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Anesthetic nursing

Kyle T Leggott, Matthew Martin, David Sklar, Deborah Helitzer, Randy Rosett, Cameron Crandall, Firoz Vagh, Deana Mercer
INTRODUCTION: To provide insight into how an innovation in healthcare is implemented and diffused, we studied the transition from routine use of general anesthesia to peripheral nerve blocks (PNBs) for ambulatory orthopedic extremity surgery. Rogers' diffusion of innovations (DOI) theory was used as our theoretical framework. We identified themes that would be helpful for others attempting to diffuse innovations into healthcare settings. MATERIAL AND METHODS: A mixed quantitative and qualitative methodology was used...
September 2016: Healthcare
Rachel Myers, Jeanette Lozenski, Matthew Wyatt, Maria Peña, Kayla Northrop, Dhaval Bhavsar, Anthony Kovac
Pain and sedation management for patients undergoing burn dressing change can be challenging. Variations appear to exist in the selection of medications before and during burn dressing change. To determine if institutional variations exist in pain and sedation management for burn dressing change, an online survey was sent to ABA Burn Center nurses and physicians. Three hundred seventy-eight anonymous responses were received from nurses (72%), nurse practitioners (10%), and physicians (18%). Burn centers had adult (22%), pediatric (12%), or pediatric and adult (66%) patients...
August 18, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
James M Boiano, Andrea L Steege
Scavenging systems and administrative and work practice controls for minimizing occupational exposure to waste anesthetic gases have been recommended for many years. Anesthetic gases and vapors that are released or leak out during medical procedures are considered waste anesthetic gases. To better understand the extent recommended practices are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted in 2011 among members of professional practice organizations representing anesthesia care providers including physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants...
October 2, 2016: Journal of Occupational and Environmental Hygiene
James K Hamill, Andrew Liley, Andrew G Hill
OBJECTIVE: The aim of this study was to investigate the efficacy of intraperitoneal local anesthetic (IPLA) on pain after acute laparoscopic appendectomy in children. SUMMARY OF BACKGROUND: IPLA reduces pain in adult elective surgery. It has not been well studied in acute peritoneal inflammatory conditions. We hypothesized that IPLA would improve recovery in pediatric acute laparoscopic appendectomy. METHODS: This randomized controlled trial in acute laparoscopic appendectomy recruited children aged 8 to 14 years to receive 20 mL 0...
August 17, 2016: Annals of Surgery
Jessica Mayeux, Kathy Alwon, Shawn Collins, Ian Hewer
Blood loss during surgical procedures poses a grave risk to the patient, but transfusion is costly and associated with adverse outcomes. Antifibrinolytics, however, offer an economical and effective means of decreasing blood loss associated with surgical procedures. Tranexamic acid (TXA) is an antifibrinolytic that blocks lysine-binding sites of fibrinogen and fibrin, preventing the breakdown of existing clots. This journal course reviews extensive research demonstrating that antifibrinolytics such as TXA decrease blood loss and in some studies reduce allogeneic transfusion requirements...
June 2016: AANA Journal
Supinya Tiviraj, Bencharatana Yokubol, Somchai Amornyotin
OBJECTIVE: The study is aimed to develop and assess the quality of an evaluation form used to evaluate the nurse anesthetic trainees' skills in undertaking a pre-use check of an anesthetic machine. MATERIAL AND METHOD: An evaluation form comprising 25 items was developed, informed by the guidelines published by national anesthesiologist societies and refined to reflect the anesthetic machine used in our institution. The item-checking included the cylinder supplies and medical gas pipelines, vaporizer back bar, ventilator anesthetic breathing system, scavenging system and emergency back-up equipment...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Jariya Lertakyamanee
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Alix Zuleta-Alarcón, John C Coffman, Suren Soghomonyan, Thomas J Papadimos, Sergio D Bergese, Kenneth R Moran
PURPOSE: The objective of this narrative review is to provide an overview of the problem of non-opioid anesthetic drug abuse among anesthesia care providers (ACPs) and to describe current approaches to screening, therapy, and rehabilitation of ACPs suffering from non-opioid anesthetic drug abuse. SOURCE: We first performed a search of all literature available on PubMed prior to April 11, 2016. The search was limited to articles published in Spanish and English, and the following key words were used: anesthesiology, anesthesia personnel, AND substance-related disorders...
July 28, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Eun Jung Chang, Eun Ji Choi, Kyung Hoon Kim
Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the µ-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys...
July 2016: Korean Journal of Pain
Edwin N Aroke, Jennifer R Dungan
BACKGROUND: Monitoring a patient's response to drug therapy and early identification of an adverse reaction are important responsibilities of nurses. Despite the relative safety of anesthesia practice, 1 in 20 perioperative medication administrations includes a medication error and/or adverse drug reaction. Although several factors contribute to an individual's response to medications, genetic predisposition accounts for over 50% of that response. OBJECTIVE: The purpose of this review is to explore the evidence of genetic variability associated with response to volatile and intravenous anesthetics...
July 2016: Nursing Research
Mary Rachel Romero, Allison Staub
Perianesthesia nursing care involves monitoring of unexpected outcomes before and after surgical and anesthetic procedures. When adverse events occur, reviewing patient data is critical to provide appropriate intervention. Current EMR software systems are limited in structure and are not cohesive in recording adverse events. Users tend to develop workarounds when systems fail to capture workflow. Analysis of adverse incident is incomplete because data entered is not retrievable. Narrative data, while sometimes necessary, cannot easily be analyzed or linked to the structured portion of the record...
2016: Studies in Health Technology and Informatics
Regis Fuzier, Philippe Izard, Claire Cabos, Brigitte Chaminade, Jacques Pouymayou
Pain is a major concern for patients suffering from cancer. Although opioid drugs remain the gold standard for treatment of pain, little is known about the interest of continuous analgesia techniques as alternative. The aim of the present article is to detail the feasibility and to present the diversity of continuous perineural infusion of local anesthetic. A series of five patients suffering from different cancer-related pain is presented. A continuous perineural block was proposed to patients presenting with unbearable pain in an area innervated by a plexus or a nerve despite parenteral analgesic pharmacotherapy...
September 2016: Journal of Pain & Palliative Care Pharmacotherapy
Helle Teglgaard Lyk-Jensen, Peter Dieckmann, Lars Konge, Rikke Malene H G Jepsen, Lene Spanager, Doris Østergaard
Nontechnical skills are critical for good anesthetic practice but are seldom addressed explicitly in clinical training. The purposes of this study were (1) to evaluate the reliability and validity of the observation-based assessment tool Nurse Anaesthetists' Non-Technical Skills system (N-ANTS) and (2) to evaluate the effect of training nurse anesthetist supervisors in the use of N-ANTS. This system comprises a global rating score, 4 categories, and 15 elements to rate nurse anesthetists' nontechnical skills...
April 2016: AANA Journal
George M Saleh, James R Wawrzynski, Kamran Saha, Phillip Smith, Declan Flanagan, Melanie Hingorani, Clinton John, Paul Sullivan
IMPORTANCE: Human factors training can enhance teamworking and reduce error. It is used regularly in certain medical disciplines, but its use has not been established for ophthalmology to our knowledge. OBJECTIVE: To explore the feasibility of providing immersive simulation human factors training for ophthalmic surgical teams. DESIGN, SETTING, AND PARTICIPANTS: Prospective scenario-based simulation and concept description at University College London Hospital and Moorfields Eye Hospital, London, England, from December 12, 2013, to March 13, 2014...
August 1, 2016: JAMA Ophthalmology
Sara K Cheung, Timur Özelsel, Saifee Rashiq, Ban C Tsui
PURPOSE: This study was designed to compare waste anesthetic gas (WAG) concentrations within patients' breathing zones after removal of the patient's airway device in the postanesthesia care unit (PACU) vs in the operating room (OR). METHODS: Following Research Ethics Board approval and patient consent, we recruited patients undergoing surgery who received volatile anesthesia via an endotracheal tube or supraglottic airway. Patients had their airway device removed in the OR or in the PACU depending on the attending anesthesiologist's preference...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Rebecca E Rosenberg, Liana Klejmont, Meghan Gallen, Jackie Fuller, Christina Dugan, Wendy Budin, Ingrid Olsen-Gallagher
BACKGROUND AND OBJECTIVES: Pediatric procedural pain management (PPPM) is best practice but was inconsistent in our large multisite general academic medical center. We hypothesized that quality improvement (QI) methods would improve and standardize PPPM in our health system within inpatient pediatric units. We aimed to increase topical anesthetic use from 10% to 40%, improve nursing pediatric pain knowledge, and increase parent satisfaction around procedures for children admitted to a general tertiary academic medical center...
June 2016: Hospital Pediatrics
Douglas Kondziolka, Melissa LoPresti, Amy Tyburczy, Cassandra Golden, Timmy Seto, Lynda Boulio, Caitlyn Doody, Brian Yeh, Joshua Silverman
BACKGROUND: All physicians seek to improve the patient experience. In an awake surgical procedure, the patient has a unique opportunity to comment on all aspects of care. The provision of a positive experience is part of quality health care. Our purpose was to define this experience to determine areas for improvement. METHODS: We evaluated 125 patients who underwent stereotactic radiosurgery using a frame-based, gamma knife technique. Patients were surveyed by a nurse practitioner across all elements of their procedural experience prior to same-day discharge...
2016: Stereotactic and Functional Neurosurgery
Amanda C Faircloth, Arkadiy Dubovoy, Chuck Biddle, Diane Dodd-McCue, John F Butterworth
Background: Randomized controlled trials show that acupuncture and acupressure support anesthesia management by decreasing anxiety, opioid requirements, and treating post-operative nausea and vomiting. Acupuncture and acupressure have demonstrated clinical usefulness but have not yet diffused into mainstream anesthesia practice. To determine why, this study assessed U.S. anesthesia provider's perceptions of acupuncture and acupressure. Methods: After institutional review board approval, 96 anesthesiology departments stratified by geographic region (Northeast, South, West, and Midwest) and institution type (university medical centers, community hospitals, children's hospitals, and veterans affairs hospitals) were selected for participation in an anonymous, pretested, online survey...
April 1, 2016: Medical Acupuncture
David W Fabi
Hip fracture is one of the most common injuries among the elderly and, because the population is aging, it is expected to remain a major clinical challenge and public health problem for the foreseeable future. The clinical importance of early mobilization and prompt participation in physical therapy after hip fracture surgery is now widely recognized. Because postoperative pain can impair mobility and delay physical therapy, much attention is now being paid to finding more effective ways of controlling pain after hip fracture...
May 2016: Journal of Orthopaedic Trauma
Elizabeth van Veen-Berkx, Menno V van Dijk, Diederich C Cornelisse, Geert Kazemier, Fleur C Mokken
BACKGROUND: A new method of scheduling anesthesia-controlled time (ACT) was implemented on July 1, 2012 in an academic inpatient operating room (OR) department. This study examined the relationship between this new scheduling method and OR performance. The new method comprised the development of predetermined time frames per anesthetic technique based on historical data of the actual time needed for anesthesia induction and emergence. Seven "anesthesia scheduling packages" (0 to 6) were established...
August 2016: Journal of the American College of Surgeons
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