Journal of Perianesthesia Nursing最新文献

{"title":"Influence of the Nursing Assistant Role in Nurse Satisfaction, Efficiency, and Patient Satisfaction in the Postanesthesia Care Unit.","authors":"Jill Setaro, Edana Ree, Jan Johrden, Allison Julian, Nicole Cruse, Jill Agostino","doi":"10.1016/j.jopan.2024.08.024","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.024","url":null,"abstract":"<p><strong>Purpose: </strong>In response to nurse concerns of the need for additional support from unit nursing assistants (NA) at the bedside, we set a goal to improve RN satisfaction with the role of the NA in the postanesthesia care unit (PACU).</p><p><strong>Design: </strong>Prospective pre/post design.</p><p><strong>Methods: </strong>Using LEAN methodology, the NA role was expanded to encompass their full scope of practice at the bedside, and the responsibility of performing patient transport from the PACU was reallocated to a Centralized Transport Service over a 6-month period.</p><p><strong>Findings: </strong>The total number of transports performed by NA decreased by approximately 20%. Time spent waiting for a Centralized Transporter decreased from an average of 56 to 11 minutes. RN satisfaction increased in the 3 areas explored, with a 12.5% increase in median overall satisfaction with the NA role. Our facility's Hospital Consumer Assessment of Healthcare Providers and Systems scores also increased from previous months after this project, alluding to more effective care delivered to patients in the PACU.</p><p><strong>Conclusions: </strong>Realignment of roles can promote efficiency and throughput. Communication fosters teamwork and can improve staff satisfaction.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773852","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":"Implementing Music Medicine to Improve Pain Outcomes After Abdominal or Pelvic Surgery: A Quality Improvement Project.","authors":"Amy B Foraker, Pamela Love","doi":"10.1016/j.jopan.2024.06.113","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.06.113","url":null,"abstract":"<p><strong>Purpose: </strong>Define the impact of the implementation of evidence-based music medicine (MM) on pain management outcomes after abdominal and pelvic surgery when combined with usual care.</p><p><strong>Design: </strong>This quality improvement project implemented MM in a hospital postanesthesia care unit using a pretest-posttest design. The Roy Adaptation Model and Kotter's Change theory guided all project phases.</p><p><strong>Methods: </strong>Nursing staff were educated in-person, via electronic formats and paper handouts. A convenience sample of adults who underwent abdominal or pelvic surgery was offered a preselected MM playlist (via earphones and MP3 players) in addition to usual care during the Phase I recovery period. The outcomes included administered opioids (oral morphine milligram equivalents), pain levels (numerical rating scale), heart rate, respiratory rate, and systolic blood pressure. The outcomes for those who accepted MM (music group) were compared to those for patients admitted to the postanesthesia care unit 1 month before project implementation (baseline group).</p><p><strong>Findings: </strong>The music group data revealed highly significant reductions in heart rate (P = .008, Cohen's d = 0.57) and systolic blood pressure (P < .001, Cohen's d = 0.78) at 30 minutes compared with pretest data. In contrast, the baseline group data showed no effect on systolic blood pressure levels (P = .274). The music group showed higher clinical significance (1.8 to >2-fold higher effect size) on reducing numerical rating scale scores at 30 minutes (music group: P < .001, Cohen's d = 1.19; baseline group: P = .008, Cohen's d = 0.55) and the final period in phase I (music group: P < .001, Cohen's d = 1.71; baseline group: P < .001, Cohen's d = 0.93). The mean morphine milligram equivalents dose for the music group (29.5 ± SD 19.8) compared with the baseline group (33.0 ± SD 26.6) was not significantly different (P = .376, Cohen's d = 0.18).</p><p><strong>Conclusions: </strong>Adding MM with usual care leads to statistically and clinically significant reductions in pain indicators in adults who had abdominal or pelvic surgeries versus usual care alone.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787456","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":"Malignant Hyperthermia in the Perioperative Setting","authors":"Maggie Thompson DNP, APRN, AGACNP-BC, CNE,&nbsp;Angela D. Pal PhD, APRN, ACNP-BC, CHSE","doi":"10.1016/j.jopan.2024.08.020","DOIUrl":"10.1016/j.jopan.2024.08.020","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1104-1105"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discharge Under Sedated Status can Decrease Postoperative Emergence Agitation in Pediatric Patients Undergoing Strabismus Surgery: A Prospective Randomized Controlled Trial","authors":"Fang Tan PhD, MD ,&nbsp;Weisha Lu RN ,&nbsp;Shuangshuang Li PhD, MD ,&nbsp;Jing Chen RN","doi":"10.1016/j.jopan.2024.01.014","DOIUrl":"10.1016/j.jopan.2024.01.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Emergence agitation (EA) is a frequent complication during emergence. The researchers aimed to investigate whether discharged pediatric patients from the postanesthesia care unit (PACU) to wards under sedated status could reduce the incidence of EA.</div></div><div><h3>Design</h3><div>Prospective randomized controlled study.</div></div><div><h3>Methods</h3><div>This study was conducted in 4 to 6 year old patients who had undergone strabismus surgeries. There were 100 patients randomly assigned to a sedated group who were discharged from PACU to the ward under a sedated state and regained consciousness accompanied with their parents (Group P, n = 50) and the control group who were fully awake when discharged (Group C, n = 50). The primary outcome was the incidence of EA. The secondary outcomes included rescue measure, discharge time, hemodynamic parameters at the point of discharge, 1 and 2 hours after extubation, and the parental satisfaction score.</div></div><div><h3>Findings</h3><div>The incidence of EA in Group P was significantly reduced compared to Group C (<em>P</em> = .023). The number of patients who needed rescue measures was higher in Group C than in Group P (<em>P</em> = .041). The PACU discharge time in Group P was significantly shorter than in Group C (<em>P</em> &lt; .001). The heart rate of the pediatric patients in Group P was significantly lower than in Group C at the point of discharge from PACU to the ward (<em>P</em> = .003), while the oxygen saturation (SpO₂) and the mean arterial blood pressure were comparable between the two groups (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Pediatric patients discharged to their parents under sedated status could reduce the incidence of EA undergoing strabismus surgery.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 985-989"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141279911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

{"title":"The Effect of Virtual Reality, Music Therapy, and Stress Ball Application on Pain and Anxiety During Outpatient Gynecological Procedures: A Randomized Controlled Trial","authors":"Tuğba Öz PhD ,&nbsp;Nurdan Demirci PhD","doi":"10.1016/j.jopan.2024.01.022","DOIUrl":"10.1016/j.jopan.2024.01.022","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to determine the effect of virtual reality, music therapy, and stress ball applications, which are methods of distraction, on pain, anxiety, and patient satisfaction during outpatient gynecological procedures.</div></div><div><h3>Design</h3><div>This study was a randomized controlled trial with control and intervention groups, pre-test and post-test.</div></div><div><h3>Methods</h3><div>The study was conducted with 200 women who underwent gynecological surgical procedures without sedation in a state hospital on the European side of Istanbul between October 2022 and March 2023. There were four groups in the study: Virtual Reality (n = 50), Music Therapy (n = 50), Stress Ball (n = 50), and Control group (n = 50). Data were collected using a Descriptive Information Form, Visual Analog Scale, State-Trait Anxiety Inventory, Life Information Follow-up Form, and Patient Satisfaction Evaluation Form. The scales were completed separately by the investigator before the procedure, 10 minutes after the procedure, and 1 hour after the procedure.</div></div><div><h3>Findings</h3><div>A statistically significant difference between the intervention groups and control groups of women who underwent a gynecological procedure at the 10th minute after the procedure (<em>P</em>=.000) and at the 1st hour after the procedure (<em>P</em>=.000) was significant. State-Trait Anxiety Inventory of women by groups decreased after the procedure and showed a statistically significant difference (<em>P</em> =.000). Satisfaction scores of the women with the intervention according to the groups also showed a significant difference (<em>P</em> =.000). When the satisfaction scores of the women with the intervention were compared by groups, the satisfaction scores ranged from the highest to the lowest, as virtual reality, music therapy, and stress ball application, respectively.</div></div><div><h3>Conclusions</h3><div>Virtual reality, music therapy, and stress ball applications, which are methods of distraction during the outpatient gynecological procedure, were effective in reducing anxiety and pain and increasing patient satisfaction.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1034-1041"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Every Second Patient Does Not Fully Understand Written Preprocedure Information: An Explorative Study About Functional Health Literacy","authors":"Emelie Janmyr CRNA, MSN ,&nbsp;Benjamin Grossmann CRNA, PhD ,&nbsp;Andreas Nilsson CRNA, PhD","doi":"10.1016/j.jopan.2024.02.004","DOIUrl":"10.1016/j.jopan.2024.02.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the self-perceived functional health literacy (FHL) of patients who underwent advanced endoscopic treatment, explore whether FHL could explain aspects of patients' perioperative experiences, and determine whether patients read the provided patient information.</div></div><div><h3>Design</h3><div>A prospective cross-sectional explorative study.</div></div><div><h3>Methods</h3><div>One hundred patients who underwent endoscopic bile duct intervention were enrolled and asked to answer the Swedish version of the FHL Scale and their perioperative experiences of the intervention. Along with procedural data, all data were analyzed for group comparisons; high or low FHL.</div></div><div><h3>Findings</h3><div>The study included a total of 100 patients, with half of them rating their FHL as problematic or inadequate (low FHL). Among those who perceived their FHL as inadequate, a majority had not read the provided information before the procedure. Patients with problematic or inadequate FHL experienced perioperative anxiety and pain more frequently than those with sufficient FHL (high FHL).</div></div><div><h3>Conclusions</h3><div>This study supports previous research on the association between low FHL and patients' well-being. To better meet patients' information needs, it is crucial for nurse anesthetists and other health care providers to have knowledge about FHL. Additionally, the study highlights the importance of using alternative and more effective means of delivering information to patients.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1075-1078"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Artificial Intelligence Patient Safety Concerns in Health Care","authors":"Jacqueline Ross RN, PhD","doi":"10.1016/j.jopan.2024.08.018","DOIUrl":"10.1016/j.jopan.2024.08.018","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1106-1107"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Implications of Glucagon-like Peptide-1 Receptor Agonists","authors":"Rachel C. Wolfe PharmD, MHA, FCCP, BCCCP","doi":"10.1016/j.jopan.2024.09.022","DOIUrl":"10.1016/j.jopan.2024.09.022","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1108-1110"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756701","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":"Celebrate PANAW, February 3-9, 2025!","authors":"","doi":"10.1016/S1089-9472(24)00542-2","DOIUrl":"10.1016/S1089-9472(24)00542-2","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Page 939"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757061","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}