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Nursing, perianesthesia pacu

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https://www.readbyqxmd.com/read/27444762/staff-developed-pacu-acuity-scoring-grid
#1
Ellen Halfpap
PURPOSE: The goal of this project was to design a tool to classify patients in the postanesthesia care unit (PACU) for acuity as defined by nursing interventions. DESIGN: An instrument development and validation approach was used. METHODS: A PACU acuity scoring grid was developed using the American Society of PeriAnesthesia Nurses (ASPAN) professional guidelines and Rothman Index concepts to help classify patients by acuity and determine PACU acuity class...
August 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/26847783/development-of-a-formalized-pediatric-visitation-program-in-the-pacu-through-evidence-based-practice
#2
Sheila Nadeau, Sandy Larson, Virginia Bennick, Tammy Bergan, Lisa Martin, Kim Senst, Sarah Griffith, Roxanne Wait
IDENTIFICATION OF THE PROBLEM: The national trend and 2003 American Society of PeriAnesthesia Nurses position statement supports visitation during Phase I care. Nurses at our institution had an inconsistent practice of rejoining families with their child during this period. PURPOSE: The purpose of this project was to investigate nurses' attitudes and beliefs toward family-centered care. A formalized pediatric visitation program was also created. METHODOLOGY: A survey was used to evaluate nurses' attitudes and beliefs regarding family-centered care...
February 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/25813297/decreasing-the-length-of-stay-in-phase-i-postanesthesia-care-unit-an-evidence-based-approach
#3
Janet M McLaren, Joan A Reynolds, Margaret M Cox, Julie S Lyall, Maureen McCarthy, Ellen M McNoble, Veronica R Petersen
Patient length of stay (LOS) in the postanesthesia care unit (PACU) Phase I and Phase II influences patient throughput, staff nurse satisfaction, and financial expenditure. The purpose of this project was to determine if re-education of nursing staff would decrease the LOS in Phase I PACU. The goals of the leadership team were to implement a plan that would result in a decreased LOS, decreased financial expenditure, increased patient throughput, and a change in culture of the work environment. Methods included re-education of nursing staff on American Society of Perianesthesia Nursing (ASPAN) Standards for patient care in Phase I and Phase II PACU...
April 2015: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/25541368/the-perioperative-handoff-protocol-evaluating-impacts-on-handoff-defects-and-provider-satisfaction-in-adult-perianesthesia-care-units
#4
Michelle A Petrovic, Hanan Aboumatar, Adam T Scholl, Randeep S Gill, Dina A Krenzischek, Melissa S Camp, Carolyn M Senger, Yi Deng, Tracy Y Chang, Yanjun Xie, Zahi R Jurdi, Elizabeth A Martinez
STUDY OBJECTIVE: To evaluate a new perioperative handoff protocol in the adult perianesthesia care units (PACUs). DESIGN: Prospective, unblinded cross-sectional study. SETTING: Perianesthesia care unit in a tertiary care facility serving 55,000 patients annually. PATIENTS: One hundred three surgery patients. INTERVENTIONS: During a 4-week preintervention phase, 53 perioperative handoffs were observed, and data were collected daily by a trained observer...
March 2015: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/25261142/a-cross-sectional-survey-study-of-nurses-self-assessed-competencies-in-obstetric-and-surgical-postanesthesia-care-units
#5
Mary Lou V H Greenfield, Denise D O'Brien, Susan K Kofflin, Jill M Mhyre
PURPOSE: The purpose of this study was to identify priorities to guide development of an obstetric PACU continuing education curriculum. DESIGN: A cross-sectional, survey design was used. METHODS: A total of 54 obstetric nurses and 68 perianesthesia Phase I nurses at an academic, tertiary care center completed online surveys for self-assessment of recent education, competency, and encounters with 14 topics related to postanesthesia nursing (eg, basic life support [BLS], advanced cardiac life support [ACLS], neonatal resuscitation, and the American Society of Perianesthesia Nurses' standards)...
October 2014: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/25062574/evaluation-and-control-of-waste-anesthetic-gases-in-the-postanesthesia-care-unit
#6
James D McGlothlin, John E Moenning, Sandra S Cole
BACKGROUND: Few studies have addressed waste anesthetic gases (WAGs) in the postanesthesia care unit (PACU) related to exhaled sevoflurane and nitrous oxide. PURPOSE: To evaluate the effectiveness of a new scavenging system to control WAGs in the PACU. DESIGN: Comparative and descriptive study. METHODS: This pilot study compared exposure to WAGs with and without a scavenging system using infrared technology to visualize and quantify exposure to these gases in the PACU...
August 2014: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/23021446/caring-for-the-patient-with-obstructive-sleep-apnea-implications-for-health-care-providers-in-postanesthesia-care
#7
Pamela D Diffee, Michelle M Beach, Norma G Cuellar
Obstructive sleep apnea (OSA) is a sleep disorder affecting 18 million Americans. The prevalence of OSA is increasing due to an epidemic rise in obesity, which is a major contributing factor. The primary treatment for OSA is continuous positive airway pressure, designed to maintain a patent airway for unobstructed breathing. OSA patients may experience postoperative hypoventilation due to residual anesthetic, analgesic requirements, and other comorbidities. Postoperative health care providers must be prepared to assess for hypoventilation and intervene using evidence-based interventions to improve outcomes...
October 2012: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/21402283/safety-huddles-in-the-pacu-when-a-patient-self-medicates
#8
Jill Setaro, Mary Connolly
The implementation of safety huddles in the PACU has been effective in enhancing and promoting patient safety during the recovery period. The case scenario presented in this article demonstrates how the safety huddle can be used to examine nursing care in the PACU. Allotting time each day to address patient-related issues that arise during patient care allows the team to troubleshoot and resolve clinical issues. Through examination of nursing practices in the recovery period, PACU nurses are able to support the best perianesthesia care possible...
April 2011: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/21276546/effect-of-infused-norepinephrine-dosage-on-pressure-ulcers-in-perianesthesia-care-unit-patients-a-pilot-study
#9
Agustín Medina-Concepción, María del Cristo Acosta-Ramos, Isabel Pérez-García, Abraham García-Díaz, Cristina Plasencia-Hernández, Auxiliadora Díaz-Melián, Alejandro Jiménez-Sosa
To determine whether treatment with moderate-high dose norepinephrine is a contributory cause increasing the risk of pressure ulcer development in critical postoperative, mechanically ventilated, hyperglycemic patients. A pilot clinical cohort study was conducted in a PACU in a tertiary hospital. A convenience sample of 16 hyperglycemic patients undergoing mechanical ventilation with at least 24 hours' stay in the PACU were divided into two groups of eight according to dosage of norepinephrine infusion at any moment during the days monitored...
February 2011: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/21276543/cardiac-arrest-in-the-pacu-an-analysis-of-evolving-challenges-for-perianesthesia-nursing
#10
Kristen Tallman, Satya Krishna Ramachandran, Robert Christensen, Denise O'Brien
Cardiac arrest in the PACU is a rare and poorly described event, with attendant limitations to experiential learning for the perianesthesia nurse. Good outcome from in-hospital cardiac arrest events differs partly because of variability in direct causes and clinical responses. Development of in-house training programs tailored to retain basic and advanced life support skills and enhance perianesthesia nurse responses to PACU arrests are essential to improving outcomes.
February 2011: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/19853815/effectiveness-of-the-essential-oils-lavender-and-ginger-in-promoting-children-s-comfort-in-a-perianesthesia-setting
#11
RANDOMIZED CONTROLLED TRIAL
DeeAnn Nord, John Belew
This randomized, controlled, blinded study examined the effectiveness of an aromatherapy intervention on the reduction of children's distress in a perianesthesia setting. The sample included children with and without developmental disabilities (n = 94). Subjects in the intervention group received an aromatherapy intervention of lavender and ginger essential oils. The control group received a placebo intervention of jojoba oil. Distress was measured at two times: before induction and in the PACU, using the Faces, Legs, Arms, Cry and Consolability (FLACC) scale...
October 2009: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/19500746/improving-patient-safety-by-understanding-past-experiences-in-day-surgery-and-pacu
#12
Jacqueline Ross, Darrell Ranum
Patient safety is a priority, yet little is understood regarding the nature of errors in the perianesthesia settings. The purpose of this claims analysis was to examine patient safety issues in the day surgery and PACU. A retrospective, exploratory design was used. Ninety-three patient safety cases were identified. Differences emerged between PACU and day surgery in regard to allegations and risk management issues. Thirty-nine percent of PACU and 25% of day surgery cases involved nurses as the primary responsible party...
June 2009: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/18926477/clinical-practice-and-routines-for-day-surgery-in-sweden-implications-for-improvement-in-nursing-interventions
#13
M Warrén Stomberg, M Segerdahl, N Rawal, J Jakobsson, M Brattwall
The purpose of this study was to examine nursing practice in day surgery settings in Sweden. A questionnaire focusing on the routines of the day surgery process of patients in Sweden was administered. Based on these findings, appropriate nursing interventions are outlined and discussed. Day surgery routines were in accordance with general worldwide practice. The study revealed that nursing involvement was rare in the preoperative routine. In addition, the major part of the recovery process, including assessments of discharge eligibility and information about pain management, was managed by PACU nurses...
October 2008: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/18039511/safe-staffing-for-the-post-anesthesia-care-unit-weighing-the-evidence-and-identifying-the-gaps
#14
REVIEW
Myrna E Mamaril, Ellen Sullivan, Theresa L Clifford, Robin Newhouse, Pamela E Windle
Postanesthesia nursing care and standards are continually evolving. ASPAN has the professional responsibility to develop standards of nursing practice to promote a safe environment of care. Currently, ASPAN's recommended staffing ratios are based on the best available evidence: expert opinion and consensus. Our Society believes that these nurse-to-patient ratios have served to provide safe, quality patient care. In 2006, the ASPAN Safe Staffing Strategic Work Team was charged with conducting a national PACU Safe Staffing Evidence-Based Practice (EBP) project...
December 2007: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/18039509/development-and-initial-testing-of-the-perianesthesia-safe-practices-instrument-an-aspan-pilot-study
#15
Pamela E Windle, Dina A Krenzischek, Myrna Mamaril
The perianesthesia environment of care is a unique high-risk health care setting that has a high susceptibility to error because of the vulnerability of patients who are undergoing surgery and anesthesia as well as the high levels of activity in these units. Safe practice in this environment is essential to quality patient care and positive patient outcomes. Consequently, ASPAN conducted a descriptive cross-sectional pilot study to test initial reliability and validity of the Perianesthesia Safe Practices Survey Instrument...
December 2007: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/17666297/a-case-of-pseudocholinesterase-deficiency-in-the-pacu
#16
REVIEW
Camille Lynette Leadingham
A 39-year-old patient with unrecognized atypical pseudocholinesterase was given succinylcholine during the rapid-sequence induction process and subsequently had a prolonged neuromuscular blockade. The patient was reassured, sedated, and ventilated in the postanesthesia care unit (PACU). The primary nursing interventions included airway clearance, communication, comfort, and patient education. Several important learning experiences occurred for the nurses in the PACU related to identifying possible causes, ordering the pseudocholinesterase and dibucaine inhibition test, interpreting the results, and developing and delivering patient education...
August 2007: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/17395076/perianesthesia-nurses-pain-management-after-tonsillectomy-and-adenoidectomy-pediatric-patient-outcomes
#17
Rodica Simona Pop, Renee C B Manworren, Cathie E Guzzetta, Linda S Hynan
Tonsillectomy and adenoidectomy (T and A) is a common, painful surgical procedure. The purpose of this descriptive-comparative study was to evaluate the effects of postanesthesia analgesic treatments on self-reported pain intensity, incidence of nausea and vomiting, and amount of oral fluid intake among pediatric patients after T and A. A total of 92 patients, 3 to 18 years old, received one of five analgesic treatments during their postoperative recovery: (1) intravenous fentanyl alone, (2) intravenous fentanyl in combination with an oral analgesic, (3) intravenous morphine alone, (4) intravenous morphine in combination with an oral analgesic, or (5) oral analgesics alone...
April 2007: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/17027442/detection-and-treatment-of-perioperative-corneal-abrasions
#18
REVIEW
Daniel D Moos, Diana M Lind
Corneal abrasion is the most common ocular injury occurring in the perioperative period. Corneal abrasion may occur during general anesthesia, monitored anesthesia care, regional anesthesia, or in the immediate recovery period. This injury is not usually apparent until the patient is in the PACU, and the perianesthesia nurse may be the first clinician to detect this complication. Preventive measures and vigilant care can help reduce the incidence of corneal abrasion in susceptible patients. Early detection and prompt intervention may help reduce the incidence of ocular morbidity...
October 2006: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/16387271/night-watch
#19
Kathy Carlson
In many hospitals, the postanesthesia care unit (PACU) functions 24 hours per day. Nurses "on-call" often cover nights, weekends, and holidays. It has been a struggle for some facilities to meet the American Society of PeriAnesthesia Nurses (ASPAN) standard of care that recommends 2 nurses be present whenever an anesthetized patient recovers in Phase I PACU. Recent practice issues of "holding" patients for inpatient beds, not transferring ICU patients, and admission of patients from the ER to the PACU has complicated staff coverage for the overnight hours in PACU...
December 2005: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/15933963/when-your-patient-is-from-the-obstetric-department-postpartum-hemorrhage-and-massive-transfusion
#20
REVIEW
Melanie Chichester
When caring for patients receiving massive transfusion, the nurse will be required to perform ongoing assessments and apply critical thinking to provide optimum care and avoid further complications. The perianesthesia nurse must be aware of the hemodynamic and coagulation changes of pregnancy when caring for an obstetric patient in the PACU to optimize patient outcomes. Understanding the causes of obstetric hemorrhage, which may result in the need for massive transfusion, will enable the nurse to anticipate and prevent potentially deadly complications...
June 2005: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
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