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Pre operative nurse

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https://www.readbyqxmd.com/read/29446494/prepared-for-surgery-communication-in-nurses-pre-operative-consultations-with-patients-undergoing-surgery-for-colorectal-cancer-after-a-person-centred-intervention
#1
M Pettersson, J Öhlen, F Friberg, L C Hydén, C Wallengren, E Sarenmalm, E Carlsson
AIMS AND OBJECTIVES: To describe preoperative communication after a person-centred intervention in nurses' consultations with patients undergoing surgery for colorectal cancer. BACKGROUND: Patients all over the world scheduled for surgery are referred for preoperative consultations with health care professionals. The goal is to assess the risk for perioperative complications, improving quality of care and enabling patients to be prepared for surgery and recovery...
February 15, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29443439/complexity-of-the-relationships-of-pain-posttraumatic-stress-and-depression-in-combat-injured-populations-an-integrative-review-to-inform-evidence-based-practice
#2
Nicholas A Giordano, Christine Bader, Therese S Richmond, Rosemary C Polomano
BACKGROUND: Understanding the complex interrelationships between combat injuries, physical health, and mental health symptoms is critical to addressing the healthcare needs of wounded military personnel and veterans. The relationship between injury characteristics, pain, posttraumatic stress disorder (PTSD), and depression among combat-injured military personnel is unique to modern conflicts and understudied in the nursing literature. AIM: This integrative review synthesizes clinical presentations and relationships of combat injury, PTSD, depression, and pain in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) United States military service members and veterans...
February 14, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29421469/negotiating-relevance-in-pre-operative-assessments
#3
Bethan Benwell, Catrin S Rhys
Preoperative assessments provide an essential clinical risk assessment aimed at identifying patient risks and requirements prior to surgery. As such they require effective and sensitive information-gathering skills. In addition to physical examination, the preoperative assessment includes a series of routine questions assessing a patient's fitness for surgery. These questions are typically designed to elicit minimal, 'no problem' responses, but patients sometimes produce expanded responses that extend beyond the projected information...
February 5, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29412440/precipitants-of-delirium-in-older-inpatients-admitted-in-surgery-for-post-fall-hip-fracture-an-observational-study
#4
E Levinoff, A Try, J Chabot, L Lee, D Zukor, O Beauchet
BACKGROUND: Hip fractures precipitate several acute adverse outcomes in elderly people, thus leading to chronic adverse outcomes. OBJECTIVES: The objective of our study was to examine the clinical characteristics associated with incident delirium in community dwelling elderly individuals who have a hip fracture. DESIGN: Retrospective observational cohort study. SETTING: Data was collected from an academic tertiary hospital affiliated with McGill University...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29406814/a-randomized-controlled-trial-of-video-education-versus-skill-demonstration-which-is-more-effective-in-teaching-sterile-surgical-technique
#5
Stephanie N Pilieci, Saad Y Salim, Daithi S Heffernan, Kamal M F Itani, Rachel G Khadaroo
BACKGROUND: Video education has many advantages over traditional education including efficiency, convenience, and individualized learning. Learning sterile surgical technique (SST) is imperative for medical students, because proper technique helps prevent surgical site infections (SSIs). We hypothesize that video education is at least as effective as traditional skill demonstration in teaching first-year medical students SST. METHODS: A video series was created to demonstrate SST ( https://www...
February 6, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29404987/enhanced-recovery-via-peripheral-nerve-block-for-open-hepatectomy
#6
Lucas W Thornblade, Yongwoo D Seo, Tracy Kwan, Jane H Cardoso, Eric Pan, Gregory Dembo, Raymond S W Yeung, James O Park
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now commonplace in many fields of surgery, but only limited data exists for their use in hepatobiliary surgery. We implemented standardized ERAS protocols for all open hepatectomies and replaced thoracic epidurals with a transversus abdominis plane (TAP) block. METHODS: We performed a retrospective cohort study of all patients undergoing open hepatectomy during the 14 months before and 19 months after implementation of an ERAS protocol at our institution (January 2014-September 2016)...
February 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29371162/associations-of-intraoperative-flow-disruptions-and-or-teamwork-during-robotic-assisted-radical-prostatectomy
#7
Matthias Weigl, Jeannette Weber, Elyse Hallett, Michael Pfandler, Boris Schlenker, Armin Becker, Ken Catchpole
OBJECTIVE: To identify type and severity of surgical flow disruptions and to determine their impact on the perception of intraoperative teamwork. METHODS: 40 radical prostatectomy cases were studied in an academic department for urology. A standardized observational tool for identification of type and severity of flow disruptions was applied during real-time prostatectomy procedures. Additionally, all OR team members evaluated intra-operative teamwork immediately after the procedure...
January 22, 2018: Urology
https://www.readbyqxmd.com/read/29369877/a-multidisciplinary-qi-initiative-to-improve-or-icu-handovers
#8
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/29337447/-geriatric-medicine
#9
Gabriel Gold, Christophe Büla, Pierre Olivier Lang, Philippe Chassagne
2017 highlights benefits of prevention. Better control of cardiovascular risk reduces the incidence of dementia and monthly high-dose vitamin D the incidence of respiratory infections in nursing home. Pre-operative geriatric assessment lowers by 20% the rate of delirium after hip-fracture surgery and complications in vascular surgery. Deleterious effects are also reported. High-dose vitamin D triples the rate of falls in supplemented residents and doesn't improve gait speed in sedentary men. Widely used in cardiovascular prevention, antithrombotic therapy is associated with an astonishing risk of subdural bleeding that further increases with the number of drugs combined together...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29330982/assessment-of-safety-levels-in-operation-rooms-at-two-major-tertiary-care-public-hospitals-of-karachi-safe-surgery-saves-life
#10
Muhammad Saeed Minhas, Muhammad Muzzammil, Jahanzeb Effendi
BACKGROUND: The objectives of this study are to determine the knowledge and attitude towards surgical safety among the health care professionals including surgeons, anaesthetist, hospital administrators, and operation room personnel and raise awareness towards the importance of safe surgery. METHODS: A pilot cross- sectional study of 543 healthcare providers working in the operating rooms and the surgical intensive care units was conducted in two tertiary care hospitals, within a study period of one month...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29325725/who-goes-to-inpatient-rehabilitation-or-skilled-nursing-facilities-unexpectedly-following-total-knee-arthroplasty
#11
Alexander J Rondon, Timothy L Tan, Max R Greenky, Karan Goswami, Noam Shohat, Jessica L Phillips, James J Purtill
BACKGROUND: Inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) represent a significant portion of post-operative expenses of bundled payments for total knee arthroplasty (TKA). Although many surgeons no longer routinely send patients to IRFs or SNFs, some patients are unable to be discharged directly home. This study identified patient factors for discharge to post-acute care facilities with an institutional protocol of discharging TKA patients home. METHODS: A retrospective review of patients undergoing primary unilateral TKA at a single institution from 2012 to 2017 was performed...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29318081/-hidden-preoperative-blood-loss-with-extracapsular-versus-intracapsular-hip-fractures-what-is-the-difference
#12
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29314751/emergency-airway-and-ventilator-procedures-for-community-based-home-care-staff-validation-of-an-educational-program
#13
Ann Marie Ramsey, Sarah Brennan, Adam Stricker, Kurt Riek, Dana Brown, Rachel Gurtowsky, Julie Sturza, Amy Goldstein Filbrun
BACKGROUND: Children discharged home with tracheostomy and chronic mechanical ventilator support are at high risk for complications and adverse events. Private duty nursing and home respiratory care services are a critical support necessary for successful discharge. The literature suggests that there are opportunities for home care staff (HCS) to improve upon the skills necessary to assess and intervene in an emergency thereby increasing the likelihood of improving long-term outcomes...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29299352/a-semi-automated-assessment-of-sarcopenia-using-psoas-area-and-density-predicts-outcomes-after-pancreaticoduodenectomy-for-pancreatic-malignancy
#14
Jukes P Namm, Kiran H Thakrar, Chi-Hsiung Wang, Susan J Stocker, Malini D Sur, Jonathan Berlin, William Dale, Mark S Talamonti, Kevin K Roggin
Background: Sarcopenia has been associated with increased adverse outcomes after major abdominal surgery. Sarcopenia defined as decreased muscle volume or increased fatty infiltration may be a proxy for frailty. In conjunction with other preoperative clinical risk factors, radiographic measures of sarcopenia using both muscle size and density may enhance prediction of outcomes after pancreaticoduodenectomy (PD) for malignancy. Methods: Preoperative computed tomography (CT) scans of patients undergoing PD for malignancy were analyzed from a prospective pancreatic surgery database...
December 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29284341/cerebral-perfusion-monitoring-in-adult-patients-following-cardiac-surgery-an-observational-study
#15
Tammy Slater, Julie Stanik-Hutt, Patricia Davidson
BACKGROUND: Strokes following adult cardiac surgery contribute to burdensome neurocognitive complications, which are often difficult to detect during the perioperative period. Fluctuations in regional cerebral perfusion and co-morbid conditions, such as hypertension, diabetes, prior stroke, symptomatic carotid stenosis, aortic atherosclerotic disease, and peripheral vascular disease are associated with perioperative strokes. Approaches to achieve optimal cerebral perfusion remain elusive and traditional strategies for perioperative monitoring are not always sufficiently sensitive to detect acute changes in cerebral perfusion...
December 28, 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/29274837/dedicated-operating-room-teams-and-clinical-outcomes-in-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#16
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/29258519/ethical-challenges-experienced-by-uk-military-medical-personnel-deployed-to-sierra-leone-operation-gritrock-during-the-2014-2015-ebola-outbreak-a-qualitative-study
#17
Heather Draper, Simon Jenkins
BACKGROUND: As part of its response to the 2014 Ebola outbreak in west Africa, the United Kingdom (UK) government established an Ebola treatment unit in Sierra Leone, staffed by military personnel. Little is known about the ethical challenges experienced by military medical staff on humanitarian deployment. We designed a qualitative study to explore this further with those who worked in the treatment unit. METHOD: Semi-structured, face-to-face and telephone interviews were conducted with 20 UK military personnel deployed between October 2014 and April 2015 in one of three roles in the Ebola treatment unit: clinician; nursing and nursing assistant; and other medical support work, including infection control and laboratory and mortuary services...
December 19, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29248159/an-effort-to-improve-the-accuracy-of-documented-surgical-wound-classifications
#18
Ryan E Chupp, Elango Edhayan
BACKGROUND: Discordance between circulating nurse- and surgeon diagnosis-based wound classifications may lead to erroneous risk-adjusted rates of surgical site infections with effects on inter-hospital rating, reimbursement, and public perceptions regarding quality of care. METHODS: After an initial two-month audit, we placed a wound class reference algorithm in each operating room and educated staff. An audit was repeated for a two-month period after this intervention...
December 2, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29243334/effects-of-a-targeted-blood-management-programme-on-allogeneic-blood-transfusion-in-abdominal-aortic-aneurysm-surgery
#19
M D Stoneham, S Von Kier, L Harvey, M Murphy
OBJECTIVES: To investigate the impact of a dedicated cell salvage practitioner team on blood loss and allogeneic transfusion in abdominal aortic aneurysm (AAA) surgery. BACKGROUND: Cell salvage reduces allogeneic transfusion in AAA surgery, but is commonly performed by the anaesthetic nurse. At our hospital, a dedicated patient blood management practitioner is present for all elective open AAA repairs. METHODS/MATERIALS: Data were collected on 171 AAA patients operated on at the John Radcliffe Hospital, Oxford over a 3-year period, looking at the Patient Blood Management processes, including: blood loss, cell salvage, near-patient testing (thrombelastography) and transfusion rates of allogeneic blood products...
December 15, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29156480/-frailty-prevalence-in-the-resident-population-of-germany-70%C3%A2-%C3%A2-79-years-of-age-a-population-based-approach
#20
Judith Fuchs, Markus Busch, Christa Scheidt-Nave
In all countries life expectancy is rising, and many older persons spend a longer period in good health. Nevertheless, frailty is present in older people and can be considered as a risk factor for limitations. The "German Health Interview and Examination Survey for Adults" (DEGS1) 2008 - 2011 comprised interviews, examinations and tests. Data on 1110 community-dwelling people aged 70 to 79 years participating in DEGS1 with full records on frailty were analysed. Physical frailty was defined as exhaustion (SF-36 item), low grip strength, slowness (Timed Up-and-Go test > 15 seconds or unable to perform) and low physical activity (no sports or exertion)...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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