Journal of Perianesthesia Nursing最新文献

{"title":"Improving Postoperative Handoff Communication in the Neuroscience Intensive Care Unit: A Quality Improvement Project.","authors":"Emily Toth, Robert Blessing, Virginia C Simmons, Valerie Sabol","doi":"10.1016/j.jopan.2024.11.014","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.11.014","url":null,"abstract":"<p><strong>Purpose: </strong>This quality improvement project aimed to improve postoperative handoff communication between anesthesia providers and neuroscience intensive care unit nurses by developing and implementing a standardized postoperative handoff checklist for the neurosurgical patient population.</p><p><strong>Design: </strong>A quality improvement project. Pre-post interventional design.</p><p><strong>Methods: </strong>The project team collaborated to develop and implement a standardized neuroscience intensive care unit-specific checklist for postoperative handoff between nursing staff and anesthesia providers. The checklist was designed to standardize communication, ensure completeness of information transfer, and empower nursing staff to ask questions during handoff. Staff education was provided regarding the use and importance of the handoff tool. In addition, staff knowledge and confidence regarding handoff communication were assessed before and after the intervention.</p><p><strong>Findings: </strong>Implementation of the postoperative handoff checklist resulted in several positive outcomes, including improved knowledge and confidence in information exchange during handoff, enhanced team communication and collaboration, and increased staff satisfaction with the handoff tool. While statistical significance was not achieved for several data points, there was an observable improvement by the participants in all categories involved highlighting the clinical relevance of the intervention.</p><p><strong>Conclusions: </strong>Implementing a standardized postoperative handoff checklist for a highly complex adult population recovering from neurosurgery shows potential for improving communication and facilitating a systematic information transfer between nursing staff and anesthesia providers. The checklist improved knowledge and confidence among nursing staff during postoperative handoff and empowered them to clarify information and ask questions during transfer of care.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634436","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":"Evidence-based Practice: Updating Contingency Paper Documentation.","authors":"Bonnie Crumley Aybar, Nicole Maheu","doi":"10.1016/j.jopan.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.11.004","url":null,"abstract":"<p><strong>Purpose: </strong>Contingency Paper Documentation (CPD) in the postanesthesia care unit (PACU) was outdated and did not include all required documentation. Crucial assessment, education, and readiness for discharge were not.</p><p><strong>Design: </strong>The design of this project and literature review was based on the Problem-Intervention-Comparison-Outcome question-How can CPD be improved to include all required PACU assessments, education, and discharge criteria?</p><p><strong>Methods: </strong>Review and rating of literature for evidence was specific to nursing documentation and paper documentation. Staff provided input to update the PACU CPD document. Multiple Plan-Do-Study-Act cycles were implemented to create the final document.</p><p><strong>Findings: </strong>There was a lack of information specific to updating the CPD. Themes identified with the literature review include the flow of documentation should mimic nursing care provided, the process, and the Electronic Health Care Record; to include user input in improvement initiatives; include evidence-based recommendations/regulations; consider quality and include outcomes in documentation; avoid abbreviations, and to use standardized language.</p><p><strong>Conclusions: </strong>The PACU CPD was updated with staff input and evidence from the literature review, and with trialing the document for formatting and content. The updated form is quicker and easier to use, with less content written in free text. Future quality assessment of the new document is planned to include quality of documentation, legibility, and meeting organizational documentation requirements, as compared with the previous CPD.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634424","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 Effects of Korean Hand Acupressure on Postoperative Pain, Nausea, Vomiting, and Retching After Thyroidectomy.","authors":"Sevgi Gür, Seher Deniz Öztekin, İlhan Öztekin, Orhan Yalçin","doi":"10.1016/j.jopan.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.11.003","url":null,"abstract":"<p><strong>Purpose: </strong>There are studies examining the effect of Chinese acupressure on postoperative nausea, vomiting, and retching, but there is no study examining the effect of Korean hand acupressure. The study was conducted to determine the effect of Korean hand acupressure applied after thyroidectomy on the number and severity of postoperative pain, nausea, vomiting, and retching.</p><p><strong>Design: </strong>An experimental study with a post-test control group design involving randomized groups.</p><p><strong>Methods: </strong>The study was conducted with 42 patients who underwent thyroidectomy between February 1, 2021 and June 1, 2022. Korean hand acupressure was applied to the intervention group for 3 minutes using mung bean seeds 30 minutes before anesthesia. The application was continued every 2 hours and terminated at the eighth hour after the surgery. Pain severity, the number severity of nausea, vomiting, and retching, antiemetic use, and Rhodes Nausea, Vomiting and Retching Index score were assessed at the 2nd, 6th, and 24th hours postoperatively.</p><p><strong>Findings: </strong>The number and severity of retching in the intervention group at the sixth hour postoperatively was significantly lower than the control group (P < .05). The number and severity of nausea in the intervention group at the 2nd, 6th, and 24th hours after the surgery, as well as the number and severity of vomiting and retching at the 2nd and 6th hours after the surgery, were found to be clinically significant compared with the control group.</p><p><strong>Conclusions: </strong>Korean hand acupressure was an effective nursing intervention for reducing the number and severity of retching at the 6th hour after thyroidectomy and also reduced the use of antiemetics.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606729","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":"Construction and Application Research of a Perioperative Inspection Checklist for Acute Upper Gastrointestinal Bleeding.","authors":"Lina Chen, Qing Shao, Liangyu Fang, Wei Wei, Jingfen Jin","doi":"10.1016/j.jopan.2024.11.002","DOIUrl":"10.1016/j.jopan.2024.11.002","url":null,"abstract":"<p><strong>Purpose: </strong>To enhance patient safety and improve communication and response times during the perioperative management of patients with acute upper gastrointestinal bleeding, a checklist was developed, tested for psychometric properties, and implemented in clinical practice.</p><p><strong>Design: </strong>This is a methodological study.</p><p><strong>Methods: </strong>A perioperative checklist for acute upper gastrointestinal bleeding was developed using a literature review and the Delphi method. The psychometric properties of the checklist were assessed through reliability and validity testing, including Cronbach's α coefficient, split-half reliability, content validity, and construct validity. A pre-and-post intervention study was conducted to evaluate the checklist's practical impact on clinical outcomes. Data were collected on safety indicators, efficiency metrics (including response times), and satisfaction levels.</p><p><strong>Findings: </strong>The final checklist comprises 19 items across 3 domains: preoperative, intraoperative, and postoperative management. The Cronbach's α coefficient was 0.775, indicating good internal consistency. Split-half reliability was 0.701. The scale-content validity index/average for the 3 domains was 0.987, 0.971, and 0.904, respectively, while the item-content validity index ranged from 0.857 to 1.000, demonstrating excellent content validity. Factor loadings for each item exceeded 0.5, and 6 latent factors explained 83.874% of the total variance, confirming the checklist's strong factor structure. In the clinical application, 210 cases were analyzed-101 before and 105 after checklist implementation. The response time for emergency endoscopy improved significantly (t = -2.556, P < 0.05). Additionally, satisfaction with team collaboration showed significant improvement (χ² = 8.56, P < 0.05), highlighting the checklist's effectiveness in enhancing clinical outcomes and coordination among the health care team.</p><p><strong>Conclusions: </strong>The perioperative checklist for acute upper gastrointestinal bleeding demonstrates strong reliability, validity, and practical utility. Its application improves response times, patient safety, and teamwork, making it an effective tool for perioperative management in patients with acute upper gastrointestinal bleeding.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606723","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":"Optimizing the Recovery of Pediatric Tonsillectomy: Application of Opioid-Free Anesthesia and Analgesia.","authors":"Yi Zeng, Yunwang Zhang, Jianhong Wu, Qingli Li, Feng Liu, Guoyi Gao, Lei Chen","doi":"10.1016/j.jopan.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.11.013","url":null,"abstract":"<p><strong>Purpose: </strong>Opioids are considered the gold standard for controlling postoperative acute pain. However, side effects such as nausea, vomiting, respiratory depression, and pain sensitization have gained significant attention. The risks are higher in children with enlarged tonsils and sleep apnea, making effective pain management while minimizing analgesia-related side effects a pressing concern.</p><p><strong>Design: </strong>This was a randomized (1:1), single-blind, parallel-group superiority trial.</p><p><strong>Methods: </strong>A prospective single-blind study was conducted with 44 children aged 3 to 7 years who planned to undergo tonsillectomy under general anesthesia. They were randomized into two groups: the experimental group and the control group using computer-assisted randomization. The control group received standardized opioid drugs for general anesthesia induction and maintenance. In the experimental group, the opioid drugs used for anesthesia induction and maintenance were replaced with nonopioid alternatives such as esketamine and dexmedetomidine. The primary outcome of interest was the pain score within 48 hours after surgery, while the secondary outcomes included the time to first food ingestion, sleep quality, nausea, vomiting, respiratory depression, insufficient analgesia, number of children requiring hydromorphone rescue analgesia, and differences in psychological symptoms such as excitement and hallucinations, postoperative bleeding, and caregiver satisfaction.</p><p><strong>Findings: </strong>The experimental group experienced significantly lower pain scores within 48 hours post surgery compared with the control group, with statistical significance at P less than .01 for 6, 12, and 24 hours, and at P less than .05 for 48 hours post surgery. In terms of the incidence of adverse events, children in the experimental group reported better sleep quality, less nausea and vomiting, and needed fewer instances of hydromorphone rescue analgesia than those in the control group. Additionally, the experimental group had higher caregiver satisfaction (P < .05).</p><p><strong>Conclusions: </strong>Nonopioid anesthesia and analgesia regimens can improve pain scores within 48 hours after tonsillectomy in children, improve sleep quality, shorten the time to first food ingestion, reduce the incidence of insufficient analgesia and nausea and vomiting, and increase caregiver satisfaction.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568655","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":"Does Preoperative Gum Chewing Reduce Postoperative Sore Throat?","authors":"Aliye Okgün Alcan, Dilek Akdağ, Hakan Aygün, Eyüp Kebabçı","doi":"10.1016/j.jopan.2024.10.019","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.10.019","url":null,"abstract":"<p><strong>Purpose: </strong>There are numerous pharmacological and nonpharmacological methods that are used to manage postoperative sore throat (POST). The purpose of this study was to compare the efficacy of different types of herbal gums on POST management.</p><p><strong>Design: </strong>A randomized controlled, blinded, prospective, experimental study.</p><p><strong>Methods: </strong>This study was carried out between June and October 2023 in a research and training hospital. A total of 72 patients scheduled for cholecystectomy were randomly assigned to one of four groups in the preoperative period: control, mastic, xylitol, and propolis groups. No intervention was applied to the control group, while patients in the experimental groups chewed either mastic-flavored, xylitol, or propolis gum. Patients in the experimental groups chewed sugar-free gum for 15 minutes immediately before surgery. The incidence and severity of sore throat were evaluated upon admission to the postanesthesia recovery unit and at the 1st, 2nd, 6th, and 24th hours postoperatively. Descriptive statistics, χ², Fisher's Exact, Independent samples t test, and Kruskal-Wallis tests were used in the analysis of the data.</p><p><strong>Findings: </strong>There was no significant difference in POST severity between the groups at admission to the postanesthesia recovery unit and at the 1st, 6th, and 24th hours postoperatively. However, the rate (P: .007) and the median POST score (P: .046) in the propolis group were significantly lower than that of the other groups at the 2 hours postoperatively. Additionally, throat dryness in the propolis group was significantly lower at the first (P: .046) and second (P: .023) hour after surgery compared to the other groups.</p><p><strong>Conclusions: </strong>Preoperative chewing sugar-free gum containing propolis effectively reduces sore throat and throat dryness within the first 2 hours after surgery.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525024","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 Short Preoperative Warming Time on Transurethral Lithotripsy Surgery: A Randomized Controlled Trial.","authors":"Jingjing Wan, Yuelong Jin, Lijun Zhu, Liying Wen, Weiwei Chang, Yu Zhu, Xiubin Tao, Anshi Wang","doi":"10.1016/j.jopan.2024.10.018","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.10.018","url":null,"abstract":"<p><strong>Purpose: </strong>Preoperative warming prevents inadvertent perioperative hypothermia (IPH). The aim of this study was to investigate the effect of preoperative warming (prewarming) on patient thermal protection and to explore the appropriate duration of preoperative warming for clinical practice.</p><p><strong>Design: </strong>Randomized controlled clinical trial.</p><p><strong>Methods: </strong>117 urological patients were randomized into no prewarming (NP), prewarming 15 minutes (P-15), and prewarming 30 minutes (P-30) groups. Patients' core temperature was monitored and the incidence of IPH, incidence of postoperative shivering, extubation time, length of stay in the postanesthesia care unit, and length of stay in hospital were recorded. The Consolidated Standards of Reporting Trials (CONSORT) checklist was followed.</p><p><strong>Findings: </strong>The intraoperative core temperature at all time points and the rise in temperature before induction of anesthesia were higher in the P-15 and P-30 groups than in the NP group, but there was no statistically significant difference between the P-15 and P-30 groups. The incidence of IPH was lower in the P-15 (33.3%) and P-30 (37.8%) groups than in the NP group (65.8%), but there was no statistically significant difference between the P-15 and P-30 groups. The incidence of shivering, extubation time, length of stay in the postanesthesia care unit, and length of stay in hospital did not differ between groups.</p><p><strong>Conclusions: </strong>Prewarming can effectively maintain intraoperative core temperature in patients undergoing transurethral lithotripsy, and reduce the incidence of IPH. Prewarming 15 minutes before surgery can achieve beneficial clinical effects.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525025","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":"Association of ABCB1 C1236T Gene Polymorphisms With the Postoperative Analgesic Effects of Sufentanil and Morphine in Patients With Femoral Fractures.","authors":"Xiaofeng Qin, Qiurui Huang, Jianzhong An, Chen Wang, Fuqi Xu, Shigang Qiao","doi":"10.1016/j.jopan.2024.10.017","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.10.017","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the association between the ABCB1 C1236T gene polymorphism and the analgesic effects of sufentanil and morphine in patients undergoing surgery for femoral fractures (FFs).</p><p><strong>Design: </strong>An experimental, exploratory design was used.</p><p><strong>Methods: </strong>400 patients who underwent FF surgery were randomly assigned to two groups using a random number table method: the morphine group and the non-morphine group. In the morphine group, patients received an epidural injection of 1.5 mL of morphine hydrochloride (referred to as morphine) at the end of the surgery. In the non-morphine group, patients received 1.5 mL of 0.9 % normal saline (NS) solution. Postoperatively, all patients were administered sufentanil exclusively through an intravenous analgesic pump. Patients were observed for genetic polymorphisms, postoperative pain and adverse reactions.</p><p><strong>Findings: </strong>A total of 369 patients participated in the study, with 185 in the morphine group and 184 in the non-morphine group. In the morphine group, there were 90 cases of the CC genotype, 90 cases of the CT genotype, and 5 cases of the TT genotype. In the non-morphine group, there were 84 cases of the CC genotype, 76 cases of the CT genotype, and 24 cases of the TT genotype. The genotype frequencies in both groups adhered to Hardy-Weinberg equilibrium. In the non-morphine group, patients with the CC genotype had significantly lower NRS scores on day 1 compared to those with CT and TT genotypes (P < 0.05). No significant differences were found in other indicators (P > 0.05). In the morphine group, no significant differences were observed among the three genotypes in terms of NRS scores (P > 0.05). Multiple linear regression analysis revealed that postoperative 1-day NRS score was associated with the time of onset of postoperative pain and the ABCB1 C1236T genotype (P < 0.05).</p><p><strong>Conclusions: </strong>The ABCB1 C1236T gene polymorphism was a genetic factor influencing early postoperative pain in Han patients with FFs. However, epidural administration of morphine could mitigate the impact of this gene mutation on early analgesia induced by sufentanil.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494417","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":"Preoperative Anxiety and Information Needs Among Patients in the Preoperative Holding Area.","authors":"Wuxing Li, Qifen He, Li Hu, Ning An, Huiping Wang, Qing Zeng","doi":"10.1016/j.jopan.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.10.001","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the current state of preoperative anxiety and the informational needs of patients undergoing surgery in a preoperative holding area.</p><p><strong>Design: </strong>Descriptive and Pre post study.</p><p><strong>Methods: </strong>A total of 655 elective surgery patients awaiting surgery were selected from November 2021 to March 2022. Multiple linear regression analyses were conducted to examine the factors associated with preoperative anxiety and informational needs in patients exhibiting shadow responses.</p><p><strong>Findings: </strong>The patients' mean anxiety scores were 10.33 ± 3.25. Among them, 51 patients had mean anxiety scores greater than or equal to 12, indicating a state of anxiety. The mean informational needs scores were 7.81 ± 2.66. A total of 71 patients had mean informational needs scores greater than or equal to 5, reflecting a moderate or higher level of informational needs. Multiple linear regression analysis identified gender, age, surgical table, type of surgery, quality of sleep before surgery, surgical experience, and anesthesia experience as the primary factors influencing preoperative anxiety in patients awaiting surgery. Age, surgical experience, and anesthesia experience were identified as the main factors affecting informational needs in the preoperative holding area.</p><p><strong>Conclusions: </strong>Patients undergoing surgery in the preoperative holding area exhibit heightened levels of anxiety and informational needs. Nurses must provide enhanced psychological support interventions for these patients, particularly focusing on those who are older, female, undergoing repeated operations, gynecological surgeries, experiencing poor sleep quality before surgery, or have had distressing surgical or anesthesia experiences.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477226","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":"Implementation of an Evidence-based Protocol to Increase the Use of Goal-directed Hemodynamic Therapy.","authors":"Cole Davis, Kelly Lindsay, Kelsey Jacks, Kendall Lowery, Jamie Nichols, Amy Yerdon","doi":"10.1016/j.jopan.2024.09.014","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.09.014","url":null,"abstract":"<p><strong>Purpose: </strong>This quality improvement project aimed to increase goal-directed hemodynamic therapy (GHDT) utilization in adult patients undergoing coronary artery bypass grafts (CABG) by implementing an evidence-based intraoperative GDHT protocol.</p><p><strong>Design: </strong>A quality improvement project.</p><p><strong>Methods: </strong>The team implemented a training bundle to raise awareness of complications associated with IOH, educate providers about GDHT benefits, and explain how to incorporate the protocol to guide intraoperative hemodynamic management. The team performed retrospective chart reviews to determine baseline and post-implementation GDHT protocol utilization and IOH incidence.</p><p><strong>Findings: </strong>After receiving the education and protocol implementation, anesthesia providers began using the GDHT monitors on 100% of CABG procedures at this facility. A total of 60 patient charts were reviewed. Average cumulative hypotensive time decreased by 16.8%, from 26.37 minutes to 21.93 minutes (P = .375, 95% CI [-5.49, 13.35]).</p><p><strong>Conclusions: </strong>Although there was no significant reduction in IOH, the training bundle and team support increased anesthesia providers' interest in using GDHT monitors. This led to a significant rise in its utilization. A future project is planned to expand the GDHT monitors and protocol to the entire operating room. Post-anesthesia care and intensive care units desiring to increase GDHT use may benefit from similar projects.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477224","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}