Journal of Perianesthesia Nursing最新文献

{"title":"Optimization of a Push Notification System to Improve First-case Delays: A Quality Improvement Project.","authors":"Chelsea Secondino, Samantha Tortora, Kerry A Milner","doi":"10.1016/j.jopan.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.11.012","url":null,"abstract":"<p><strong>Purpose: </strong>To increase first-case on-time start (FCOTS) rates at a large New England hospital by optimizing the use of a preoperative (pre-op) push notification system to reduce delays and improve operating room efficiency.</p><p><strong>Design: </strong>The project employed a quality improvement approach guided by the Model for Improvement from the Institute for Healthcare Improvement.</p><p><strong>Methods: </strong>A push notification system integrated into the electronic health record was used to enhance communication between surgeons and pre-op nurses across three surgical pavilions. Mandatory education sessions were provided for all enrolled staff, and Plan-Do-Study-Act cycles were conducted to refine processes and monitor outcomes. Data on notification usage and FCOTS rates were tracked from pre implementation (August 2023) through the implementation phase (December 2023).</p><p><strong>Findings: </strong>Training resulted in 87% (n = 60) of nurses completing the push notification education, and 31% (n = 28) of surgeons confirmed reviewing training materials. Initial implementation increased push notification use among nurses from 26% to a peak of 51% in October 2023, though this later declined to 39% by year-end with net gain of 17%. Among surgeons, push notification usage peaked at 18%, with a net gain of 2% over the baseline. The East pavilion maintained relatively high FCOTS rates, decreasing slightly from 82% in October to 78% by year-end. In the North and South pavilions, increased push notification usage by nurses aligned with gradual FCOTS improvements: the North pavilion rose from 63% to 65%, while the South pavilion experienced fluctuations, ultimately achieving a 12% increase from baseline to reach 57% in December.</p><p><strong>Conclusions: </strong>These findings suggest that while increased push notification use among nurses helped improve FCOTS in some pavilions, limited surgeon participation may have hindered the overall impact on reducing delays. Future strategies should focus on increasing engagement from all staff, improving workflow integration, and implementing ongoing performance tracking to optimize surgical efficiency across all pavilions. Enhancing FCOTS not only improves the patient experience by reducing wait times and increasing satisfaction, but also benefits staff by streamlining workflows and reducing stress. Ultimately, these improvements support organizational goals for greater efficiency and cost-effectiveness in perioperative care.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191052","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":"Impact of Sevoflurane and Propofol on Perioperative Respiratory Adverse Events in Pediatrics: A Systematic Review and Meta-analysis","authors":"Caiping Li BD ,&nbsp;Yongmei Zhu BD","doi":"10.1016/j.jopan.2024.03.006","DOIUrl":"10.1016/j.jopan.2024.03.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Perioperative respiratory adverse events continue to pose significant challenges in pediatric anesthesia. Research has hinted at a lower incidence of these complications in children anesthetized with propofol than sevoflurane. This study aimed to assess and compare respiratory complications in children undergoing general anesthesia with either sevoflurane or propofol during surgery.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>We conducted comprehensive searches of the PubMed, Embase, and Cochrane Library databases and manual searches to identify pertinent randomized controlled trials (RCTs) published up to August 19, 2023. The Cochrane risk assessment tool was employed to evaluate the risk of bias in the selected studies. The pooled analysis of relevant data compared respiratory complications, vomiting, agitation, anesthesia duration, extubation time, and recovery time in pediatric patients undergoing anesthesia with sevoflurane and propofol.</div></div><div><h3>Findings</h3><div>A total of 17 RCTs, containing 1,758 pediatric participants, were included and analyzed. Respiratory adverse events were examined, encompassing laryngospasm, apnea, cough, and SpO2. In comparison to sevoflurane, children subjected to propofol anesthesia demonstrated a significant reduction in the risk of laryngospasm (<em>P</em> = .001), vomiting (<em>P</em> &lt; .001), and agitation (<em>P</em> = .029). Especially in patients receiving laryngeal mask airway, propofol anesthesia significantly reduced the incidence of laryngospasm (<em>P</em> = .003) and agitation (<em>P</em> &lt; .001). At the same time, they exhibited an increased risk of apnea (<em>P</em> = .039). Notably, no statistically significant disparities were observed between sevoflurane and propofol concerning cough, SpO2 &lt; 95%, anesthesia time, extubation time, and recovery time. Administration of propofol following sevoflurane anesthesia did not significantly impact the occurrence of vomiting or the recovery time.</div></div><div><h3>Conclusions</h3><div>While propofol presents an elevated risk of apnea, it concurrently yields a significant reduction in laryngospasm, vomiting, and agitation. Consequently, propofol emerges as a favorable anesthetic option for pediatric patients.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 158-168"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299336","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":"Mary Hanna Memorial Journalism Award","authors":"","doi":"10.1016/S1089-9472(25)00021-8","DOIUrl":"10.1016/S1089-9472(25)00021-8","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Page 4"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129640","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":"Effect of Short-term Deep Breathing Exercises on Perioperative Anxiety and Pain in Pediatric Orthopedic Patients: A Randomized Controlled Trial","authors":"Lingling Hu BSN ,&nbsp;Yanxiao Hua BSN, RN ,&nbsp;Lingling Wang BSN ,&nbsp;Ziwen Mao BMed ,&nbsp;Xiaofei Jia BSN ,&nbsp;Zhen Lei BSN ,&nbsp;Danshao Chang BSN ,&nbsp;Weyland Cheng PhD","doi":"10.1016/j.jopan.2024.03.009","DOIUrl":"10.1016/j.jopan.2024.03.009","url":null,"abstract":"<div><h3>Purpose</h3><div>There are currently no pediatric studies examining the effects of deep breathing on perioperative pain and anxiety. This study sought to determine the effect of short-term deep breathing exercises on perioperative anxiety and pain in pediatric patients and their parents.</div></div><div><h3>Design</h3><div>A randomized controlled trial was conducted in the Department of Orthopaedic Surgery where pediatric patients about to undergo surgery were allocated to a control group or a deep breathing group. In the intervention group, patients and their main guardian were guided to practice 10 minutes of deep breathing exercises twice a day for 3 to 4 days prior to surgery. Perioperative anxiety and pain were measured for both the children and parents as outcome indicators.</div></div><div><h3>Methods</h3><div>Perioperative anxiety was measured using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) and state anxiety was measured using the State-Trait Anxiety Inventory (STAI). Patients reported their pain levels daily using the Wong-Baker FACES Pain Rating Scale. The following cutoffs were determined as high levels of anxiety: STAI (adult) &gt; 44, STAI (child) &gt; 36, and mYPAS-SF ≥ 30.</div></div><div><h3>Findings</h3><div>No significant differences were found in the STAI, mYPAS-SF, and Wong-Baker FACES Pain Rating Scale scores of the patients between the intervention and control group. Overall statistics showed that parents had significantly higher postoperative state anxiety levels toward female children (44.93 ± 9.01) compared to male children (40.18 ± 9.89). Preoperative and postoperative parental state anxiety levels were correlated with the child’s postoperative anxiety. Furthermore, children’s postoperative state anxiety was slightly correlated with postoperative pain.</div></div><div><h3>Conclusions</h3><div>Short-term use of our deep breathing exercises was ineffective in reducing incidences of perioperative pain and anxiety in pediatric orthopedic patients. A longer period of deep breathing administration may be required for the intervention to be effective. Parental anxiety may have an effect on anxiety levels in children, and postoperative parental anxiety may be affected by the gender of the child.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 69-75"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560106","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":"Effects of Remifentanil Pretreatment on Sufentanil-induced Cough Suppression During the Induction of General Anesthesia","authors":"Jinjin Zhang PhD ,&nbsp;Daying Zhang MD ,&nbsp;Yuhan Liu PhD ,&nbsp;Wenjun Yu MD ,&nbsp;Yue Lin MD ,&nbsp;Fuzhou Hua PhD ,&nbsp;Jun Ying MD","doi":"10.1016/j.jopan.2024.03.015","DOIUrl":"10.1016/j.jopan.2024.03.015","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to evaluate the effect of remifentanil pretreatment on sufentanil-induced cough during general anesthesia induction.</div></div><div><h3>Design</h3><div>This experimental research was conducted as a single-center, randomized, parallel-group trial.</div></div><div><h3>Methods</h3><div>A total of 120 patients scheduled for elective surgery were equally randomized into two groups (remifentanil and control). The incidence and severity of coughing in both groups were recorded after sufentanil administration during general anesthesia induction. The mean arterial pressure, heart rate, and pulse oxygen saturation were recorded at T₁ (before the injection of remifentanil or normal saline), T₂ (1 minute after remifentanil administration), T₃ (before intubation), and T₄ (1 minute after intubation). Additionally, the incidences of adverse events, including dizziness, nausea, apnea, truncal rigidity, bradycardia, or other adverse effects were also recorded.</div></div><div><h3>Findings</h3><div>The incidence of sufentanil-induced cough in the remifentanil group was significantly decreased when compared with the control group (5.0% vs 35.0%, respectively; <em>P</em> &lt; .001). No statistical differences were found in mean arterial pressure, heart rate, pulse oxygen saturation, and the incidences of other side effects between the two groups at T₁, T₂, T₃, and T₄ (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Pretreatment with remifentanil at a dose of 0.5 mcg/kg can effectively and safely suppress the incidence and severity of sufentanil-induced coughing, providing a reference for medication during general anesthesia induction.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 90-94"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635169","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":"Guided Imagery Effects on Pain, Anxiety, and Sleep for Lumbar Discectomy Patients","authors":"Handan Topan PhD ,&nbsp;Eda Albayrak Günday PhD ,&nbsp;Yeliz Sürme PhD ,&nbsp;Özlem Ceyhan PhD ,&nbsp;Nuray Şimşek PhD ,&nbsp;Ahmet Küçük PhD","doi":"10.1016/j.jopan.2024.03.004","DOIUrl":"10.1016/j.jopan.2024.03.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Pain, sleep problems, and anxiety due to all these are common problems in patients who have had herniated disk surgery. This study aims to analyze the effect of the guided imagery technique on the patients' pain, anxiety, and sleep levels before and after a lumbar disk herniation (LDH) operation.</div></div><div><h3>Design</h3><div>This study was conducted as a prospective randomized controlled clinical trial.</div></div><div><h3>Methods</h3><div>The research was conducted with 60 patients who underwent LDH surgery and met the inclusion criteria. Patients were divided into experimental and control groups according to a computer-generated randomization list. The treatment group (n = 31) applied guided imagery techniques twice, once in the preoperative and postoperative periods. The control group (n = 29) was provided with routine care. “Introductory Information Form,” “Surgery-Specific Anxiety Scale,” “Richard-Campbell Sleep Questionnaire,” and “Visual Analogue Scale (VAS)” were used. The data were analyzed using the Shapiro-Wilk test, paired sample <em>t</em> test, independent sample <em>t</em> test, Pearson chi-square exact test, and repeated measures two-way analysis of variance. In all results, <em>P</em> &lt; .05 was considered statistically significant.</div></div><div><h3>Findings</h3><div>The preoperative anxiety level of the treatment group was lower compared to the anxiety level of the control group (<em>P</em> &lt; .05). The sleep score of the treatment group in the preoperative period was higher than the sleep score of the control group (<em>P</em> &lt; .05). The sleep score of the treatment group in the postoperative period was found to be higher than the sleep score of the control group (<em>P</em> &lt; .05). The pain average of the treatment group in the postoperative period was lower than the pain average of the control group (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Our study results revealed that guided imagery applied in the preoperative and postoperative periods effectively decreased pain and anxiety levels and increased the sleep quality of patients with LDH.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 56-61"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635170","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 Internet Information Pollution on Surgical Fear in Patients Undergoing Surgery","authors":"Elif Gezginci RN, PhD ,&nbsp;Arife Cakin RN, MSc ,&nbsp;Sonay Goktas RN, PhD","doi":"10.1016/j.jopan.2024.03.023","DOIUrl":"10.1016/j.jopan.2024.03.023","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to determine the effect of internet information pollution on levels of surgical fear among patients undergoing surgery.</div></div><div><h3>Design</h3><div>Observational study.</div></div><div><h3>Methods</h3><div>This study was conducted with 407 patients scheduled for surgery in the surgical wards of a university hospital. Data were collected preoperatively using a patient information form, the Internet Information Pollution Scale, and the Surgical Fear Questionnaire.</div></div><div><h3>Findings</h3><div>A very weak positive correlation was found between total internet information pollution score and total surgical fear score (r = 0.184; <em>P</em> &lt; .001). In regression analysis of the impact of internet information pollution on total surgical fear score, the regression model was significant (F = 13.183; <em>P</em> &lt; .001), with 2.9% of the total change in surgical fear score explained by the total internet information pollution score (R² = 0.029).</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that the information pollution surgical patients encounter on the internet may increase their surgical fear. We recommend directing patients to reliable information sources and attempting to control unreliable data sources to prevent online information pollution and reduce patients’ surgical fear.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 114-119.e1"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604363","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":"Intrathecal Morphine for Postoperative Analgesia: Balance of Efficacy and Safety","authors":"Burhan Dost MD ,&nbsp;Cengiz Kaya MD","doi":"10.1016/j.jopan.2024.10.014","DOIUrl":"10.1016/j.jopan.2024.10.014","url":null,"abstract":"<div><div>Intrathecal morphine (ITM) has been a reliable technique for postoperative pain management since 1979. As a key component of multimodal analgesia, ITM provides long-lasting pain relief. ITM’s simplicity, lack of need for expensive equipment, and minimal training requirements contribute to its wide use. In this article, we highlight the current state of affairs in terms of ITM for postoperative analgesia, including aspects that are still under debate. In particular, we emphasize the doses that are efficacious while minimizing the risk of respiratory depression. Further, we believe that when used in low doses (&lt;200 mcg) and without the administration of potential augmenting medications, intrathecal morphine does not pose a greater risk of respiratory depression than systemic opioid therapies commonly used in routine clinical practice. We particularly emphasize that standard nursing care is sufficient for postanesthesia monitoring of patients in such cases.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 234-235"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076067","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 Analgesic Effect of a Transdermal Lappaconitine Patch Combined With Ibuprofen Suspension for Children After Adenoidectomy and Tonsillectomy: A Randomized Clinical Trial","authors":"Jiayuan Xu ADN, RN, CNOR ,&nbsp;Min Wu BSN, RN, CAPA ,&nbsp;Bo Duan MM,&nbsp;Yihua Ni MM,&nbsp;Anken Wang MM","doi":"10.1016/j.jopan.2024.03.025","DOIUrl":"10.1016/j.jopan.2024.03.025","url":null,"abstract":"<div><h3>Purpose</h3><div>To study the analgesic effects and side effects of a transdermal lappaconitine (TLA) patch, ibuprofen suspension (IS), and TLA combined with IS (TLACIS) after adenoidectomy and tonsillectomy.</div></div><div><h3>Design</h3><div>Prospective, randomized clinical trial.</div></div><div><h3>Methods</h3><div>The patients were randomized into three groups defined by different analgesic drug regimens: the TLA group, the IS group, and the TLACIS group. Pain scores at 2, 12, and 24 hours after surgery and adverse-event reports within the first postoperative week were collected.</div></div><div><h3>Results</h3><div>Ultimately, this study included 102 cases in the TLA group, 101 cases in the IS group, and 101 cases in the TLACIS group. At 2 hours after surgery, the pain scores of the TLA and the TLACIS groups were both significantly lower than that of the IS group (all <em>P</em> &lt; .05). At 12 and 24 hours after surgery, the pain score of the TLACIS group was significantly lower than those of the TLA and IS groups (all <em>P</em> &lt; .05); furthermore, the pain score of the IS group was significantly lower than that of the TLA group (<em>P</em> &lt; .05). Within 1 week after the operation, there was no significant difference in the incidence of adverse events.</div></div><div><h3>Conclusions</h3><div>The addition of a TLA patch can speed the onset of analgesia. In terms of analgesic effects, IS alone is more advantageous than TLA alone, while the combination of TLA and IS has the best analgesic effect. No significant differences were found in the incidence of adverse events among the three regimens.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 126-133"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560108","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":"Avoid a Blind Spot by Engaging Patients as Collaborators in Evidence-based Care","authors":"Cassandra Fowler MSN, RN, NPD-BC ,&nbsp;Stephanie W. Edmonds PhD, MPH, RN ,&nbsp;Laura Cullen DNP, RN, FAAN","doi":"10.1016/j.jopan.2024.07.004","DOIUrl":"10.1016/j.jopan.2024.07.004","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 225-231"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076062","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}