AANA journal最新文献_第3页

Exploring Safety Culture, Production Pressure, Occupational Burnout, and Patient Safety in Anesthesia. 探讨麻醉中的安全文化、生产压力、职业倦怠和患者安全。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001029

Bryan Wilbanks, Edwin Aroke, Marjorie Everson, Beth Ann Clayton, Peng Li

{"title":"Exploring Safety Culture, Production Pressure, Occupational Burnout, and Patient Safety in Anesthesia.","authors":"Bryan Wilbanks, Edwin Aroke, Marjorie Everson, Beth Ann Clayton, Peng Li","doi":"10.70278/AANAJ/.0000001029","DOIUrl":"10.70278/AANAJ/.0000001029","url":null,"abstract":"Anesthesia-related studies have found that many adverse events are related to human factors including occupational burnout, safety culture, and production pressure. The purpose of this study was to explore the relationships between those factors to identify potential interventions to improve patient safety and anesthesia practice. This exploratory study used a cross-sectional design with a survey administered via e-mail to nurse anesthetists. The survey consisted of the Survey on Patient Safety, Maslach's Burnout Inventory, and the NASA task-load-index. Data analysis included linear mixed regression models, Spearman correlations, and Cronbach's alpha. Covariates included age, years of clinical experience, zip codes, and gender. We found that the best predictors of patient safety are hospitals' culture of safety and staffing patterns. Adequate staffing had the largest impact on reducing occupational burnout and nurse anesthetists' intentions to leave their jobs. Less experienced nurse anesthetists reported lower patient safety scores. Successful interventions to improve institutional factors need to be implemented and supported by management with an emphasis on open communication among all team members to elicit lasting changes. Additionally, interventions should focus on appropriate staffing, team training, and resilience training because these have the greatest impact.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Novel Device for Training and Evaluating Ultrasound-Guided Procedures in Anesthesia. 一种用于训练和评估超声引导麻醉过程的新装置。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001004

Shayne D Hauglum, Karina Gattamorta, Martin Hossbach, Pezhman Foroughi, Alican Demir, Purnima Rajan

{"title":"A Novel Device for Training and Evaluating Ultrasound-Guided Procedures in Anesthesia.","authors":"Shayne D Hauglum, Karina Gattamorta, Martin Hossbach, Pezhman Foroughi, Alican Demir, Purnima Rajan","doi":"10.70278/AANAJ/.0000001004","DOIUrl":"10.70278/AANAJ/.0000001004","url":null,"abstract":"To improve dynamic needle-tip visualization, nurse anesthesiology students were evaluated during simulated ultrasound-guided procedures. This quasiexperimental study utilized two computed tomography 3D printed models. Thirty-two students performed each procedure twice, once without and once with needle guidance. Measures focused on accuracy and procedural performance to determine the impact that guidance versus no guidance had on attempts. Students evaluated their experiences, self-confidence, feasibility, and usability using needle guidance technology. Needle guidance improved the distance to target, total procedure time, phantom penetration time, number of attempts, completion rate, and effectiveness in both procedures. Overall, a decrease in distance to target in millimeters was uncovered when needle guidance was utilized (Z = -5.723, P < .001). Needle guidance showed a decrease of 3.96 attempts when guidance was utilized for the infraclavicular (F[1, 22] = 51.79, P < .001) and 0.96 attempts during the thoracic paravertebral procedure (F[1, 22] = 6.02, P = .023). Students found that needle guidance enhanced ease, speed, and overall performance, while feeling significantly more confident performing the infraclavicular (P < .001) and thoracic paravertebral (P < .001) procedures. The use of needle guidance technology showed improvement in accuracy comparable with results obtained using external tracking technology.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"30-38"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Critical Events in Patients With Alternating Hemiplegia of Childhood: A Cohort Study Subgroup Analysis. 儿童交替性偏瘫患者的关键事件：队列研究亚组分析。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001028

Emily M Funk, Guy de L Dear, Mary E Moya-Mendez, Andrew P Landstrom, Andrew Breglio, Lauren E Parker, April Boggs, Lyndsey Prange, Loraine Barstow, Mohamad A Mikati

{"title":"Critical Events in Patients With Alternating Hemiplegia of Childhood: A Cohort Study Subgroup Analysis.","authors":"Emily M Funk, Guy de L Dear, Mary E Moya-Mendez, Andrew P Landstrom, Andrew Breglio, Lauren E Parker, April Boggs, Lyndsey Prange, Loraine Barstow, Mohamad A Mikati","doi":"10.70278/AANAJ/.0000001028","DOIUrl":"10.70278/AANAJ/.0000001028","url":null,"abstract":"People with alternating hemiplegia of childhood undergoing general anesthesia are at risk for severe complications including critical bradycardia and hemiplegic incidents. We performed a 10-year historical cohort study and completed a subgroup analysis of patients who specifically underwent general anesthesia. Patients with ATP1A3 positive variants were compared with those without such variants. The 14 patients reviewed underwent general anesthesia a combined total of 39 times. Two patients had a short QTc documented prior to anesthesia and presented with bradycardia in the recovery room. Two other patients experienced a suspected seizure and hemiplegic incident; one of those patients received no facility-administered medications prior to experiencing a hemiplegic incident, and the other experienced a hemiplegic incident on emergence from anesthesia with subsequent cardiac arrest and successful resuscitation. No apparent association was identified between type of anesthesia and the development of bradycardia or hemiplegic incidences. Of the four patients experiencing critical events, three had the ATP1A3-D801N variant. Although additional research is necessary to confirm such associations, patients with alternating hemiplegia of childhood, specifically the ATP1A3-D801N variant, appear to be at elevated risk for complications associated with general anesthesia, suggesting the need for an increased anticipation of complications for this population.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"19-29"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Editor's Desk: Journal Updates. 编辑台：期刊更新。

AANA journal Pub Date : 2025-02-01

Ladan Eshkevari

引用次数: 0

Calendar of Events. 事件日历。

AANA journal Pub Date : 2025-02-01

引用次数: 0

Anesthetic Management and Outcomes of Pregnant Women With Ebstein's Anomaly: Prospective Report. Ebstein异常孕妇的麻醉管理和结局：前瞻性报告。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001005

Ajay Kumar Jha, Bhagyashree Gundagurti, Nivedita Jha

{"title":"Anesthetic Management and Outcomes of Pregnant Women With Ebstein's Anomaly: Prospective Report.","authors":"Ajay Kumar Jha, Bhagyashree Gundagurti, Nivedita Jha","doi":"10.70278/AANAJ/.0000001005","DOIUrl":"10.70278/AANAJ/.0000001005","url":null,"abstract":"Fetomaternal outcomes and anesthetic management of pregnancy have rarely been described in a prospective cohort of women with Ebstein's anomaly. Therefore, due to the scarcity of data, diagnostic approaches and obstetric and anesthetic management plans are still evolving. In this prospective observational study, we describe the anesthetic management and fetomaternal outcomes of seven women with different grades of unrepaired Ebstein's anomaly. All women were in NYHA (New York Heart Association) Class II, none had cyanosis or cardiac decompensation at the time of admission during pregnancy. Pregnancy was uneventful except in one woman who developed pulmonary oedema. Two women developed supraventricular arrhythmia in the postpartum period. Six women underwent vaginal or assisted vaginal delivery, while one woman underwent cesarean delivery due to the transverse lie of the fetus. All mothers returned to NYHA Class I at 6 weeks follow up. In conclusion, pregnancy increases the risk of maternal complications in asymptomatic women with Ebstein's anomaly. Therefore, preoperative functional and echocardiographic risk stratification is crucial for prepregnancy counseling. Intrapartum and postpartum surveillance, prompt diagnosis of complications, and appropriate management in multidisciplinary hospital settings are associated with favorable fetomaternal outcomes.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anesthesia Management of the Patient With Pulmonary Alveolar Proteinosis Undergoing Lung Lavage. 对肺泡蛋白沉积症患者进行肺灌洗的麻醉管理

AANA journal Pub Date : 2024-12-01

Emily Hall, Brittany Hollabaugh, Jennifer Bendure

引用次数: 0

A Case Report of a Rescue of Unanticipated Obstetric Difficult Airway Secondary to Limited Mouth Opening With i-gel® and Establishing Definitive Airway With Aintree and Fiberscope-Guided Intubation. 用 i-gel® 抢救因张口受限而导致的产科困难气道，并用 Aintree 和纤维镜引导插管建立最终气道的病例报告。

AANA journal Pub Date : 2024-12-01

Amy I Lee, Jaime Ortiz, Maya S Suresh

引用次数: 0

Factors Affecting Nurse Anesthetists' Transition from Clinical Practice to Academia: A Scoping Review. 影响麻醉护士从临床实践向学术界过渡的因素：范围审查。

AANA journal Pub Date : 2024-12-01

Denise J Stuit, Travis L Chabo, David Hart, Kerry Sewell, Susan P McMullan

{"title":"Factors Affecting Nurse Anesthetists' Transition from Clinical Practice to Academia: A Scoping Review.","authors":"Denise J Stuit, Travis L Chabo, David Hart, Kerry Sewell, Susan P McMullan","doi":"","DOIUrl":"","url":null,"abstract":"Workforce shortages influence all areas of healthcare including healthcare education. While recruitment and retention are known barriers within academia, the factors associated with the nurse anesthetist's transition from clinician to academics are unknown. The purpose of this scoping review was to identify factors that affect the transition from nurse anesthesia clinical practice to academia. A scoping review was conducted using the framework of Arksey and O'Malley. The search was performed using MEDLINE and CINAHL databases. Review selection was performed by two teams of two independent reviewers and summary of findings input into a comprehensive table. The search identified 733 articles published from 2014 to May 2023. Reviews were limited in nurse anesthesia and mainly consisted of alternate nursing specialties. Seven themes were extrapolated from the findings including mentorship (82%), orientation (47%), work-life balance (41%), early identification and empowerment (18%), formal pedagogical training (41%), faculty compensation (29%), and alternative faculty positions (23%). The review overwhelmingly revealed educator strategies available for undergraduate nursing, nurse practitioners, and midwifery, but not for nurse anesthetists. To gain a more robust knowledge of this current issue, additional research is required to educate, support, inform, and evaluate the current nurse anesthesia transition to academia process.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 6","pages":"411-419"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emergency Cesarean Section With Acute Promyelocytic Leukemia and Disseminated Intravascular Coagulation-A Case Report. 伴有急性早幼粒细胞白血病和弥散性血管内凝血的紧急剖腹产--病例报告。

AANA journal Pub Date : 2024-12-01

Rachel M Smith-Steinert, Benu Makkad

{"title":"Emergency Cesarean Section With Acute Promyelocytic Leukemia and Disseminated Intravascular Coagulation-A Case Report.","authors":"Rachel M Smith-Steinert, Benu Makkad","doi":"","DOIUrl":"","url":null,"abstract":"Acute promyelocytic leukemia (APML), a rare disease encountered during pregnancy, is associated with high mortality secondary to consumptive coagulopathy and fatal bleeding diathesis. It usually presents as a medical emergency and warrants prompt diagnosis and treatment to improve maternal survival. This case report details a 19-year-old female with new onset APML who presented for emergency cesarean section because of respiratory distress and suspected placental abruption. Antifibrinolytics, which are commonly utilized to treat postpartum hemorrhage, were contraindicated because the patient was receiving all transretinoic acid (ATRA) therapy for APML. This case adds insight into the disease and its management along with anesthesia considerations for patients undergoing emergent caesarean delivery in the setting of acute disseminated intravascular coagulation and ATRA therapy. It also highlights the importance of a multidisciplinary team approach to plan for treatment and timing of delivery that balances the risk of disease progression and fetal well-being. Such multidisciplinary care and proper planning helped in attaining the best possible outcomes for both mother and baby.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 6","pages":"448-452"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0