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1
Morrongiello, Laura Ann. "Cesarean section outcome in primiparous women receiving epidural anesthesia /." Staten Island, N.Y. : [s.n.], 1999. http://library.wagner.edu/theses/nursing/1999/thesis_nur_1999_morro_cesar.pdf.
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Ferrell, Cheyenne, and L. Lee Glenn. "Anesthesia Provider Fingerbreadth and Preoperative Airway Assessment." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7503.
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Anselm, Robin Lee. "Consensus in Anesthesia Handoff Reporting." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3929.
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Despite some improvement, no consensus exists to perfect quality in anesthesia handoff practice and policy. This quality improvement project was designed to assist a local anesthesia and perioperative workforce questioning the quality of its current handoff. Theories and models used to inform the project included the Inter-Professional Team Collaborative, Lewin's change theory, the continuous quality improvement theory, and the knowledge to action model. The communication assessment tool (CAT) functioned as a needs assessment yielding a gap in handoff practice of 25 participants. The CAT also served as the post project evaluation survey. The situation, background, assessment, and recommendation (SBAR) tool was preferred. Participants received SBAR education, and clinical evaluation experience (CEX) survey training. The CEX described the quality indicators of participant handovers during four consecutive weeks. Descriptive and inferential statistics used to analyze data collections included means and standard deviations, examining trends in the continuous level variables. Reliability of the CAT variables was evaluated through Cronbach's alpha test of internal consistency. Inferential analyses included independent sample t tests, Pearson correlations, and analyses of variance (ANOVAs). Statistical significance was evaluated at the conventional level, α = .05. The use of the SBAR handoff tool showed parity in communication competency. Quality indicators of overall handoff remained highly satisfactory. Recommendations include the consensual use of SBAR handoff and competency evaluation across the anesthesia community. Modification of handoff practices and policies will enable social change by promoting quality indicators in anesthesia collaborative communication.
4
Errichetti, Dianne. "A comparison study of maternal satisfaction of the birth experience and the use of epidural anesthesia /." Staten Island, N.Y. : [s.n.], 1993. http://library.wagner.edu/theses/nursing/1993/thesis_nur_1993_erric_compa.pdf.
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Seneca, Martha E. "Improving Anesthesia Professional Adherence to Hand Hygiene." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/502.
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Performance of hand hygiene is among the most effective means of preventing healthcare associated infections (HAI) among patients. Deaths resulting from HAIs are one of the top ten leading causes of death in the United States. Any improvement in the frequency of hand hygiene among healthcare professionals may have a direct impact on patient mortality and associated costs. While anesthesia professionals have been found to have low rates of hand hygiene adherence, few targeted studies seeking to improve hand hygiene adherence among this group exist. Studies conducted to improve hand hygiene among health care professionals have reported limited improvement, with overall inconclusive recommendations for improving prolonged hand hygiene adherence rates. The purpose of this project was to improve anesthesia professionals’ hand hygiene through encouragement of performance and education on the current state of research in the area of anesthesia associated HAIs. Hand hygiene rates were evaluated through measuring the amount of hand sanitizer used at eleven anesthesia workstations in the main operating room of a hospital. Measurements were taken at baseline and continued for three months after the educational program was implemented.
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Yale, Ninon. "Postcesarean pain : characteristics and relationship with surgical anesthesia." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61298.
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This study was designed to characterize postcesarean pain and examine its relationship with surgical anesthesia. Pain intensity was measured using a 0 to 10 numerical rating scale. The Short-Form McGill Pain Questionnaire was used to measure quality. The most common pain types reported were movement-associated and constant incisional pain (100% of subjects), gas pain (88.1%), and uterine contraction pain (83.3%). Each pain type differed in its intensity, duration and quality. Movement-associated incisional pain was the most intense and long-lasting pain type reported. On postoperative days 2 to 4, mothers who received complete epidural anesthesia during surgery reported less intense movement-associated incisional pain than those who received general or incomplete epidural anesthesia. However, statistical significance was not often obtained. These findings demonstrate the uniqueness of each pain type composing the postcesarean pain experience. The clinical data also support the hypothesis that epidural anesthesia diminishes the sustained hyperexcitability of the central nervous system caused by surgery.
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Harmon, debran L. "Anesthesia Safety: Filter Needle Use With Glass Ampules." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/538.
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Glass particle contamination of medication occurs when opening ampules which may cause patient harm. The use of filter needles reduces this risk. Many anesthesia providers use ampules daily, but do not use filter needles when aspirating medications from ampules. In addition, filter needles may not be readily available at the anesthesia medication preparation site. Not using filter needles or having them available for use can increase the risk of patient harm by glass particle contamination. The purpose of this project was to increase anesthesia provider’s knowledge thereby improving compliance with evidence-based standards when preparing medications from ampules. The goal is to increase filter needle use when medication is aspirated from an ampule in order to decrease the risk of glass particle contamination to the patient. This project consisted of a one-group pre/post intervention design using a piloted self-developed survey, an education intervention, and tracking of filter needle use. The convenience sample of eighty-three recruited anesthesia providers included anesthesiologists, nurse anesthetists, and anesthesiologist assistants that consented to participate. The filter needle inventory was tracked via an existing software program to determine filter needle use three months prior and three months after the intervention. Data were collected and analyzed using descriptive statistics. The results of this project found greater awareness among participants of standards and organizations regarding filter needle use with ampules, greater awareness of availability of filter needles on anesthesia carts, and a five-fold increase in filter needle usage by participants three months following the intervention as compared to three months prior to the intervention.
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Martens, Jennifer. "Certified Registered Nurse Anesthetists' Transition to Manager of an Anesthesia Department." Thesis, University of Michigan-Flint, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10680642.
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The purpose of this exploratory qualitative study was to identify experiences or barriers that arise during the first year as Certified Registered Nurse Anesthetists (CRNAs) transition into management and; if these shared experiences can prepare future CRNA managers by providing insight into what knowledge, skills, and abilities are necessary to ensure a smooth and successful career transition.
A representative sample by email and Facebook (FB) elicited 18 phone interviews of current and past Certified Registered Nurse Anesthetist (CRNA) managers. One interviewer asked 16 questions: seven demographic and nine open-ended. Survey information was (1) transcribed, (2) reviewed and de-identified, and (3) coded for content and classical analysis by two experienced independent coders. A coding tree was developed by coders after independent and random assessment of codes with an IRR (0.93). NVivo 11 software was used to assist with analysis of codes.
CRNA participants (66%) had less than five years of CRNA management experience, and 61% had no previous management experience or education before accepting their first role as a CRNA manager. An incidental finding, 83% of participants were reluctant managers and 76% of CRNA managers devoted greater than 50% of their time to performing clinical duties over managerial duties. Two resources that CRNA participants agreed were helpful resources during transition included: mentors (83%) and previous education or experiences (44%), especially in business, finance, or management. The skills CRNA participants believed were important during transition included people skills (56%), financial knowledge (33%), and communication (28%).
CRNA managers are more likely to be reluctant managers that may be relatively new in the role, and with no previous management experience or education. Recommendations for new CRNA managers during transition included; mastering “people skills,” either through relationship management or communication skills. Derailment may be avoided if new managers consider the results of this investigation.
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Stewart, Lois E. "An Evaluation of Critical Resources in Nurse Anesthesia Educational Programs." VCU Scholars Compass, 2017. https://scholarscompass.vcu.edu/etd/5173.
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Advanced practice nurses fill a vital need in the U.S. by increasing access to needed healthcare. Certified Registered Nurse Anesthetists (CRNAs) are one type of advanced practice nurse with a long history of safe and effective peri-anesthetic care. Nurse anesthetists have a rich tradition of providing anesthetic care for rural and underserved communities, and are a primary provider of anesthesia for active and retired military personnel. CRNAs comprise over one-half of the actively practicing U.S. anesthesia workforce currently, and are able to function in any anesthetic care model. Nurse anesthesia educational programs (NAEPs) are the single source for new graduate nurse anesthetists in the U.S.
Demographic, geographic and epidemiological factors have combined to produce a predicted increase in the demand for peri-operative anesthesia care among a complex, aging and increasing patient population. The uninterrupted or increased supply of CRNAs to the anesthesia workforce is important. The goal of this study was the production of a comprehensive analysis of potential resource constraints upon the NAEPs in the U.S. This was accomplished through a focused, prospective and correlational research design, grounded conceptually in Resource Dependence Theory. A novel survey tool was developed for the assessment of critical resource constraints, completed by U.S. NAEP administrators and faculty. This research was exploratory in nature and is the basis for continued work in critical resource planning tools for U.S. NAEPs.
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Ward, Robyn Camille. "Assessing the Validity and Reliability of Computer-based Case Simulations in a Nurse Anesthesia Specialty." Thesis, Rush University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10746481.
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Chronic pain has become a public health crisis in America, with subsequent high dependence on opioids. The use of nonsurgical pain management methods to treat pain is a viable alternative. Certified registered nurse anesthetists (CRNAs) have treated chronic pain patients with nonsurgical pain management methods for years, however, scope of practice and reimbursement issues over the past decade have threatened patients’ access to chronic pain care by CRNAs. As a result, the need for specialty certification in nonsurgical pain management became apparent. Assessing decision-making in healthcare professions with computerized simulation-based methods which aim to assess higher performance-based domains of competence have gained notoriety in recent years, however validity evidence is lacking. The purpose of this dissertation was to assess the validity and reliability of computer-based case simulations on the nonsurgical pain management certification examination for CRNAs who specialize in nonsurgical pain management. Computer-based case simulations, also known as clinical scenario items (CSIs), were developed by the National Board of Certification and Recertification for Nurse Anesthetists in 2013, and were tested for construct validity and internal consistency in this study. Miller’s pyramid was chosen as the theoretical framework based on its hierarchical progression of assessment methods from foundational knowledge to performance in practice. Data from a convenience sample of 32 examinees who took the nonsurgical pain management examination were utilized, and consisted of 134 multiple choice questions (MCQs) and 2 clinical scenario items (CSIs) per examinee. Exploratory factor analysis revealed two underlying factors in the assessment of knowledge using MCQs, and three factors in the assessment of decision-making using CSIs. Internal consistency reliability was low to moderate for all constructs. A weakly positive correlation between MCQ scores and CSI scores revealed a weakly modest validation that CSIs measure a higher construct of competence. Correlation between time in practice to MCQ scores and CSI scores were both nonsignificant, and demonstrated that more time in practice did not correlate with higher examination performance. This study demonstrated that competence is best evaluated by a multimodal approach, such as practice outcome data and peer attestations of competent performance.
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Bäck, Andreas, and Robin Augustsson. "Oönskad perioperativ hypotermi : En kvalitativ studie om anestesisjuksköterskans upplevelse." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-309.
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Många patienter blir hypoterma under den perioperativa vården. Det finns en mängd åtgärder som kan vidtas för att minska oönskad hypotermi. Pre- och intraoperativ uppvärmning med värmetäcke, varmt på operationssalen, cirkelsystem och användning av varma infusioner kan vara en bra kombination. Oavsett vilken terapi som används är normotermi alltid högt prioriterat. Det handlar om patientsäkerhet. Genom att effektivt motverka hypotermi skulle möjligheten öka till snabbare återhämtning, färre postoperativa infektioner, mindre kostnader för sjukhuset och minskat lidande för patienter. Syftet med studien var att undersöka anestesisjuksköterskans upplevelser av att förebygga perioperativ hypotermi hos vuxna elektiva patienter. En kvalitativ intervjustudie med induktiv ansats gjordes inom problemområdet. Insamlingen av data gjordes genom intervjuer som spelades in. Intervjuerna transkriberades och analyserades med kvalitativ innehållsanalys. I resultatet framkommer att, även om normotermi är målet och ambitionen finns, är det många faktorer som spelar in hur vida de hypotermiförebyggande åtgärderna når framgång. Det krävs en god planering samt erfarenhet av förebyggande arbete. Att mätmetoderna är ifrågasatta kan bidra till att mätning inte alltid utförs. Avsaknad av riktlinjer kring hypotermiförebyggande åtgärder bidrar till oklarheter för vårdpersonalen. Alla de olika personalkategorierna kring en operation tenderar att fokusera på sina egna uppgifter. En stor ansvarskänsla samt till viss del ensamhetskänsla i besluten, om vilka åtgärder som skall vidtas samt när finns hos anestesisjuksköterskan. När patienten blir kall trots att anestesisjuksköterskan har gjort allt kan det upplevas som ett misslyckande att inte räcka till. När patienten anländer kall till uppvaket kan anestesisjuksköterskan känna skuld till patientens tillstånd samt lidandet det medför. Strävan är att patienten ska må bra även postoperativt. Genom att informera patienten om varför det är nödvändigt att det tillförs extra värme gör att patienten blir delaktig i omvårdnaden. Anestesisjuksköterskan upplever att värmda täcken, strumpor samt mössa gör patienten mindre spänd samt stressad. På så vis ökar man patientens upplevs av välbefinnandet.
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Zeitz, Kathryn. "Post-operative observations, ritualised or vital in the detection of post-operative complications." Title page, contents and abstract only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phz483.pdf.
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Copy of author's previously published work inserted. Includes bibliographical references (leaves 273-283). Aims to identify if the current practice of post-operative vital sign collection detects complications in the first 24 hours after the patient has returned to the general ward setting using a combination of methods within a triangulated approach to data collection.
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Fishell, Royce A. "The Relationship Between Position and Incidence of Spinal Headache Following Spinal Anesthesia in the Young Adult Female." VCU Scholars Compass, 1988. http://scholarscompass.vcu.edu/etd/4550.
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This investigation determined the difference in the incidence of spinal headache in 33 patients placed in 30 degrees (°) head-up position versus 33 patients who remained flat for four hours following the administration of spinal anesthesia. An experimental design was used. The two randomly assigned groups presented for elective postpartum tubal ligation under spinal anesthesia. Group A was placed flat and group B had the head of their beds elevated 30° postoperatively. Strict procedural protocol was adhered to prior to and during the administration of the spinal anesthetic. To determine if the patients had any symptoms consistent with spinal headache, patients were visited postoperatively in the hospital and were contacted again on the seventh to ninth postoperative day. Pain in the frontal and/or occipital area which was aggravated by sitting up and relieved by lying down was used as the criteria for spinal headache. The data were analyzed using the Fisher Exact Test.
There was no statistically significant difference in the incidence of headache between the postpartum tubal ligation patients who were placed flat postoperatively and those who had the head of their bed elevated 30° (p = 1). The null hypothesis was therefore supported at p > .05. The findings support relaxing restrictions placed on patient's positioning following spinal anesthesia.
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Davidson, Zachary T., and L. Lee Glenn. "Postanesthesia Care Unit Visitation, Anxiety, and Experimental Design." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7487.
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The recent study by Carter et al1 concluded that “The results from this study support the value and importance of postanesthesia care unit (PACU) visitation for family members.” However, this conclusion is not supported by their study because of shortcomings in the control group and the weakness of the effect sizes, as explained below.
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Larsen, Kim M. "COMPARISON OF EPIDURAL AND INTRAVENOUS FENTANYL PATIENT-CONTROLLED ANALGESIA AFTER CESAREAN SECTION UNDER EPIDURAL ANESTHESIA WITH CHLOROPROCAINE." VCU Scholars Compass, 1997. https://scholarscompass.vcu.edu/etd/5134.
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This study compared two methods of postcesarean fentanyl patient- controlled analgesia (PCA). Fentanyl was administered intravenously (PCAI) or epidurally (PCAE) following cesarean section under epidural chloroprocaine anesthesia. Twenty-one ASA I and II parturients were randomly assigned to receive fentanyl PCAI (n = 9) or PCA (n = 12). At surgical completion fentanyl 1.0 mcg/kg was given and the PCA initiated with a dose of 30 mcg, a lockout interval of 10 minutes, a maximum dose of 180 mcg/hr, and no basal rate. Data were collected over 24 hours including visual analog scale (VAS) pain scores, plasma fentanyl levels, total fentanyl usage, and side effects.
Surgical time was significantly longer for the PCA, group (p = 0.0213). There was no difference in VAS scores until 24 hours when the PCAE group’s were significantly lower (p = 0.0295). The PCAE group almost always had lower VAS scores. Total fentanyl usage was significantly lower for the PCAE group (p = 0.050). There was no significant difference in plasma fentanyl levels, side effects, or patient satisfaction. The data revealed that both methods provided adequate postoperative analgesia and epidural fentanyl provided both local and systemic mediated analgesia.
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Piotrowski, Kathleen Ann. "A Feasibility Evaluation of a Digital Pen and Paper System for Accomplishing Electronic Anesthesia Record-keeping." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/202988.
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In 2001, the Institute of Medicine stated that one of the parameters needing to be addressed to improve health care was the creation of electronic health records for all patients. This goal has proven to be very challenging to health care providers. Many barriers exist that prevent the goal of computerizing health records such as high costs, usability problems, interface incompatibility, and fear of change. The purpose of this feasibility project was to evaluate the usefulness and acceptability of a digital pen and paper (DPP) system for anesthesia documentation. The specific DPP technology used in this evaluation was a product developed by Shareable Ink®. Seven certified registered nurse anesthetists (CRNAs) evaluated the DPP system through a cognitive walkthrough procedure. During the cognitive walkthrough, the participants talked aloud as they carried out a series of anesthesia documentation tasks. Just prior to the cognitive walkthrough, participants were given a questionnaire that measured their perceived computer knowledge, attitudes and skills. After the cognitive walkthrough, a second questionnaire was used to determine their satisfaction with the DPP and their opinions about its usefulness for use in multiple anesthesia work settings. In the second phase of the project, I interviewed other stakeholders in the hospital environment who would also be affected by implementation of a DPP system. This portion of the study was conducted at a community hospital without electronic record-keeping capability. Participation from several departments was sought via contact with hospital administration and department heads. Among those departments targeted for interviews were: Information Technology, Chief of Anesthesia, Anesthesia Billing, Medical Records and Nursing. Semi- structured interviews were conducted and the responses of the participants recorded both as field notes and via audio recording. This intent of this study was to test the feasibility of the digital pen and paper system for various types of anesthesia work environments by means of descriptive, survey and qualitative data analysis. Overall, the device was not only found to be usable by providers but also acceptable to stakeholders. Therefore, this device could be deemed a feasible solution toward implementing and adopting electronic documentation in some anesthesia work settings.
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King, Rickey Don. "Development of Emotional Intelligence Training for Certified Registered Nurse Anesthetists." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2091.
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Walden University
College of Health Sciences
This is to certify that the doctoral study by
Rickey King
has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.
Review Committee
Dr. Marisa Wilson, Committee Chairperson, Health Services Faculty
Dr. Murielle Beene, Committee Member, Health Services Faculty
Dr. Deborah Lewis, University Reviewer, Health Services Faculty
Chief Academic Officer
Eric Riedel, Ph.D.
Walden University
2015
Abstract
Development of Emotional Intelligence Training for Certified Registered Nurse Anesthetists
by
Rickey King
MSNA, Gooding Institute of Nurse Anesthesia, 2006
BSN, Jacksonville University, 2003
ASN, Oklahoma State University, 1988
Project Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Nursing Practice
Walden University
February 2016
The operating room is a high stress, high stakes, emotionally charged area with an interdisciplinary team that must work cohesively for the benefit of all. If an operating room staff does not understand those emotions, such a deficit can lead to decreased effective communication and an ineffectual response to problems. Emotional intelligence is a conceptual framework encompassing the ability to identify, assess, perceive, and manage emotions. The research question for this project is aimed at understanding how an educational intervention could help to improve the emotional intelligence of anesthetists and their ability to communicate with other operation room staff to produce effective problem solving. The purpose of this scholarly project was to design a 5-week evidence-based, educational intervention that will be implemented for 16 nurse anesthetists practicing in 3 rural hospitals in Southern Kentucky. The Emotional and Social Competency Inventory - University Edition will be offered to the nurse anesthetists prior to the educational intervention and 6 weeks post implementation to determine impact on the 12 core concepts of emotional intelligence which are categorized under self-awareness, social awareness, self-management, and relationship management. It is hoped that this project will improve emotional intelligence, which directly impacts interdisciplinary communication and produces effective problem solving and improved patient outcomes. The positive social change lies in the ability of the interdisciplinary participants to address stressful events benefitting patients, operating room personnel, and the anesthetist by decreasing negative outcomes and horizontal violence in the operating room.
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Norlin, Jonas, and Kristin Staffansdotter. "Upplevelsen av musik i en perioperativ vårdmiljö : En integrativ litteraturöversikt." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-24949.
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Att opereras under lokalanestesi innebär att patienten kan vara vaken under operationen, forskning visar på både positiva och negativa upplevelser av detta. Ångest och oro är påtagligt och att patienterna känner att de tappar kontrollen över situationen. Samtidigt är anestesisjuksköterskans roll viktig för att se och bekräfta patienten. Att låta patienten lyssna på musik kan vara ett verktyg som sjuksköterskan kan ta till, eftersom musik har kunnat minska ångest hos andra patientgrupper. Syftet med denna studie är att utforska upplevelser hos patienter som lyssnar på musik perioperativt i lokalanestesi. Den metod som används är en systematisk litteraturöversikt med en integrativ design. Resultatet baserades på 21 artiklar, varav 18 är kvantitativa och 3 kvalitativa. Studien utmynnar i fem teman; ångest, smärta, välbefinnande, coping och upplevelser utöver musiken. Musik påverkar patienternas ångest och smärta på olika sätt. Ofta lindras ångest och smärta men i flera studier har musiken ingen eller tveksam inverkan. Musiken har även effekter på patienternas välbefinnande och påverkar deras copingstrategi. Studien visar på viktiga upplevelser utöver musiken, där sjuksköterskans betydelse för patienten är framträdande. Musik visas öka patienternas välbefinnande men att sjuksköterskan har kännedom om hur smärtsamt och ångestladdat ett ingrepp är, kan vara angeläget för att inte lägga för stor tilltro till musikens effekt på patienten. Ytterligare forskning krävs för att få en ännu djupare förståelse och beskrivning av patienters upplevelse. Att även belysa olika ingrepps inverkan på patienternas upplevelse av musik, är av vikt.
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Mosier, Casey. "Pain management in the post anesthesia phase of nursing care: A systematic review of the literature." Kent State University Honors College / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors1304693745.
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Pabalate, Jonathan. "The Effect of Electronic Feedback on Anesthesia Providers' Timely Preoperative Antibiotic Administration." UNF Digital Commons, 2009. http://digitalcommons.unf.edu/etd/208.
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The growing presence of electronic anesthesia record keeping and perioperative informatics systems is contributing to a database of valuable information that can significantly improve patient care and patient outcomes. Efforts such as the National Surgical Quality Improvement Project and the Surgical Care Improvement Project have analyzed quality measures that directly correlate to patient outcomes. Several of these quality indicators are influenced by the performance of anesthesia providers’ activities in the perioperative period. These programs promote timely administration of preoperative antibiotics. One of their guidelines states that preoperative antibiotic should be given within an hour prior to surgical incision. Surgical site infections are the most common postoperative complication. Reducing postoperative complications can reduce health care costs, and postoperative morbidity and mortality rates. The purpose of this project was to utilize an electronic feedback mechanism to improve anesthesia providers’ documentation of timely preoperative antibiotic administration. Electronic feedback reminders in the form of screensaver dashboards displaying updated departmental timely antibiotic percentage metrics for the day, the past week, and the past month were displayed for 16 weeks. Text messages were delivered once a week for 6 weeks showing an anesthesia providers’ prior average one week on time antibiotic along with an equivalent department on time average. The measures were effective in improving the documentation of timely antibiotic administration.
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Lai, Yat-ming, and 黎一鳴. "The use of topical anesthesia to reduce pediatric IV cannulation pain in an emergency department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48335447.
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Intravenous cannulation of pediatric patients is a common procedure in emergency departments. It is a useful tool to facilitate medical investigations and drug administration. However, the pain induced by the procedure can lead to patient distress and bother the nursing and medical procedures afterwards. There are many kinds of topical anesthesia but no relevant evidence-based guideline for their use is available for the emergency departments. This dissertation synthesizes the available evidence in the literature to establish an evidence-based guideline for the use of topical anesthesia to reduce pain caused by pediatric intravenous cannulation in an emergency department. The communication, implementation and evaluation plan are also developed.
A systematic literature review was conducted from 30th August to 2nd September, 2011. A number of electronic databases, including PubMed, CINAHL Plus and Embase were searched. Thirteen eligible randomized controlled trials were identified. They were integrated into a table of evidence and were critically appraised by the SIGN Methodology Checklist. After synthesis of evidence, it is suggested that needleless anesthesia with apparatus assistance significantly reduced pain as early as in five minutes. Patients should however be observed for two hours after the administration of anesthesia for signs of adverse effects.
The implementation potential, in terms of the transferability, feasibility and cost-benefit ratio, was examined. Among the anesthesia devices, the Jet lidocaine device has satisfactory transferability, feasibility and cost-benefit ratio. The evidence is then translated into a practice guideline with the recommendations scored based on the “SIGN 50: A guideline developer’s handbook”.
A fourteen-month implementation plan,including a communication plan, a pilot study and an evaluation plan is developed. The communication phase lasts for three months and the stakeholders including the Chief of Service, Department Operation Manager, Advanced Practice Nurses, frontline healthcare professionals and the pharmacy department are identified. The pilot plan lasts for ten weeks, which includes a two-week training period, a three-week observational period for baseline measurement, a three-week intervention period and an eight-week amendment period. The pilot study collects data regarding the pain level at baseline and identifies unanticipated problems in the guideline. Amendments would be made accordingly and the revised guideline would be sent for ethical approval before the implementation phase.
In the evaluation plan, the primary outcome for the innovation is the level of pain. The secondary outcomes are the admission rate and length of hospital stay. Other outcomes are the satisfaction of healthcare professionals, utilization rate and cost. It is expected that the cannulation pain, admission rate and length of hospital stay would be lower with the application of topical anesthesia.published_or_final_version
Nursing Studies
Master
Master of Nursing
22
Weilenmann, Leni, and Anu Taina. "Anestesisjuksköterskans stöd till den födande kvinnan : Vid planerat kejsarsnitt i spinalanestesi." Thesis, Röda Korsets Högskola, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-286.
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Bakgrund: Kejsarsnitt har blivit vanligare, orsaken kan vara medicinska indikationer, men också förlossningsrädsla. Att kvinnor som föder barn vaginalt får en bättre upplevelse om de får stöd av en medmänniska är välkänt. Studier av kvinnor som föder barn med planerade kejsarsnitt visar att de också behöver stöd. Detta stöd ges framför allt av anestesisjuksköterskor eftersom barnmorskan är sterilklädd. Syfte: Syftet var att beskriva hur anestesisjuksköterskan ger stöd till den födande kvinnan vid planerat kejsarsnitt i spinalanestesi. Metod: En empirisk, deskriptiv studie med kvalitativ ansats genomfördes. Fem anestesisjuksköterskor intervjuades. Deras berättelser analyserades med kvalitativ innehållsanalys. Resultat: I resultatet framkom fem olika teman och tio subkategorier. Resultatet visar hur anestesisjuksköterskorna ger stöd. Temana var främja delaktighet (kommunicera, involvera närstående), värna integritet (stå bakom, dela födelsen), inge trygghet (vara närvarande, utstråla kompetens, teamarbete) och skapa relation (emotionellt engagemang, använda personligheten, känna in den unika patienten). Det femte temat produktionskrav beskriver de tidspressade förhållanden som gäller där anestesisjuksköterskorna ger stödet. Slutsats: Att ge stöd vid kejsarsnitt innebär att anestesisjuksköterskorna pendlar mellan närhet och distans till patienten, utifrån den unika patientens behov. Målet för stödet var att den blivande modern skulle kunna föda sitt barn lugn och trygg, tillsammans med sin närstående. Arbetsmiljö med flera kejsarsnitt per dag påverkar anestesisjuksköterskornas möjligheter att ge stöd. Klinisk betydelse: Denna studie avser att öka kunskapen om anestesisjuksköterskans stöd vid planerade kejsarsnitt. Detta är en pilotstudie som det kan vara värdefullt att reflektera kring som kliniskt verksam anestesisjuksköterska.Background: Caesarean section has become more common, the cause may be medical indications, but also fear of childbirth. It is well known that women who give birth vaginally have a better experience if they are supported by a fellow human being. Studies of women who give birth with planned caesarean section shows that they also need support. The purpose was to describe how the nurse anesthetist provides support to the woman in labor at elective caesarean section in spinal anesthesia. Method: An empirical, descriptive study with qualitative approach was conducted. Five nurse anesthetists were interviewed. Their stories were analyzed using qualitative content analysis. Results: The results revealed five different themes and ten subcategories. The results show how a nurse anesthetist provides support. Nurse anesthetists provide support by promoting participation, protect integrity, provide safety and build relationships. The fifth theme, which is called the production requirements, describes the time-strained circumstances of the place where nurse anesthetists provide support. Conclusion: Nurse anesthetists were prepared to provide support so that the mother could give birth to the baby while feeling safe and calm. Working environment with multiple caesarean sections per day affects nurse anesthetist capacity to provide support. Clinical significance: This study intends to increase awareness of the nurse anesthetist support for this form of childbirth. This is a pilot study that it may be useful for the clinically active nurse anesthetist to reflect on.
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Gebhardt, Pamela Gipe. "Reliability and validity of the Interchange of Gases Assessment Tool for monitoring the respiratory status of patients in the postanesthetic care unit." Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/144669.
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The purpose of this descriptive study was to evaluate, through clinical testing, the interrater reliability and concurrent validity of the Interchange of Gases Assessment Tool (IGAST) for monitoring the respiratory status of patients in the Postanesthesia Care Unit. The IGAST was used to assess the respiratory status of 20 patients over three time periods (60 data samples). Findings indicated that interrater reliability of the IGAST was acceptable for clinical use in the PACU. The IGAST received a mean interrater reliability rating of 98% in the PACU setting. Results of the mean dimension scores supported the patients' readiness for discharge. Chart audit revealed that the IGAST had concurrent validity since charted information and rated IGAST items were congruent. Further findings suggested that nurses using the IGAST document the respiratory status of patients more completely and more consistently than nurses using narrative documentation.
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Mogan, Susan. "A Clinical Practice Guideline for Pain Management in the Post Anesthesia Care Unit." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6247.
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Ineffective pain management in the post anesthesia care unit (PACU) increases patients' risk of adverse effects including decreased mobility, infection, chronic pain, depression, cardiopulmonary complications, increased length of stay, insomnia, fatigue, and overall decrease in quality of life. The PACU in a community hospital did not provide an evidence-based pain management guideline for nurses treating postoperative patients, resulting in nurses' concerns about providing pain management. The purpose of this project was to translate evidence on pain management into an evidence-based guideline for improved nursing practice in a PACU. Evidence was obtained from a detailed literature search using multiple databases and professional organizations' guidelines. Nursing practice guidelines were developed and evaluated by 3 expert panelists using the Agree II guidelines. The panelists selected included; Two anesthesiologists, one who is trained in pain management and is also a pharmacist. The third expert is a practicing nurse practitioner in an acute setting who is also a surgical first assist and the associate director of robotics. The panel endorsed the guidelines for advancement through the hospital's review committees. Implementation of the evidence-based pain management guideline in the PACU might provide nurses with tools to guide their interventions and improve patient outcomes. Social changes resulting from the use of evidence-based pain management guidelines include decreased time to opiate administration, decreased adverse effects, improved assessment of pain, and an increase in the number of patients who receive proper pain management.
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Barin, Fredrik, and Marianne Nygren. "Anestesisjuksköterskors erfarenheter av att förebygga hypotermi i samband med anestesi." Thesis, Luleå tekniska universitet, Omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-69099.
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Introduktion: Hypotermi är en av de vanligaste komplikationerna till anestesi. Konsekvenserna av hypotermi är bland annat rubbningar på koagulationen med ökad blödningsrisk, sårinfektioner och kardiella komplikationer. Patienter har beskrivit hypotermi som den värsta upplevelsen under sjukhusvistelsen och värderar det högre än den kirurgiska smärtan. Syfte: Att beskriva anestesisjuksköterskors erfarenheter av att förebygga hypotermi i samband med anestesi Metod: Studien har en kvalitativ ansats. Tio anestesisjuksköterskor, verksamma på en operationsavdelning i Västra Götalands län och Region Västernorrland medverkade i studien. Sjukhusen som inkluderades i studien liknade varandra till storlek och i vilken typ av ingrepp som utfördes där. Kvalitativa semistrukturerade intervjuer användes för att samla data och intervjuerna analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier och visar att förebyggandet av hypotermi är viktigt enligt anestesisjuksköterskor och att medvetenheten kring hypotermi och hur det förebyggs har ökat. Samtidigt beskrevs att mer skulle kunna göras. Anestesisjuksköterskorna upplevde att det finns bra rutiner som ökar tryggheten i förebyggandet av hypotermi. Det beskrevs dock som svårt att hinna hålla sig uppdaterad och vara på framkant i det senaste kring forskning. För att öka förutsättningarna och för att kunna vidareutveckla personalgruppen, i hypotermiförebyggande åtgärder, behövs ett ansvarsområde kring hypotermi. Slutsats: Kunskap, erfarenhet, forskning och samarbete i operationslaget är grundläggande förutsättningar för att hypotermi ska förebyggas på bästa sätt. Anestesisjuksköterskorna upplever inte hypotermi som något vardagsproblem, men menar att mer skulle kunna göras. Det behövs mer forskning på hur stor nytta ett särskilt ansvarsområde inom hypotermiprevention skulle utgöra.Background: Hypothermia is one of the most common complications of anesthesia. The consequences of hypothermia include disorders of coagulation with increased risk of bleeding, wound infections and cardiac complications. Patients have described hypothermia as the worst experience during hospitalization and value it higher than the surgical pain. Aim: The aim of this study was to describe the anesthesia nurse's experience in preventing hypothermia associated with anesthesia. Method: The study has a qualitative approach. Ten anesthesia nurses, active in an operations department in Västra Götaland county and the region of Västernorrland, participated in the study. The hospitals included in the study were similar in size and what type of surgery performed there. Qualitative semi- structured interviews were used to gather data and the interviews were analyzed with a qualitative content analysis. Results: The analysis resulted in three categories and shows that prevention of hypothermia is important according to the anesthesia nurses and that awareness about hypothermia and its prevention has increased. At the same time, it was described that more could be done. The anesthetic nurses felt that there are good practices that increase safety in the prevention of hypothermia. However, it was described as difficult to keep themselves up to date of the latest research. In order to increase the prerequisites and to further develop the staff group, in hypothermia prevention, a person responsible for hypothermia prevention is needed. Conclusion: Knowledge, experience, research and collaboration in the operations team are fundamental factors for preventing hypothermia in the patient, in the best possible way. The anesthetic nurses do not experience hypothermia as a daily problem but mean that more could be done, within that area. More research is needed regarding the usefulness of a person responsible for hypothermia prevention would represent.
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McLain, Nina E. "Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make A Difference?" Availabe to VCU users online at:, 2007. http://hdl.handle.net/10156/1778.
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Bonanno, Laura S. "Nurse Anesthesia Program Administrator's Decision-Making in Determining Interventions for a Student Exhibiting Unsatisfactory Clinical Performance." ScholarWorks@UNO, 2019. https://scholarworks.uno.edu/td/2587.
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The purpose of this grounded theory study is to define the process that nurse anesthesia program administrators use to determine if a student nurse anesthetist’s unsatisfactory clinical performance warrants intervention by the program. There is little room for error in anesthesia practice as mishaps typically result in significant injury and death. Students who exhibit unsatisfactory clinical performance may pose an immediate risk to patient safety as well as a future risk if allowed to progress in the program. The lack of guidance in the form of clearly articulated expectations and processes contribute to the emotional strain nurse anesthesia faculty and administrators experience when observing unsatisfactory clinical performance. From the data collected in the interviews with ten nurse anesthesia program administrators, a five-phase decision-making model entitled the Nurse Anesthesia Program Administrator Decision Making Model was developed. The five phases of the model include: receiving the feedback, validating the concern, assessing accountability and planning for remediation, removing the student from clinical training and moving to dismissal, and notifying the student of the decision. The guiding principle of this model is the importance of following institutional and program policies throughout the process. This study is intended to provide guidance to nurse anesthesia program administrators who are faced with a student demonstrating unsatisfactory clinical performance regarding what behaviors may require an intervention by the program.
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Gülich, Sofia, and Linda Stöt. "Anestesisjuksköterskans möte med den vuxna oroliga patienten : En intervjustudie." Thesis, Umeå universitet, Institutionen för omvårdnad, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-117916.
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Syftet med studien var att beskriva anestesisjuksköterskors upplevelse av möten med vuxna patienter som är oroliga inför generell anestesi. Bakgrund Att sövas innebär för de flesta patienter någon form av oro. För anestesisjukskö- terskor innebär det att på kort tid skapa ett möte där patienter känner trygghet, tillit och där- med mindre oro. Detta är en utmaning då det idag är ett högt flöde av patienter som ska ope- reras, samtidigt som det ställs höga krav på en säker vård där alla patienter ska mötas utifrån sina egna förutsättningar. Få studier har gjorts angående patienters oro utifrån anestesisjuk- sköterskornas perspektiv och är motiveringen till denna studie. Design Studien genomfördes med en kvalitativ design med induktiv ansats. Metod Deltagarna valdes ut med ett ändamålsenligt urval. Datainsamlingen bestod av semi- strukturerade intervjuer med anestesisjuksköterskor på två sjukhus i norra Sverige. Intervjuer- na transkriberades och analyserades med en kvalitativ innehållsanalys. Resultat Elva intervjuer genomfördes under hösten 2015. Analysen av materialet mynnade ut i ett tema med titeln ”Vara professionell”. Temat bestod av fem kategorier med benämningen ”Att lyckas med ett möte”, ”Att se patienternas oro”, ”Att bemöta patienternas oro”, ”Att på- verkas av mötet” och ”Att samarbeta och utvecklas”. Slutsats Anestesisjuksköterskorna upplevde att det i mötena med vuxna oroliga patienter handlade om att vara professionell i sin yrkesutövning. Att vara professionell inkluderade många områden, bland annat inställning, förhållningssätt och att sträva efter samma mål, detta för att kunna se och bemöta patienternas oro.The aim of this study was to describe anesthetic nurses experiences, when interacting with adult patients that expresses anxiety in regards to their upcoming general anesthesia. Background: To undergo general anesthesia, is for most people, associated with some anxie- ty. The anesthetic nurse only has a limited time to build the patient ́s trust, and to try to relieve the anxiety and apprehension for the upcoming anesthesia. This is now becoming a bigger challenge, due to an increase in patient flow and stricter patient safety regulations, including requirements regarding patient centerdness. There has only been a limited number of studies looking at patient ́s pre-anesthetic anxiety, from a nursing perspective, hence the purpose of this study. Design: A qualitative research design with an inductive approach. Methods: The participants in this study were chosen based on their work. The data collection consisted of semi-structured interviews with anesthetic nurses at two hospitals in northern Sweden. The interviews were transcribed and analyzed using a qualitative content method. Findings: Eleven interviews were conducted during the autumn of 2015. When analyzing the material, a theme ”Be professional” was established. This was further divided to five catego- ries entitled: “How to succeed with a patient interaction”, “To acknowledge patient ́s anxie- ty”, “To master the patient ́s anxiety”, “To be affected by the interaction” and “To cooperate and develop professionally. Conclusion: The anesthetic nurses emphasized the importance of professionalism when deal- ing with anxious pre-anesthetic patients. This professionalism encompasses a number of dif- ferent attributes such as attitude, approach and to work towards a common goal, to acknowledge and address patients concerns and anxiety.
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Larsson, Mauleon Annika. "Care for the elderly : a challenge in the anaesthesia context /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-209-8/.
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Allisson, Anna. "Anestesisjuksköterskans omvårdnadsstrategier i samband med patienters oro inför generell anestesi." Thesis, Högskolan i Halmstad, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-26852.
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Det är välkänt att patienter känner oro inför generell anestesi vilket utgör ett problem i den anestesiologiska omvårdnaden. Studier gjorda över olika decennier visar att över 80 % av patienter som ska genomgå operation känner oro inför generell anestesi. Det patienter känner oro inför är exempelvis att tappa kontrollen, vakna under anestesin, att inte vakna efter operationen, erhålla perifer venkateter och lång väntan. Anestesisjuksköterskan träffar patienten först i det preoperativa samtalet och ska då under några minuter identifiera patientens oro samt planera omvårdnadsåtgärderna för att försöka lindra den. Detta medför ett stort behov av adekvata omvårdnadsåtgärder som kan hjälpa patienten lindra sin oro. Syftet med studien var att beskriva anestesisjuksköterskans omvårdnadsstrategier för att lindra patientens oro inför generell anestesi. Studien har en deskriptiv kvalitativ design med semistrukturerade intervjuer som datainsamlingsmetod. Studien innefattade intervjuer med fyra verksamma anestesisjuksköterskor på ett sjukhus i västra Sverige. Efter dataanalysen framkom två kategorier som beskriver anestesisjuksköterskans omvårdnadsstrategier preoperativt för att lindra patientens oro inför generell anestesi. En spridning av studiens material kan kanske öka medvetenheten om användningen av olika omvårdnadsstrategier. Detta skulle i sin tur kunna bidra till att lindra den preoperativa oron inför generell anestesi.It is well-known that patients feel anxious about general anesthesia and that makes a problem in the nursing of anesthesia. Studies made over decades show that over 80% of the patients undergoing operation feel anxious about general anesthesia. Patients feel anxious about to lose control, wake up during the operation, never wake up, to get a needle and to wait long. The anesthesia nurse sees the patient at the first time in the preoperative meeting and have to identify anxiety and plan the nursing strategies in a few minutes. This lead to a large need of adequate nursing strategies which can mitigate patients anxiety. The aim of this study was to describe nursing strategies preoperative to mitigate patients anxiety before general anesthesia. The study has a descriptive qualitative design and semi structured interviews were used to collect data. The study was based on four working anesthesia nurses in a hospital in the west of Sweden. After the analysis two categories were identified to describe the nursing strategies to ease the patients anxiety before operation. The results of the study can get around and add the consciousness to use different nursing strategies. This could in turn conduct to help patients ease the preoperative anxiety before general anesthesia.
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Timo, Niemi, and Eklund Josef. "Svårigheter vid luftvägshantering av vuxna patienter med obesitas : En litteraturöversikt." Thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-148410.
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Bakgrund: Övervikt och fetma är ett globalt växande problem. Specialistsjuksköterskor med inriktning anestesisjukvård måste ha god kännedom om de anatomiska, fysiologiska och psykologiska förändringar som fetma medför för att kunna erbjuda säker vård till denna patientgrupp. Syfte: Att identifiera svårigheter vid hantering av luftvägen hos vuxna patienter med obesitas. Metod: En systematisk litteraturöversikt med syntes utfördes. Analysen av insamlad data har skett enligt mall av Statens beredning för medicinsk och social utvärdering (SBU). Syntesen och analysen har genererat två huvudområden. Resultat: Två huvudsakliga områden som alla har betydelse och påverkas av obesitas har identifierats. De områden som framkommit är maskventilation och intubation, Under dessa kategorier presenteras försvårande faktorer vid anestesi till patienten med obesitas, som stort nackomfång, minskad rörlighet i käken samt hög mallampatiklass. Konklusion: Den här litteraturstudien har identifierat svårigheter som anestesisjuksköterskan i sitt dagliga arbete kan ställas inför i mötet med den obesa patienten. Med kännedom om dessa svårigheter kan anestesisjuksköterskan skapa strategier för en anpassad och säker vård till även den obesa patienten.Background: Obesity and obesity are a global growing problem. Specialist nurses with anesthetic care focus need to have a good knowledge of the anatomical, physiological and psychological changes that obesity causes to provide safe care to this patient group. Purpose: To identify difficulties in managing the airway in adults patients with obesity. Method: A systematic literature review with synthesis was performed. The analysis of collected data has been carried out according to the template of the Swedish Medical and Social Assessment (SBU) preparation. The synthesis of the analysis has generated two main areas. Results: Two main areas all of which are important and affected by obesity have been identified. The areas identified are mask ventilation and intubation. Under these categories, aggravating factors in anesthesia are presented to the patient with obesity, such as high neck circumference, reduced jaw movement, and high mallampathy class. Conclusion: This literature study has identified difficulties that the anesthetist nurse in his daily work can face in the meeting with the obese patient. Knowing these difficulties, the anesthesia nurse can create strategies for a customized and safe care to the obese patient.
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Jansson, Anna, and Rikard Andersson. "Patientens perioperativa upplevelse vid regional anestesi : En intervjustudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-323553.
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Bakgrund: Regional anestesi innebär att patienten är vaken men bedövad under det kirurgiska ingreppet. Detta blir allt vanligare då metoden innebär flertalet fördelar, både medicinsk och ur ett patientperspektiv. Det är anestesisjuksköterskans uppgift att se till att patienten känner sig trygg under det kirurgiska ingreppet. Tidigare forskning visar på att sjuksköterskan under regional anestesi bör vara närvarande, engagerad och hela tiden ha kontakt med patienten. Genom att aktivt lyssna och kommunicera samt ge god information uppnås en bra kontakt. Syfte: Syftet med denna studie var att undersöka patientens perioperativa upplevelse vid regional anestesi. Metod: För denna studie valdes en kvalitativ inriktning med deskriptiv ansats. Ett lämplighetsurval gjordes på en ortopedavdelning med patienter som genomgått en operation i regional anestesi. Tio patienter inkluderades i studien. Semistrukturerade intervjuer med delvis öppna frågor användes. Intervjuerna analyserades med en kvalitativ innehållsanalys. Resultat: Analysen resulterade i fyra teman samt sex kategorier. Dessa teman var; Att uppleva negativa känslor, Preoperativa tankar, Perioperativ kommunikation samt professionellt bemötande. Kategorierna bestod av upplevelse av smärta och obehag, känslan av nervositet och övergivenhet, förväntningar, önskemål och delaktighet, information, känsla av säkerhet och trygghet samt att få ett bra bemötande. Slutsats: Denna studie, i enlighet med tidigare forskning visar på att patienter i högre grad upplevde trygghet vid regional anestesi när anestesisjuksköterskan informerar och hela tiden är närvarande hos patienten. Är anestesisjuksköterskan frånvarande minskar patientens känsla av trygghet och den regionala anestesin kan bli en negativ upplevelse.Background: Regional anesthesia is becoming more common in surgical procedures, as the method involves several benefits, both from the patient's perspective and from a medical perspective. It is the task of the nurse anesthesia to ensure that the patient feels safe. Previous research shows that the nurse anesthesia should be present, committed and constantly in contact with the patient. By actively listening and communicating as well as providing valuable information, a good contact is achieved. If the nurse anesthetist is successful in this, the experience of regional anesthesia can be a good one. Aim: The aim of this study was to investigate the patient's perioperative experience in regional anesthesia. Methods: A qualitative study with a descriptive approach. An aptitude selection was conducted in an orthopedic department with patients undergoing surgery in regional anesthesia. Ten patients were included in the study. Semi-structured interviews with partially open questions were used. The interviews were analyzed with a qualitative content analysis. Results: The analysis resulted in four themes as well as six categories. These themes were; To experience negative feelings, Preoperative thoughts, Perioperative communication as well as Professional treatment. The categories consisted of experience of pain and discomfort, feeling of nervousness and abandonment, expectations, wishes and participation, information, a sense of safety and security, and to get a good treatment. Conclusions: Previous research shows, as does this study, that a nurse anesthesia who informs and is constantly present at the operation room will make the patient feel safer. If the nurse anesthesia is absenting the patient's sense of safety decreases and regional anesthesia can be a negative experience.
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Maloy, Debra A. "An Educational Intervention to Promote Self-management and Professional Socialization in Graduate Nurse Anesthesia Students." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc822767/.
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Traditionally, nurse anesthesia educators have utilized prior academic achievement to predict student success. However, research has indicated that prior academic achievement offers an inadequate assessment of student success in graduate healthcare programs with extensive clinical residencies. The educational literature has identified many non-cognitive factors, such as self-efficacy and locus of control, that may provide a more holistic prediction model of student success. An experimental study with pretest-posttest design and stratified random assignment was conducted to evaluate the effectiveness of an educational intervention to promote self-management, professional socialization, and academic achievement among first semester graduate nurse anesthesia students. Participants (N = 66) were demographically similar to the national graduate nurse anesthesia student body, though Hispanics and younger students were a little over-represented in the sample (56% female, 75.8% White, 15.2% Hispanic, 6% Other, 59% ≤ 30-years-old, 67% ≤ 3 years of ICU). The results showed that most graduate anesthesia students had strong self-management and professional socialization characteristics on admission. The results did not support the effectiveness of this educational intervention. Thus, ceiling effect may have accounted in part for statistically non-significant results regarding self-efficacy (p = .190, ω2 = .03), locus of control (p = .137, ω2 = .04), professional socialization (p = .819, ω2 = .001), and academic achievement (p = .689, ω2 = .003). Future researchers may need to expand the scope of the intervention, use a more powerful and sensitive instrument, and utilize a larger sample.
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Aastrup, Minna, and Tyra Bergström. "Sjuksköterskans postoperativa omhändertagande av patienter som genomgått generell narkos." Thesis, University of Skövde, School of Life Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-108.
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Tidigare forskning visar att patienter har olika behov postoperativt, det är sjuksköterskans uppgift att anpassa omvårdnaden till individen. Patienter har postoperativt ett extra stort behov av information. Sjuksköterskor och patienter har olika åsikter om vilka behov som ska tillgodoses först. Sjuksköterskan anser att kompetenta vårdgivare, smärtlindring och den behandling som vårdpersonal ger ska prioriteras först. Det viktigaste för patienterna var kompetenta vårdgivare, kommunikation samt god omvårdnad. Syftet med studien är att beskriva sjuksköterskans postoperativa omhändertagande av patienter som genomgått generell narkos och vårdas på kirurgavdelning. Studien har en kvalitativ ansats. Datamaterialet har samlats in genom semistrukturerade intervjuer. Sex sjuksköterskor intervjuades. Resultatet visar att information är en viktig aspekt i omhändertagandet, både när det gäller att informera patienter om vad som ska ske och vad som sker men också information som patienten själv lämnar till sjuksköterskan om tillståndet. Det är även viktigt att det finns ett fungerande informationsutbyte mellan olika vårdgivare. Ett fungerande samarbete mellan vårdpersonalen och även mellan patient och sjuksköterska behövs för att det ska bli ett bra omhändertagande. Vården som ges ska anpassas efter varje individ och dennes behov. Slutligen anser sjuksköterskorna det vara av vikt att vara lyhörd för patienternas smärttillstånd.
Studies have shown that the care should be adapted to the individual patient. The postoperative patient has a special need for information. The postoperative needs are ranked different by nurses and patients. Nurses find that competent caregivers, pain relief and the treatment should be a high priority. Patients feel that competent caregivers, communication and a good care are the most important needs that they have in the postoperative setting. The aim of this study is to describe nurses postoperative care of patients who has undergone a general anesthesia and who is treated at surgical ward. The study has a qualitative approach. The data has been collected through semistructural interviews. Six nurses have been interviewed. This study shows that information is an important aspect in the patients care. It is important to inform the patient about what is going to happen and what has happened, the patient should also inform the nurse about their condition. There should also be a communication between the different caregivers. Is it also essential that the nurses are attentive to the patients pain. Collaboration between caregivers and between the nurse and patient is vital for a good care. The care should be adapted to the individual needs of the patients.
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Reda, Elaine. "Instrumento de registro utilizado na avaliação em sala de recuperação pós-anestésica: importância na continuidade da assistência ao paciente cirúrgico." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-03102006-083440/.
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Este estudo tem como objetivo geral conhecer a avaliação, feita pelos enfermeiros das unidades pós-operatórias, a respeito da continuidade da assistência de enfermagem ao paciente cirúrgico. Como objetivos específicos, o seu propósito é identificar não só as dificuldades apresentadas pelos enfermeiros na obtenção dos dados clínicos referentes ao período de recuperação pós-anestésica como também indicar a melhor estratégia para obter os dados clínicos necessários para a continuidade da assistência de enfermagem ao paciente cirúrgico, após receber alta da sala de recuperação pós-anestésica, além de levantar os dados clínicos, referentes ao período de recuperação pós-anestésica, considerados necessários para o planejamento da assistência de enfermagem no período pós-operatório. A amostra foi constituída por enfermeiros, de duas instituições hospitalares identificadas por I e II, localizadas no interior do Estado de São Paulo, que assistem pacientes provenientes da recuperação pós-anestésica. Procedeu-se à coleta de dados, no período de julho a agosto de 2005, utilizando-se um formulário, a fim de contemplar o objetivo deste estudo. Os resultados mostraram que, no Hospital I, as dificuldades mais freqüentes, que interferem na obtenção dos dados clínicos do paciente referente ao período de recuperação pós-anestésica, foram, com 22 (84,62%) relatos cada: ausência do instrumento no prontuário e ausência da passagem de plantão por telefone, seguidas da ausência de informações necessárias no instrumento 19 (73,08%); preenchimento incompleto do instrumento 12 (46,15%) e passagem incompleta de plantão por telefone 2 (7,69%). No Hospital II destacaram-se: preenchimento incompleto do instrumento 25 (75,76%), seguidas da ausência de informações necessárias no instrumento 19 (57,58%). E com 18 (54,55%) relatos cada: ausência do instrumento no prontuário; ausência da passagem de plantão por telefone e passagem incompleta de plantão por telefone 2 (7,69%). No Hospital II destacaram-se: preenchimento incompleto do instrumento 25 (75,76%), seguidas da ausência de informações necessárias no instrumento 19 (57,58%). E com 18 (54,55%) relatos cada: ausência do instrumento no prontuário; ausência da passagem de plantão por telefone e passagem incompleta de plantão por telefone. No Hospital I, a melhor estratégia para se obter informações do paciente com alta da recuperação pós-anestésica foi um instrumento de registro associado à passagem de plantão por telefone 17 (65,38%), enquanto que no Hospital II a maioria, 20 enfermeiros (60,61%), agregou os diversos meios de se obter informações. Dentre os dados clínicos considerados necessários, pelos enfermeiros que não consultavam esse instrumento, no Hospital I, destacaram-se as características dos curativos e drenos, nível de consciência, controle das sondas, sinais vitais e acesso venoso. No Hospital II destacaram-se sinais vitais e características dos drenos, seguidos de curativos, saturação de oxigênio e exame físico. Quanto aos enfermeiros que o consultaram, 8 (30,77%) do Hospital I e 21 (63,64%) do Hospital II, foram de opinião que os dados clínicos presentes neste instrumento eram extremamente importantes, com exceção dos parâmetros referentes à temperatura e pulso que, no Hospital I, apresentaram diferenças de opinião quanto ao nível de importância (extremamente importante e muito importante). Sendo assim, observa-se que, nos dois hospitais estudados, o instrumento de registro, meio concreto de comunicação, auxilia no planejamento, promove a continuidade, é um indicador de qualidade e um meio de documentar o cuidado com o paciente.This study has the main objective to know the valuation, done by nurses in the post-operator units, to continue giving nursing assistance to the chirurgical patient. As specific objectives it has the purpose to identify not only the difficulties presented by the nurses to obtain the clinical data referring to the post-anesthetic period but also to indicate the best strategy to get the clinical data necessary to continue the nursing assistance to the chirurgical patient after receiving discharge of the post-anesthetic recovery room, besides uplifting clinical data, referring to the post-anesthetic recovery period, considered necessary to plan the nursing assistance in the post-operator period. The sample was constituted by nurses in two hospitals identified by I and II, located in the State of São Paulo inland, Brazil which assist patients deriving from post-anesthetic recovery. During July to August 2005, the data collection was conducted, using a formulary in order to contemplate the objective of this study. The results showed that, at the Hospital I, the most frequent difficulties, that interfere in the acquisition of the patient\'s clinical data referred to the post-anesthetic period were, with 22 (85, 62%) reports each: absence of the instrument in the formulary and also absence of the duty passage by telephone, followed by the absence of information necessary in the instrument 19 (73,08%); incomplete fulfilling of the instrument 12 (46,15%) and incomplete duty passage by telephone 2 (7,69%). It was distinguished at the Hospital II: incomplete fulfilling of the instrument 25 (75,76%), followed by absence of information necessary in the instrument 19 (57,58%). And with 18 (54,55%) reports each: absence of the instrument in the formulary; absence in the duty passage by telephone and incomplete duty passage by telephone. At the Hospital I, the best strategy to obtain patient\'s information with discharge from the post-anesthetic recovery was an instrument of register associated to the duty passage by telephone 17 (65, 38%), while at the Hospital II the majority, 20 nurses (60,61%), added diverse ways to obtain information. Among the clinical data considered necessary by the nurses who did not consult this instrument, at the Hospital I, the characteristics of the bandaging and drains; level of consciousness; control of probes; vital signals and vein access were distinguished. At the Hospital II: vital signals and characteristics of the drains, followed by bandaging; saturation of oxygen and physical exam. As to the nurses who have consulted it, 8 (30,77%) at the Hospital I and 21 (63,64%) at the Hospital II, they had the opinion that the clinical data presented in this instrument were extremely important, with exception of the parameters referred to temperature and pulse that, at the Hospital I, presented differences of opinion as to the level of importance (extremely important and very important). So, it was observed that in the two hospitals the instrument of register, a concrete way of communication, helps the planning, promotes the continuity, it is a quality indicator and a way to prove the care with the patient.
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Brage, Olivia, and Sara Berglund. "Hyperoxygenering : – I vilken utsträckning exponeras patienter för höga syrgaskoncentrationer under anestesi?" Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-325645.
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Det har under en längre tid funnits en stor vilja att under den perioperativa fasen ge patienter höga koncentrationer av syrgas med motiveringen att förbättra vävnadsperfusion och därmed den postoperativa återhämtningen. Nyare studier har påvisat de komplikationer vilka hyperoxygenering skulle kunna medföra i form av ökad mortalitet och morbiditet. Syftet med föreliggande studie var att undersöka huruvida patienter utsätts för hyperoxygenering peroperativt. Studien inkluderade 100 patienter och har genomförts genom en deskriptiv retrospektiv journalgranskning med tillägg av jämförande analyser mellan de undersökta operationsavdelningarna. Huvudresultat för studien var att samtliga undersökta operationsavdelningar hyperoxygenerade patienter under anestesi. För hela det undersökta underlaget uppmättes medelvärdet av parametern maximalt PaO2 till 30,7 ±11,7 kPa och medelvärdet av det genomsnittligt inspiratoriska FiO2 uppmättes till 45,5 ±7,6 %. Det högst uppmätta PaO2-värdet var vid en av de undersökta operationsavdelningarna 66,5 kPa. Slutsatsen vilken kan dras av denna studie är att patienter som undergår anestesi hyperoxygeneras till en nivå som visats innebära ökade risker och hyperoxygenering skulle potentiellt kunna vara ett större peroperativt problem än vad som idag är känt.For a long period of time, there has been a great desire to provide high concentrations of oxygen in patients during the perioperative phase with the motivation to improve tissue perfusion and postoperative recovery. Recent studies have shown that hyperoxygenation may result in complications such as increased mortality and morbidity. The purpose of the present study was to investigate if patients are exposed to hyperoxygenation perioperatively. The study included 100 patients and was conducted through a descriptive retrospective journal review, with the addition of comparative analyzes between the investigated surgical departments. The main result of the study was that all investigated surgical departments hyperoxygenated patients under anesthesia. For the entire sample material examined, the average parameter of the substrate PaO2 was measured to 30.7 ±11.7 kPa, and the mean of the average inspirational FiO2 was measured to 45,5 ±7,6 %. The highest measured PaO2 value at one of the surgical departments being investigated was 66,5 kPa. In conclusion, the results from this study shows that patients undergoing anesthesia are presently being hyperoxygenated up to a level associated with increased risks, and that hyperoxygenation potentially is a greater peroperative problem than currently known.
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Ballard, Kacy C. "IMPLEMENTATION OF AN EDUCATIONAL SESSION TO IMPROVE COMPLIANCE OF REPORTING MEDICATION ERRORS AND NEAR MISSES AMONG ANESTHESIA PROVIDERS." Otterbein University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1459975850.
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Fischhaber, Josephine, and Albèr Bjarne Larsson. "Musik och dess inverkan på oro i samband med anestesi och operation." Thesis, Luleå tekniska universitet, Omvårdnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-80053.
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Bakgrund: Forskning har visat att det är vanligt att uppleva oro inför en operation och anestesi. Oro kan präglas av nervositet, oroliga tankar och fysiologiska reaktioner. De fysiologiska reaktionerna är de samma som vid en stressreaktion, vilket kan påverka den intra- och postoperativa utgången. Att använda musik i operationsförloppet ses som en omvårdnadsintervention, vilken kan användas av anestesisjuksköterskan för att lindra patienters oro. Syfte: Syftet med denna litteraturöversikt är att sammanställa det aktuella forskningsläget avseende musik som omvårdnadsintervention med avsikt att minska oro i samband med anestesi och operation samt att sammanställa vilka typer av interventioner som ger bäst oroslindrande effekt. Metod: En litteraturöversikt med integrativ design genomfördes. Sökningarna genomfördes under 2020 i databaserna PubMed och CINAHL; artiklar som var peer-reviewed publicerade på engelska om musikinterventioner under operation och anestesi, 126 potentiellt relevanta artiklar identifierades. Efter kvalitetsgranskning identifierades och analyserades 17 relevanta studier. Resultat: De 17 inkluderande studierna avsåg alla planerade operationer och deras resultat indikerade överlag att musik associerades med lägre nivåer av oro bland patienter som genomgår operationer. Musik fungerar som en distraktion för patienter och kan verka som en trygg familjaritet i en okänd och skrämmande miljö. Analysen genererade tre huvudkategorier som beskriver vad som påverkar musikinterventionens effektivitet: Hur och när musiken spelades, vilken typ av musik samt hur länge musiken spelades. Musik som spelas upp under operation fungerar bäst när det spelas ur högtalare, jämfört med hörlurar. Kulturell kontext påverkar valet av musik och dess effektivitet samt durationen av interventionen kan påverka resultatet. Slutsats: Lugnande musik som spelas från en högtalare under en operation är en effektiv omvårdnadsåtgärd som kan användas för att reducera patienters oro som enda åtgärd, eller i kombination med andra omvårdnadsåtgärder. Omvårdnadsinterventionen är både kostnads- och tidseffektiv. Behov av mer forskning finns avseende patientupplevelser och implementering i olika operationsförhållanden.Background: Previous research has demonstrated that it is common to experience anxiety during surgery and anesthesia. Anxiety is characterized by nervousness, uneasy thoughts and physiological reactions. The physiological reactions of anxiety are similar to those of a stress reaction, which may affect intra- and postoperative outcomes. To use music during the course of surgery is considered as a nursing intervention, which may be used by the nurse anesthetist to ease the anxiety of patients. Aim: To conduct a literature review of previous results on the use of music as a nursing intervention, to reduce the patient's anxiety during anesthesia and surgery. Additionally, another aim was to explore the characteristics of the music intervention which are associated with lower levels of anxiety. Method: A literature review with an integrative design was conducted. Searches were conducted in 2020 in PubMed and CINAHL databases for peer-reviewed scientific articles published in English regarding music interventions during surgery and anesthesia and identified 126 potentially relevant studies. After a structured quality assessment, 17 relevant studies were identified and analyzed. Results: The 17 included studies all regarded planned surgeries with the results overall indicating that music was associated with lower levels of anxiety among patients undergoing surgeries requiring anesthesia. Music seems to work as a distraction for patients and can also provide a safe familiarity in an unknown and scary environment. Three characteristics that affected the effectiveness of the music intervention to reduce anxiety levels were generated: how and when the music was played, what type of music was played and the duration of the intervention. Overall, music during surgery is most effective when it is played through a loudspeaker, compared with using headphones. Cultural context affects the choice of music and the effectiveness of the intervention and the duration can also impact the results. Conclusion: Calming music played through a loudspeaker during surgery is an effective nursing intervention that can be implemented to reduce patient anxiety in itself or as a complement alongside existing interventions. Music as a nursing intervention is both cost effective and time efficient. More research is needed regarding the patient’s experience and implementation in different settings.
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Blom, Ulrika, and Anna Råberus. "Hur känner du inför att bli sövd? : Patienters upplevelse inför generell anestesi." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-310.
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Tanken på att komma till en operationsavdelning kan upplevas som främmande och i visa fall även skrämmande. På en operationsavdelning ska flera operationer genomföras under en dag och flödet av patienter och operationer ska ske effektivt. För att patienten ska uppleva trygghet och få god omvårdnad i den situationen är det av stor vikt att få ta del av patientens tankar och känslor inför generell anestesi. Syftet med studien var just att beskriva patienters tankar och känslor inför generell anestesi. För att bäst kunna besvara syftet har en öppen kvalitativ induktiv intervjustudie med livsvärldsperspektiv använts i den här studien. Åtta intervjuer genomfördes och analyserades med hjälp av en induktiv innehållsanalys. Resultatet visar på en variation av upplevelser. Ett lidande i form av oro och otrygghet förekom hos vissa patienter, som exempelvis att inte veta vad som ska hända, osäkerhetskänsla och att något kan inträffa under sövningen. Även lugn och trygghet var känslor som uttrycktes av patienterna och till grund för det låg bland annat en god vårdrelation till anestesipersonalen baserat på tidigare positiva erfarenheter av generell anestesi. Viktigt för de patienter som intervjuades var att få tillräcklig information och mötas av trygg och erfaren anestesisjuksköterska. Resultatet av studien har bland annat väckt tankar runt hur viktigt det är att som anestesisjuksköterska få reda på om patienten är orolig inför sövningen och utifrån det kunna planera och utforma bemötandet.
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Sarajärvi, Tanja, and Carola Norén. "Interventioner som reducerar oro inför och under anestesi hos vuxna patienter." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-227227.
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Background Research shows that the majority of patients feel anxiety before and during anesthesia. It has been shown in several studies that preoperative anxiety may cause adverse effects in the postoperative course. Nurse anesthetists have a key role in creating a safe environment and the opportunity to use different interventions to reduce the degree of anxiety. Aim The aim of the study was to examine which interventions may reduce anxiety in adult patients before and during both general, local and regional anesthesia. Design Systematic literature review with a quantitative approach. Results Several studies indicate that gabapentin and pregabalin can reduce anxiety before and during anesthesia. The anxiety reducing effect appeared to be dose dependent. The naturopathic drugs Citrus aurantium blossom and Passiflora incarnata Linneaus were found to reduce anxiety before anesthesia. Music on headphones was also found to reduce the patient´s anxiety before and during anesthesia. In this study information provided as video and electronic information material did not demonstrate a reduction in pre-and perioperative anxiety, with exception of one study. Conclusions Several studies indicated that pharmacological interventions could reduce anxiety before and during anesthesia. Listening to music in connection with anesthesia was also found to reduce the degree of anxiety. Music is a simple intervention for the nurse anesthetist to initialize and the patients themselves may be given the opportunity to participate in their treatment by selecting the music. Considerably more research is needed on non-pharmacological interventions to complement all pharmacological research being conducted.Bakgrund Forskning visar att majoriteten av patienterna känner oro inför och under anestesi. Det har visat sig i flera studier att preoperativ oro kan ge negativa konsekvenser i det postoperativa förloppet. Anestesisjuksköterskan har en viktig uppgift i att skapa en trygg miljö och möjlighet att med olika interventioner minska graden av oro. Syfte Syftet med studien var att undersöka vilka interventioner som kan minska vuxna patienters oro inför och under såväl generell som lokal och regional anestesi. Design Systematisk litteraturstudie med kvantitativ ansats. Resultat Flera studier visade att gabapentin och pregabalin kunde minska patientens oro före och under anestesi. Den orosreducerande effekten visade sig emellertid vara dosberoende. Naturläkemedlen Citrus aurantium Blossom och Passiflora incarnata Linneaus visade sig minska oro inför anestesi. Musik i hörlurar sågs också minska patientens oro före och under anestesi. I denna studie påvisade information i form av video och elektroniskt informationsmaterial inte någon reducering av pre- och peroperativ oro, med undantag för en studie. Slutsats Flera studier pekade på att farmakologisk behandling kunde minska oro före och under anestesi. Att lyssna på musik i samband med anestesi visade sig också minska graden av oro. Musik är en enkel intervention för anestesisjuksköterskan att initiera och patienten kan ges möjlighet till delaktighet i sin behandling genom att själv välja musiken. Betydligt mer forskning behövs dock om icke-farmakologiska interventioner som komplement till all farmakologisk forskning som bedrivs.
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Ekholm, Linnéa, and Lena Johansson. "Att förebygga postoperativ halssmärta (POST) som komplikation efter generell anestesi med intubation : Vad kan anestesisjuksköterskan göra?" Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-14729.
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Postoperativ halssmärta (POST) är en mycket vanlig komplikation hos patienter som genomgått generell anestesi med intubation. POST anses av anestesipersonal vara en relativt lindrig komplikation. Patienter upplever det dock som ett stort problem och därför bör det undvikas. Syftet med denna litteraturstudie var att undersöka vad anestesisjuksköterskor kan göra för att förebygga POST som komplikation hos patienter som genomgått generell anestesi med intubation. Examensarbetet är en integrativ litteraturstudie som innefattar tolv globala studier. Litteraturstudiens resultat visar att det finns flera farmakologiska och icke farmakologiska metoder som kan förebygga POST. Lokal behandling med kortikosteroider och NSAID-preparat har förebyggande effekt på POST. Icke farmakologiska interventioner som konformad kuff, substanser som lakritslösning, magnesium och zink lindrar. Vissa studier finner att kortikosteroider och lidokain kan öka förekomsten av POST. I nuläget kan resultatet inte tillämpas av anestesisjuksköterskor då resultaten är tvetydiga och inte kan utföras utan ordination av anestesiolog. Vidare forskning inom området med inriktning på omvårdnad är av yttersta vikt.
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Youssef, Sara. "Anestesisjuksköterskors erfarenheter av följsamhet till basala hygienrutiner : En kvalitativ intervjustudie." Thesis, Luleå tekniska universitet, Omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-70477.
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Introduktion: Anestesiverksamhet betraktas enligt Socialstyrelsen som en högriskspecialitet med avseende på patientsäkerhet. Varje år skapar vårdrelaterade infektioner onödigt lidande för patienter, förlänger vårdtider och kostar samhället enorma summor. Med en god och säker vård med hög kvalitet kan anestesisjuksköterskor förbättra säkerhetsarbetet för patienten. Syfte: Att beskriva anestesisjuksköterskors erfarenheter av faktorer som påverkar följsamheten till basala hygienrutiner i samband med anestesiinduktion. Metod: Studien har en kvalitativ ansats. Åtta anestesisjuksköterskor från tre olika sjukhus i Sverige medverkade i studien. Data samlades in med kvalitativa semistrukturerade intervjuer och intervjuerna analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i fem huvudfaktorer: Stress och tidsbrist vid akuta situationer, operationssalens fysiska miljö, dåliga vanor, bristande feedback och patientens psykiska tillstånd. Slutsats: Det som framkom i studien var att hygienen brister av anledningar som går att förhindra och förbättra. För att motverka bristande hygienrutiner måste alla inom anestesiverksamheten arbeta tillsammans med hjälp av god kommunikation samt mot ett gemensamt mål. Anestesiverksamheten borde se dessa faktorer som en utav de mest primära och ha mer öppna dialoger tillsammans med medarbetarna för att identifiera liknande problem.Introduction: Anesthetic healthcare are considered according to the National Board of Health and Welfare as a high risk specialist in patient safety. Health related infections create unnecessary suffering for patients, prolongs care times and cost the community huge amounts of money. With a good and safe healthcare of high quality, anesthetic nurses can improve the safety work for the patient. Aim: To highlight the anesthesia nurses experience of the factors that affects the compliance with basic hygiene routines associated with anesthesia induction. Method: The study has a qualitative approach. Eight anesthesia nurses from three different hospitals in Sweden participated in the study. Data was collected using qualitative semi-structured interviews and the interviews were analyzed with qualitative content analysis. Results: The analysis resulted in five main factors: stress and lack of time in acute situations, physical environment of the operating room, bad habits, lack of feedback and patients mental condition. Conclusion: The study found that hygiene is lacking for reasons that can be prevented and improved. In order to counter the lack of hygiene routines, all within the anesthetic healthcare units must work together with the help of good communication and towards a common goal. Anesthetic healthcare units should consider these factors as one of the most primary and have more open dialogues with employees to identify similar issues.
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Snell, Jennifer Miranda. "Pediatric Emergence Delirium in the Postoperative Setting." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3921.
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Emergence delirium (ED), also known as emergence agitation, is a postoperative condition characterized by aberrant cognitive and psychomotor behaviors following general anesthesia. The incidence of ED is 3 to 8 times higher in children 5 years of age or less. There is no standard of nursing practice for managing ED symptoms in the pediatric surgical population. The purpose of this quality improvement project was to address a gap in knowledge needed to inform clinical decision-making when managing ED in the postoperative setting. Using an educational presentation for post anesthesia care unit (PACU) nurses, this project introduced the use of non-pharmacological interventions to mitigate symptoms of ED in the pediatric population as inspired by The Green Star Initiative, an Army program at Fort Carson. The project aim was to describe the effectiveness of ED-specific interventions from the nursing perspective. Using tenets of the Iowa model, this quality improvement project included a needs assessment survey, PowerPoint presentation, parent education leaflet, ED cheat sheet, and a post-intervention survey. Applying the context, input, process, product model for evaluation, this project increased knowledge of ED-specific interventions used by nurses that demonstrates a change in clinical decision-making. PACU nurses rated the interventions 43% effective on pediatric patients. This project addressed the gap in practice by providing structured education on ED, inspiring the use of ED-specific interventions, and promoting readiness to care for the pediatric surgical population. Outcomes add to the nursing literature by introducing ED-specific interventions to manage pediatric ED in facilities nationwide. A social implication of this project is to improve the care of pediatric surgical patients.
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Rabinowitz, Patricia. "Malignant Hypothermia Preparedness for Labor and Delivery Nurses." Otterbein University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1596205650329567.
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Holmgren, Anniqa. "Att vara bedövad : – En pilotstudie om hur patienter erfar spinalanestesi." Thesis, Röda Korsets Högskola, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-470.
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Bakgrund Knä- och höftplastikoperationer genomförs vanligtvis i spinalanestesi som är en säkrare behandling för patienten. En tredjedel av de patienter som ska genomgå spinalanestesi är mycket oroliga före operation. Få studier fokuserar på patienters upplevelser och erfarenheter av spinalanestesi. Syftet med studien var att undersöka patienters upplevelser av spinalanestesi Metod Studien har en kvalitativ ansats och datainsamling har skett med hjälp av sex semistrukturerade intervjuer. Ett bekvämlighetsurval gjordes av de patienter som fanns inbokade på en ortopedmottagning, våren 2012. Datamaterialet bearbetades och analyserades med en fenomenologisk tolkning av de fyra existentialerna rummet, kroppen, tiden och relationen. Resultatet Patienter beskrev att kroppen upplevdes som en maskindel som skulle repareras. Det var knappt märkbart att få ryggbedövning med ett stick i ryggen men att få flera stick upplevdes ge svåra smärtor. Att objektivera den egna kroppen genom att flytta in i sig själv, inte känna efter och överlämna kroppen i någon annans ansvar var strategier som användes. Att själv få välja att vara medveten om rummet och ha kontroll gjorde upplevelsen behaglig men att välja det omedvetna rummet var befriande för dem som upplevde situationen obehaglig. Trygghet upplevdes av en omhändertagande personal och känslan av att vara unik infann sig när patienter bekräftades med sitt namn. Otrygghet upplevdes då personalen inte informerade och kommunicerade vid bedövningen. Den objektiva tiden upplevdes utav några patienter som lät tiden ha sin gång. För andra blev upplevelsen av tiden mer svåruppfattad, den subjektiva tiden kändes kortare, längre eller inte alls. Slutsats Kroppen upplevdes utifrån och patienter objektiverade sina kroppar genom att överlämna och stänga av dem när de var bedövade. Det trygga rummet fanns i det fungerande sociala rummet och det otrygga rummet upplevdes när det sociala rummet var otillräckligt. Patienter valde själva det medvetna eller det icke medvetna rummet. Den levda tiden var svåruppfattad och upplevdes kortare, längre eller så fann sig patienterna i tiden. Klinisk betydelse Patienters upplevelser är en värdefull källa till kunskap för att personalen ska kunna förstå, utvärdera och utveckla vården för att kunna ge patienterna ett bättre omhändertagande.Background Knee and hip replacement surgery usually carried out under spinal anaesthesia, which is a safer management of the patient. One third of the patients to undergo spinal anaesthesia are very anxious before surgery. Of the studies carried out so far, only a few have focused on patient’s experiences of spinal anaesthesia. The aim of the study was to investigate patients experiences of spinal anaesthesia. Method The study has a qualitative approach and data collection was performed using six semistructured interviews. A convenience sample was made using the patients who were scheduled for an orthopaedic reception, spring 2012. The data was processed and analyzed using a phenomenological interpretation of the four existentials lived space, lived body, lived time and lived human relation. Result Patients reported that the body was perceived as a piece of machinery to be repaired. It was barely noticeable to get an spinal anestheisa with a single injection in the back but getting additional injections was perceived as severe pain. Objectification of the body by moving in on itself, shutting out feelings and submit it to someone else's responsibility were strategies frequently used. To be able to chose if you want to be aware of the room and the surrounding environment to be in control, contributed to an over all comforting experience for patients that were confident with the situation. On the other hand, choosing the unaware state and not being aware of the environment resulted in a relief for patients that experienced their situation as discomforting. A patients perception of security was reinforced by caring health professionals and the feeling of being unique was confirmed when patients were called their names. The feeling of insecurity was reinforced by the lack of information to and communication with the patient during the anaesthetics. Some patients that put up with time passing experienced a correct clock time. For others, the difference between subjective and objective time was harder to perceive, the subjective time felt shorter, longer or not at all. Conclusion The body was perceived from the outside and patients objectified their bodies by handing them over and shut them down when they were anaesthetized. The safe room was in the functioning of social space and the room felt insecure when the social space was insufficient. Patients chose themselves the conscious or non-conscious room. The lived time was difficult to perceive. It was either shorter, longer or they found themselves patients in actual time. Clinical contribution Patients views will always be a valuable source of information from which health professionals can evaluate and develop their care.
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Caldwell, Mark Andrew. "The Relationship Between Success or Failure in First Semester Nurse Anesthesia Courses and Success or Failure on the Certification Examination and Attrition." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1425658980.
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Klingborg, Ellinor, and Emmy Klingborg. "Patienters upplevelser av att vara vaken under ett kirurgiskt ingrepp i regional anestesi : En strukturerad litteraturstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-93370.
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Bakgrund: Regional anestesi är en metod som blivit allt vanligare inom sjukvården. Metoden innebär att alla sinnesintryck temporärt elimineras från den valda kroppsdelen där kirurgin ska genomföras, detta görs genom att anlägga en nervblockad. Metoden möjliggör att patienten kan vara vaken under ett kirurgiskt ingrepp. Den högteknologiska operationsmiljön beskrivs många gånger som opersonlig, distanserad och kall, vilket kan medföra att patienterna upplever osäkerhet och sårbarhet. Således är det av vikt att undersöka patienters upplevelser för att anestesisjuksköterskan bättre ska kunna bemöta, vårda och stödja dem genom kirurgin. Syfte: Studiens syfte var att beskriva patienters upplevelser av att vara vaken under ett kirurgiskt ingrepp i regional anestesi. Metod: En strukturerad litteraturstudie med kvalitativ design, baserad på 13 vetenskapliga artiklar. De vetenskapliga artiklarna har analyserades med hjälp av Bettany-Saltikov och McSherrys dataextraktion. Resultat: I resultatet framkom tre huvudkategorier: Miljöns och kirurgins påverkan, Upplevelser av att överlämna sin kropp och Vårdpersonalens betydelse. Upplevelsen av att vara vaken under ett kirurgiskt ingrepp i regional anestesi kan upplevas både positivt och negativt. Vissa patienter upplevde delaktighet och kontroll medan andra upplevde motsatsen. Vidare kunde de uppleva smärta, rädsla, oro och obehag i samband med det kirurgiska ingreppet, trots detta var de generellt nöjda genom interaktionen de hade med vårdpersonalen. Slutsats: Anestesisjuksköterskan har en avgörande roll för patientens upplevelse av att vara vaken under kirurgi. Stöd, tröst och omtanke från anestesisjuksköterskan hjälpte patienten att överkomma sin oro och rädsla. En god kommunikation, information och närhet från vårdpersonalen kan stärka patientens välbefinnande och delaktighet.
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Johansson, Marita, and Cathrin Jonasson. "En varm patient : Sjuksköterskans omvårdnad och förebyggande av hypotermi i samband med dagkirurgisk operation." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-15141.
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Nästan alla patienter blev hypoterma före, under och efter operation. För att undvika detta vidtog sjuksköterskan olika omvårdnadsåtgärder för att minska risken för oönskad hypotermi. Det var viktigt för vårdpersonal att få kunskap om vilka omvårdnadsåtgärder som är optimala för att minska komplikationer, samt få förståelse för hur hypotermi påverkar patienten under hela vårdförloppet. Kunskapen behövs för att lindra lidandet och öka tryggheten i samband med operation. Syftet var att söka evidens för bästa beprövade omvårdnadsåtgärd för att förebygga hypotermi hos patienter samt beskriva hypotermins påverkan på patienter under dagoperativt vårdförlopp. En litteraturstudie genomfördes där kvantitativa och kvalitativa artiklar analyserades med hjälp av innehållsanalys enligt Fribergs modell (Friberg 2012). Resultatet visade att det var viktigt att börja värma patienten före operation och att starta med en högre begynnelsetemperatur. Vid steriltvättning rekommenderades varm desinfektion. Även vid artroskopier var det en fördel att använda uppvärmd vätska. Vid korta ingrepp fungerade både värmekällan Hot dog (elektriskt täcke/madrass) och Bair Hugger (varmluftstäcke). Bair Hugger var i dagsläget den enskilt mest effektiva metoden för att snabbt höja temperaturen, mest miljömässiga samt ekonomiskt hållbara metoden vid längre operationer, givet att den var inställd på hög värme (43°C). Dock räckte det inte med en metod för att få en normaltempererad patient, utan flera olika metoder behövde kombineras samtidigt. En riktlinje för sjuksköterskor var att fortsätta med hög temperatur på värmekällan även då patientens kroppstemperatur hade uppnått normal temperatur. Först när patienten började svettas var det lämpligt att sänka temperaturen. Det var viktigt att mäta temperaturen för att fånga upp alla som var hypoterma, då inte alla patienter uppvisade symtom såsom shivering. Öka vårdpersonalens medvetenhet om vikten av att värma patienter på operation och använda alla metoder som finns tillgängliga för att minska hypotermi och öka välbefinnandet.
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Ricardo, Carolina Martins. "Tempo das intervenções e atividades de enfermagem na sala de recuperação pós-anestésica: subsídio para determinação da carga de trabalho." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-10092013-144343/.
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A escassez de pesquisas, instrumentos e parâmetros que subsidie o planejamento e a avaliação quantitativa e qualitativa de profissionais de enfermagem em salas de recuperação pós-anestésicas (SRPA) dificulta a provisão adequada de profissionais nessa área. Objetivo: Identificar o tempo médio das intervenções e atividades realizadas pela equipe de enfermagem em SRPA, como subsídio para a determinação da carga de trabalho. Método: Trata-se de um estudo de caso, observacional, transversal, de natureza quantitativa, realizado na SRPA do Hospital Universitário da Universidade de São Paulo (HU-USP). Participaram do estudo todos os profissionais de enfermagem que trabalharam na SRPA durante o período de coleta de dados. Os dados da pesquisa foram coletados e organizados de acordo com as seguintes etapas: identificação das atividades realizadas pela equipe de enfermagem, por meio da análise dos prontuários dos pacientes e da observação direta dos profissionais; mapeamento das atividades identificadas em intervenções de enfermagem, segundo a Nursing Intervention Classification (NIC); validação do mapeamento das atividades em intervenções de enfermagem, por meio de Oficinas de trabalho; mensuração do tempo despendido na execução das intervenções e atividades, utilizando a técnica Tempos Cronometrados. Resultados: Foram coletadas 6032 amostras de intervenções e atividades realizadas pelos profissionais de enfermagem na SRPA. O tempo total de execução dessas intervenções e atividades, cronometrados por observadores de campo, correspondeu a 192 horas, 56 minutos e 40 segundos. A distribuição da proporção do tempo de execução das intervenções de enfermagem evidenciou que as principais intervenções executadas foram Cuidados Pós-ANESTESIA (16,9%), DOCUMENTAÇÃO (14,3%), Controle de INFEÇÃO (5,9%). Os Domínios de maior representatividade foram: Domínio 6 - Sistema de Saúde (37%), Domínio 2 - Fisiológico Complexo (36%), Domínio 4 - Segurança (16%), Domínio 1 - Fisiológico Básico (10%) e Domínio 5 - Família (1%). O tempo da equipe está dividido em: 67% de intervenções de enfermagem; 9% de atividades associadas; 11% de atividades pessoais; 11% de tempo de espera e 2% de atividades realizadas no CC. A produtividade das enfermeiras foi de 92%, enquanto o tempo produtivo dos técnicos/auxiliares correspondeu à 86%. O tempo médio das intervenções e atividades correspondeu a dois minutos e treze segundos. A literatura não oferece dados que possibilite a comparação dos tempos médios das intervenções e atividades de enfermagem encontrados na presente pesquisa. Conclusão: A realização deste estudo permitiu identificar os tempos médios das intervenções e atividades executadas pela equipe de enfermagem na SRPA, contribuindo para a determinação da carga de trabalho e, consequentemente, para a superação das dificuldades relacionadas ao dimensionamento de profissionais nessa áreaThe scarcity of studies, tools and parameters to subsidize the planning and quantitative and qualitative evaluation of nursing professionals in post-anesthesia recovery room (PARR) hinders the adequate supply of professionals in this area. Objective: To identify the mean time of interventions and activities performed by the nursing staff in PARR, as the basis to determine the workload. Method: This is an observational, cross-sectional, quantitative case study, performed in the PARR of Hospital Universitário da Universidade de São Paulo (HU-USP). All study participants were nurses who worked in the PARR during the data collection. The study data were collected and organized according to the following steps: identification of the activities performed by the nursing staff, analysis of patients\' medical records and direct observation of professionals; mapping of activities identified in nursing interventions according to Nursing Intervention Classification (NIC); validation of activity mapping in nursing interventions through workshops; measuring the time spent on the implementation of interventions and activities, using the Clocked Time. Results: A total of 6032 samples of interventions and activities performed by nurses in the PARR were collected. The total performance time of these interventions and activities, timed by field observers, corresponded to 192 hours, 56 minutes and 40 seconds. The distribution of the performance time proportion of nursing interventions showed that the main interventions performed were: POST-ANESTHESIA care (16.9%), DOCUMENTATION (14.3%), INFECTION control (5.9%). The most representative domains were: Domain 6 - Health System (37%), Domain 2 - Physiological Complex (36%), Domain 4 - Security (16%), Domain 1 - Basic Physiologic (10%) and Domain 5 - Family (1%). The team\'s time is divided into: 67% of nursing interventions; 9% of associated activities 11% of personal activities, 11% waiting time and 2% for activities in the OR. The nurses productivity was 92%, whereas the productive time of technical/auxiliary staff corresponded to 86%. The mean time of interventions and activities corresponded to two minutes and thirteen seconds. The literature does not provide data that allows the comparison of the mean time of nursing interventions and activities found in this study. Conclusion: This study identified the mean times of interventions and activities performed by the nursing staff in the PARR, contributing to determine the workload and, consequently, to overcome the difficulties related to the activities of professionals in this area.
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Steed, Martina Renee. "Cultural Competence in Certified Registered Nurse Anesthetists." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1749.
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For several decades, the field of nursing has focused on the integration of cultural competence content into its prelicensure educational programs. Despite this focus, little is known about the cultural competence of nurses extending their education past initial licensure into an advanced practice nursing specialty, such as nurse anesthesia. Researchers in other fields have found that provider race and previous cultural competence training are associated with higher levels of cultural competence. This research, guided by the culture care diversity and universality theory, sought to determine the relationship between the two subscales, Cultural Awareness and Sensitivity (CAS) and the Cultural Competence Behavior (CCB) of the Cultural Competence Assessment (CCA) tool, and describe the relationships that exist between selected demographic variables and the total cultural competence scores for nurse anesthetists. One hundred and fifty-eight members of the American Association of Nurse Anesthetists participated in the study. The total CCA score for the population was 4.98 out of a potential total score of 7 (SD = .79). Mean scores were 5.64 (SD = .73) and 4.38 (SD = 1.19) for the CAS and CCB subscales, respectively. Hierarchical multiple regression analysis confirmed a positive relationship between post graduate diversity training and total CCA score (B = .28, p < .05). Identifying the cultural competence of this population and the characteristics that are associated with high levels of cultural competence could lead to better provider awareness of their own interactions and perceptions of patients and improved patient-centered care for patients in minority populations who are served by certified registered nurse anesthetists, resulting in positive social change.