Journal of Perianesthesia Nursing最新文献

{"title":"Perioperative Vision Loss Following Prone Spine Surgery: A Case-Control Study","authors":"","doi":"10.1016/j.jopan.2023.12.004","DOIUrl":"10.1016/j.jopan.2023.12.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Perioperative vision loss (POVL) is a rare and devastating complication following prone spine surgery. Due to the rare nature of this complication, there is limited research available about patient and surgical risk factors that increase the risk of POVL. The objective of this study was to investigate associated risk factors for POVL with use of the National Surgical Quality Improvement Program (NSQIP) database.</div></div><div><h3>Design</h3><div>This study used a case-control secondary data analysis methodology that included five cases of POVL and 250 controls from the American College of Surgeons National Surgical Quality Improvement Program database who all underwent prone spine surgery between 2010 and 2020.</div></div><div><h3>Methods</h3><div>Each POVL case was matched to 50 randomly selected controls (n = 250) based on type and year of surgery. Demographics and variables of interest were compared among the POVL cases, among POVL cases and the aggregate control group (n = 250), and POVL cases against their matched control group. Univariate and multivariate conditional logistic regression were then used to estimate the odds of developing POVL in relation to potential patient and surgical risk factors.</div></div><div><h3>Findings</h3><div>When POVL cases were compared to the 250 control cases using univariate analysis, patients who developed POVL were more likely to have received a blood transfusion within 72 hours of surgery (<em>P</em> &lt; .0001). and have longer operative times (odds ratio = 1.01, 95% CI [1.003, 1.017], <em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>Two surgical risk factors were determined to be statistically significant, including the need for perioperative blood transfusion and prolonged operative time. These findings support previous research on POVL which often identified blood loss and prolonged operative times as surgical risk factors. The narrow patient population used in this project may have limited the ability to perform a more robust study on POVL. Therefore, further research on POVL using the National Surgical Quality Improvement Program database is strongly encouraged.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742443","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":"General Anesthesia Exposure in Infancy and Childhood: A 10-year Bibliometric Analysis","authors":"","doi":"10.1016/j.jopan.2023.12.006","DOIUrl":"10.1016/j.jopan.2023.12.006","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Heated discussions have divided health care providers and policymakers on the risks versus benefits of general anesthesia in </span>pediatric populations. We conducted this study to provide a comprehensive bibliometric analysis of general anesthesia in this specific population over the past decade.</div></div><div><h3>Design</h3><div>We summarized and quantitatively analyzed the studies related to general anesthesia in children and infants over the past decade.</div></div><div><h3>Methods</h3><div>Using the Web of Science Core Collection as the data source, we analyzed the literature using CiteSpace software, focusing on authors, countries, institutions, keywords, and references to identify hotspots and predict research trends.</div></div><div><h3>Findings</h3><div>A total of 2,364 publications on pediatric anesthesia<span> were included in the analysis. The number of related publications and citations steadily increased from 2013 to 2022. The United States was the leading country in terms of output, and University of Toronto was the primary contributing institution. Co-citation analysis revealed that over the past decade research has mainly focused on the long-term adverse effects of general anesthesia on neurodevelopment and acute perioperative crisis events. Keyword analysis identified infant sedation and drug selection and compatibility as promising areas for development. In addition, improving the quality of perioperative anesthesia will be a major research focus in the future.</span></div></div><div><h3>Conclusions</h3><div>Recent research in pediatric anesthesia has focused on mitigating the adverse effects of general anesthesia in infants and young children and studying the pharmacological compatibility of anesthetics. Our study results would assist researchers and clinicians in understanding the current research status and optimizing clinical practice in this field.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194906","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 Scheduling Mode of Anesthesia Nurses Affects Postanesthesia Care Unit Efficiency: A Single-Center Retrospective Study From China","authors":"","doi":"10.1016/j.jopan.2023.11.015","DOIUrl":"10.1016/j.jopan.2023.11.015","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Anesthesia nurses play an important postsurgical role during the </span>anesthesia recovery period<span>, which is characterized by a high incidence of complications related to anesthesia and surgery. Strengthening staff allocation and skill management in the postanesthesia care unit (PACU) is therefore particularly important in managing length of stay. We aimed to investigate the effect of two schedule modes for anesthesia nurses on PACU efficiency.</span></div></div><div><h3>Design</h3><div>A retrospective observational cohort study.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study in a large tertiary academic medical center. In 2018, the PACU operated with traditional scheduling and the nurse-to-patient ratio was 1.2:1. The PACU implemented intensive scheduling and this ratio was adjusted to 1:1 in 2019 by adjusting the anesthesia nurse allocation scheme. We compared the number of admitted patients, length of PACU stay, the incidence of anesthesia-related complications, and nurse satisfaction with the two modes.</div></div><div><h3>Findings</h3><div>The total number of admitted patients was 10,531 in 2018 and 10,914 in 2019. PACU admitted 401 more patients in 2019 than in 2018, even with two fewer nurses per day. Nevertheless, the median length of PACU stay in 2019 was statistically significantly shorter than in 2018 (29 [22-40] vs 28 [21-39], <em>P</em><span> &lt; .001], while the incidence of anesthesia-related complications including postoperative pain, nausea and vomiting, hypertension, and shivering were comparable in the 2 years (</span><em>P</em> &gt; .091). The intensive scheduling implemented in 2019 received more satisfaction from nurses than the traditional scheduling applied in 2018 (<em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>The scheduling of anesthesia nurses affects PACU efficiency. The intensive scheduling mode implemented in 2019 resulted in a comparable number of admitted patients, a better quality of care, and higher nurse satisfaction than those under the traditional scheduling mode.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899620","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":"Eliminating Hands-off Handoffs: Improvement in Perioperative Handoff Communication With a Multidisciplinary Tool Initiative","authors":"","doi":"10.1016/j.jopan.2024.07.022","DOIUrl":"10.1016/j.jopan.2024.07.022","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358506","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":"Comments on: Effect of Spray Use on Mouth Dryness and Thirst of Patients Undergoing Major Abdominal Surgery: A Randomized Controlled Study","authors":"","doi":"10.1016/j.jopan.2024.06.105","DOIUrl":"10.1016/j.jopan.2024.06.105","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357983","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":"Improving Postanesthesia Care Unit (PACU) Delays: A Quality Improvement Project","authors":"","doi":"10.1016/j.jopan.2023.12.001","DOIUrl":"10.1016/j.jopan.2023.12.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Delays within the postanesthesia care unit (PACU) are a major cause of complications and inefficiency. In this project, we investigated the factors associated with delays in the PACU and implemented policies to mitigate these factors.</div></div><div><h3>Design</h3><div>A quality improvement project.</div></div><div><h3>Methods</h3><div>Data were collected for 10 months and included 1,134 surgical patients in a tertiary Obstetrics and Gynecology hospital in Kuwait. Several meetings were held with stakeholders to identify and overcome the reasons contributing to delays within the PACU.</div></div><div><h3>Findings</h3><div>Among the top reasons for PACU delay were manpower shortage and lack of bed availability in the surgical wards<span> due to improper admission and discharge policies. Policies were implemented to improve admission policy, hasten patient discharge, and improve patient flow through the operating theater (OT). These policies lead to a significant reduction (25 minutes) in the average time patients spend in the OT, mainly by reducing the stay in the PACU by 19 minutes.</span></div></div><div><h3>Conclusions</h3><div>PACU delays were mostly due to reasons outside the OT. Further, follow-up is needed to assess the sustainability of these improvements and identify any new challenges that may arise.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742442","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":"Green Tea Intake: A Protective Factor Against Postsurgical Hypothyroidism and Hypoparathyroidism","authors":"","doi":"10.1016/j.jopan.2023.12.016","DOIUrl":"10.1016/j.jopan.2023.12.016","url":null,"abstract":"<div><h3>Purpose</h3><div>Tea and coffee are the most commonly consumed types of drinks, identified with multiple health benefits. However, the association between tea and coffee intake and postsurgical hypothyroidism and hypoparathyroidism (PHypoTP) is still unclear. Therefore, the objective of this study is to explore the effect of tea and coffee intake on the risk of PHypoTP.</div></div><div><h3>Design</h3><div>Two-sample Mendelian randomization (MR).</div></div><div><h3>Methods</h3><div>The primary approach for MR estimates was the inverse-variance-weighted method. MR-Egger, MR Pleiotropy RESidual Sum and Outlier (PRESSO), weighted median, simple mode, and weighted mode were used to detect pleiotropy and heterogeneity.</div></div><div><h3>Findings</h3><div>We found that green tea intake was causally associated with the decreased risk of PHypoTP (β = −0.019; 95% confidence interval: −0.038 to −0.001; <em>P</em> = .029). However, there was no significant association between coffee intake and the risk of PHypoTP. No heterogeneity or pleiotropy in these results was detected.</div></div><div><h3>Conclusions</h3><div>Our findings provide the genetic<span> evidence supporting that green tea intake was a protective factor against PHypoTP. Accordingly, we may suggest that patients after thyroidectomy to add green tea into their habitual diet during nursing education.</span></div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944598","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":"Analysis of Adverse Events in the Postanesthesia Unit at a Tertiary Pediatric Hospital","authors":"","doi":"10.1016/j.jopan.2023.12.003","DOIUrl":"10.1016/j.jopan.2023.12.003","url":null,"abstract":"<div><h3>Purpose</h3><div>The postanesthesia care unit<span> (PACU) is an indispensable part of modern medicine which provides critical care to patients to ensure safe and smooth emergence from anesthesia. The adverse events in the PACU have been widely investigated in adults. However, little is known about the adverse events in pediatric populations. This study was designed to investigate adverse events, including the incidence, disease spectrum, and possible risk factors, in pediatric patients in the PACU at a tertiary pediatric hospital.</span></div></div><div><h3>Design</h3><div>This is a retrospective observational study.</div></div><div><h3>Methods</h3><div><span>Children admitted to the PACU at the Children's Hospital of Fudan University from September 2021 to August 2022 were included in the study. The following adverse events were recorded: hypothermia, fever, adverse airway events, hypotension, hypertension, prolonged length of stay in PACU, pain, reintubation, neurological events, unplanned admission to the intensive care unit, arrhythmia, water-electrolyte imbalance, and bleeding requiring medical intervention. Descriptive analyses, </span><em>t</em> tests, and χ² tests were performed.</div></div><div><h3>Findings</h3><div><span>A total of 16,012 children were included in the study, and 305 adverse events occurred in 237 (1.48%) children. The three most frequently occurring adverse events were prolonged stay in the PACU (8.4%), adverse airway events (5.6%), and abnormal temperature (2.7%). Age, American Society of Anesthesiologists' grade, and general surgery were independent risk factors of both overall adverse events and prolonged stay in the PACU in multivariate logistic regression analysis. Children with adverse events stayed in the PACU significantly longer than those without adverse events (60.04 ± 1.01 vs 95.8 ± 47.25 minutes, </span><em>P</em><span><span> &lt; .05). Compared with the other surgeries, a significantly higher proportion of severe pain (37.5% vs 0%) after thoracic surgery, prolonged stay in the PACU (52.9% vs 36.4%) after general surgery, and neurological events (14.7% vs 0%) after </span>neurological surgery was detected, while a significantly lower proportion of adverse airway events after general surgery (21.1% vs 43%) and neurological surgery (8.8% vs 43%) was detected, respectively.</span></div></div><div><h3>Conclusions</h3><div>Our study reports the current incidence and spectrum of adverse events in the PACU at a tertiary pediatric hospital. Patients with young age, high American Society of Anesthesiologists' grade, and those from the general surgery department are at a significantly increased risk of adverse events in the PACU. Significant differences were detected in the proportion of specific adverse events after specific surgeries.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984238","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":"Local Anesthetic Systemic Toxicity: Ensuring Sustained Nursing Knowledge in a High-Volume Outpatient Surgery Center","authors":"","doi":"10.1016/j.jopan.2023.12.007","DOIUrl":"10.1016/j.jopan.2023.12.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Local anesthetic systemic toxicity (LAST) is a low-frequency, high-risk event that can occur within minutes of a patient receiving a local anesthetic. The goals of this project were to standardize LAST care management across an academic medical center and sustain an improvement in nurses’ knowledge of how to recognize signs and symptoms of LAST and how to competently manage a LAST scenario.</div></div><div><h3>Design</h3><div>We used a quantitative design to accomplish the goals of the project.</div></div><div><h3>Methods</h3><div><span>Our interdisciplinary team<span> developed a clinical practice guideline based on the LAST Checklist published by the American Society of </span></span>Regional Anesthesia and Pain Medicine, and used a simulation scaffolded by multimodal education and system changes to ensure sustained knowledge. We measured improvement using a graded knowledge assessment as well as qualitative feedback.</div></div><div><h3>Findings</h3><div>Scores on the assessment increased from 4.76 to 6.34 (out of seven points) following the intervention and remained significantly higher than the baseline 9 months after the educational intervention (9-month score = 6.19, t = 2.99, <em>P</em> = .004). Nurses reported feeling more confident and knowledgeable following the intervention and requested to have regular sessions of the simulation. To sustain improvements, we developed a computer-based learning module. The module and simulation were integrated into nursing orientation and an annual competency.</div></div><div><h3>Conclusions</h3><div>While standardizing LAST care in accordance with evidence-based guidance is critical to patient safety due to its infrequent occurrence, nurses should consider implementing simulation supplemented with multimodal education and system changes to ensure sustained knowledge.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121166","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":"Perioperative Health Care Professionals’ Knowledge of Evidence-Based Inadvertent Perioperative Hypothermia Management","authors":"","doi":"10.1016/j.jopan.2023.12.009","DOIUrl":"10.1016/j.jopan.2023.12.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the perioperative health care professionals’ knowledge of evidence-based inadvertent perioperative hypothermia management.</div></div><div><h3>Design</h3><div>A descriptive, cross-sectional study.</div></div><div><h3>Methods</h3><div><span>The research sample consisted of 219 perioperative nurses and anesthesia technicians working in the university hospital and participating in </span>perioperative care. Data were collected by the researchers using a questionnaire that included descriptive characteristics of health care professionals and inadvertent perioperative hypothermia management between March and April 2021. Descriptive statistics, Shapiro-Wilk normality, Kruskal Wallis, Mann Whitney U, and Spearman correlation test were used to analyze the data.</div></div><div><h3>Findings</h3><div>In this study, only 29.2% of the health care professionals knew that the threshold value for inadvertent perioperative hypothermia was &lt;36 °C. The mean knowledge score of health care professionals on the management of inadvertent perioperative hypothermia was 13.78 ± 3.47. The knowledge score of 79.5% of health care professionals was moderate level. A significant correlation was determined between inadvertent perioperative hypothermia management knowledge score and education status (<em>P</em> = .032), task (<em>P</em><span> &lt; .001), and mean years in the profession (</span><em>P</em> = .02).</div></div><div><h3>Conclusions</h3><div>The knowledge of the health care professionals working in the perioperative process about evidence-based practices related to inadvertent perioperative hypothermia management was determined to be moderate. We recommend increasing the level of knowledge of health care professionals by providing education on guidelines regarding inadvertent perioperative hypothermia management.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194908","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}