AANA journal最新文献_第9页

Understanding Pain in Alzheimer's Disease in Anesthesia. 了解阿尔茨海默病麻醉中的疼痛。

AANA journal Pub Date : 2023-06-01

Cindi Dabney, Todd Monroe, Ronald Cowan, Michael Carter

引用次数: 0

Bupivacaine Dosing for Cesarean Delivery in Parturients of Short Stature: A Retrospective Case-Control Study. 布比卡因用于矮小产妇剖宫产:一项回顾性病例对照研究。

AANA journal Pub Date : 2023-06-01

Elizabeth M S Lange, Paloma Toledo, Jillian Stariha, Josephine LiMandri, Derek Morley, Heather C Nixon

{"title":"Bupivacaine Dosing for Cesarean Delivery in Parturients of Short Stature: A Retrospective Case-Control Study.","authors":"Elizabeth M S Lange, Paloma Toledo, Jillian Stariha, Josephine LiMandri, Derek Morley, Heather C Nixon","doi":"","DOIUrl":"","url":null,"abstract":"The ED50 and ED95 of spinal bupivacaine for cesarean delivery has been well described in the literature; however, parturients with extremes of stature have been excluded. Parturients of short stature are a height of ≤ 148 cm. This retrospective, case-control study evaluated anesthetic outcomes for parturients of short stature and controls who underwent cesarean delivery over a 10-year period. Women were matched for anesthetic type and body mass index. Data extracted included patient demographics and obstetric and anesthetic information. The primary outcome was dose of intrathecal bupivacaine. Categorical data were compared using a chi-squared test, continuous data were compared using a t-test or Mann-Whitney U test. Data for 26 women of short stature and 52 controls were evaluated. The mean dose of bupivacaine used for spinal anesthesia in parturients of short stature was 9.8 ± 1.0 mg (P <.0001). The mean intrathecal bupivacaine dose used in combined spinal epidural anesthesia was 10.5 mg (interquartile range, 9-10.9) in parturients of short stature (P = .002). All but one patient of short stature achieved an adequate surgical level; there were no instances of high spinal blockade. Adequate surgical anesthesia was achieved with reduced dosing of spinal bupivacaine in parturients of short stature without an increase in adverse outcomes.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 3","pages":"206-210"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9885247","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

Use of Single-Dose Dexamethasone in Patients With Diabetes Undergoing Surgery: A Systematic Review and Meta-Analysis. 单剂量地塞米松在糖尿病手术患者中的应用:系统回顾和荟萃分析

AANA journal Pub Date : 2023-06-01

Joshua C Sanders, Patrick K Russell, Tito D Tubog

{"title":"Use of Single-Dose Dexamethasone in Patients With Diabetes Undergoing Surgery: A Systematic Review and Meta-Analysis.","authors":"Joshua C Sanders, Patrick K Russell, Tito D Tubog","doi":"","DOIUrl":"","url":null,"abstract":"The purpose of this review was to examine the effect of single-dose dexamethasone on perioperative blood glucose in diabetic patients. We used PubMed, Cochrane Library, MEDLINE, CINAHL, Google Scholar, and grey literature for our search. Only randomized controlled trials were included. Risk ratio (RR) and mean difference (MD) were used to estimate outcomes with suitable effect models. Quality of evidence was assessed using the Risk of Bias and GRADE systems. We analyzed seven trials involving 1,321 patients. Diabetic patients treated with single-dose dexamethasone had statistically significant changes in blood glucose levels from baseline by 33.61 mg/dL (MD, 33.61; 95% CI, 17.59 to 49.63; P < .0001). Dexamethasone increased blood glucose levels 1-4 hours (MD, 29.02; 95% CI, 7.09 to 50.94; P = .010), 8-24 hours (MD, 30.81; 95% CI, 9.21 to 52.41; P = .005) after administration and increased risks of hyperglycemia. However, there was no difference in surgical site infection (SSI) (RR, 0.81; 95% CI, 0.59 to 1.11; P = .19). Effect size imprecision, substantial heterogeneity, and publication bias was the study's limitations. We found that single-dose dexamethasone increased glucose concentration 24 hours after surgery with little to no effect on SSI. Extrapolation of these findings to clinical settings must take into consideration the review's limitations.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 3","pages":"185-193"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9901387","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

Cervical Erector Spinae Plane Block for Giant Dermatofibrosarcoma Protuberans of Neck and Chest Wall: A Case Report. 颈胸壁巨大隆突性皮肤纤维肉瘤的颈竖脊平面阻滞1例。

AANA journal Pub Date : 2023-06-01

Kiran Mahendru, Nishkarsh Gupta, Krithika Rangarajan, Sunil Kumar, Sheragaru Hanumanthappa Chandrashekhara

引用次数: 0

Hemoglobin Louisville: A Case Report. 血红蛋白路易斯维尔:一个病例报告。

AANA journal Pub Date : 2023-04-01

Ionela Morosanu, Yaniv Ergas, Martina Cade, Mary Scott-Herring

引用次数: 0

Sustained Implementation of an Evidence-Based Extubation Checklist Reduced Extubation Failure in Trauma Patients. 持续实施循证拔管检查表减少创伤患者拔管失败。

AANA journal Pub Date : 2023-04-01

William O Howie, Benjamin A Howie, Miranda E Gibbons, Yvette Fouche'-Weber, George Zangaro, Patricia C McMullen, Peter Rock, Megan G Anders

引用次数: 0

Assessment Tools for the Evaluation of Simulation-Based Competency In Ultrasound-Guided Regional Anesthesia: An Integrative Review. 超声引导区域麻醉中基于模拟的能力评估工具:综合综述。

AANA journal Pub Date : 2023-04-01

Gail L Beutler Crawford, Bill Johnson, Hallie Evans

{"title":"Assessment Tools for the Evaluation of Simulation-Based Competency In Ultrasound-Guided Regional Anesthesia: An Integrative Review.","authors":"Gail L Beutler Crawford, Bill Johnson, Hallie Evans","doi":"","DOIUrl":"","url":null,"abstract":"Ultrasound-guided regional anesthesia (UGRA) requires the interaction of technical skills, manual dexterity, and cognitive knowledge which many novice anesthesia providers find challenging. Although simulation improves clinical competency and enhances patient safety, there is no standard tool for assessing UGRA competency in the simulation setting. Therefore, this integrative review aims to determine the most accurate, reliable, and feasible method of evaluating UGRA competency in a simulation environment. Strict inclusion and exclusion criteria were used to conduct this review, yielding 19 articles. The primary objective was the evaluation of validity and reliability outcomes of tools used to assess provider skill level. Secondary objectives were the evaluation of multirater agreement, internal and external reliability, and feasibility. Hand motion analysis and eye motion tracking demonstrated promising results, however, expense and training requirements limit widespread accessibility of those tools. The Regional Anesthesia Procedural Skills tool and McLeod checklist possessed discriminate ability of skill level, high interrater agreement, and feasibility in assessing psychometric competency in simulation. The Naik Global Rating Scale allows for assessment of nontechnical professional attributes. Based on the evidence of this review, the validity and reliability of these tools have the most utility as simulation-based competency tools compared with other tools reviewed.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 2","pages":"109-116"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9169047","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

Temporary Intraoperative Handoff Report Among Nurse Anesthetists: Utilization of Standardized Handoff Tools and Barriers to Implementation. 麻醉护士术中临时交接报告:标准化交接工具的使用和实施障碍。

AANA journal Pub Date : 2023-04-01

Rachael Allen, Candice Nemec, Crystal O'Guin, Suzanne Wright, Carrie Bowman Dalley

{"title":"Temporary Intraoperative Handoff Report Among Nurse Anesthetists: Utilization of Standardized Handoff Tools and Barriers to Implementation.","authors":"Rachael Allen, Candice Nemec, Crystal O'Guin, Suzanne Wright, Carrie Bowman Dalley","doi":"","DOIUrl":"","url":null,"abstract":"The demanding nature of the intraoperative period presents several distractions to anesthesia providers that can hinder effective communication. Implementation of intraoperative and postoperative standardized handoff protocols have improved provider communication; however, these protocols remain underutilized. While temporary anesthesia handoffs arise more frequently than permanent handoffs, limited data exist on how the specific transfer of care processes transpire. The purpose of this study was to explore the usage of standardized handoff tools among certified registered nurse anesthetists, as well as the barriers to implementation during temporary intraoperative handoff. Data from this exploratory mixed-methods study were collected using a 16-question voluntary electronic survey. Most participants (81.2%) reported that they do not use a standardized handoff tool during temporary handoff, but over half (57.1%) believed such tools should be used. Study participants who used a standardized handoff tool were significantly less likely to rank \"increases the time spent giving a handoff\" as an important barrier (48.6%) compared with those who did not use a tool (71.9%), ( X2(1) = 7.39, P = .007, V = .19). Failure to make standardized handoffs a facility standard of care and lack of reception by receiving anesthesia providers were also ranked as major barriers to implementation.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 2","pages":"130-136"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9169048","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

Entrustable Professional Activities: Can this Framework be Applied to Nurse Anesthesia Education to Assist in the Transition to Competency-Based Teaching? 可委托的专业活动：这一框架能否应用于麻醉护士教育，以协助向基于能力的教学过渡？

AANA journal Pub Date : 2023-04-01

Amy Yerdon, Kenneth Taylor

{"title":"Entrustable Professional Activities: Can this Framework be Applied to Nurse Anesthesia Education to Assist in the Transition to Competency-Based Teaching?","authors":"Amy Yerdon, Kenneth Taylor","doi":"","DOIUrl":"","url":null,"abstract":"Entrustable professional activities (EPAs) are the tasks or responsibilities which can be entrusted to a learner competent in that task to allow for unsupervised practice. The concept of EPAs is well documented in medical education literature, but only recently in nursing education. A paucity of literature exists on the application of an EPA framework specifically in nurse anesthesia. Based on the successful application of EPAs in competency-based medical and nursing education, we are of the opinion that this framework may also be utilized in the transition to competency-based education for nurse anesthesia learners. Many certified registered nurse anesthetists clinical preceptors lack training in competency-based education and teaching. The concept of EPAs may assist clinical preceptors in the translation of competencies and performance evaluation of learners. EPAs are defined for the nurse anesthesia clinical education setting. Examples of EPAs specific to nurse anesthesia include anesthesia machine checks, intubation, invasive line placement, regional anesthesia blocks, and preoperative assessment. Criteria of EPAs, barriers to use, and concrete examples are provided. Deliberate use of the EPA framework by clinical preceptors may lead to a more effective evaluation of the learner, thus resulting in purposeful progression to competence.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"91 2","pages":"8-13"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160261","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

Calendar of Events. 事件日历。

AANA journal Pub Date : 2023-04-01

引用次数: 0