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Nursing AND Perioperative

Li-Hua Luo, Zhu Chen, Li-Nan Hu, Cong Ma, En-Hua Xiao
PURPOSE: To investigate the effect of cold and room temperature tumescence anesthesia solution (TAS) on the treatment of lower limb varicose veins via endovenous laser ablation. DESIGN: On the basis of the TAS temperature, patients were divided into two groups: group A (n = 26) received room temperature (24°C) TAS, and group B (n = 25) received cold (4°C) TAS. METHODS: A numerical rating scale was used to evaluate pain. Perioperative and intraoperative nursing care and clinical observations were performed following a generalized standard...
October 8, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Gretchen Glaser, Sean C Dowdy, Abraham Peedicayil
Enhanced recovery protocols consist of a bundle of concepts including early feeding, opioid-sparing multimodal pain management, and euvolemia, with the overarching goal of hastening postoperative recovery. Enhanced recovery after surgery has been shown to reduce hospital length of stay, reduce costs, and decrease perioperative opioid requirements in benign and oncologic gynecologic surgery. Interventions without supporting evidence of benefit, such as the use of mechanical bowel preparation, routine use of nasogastric tubes and surgical drains, caloric restriction, routine use of intravenous opioid analgesics, and over-vigorous intravenous hydration should be discouraged to improve broader endpoints such as patient satisfaction and overall recovery...
October 2018: International Journal of Gynaecology and Obstetrics
Josh Zimmerman, Linda Shore-Lesserson
PURPOSE OF REVIEW: As our population ages and cardiovascular disease increases in prevalence, a growing number of patients will be candidates for coronary artery bypass grafting (CABG). Outcomes from this common surgery can be improved by a coordinated team approach involving physicians, nurses, and healthcare professionals from multiple specialties. This review will discuss the role cardiovascular anesthesiologists play in the perioperative care of these complex patients. RECENT FINDINGS: Cardiovascular anesthesiologists may play a variety of important roles throughout the entire perioperative period of patients undergoing CABG...
November 2018: Current Opinion in Cardiology
Izabela Leahy, Connor Johnson, Steven J Staffa, Reza Rahbar, Lynne R Ferrari
BACKGROUND: The Pediatric Perioperative Surgical Home (PPSH) model is an integrative care model designed to provide better patient care and value by shifting focus from the patient encounter level to the overarching surgical episode of care. So far, no PPSH model has targeted a complex airway disorder. It was hypothesized that the development of a PPSH for laryngeal cleft repair would reduce the high rates of postoperative resource utilization observed in this population. METHODS: Institutional review board approval was obtained for the purpose of data collection and analysis...
October 8, 2018: Anesthesia and Analgesia
Jingyi Liu, Natalia Gormley, Hormuzdiyar H Dasenbrock, Linda S Aglio, Timothy R Smith, William B Gormley, Faith C Robertson
BACKGROUND: Transitional care programs (TCPs) coordinate care to improve safety and efficiency surrounding hospital discharge. While TCPs have the potential to reduce hospital length of stay and readmissions, their financial implications are less well understood. OBJECTIVE: To perform a cost-benefit analysis of a previously published neurosurgical TCP implemented at an urban academic hospital from 2013 to 2015. METHODS: Patients received intensive preoperative education and framing of expectations for hospitalization, in-hospital discharge planning and medication reconciliation with a nurse educator, and a follow-up phone call postdischarge...
September 28, 2018: Neurosurgery
Sebastien Perbet, Franck Verdonk, Thomas Godet, Matthieu Jabaudon, Christian Chartier, Sophie Cayot, Renaud Guerin, Dominique Morand, Jean-Etienne Bazin, Emmanuel Futier, Bruno Pereira, Jean-Michel Constantin
CONTEXT: Low doses of ketamine are commonly used to decrease opiates tolerance, hyperalgesia and delirium in perioperative theatre but these properties have never been studied in intensive care unit (ICU) patients. PURPOSE: To determine the impact of ketamine infusion on opiates consumption when added to standard care in ICU patients requiring sedation for mechanical ventilation. METHODS: Patients admitted in a general ICU of a university hospital and undergoing mechanical ventilation (n = 162) with nurse-driven sedation protocol were randomly assigned into ketamine (2 mg/kg/h) or placebo in a double-blinded control trial...
September 27, 2018: Anaesthesia, Critical Care & Pain Medicine
Marilyn W Butler, Sandy Zarosinski, Dagmar Rockstroh
BACKGROUND: Inaccurate assignment of surgical wound class (SWC) remains a challenge in perioperative documentation. The purpose of our intervention was to increase the accuracy of SWC through a targeted training program directed toward pediatric surgeons and nurses. METHODS: A retrospective electronic medical record (EMR) chart review of 400 operations was performed according to NSQIP criteria during specified periods in 2014 and 2017, assessing SWC errors before and after a training program and posting of reference materials in operating rooms at a 165-bed children's hospital...
September 4, 2018: Journal of Pediatric Surgery
Jennifer Bezaire, Dorothy Thomson, Erick McNair
Patients with hemophilia A (Hem A) requiring cardiopulmonary bypass-supported cardiac surgery pose unique challenges for perioperative hemostatic management. This report describes a staged perioperative approach to clinical hematologic management as applied to an 80-year-old male of O-positive blood type with mild Hem A, who underwent successful, uncomplicated coronary artery bypass graft surgery. Hematologic management primarily consisted of normalization of plasma factor VIII levels followed by standard care...
September 2018: Journal of Extra-corporeal Technology
David C Cron, Jay S Lee, James M Dupree, John D Syrjamaki, Hsou Mei Hu, William C Palazzolo, Michael J Englesbe, Chad M Brummett, Jennifer F Waljee
OBJECTIVE: To characterize differences in postoperative opioid prescribing across surgical, nonsurgical, and advanced practice providers. BACKGROUND: There is a critical need to identify best practices around perioperative opioid prescribing. To date, differences in postoperative prescribing among providers are poorly understood. METHODS: This is a retrospective multicenter analysis of commercial insurance claims from a statewide quality collaborative...
September 20, 2018: Annals of Surgery
JoAnn Deselms, Laura Duvall, Shelley Ruyle
The purpose of this article was to report on the nurse liaison role developed at a 400-bed community hospital in response to a previously published best practice project on the effect of family visitation in the PACU on family member anxiety. The evidence resulted in the development of the nurse liaison role, which changed nursing practice and involved each area of perioperative services as we embarked on family-centered care (FCC). The nurse liaison program has served as a model for other hospital departments as well as area hospitals...
October 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Carla R Jungquist, Elizabeth Card, Jean Charchaflieh, Bhargavi Gali, Meltem Yilmaz
PURPOSE: To enhance the role of nursing interventions in the management of perioperative opioid-induced respiratory depression (OIRD) in patients with obstructive sleep apnea (OSA). DESIGN: Narrative review of the literature. METHODS: Literature reviewed with emphasis on recommendations by professional and accrediting organizations. FINDINGS: Postsurgical OIRD increases hospital stay (55%), cost of care (47%), 30-day readmission (36%), and inpatient mortality (3...
October 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Mary Frances Mullins
Malignant hyperthermia is an uncommon, but potentially lethal condition that may be encountered during the perioperative period. There is wide variability in the manner in which malignant hyperthermia may manifest. For a patient to survive a malignant hyperthermia crisis, prompt recognition and treatment is of paramount importance. Perioperative nurses play a pivotal role in the successful management of malignant hyperthermia. The fictitious case study presented in this paper describes the identification, presentation, pathophysiology, and treatment of a general anesthesia patient with fulminant malignant hyperthermia...
October 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Alexander T Yahanda, Nikolas E Marino, John Barron, Angela Concepcion, Theresa St John, Keyin Lu, Christopher Chermside-Scabbo, Bola Aladegbami, Will Ross, John Clohisy, John P Kirby
BACKGROUND: We designed two telemonitoring text and voice messaging interventions, EpxDecolonization (EpxDecol) and EpxWound, to improve management of orthopedic joint replacement patients at Washington University. We reviewed the use of these tools for a period of 88 weeks. METHODS: Cohorts of 1,392 and 1,753 participants completed EpxDecol and EpxWound, respectively. All patients who completed EpxDecol also completed EpxWound. We assessed patient use of and satisfaction with these interventions...
September 7, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
James T Carson, Sabin G Shah, Gezzer Ortega, Sorawut Thamyongkit, Erik A Hasenboehler, Babar Shafiq
Background: There have been no large-scale epidemiological studies of outcomes and perioperative complications in morbidly obese trauma patients who have sustained closed pelvic ring or acetabular fractures. We examined this population and compared their rate of inpatient complications with that of control patients. Methods: We retrospectively reviewed the records of patients treated for closed pelvic ring or acetabular fracture, aged 16-85 years, with Injury Severity Scores ≤15 from the National Trauma Data Bank Research Dataset for the years 2007 through 2010...
2018: Patient Safety in Surgery
Shufang Tan, Lifen Pan, Haixuan Zhao, Jiemin Hu, Huiyi Chen
Background: To investigate the value of the nursing cooperation workflow for immediate breast reconstruction with deep inferior epigastric perforator (DIEP) flap after breast cancer resection. Methods: The clinical data of 29 patients who had undergone immediate breast reconstruction with DIEP flap after breast cancer resection in our center from January 2016 to December 2017 were retrospectively analyzed. In particular, the nursing cooperation workflow was reviewed...
July 2018: Journal of Thoracic Disease
Morgan M Sellers, Ian Berger, Jennifer S Myers, Judy A Shea, Jon B Morris, Rachel R Kelz
OBJECTIVE: To examine patient safety event reporting behavior by trainees caring for surgical patients compared to other clinicians. DESIGN: Qualitative analysis of a patient safety event reporting system comparing reports entered by trainees to those entered by attending physicians and nurses. Categorical data associated with reports were compared, and free-text event descriptions underwent content analysis focusing on themes related to report completeness and report focus...
August 30, 2018: Journal of Surgical Education
Kristen A Oster
Acoustic neuromas, also known as vestibular schwannomas, are slow-growing, benign tumors that develop on the eighth cranial nerve. Common signs and symptoms of an acoustic neuroma include hearing loss and balance disturbances. A physical examination, a hearing evaluation, and diagnostic imaging assist in the diagnosis of an acoustic neuroma. Patients with a confirmed tumor have three treatment options: observation, stereotactic radiosurgery, and surgical removal. Complications include cerebrospinal fluid leakage, damage to ancillary brain structures, facial nerve damage, and bleeding or vascular injury...
August 2018: AORN Journal
Caroline A Dufault
Perioperative nurses care for patients undergoing a wide range of surgical procedures. One fast-growing surgical specialty is spine surgery performed using minimally invasive techniques. Patients may be candidates for minimally invasive spine surgery based on their presenting signs and symptoms and medical imaging test results. Open anterior and posterior surgical approaches to spine surgery are how surgeons traditionally have performed these procedures. However, new technology has enabled a minimally invasive lateral approach to the spine...
August 2018: AORN Journal
Mary C Fearon
No abstract text is available yet for this article.
August 2018: AORN Journal
Donna J Doyle
No abstract text is available yet for this article.
August 2018: AORN Journal
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