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https://www.readbyqxmd.com/read/29465538/enhanced-recovery-after-surgery-eras-programs-for-esophagectomy-protocol-for-a-systematic-review-and-meta-analysis
#1
Feiyu Liu, Wei Wang, Chengde Wang, Xiaonu Peng
BACKGROUND: Esophageal cancer is one of the worst malignant digestive neoplasms with poor treatment outcomes. Esophagectomy plays an important role and offers a potential curable chance to these patients. However, esophagectomy with radical lymphadenectomy is known as one of the most invasive digestive surgeries which are associated with high morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition, and psychology, which is designed for reducing complications, promoting recovery, and improving treatment outcomes...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29428034/impact-of-trauma-certified-registered-nurse-anesthetists-team-on-intra-operative-resuscitation-and-postoperative-outcomes-of-trauma-patients
#2
Juan Duchesne, Chad Majoue, Marquinn Duke, Rosemarie Robledo, Chad Achord, Leslie McHale, Brandy Davis, Lusine Nahapetyan
A Trauma Certified Registered Nurse Anesthetists Team (TCT) was created and trained to provide trauma-focused anesthesia and resuscitation. The purpose of this study was to examine patient outcomes after implementation of TCT. We conducted retrospective analyses of trauma patients managed with surgical intervention from March to December 2015. During the first five months, patients managed before the development of TCT were grouped No-TCT, patients managed after were grouped TCT. To assess outcomes, we used hospital and intensive care unit length of stay, ventilator days, and a validated 10-point intraoperative Apgar score (IOAS)...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29421914/the-safety-of-deep-sedation-with-propofol-controlled-by-the-endoscopist-in-endoscopic-retrograde-cholangiopancreatography-ercp-a-prospective-study-in-a-tertiary-hospital
#3
Lara Luzón Solanas, Leticia Ollero Domenche, Eva María Sierra Moros, José Val Pérez, María Teresa Soria San Teodoro, Teresa Giménez Júlvez, Rafael Uribarrena Amezaga
INTRODUCTION: propofol administered by an endoscopist with a trained nurse has evolved as an alternative to anesthesia monitoring and is increasingly common in the routine clinical practice, even in advanced endoscopy. OBJECTIVE: to evaluate the safety of deep sedation with endoscopist-controlled propofol in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). MATERIAL AND METHODS: this was a prospective study in patients undergoing ERCP under deep sedation with propofol...
February 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29388247/association-between-provider-type-and-cesarean-birth-in-healthy-nulliparous-laboring-women-a-retrospective-cohort-study
#4
Nicole S Carlson, Elizabeth J Corwin, Teri L Hernandez, Elizabeth Holt, Nancy K Lowe, K Joseph Hurt
BACKGROUND: Term nulliparous women have the greatest variation across hospitals and providers in cesarean rates and therefore present an opportunity to improve quality through optimal care. We evaluated associations between provider type and mode of birth, including examination of intrapartum management in healthy, laboring nulliparous women. METHODS: Retrospective cohort study using prospectively collected perinatal data from a United States academic medical center (2005-2012)...
January 31, 2018: Birth
https://www.readbyqxmd.com/read/29369877/a-multidisciplinary-qi-initiative-to-improve-or-icu-handovers
#5
Dawn Krimminger, Carrie Sona, Elaine Thomas-Horton, Marilyn Schallom
: Background: Handover from the operating room (OR) staff to the ICU staff is a critical transition time for patients, in which the potential for error and miscommunication is high. Therefore, minimization of extraneous interruptions during the exchange of crucial information between the anesthesia and surgical teams and the nursing, respiratory therapy, and medical teams is imperative. OBJECTIVES: The aim of this quality improvement (QI) initiative was, first, to examine the impact of a standardized handover process between the OR and the ICU on process and information-sharing errors, and second, to examine provider satisfaction with the handover process...
February 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29362219/incentive-spirometry-adherence-a-national-survey-of-provider-perspectives
#6
Adam E M Eltorai, Grayson L Baird, Ashley Szabo Eltorai, Joshua Pangborn, Valentin Antoci, H Allethaire Cullen, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
BACKGROUND: Patient adherence is a critical factor for success of patient-administered therapies, including incentive spirometry (IS). Patient adherence with IS is not known, so we sought to evaluate providers'perspectives on the current state of IS adherence and elucidate possible factors hindering patient adherence. METHODS: Respiratory therapists (RTs) and nurses across the United States were surveyed via social media and online newsletters. Surveys were distributed to the relevant national RT and nursing societies: the American Association for Respiratory Care, the Academy of Medical-Surgical Nurses, the American Society of Peri-Anesthesia Nurses, and the American Association of Critical-Care Nurses...
January 23, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29362050/nurses-experience-of-patient-care-in-multibed-hospital-rooms-results-from-in-depth-interviews-with-nurses-after-further-education-in-anesthesia
#7
Ferid Krupic, Olof Sköldenberg, Kristian Samuelsson, Thomas Eisler
PURPOSE: The purpose of this study was to investigate and explore nurse's previous experiences of patient care in MBRs before their further education in anesthesia. DESIGN: Qualitative research. METHODS: Data were collected through three focus group interviews using content data analysis. FINDINGS: Maintaining patient privacy, providing conditions for communication between health care professionals and patients, and undertaking daily practical care were stated as the main problems in MBR care...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29362044/intrathecal-morphine-related-perioperative-hypothermia-in-women-undergoing-cesarean-delivery-a-retrospective-case-control-study
#8
Judy Munday, Sonya Osborne, Patsy Yates
PURPOSE: Rates of inadvertent perioperative hypothermia among women undergoing spinal anesthesia for cesarean delivery are reported to be high. Intrathecal morphine has been noted to have a potentially potent effect on thermoregulation. This retrospective case-control study sought to investigate the incidence of perioperative hypothermia in women undergoing cesarean delivery with and without intrathecal morphine and to describe any clinical factors associated with the condition, the identification of which would provide direction for nursing priorities in the care of the condition...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29343981/assessment-of-pain-score-and-specimen-adequacy-for-ultrasound-guided-fine-needle-aspiration-biopsy-of-thyroid-nodules
#9
Li-Jen Liao, Wu-Chia Lo, Wan-Lun Hsu, Po-Wen Cheng, Cheng-Ping Wang
Objective: The aim of this study was to evaluate pain scores and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules without and with local anesthesia (LA). Materials and methods: The US-FNAB procedure was performed on 183 patients with and without LA. One puncture was made for solid nodules, and if patients could tolerate it, a two-puncture technique was used for nodules with a cystic change. Four-point verbal rating scores were assessed by a nursing assistant after completion of US-FNAB...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29331398/critical-differences-between-elective-and-emergency-surgery-identifying-domains-for-quality-improvement-in-emergency-general-surgery
#10
Alexandra B Columbus, Megan A Morris, Elizabeth J Lilley, Alyssa F Harlow, Adil H Haider, Ali Salim, Joaquim M Havens
OBJECTIVE: The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. BACKGROUND: Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed...
January 10, 2018: Surgery
https://www.readbyqxmd.com/read/29329162/reorganizing-care-with-the-implementation-of-electronic-medical-records-a-time-motion-study-in-the-picu
#11
Nadia Roumeliotis, Geneviève Parisien, Sylvie Charette, Elizabeth Arpin, Fabrice Brunet, Philippe Jouvet
OBJECTIVES: To assess caregivers' patient care time before and after the implementation of a reorganization of care plan with electronic medical records. DESIGN: A prospective, observational, time-motion study. SETTING: A level 3 PICU. PARTICIPANTS: Nurses and orderlies caring for intubated patients during an 8-hour work shift before (2008-2009) and after (2016) implementation of reorganization of care in 2013. INTERVENTIONS: The reorganization plan included improved telecommunication for healthcare workers, increased tasks delegated to orderlies, and an ICU-specific electronic medical record (Intellispace Critical Care and Anesthesia information system, Philips Healthcare)...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29315137/reducing-ischemic-injury-from-indwelling-peripheral-arterial-catheters-in-a-pediatric-cardiac-icu-a-quality-improvement-initiative
#12
Adam C Adler, Stephanie Helman, Cynthia Field, Judith J Stellar, Lauren A Brown, Nicole Omensetter, Andrew T Costarino, Mahsun Yuerek, Karen S Bender
OBJECTIVES: To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease. DESIGN: This is a quality improvement study with pre- and postintervention groups. SETTING: University-affiliated pediatric cardiac center in a quaternary care freestanding children's hospital. PATIENTS: All patients with an indwelling peripheral arterial catheter placed in the Children's Hospital of Philadelphia Cardiac Center associated with an admission to the Cardiac Intensive Cardiac Unit from January 2015 to July 2017 are included...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29312839/safety-and-efficacy-of-the-use-of-intrathecal-morphine-for-spinal-three-column-osteotomy
#13
Jason R Audlin, Swamy Kurra, William Lavelle, Richard A Tallarico, Mike H Sun, Nathaniel R Ordway, Elizabeth A Demers Lavelle
Introduction The use of intrathecal morphine has the potential to help alleviate the pain that patients experience undergoing spinal surgeries. Complications can cause immobilization, which can lead to vascular thrombosis and ileus. Studies have shown epidural analgesia significantly lowered postoperative pain scores in scoliosis surgeries. Intrathecal anesthesia has been shown to have good pain control over the initial 24-hour postoperative period. Purpose Determine if intrathecal morphine would reduce postoperative pain with minimal side effects...
November 3, 2017: Curēus
https://www.readbyqxmd.com/read/29274837/dedicated-operating-room-teams-and-clinical-outcomes-in-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#14
Michael C Grant, Andrew Hanna, Andrew Benson, Deborah Hobson, Christopher L Wu, Christina T Yuan, Michael Rosen, Elizabeth C Wick
INTRODUCTION: To determine if the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery After Surgery (ERAS). ERAS programs involve the application of bundled best-practices to improve value of the perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. METHODS: Development of dedicated teams of anesthesia providers was a component of the ERAS implementation...
December 21, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29236837/construction-and-validation-of-a-nursing-care-protocol-in-anesthesia
#15
Cassiane de Santana Lemos, Vanessa de Brito Poveda, Aparecida de Cassia Giane Peniche
OBJECTIVE: To construct and validate a nursing care protocol in anesthesia. METHOD: methodological study of face and content validation, judging clarity, relevance, pertinence and comprehensiveness of a care protocol, elaborated from the integrative review of previous literature and based on the conceptual model of assistance perioperative nursing of Castellanos and Jouclas. The protocol was evaluated by five anesthesiologists and nurses from the surgical center...
December 11, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29233951/exposure-assessment-biological-monitoring-and-liver-function-tests-of-operating-room-personnel-exposed-to-halothane-in-hamedan-hospitals-west-of-iran
#16
Mohammad Hossien Bakhshaei, Abdorrahman Bahrami, Amin Mirzakhani, Hossien Mahjub, Mohammad Javad Assari
BACKGROUND: Occupational exposure to halogenated hydrocarbons has been associated with halothane hepatitis, an increase of liver enzymes, and congenital malformations. The objectives of this study were to investigate whether bromide, a urinary metabolite of halothane, could be used as a biological marker of exposure to this anesthetic gas and assessment of associated exposure to halothane with any significant changes in conventional parameters of liver function (serum aminotransferase activities)...
November 4, 2017: Journal of Research in Health Sciences
https://www.readbyqxmd.com/read/29223665/guidelines-and-checklists-for-short-term-missions-in-global-pediatric-surgery-recommendations-from-the-american-academy-of-pediatrics-delivery-of-surgical-care-global-health-subcommittee-american-pediatric-surgical-association-global-pediatric-surgery-committee
#17
REVIEW
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, J Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
INTRODUCTION: Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries (HICs) are increasingly engaged in resource-limited areas, with short-term missions (STMs) as the most common form of involvement. However, consensus recommendations currently do not exist for STMs in pediatric general surgery and associated perioperative care. METHODS: The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
November 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29215547/hypnosis-as-an-effective-and-inexpensive-option-to-control-pain-in-transcatheter-ablation-of-cardiac-arrhythmias
#18
Umberto Barbero, Federico Ferraris, Milena Muro, Carlo Budano, Matteo Anselmino, Fiorenzo Gaita
: Supportive care for pain relief and back discomfort during electrophysiology interventions is usually needed in the electrophysiology lab, especially in long-lasting procedures like atrial fibrillation ablation. Although this is usually achieved with conventional pharmacologic anesthesia, hypnosis has recently aroused interest as a reliable tool to complement and possibly enhance conscious sedation. We collected five case of percutaneous arrhythmia ablation in which, after informed consent, hypnosis was performed by nurse anesthetists in the cath lab...
January 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29211198/respiratory-status-of-adult-patients-in-the-postoperative-period-of-thoracic-or-upper-abdominal-surgeries
#19
Alana Gomes de Araujo Almeida, Lívia Maia Pascoal, Francisco Dimitre Rodrigo Pereira Santos, Pedro Martins Lima, Simony Fabíola Lopes Nunes, Vanessa Emille Carvalho de Sousa
OBJECTIVE: to evaluate the respiratory status of postoperative adult patients by assessing the nursing outcome Respiratory Status. METHOD: descriptive, cross-sectional study developed with 312 patients. Eighteen NOC indicators were assessed and rated using a Likert-scale questionnaire and definitions. Descriptive and correlative analysis were conducted. RESULTS: the most compromised clinical indicators were coughing (65.5%), auscultated breath sounds (55%), and respiratory rate (51...
December 4, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#20
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
January 17, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
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