AANA journal最新文献_第4页

Perioperative Management of Atrial Fibrillation In a Geriatric Neurosurgical Patient With Acute Aneurysmal Subarachnoid Hemorrhage. 急性动脉瘤性蛛网膜下腔出血老年神经外科患者心房颤动的围手术期处理。

AANA journal Pub Date : 2024-12-01

Ashwini Reddy, Shalvi Mahajan, Nidhi Panda, Sanjay Kumar

引用次数: 0

The Editor's Desk: Artificial Intelligence. 编辑台：人工智能。

AANA journal Pub Date : 2024-10-01

Ladan Eshkevari

引用次数: 0

Successful Treatment of Idiopathic, Intractable Hiccups With Prescriptive Positive Pressure Ventilation-A Case Report. 利用处方正压通气成功治疗特发性顽固性呃逆--病例报告。

AANA journal Pub Date : 2024-10-01

Delisa Rampersad, Josh Slaven

引用次数: 0

Exploring the Experience of CRNAs Choosing to Quit Their Jobs: A Qualitative Study. 探索选择辞职的注册护士的经历：定性研究。

AANA journal Pub Date : 2024-10-01

Michael C Lambert, Robyn Ward, Dru Riddle

引用次数: 0

Impact of a Tranexamic Acid Dosing Practice Guideline in Reducing Blood Product Administration in Pediatric Scoliosis Surgery. 氨甲环酸剂量实践指南对减少小儿脊柱侧凸手术中血液制品用量的影响。

AANA journal Pub Date : 2024-10-01

Katherine D Jones, Cameron Hatlevig, Julie A Thompson, Beau Rowe, Lisa M Einhorn, Emily M Funk

{"title":"Impact of a Tranexamic Acid Dosing Practice Guideline in Reducing Blood Product Administration in Pediatric Scoliosis Surgery.","authors":"Katherine D Jones, Cameron Hatlevig, Julie A Thompson, Beau Rowe, Lisa M Einhorn, Emily M Funk","doi":"","DOIUrl":"","url":null,"abstract":"Pediatric patients who undergo spinal corrective surgery often require multiple blood product transfusions. The use of antifibrinolytics, especially tranexamic acid (TXA), to mitigate intraoperative blood loss has increased in popularity. The goal of this quality improvement project was to evaluate provider compliance with a TXA dosing protocol during pediatric corrective spine procedures. A retrospective chart review was conducted to compare pre- and postimplementation data on cell saver and packed red blood cell (PRBC) administration and dose of antifibrinolytic administered. A total of 486 patients (68% idiopathic and 32% neuromuscular) were evaluated over a 9-year period. Following implementation of the protocol, patients of idiopathic origin experienced a 20% reduction in cell saver administration, a 10% reduction in PRBC administration, and a 37% increase in provider compliance with the dosing protocol. Patients of neuromuscular origin experienced a 53% increase in provider compliance with the recommended TXA dosing protocol; however, this patient population did not experience a statistically significant reduction in transfusion requirements. Implementation of an antifibrinolytic protocol can facilitate compliance with recommended TXA dosing parameters and potentially decrease intraoperative blood loss, reducing blood product transfusion requirements.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 5","pages":"363-371"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370708","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

Shared Experiences of Nurse Anesthesiology Faculty During the COVID-19 Pandemic. 麻醉学护士在 COVID-19 大流行期间的共同经历。

AANA journal Pub Date : 2024-10-01

Bryan Wilbanks, Anne Hranchook, Vicki Callan, Marjorie Everson, Beth Ann Clayton, Maria Hirsch, Lorraine Jordan

引用次数: 0

Implementation of a Perioperative Lung Protective Ventilation Protocol for Robotic-Assisted Surgeries. 为机器人辅助手术实施围手术期肺保护通气方案。

AANA journal Pub Date : 2024-10-01

Sydney A Elmore, Denise H Tola, Virginia C Simmons, Lauren A Wilson, Jessica D Szydlowski

{"title":"Implementation of a Perioperative Lung Protective Ventilation Protocol for Robotic-Assisted Surgeries.","authors":"Sydney A Elmore, Denise H Tola, Virginia C Simmons, Lauren A Wilson, Jessica D Szydlowski","doi":"","DOIUrl":"","url":null,"abstract":"This project sought to educate providers on the benefits of lung protective ventilation (LPV), implement a LPV protocol in robotic surgery, and evaluate adherence to the protocol in the adult (≥ 18 years) robotic-assisted surgery population. This project used a pre/post quality improvement design with a retrospective chart review and periodic knowledge, attitude, and practice surveys over the course of 6 months. This project retrospectively reviewed electronic medical records to assess adherence to the LPV protocol. The type of surgery; ventilator settings including positive end-expiratory pressure, FiO2, tidal volume, SpO2, ventilator mode, compliance, driving pressure and peak pressure; patient height and weight; patient body mass index; and American Society of Anesthesiologists physical status classification were collected. Analyzed results compared baseline preeducation data and data collected at 3- and 6-months postimplementation. Adherence to the LPV protocol parameters of tidal volume (P < .001), respiratory rate (P = .014), and driving pressure (P < .001) within LPV limits improved with statistical significance from pre- to postimplementation. Provider confidence and knowledge increased from pre- to posteducation (P = .049). Adherence to a LPV protocol improved with education and information tools.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 5","pages":"337-344"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370709","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

Dexmedetomidine for Postoperative Delirium Prevention in the Older Adult: An Integrative Review. 右美托咪定用于预防老年人术后谵妄：综合综述。

AANA journal Pub Date : 2024-10-01

Ali Luchini Strada, Aaron Tevay, Misty Scoggins, Kimberly Gonzalez

{"title":"Dexmedetomidine for Postoperative Delirium Prevention in the Older Adult: An Integrative Review.","authors":"Ali Luchini Strada, Aaron Tevay, Misty Scoggins, Kimberly Gonzalez","doi":"","DOIUrl":"","url":null,"abstract":"The brain and cognition are particularly vulnerable to anesthetic and surgical insults, with postoperative delirium being the most common postoperative complication in patients aged ≥ 65 years. The body releases psychoactive proinflammatory cytokines in response to surgical trauma, including interleukin-1β, interleukin-6, and tumor necrosis factor-α. This promotes a porous blood-brain barrier, promoting postoperative cognitive dysfunction. Aging adults lose brain volume, cerebrospinal fluid, and dendritic synapses, thereby increasing neurologic stress and vulnerability to these surgical changes. Anesthetic technique influences the process, necessitating the importance of educated certified registered nurse anesthetists. Dexmedetomidine, a nonspecific α2-adrenergic receptor agonist, exhibits anti-inflammatory properties that counteract the proinflammatory mechanisms initiated by surgical insult. Additionally, dexmedetomidine mimics natural sleep pathways and reduces opioid dosing requirements, promoting cognitive preservation. While further research is required to establish an association with long-term effects, current literature indicates that dexmedetomidine may reduce postoperative delirium and cognitive dysfunction in older adults through various dosing regimens. This journal course reviews the pathophysiology of postoperative neurocognitive dysfunction and delirium, dexmedetomidine as an adjunct to mitigate these pathologic changes, and the current literature on dexmedetomidine's impact on postoperative delirium in older adults.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 5","pages":"383-389"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370705","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

Ultrasound-Guided Quadratus Lumborum Block Versus Caudal Block for Perioperative. 超声引导下腰椎四头肌阻滞与腹腔阻滞在围手术期的应用

AANA journal Pub Date : 2024-10-01

Shreya B Shah, Deepanjali Pant, Archna Koul, Anirban Roy, Jayashree Sood, Parul T Chugh

{"title":"Ultrasound-Guided Quadratus Lumborum Block Versus Caudal Block for Perioperative.","authors":"Shreya B Shah, Deepanjali Pant, Archna Koul, Anirban Roy, Jayashree Sood, Parul T Chugh","doi":"","DOIUrl":"","url":null,"abstract":"Quadratus lumborum block is an effective truncal block for postoperative analgesia in patients undergoing abdominal surgeries. We aimed to compare the analgesic efficacy of caudal block versus ultrasonography-guided quadratus lumborum block in pediatric patients undergoing open pyeloplasty. Fifty patients weighing ≤ 16 kg (age ≤ 4 years) with ASA physical status I-II scheduled for elective open pyeloplasty under general anesthesia were randomized into caudal block or transmuscular quadratus lumborum block groups. Fifty patients were included in the analysis. The mean duration of postoperative analgesia in the caudal group was 6.85 ± 1.99 hr, and for the quadratus lumborum block group it was 11.27 ± 3.74 hr (P < .001). There was no significant difference between the groups in terms of perioperative fentanyl requirement. However, there was a significant difference in postoperative paracetamol requirement between the groups (P = .005). There was a significant difference in postoperative pain score between the groups at 30 min, 1 hr, 1.5 hr, 2 hr, 8 hr, and 24 hr (P < .05). Mean heart rate and mean arterial pressure were comparable. No complications were recorded. Quadratus lumborum block was more effective than caudal block in terms of duration of postoperative analgesia and postoperative analgesic consumption.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 5","pages":"329-336"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370713","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

Evaluation of the International Scope of Practice of Nonphysician Anesthesia Providers Between 2012 and 2022. 评估 2012 年至 2022 年国际非医师麻醉提供者的执业范围。

AANA journal Pub Date : 2024-10-01

Vera Meeusen, James R Walker, Jakob Ibsen Vedtofte

{"title":"Evaluation of the International Scope of Practice of Nonphysician Anesthesia Providers Between 2012 and 2022.","authors":"Vera Meeusen, James R Walker, Jakob Ibsen Vedtofte","doi":"","DOIUrl":"","url":null,"abstract":"In 2012, representatives of the 44 International Federation of Nurse Anesthetists (IFNA) member countries were surveyed about their scope of practice. Ten years later, the researchers repeated the study to evaluate the professional development of nonphysician anesthesia providers. The survey was prepared by the IFNA Practice Committee and explored demographics, training, anesthesia team members, and daily activities of the nonphysician anesthesia providers (NPAPs). The online survey was sent to all IFNA Country National Representatives. In 2022, 22 out of 44 countries had more than one type of NPAP including five countries that had anesthesia technicians. NPAPs work in operating theatres (94.4%), postanesthesia care units (81.9%), intensive care units (46%), acute (51%), chronic pain (28%), air ambulance (28%), resuscitation (69%), or trauma team (42%), preoperative screening (57%). Formal recognition of the profession and the requirement of licensure to practice has increased. Education levels have increased substantially, which resulted in more indirect supervision. Direct supervision by physicians is related to education levels and limited scope of practice. The NPAP workforce is growing toward IFNA standards, but it has become a more diversely educated workforce. NPAPs who are educated at a bachelor or higher level and require officially recognized licensure to practice, have an extensive scope of practice.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"92 5","pages":"357-362"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370706","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