R.R. Krishnabhat , D. Shetty , S. Thimmaiah Kanakalakshmi

Background

Spinal anaesthesia is the preferred technique for caesarean delivery, owing to the several benefits it carries for mother and fetus. Appropriate patient positioning is vital as it improves the patient comfort, reduces the time taken, the number of attempts required, and decreases the number of needle and bone contacts during the procedure. Our study primarily aimed to compare number of attempts taken for successful needle placement in a sitting position versus a cross-legged sitting position. Secondary objectives included patient comfort, ease of palpation, and block characteristics.

Methods

Our study was a prospective, nonblinded, single-centre study. The patients were randomly assigned to one of the two groups using a computer-generated randomisation table and opaque envelope technique. A total of 110 parturients posted for the elective caesarean delivery received spinal anaesthesia in either a traditional sitting position or a cross-legged sitting position.

Results

The parturients in both groups were comparable in terms of age, height and weight. The number of attempts was equal in both groups, with 60 % of patients were successful at 1st attempt; n = 33 p-Value = 0.384). The landmark palpability, block characteristics and patient comfort were comparable in both groups

Conclusion

We found comparable results in both positions, either traditional sitting position can be used to administer spinal anaesthesia in parturients based on their comfort and preference

背景脊髓麻醉是剖腹产的首选技术，因为它对母亲和胎儿都有好处。适当的患者体位至关重要，因为它可以改善患者的舒适度，减少所需的时间和尝试次数，并减少手术过程中针头和骨头接触的次数。我们的研究主要是为了比较坐姿和盘腿坐姿成功放置针头的次数。次要目标包括患者舒适度、触诊便利性和阻滞特征。方法本研究为前瞻性、非盲、单中心研究。使用计算机生成的随机表和不透明包膜技术将患者随机分配到两组中的一组。共有110例择期剖宫产产妇采用传统坐姿或盘腿坐姿进行脊柱麻醉。结果两组产妇年龄、身高、体重具有可比性。两组患者尝试次数相等，60%的患者第一次尝试成功；n = 33， p值= 0.384)。结论两种体位均具有可比性，可根据产妇的舒适度和偏好选择传统坐位进行脊髓麻醉

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引用次数: 0

Comparative efficacy of intrathecal morphine and posterior quadratus lumborum block for post-caesarean analgesia 鞘内吗啡与腰方肌后阻滞用于剖宫产后镇痛的比较疗效

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-22 DOI: 10.1016/j.pcorm.2025.100559

Ahmed Omar Mahmoud , Gamal Mohamed Abu Dahab Ibrahim , Mahmoud Alhasan Mohamed Hasan , Waleed Ahmad Ali Hussein Atteia , Ahmed Abdelkader Ahmed , Mostafa Hassanien Hassanien Bakr

Background

Effective pain management after caesarean delivery is essential to promote maternal recovery, facilitate early mobility, and support mother-infant bonding. Traditionally, intrathecal morphine (ITM) has been widely used due to its strong analgesic effects, but concerns about opioid-related side effects have led to growing interest in alternative regional techniques such as the quadratus lumborum block (QLB). Comparative evidence on the efficacy of these approaches in obstetric patients remains limited.

Methods

In a randomized trial, 70 cesarean patients underwent spinal anesthetic at Assiut University Hospital. The study compared bilateral posterior QLB with 0.25 % bupivacaine to 100 μg ITM. Secondary outcomes included pain scores, time to first morphine request, side effects, quality of recovery, and functional outcomes; the primary outcome was 24-hour IV morphine consumption.

Results

Morphine consumption over 24 h was similar between the ITM and QLB groups, averaging 6.4 mg and 8.5 mg, respectively. Pain levels at rest and during movement did not differ significantly between the two groups at any time point. However, a subgroup analysis showed that QLB patients with a BMI of 30 kg/m² or higher required more morphine and reported higher peak pain scores compared to those in the ITM group (10.5 mg vs 7.4 mg, p < 0.05). No such difference was seen in patients with a BMI below 30 kg/m². In a multivariate analysis, BMI emerged as the only significant predictor of 24-hour morphine consumption (p = 0.016).

Conclusion

ITM and posterior QLB provide comparable postoperative analgesia after cesarean delivery for the general population. However, patient factors such as BMI and age may influence postoperative opioid requirements and should be considered when selecting an analgesic technique to optimize recovery and minimize side effects.

背景剖宫产后有效的疼痛管理对于促进产妇康复、促进早期活动和支持母婴关系至关重要。传统上，鞘内吗啡（ITM）因其强大的镇痛作用而被广泛使用，但对阿片类药物相关副作用的担忧导致人们对替代区域性技术（如腰方肌阻滞（QLB））的兴趣日益浓厚。关于这些方法在产科患者中的疗效的比较证据仍然有限。方法对70例剖宫产患者在阿西尤特大学医院行脊髓麻醉进行随机对照试验。该研究将双侧后路QLB与0.25%布比卡因和100 μg ITM进行比较。次要结局包括疼痛评分、到第一次吗啡请求的时间、副作用、恢复质量和功能结局；主要终点为24小时静脉注射吗啡。结果ITM组和QLB组24 h吗啡摄取量相似，平均分别为6.4 mg和8.5 mg。两组在休息和运动时的疼痛水平在任何时间点均无显著差异。然而，亚组分析显示，与ITM组相比，BMI为30 kg/m²或更高的QLB患者需要更多的吗啡，并报告更高的峰值疼痛评分（10.5 mg vs 7.4 mg, p < 0.05）。BMI低于30 kg/m²的患者没有这种差异。在多变量分析中，BMI是24小时吗啡摄入量的唯一显著预测因子（p = 0.016）。结论itm与后路QLB对一般人群剖宫产术后镇痛效果相当。然而，BMI和年龄等患者因素可能会影响术后阿片类药物的需求，在选择镇痛技术时应考虑这些因素，以优化恢复并减少副作用。

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引用次数: 0

Development of a clinical competency evaluation index for operating room nurses in the Italian context: Delphi method and analytic hierarchy process 意大利手术室护士临床胜任力评价指标的制定：德尔菲法与层次分析法

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-18 DOI: 10.1016/j.pcorm.2025.100554

Gabriele Caggianelli , Irene Dello Iacono , Rita Patrizia Tomasin , Pamela Pellini , Luana Di Marte , Eleonora Bruno , Claudia Angelucci , Paolo Mazzuca , Fabio Petrelli , Sara Morales Palomares , Giovanni Cangelosi , Stefano Mancin

Purpose

To achieve consensus on essential elements of a clinical competency assessment for operating room nurses (OR) in Italy

Design

Delphi study

Methods

Between October 2023 and September 2024, 24 experts, including OR nurses, coordinators, and managers, identified key elements. Data collection involved two Delphi rounds and the analytic hierarchy process. Consensus was reached with a mean score ≥ 3.5 or variance < 20 %.

Findings

Five key dimensions were identified: Professional, Ethical, and Legal Practice; Nursing Care & Perioperative Practice; Interpersonal Relationships & Communication; Organizational, Managerial & Leadership Skills; and Education, Research & Professional Development. The framework, with 66 competency elements, highlights the central role of nursing care and perioperative practice.

Conclusions

This framework highlights the multifaceted nature of perioperative nursing, with the Nursing Care & Perioperative Practice dimension being central. It also emphasizes the importance of non-technical competencies, such as communication, leadership, and professional development, in improving patient outcomes and teamwork.

目的：对意大利手术室护士临床胜任力评估的基本要素达成共识。方法：2023年10月至2024年9月，包括手术室护士、协调员和管理人员在内的24名专家确定了关键要素。数据收集包括两轮德尔菲法和层次分析法。平均评分≥3.5分或方差≤20%时达成共识。调查结果确定了五个关键方面：专业、道德和法律实践；护理与围手术期实践；人际关系与沟通；组织、管理和领导能力；教育、研究和专业发展。该框架包含66个能力要素，突出了护理和围手术期实践的核心作用。结论：该框架突出了围手术期护理的多面性，以围手术期护理和实践维度为中心。它还强调了非技术能力的重要性，如沟通、领导和专业发展，以改善患者的结果和团队合作。

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引用次数: 0

Patient and staff safety differences between open and laparoscopic surgical procedures: A qualitative study of operating room nurses' perspectives 开放和腹腔镜手术的患者和工作人员安全差异：手术室护士观点的定性研究

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-17 DOI: 10.1016/j.pcorm.2025.100555

Neslihan Ilkaz , Dercan Gencbas

Background

Operating room nurses play a critical role in maintaining safety for both patients and staff during the perioperative period. Given the distinct nature of open and laparoscopic surgical procedures, they must identify and address procedure-specific safety risks through preventive strategies.

Aim

This study aimed to investigate the factors that threaten patient and staff safety in open and laparoscopic surgeries.

Methods

Data were collected through semi-structured interviews with 18 operating room nurses from various surgical units selected via purposive sampling. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed.

Results

Analysis yielded three main themes: Operating room environment, Staff responsibility,and Risk specific for surgical procedure. Sub-themes included environmental and psychological factors, team harmony, risk in surgical preparation, and risk during intraoperative. The findings showed that open and laparoscopic surgical procedures posed different risks to patient and staff safety.

Conclusions

Recognizing the safety challenges of different surgical methods is essential for improving outcomes. Operating room nurses and surgical teams should implement proactive, procedure-specific strategies to mitigate risks across all phases of surgery.

背景手术室护士在围手术期维护患者和工作人员的安全方面发挥着至关重要的作用。鉴于开放和腹腔镜手术的不同性质，他们必须通过预防策略识别和解决手术特定的安全风险。目的探讨腹腔镜和开放手术中威胁患者和工作人员安全的因素。方法采用半结构化访谈法对18名不同科室的手术室护士进行有目的抽样调查。采访录音，逐字抄录，并按主题进行分析。结果分析得出三个主要主题：手术室环境、工作人员责任和外科手术的特定风险。分主题包括环境和心理因素、团队和谐、手术准备中的风险和术中风险。研究结果表明，开放和腹腔镜手术对患者和工作人员的安全构成不同的风险。结论认识到不同手术方法的安全性挑战对改善预后至关重要。手术室护士和外科团队应该实施积极主动的、具体的手术策略，以减轻手术所有阶段的风险。

{"title":"Patient and staff safety differences between open and laparoscopic surgical procedures: A qualitative study of operating room nurses' perspectives","authors":"Neslihan Ilkaz , Dercan Gencbas","doi":"10.1016/j.pcorm.2025.100555","DOIUrl":"10.1016/j.pcorm.2025.100555","url":null,"abstract":"<div><h3>Background</h3><div>Operating room nurses play a critical role in maintaining safety for both patients and staff during the perioperative period. Given the distinct nature of open and laparoscopic surgical procedures, they must identify and address procedure-specific safety risks through preventive strategies.</div></div><div><h3>Aim</h3><div>This study aimed to investigate the factors that threaten patient and staff safety in open and laparoscopic surgeries.</div></div><div><h3>Methods</h3><div>Data were collected through semi-structured interviews with 18 operating room nurses from various surgical units selected via purposive sampling. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed.</div></div><div><h3>Results</h3><div>Analysis yielded three main themes: Operating room environment, Staff responsibility,and Risk specific for surgical procedure. Sub-themes included environmental and psychological factors, team harmony, risk in surgical preparation, and risk during intraoperative. The findings showed that open and laparoscopic surgical procedures posed different risks to patient and staff safety.</div></div><div><h3>Conclusions</h3><div>Recognizing the safety challenges of different surgical methods is essential for improving outcomes. Operating room nurses and surgical teams should implement proactive, procedure-specific strategies to mitigate risks across all phases of surgery.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100555"},"PeriodicalIF":1.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120953","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

Communication challenges faced by operating room students in clinical environments: Insights from a qualitative content analysis 手术室学生在临床环境中面临的沟通挑战：来自定性内容分析的见解

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-16 DOI: 10.1016/j.pcorm.2025.100553

Fatemeh Davodabadi , Amirali Alizadeh , Fatemeh Samiee , Behzad Imani

Background

Effective communication is a crucial non-technical skill in high-pressure clinical environments like operating rooms, impacting patient safety and team coordination. However, operating room students face obstacles in developing these skills during clinical training. This study aimed to explore and provide an in-depth understanding of the contextual and system-level factors shaping communication barriers encountered by operating room students in clinical settings.

Methods

A qualitative study with a conventional content analysis approach was conducted in 2025 among ten undergraduate operating room students from Hamadan University of Medical Sciences, western Iran. Participants were selected through purposive sampling, and recruitment continued until data saturation was achieved. Data were collected through semi-structured interviews and analyzed concurrently using the Graneheim and Lundman method. Trustworthiness was ensured using Guba and Lincoln’s criteria.

Results

The analysis identified five main themes:(1) Intrapersonal barriers (fear of mistakes, low self-esteem, introversion, lack of interest in the clinical environment),(2) Restrictive organizational and hierarchical structures (surgeons’ authoritarianism, hierarchical culture, lack of formal communication channels),(3) Gap between academic training and clinical demands (insufficient communication skills training, exclusive focus on technical skills, lack of structured feedback),(4) Clinical environmental pressures (heavy workload, time constraints, adverse physical and psychological conditions), and (5) Lack of professional support (absence of active clinical instructors, neglect of students’ roles by the healthcare team, scarcity of positive communication role models).

Conclusion

Communication barriers among operating room students are multifaceted, shaped by individual, organizational, educational, and environmental factors. Addressing these challenges requires curriculum revisions, strengthened professional support, and fostering psychologically safe clinical environments.

在手术室等高压临床环境中，有效的沟通是一项至关重要的非技术技能，影响患者安全和团队协调。然而，在临床培训中，手术室学生在发展这些技能方面面临障碍。本研究旨在探讨并深入了解影响手术室学生在临床环境中遇到的沟通障碍的环境和系统层面因素。方法采用常规内容分析方法，对伊朗西部哈马丹医科大学10名本科手术室学生进行定性研究。参与者通过有目的的抽样选择，并继续招募，直到数据饱和。通过半结构化访谈收集数据，并同时使用Graneheim和Lundman方法进行分析。根据古巴和林肯的标准，可信赖性得到了保证。结果分析确定了五个主要主题：(1)个人障碍（害怕错误、自卑、内向、对临床环境缺乏兴趣）；(2)限制性组织和等级结构（外科医生的专制主义、等级文化、缺乏正式的沟通渠道）；(3)学术培训与临床需求的差距（沟通技能培训不足、只注重技术技能、缺乏专业技能）；(4)临床环境压力（繁重的工作量、时间限制、不利的身心状况），以及(5)缺乏专业支持（缺乏积极的临床导师，医疗团队忽视学生的角色，缺乏积极的沟通榜样）。结论手术室学生的沟通障碍是多方面的，有个人因素、组织因素、教育因素和环境因素。应对这些挑战需要修订课程，加强专业支持，培养心理安全的临床环境。

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引用次数: 0

Comparative analgesic efficacy of erector spinae block, quadratus lumborum block, and intrathecal morphine for post-operative pain relief after cesarean section: A randomized study 竖脊肌阻滞、腰方肌阻滞和鞘内吗啡对剖宫产术后疼痛的镇痛效果比较：一项随机研究

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-12 DOI: 10.1016/j.pcorm.2025.100552

Ghada Mohammad AboElfadl , Obey Mohamed Shaker , Ismail Elsaid Eldeeb , Mahmoud Mamdouh Ekram , Ahmad Mohamed Aboelfadl

Background

Optimal post-cesarean analgesia remains challenging. We compared the efficacy of erector spinae plane block (ESB), quadratus lumborum block (QL), and intrathecal morphine (ITM) in a randomized trial.

Methods

Patients undergoing cesarean delivery under spinal anesthesia were randomized to three groups 40 patients each. ITM group (hyperbaric bupivacaine + 150 µg morphine), QL group (ITM + bilateral QL block with 0.25 % bupivacaine + dexamethasone), ESB group (ITM + bilateral ESB block with 0.25 % bupivacaine + dexamethasone). The primary outcome was the time to first rescue analgesia. Secondary outcomes included pain scores (NRS at rest and on movement), the amount of analgesics consumption during the first 24 h following surgery, changes in hemodynamics, side effects, and patient satisfaction.

Results

QLB group provided a significantly longer time to the first analgesic request compared to both ESB and ITM (17.53 ± 1.92 h, 12.63 ± 1.19 h, 8.43 ± 1.13 h respectively), with p < 0.001. QLB group also resulted in a significantly lower number of analgesic doses compared to ITM and ESB groups. Numeric Rating Scale (NRS)pain scores at rest & on movement was significantly lower in the QLB and ESB group at various times compared to ITM. Patient satisfaction was highest in the QLB group.

Conclusion

QL and ESB blocks are superior to ITM alone, with QL potentially offering better visceral analgesia.

背景：剖宫产后最佳镇痛仍然具有挑战性。在一项随机试验中，我们比较了竖脊肌平面阻滞（ESB）、腰方肌阻滞（QL）和鞘内吗啡（ITM）的疗效。方法将腰麻下剖宫产患者随机分为3组，每组40例。ITM组（高压布比卡因+ 150µg吗啡）、QL组（ITM + 0.25%布比卡因+地塞米松双侧ESB阻滞）、ESB组（ITM + 0.25%布比卡因+地塞米松双侧ESB阻滞）。主要观察指标为首次抢救镇痛的时间。次要结局包括疼痛评分（休息和运动时的NRS）、手术后24小时内镇痛药的用量、血流动力学变化、副作用和患者满意度。结果qlb组对首次镇痛要求的响应时间较ESB组和ITM组明显延长（分别为17.53±1.92 h、12.63±1.19 h、8.43±1.13 h）， p < 0.001。与ITM和ESB组相比，QLB组镇痛剂量明显减少。与ITM相比，QLB组和ESB组在不同时间的休息和运动时的NRS疼痛评分明显较低。QLB组患者满意度最高。结论QL和ESB阻滞优于ITM单独阻滞，QL可能具有更好的内脏镇痛效果。

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引用次数: 0

Evaluation of surgical technologists' performance in laparoscopic instrument decontamination and sterilization by 360-degree appraisal method: An observational study 用360度评价法评价外科技术人员在腹腔镜器械消毒灭菌中的表现：一项观察性研究

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-06 DOI: 10.1016/j.pcorm.2025.100551

Leila Sadati, Seyedeh Sanaz Mirrahimi, Rana Abjar

Introduction

Surgical technologists play a crucial role in maintaining patient safety and ensuring the overall quality of care in surgical settings. Their performance in the field of decontamination and sterilization of laparoscopic instruments is as important as it directly affects the risk of surgical complications. Therefore, the present study aimed to appraise the performance of surgical technologists in laparoscopic instrument decontamination and sterilization by A 360-degree performance appraisal method in selected hospitals in Alborz Province, Iran.

Methods

The present study is a cross-sectional study which was conducted among 110 surgical technologists in Alborz Province, Iran from May 2024 to January 2025 using convenient sampling. Data were collected using a performance checklist and the 360-degree evaluation method. The checklist's validity was confirmed through content validity and expert panel opinions. Its reliability was established with a 0.91 agreement coefficient between two external raters and an intraclass correlation coefficient (ICC) of 0.822 for the questionnaire. Data were analyzed using SPSS version 28 software and one-sample t-test, independent groups t-test, and one-way analysis of variance.

Results

The findings on the performance of surgical technologists in the decontamination and sterilization of laparoscopic instruments reveal that 2 technologists were classified in the low performance category, with scores between 0 and 16. A total of 101 technologists fell into the moderate performance category, achieving scores ranging from 17 to 33. Furthermore, 7 technologists achieved the high-performance level, with scores between 34 and 50.

Conclusion

This study utilized the 360-degree feedback method, which revealed that surgical technologists perform moderately in reprocessing laparoscopic instruments. To gain a clearer understanding of their strengths and areas needing improvement, it is important to conduct ongoing evaluations using a range of methods.

外科技术人员在维护患者安全和确保手术环境的整体护理质量方面发挥着至关重要的作用。它们在腹腔镜手术器械的消毒和灭菌方面的表现同样重要，因为它直接影响手术并发症的风险。因此，本研究旨在通过360度绩效评估方法，对伊朗Alborz省选定医院的外科技术人员在腹腔镜器械去污消毒方面的表现进行评估。方法采用方便抽样的方法，对2024年5月至2025年1月伊朗阿尔博尔兹省110名外科技术人员进行横断面调查。使用性能检查表和360度评估方法收集数据。通过内容效度和专家小组意见两种方式确认了本量表的效度。两外部评分者的一致系数为0.91，类内相关系数（ICC）为0.822。数据分析采用SPSS 28版软件，采用单样本t检验、独立组t检验和单因素方差分析。结果对外科技术人员在腹腔镜器械消毒灭菌工作中的表现进行调查，结果显示有2名技术人员表现较差，得分在0 ~ 16分之间。共有101名技术人员属于中等表现类别，得分从17分到33分不等。此外，7名技术人员达到了高性能水平，得分在34到50之间。结论本研究采用360度反馈方法，显示外科医师在腹腔镜器械的再处理中表现适度。为了更清楚地了解它们的优势和需要改进的领域，使用一系列方法进行持续的评估是很重要的。

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引用次数: 0

Unveiling a rare yet critical peril: Subcutaneous emphysema and pneumomediastinum post-tonsillectomy - A case report 揭示一个罕见但危险的危险：扁桃体切除术后皮下肺气肿和纵隔气肿1例报告

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-01 DOI: 10.1016/j.pcorm.2025.100550

Serveh Mohammadi , Behzad Imani , Abbas Khalilpour , Yaser Ghaderi , Habib Azimi , Mohsen Akbaribazm

This case report describes a highly unusual presentation of extensive subcutaneous emphysema (SE), pneumomediastinum (PM), and right-sided pneumothorax in a 6-year-old boy following an otherwise uneventful elective tonsillectomy. The patient’s intraoperative course, including the wound closure phase, remained completely stable, with no notable changes in hemodynamics or respiratory status observed. However, in the post-anesthesia care unit (PACU), the patient was suddenly diagnosed with crepitus, which rapidly spread from the face toward the chest. Concurrently, capnography showed persistent hypercapnia, with end-tidal CO₂ values ranging from 60 to 70 mmHg. Chest imaging confirmed the presence of SE, PM, and pneumothorax in the absence of tracheal or esophageal injury. The patient was managed conservatively with supplemental oxygen and close monitoring in an intensive care unit. No surgical intervention was required, and full recovery was observed within one week. This report also provides a brief literature review exploring the possible mechanisms behind these rare complications, as well as current evidence-based management strategies.

这个病例报告描述了一个非常不寻常的表现，广泛的皮下肺气肿（SE），纵隔气肿（PM），和右侧气胸在一个6岁的男孩在其他平安无事的选择性扁桃体切除术后。患者的术中过程，包括伤口闭合阶段，保持完全稳定，血流动力学和呼吸状态未见明显变化。然而，在麻醉后护理病房（PACU），患者突然被诊断为crepitus，并迅速从面部向胸部扩散。同时，血糖检查显示持续的高碳酸血症，潮末CO₂值在60 - 70 mmHg之间。胸部影像学证实在没有气管或食管损伤的情况下存在SE、PM和气胸。患者在重症监护病房接受保守治疗，补充氧气并密切监测。无手术干预，1周内完全恢复。本报告还提供了一个简短的文献综述，探讨这些罕见并发症背后的可能机制，以及目前的循证管理策略。

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引用次数: 0

The relationship between operating room nurses' comfort and burnout levels: A cross-sectional study 手术室护士舒适度与职业倦怠的关系：一项横断面研究

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-09-01 DOI: 10.1016/j.pcorm.2025.100548

Hatice Çiftçi , Sevda Korkut , Mustafa Mart , Zerrin Özçelik

Background

Nurses' comfort level plays an important role in their ability to perform their professional duties effectively and in supporting their job satisfaction and physical-psychological well-being. Comfort can reduce stress levels and increase a person's ability to cope with challenges in their work or personal life. The study was conducted to determine the relationship between comfort and burnout level of operating room nurses.

Methods

This cross-sectional study was completed with the participation of 115 operating room nurses. Descriptive Characteristics Form, Nurse Comfort Questionnaire and Maslach Burnout Inventory were used to collect the study data.

Results

The burnout level of the nurses was significant and negatively correlated with the total comfort level, sociocultural, psychospiritual and physical comfort. The physical, sociocultural and psychospiritual comfort predicted 49% of the total variance in emotional exhaustion and 18% of the total variance in depersonalization.

Conclusions

As the comfort of the nurses working in the operating room decreased, their burnout levels increased. The nurses' emotional burnout level was significantly and negatively correlated with total comfort level, sociocultural and psychospiritual comfort, and depersonalization level was significantly and negatively correlated with total comfort level, sociocultural, psychospiritual and physical comfort level. In addition, comfort sub-dimensions significantly predicted emotional exhaustion and depersonalization. In order to improve the quality of healthcare services and increase nurses' overall well-being and job satisfaction, it is recommended that future studies focus on intervention-based studies aimed at increasing nurses' comfort.

护士的舒适程度在他们有效履行专业职责的能力和支持他们的工作满意度和身心健康方面起着重要的作用。舒适可以减轻压力，提高一个人在工作或个人生活中应对挑战的能力。本研究旨在探讨手术室护士的舒适度与职业倦怠水平的关系。方法对115名手术室护士进行横断面研究。采用描述性特征表、护士舒适度问卷和Maslach倦怠量表收集研究数据。结果护士职业倦怠水平与总舒适度、社会文化舒适度、身心舒适度呈显著负相关。身体、社会文化和心理安慰预测了情绪耗竭总方差的49%和人格解体总方差的18%。结论手术室护士的工作舒适度越低，倦怠程度越高。护士情绪倦怠水平与总舒适度、社会文化舒适度、心理精神舒适度呈显著负相关，去人格化水平与总舒适度、社会文化舒适度、心理精神舒适度、身体舒适度呈显著负相关。此外，舒适子维度显著预测情绪耗竭和去人格化。为了提高医疗服务质量，提高护士的整体幸福感和工作满意度，建议未来的研究侧重于以干预为基础的研究，以提高护士的舒适度。

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