Fang Tan PhD, MD , Weisha Lu RN , Shuangshuang Li PhD, MD , Jing Chen RN
{"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 , Weisha Lu RN , Shuangshuang Li PhD, MD , 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> < .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 (SpO<sub>2</sub>) and the mean arterial blood pressure were comparable between the two groups (<em>P</em> > .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":"Care of the Patient Having Local-Only Procedures","authors":"Theresa Clifford DNP, RN, CPAN, CAPA, FASPAN, FAAN","doi":"10.1016/j.jopan.2024.08.019","DOIUrl":"10.1016/j.jopan.2024.08.019","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1111-1112"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511183","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":"Design Specifications for an Automated System to Deliver Instructions About Preprocedure Fasting","authors":"Kristina Chang MScN, RN-EC, NP-PHC , Amanda Matthews RN , Sheryl Alexandre MScN, CCCN(c), RN , Julie Vizza MHSc , Aaron Conway BN (Hons), PhD","doi":"10.1016/j.jopan.2024.02.001","DOIUrl":"10.1016/j.jopan.2024.02.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Many patients undergoing surgical and other medical procedures requiring sedation or anesthesia receive standardized “no eating or drinking after midnight” instructions. This “standardized” instruction does not change regardless of potential alterations in scheduling that result in significant delays in procedure start times. As a result, the duration of preprocedure fasting often far exceeds recommended requirements. A technological solution that automates the delivery of preprocedure fasting instructions to patients would likely improve the patient experience. The purpose of this study was to determine design specifications for the delivery of notifications to patients as part of an automated system.</div></div><div><h3>Design</h3><div>A qualitative study was conducted with 14 adult participants using the persona-scenario method.</div></div><div><h3>Methods</h3><div>Participants worked in groups to create realistic but fictitious personas and scenarios that described how individuals like themselves would interact with an automated preprocedure fasting instruction system. Data generated through the development of the scenarios were analyzed to first identify important themes, which were then interpreted into design specifications.</div></div><div><h3>Findings</h3><div>Seven women and seven men, aged 25 to 75, developed 9 persona-scenarios, which captured outpatient and inpatient preprocedure fasting experiences, as well as perspectives of individuals who were not comfortable with technology, or those for which English was not the primary spoken language. Most scenarios described preprocedure fasting instructions delivered by an automated bidirectional short message service system. Two major themes were identified as patient priorities, including: (1) enhancing communication between patients and healthcare providers; and (2) the importance of using simple technology so that a greater number of patients with varying degrees of comfort and capabilities would be able to use the system confidently. A corresponding set of proposed design specifications was devised.</div></div><div><h3>Conclusions</h3><div>The results of this study provide actionable ways to operationalize patient-centered ideas in the design of an automated preprocedure fasting instruction system.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1069-1074"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181366","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":"Cross-sectional and Correlational Examination of Patients’ Preoperative Anxiety, Information Need, and Health Literacy in a Presurgical Consultation","authors":"Patrick Teixeira Machado MscN , Claudia Lecoultre MscN , Cécile Courbon MD","doi":"10.1016/j.jopan.2024.01.020","DOIUrl":"10.1016/j.jopan.2024.01.020","url":null,"abstract":"<div><h3>Purpose</h3><div>This study elucidates the preoperative anxiety (PA), information need (IN), and health literacy (HL) levels of an elective preoperative sample in Switzerland and examines the possible associations between PA and the patients’ characteristics. By knowing these patient dimensions, which can influence perioperative outcomes, one can tailor individualized nursing interventions to improve patients’ surgical experience.</div></div><div><h3>Design</h3><div>This was a cross-sectional and correlational study.</div></div><div><h3>Methods</h3><div>The sample consisted of 88 patients who underwent a preoperative consultation at a Swiss tertiary hosptial. Patients’ PA and IN were assessed using the Anxiety Preoperative and Information Scale, and their HL was measured using the Functional, Communicative, and Critical Health Literacy Scale. Data on other patient characteristics were collected from the patients, physicians, and electronic patient records. Association tests, as well as univariate regressions, were performed on PA, IN, HL, and patient characteristics.</div></div><div><h3>Findings</h3><div>Among participants, 40.91%, 78.41%, and 59% reported having PA, IN, and low HL, respectively. Finally, PA was associated with IN, HL, solitary living, and the American Society of Anesthesiology score.</div></div><div><h3>Conclusions</h3><div>A high proportion of patients scheduled for presurgical consultation were found to be anxious. They presented high IN and low HL. An examination of patients’ PA–associated characteristics can help improve their surgical experience. More studies should examine PA–associated characteristics.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1019-1025"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960462","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}
Zheng Yuan MN , Yali You BN , Xiaofei Song MM , Wenbo Wu MM , Xiaopeng Zhang MD , Guochen Duan MD
{"title":"A Delphi Method Comfort Status Scale for Patients With Lung Cancer After Thoracoscopic Surgery","authors":"Zheng Yuan MN , Yali You BN , Xiaofei Song MM , Wenbo Wu MM , Xiaopeng Zhang MD , Guochen Duan MD","doi":"10.1016/j.jopan.2024.01.002","DOIUrl":"10.1016/j.jopan.2024.01.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To construct the comfort status scale for patients with lung cancer after thoracoscopic surgery.</div></div><div><h3>Design</h3><div>Delphi method inquiry to 15 clinical and nursing experts.</div></div><div><h3>Methods</h3><div>On the basis of the comfort status scale and the subjective experience and objective symptoms of patients with lung cancer after thoracoscopic surgery, the relevant literature was consulted, semistructured interviews and group discussions were conducted, the pool of items of the postoperative comfort status scale for patients with lung cancer was initially formed, and the postoperative comfort status scale for patients with lung cancer was finally established.</div></div><div><h3>Findings</h3><div>The positive coefficient of experts was 100%, the coefficient of authority was 0.92 and 0.93, and the Kendal's W was 0.257 and 0.298, the degree of coordination of expert opinions was statistically significant (<em>P</em> < .05). Finally, a total of 28 items in four dimensions were formed to assess the postoperative comfort status of patients with lung cancer after thoracoscopic surgery.</div></div><div><h3>Conclusions</h3><div>The Delphi method-based comfort status scale for patients with lung cancer after thoracoscopic surgery is scientific and reliable, and can provide a quantitative basis for the evaluation of the comfort status of patients after lung cancer thoracoscopic surgery, to further provide individual comfort care measures.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 958-963.e1"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873878","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":"An Innovative Method to Debrief Critical Events","authors":"Lori Helms DNP, RN, NPD-BC, CPAN, Lori Buzalewski BSN, RN, CPAN, Michelle Pachuilo BSN, RN, CPAN, Ariana Pilat BSN, RN, CCRN, CGRN, Kimberly Reeser MSN, RN, CAPA","doi":"10.1016/j.jopan.2024.01.003","DOIUrl":"10.1016/j.jopan.2024.01.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore if cold debriefing, which by definition, occurs days to weeks following the critical event, addresses identified barriers to routine debriefing and results in instituting debriefing as standard practice in the perianesthesia division at the site hospital.</div></div><div><h3>Design</h3><div>A qualitative descriptive design using case study reviews</div></div><div><h3>Methods</h3><div>Seven critical events, meeting the criteria of a preproject list, were debriefed by the patient’s primary nurse using a cold debriefing method. Following the debriefing session, the nurse outlining the event, and the staff in attendance were asked to complete a short survey. Knowledge gained or education needed, suggestions for process improvements, and perceived safety of the environment, and feeling safe to provide feedback were assessed.</div></div><div><h3>Findings</h3><div>Identified barriers were reduced with the institution of cold debriefing. An average of 33% of the working staff were able to attend at least one debriefing session, indicating the barrier of time may be diminished by using cold debriefing. Most staff and debriefers also felt the environment was safe, and feedback provided during the debriefing sessions resulted in identified needed education and process improvement measures.</div></div><div><h3>Conclusions</h3><div>Implementation of cold debriefing to share and examine information following a critical event may address common barriers, result in process improvement measures, and identify educational needs required by the perianesthesia staff.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 949-954"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141328012","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}
Ping Xue , Qin Zhang , Jueying Xiang , Huan Yang , Dan Wang , Qinghua Jia , Ling Chen , Yiling Liu , Jing Wu
{"title":"Effect of Pressure and Nonpressure Dressings on Postoperative Complications in Patients With Mixed Hemorrhoids: A Single-blind Controlled Study","authors":"Ping Xue , Qin Zhang , Jueying Xiang , Huan Yang , Dan Wang , Qinghua Jia , Ling Chen , Yiling Liu , Jing Wu","doi":"10.1016/j.jopan.2024.02.006","DOIUrl":"10.1016/j.jopan.2024.02.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the clinical effects of nonpressure and pressure dressings on the postoperative complications of modified Milligan-Morgan hemorrhoidectomy.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Methods</h3><div>A total of 186 patients with grade II to III mixed hemorrhoids who had been excluded from cardiovascular and cerebrovascular diseases and anorectal surgery were included and randomly assigned to the nonpressure dressings group and the pressure dressings group by random number table. The incidence of acute urinary retention and medical adhesive-related skin injury, pain, hemostatic effect, anal distension, anal edema, use of analgesics, length of hospital stay, and hospitalization costs were compared between the two groups. The Consolidated Standards of Reporting Trials checklist for randomized controlled trials was used in this study.</div></div><div><h3>Findings</h3><div>The incidence of acute urinary retention in both men and women was significantly lower in the nonpressure dressing group (relative risk [RR] = 0.20, 95% confidence interval [CI] [0.13, 0.37], <em>P</em> = .002); (RR = 0.47, 95% CI [0.22, 0.76], <em>P</em> = .015). The postoperative pain at 6 hours/18 hours/25 hours was significantly lower in the nonpressure dressing group (<em>P</em> < .001, <em>P</em> = .004 < 0.05, <em>P</em> = .009). The anal distension at 6 hours and the number of patients who used analgesics were significantly lower in the nonpressure dressing group (<em>P</em> < .001). The incidence of medical adhesive-related skin injuries was significantly lower in the nonpressure dressing group (RR = 0.061, 95% CI [0.020, 0.189], <em>P <</em> .001). No primary bleeding was observed in both groups. However, there were no significant differences between both groups in terms of anal edema scores, length of stay, or hospitalization expenses. No adverse events were reported in either group during the study period.</div></div><div><h3>Conclusions</h3><div>Nonpressure dressings can effectively reduce the incidence of acute urinary retention and medical adhesion-related skin injury after surgery for grade III to IV mixed hemorrhoids. They can also safely relieve pain and distension.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1088-1094"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307238","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}