Dissertations / Theses: 'Perioperative, Operating Room and Surgical Nursing'

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Hilton, George Leslie. "SENSORY REGRESSION TIME FROM SUBARACHNOID BLOCK WITH HYPERBARIC 0.75% BUPIVACAINE IN THE OBESE PATIENT." VCU Scholars Compass, 1989. http://scholarscompass.vcu.edu/etd/5067.

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The purpose of this study was to determine if obese patients have a different sensory regression time from subarachnoid block than non-obese patients using hyperbaric 0.75% bupivacaine. A quasi-experimental design was used. Twenty patients were separated into two groups; one group was classified as obese, and the other group was classified as non-obese. The data consisting of age, height, weight, sex, and surgical procedure were recorded preoperatively. All the patients received hyperbaric 0.75% bupivacaine via subarachnoid puncture. The levels of spinal anesthesia were recorded at the highest level achieved. The injection time was also recorded. When the surgery was completed, the patient was transferred to the recovery room and levels of sensory blockade were checked by pin-prick with an 18-gauge needle every 10 minutes until complete recovery from the spinal anesthesia had been achieved. The hypothesis, there will be no difference in sensory regression time from SAB with hyperbaric 0.75% bupivacaine between obese and non-obese patients, failed to be rejected. No statistically significant difference, using linear regression analysis, was found in mean regression time between groups (obese versus non-obese).

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Hudalla, Christa Choate. "The Effect of Tourniquet Application On Systemic Coagulation." VCU Scholars Compass, 1992. http://scholarscompass.vcu.edu/etd/5073.

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Seven orthopedic surgery patients requiring the use of a tourniquet were studied. The hypothesis stated that tourniquet application does not affect coagulation. A total of 5 blood samples were drawn perioperatively (preoperative, 5 minutes after induction of anesthesia, 30 minutes after tourniquet inflation, 2 - 5 minutes after tourniquet deflation, and 30 minutes after tourniquet deflation. For each sample, TEG parameters (R, R + k, MA and α) were measured. The value for each TEG parameter was compared by analysis of variance (ANOVA), then the samples were contrasted and examined by repeated measures ANOVA. None of the TEG parameters showed a statistically significant difference in the blood samples before, during or after tourniquet application. The hypothesis could not be rejected at the α = .05 level of significance. A t test was used to examine the effect of anesthesia on coagulation. The TEG parameters indicated a significant relationship between the TEG values R and R + k, and a near significant relationship between TEG values MA and a and the administration of anesthesia. It was concluded that tourniquet use does not effect coagulation when applied 2 hours or less. However, anesthesia had a significant effect on TEG parameters R and R + k. The clinical significance of this effect was questionable since the type of anesthesia varied in some patients, and none of the patients in the study demonstrated symptoms of coagulopathy.

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Berry, Judith. "Pressure ulcer prevention in the perioperative environment." Title page, table of contents and overview only, 2004. http://hdl.handle.net/2440/37709.

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There are many terms used to describe pressure ulcers: pressure sores, decubitus ulcers, bedsores, and pressure necrosis or ischaemic ulcers. Essentially they all describe damage to the patient's skin and underlying tissue. The nursing literature abounds with information about the risk, grading, prevention and treatment of pressure ulcers. These ulcers are a problem in hospital and long term care facilities, and are a major cause of morbidity. In the hospital setting they contribute to an extended length of stay and by doing so 'block' the bed for use by another patient. The ulcers are difficult to treat, are an ongoing cause for pain and discomfort for the patient and can be a strain on hospital finances. Pressure ulcers are not unique to modern times, as they have been discovered on the remains of an Egyptian mummified body (Armstrong & Bortz 2001). This would suggest that the problem dates back to the Pharoahs, and has continued to be a challenging problem throughout the centuries (Bridel 1992). The escalating costs of treating these ulcers today, has brought about an emphasis on the risk factors, prevention and the appropriate interventions, rather than an acceptance of these ulcers as a tolerable ondition (Bridel 1992). In the operating room, nurses are faced with unique challenges when caring for their patients. This is due to difficulty in caring for patients under the influence of the anaesthesia required for surgery, long periods of forced immobility and the inability of the patient to perceive pain and discomfort from the pressure of the hard surface of the operating room table. These problems are increased by nurses' inability to gain access to the patient because of the sterile drapes required to cover the patient for surgery. Armstrong and Bortz (2001) present information from one study in which it is stated that surgical patients have 90% greater chance of developing pressure ulcers than medical patients. One reason for this may be due to the limited information available in regard to the most effective support surface to place on top of the operating room table. This gap in information is problematic for operating room nurses as it limits their ability to select the most effective item of equipment, and determine if the chosen equipment reduces pressure on tissue intra- operatively. The most effective operating room table mattress used and the skills and knowledge of the operating room nurse about the aetiology and prevention of pressure ulcer prevention, are important aspects of nursing care and can influence patient outcomes. The potential for complications to occur may be dependent on single or combined factors such as the patient's age, disease processes, nutritional status and mobility. Preparatory and supportive nursing interventions for surgical procedures based on best available evidence, nursing experience and patient preference, can reduce the incidence of pressure ulcer development in the perioperative environment. This doctoral portfolio contains four separate sections related and linked together by a common theme - pressure ulcer prevention in the perioperative environment. This first section of the portfolio situates the topic and provides a brief overview of the portfolio. The second section is a critical review of the literature pertaining to the most commonly used operating room table mattresses, and the effectiveness of these mattresses in the prevention of pressure ulcer development. This review highlighted a lack of quality research in this area, and while many evaluations have been undertaken to determine the effectiveness of perating room table mattresses, the results are contradictory concerning the patients, exposures and interventions. Because of issues related to the methodological quality of published research in this area a systematic review using meta- analysis was not possible rather a critical review of the research literature is used. The third section of the portfolio reports on a hermeneutic ethnography of the perceived skills and knowledge of nurses in the prevention of pressure ulcer development in the perioperative environment. This study was designed to determine if pressure ulcer prevention forms an aspect of the everyday practice of perioperative nurses. This review has highlighted the need for operating room nurses to review practices when caring for patients in the perioperative environment particularly in respect of pressure ulcer prevention. The fourth and final section of the portfolio summarises the research and provides recommendations for nursing practice and further research in the area of pressure ulcer prevention in the perioperative environment.
Thesis (D.Nurs.)--Department of Clinical Nursing, 2004.

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Paterson, Robyn A. "Preoperative predictors of postoperative pain." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1993. https://ro.ecu.edu.au/theses/1142.

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The purpose of this study was to investigate five factors, which have been identified in the literature as having influence on the experience of postoperative pain. (1) Patient satisfaction with preoperative information, (2) Anticipated postoperative pain, (3) General self-efficacy, (4) Age, (5) Gender. These variables were examined to determine their relationship, if any with postoperative pain. Any relationship between these variables was also examined. Review of the literature revealed considerable research on pain, and that much of that research has been directed at the treatment of, rather than prediction of postoperative pain. Also, these studies have focused on patients who are receiving analgesia via traditional methods. No work has been reported on preoperative estimation of postoperative pain on those patients using Patient Controlled Analgesia as a single method of pain control. For this reason the study group consisted of patients who have undergone abdominal surgery, and have used the Patient Controlled Method of postoperative pain control. One Independent variable, self-efficacy, was shown to be significantly correlated to postoperative pain scores and to contribute to the preoperative prediction of how much postoperative pain an Individual may experience. Weak but significant correlations were also noted between satisfaction with preoperative Information, age and expectation of postoperative pain. The results also demonstrated a significant lack of specific preoperative information of pain and pain control methods amongst the subjects. There were large inconsistencies noted between how much pain subjects experienced and how much pain they had expected to experience. The results are of particular importance to nurses as they affect the nature of preoperative teaching, patient assessment and the provision of effective postoperative pain control, all of which are significant nursing responsibilities.

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Ellis, Anna K., and L. Lee Glenn. "Challenges in Staging of Transient Pressure Ulcers Following Urologic Surgery." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7514.

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Cosgrove, Marianne S. "PERCEIVED IMPACT OF AMBIENT OPERATING ROOM NOISE BY CERTIFIED REGISTERED NURSE ANESTHETISTS." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5963.

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It is widely acknowledged that elevated levels of noise are commonplace in the healthcare environment, particularly in high acuity areas such as the operating room (OR). Excessive ambient noise may pose a threat to patient safety by adversely impacting provider performance and interfering with communication among perioperative care team members. With respect to the certified registered nurse anesthetist (CRNA), increased ambient OR noise may engender distractibility, diminish situation awareness and cause untoward health effects, thereby increasing the possibility for the occurrence of error and patient injury. This research project analytically examines the perceived impact of ambient noise in the operating room by CRNAs. Findings from this study reveal that CRNAs perceive elevated noise to be regularly present in the OR, specifically during the critical emergence phase of the anesthetic. However, CRNAs feel that increased noise only occasionally limits their ability to perform procedures, concentrate and communicate with the perioperative team. OR noise rarely interferes with memory retrieval. CRNAs perceive that noise is sometimes a threat to patient safety but infrequently engenders adverse patient outcomes. CRNAs do not perceive noise in the OR to be detrimental to their health but strongly agree that excessive noise can and should be controlled. Increased ambient OR noise is a veritable reality that may pose a potential threat to patient safety. Further research to identify elevations in noise during critical phases of the anesthetic and delineation of significant contributors to its genesis is warranted.

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Forren, Jan Odom. "POST DISCHARGE NAUSEA AND VOMITING IN AMBULATORY SURGICAL PATIENTS: INCIDENCE AND MANAGEMENT STRATEGIES." Lexington, Ky. : [University of Kentucky Libraries], 2009. http://hdl.handle.net/10225/1141.

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Thesis (Ph. D.)--University of Kentucky, 2009.
Title from document title page (viewed on May 12, 2010). Document formatted into pages; contains: vii, 166 p. : ill. Includes abstract and vita. Includes bibliographical references (p. 141-157).

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Austin, Erin, and L. Lee Glenn. "Online and Face-To-Face Orthopaedic Surgery Education Methods." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7497.

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Patterson, Michele M. Tervo. "Adolescent Experience with Trauma and Orthopedic External Fixation: A Dissertation." eScholarship@UMMS, 2007. https://escholarship.umassmed.edu/gsn_diss/7.

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Over 13 million adolescents sustain traumatic injuries yearly, resulting in functional disability, disfigurement, psychosocial problems and fractures. These fractures are increasingly being treated with orthopedic external fixation devices (EFDs). The purpose of this study was to describe the experience of traumatically injured adolescents treated with EFDs. The 4 aims of the study focused on the circumstances leading to the traumatic event, experiences following the traumatic event, the impact of EFD treatment, and adolescents’ role in pin-care self-management, which is crucial to preventing infection. This longitudinal, qualitative descriptive study used purposive sampling to recruit 5 male and 4 female adolescents, 13-20 years old, from a New England level-1 trauma center. Participants were injured in motor vehicle crashes (including an all-terrain vehicle), falls, by gunshot, trampoline and football trauma. Interview questions were framed by two themes from a study of adult recovery from physical injury, i.e., the event and fallout. Participants were interviewed within days of the injury, 2 weeks after returning home, and within one month of EFD removal. Data were coded from verbatim transcripts using NVIVO and organized into themes guided by the principles of qualitative analysis. An overarching theme of “old self no more; forever changed” emerged from 26 interviews. The participants’ experience affected all tasks of adolescence: independence from parents, accepting body image, peer relations, and forming an identity. Major themes included “what risk?”, regarding circumstances leading to the traumatic event, mastering the environment, was 2 part first, processing the event, where determining fault and realizing everything has changed, they were ambivalently lucky, and not invincible. Secondly “suck it up and deal with it”, where strategies to deal with traumatic injury emerged (i.e. medication, channeling outlets, and slow caution). EFD experience revealed “Space age robot” and “they’ll do it themselves” as emergent themes. EFDs were described as painless, robotic, no big deal and necessary. One draining pin-site was noted. Findings related to use of self-administered analgesics, information technology, recall of detail, and gender differences in coping may lead to future interventions. These findings lay the groundwork for future studies that may improve care of adolescents during acute recovery from traumatic injury.

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Paqueo, Mariefel Casino. "Low Health Literacy and Preoperative Instruction Compliance Among Patients Undergoing Surgical Procedures." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4318.

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In addition to cancelations and delays of needed surgical procedures, serious or fatal complications can occur when patients with low health literacy do not comply with preoperative instructions. The purpose of this quality improvement project was to provide more insight about ways to decrease on cancelled and delayed surgical procedures in low health literacy patients' due to noncompliance with preoperative fasting instructions. The project was informed by the reach, effectiveness, adoption, implementation, and maintenance model (King, D. K., Glasgow, R. E., and Leeman-Castillo, B. (2010). The project question centered on whether health literate preoperative fasting instructions could decrease cancellations and delays of surgical procedures in low health literate patients. The project setting was conducted at a doctor's office. Interventions and changes to the preoperative instruction sheet were evaluated by using the preoperative communication checklist (POCC) which was developed for this project study. A 3-month pre-post POCC intervention design was used to evaluate changes in the numbers of cancelled and delayed surgical cases among 30 low health literate patients at a local community physician's office. The Newest Vital Sign which is a health literacy skill level assessment tool developed by Pfizer (2012), was used to assess patient health literacy. 30 (13 women and 17 men) who were aged 17-75 were enrolled. Pre-intervention, the and cancellation rate was 16.67%. Post intervention, there was a zero percent cancellation rate. This project has potential to produce positive social change by empowering patients with health literacy instructions for better understanding of what is being asked of them when having surgical procedures. This knowledge may result in better patient outcomes.

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Yackzan, Susan G. "FACTORS INFLUENCING PREFERENCE FOR SURGICAL CHOICE AMONG WOMEN WITH EARLY STAGE BREAST CANCER." UKnowledge, 2017. https://uknowledge.uky.edu/nursing_etds/34.

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Breast cancer is the most common cancer among women in the United States with over 60% of cases diagnosed as early stage disease. For those women without prohibiting clinical or cosmetic concerns, a choice between breast-conserving surgery and mastectomy can be made. Either choice confers equivalent survival. The decision-making process also involves consideration of recurrence risk as well as management of the unaffected, contralateral breast for both future surveillance and risk reduction. In recent years, increasing rates of mastectomy with contralateral prophylactic mastectomy have been reported among women with unilateral, early stage breast cancer. If eligible for a choice among surgical options, a woman’s decision becomes one of personal preference. The decision-making process is complex and involves consideration of potential benefits and harms with each option. The purpose of this dissertation was to: 1) analyze the psychometric properties of the Anxiety Subscale of the Depression Anxiety Stress Scale, 2) critically review Decisional Conflict Scales and 3) prospectively identify demographic, clinical, cognitive and affective factors influencing a woman’s decision to choose either breast conserving surgery or mastectomy with contralateral prophylactic mastectomy and to identify self-reported sources of information in the surgical decision-making process. Three manuscripts make up the dissertation. A secondary data analysis was conducted to test the psychometric properties of the Anxiety Subscale of the Depression Anxiety Stress Scale (DASS). The results of this analysis supported the reliability and validity of the DASS anxiety subscale. A critical review of decisional conflict measures for use with early stage breast cancer patients making surgical treatment decisions was conducted. The results of this review supported the use of Decisional Conflict Scales from a clinical and research perspective. Existing Decisional Conflict Scales show moderate to acceptable reliability. The first two manuscripts provided background and support for the use of scales included in the research study described in the third manuscript. This study was a prospective, exploratory, cross-sectional, mixed-methods study describing factors influencing preference for surgical choice among women with early stage breast cancer. A sample of 78 participants enrolled in the study, 47 who chose breast conserving surgery and 31 who chose mastectomy with contralateral prophylactic mastectomy. Differences were tested between the groups. Women who chose mastectomy with contralateral prophylactic mastectomy were younger, more likely to work full or part-time, had larger tumors and participated in preoperative genetic counselling. Women who chose breast conserving surgery were more likely to have participated in preoperative breast magnetic resonance imaging. Overall, women choosing either surgery were not experiencing severe levels of distress, depression, anxiety or stress although there were individual variations. Women choosing mastectomy with contralateral prophylactic mastectomy were more anxious and had more frequent intrusive thoughts about the diagnosis. They also had less decisional conflict as compared to women choosing breast conserving surgery. Information sources were similar but the most influential information source differed among the two groups. In both groups, intention for surgical choice was matched by the final decision. There are many factors influencing surgical choice among women with early stage breast cancer. Previous work has focused on clinical, demographic and diagnostic processes influencing the decision. With this study, evidence regarding the influence of cognitive and affective factors is described.

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Vitori, Tracey. "PSYCHOLOGICAL DISTRESS AND CARDIAC DISEASE." UKnowledge, 2016. https://uknowledge.uky.edu/nursing_etds/26.

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The purpose of this dissertation was to evaluate the association of psychological distress with cardiac disease, events, and mortality. Specific aims were to: 1) to evaluate the association between hostility level and recurrence of acute coronary syndrome (ACS) and all-cause mortality in patients with coronary heart disease (CHD); 2) to evaluate the psychometric properties of the Brief Symptom Inventory (BSI) hostility and anxiety subscales in a group of incarcerated participants at high risk of cardiovascular disease; and 3) to evaluate the association of patient and caregiver psychological state with quality of life in both patient and caregiver, and postoperative complications after cardiac surgery. Specific aim one was addressed through a secondary analysis of data collected during the Patient Response to Myocardial Infarction following a Teaching Intervention Offered by Nurses trial to determine whether hostility was a predictor of ACS recurrence and mortality. Hostility was common after ACS and predicted all-cause mortality. Hostility did not predict recurrent ACS. Specific aim 2 was addressed in a secondary analysis of baseline data from a randomized controlled trial in male prisoners. Participants completed the BSI at baseline prior to the intervention. Internal consistency reliability was good for both subscales (Cronbach’s alpha - hostility 0.83, anxiety 0.81). Items from the two dimensions were analyzed together using exploratory factor analysis with varimax rotation. Two dimensions, anxiety and hostility, were identified. Construct validity was supported; those with high anxiety and hostility reported a greater number of days where their self-reported health was rated as fair or poor. Those prisoners with less perceived control had higher levels of anxiety and hostility. Specific aim 3 was addressed through a prospective, descriptive correlational study that measured patient and caregiver anxiety, hostility and depressive symptoms, at baseline to determine whether these predicted quality of life using a multilevel dyadic analysis; and to evaluate the association of baseline anxiety, hostility and depressive symptoms and quality of life with postoperative complications and mortality. Anxiety, hostility, and depressive symptoms were common in both cardiac patients and their caregiver. Psychological state influenced quality of life in both dyad members, but was not associated with complications.

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Heriot, Jody L. "Implementation of a Beta Blocker Protocol." UNF Digital Commons, 2012. http://digitalcommons.unf.edu/etd/415.

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Background: Beta blockers are recommended by the American College of Cardiology/American Heart Association Guidelines for high and intermediate-risk cardiac patients undergoing non-cardiac surgery. Beta blockers are a class of drugs that moderate the effects of increased catecholamine levels on the heart by selectively blocking beta receptors in the heart and blood vessels, resulting in a lower heart rate and blood pressure. Beta blocker use perioperatively has been shown to reduce the risk of ischemia and infarction. Purpose: The purpose of this project is to address beta blocker use in a group of anesthesia providers who routinely attend to high-risk and intermediate-risk cardiac patients undergoing non-cardiac surgery in a medium-sized private hospital in suburban South Florida. There are barriers to the implementation of the published guidelines for beta blocker administration, including lack of awareness of the best current practice and a lack of a formal beta blocker protocol at the institutional level. Methods: A simple and inexpensive beta blocker protocol was implemented and evaluated by various means. Beta blocker administration practices were examined and documented prior to and after protocol implementation. Beta blocker usage was examined prior to and after protocol implementation Findings/Implications: It was hypothesized that increased anesthesia provider awareness would lead to increased administration of perioperative beta blockers to high-risk and intermediate-risk cardiac patients undergoing non-cardiac procedures. Although there was a knowledge increase related to the new beta blocker protocol, no change in practice was observed.

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Machan, Melissa Dawn. "Emerging Evidence in Infection Control Effecting Change." UNF Digital Commons, 2011. http://digitalcommons.unf.edu/etd/385.

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Current procedures for cleaning anesthesia airway equipment have been reported to be ineffective. The potential for cross-contamination from some airway equipment to a patient has been documented in several studies. In order to prevent potential infections, it should be ascertained as to why all anesthesia providers are not using disposable laryngoscope blades. The purpose of this evidence based project is to determine the perceptions of anesthesia providers regarding the use of disposable laryngoscope blades. Their frequency of use, their evaluation of ease of use, and any complications encountered when using the disposable blade before and after an in-service program designed to increase the use of disposable blades will be determined. Once Institutional Review Board (IRB) approval and written consent were obtained, anesthesia providers were asked to complete an anonymous one page questionnaire on their knowledge and practice regarding disposable laryngoscope blades. Immediately following the completion of the questionnaire, participants were given an investigator developed article to read. Participants completed the same anonymous questionnaire 3 months following the pre-intervention questionnaire. Inventory of the disposable laryngoscope blades were collected at the start of the project, at one month, and then again at three months. A total of 12 anesthesia providers participated in the evidence based practice project. An increased number of providers stated that they felt disposable laryngoscope blades were easy to use at the completion of the project and there was an increased use of disposable laryngoscope blades. At post-intervention, anesthesia providers described performance (25%) as their reason for not using the disposable laryngoscope blade which was down from the start of the project (60%). A single proportion Z-Test showed that the 23% increase in use of disposable laryngoscope blades after the intervention was statistically significant (Z=2.046, p=0.041). This evidence based project has shown that despite initial apprehension, a change in practice was evident after dissemination of the best and most recent clinical evidence regarding laryngoscope blades which should translate to improved patient outcomes.

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Elam, Charles R. IV. "Predicting Arterial Oxygen Desaturation Events Via Patient Journal and Pulse Oximetry Data in Postoperative Ambulatory Surgery Patients." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5649.

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Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical. Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity and mortality is on the horizon unless aggressive measures are taken at mitigating risk. Similarly, as the obesity epidemic expands, obesity-related comorbid conditions including obstructive sleep apnea (OSA) are likely to grow. The purpose of this research was to explore the relationship between ambulatory orthopedic patient-reported activities (quality of life metrics) and diagnostic factors (physical and perioperative care data) in the immediate postoperative period that are predictive of arterial oxygen desaturation. Data was obtained using a novel patient journal exploring sleep, pain, nausea, tobacco use, alcohol use, and appetite in conjunction with a valid and reliable portable, wrist-worn pulse oximeter. Additional assessment data was taken from the preanesthetic assessment. All participants were scored according to the STOP-Bang questionnaire, an accepted survey of OSA risk. Patients were recruited from a busy metropolitan ambulatory surgery center in Richmond, Virginia that sees approximately 500 cases monthly, and a 309-bed tertiary care hospital in West Burlington, Iowa. The target sample included 52 individual patients with data collected over the first two post-operative nights following discharge. Two patients were excluded. Negative binomial regression, log10 transformation, and least-squares regression examined the relationships the STOP-Bang questionnaire, quality of life data, and physical perioperative data had on postoperative desaturation events. Results suggested the STOP-Bang score predicted desaturation events and that age and BMI were significant individual predictors. Opiate pain medication treatment, a happy mood, and home CPAP use were associated with decreased events. This study provided a unique perspective in patient safety research, relating human behaviors and experiences with postoperative oxygen desaturation. Future research projects aligned with postoperative monitoring, pulse oximetry, patient safety, and obstructive sleep apnea are potential following the findings of this study.

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Balfour, Lindsay E. "Hospital Loneliness and the Patient-Physician Relationship: A Preliminary Analysis of Associations with Recovery in Bone Marrow Transplant Patients." UNF Digital Commons, 2012. http://digitalcommons.unf.edu/etd/336.

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The purpose of the present study was to examine general loneliness, hospital loneliness, and the patient-physician relationship in regards to their associations with Bone Marrow Transplant (BMT) recovery outcome variables (days until engraftment and quality of life). Fifteen (66.7% female, 33.3% male; 93.3% white, 6.7% Black/African American; average age 61.73) individuals who had an allogeneic or autologous BMT at The Mayo Clinic of Jacksonville completed the FACT-BMT, UCLA-Loneliness Scale Version 3, the CARE Measure, and provided disease and treatment information at the 6 month posttransplant date (+/- 30 days). Patients recovering from BMT indicated significantly higher scores of hospital loneliness in comparison to their general loneliness scores. This increase is believed to represent the outcome of experiencing hospital isolation during the post-transplant recovery process. Increases in hospital loneliness were marginally significant in predicting decreases in the patients overall quality of life. The patient physician consultational relationship was found to have a significant relationship with the number of days until engraftment, however the direction of the relationship was opposite the hypothesized direction. This may suggest that engraftment influences the quality of the relationship instead of vice versa. These results imply that there is a relationship between hospital isolation and increases in the amount of loneliness experienced during recovery from a BMT. Loneliness has been found to have a negative relationship with a number of physiological and quality of life outcomes. The present study also elucidates possible correlates with the patient-physician relationship.

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Taylor, Andrew. "Effect of a Self-Care and Self-Awareness Education Program on Resilience to Burnout and Depression in Clinically Experienced Nursing Students." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/honors/637.

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The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these hazards. The educational intervention had a strong positive effect on resilience scores (effect size of r=72%; p < 0.05). Eighty-six percent of the participants believed that the intervention increased their capabilities for self-care, especially in sleep, spending time outside, hydration, nutrition, and physical stretching exercises but not in journaling. Eighty-one percent stated that they would be likely to seek professional help if needed. Although this study must be repeated in other samples before it be implemented with full confidence, the standardized, high intensity, short duration, resilience training session can be recommended to nursing programs just prior to graduation and to hospitals for nurse orientation programs.

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McWhirter, Lynn. "Novel Oral Anticoagulants: Bedrest and Bleeding in Patients Undergoing Atrial Fibrillation Catheter Ablation." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/520.

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Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and sometimes arterial, sheath removal and hemostasis. Limited research is available on the appropriate duration of bedrest to minimize bleeding complications associated with AF ablation in patients who use NOACs. The purpose of this quality improvement project was to compare and evaluate the effect of bedrest duration on post-procedure bleeding outcomes, urinary complaints, and back pain among patients taking NOACs while undergoing AFCA. Thirty patients undergoing elective AFCA on NOACs were orally consented to participate in the study and placed on shortened (8 hours) or prolonged (>8 hours) bedrest following vascular hemostasis. Outcome measurements included bleeding after ambulation, back pain, and urinary complaints. Fifteen patients (50%) were on shortened bedrest and 15 (50%) were on prolonged bedrest. No statistically significant difference in bleeding, urinary complaints, or back pain were found. Since there is no clear advantage to prolonged bedrest for patients on NOACS after an AFCA procedure, clinicians should consider this when deciding on bedrest duration for their patients.

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Eakin, Sherri. "Operating room nurses and surgical technologists perceptions of job satisfaction in the operating room environment." Thesis, University of Phoenix, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10024192.

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The predicted future operating room nurse and surgical technologist shortages may have significant implications for the healthcare industry. Improving the job satisfaction of operating room personnel could promote retention and provide adequate staffing in operating rooms. The job satisfaction of operating room nurses and surgical technologists can result in positive or negative work environments. The purpose of the qualitative phenomenological study was to explore the perceptions of job satisfaction of operating room nurses and surgical technologists to discover how job satisfaction influences the intent to leave or remain in the work environment of the operating room. A purposive selection was made of 12 registered nurses and 12 surgical technologists who had varying degrees of experience in the healthcare field, and were working part time or full time in the operating room of a pediatric medical center in North, Texas. Interviews were audio-recorded and the seven steps were used from Moustakas van Kaam analysis to reveal themes and patterns from the research data. Six themes emerged from the research study that included teamwork, recognition from surgeon, working with pediatric patients and their families, staff appreciation, work environment, and executive leadership. Based on the findings, further research is needed to ascertain strategies that would improve operating room registered nurses and surgical technologists’ job satisfaction and retention.

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Liechty, Elizabeth. "Values and perceptions of caring by perioperative nurse associates." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/958799.

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Caring is emerging as an important concept for the nursing profession especially within the perioperative arena (Bickler, 1994; McNamara, 1995; Rawnsley, 1990). The purposes of this study were to investigate: (a) the relationship between perioperative nurse associates' values and caring behaviors; and (b) the relationship between perioperative nurse associates' perceptions of own demonstrated caring behaviors to demonstrated caring behaviors of nurse managers.The study was based upon Watson's (1985) model of Human Caring. The instruments used were Staub's (1989) Values Questionnaire and Nkongho's (1990) Caring Ability Inventory. A demographic profile of study participants was obtained. The population included all nurses (48,000) who were members of the Association of Operating Room Nurses (AORN). The sample consisted of 300 randomly selected non-managerial perioperative nurse associates obtained from the membership list of AORN.A cover letter explaining the study along with a demographic questionnaire and three survey instruments were mailed to the 300 perioperative associates at their home address. The surveys were returned to the investigator by mail in a furnished self-addressed stamped envelope (n=96). Procedures for human subject protection were followed.A descriptive correlation design and descriptive statistics were used for data analysis. Perioperative nurses identified three recurring themes as suggestions for incorporating caring behaviors by nurse managers; (a) improved communication skills; (b) increased accessibility; and (c) empowerment of nurses. Findings showed a moderately positive and significant relationship between values and caring behaviors supporting Watson's Theory of Human Care (1985). Results showed no relationship of caring behaviors between nurse associates and nurse managers. However, the data did reveal that nurse associates perceived themselves as more caring than the nurse managers.
School of Nursing

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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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Opadotun, Olukemi. "Infection control practices for the prevention of surgical site infections in the operating room." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1017195.

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Infections are a major cause of morbidity and mortality during the post-operative phase of patients’ recovery. Wound infections are the second most commonly encountered type of nosocomial infection. Because wound infections can be introduced by not applying infection control measures and sterile technique principles in the operating room, the implementation of infection control principles is an imperative. The aim of this study was to explore and describe infection control practices related to the prevention of Surgical site infections in the operating rooms in a public health care sector in the Nelson Mandela Bay Municipality. The findings were compared with practices, as indicated in an evidence-based guideline. The research design was quantitative, explorative, descriptive, comparative-descriptive and contextual in nature. The research sample consisted of all the professional nurses, in the operating room. The data were collected by means of a self-administered questionnaire. Descriptive statistics was used to present the data in the form of tables and graphs. Based on the analysis of the data, some recommendations were made for the implementation of infection control practices, in order to prevent Surgical site infections in the operating room.

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Gosse, C. Suzanne. "Critical thinking skills : a comparative analysis of experienced operating room and medical-surgical registered nurses." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/958783.

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Critical thinking skills have emerged as a vital tool for the professional nurse confronting an explosion of technology and compressed plans of treatment. The purpose of this research was to compare the critical thinking skills of experienced registered nurses from two practice settings: the operating room and general medical-surgical floors. Critical thinking was defined as a "composite of attitudes, knowledge, and skills" (Watson-Glaser, 1980, p. 1).The research of Benner (1984) provided the foundation for this research. Benner documented the development of knowledge and skill in nursing practice. Nurses at the proficient and expert stages of development were the focus of this research.A non-random, convenience sample containing fifty one nurses was drawn from two Midwestern hospitals. Demographic data was gathered to further describe the sample. Participation in the study was voluntary and anonymity of subjects was assured.The Watson-Glaser Critical Thinking Appraisal (WGCTA) (1980) was the instrument utilized to measure the critical thinking skills of the experienced nurses. This tool has established validity and reliability and is considered a benchmark for measuring critical thinking ability.Analysis of the WGCTA (1980), results revealed a mean of 54.29, SD 9.66 for the total group of experienced registered nurses (N=5 1). For the operating room nurses (n=28) a mean of 52.71 with a SD of 9.41 was obtained. Among the medical-surgical nurses (n=23), the mean score was 56.21 with a SD of 9.81. T-test and MANOVA analysis was carried out. No significant statistical differences were found between the means in either the total scores of the WGCTA or on the five sub-tests for the two groups. The data submitted for analysis reflected a very experienced group (51 % with > 15 years nursing experience) and predominate Associate and Diploma preparation (61 %). Norming information available for the WGCTA indicated the scores obtained in this research were comparable to much larger samples drawn from nursing students and police officers.A conclusion of this research is that critical thinking, as measured by the WGCTA (1980), develops uniformly across diverse practice areas. An examination of the usefulness of the WGCTA to accurately measure the process of critical thinking in experienced nurses is recommended. More research into the important issues of critical thinking and experienced nursing practice is recommended.
School of Nursing

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Bull, Rosalind Margaret. "Theatre wear must be worn beyond this point : a hermeneutic ethnographic exploration of operating room nursing." Title page, table of contents and abstract only, 2002. http://web4.library.adelaide.edu.au/theses/09PH/09phb9355.pdf.

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Doyle, Donna J. "Succession Planning and the Identification of Future Perioperative Leaders: A Mixed Methods Study." Otterbein University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=otbn149209761975162.

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Binns-Turner, Pamela Gail. "Perioperative music and its effects on anxiety, hemodynamics, and pain in women undergoing mastectomy." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2008d/binns-turner.pdf.

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Batista, Ana Patrícia Antunes. "A integração de novos enfermeiros no bloco operatório para garantir a qualidade dos cuidados: contributos para a elaboração de um guião." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2019. http://hdl.handle.net/10400.26/28731.

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Relatório de Projeto/Estágio do Mestrado em Enfermagem Perioperatória
No âmbito da unidade curricular Projeto/Estágio I e II, integrado no Curso Mestrado em Enfermagem Perioperatória, foi-me proposto o desenvolvimento de um projeto de estágio, utilizando a Metodologia de Trabalho de Projeto. A temática escolhida foi a integração de enfermeiros em contexto perioperatório: contributos para a elaboração de um guião, após estabelecido um diagnóstico de situação (reunião com enfermeiro chefe, análise swot e 2 questionários fechados à equipa de enfermagem – caracterização socioprofissional e pertinência da temática), identificando a existência desta necessidade em contexto de estágio. O objetivo principal deste projeto é contribuir para o processo de integração de novos enfermeiros no bloco operatório para a melhoria da qualidade dos cuidados, sendo que para que este objetivo fosse atingido foram desenvolvidas atividades, tais como: uma revisão da literatura, aplicação de questionários, elaboração de um guião de integração de acordo com as suas especificidades, planeamento de uma acção de formação para divulgação do guia de integração, ajustar o guia de integração às carências manifestadas pelos enfermeiros após apresentação do mesmo. Consegui alcançar não só os objetivos propostos relativos ao desenvolvimento do projeto de estágio, como ao desenvolvimento de competências de mestre em enfermagem perioperatória adquiridos ao longo de três semestres. Conclui-se que o processo de integração é fundamental para otimizar as competências do indivíduo que não só o próprio beneficiará, mas também a organização e o cliente cirúrgico, através de uma integração estruturada, planeada e individualizada.
Within the curricular unit Project/internship I and II, integrated into Perioperative Nursing Master's Course, I proposed the development of a training course, using as a working methodology, the Project Methodology. The theme chosen was the integration of nurses in perioperative context: contributions to the creation of a script, after a diagnosis of situation (meeting with charge nurse, swot analysis and 2 questionnaires closed nursing team -characterization and socio-occupational relevance of subject), identifying the existence of this need in the context of stage. The main objective of this project is to contribute to the process of integration of new nurses in the operating room to improve the quality of care, and pointed out that this goal was reached were developed activities such as: a review of literature, questionnaires, preparation of a script of integration according to their specific needs, planning a training course for publicizing the integration guide, adjust the integration guide to the needs expressed by nurses after presentation. I was able to achieve not only the objectives proposed for the project development stage, as the development of perioperative nursing master skills acquired over three semesters. It is concluded that the process of integration is critical to enhance the skills of the individual who not only their own benefit, but also the organization and the customer, through a structured, planned and individual integration.

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Salvage, Eva. "Vårdenhetschefers och sektionsledares uppfattningar om operationssjuksköterskans perioperativa omvårdnadsarbete samt införande av denna arbetsmetod." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-11588.

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Introduktion: Den perioperativa omvårdnaden där operationssjuksköterskan ingår innefattar faserna före, under och efter operation och kan ses som ett arbetssätt. Perioperativ omvårdnad har utarbetats under 1990-talet. Arbetssättet har inte efterlevts i någon stor grad trots positiva effekter för patienter och personal. Operationssjuksköterskans arbete är fortfarande övervägande traditionellt, med fokus på tiden då patienten är sövd och opereras. Vårdenhetschefers och sektionsledares uppfattningar om den perioperativa omvårdnaden har betydelse för hur arbetet bedrivs på operationsavdelningar. Syfte: Att beskriva vårdenhetschefers och sektionsledares uppfattningar om operationssjuksköterskans perioperativa omvårdnadsarbete samt om införandet av perioperativ omvårdnad. Metod:Datainsamling skedde genom öppna intervjuer med fyra vårdenhetschefer och fyra sektionsledare inom operationssjukvården på två länssjukhus och två universitetssjukhus i Sverige. Insamlad data har analyserats kvalitativt med manifest innehållsanalys. Huvudresultat: Perioperativ omvårdnad som arbetssätt hade enligt vårdenhetschefer och sektionsledare inom operationssjukvård ett värde genom att förnya operationssjuksköterskans arbetssätt vilket anses förbättra patientens omvårdnad. För att införa perioperativ omvårdnad krävdes att olika behov tillgodoses, som tydliggörande av patientnyttan, stöd som skapar rätt förutsättningar, samt att det behövs motivation hos operationssjuksköterskor. Slutsats: Perioperativt omvårdnadsarbete är, trots dess värde, inte möjligt att genomföra utan långtgående förändringar i synsätt och organisation.
Introduction: Perioperative care in which the operating room nurse takes part includes the phases before, during and after operation and can be seen as a way of working in parallel with the care process. This approach has however not been applied to any great extent in pratice despite several studies having shown the positive effects for both patients and staff. The common view of the operating room nurse’s role is still a traditional one with the focus on the time when the patient is anaesthetized and during the actual surgery. Unit managers and section leaders perceptions of perioperative care are important since it affects how the approach is applied in practice. Aim: To describe the unit managers and section leaders perceptions of the operating nurse’s perioperative care work together with how the process is applied in practice. Method: Data were collected by semi-structured interviews with four unit managers and four section leaders within the operating room unit of two provincial hospitals and two university hospitals in Sweden. Data have been analysed with a qualitative content analysis. Main results: Perioperative care as an approach has, according to the unit managers and section leaders in the operating room unit, a value as it revitalises the operating room nurse’s method of working which in turn is thought to improve patient care. It is maintained that in order to introduce perioperative care certain requirements need to be fulfilled, such as clarification of the benefit to patients, support in order to create the right conditions, as well as the need for motivated operating room nurses. Conclusion: Perioperative nursing care is, despite its value, not possible to implement without farreaching changes to how operating room nursing is approached as well as organisational changes.

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Leon, Maria Denise. "Ansiedade e medo no pré-operatório de cirurgia cardíaca: intervenção de enfermagem na abordagem psicossocial." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-17052007-113555/.

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O investimento dessa pesquisa foi colocar em evidência os sentimentos de ansiedade e medo, encontrados em pessoas que se submeteriam à cirurgia de revascularização do miocárdio, por meio da aplicação de uma estratégia de intervenção grupal, na abordagem psicossocial. Os objetivos foram: identificar os níveis de ansiedade e medo nas pessoas que iriam se submeter à cirurgia de revascularização do miocárdio (RM); implementar uma estratégia de orientação grupal na visita pré-operatória, na abordagem psicossocial, para as pessoas que apresentaram medo e ansiedade no pré-operatório de cirurgia de RM; comparar os níveis de ansiedade e medo entre as pessoas que receberam as orientações tradicionais da instituição e aquelas que participaram da estratégia de orientação grupal na visita pré-operatória; apreender o significado das orientações pré-operatórias segundo a percepção das pessoas participantes dos grupos de intervenção. A pesquisa, de natureza quantitativa e qualitativa, foi realizada em um hospital especializado em cardiologia, no município de São Paulo no período de abril a agosto de 2006. Das pessoas abordadas para avaliação (109), 60 participaram efetivamente do estudo, sendo 30 no grupo de intervenção e 30 no grupo controle. Foi realizado um ensaio clínico controlado randomizado. Os dados foram analisados por meio de análise estatística e de análise de conteúdo, segundo Bardin. No grupo de intervenção foram utilizadas dinâmicas grupais para promover um ambiente relaxante e possibilitar aberturas para livre expressão das pessoas participantes. A maioria dos participantes era do sexo masculino, com Ensino Fundamental Incompleto, com nível sócio-econômico médio, com idade média de 62,02 anos. Verificou-se que as pessoas que participaram do grupo de intervenção tiveram redução nos níveis de ansiedade e o medo de forma clínica e estatisticamente significantes. As dinâmicas proporcionaram um momento lúdico e expressivo, além do significado cognitivo/afetivo e relacional, sendo alcançada. a segurança e a tranqüilidade que levaram à redução da ansiedade e do medo. Os resultados indicam que as orientações pré-operatórias realizadas de forma grupal, na abordagem psicossocial, produzem resultados efetivos e, portanto, recomenda-se que essa estratégia seja implementada nas instituições hospitalares
This research is aimed at highlighting the importance of feelings such as anxiety and fear in those who are to undergo myocardial revascularization surgery (RM), and the adoption of a psychosocial approach by which a strategy of group intervention is used. Aiming at identifying the levels of anxiety and fear in those patients, a strategy of group guidance during the pre-surgery round was adopted, using a psychosocial approach, comparing the levels of anxiety and fear in those who received traditional institutional guidance, and those who took part in the group guidance pre-surgical session, and also at comprehending the meaning of the pre-surgical guidance in the perception of the intervention group participants. This research is of a quantitative and qualitative nature, and was conducted in a specialized cardio hospital, in the city of Sao Paulo, in the period between April and August 2006. Out of the 109 people approached for assessment, 60 took an effective participation in the study, of which 30 were in the intervention group and 30 in the control group. A controlled, random clinical rehearsal was performed. The data was analyzed statistically and content wise, in accordance to Bardin. With the intervention group, group dynamics were applied so as to promote a relaxing, friendly environment, and allow for the participants free expression. Most of the subjects in this group were male, with incomplete lower education, average socio-economic class, and 62,02 years old on average. It was noted that this group subjects had their levels of anxiety and fear lowered, in a statistically significant manner. The dynamics provided them with more than only a playful, expressive moment; they had a cognitive/affectionate, relational significance, through which security and tranquility were achieved, and, as a result, levels of anxiety and fear were reduced. Results indicate that group pre-surgical guidance in a psychosocial approach produces effective results, and is thus recommended for undertaking in hospital

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Herbert, Suzan Margaret. "Factors underlying registered nurse interactions in a multicultural tertiary healthcare perioperative area." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97009.

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Thesis (MCur)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: Disruptive behaviour among health care providers in high stress areas such as the perioperative setting has been linked to negative patient safety. Conflicts of power, role and personality lead to communication failure, which are identified as the leading root cause of medication errors and wrong site surgery. The aim of the study was to explore and describe the factors underlying registered nurse (RN) interactions in a tertiary healthcare perioperative area. A non-experimental, descriptive, exploratory study with self-administered survey using a quantitative approach was used. The total population of N=52 participants working in the perioperative area of a Middle Eastern tertiary healthcare centre were invited to participate in the study and the response rate was n=44, 85%. A structured self-administered questionnaire was used to collect the data. Reliability and validity was assured by means of a pilot study and consultation with nursing experts and a statistician. The Health Research Ethics Committee of the University of Stellenbosch approved the study. Permission for the study to be done in the tertiary care centre was obtained from the Internal Ethical Review Board and the Nursing Executive. Informed written consent was obtained from the participants. Anonymity and confidentiality was respected. The data was analysed with the assistance of a statistician and presented in frequencies, tables and histograms. The responses were compared using Mann-Whitney U test, Kruskal- Wallis ANOVA and Spearman’s Rank correlation, on a 95% confidence level. Only one factor showed a significant result, following Spearman’s Rank correlation that an association exists between work experience and lateral violence (p≤0.045239). The open-ended questions were categorized into themes and respect and communication emerged as factors necessary in teamwork and task management The level of respect and open communication between RNs were seen as important factors for interacting with colleagues in the workplace and if poor, affects team work. An area of concern was the high number of neutral responses to the statements on morale and conflict. Underpinned by the literature and the outcomes of this study, it is recommended that strong leadership is required to implement regular team building activities. Furthermore, perioperative staff should be monitored for emotional fatigue which results from conflict situations in order to avert adverse patient care events.
AFRIKAANSE OPSOMMING: Steurende gedrag onder gesondheidsorgwerkers in hoë gespanne areas soos in die perioperatiewe omgewing, word gekoppel aan negatiewe pasiënt veiligheid. Konflikte van mag, rol en persoonlikheid lei tot mislukking van kommunikasie wat geïdentifiseer word as die hoofoorsaak van foute by die toediening van medikasie en verkeerde plek vir chirurgie. Die doel van die studie was om die faktore te ondersoek en te beskryf wat onderliggend is aan geregistreerde verpleeg (GV) interaksies in ’n tersiêre gesondheidsorg perioperatiewe area. ’n Nie-eksperimentele, beskrywende, ondersoekende studie met ’n self-administrerende opname deur ’n kwantitatiewe benadering, was gebruik. Die totale populasie van N=52 deelnemers wat in die perioperatiewe area van ’n Midde-Oosterse tersiêre gesondheidsorgsentrum werk, was uitgenooi om deel te neem aan hierdie studie en die responskoers was n=44, 85%. ’n Gestruktureerde self-administrerende vraelys was gebruik om die data te kollekteer. Betroubaarheid en geldigheid was verseker deur die gebruik van ’n loodsprojek en konsultasie met verpleegdeskundiges, asook ’n statistikus. Die Gesondheidsnavorsingsetiekkomitee aan die Universiteit van Stellenbosch het die studie goedgekeur. Toestemming vir die uitvoer van die studie by die tersiêre gesondheidssentrum was verkry van die Interne Etiese Oorsigraad en die Uitvoerende Verplegingsbestuur. Ingeligte geskrewe toestemming was verkry van die deelnemers. Anonimiteit en vertroulikheid was gerespekteer. Die data was geanaliseer met die hulp van ’n statistikus en aangebied in frekwensies, tafels en histogramme. Die response was vergelyk deur van Mann-Whitney U-toets, Kruskal-Wallis ANOVA of Spearman se Rangkorrelasie op ’n 95% vertroulikheidsvlak gebruik te maak. Slegs een faktor het ’n beduidende resultaat getoon, dat daar ’n assosiasie bestaan tussen werkservaring en laterale geweld (p≤0.045239), deur Spearman se Rangkorrelasie te volg. Die ope-vrae was gekategoriseer in temas. Respek en kommunikasie het as noodsaaklike faktore vir spanwerk en taakbestuur na vore gekom. Die vlak van respek en ope kommunikasie tussen geregistreerde verpleegsters was gesien as belangrike faktore vir interaksie met kollegas in die werkplek en indien dit swak is, affekteer dit spanwerk. ’n Area van besorgdheid was die hoë aantal neutrale response op die stellings oor moraal en konflik. Ondersteun deur die literatuur en die uitkomste van die studie, word dit aanbeveel dat sterk leierskap vereis word om gereelde spanbou aktiwiteite te implementeer. Verder behoort perioperatiewe personeel gemonitor te word vir emosionele moegheid wat spruit uit konfliksituasies, ten einde nadelige pasiëntsorg af te weer.

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Bexell, Hanna, and Agnes Ulvegard. "Patientkännedom i den perioperativa vården : En intervjustudie med operationssjuksköterskor." Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-55128.

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Introduktion: Operationssjuksköterskan ansvarar för en god och patientsäker perioperativ omvårdnad. Preoperativ personcentrerad information är en förutsättning för att kunna tillgodose patientens unika behov och främja kontinuitet i vården. Patientens individuella riskfaktorer är väsentligt för operationssjuksköterskan att känna till för att kunna förebygga vårdskador och genomföra en patientsäker perioperativ vård. Syfte: Syftet var att beskriva operationssjuksköterskors erfarenheter av att inhämta information för att skapa patientkännedom i den perioperativa vården. Metod: En kvalitativ studiedesign med en induktiv ansats tillämpades. Tio operationssjuksköterskor på ett länssjukhus i Sverige intervjuades. Intervjuerna spelades in och transkriberades i sin helhet. Innehållsanalys valdes som metod för dataanalys. Resultat: Två generiska kategorier framkom: Ta del av skriftlig information om patienten och Det preoperativa mötet med patienten. Dessa bildar tillsammans den övergripande huvudkategorin Förutsättning för personcentrerad och patientsäker perioperativ vård. Till den generiska kategorin Ta del av skriftlig information om patienten hör subkategorierna Att inhämta grundläggande kunskap och Att prioritera och ta vara på möjligheter. Till den generiska kategorin Det preoperativa mötet med patienten hör subkategorierna Att träffa och tala med patienten och Att skapa förutsättningar för samtal. Konklusion: Resultatet bidrar med fördjupade kunskaper kring vad som är väsentligt att veta om patienten i den perioperativa vården och varför det är viktig information, utifrån operationssjuksköterskans perspektiv. Både skriftlig information och ett preoperativt möte med patienten behövs för att skapa förutsättning för personcentrerad och patientsäker perioperativ vård. Resultatet tyder på att det behövs ett förändrat arbetssätt för att möjliggöra skapandet av god kännedom om varje enskild patient och på så sätt öka patientsäkerheten.
Introduction: The operating room nurse is responsible for a good and safe perioperative care. Preoperative person-centered information is a prerequisite to meet the patient´s unique needs and promote continuity of care. The patient´s individual risk factors are essential for the operating room nurse to know in order to prevent hospital acquired injuries and to accomplish safe perioperative care. Aim: The aim was to describe operating room nurses´ experiences of obtaining information to create knowledge of the patient in perioperative care. Method: A qualitative study with an inductive approach was conducted. Ten operating room nurses at a hospital in Sweden were interviewed. The interviews were recorded and transcribed. Content analysis was chosen as the method of data analysis. Result: Two generic categories emerged: Read written information about the patient and The preoperative meeting with the patient. These generic categories together form the main category Prerequisite for person-centered and safe perioperative care. The generic category Read written information about the patient includes the subcategories To acquire basic knowledge and To prioritize and to seize opportunities. The generic category The preoperative meeting with the patient includes the subcategories To meet and talk with the patient and To create conditions for conversation. Conclusion: The findings contribute to a deeper knowledge of what is essential to know about the patient in perioperative care and why this is important information, from the operating room nurse´s perspective. Both written information and a preoperative meeting with the patient are required to create prerequisite for person-centered and safe perioperative care. The results indicate a need of change in the way of working to enable good knowledge of each patient, and thereby increase patient safety in perioperative care.

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Pavão, Sandra Patrícia Benevides Fragoso. "Ferramenta de gestão na promoção da melhoria contínua da qualidade e segurança do utente a ser submetido a cirurgia eletiva: checklist DIIVA." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2019. http://hdl.handle.net/10400.26/28468.

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Relatório de Estágio do Mestrado em Enfermagem Perioperatória
O presente relatório surge no âmbito do 2º Mestrado em Enfermagem Perioperatória da Escola Superior de Saúde do Instituto Politécnico de Setúbal, sendo o Relatório de Estágio o trabalho final de Mestrado. Ao longo do mesmo é realizada a análise e reflexão do percurso percorrido com vista à aquisição de conhecimentos e competências de enfermeiro Mestre em Enfermagem Perioperatória. Este relatório pretende apresentar o trabalho desenvolvido em estágio em ambiente clínico perioperatório, centrado na identificação de um problema real, apoiado pela metodologia de projeto. Sendo a cultura de segurança no meio hospitalar um assunto emergente da atualidade, esta surge também na identificação de áreas problemáticas no local de trabalho. Deteta-se o adiamento ou cancelamento de cirurgias por falta de material, resultante da ausência de ferramentas da gestão do mesmo. A lista de verificação da segurança cirúrgica da OMS, apesar da sua extrema importância e utilidade, não prevê atempadamente a preparação de todos os dispositivos, instrumentos e implantes que possam ser necessários à cirurgia. Foi utilizado como referencial teórico, a Teoria das Transições de Afaf Meleis, uma Teoria de Médio Alcance que, a nosso ver, está estreitamente relacionada com os utentes a serem submetidos a cirurgia, e a sua relação com os enfermeiros perioperatórios. De forma a fundamentar as temáticas abordadas ao longo do relatório, efetuou-se uma revisão integrativa da literatura, realizando uma pesquisa alargada do fenómeno em estudo. A recolha de dados foi efetuada em junho de 2018, com recurso a um questionário aplicado aos profissionais de saúde de um bloco operatório. Participaram 36 profissionais e a maioria identificou como intercorrências no bloco operatório do último ano: cancelamento de cirurgias por falta de material, falta de comunicação da equipa multidisciplinar, material fora do prazo de validade, falta de instrumental cirúrgico e falha nos equipamentos. Dada a identificação da problemática por parte dos profissionais, foi criada uma ferramenta de apoio à gestão do material cirúrgico - Checklist DIIVA - que permite verificar a disponibilidade dos dispositivos, implantes e instrumentos e respetivos prazos validade, atempadamente, procurando dar resposta ao problema identificado e assegurar a melhoria contínua dos cuidados de enfermagem perioperatórios.
This report is presented within the scope of the 2nd Masters in Perioperative Nursing taken in Escola Superior de Saúde do Instituto Politécnico de Setúbal. The Internship Report is the final master’s work. Throughout the same is carried out the analysis and reflection of the course viewing the acquisition of knowledge and skills of Master nurse in Perioperative Nursing. This report intends to present the work developed in a perioperative clinical stage, centered on the identification of a real problem, supported by the project methodology. Since safety culture in the hospital environment is an emerging issue, it also arises in the identification of problem areas in the workplace. Deferral is the postponement or cancellation of surgeries due to lack of material, resulting from the absence of management tools. The surgical safety checklist, despite its extreme importance and usefulness, does not provide timely preparation of all devices, instruments and implants that may be necessary for surgery. The Afaf Meleis Theory of Transitions was used as a theoretical reference. It´s a Medium Sized Theory that, in our opinion, is closely related to the patients to be submitted to surgery, and its relationship with the perioperative nurses. To substantiate the themes addressed throughout the report, an integrative review of the literature was carried out, executing a broad survey of the phenomenon under study. Data collection was performed in June 2018, using a questionnaire applied to health professionals from an operating room. 36 professionals participated and most identified as complications in the last year's operating room: surgery cancellation due to lack of material, lack of communication of the multidisciplinary team, material with expired date, lack of surgical instruments and equipment failure. Given the identification of the problem by the professionals, a tool was created to support the management of the surgical material - DIIVA checklist - which allows checking the availability of devices, implants and instruments and their validity, in a timely manner, to respond to the identified problem and continuous improvement of perioperative nursing care.

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Melchior, Lorena Morena Rosa. "Ansiedade pré-operatória em pacientes cirúrgicos hospitalizados de Goiânia-Go." Universidade Federal de Goiás, 2017. http://repositorio.bc.ufg.br/tede/handle/tede/7227.

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INTRODUCTION: The anesthetic-surgical procedure is a complex and critical process, a moment that can generate important implications for the patients, and can generate diverse feelings such as anxiety and fear. Preoperative anxiety has affected about 60 to 80% of surgical patients. The patient's emotionally unstable surgery is scary and traumatic and is still predisposed to complications. PURPOSE: To investigate the profile of anxious patients hospitalized in preoperative elective surgery. METHOD: A cross-sectional, analytical study with subsequent cohort formation, performed at a public university hospital in the city of Goiânia-GO, Brazil. The population consisted of preoperative elective surgery patients hospitalized in surgical units, the sample was constituted of 200 patients in the preoperative period, by means of a sample calculation. Four instruments were used, one structured with sociodemographic and clinical-surgical questions; The Hamilton anxiety scale; The numerical scale of pain and the admission card of the surgical center. The study was carried out in total accordance with the Resolution 466/2012 regarding ethical issues. The analysis was expressed in absolute and relative frequencies and the Chi-square test was employed, with a significance level of 5%. The Prevalence Ratio (PR) was evaluated through gross and adjusted Poisson regression. RESULTS: The prevalence of anxiety was 53,0% (n=106) (CI 95% 46,06/59,85), mild anxiety was present in 67,0% (n=71) (CI 95%; 57,6-75,4), and 33,0% (n=35) (CI 95% 24,5/42,3) of the patients presented moderate and severe anxiety. In the multivariate analysis, sex, occupation and fear of anesthesia were significant, configuring as predictors to moderate and severe anxiety. The fear of anesthesia, of something going wrong, or of dying emerged in a predominant part of the sample, and the fear of errors showed significant relation to moderate and severe anxiety. CONCLUSIONS: The prevalence of preoperative anxiety found in the study was high. Most of the anxious patients expressed levels of mild anxiety. The most common factors that led to anxiety were the fear of death and of errors by the surgical team. Sex, occupation and fear of anesthesia configured as predictors to moderate and severe anxiety.
INTRODUÇÃO: O procedimento anestésico-cirúrgico é um processo complexo e crítico, um momento capaz de gerar implicações importantes aos pacientes, podendo gerar diversos sentimentos como o de ansiedade e o medo. A ansiedade pré-operatória tem afetado cerca de 60 a 80% dos pacientes cirúrgicos. O paciente instável emocionalmente a cirurgia é algo assustador e traumático e ainda está predisposto a complicações. OBJETIVO: Investigar o perfil dos pacientes ansiosos hospitalizados em pré-operatório de cirurgia eletiva. MÉTODO: Estudo de delineamento transversal, analítico, com posterior formação de coorte, realizado num hospital universitário público do município de Goiânia-GO, Brasil. A população foi constituída por pacientes em pré-operatório de cirurgia eletiva internados em unidades cirúrgicas, a amostra foi constituída de 200 pacientes em pré-operatório, mediante cálculo amostral. Utilizou-se quatro instrumentos, um estruturado com questões sociodemográficas e clínico-cirúrgicas; a escala de ansiedade de Hamilton; a escala numérica de dor e a ficha de admissão do centro cirúrgico. O desenvolvimento do estudo atendeu integralmente à Resolução 466/2012, quanto às questões éticas. Realizou-se análise expressa em frequências absoluta e relativa e utilizou-se o teste qui-quadrado, considerando nível de significância de 5%. A Razão de Prevalência (RP) foi avaliada por meio da Regressão de Poisson bruta e ajustada. RESULTADOS: A prevalência de ansiedade pré-operatória foi 53,0% (n=106) (IC 95% 46,06/59,85), a ansiedade leve foi de 67,0% (n=71) (IC 95%; 57,6- 75,4), e 33,0% (n=35) (IC 95% 24,5/42,3) dos pacientes apresentaram ansiedade moderada e grave. O perfil dos ansiosos foi formado por pacientes na faixa etária entre 50 a 69 anos, mulheres, baixa escolaridade, casados, moradores do interior do estado de Goiás, em casas cujo provedor era único, trabalhadores informais/desempregados, não tabagistas/etilistas, com menos de 24 horas de internação, com experiência cirúrgica prévia, sem doenças crônicas e sem dor no pré-operatório. Na análise multivariada, o sexo, a ocupação e o medo da anestesia foram significativos, configurando-se em preditores para ansiedade moderada e grave. O medo da anestesia, de algo dar errado, ou de morrer, esteve em parte predominante da amostra e o medo de erros mostrou relação significante com a ansiedade moderada e grave. CONCLUSÕES: A prevalência de ansiedade pré- operatória encontrada foi alta, comparada a estudos semelhantes. A maioria dos pacientes ansiosos demonstrou níveis de ansiedade leve. O sexo, a ocupação e o medo da anestesia configuraram-se em preditores para ansiedade moderada e grave nos pacientes cirúrgicos.

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Ramdas, Leonard Harichand. "Strategies to Prevent the Unintentional Retention of Foreign Objects in Surgical Patients." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1656.

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The Institute of Medicine's report in 2000, To Err Is Human: Building a Safer Health System, highlighted the seriousness of medical errors in the U.S. health care system. The unintentional retention of foreign objects in surgical patients is one of those errors. At the time of this study, there was no standardized counting policy and process across operating rooms in the United States. The purpose of this project was to develop a best practice educational counting program to help prevent the unintentional retention of foreign objects in surgical patients. The Logic Model was used to guide the design of the educational program and expected learning outcomes. A draft of the educational program was distributed to 10 perioperative stakeholders for an initial formative review. Changes were incorporated into the program and it was distributed to 6 perioperative experts for an additional summative assessment and content validation utilizing the AGREE II Instrument. The overall quality evaluation of the educational program was 85%, indicating that it was of high quality. Four of the respondents recommended the educational program for implementation without any changes and 2 recommended it for implementation with some minor modifications related to rewording of one question in the pretest-posttest. There were no recommended modifications in the content of the educational program. As a result, the project was recommended for adoption as a best practices-based educational program to prevent the unintentional retention of foreign objects in surgical patients. The study promotes positive social change by providing suggestions to improve the provision of safe care to surgical patients and decrease health care costs.

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Nilsson, Rebecca, and Carina Sörensen. "Operationssjuksköterskors erfarenheter vid organdonation när donatorn är hjärndöd." Thesis, Karlstad University, Faculty of Social and Life Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-4498.

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En operationssjuksköterska kan under sin yrkesverksamma tid förväntas att ansvara vid en operation där patienten konstaterats hjärndöd och det beslutats att organdonation ska genomföras. Syftet med denna studie var att beskriva operationssjuksköterskors erfarenheter vid organdonation när donatorn är hjärndöd. Studien har en kvalitativ ansats, där forskarna strävar efter en helhetsförståelse av det studerade intresseområdet. Datainsamling utfördes via ostrukturerade intervjuer med öppna frågor. Sju intervjuer genomfördes med operationssjuksköterskor som medverkat vid organdonation när donatorn var hjärndöd. Innehållsanalys genomfördes och fyra huvudkategorier framträdde: Inför donation, Genomförande av donation, Efter donation och Etiska aspekter vid donation. Resultatet visade att operationssjuksköterskorna hade liknande erfarenheter vid organdonation när donatorn var hjärndöd som vid andra operationer angående arbetsuppgifter och ansvarsområden. Teamarbete hade en central roll och vikten av värdighet i vården framträdde tydligt. Många olika tankar och känslor väcktes hos operationssjuksköterskorna i samband med en organdonation. En operationssjuksköterska kan under sin yrkesverksamma tid förväntas att ansvara vid en operation där patienten konstaterats hjärndöd och det beslutats att organdonation ska genomföras. Syftet med denna studie var att beskriva operationssjuksköterskors erfarenheter vid organdonation när donatorn är hjärndöd. Studien har en kvalitativ ansats, där forskarna strävar efter en helhetsförståelse av det studerade intresseområdet. Datainsamling utfördes via ostrukturerade intervjuer med öppna frågor. Sju intervjuer genomfördes med operationssjuksköterskor som medverkat vid organdonation när donatorn var hjärndöd. Innehållsanalys genomfördes och fyra huvudkategorier framträdde: Inför donation, Genomförande av donation, Efter donation och Etiska aspekter vid donation. Resultatet visade att operationssjuksköterskorna hade liknande erfarenheter vid organdonation när donatorn var hjärndöd som vid andra operationer angående arbetsuppgifter och ansvarsområden. Teamarbete hade en central roll och vikten av värdighet i vården framträdde tydligt. Många olika tankar och känslor väcktes hos operationssjuksköterskorna i samband med en organdonation.

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Silva, Tiago Manuel Magalhães Cardoso da. "Competências não técnicas do enfermeiro instrumentista." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2016. http://hdl.handle.net/10400.26/17276.

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Relatório de Estágio apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Enfermagem Perioperatória
O presente relatório de estágio enquadra-se no 1º Curso de Mestrado em Enfermagem Perioperatória, da Escola Superior de Saúde do Instituto Politécnico de Setúbal. Foi redigido segundo a metodologia de projeto, focando-se na integração de conhecimentos e competências adquiridas durante o curso, no domínio da enfermagem perioperatória. Tem como objetivos estabelecidos: (1) reflexão crítica acerca das atividades realizadas em contexto de estágio; (2) desenvolvimento de um projeto acerca das competências não técnicas do enfermeiro instrumentista; (3) reflexão crítica acerca do desenvolvimento de competências de mestre em enfermagem perioperatória. De forma a responder aos objetivos propostos organizou-se a estrutura deste relatório por três capítulos distintos: Capítulo I – onde consta o enquadramento concetual, considerando a teoria do autocuidado de Dorothea Elizabeth Orem; e enquadramento teórico, acerca do conceito de competência em enfermagem perioperatória. Capítulo II – corresponde ao enquadramento metodológico, onde é fundamentado o método seguido para a construção do projeto, exposto o tipo de estudo conduzido, o trabalho de campo desenvolvido, bem como os processos de colheita e tratamento de dados, considerando sempre as questões éticas do processo de investigação. Capítulo III – é realizada a reflexão sobre o estágio realizado, assim como a aquisição do perfil de competências de mestre em enfermagem perioperatória. A realização deste relatório de estágio permitiu a aquisição de conhecimentos no domínio da enfermagem perioperatória. Com os contributos da investigação elaborada, foi possível a compreensão e aplicação destes saberes para a resolução de problemas, em ambiente clinico multidisciplinar, consciente das implicações científicas, éticas, deontológicas e jurídicas.
This internship report is part of the 1st Master in Perioperative Nursing, taken in Escola Superior de Saúde do Instituto Politécnico de Setúbal. It has been drafted according to project methodology, focusing on the integration of knowledge and skills acquired during the course in the field of perioperative nursing. Its stated objetives are: (1) critical analysis of the activities undertaken in the stage context; (2) project development for scrub nurses non-technical skills; (3) critical assessment on the development master competencies in perioperative nursing. In order to meet the proposed objetives, this report is organized by three chapters: Chapter I – with the conceptual framework, considering the self-care theory of Dorothea Elizabeth Orem; and theoretical framework of competence in perioperative nursing. Chapter II - corresponds to the methodological framework, which is based the method followed for the construction of the project, stated the type of study conducted, the field work and the procedures for collection and processing of data, always considering ethical issues in research process. Chapter III - is held to assess the internship stage, as well as the acquisition of master skills profile in perioperative nursing. The completion of this internship report allowed the acquisition of knowledge in the field of perioperative nursing. With the contributions of elaborate investigation, it was possible the understanding and application of this knowledge to solve problems in a multidisciplinary clinical environment, aware of the scientific, ethical, ethical and legal implications.

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Giron, Mariana Nepomuceno. "O acolhimento de usuários no centro cirúrgico e a humanização das práticas cotidianas do cuidado de enfermagem." Universidade do Estado do Rio de Janeiro, 2013. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=6670.

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Falar da humanização é retomar a tradição do ocidente de pensar o lugar que o ser humano ocupa no mundo, nas inter-relações com seus semelhantes, na esfera social e também de saúde, em uma ética e solidariedade. Para uma prática de cuidados humanizada, o início destes cuidados deve ocorrer com o acolhimento do usuário em todos os setores, entre eles o Centro Cirúrgico. Este estudo tem como objetivo geral: compreender o processo de acolhimento no cotidiano da assistência de enfermagem no Centro Cirúrgico a partir da diretriz: acolhimento, ambiência e clínica ampliada da Política Nacional de Humanização. E como objetivos específicos: descrever o acolhimento do usuário durante as práticas cotidianas do cuidado de enfermagem no Centro Cirúrgico; analisar as experiências de acolhimento na perspectiva dos usuários no Centro Cirúrgico durante as práticas cotidianas do cuidado de enfermagem e identificar as estratégias utilizadas durante o cuidado de enfermagem no Centro Cirúrgico que concretizam a viabilização da diretriz: acolhimento, ambiência e clínica ampliada. Para dar conta do estudo selecionamos a abordagem etnometodológica, caráter exploratório. O cenário do estudo foi um hospital da rede estadual do Rio de Janeiro e os dados foram coletados por meio de entrevista semiestruturada realizada com 18 usuários em pós-operatório e observação participante no Centro Cirúrgico. Em seguida submetidos à análise de conteúdo de Bardin, emergindo três categorias: A recepção do usuário no Centro Cirúrgico; caracterização da realização do acolhimento na recepção do Centro Cirúrgico na perspectiva do usuário e estratégias de cuidado direcionadas para ambiência, acolhimento e clínica ampliada. Conclui-se que compreender o processo de acolhimento no cotidiano da assistência de enfermagem somente foi possível pelo compartilhamento de experiências de usuários que utilizaram os serviços da unidade. O cuidado de enfermagem neste ambiente foi identificado a partir de duas práxis: na recepção do paciente para cirurgia eletiva e diferentemente para cirurgia de emergência. O ambiente do Centro Cirúrgico gera no usuário uma gama de sentimentos e há um imaginário em torno do evento cirúrgico e deste espaço. No que se refere à diretriz, o cuidado de enfermagem neste setor atende parcialmente ao que esta estabelecido. Um caminho para a viabilização da PNH e da diretriz: acolhimento, ambiência e clínica ampliada é a educação continuada em serviço que deve não somente dispor da política em sua teoria, mas desenvolver métodos para que a torne concreta e palpável promovendo melhoria no cuidado de enfermagem.
To talk about humanization is to recapture the western tradition of thinking about the place where the human being occupies in the world, about the interrelationship between its fellow human beings, about the social as well as health care sphere, about ethics and solidarity. To a humanized care practice the beginning of this care must occur with the user embracement in all sectors, including the general surgical ward. The main goal of this study is: to comprehend the user embracement process in the everyday of the nurse assistance in the general surgical ward through the directive: user embracement, ambiance and extended general practice from the Política Nacional de Humanização (PNH). As the specific goals: to describe the user embracement during the daily nursing care practice in the general surgical ward; to analyze the user embracement experiences from the perspective from the users in the general surgical ward during the daily nursing care practice and to identify the strategies used during the nursing care in the general surgical ward that make the feasibility of the directive real: User Embracement, Ambiance and Extended General Practice. In order to carry the study through we chose the ethnomethodological approach with an exploratory research design. The study scenario is a Rio de Janeiro States hospital and the data were collected through semi-structured interviews with eighteen participants in post-operative care and participant observation in the general surgical ward. Afterwards they were submitted to the Bardins content analysis, from what three categories emerged: the reception of the user in the general surgical ward; characterization of the execution of the user embracement in the general surgical wards reception from the users perspective and strategies of care oriented towards the ambiance, user embracement and extended general practice. Final considerations: comprehending the user embracement process in the everyday of the nurse assistance was only possible through the sharing of the experiences of the users that used the services of the unit. Nursing care in this environment was identified through two praxes: in the reception of the user to elective surgery and differently to the emergency surgery. The ambiance of the general surgical ward creates in the user a range of feelings and there is an imaginary around the surgical event and this space. About the directive, the nursing care in this sector attends partially what is established. A way to the feasibility of the PNH and the directive: user embracement, ambiance and extended general practice is a lifelong learning in work that must not only employ the politics in its theory, but develop methods in order to make it real and tangible, promoting an improvement in the nursing care.

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Ribeiro, Celso Pires. "Boa Prática de Enfermagem à Pessoa submetida a Vitrectomia: integração de profissionais de enfermagem perioperatórios, na instrumentação da cirurgia oftalmológica de segmento posterior." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2013. http://hdl.handle.net/10400.26/6158.

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Relatório de Trabalho de Projeto apresentado para cumprimento dos requisitos necessários à obtenção do Grau de Mestre em Enfermagem Médico-Cirúrgica.
O presente relatório inclui-se no plano de estudos do I Curso de Mestrado em Enfermagem Médico-Cirúrgica, da Escola Superior de Saúde do Instituto Politécnico de Setúbal, surgindo como um documento ilustrativo do desenvolvimento de competências durante o estágio, realizado no serviço do Bloco Operatório de um Hospital da margem sul do Rio Tejo. Neste contexto, foi desenvolvido um projeto de intervenção em serviço, denominado então de “Boa Prática de Enfermagem à Pessoa submetida a Vitrectomia”, com o objectivo geral de contribuir para a integração dos enfermeiros no bloco operatório, afim de melhorar a qualidade e segurança dos cuidados de enfermagem prestados à pessoa submetida à cirurgia de Vitrectomia. A demonstração da importância da aquisição das respectivas competências, para o desempenho da função enquanto Mestre e Enfermeiro Especialista em Enfermagem Médico- Cirúrgica, encontra-se descrito na reflexão crítica dos objectivos gerais e específicos realizados. A metodologia escolhida para a realização deste relatório baseia-se no método descritivo e analítico, através da reflexão do confronto das atividades referidas no projeto de estágio, com a exposição das atividades realizadas.
Abstract: This report is included in the study programme of I Master's in Medical-Surgical Nursing, of School of Health Sciences, in Polytechnic Institute of Setúbal, emerging as a document illustrating skills development during the training programme, performed in the service of Operating Room in a Hospital located on the south bank of the Tagus River. In this context, we developed an intervention project in service, then called the "Good Nursing Practice of Person submitted to Vitrectomy", with the overall objective of contributing to the integration of nurses in the operating theater in order to improve the quality and safety of nursing care provided to the person subjected to vitrectomy surgery. The demonstration of the importance of the acquisition of these skills, to perform the function as Master and Nurse Specialist Medical-Surgical Nursing, is described in the critical reflection of the general and specific objectives achieved. The methodology chosen for the realization of this report is based on the descriptive and analytical method, through reflection of the confrontation of the activities referred in the training programme project, with the exposure of the activities performed.

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D'Oliveira, David André Espanhol. "A presença dos pais/pessoa significativa no bloco operatório junto da criança/jovem em situação perioperatória." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2019. http://hdl.handle.net/10400.26/28424.

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Relatório de Dissertação/ estágio/projeto de Investigação do Mestrado em Enfermagem Perioperatória
O presente relatório foi elaborado no âmbito do 2.º Curso de Mestrado em Enfermagem Perioperatória. Corresponde ao trabalho final do Mestrado onde é realizada uma reflexão de todo o processo de aquisição e desenvolvimento de competências de Mestre. O Estágio foi um meio importante para todo o processo de desenvolvimento de competências, aquisição e aprofundamento de conhecimentos em Enfermagem Perioperatória e nas competências de Mestre. Também é apresentado todo o trabalho desenvolvido de acordo com a metodologia de projeto. O problema no qual nos centrámos foi na presença dos pais/pessoa significativa no Bloco Operatório, até à indução anestésica. Com o desenvolvimento deste pretendemos demostrar que a presença dos pais/pessoa significativa até à indução anestésica, no Bloco Operatório, tem benefícios para a criança/jovem, para os pais/pessoa significativa, equipa e para a Enfermagem Perioperatória. De forma a sustentar todo o trabalho foi realizada uma Revisão Integrativa da Literatura. Como propostas de trabalho foram realizados um Guia de Acolhimento para os pais/pessoa significativa no Bloco Operatório, Revisão da Lista de Verificação Pré-Operatória e uma Norma de Procedimento sobre o Acolhimento dos pais/pessoa significativa no Bloco Operatório. Também se torna importante realçar que foi realizado um Estágio de Observação, uma Revisão Integrativa da Literatura e uma Formação em Serviço de forma a chegarmos às propostas de trabalho e posteriormente, conseguirmos atingir os nossos objetivos. De forma a sustentar o trabalho teoricamente baseámo-nos na Teórica Jean Watson. Para chegarmos ao resultado final passámos por várias etapas de forma a contribuirmos para a melhoria da experiência cirúrgica das crianças/jovens e dos próprios pais/pessoa significativa no Bloco Operatório, até à indução anestésica.
This report was prepared within the framework of the 2nd Master's Course in Perioperative Nursing. It corresponds to the final work of the Masters where a reflection of the entire process of acquisition and development of Master's competences is carried out. The Internship was an important means for the entire process of skills development, acquisition and deepening of knowledge in Perioperative Nursing and Master's competences. Also presented is all the work developed according to the project methodology. The problem in which we focused was in the presence of the parents / significant person in the Operative Block, until anesthetic induction. With the development of this, we intend to demonstrate that the presence of parents / significant person until anesthetic induction, in the Operative Block, has benefits for the child / young person, for the significant person / parent, team and for the Perioperative Nursing. In order to sustain all the work an Integral Literature Review was carried out. As a work proposal, a Parent / Person Placement Guide was made meaningful in the Operative Block, Preoperative Check List Review and a Parent / Person Placement Standard of Operation in the Operative Block. It is also important to emphasize that an Observation Stage, an Integral Review of Literature and a Training in Service were carried out in order to reach the work proposals and later, to achieve our objectives. In order to sustain the work theoretically we were based on the theoretical Jean Watson. To reach the final result we went through several steps in order to contribute to the improvement of the surgical experience of the children / youngsters and of the parents / significant person in the Operative Block until anesthetic induction.

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Camargo, Tamara Carolina de. "Avaliação da esterilização a vapor do instrumental laparoscópico montado: abordagem laboratorial." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-20092013-153759/.

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Esta pesquisa avaliou a segurança microbiológica da esterilização a vapor do instrumental laparoscópico reutilizável montado. Foram selecionados dois tipos de instrumental laparoscópico reutilizável: trocarte e pinça de dissecção de 5mm. Considerando a eficácia da limpeza como pré-requisito essencial para o processo de esterilização, a PRIMEIRA ETAPA da pesquisa, avaliou 66 instrumentos laparoscópicos, sendo 33 pinças e 33trocartes, submetidos a diferentes métodos de limpeza, avaliando como desfecho os resíduos orgânicos de proteína, hemoglobina e carboidrato, após contaminação intencional com sangue de placenta humana. Os métodos de limpeza testados foram: (1) limpeza manual com enxágue em água potável; (2) limpeza manual com enxágue em água potável, seguida de limpeza ultrassônica sem enxágue; (3) limpeza manual com enxágue em água potável, seguida de limpeza ultrassônica com enxágue em água potável e (4) limpeza manual com enxágue em água potável, seguida de limpeza ultrassônica com enxágue em água potável e último enxágue em água destilada esterilizada. Os experimentos foram acompanhados pelos grupos controle Positivo (sem limpeza) e Negativo, composto por instrumental laparoscópico novos sem contaminação intencional, avaliados após os procedimentos de limpeza (1) e (4). Para avaliação dos resíduos orgânicos, utilizou-se o kit Quantipro BCA para dosagem de proteínas, TMB One para hemoglobina, fenol 5% e ácido sulfúrico para carboidrato, todos com leitura por espectrofotometria. O grupo controle Positivo evidenciou níveis médios de 332µg/cm2 proteína, 30µg/cm2 carboidrato e 417µg/cm2 hemoglobina. Conforme esperado, o método de limpeza (4) apresentou desempenho superior quando comparado com o método (1), reduzindo 92% a mais de µg/proteína/pinça e 60% a mais de µg/carboidrato/pinça e por trocarte, embora esta superioridade não tenha sido observada de uma forma uniforme em todo o experimento. No grupo controle Negativo, os níveis máximos de proteína detectados foram 1,70µg/cm2 e de carboidrato de 1,07µg/cm2, não sendo detectada hemoglobina. A SEGUNDA ETAPA, avaliou a esterilização do instrumental laparoscópico reutilizável montado com contaminação desafio de três vezes 106 esporos Geobacillus stearothermophillus ATCC 7953, impregnados em suporte de papel filtro extraídos do indicador biológico comercialmente disponível para monitoramento da autoclavação. Os experimentos microbiológicos foram acompanhados dos grupos controle Positivo (suporte do indicador biológico não submetido à esterilização) e controle Negativo (instrumentos laparoscópicos esterilizados desmontados com contaminação desafio). Como grupo Experimental, foram analisados 370 instrumentos laparoscópicos esterilizados montados, sendo 185 pinças e 185 trocartes. Três suportes de papel impregnados com os esporos foram introduzidos no interior de cada instrumento laparoscópico, precedidos de limpeza tipo (4), embalados em papel grau cirúrgico e submetidos à esterilização a vapor saturado sob pressão (134oC por 5 minutos). Com técnica asséptica, cada suporte de papel foi inoculado em meio de cultura de Tryptic Soy Broth (TSB), incubado a 56oC por 21 dias. Não sendo observado crescimento, as amostras foram submetidas a um choque térmico a 80oC, por 20 minutos, para estimular a germinação, com reincubação por mais 72 horas. Não houve crescimento microbiano algum nas amostras do grupo Experimental. Os resultados dos grupos controles foram satisfatórios. O controle Positivo confirmou o desafio imposto aos experimentos e o controle Negativo apresentou resultados esperados de ausência de crescimento. Este estudo forneceu fortes evidências científicas para os Centros de Material e Esterilização sustentarem a segurança microbiológica da prática de esterilização do instrumental laparoscópico montado
This study evaluated the microbiological safety of steam sterilization, the reusable laparoscopic instrument assembled. We selected two types of reusable laparoscopic instrument: trocar and dissecting forceps 5mm. Considering the efficacy of cleaning as an essential prerequisite for the sterilization process, the FIRST STEP evaluated 66 laparoscopic instruments, 33 trocars and 33 dissecting forceps, subjected to different cleaning methods evaluating outcome as organic waste protein, hemoglobin and carbohydrate after intentional contamination with blood from human placenta. Cleaning methods were tested: (1) manual cleaning rinse with potable water, (2) manual cleaning with rinsing in clean water, then cleaning ultrasonic without rinsing, (3) manual cleaning with rinsing in clean water, then cleaning ultrasonic rinse with potable water and (4) manual cleaning rinse with potable water, followed by ultrasonic cleaning with potable water rinse and final rinse in sterile distilled water. The experiments were accompanied by positive control groups (without cleaning) and negative, composed of laparoscopic instruments again without intentional contamination, assessed after the cleaning procedures (1) and (4). For evaluation of organic waste is used Quantipro BCA kit for the determination of protein, TMB One to hemoglobin, 5% phenol and sulfuric acid of carbohydrate with any read by spectrophotometry. The positive control group showed average levels of 332µg/cm2 protein, carbohydrate 30µg/cm2 and 417µg/cm2 hemoglobin. As expected, the cleaning method (4) superior performance when compared with the method (1), reducing 92% more µg/protein/forceps and more than 60% µg/carbohydrate/forceps and trocar, although this superiority has not been observed in a uniform manner throughout the experiment. In the negative control group maximum levels of protein detected were 1.70 µg/cm2 and 1.07 µg/cm2carbohydrate was not detected hemoglobin. The SECOND STEP evaluated the sterilization of reusable laparoscopic instruments assembled with contamination challenge 3 times 10 Geobacillusstearothermophillus spores ATCC 7953, impregnated strips filter paper extracted from commercially available biological indicator for monitoring steam sterilization. The experiments were accompanied microbiological positive control groups (biological indicator spore strips non-sterile) and negative (laparoscopic instruments sterilized contamination disassembled challenge). As experimental group were analyzed 370 laparoscopic instruments sterilized assembled, 185 dissecting forceps and 185 trocars. Three spore strips of paper impregnated were introduced in laparoscopic instrument within each preceded by cleaning type (4), packed in surgical paper and subjected to saturated steam sterilization under pressure (134oC for 5 minutes). With aseptic technique, each paper spore strip was inoculated into culture medium Tryptic Soy Broth (TSB) and incubated at 56oC for 21 days. No growth was observed, they were subjected to heat shock at 80oC for 20 minutes to stimulate germination, with more reincubation for 72 hours. There was no microbial growth in some samples of the experimental group. The results of the control groups were satisfactory. The Positive Control confirmed the challenge posed to experiments and the negative control presented results expected from the absence of growth. This study provides strong scientific evidence for the Centers for Material and Sterilization sustain the microbiological safety of the practice of sterilization of laparoscopic instruments assembled.

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Mattia, Ana Lucia De. "Utilização das horas de enfermagem em salas de operações, segundo a complexidade do paciente e do procedimento anestésico-cirúrgico." Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/7/7136/tde-06052009-101000/.

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Esta pesquisa é um estudo de caso, com natureza exploratória, descritiva e comparativa de campo, transversal e com abordagem quantitativa. Tem como objetivo classificar as cirurgias em categorias, segundo a necessidade de horas de enfermagem em salas de operações, subsidiando o dimensionamento de pessoal de enfermagem em centro cirúrgico. Foi realizada em um Hospital geral, de grande porte, da rede privada da cidade de São Paulo. A amostra foi constituída de 140 pacientes, divididos em 14 grupos, sendo 10 pacientes em cada grupo. Para a formação dos grupos foi considerado a condição física do paciente, segundo Americam Society of Anestesiologists (ASA), o porte anestésico segundo a Associação Médica Brasileira (AMB), o tipo de procedimento anestésico-cirúrgico, invasivo ou minimamente invasivo (MI) e cirurgias eletivas. Quanto à condição física do paciente, os grupos foram formados com ASA1, ASA2 e ASA3; a ASA4 foi excluída por não apresentar casos, ASA 5 e 6 foram excluídos por serem cirurgias de urgência ou emergência. Quanto ao porte anestésico, as cirurgias foram classificadas em pequeno porte, médio porte, grande porte e porte especial. Desta forma os grupos ficaram simbolizados como: 1P, 1M, 1G, 1E, 2P, 2M, 2G, 2E, 3M, 3G, 3E, 1PMI, 1MMI e 2MMI. A coleta de dados foi realizada dentro das salas de operações, por meio de observação estruturada, a qual foi utilizado um roteiro com itens referentes à caracterização da cirurgia, recursos humanos, condição física do paciente e procedimentos anestésicos-cirúrgicos. O tratamento dos dados foi feito segundo a caracterização do paciente cirúrgico, horas utilizadas pelos recursos humanos e pelo paciente, procedimentos realizados e recursos materiais utilizados. Na comparação entre os grupos, a caracterização do paciente cirúrgico permitiu os seguintes resultados: quanto ao sexo, 83 (59,29%) do sexo feminino e 57 (40,71%) masculino, a maior frequência de idade foi entre 30 e 40 anos, em 34 (24,29%) dos pacientes. As especialidades cirúrgicas de maior frequência foram otorrinolaringologia em 23 (16,43%), ginecologia e obstetrícia 21 (15%) e ortopedia e traumatologia 21 (15%). A anestesia geral prevaleceu com 75 (53,58%) dos pacientes. Quanto aos distúrbios sistêmicos que caracterizaram a ASA, as doenças cardiovasculares prevaleceram em 52 (65%) dos pacientes, sendo 40 (50%) com hipertensão arterial sistêmica e 16 (20%) com diabetes Mellitus. Quanto às horas utilizadas, as média das horas utilizadas por paciente foram: 3,40 horas de enfermagem (HE); 0,10 horas de enfermeira (HEn); 3,28 horas de técnico/auxiliar de enfermagem (HT/A); 6,14 horas da equipe médica (HEM); 1,12 horas de cirurgia (HC); 1,95 horas de salas de operações (HSO); 0,21 horas de preparo para anestesia (HPA) e 0,16 horas de preparo para cirurgia (HPC). Para uma hora de cirurgia (HC), as médias de horas utilizadas em cada paciente foram: 3,54 HE; 0,14 HEn; 3,40 HT/A; 5,77 HEM e 1,90 HSO. Para uma hora de sala de operações (HSO), as médias de horas utilizadas em cada paciente foram: 1,81 HE; 0,06 HEn; 1,75 HT/A; 3,08 HEM e 0,54 HC. Quanto aos procedimentos realizados, as médias dos invasivos foi de 2,04 procedimentos e não invasivos de 5,70 procedimentos; com total de 7,74 procedimentos. A média de recursos materiais utilizados para anestesia foi de 4,19 equipamentos e para a cirurgia de 2,76 equipamentos; com total de 6,95 equipamentos. Na análise estatística dos grupos, referentes às ASA, segundo os portes anestésicos; os resultados demonstraram que os portes anestésicos pequeno e médio não diferiram significativamente entre si, sendo inferiores aos portes grande e especial, nas variáveis HE, HT/A, HEM; quanto aos portes anestésicos, segundo às ASA; os resultados demonstraram que quase não houve diferenças entres as ASA. Os grupos de cirurgias minimamente invasivas, houve diferença apenas nos recursos materiais, sendo superiores conforme o porte anestésico e a análise entre os grupos de cirurgias invasivas e minimamente invasivas, com portes anestésicos e ASA semelhantes, os resultados demonstraram que os grupos de cirurgias invasivas apresentaram - se significativamente inferiores nas variáveis estudadas em relação aos grupos de cirurgias minimamente invasivas. Desta forma, conclui-se com este estudo, que as HE estão relacionadas aos portes anestésicos, onde quanto mais complexo o procedimento anestésico-cirúrgico, mais horas de enfermagem são utilizadas, não foi observado relação das HE utilizadas com a condição física do paciente. Assim, foi elaborado uma classificação das cirurgias em categorias, segundo a necessidade de horas de enfermagem, para uma hora de sala de operações, sendo: cuidados padrão de enfermagem, com 1,41 horas; cuidados complexos de enfermagem, com 1,99 horas e cuidados diferenciados de enfermagem, com 1,78 horas
This is a case study with exploratory character, descriptive and comparative, and a fieldwork with a quantitative approach. It aims to classify the surgeries in categories according to the number of nursing hours in operating rooms, subsidizing the dimensioning of the nursing staff in operating rooms. It was performed in a large general private Hospital in São Paulo. The sample was constituted of 140 patients, divided into 14 groups, 10 patients on each group. To organize the groups it was taken on account the patient\'s physical condition, according to the American Society of Anesthesiologists (ASA), the anesthetic complexity, according to the Brazilian Medical Association (BMA), the sort of surgical anesthetic procedure: invasive, or minimally invasive (MI) and elective surgeries. According to the patient\'s physical condition, groups were constituted with ASA1, ASA2 and ASA3. ASA 4 was put away because there were no cases, and ASA 5 and ASA 6 were put away because they were urgency or emergency surgeries. As to the anesthetic complexity, surgeries were classified as presenting small complexity, mean complexity, large complexity and special complexity. Therefore groups were symbolized as: 1S, 1M, 1L, 1S, 2S, 2M, 2L, 2S, 3M, 3L, 3S, 1SMI, 1MMI AND 2AMI. Data were collect inside the operating rooms, by means of organized observation, according to a guide presenting items referring to the surgery characteristics, human resources, patient\'s physical condition and surgical anesthetic procedures. Data analysis was performed according to the surgical patient\'s characteristics, hours taken by human resources and by the patient, procedures and material resources employed. In the comparison among groups, the characterization of the surgical patient led to the following results: as to gender, 83 (59,29%) female and 57 (40,71%) male, the higher age frequency was between 30 and 40 years in 34 (24,29%) of the patients. The most frequent surgical specialties were otorhinolaryngology and traumatology in 23 (16,43%), gynecology and obstetrics in 21 (15%) and orthopedics and traumatology in 21 patients (15%). General anesthesia prevailed in 75 (53,58%) of the patients. Concerning the systemic disorders that characterize the ASA, cardiovascular disorders prevailed in 52 (65%) of the patients, 40 (50%) presenting systemic arterial hypertension and 16 (20%) presenting diabetes Mellitus. As to the hours taken, the average hours taken by patients was: 3,40 hours of nursing (NH); 0,10 hours of nurse (NeH); 3,28 hours of nursing assistant (NaH); 6,14 hours of medical staff (MSH); 1,12 hours of surgery (SH), 1,95 hours of operating room (ORH); 0,21 hours of anesthetic preparation (APH) and 0,16 hours of surgery preparation (SPH). For one SH, the average hours taken for each patient was: 3,54 NH; 0,14 NeH; 3,40 NaH; 3,08 MSH and 0,54 SH. Concerning to the procedures taken, the average of invasive procedures was 2,04 and non-invasive procedures 5,70; total procedures 7,74. The average material resources used for anesthesia was 4,19 equipment and for surgery 2,76 equipment; total 6,95 equipment. In the statistical analysis of groups referring to the ASA, according to the anesthetic complexity, results evidenced that small and mean anesthetic complexity presented no significant difference, and were inferior to large and special complexity in variables NH, NaH and MSH; as to the anesthetic complexity according to the ASA the results evidenced that there were almost none difference among the ASA. In the group of minimally invasive surgeries, there was difference only in the material resources, that were superior according to the anesthetic complexity and in the analysis comparing groups of invasive and minimally invasive surgeries with similar anesthetic complexity and ASA the results evidenced that groups of invasive surgeries were significantly inferior in the studied variables in relation to groups of minimally invasive surgeries. Therefore, this study concludes that the NH are related to the anesthetic complexity, and the more complex the anesthetic surgical procedure, the more nursing hours are taken. The relation of NH taken with the patient\'s physical condition was not observed. Thus a classification of surgeries in categories was done, according to the necessary nursing hours for one hour of operating room, that is: standard nursing cares, 1,41 hours; complex nursing cares, 1,99 hours and differentiate nursing cares, 1,78 hours

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Almeida, Mailma Costa de. "Enfermagem perioperatória e sua inserção nos cursos de graduação." Universidade Federal do Amazonas - Universidade Federal do Pará, 2015. http://tede.ufam.edu.br/handle/tede/5021.

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Introduction. Perioperative nursing can be understood as the nursing care provided to patients who will undergo a surgical procedure and it is inserted in the pre, trans and postoperative periods. The perioperative nursing content are contained in undergraduate courses in Nursing curricular activities that address the individual in their life cycle and stages of the training process. Such content become important for the formation of reason in nursing professionals representing the surgical procedures in relation to the clinical status of the country. Objective: To analyze the teaching of perioperative nursing in public higher education institutions of nursing undergraduate courses in the city of Manaus. Methodology: exploratory and descriptive study of qualitative approach, carried out in two public universities in the State of Manaus, Amazonas, with the six subject teachers who teach Perioperative Nursing content. It was used as a technique for the collection of interview data, focuses groups and document analysis. Data instruments were questionnaire script for the focus group and script for analysis of educational plans. Results: Analysis of the data indicates that the teaching of Perioperative Nursing in public higher education institutions of undergraduate courses in Manaus, showed that teachers were mostly female and has the experience both in teaching and in the assistance in Perioperative Nursing. The teaching plans allows a partial view of how is the teaching of Perioperative Nursing since that field contents are divided in four disciplines. It was found that the four of the disciplines, three have theoretical and practical hours and one practice of the discipline of Urban Internship. The syllabus of the Perioperative Nursing content is presented in two disciplines of explicit ways and two implicitly. The goals were presented explicitly in three disciplines. One of the issue of the program content observed that are directed to Perioperative Nursing. It was noted a disagreement between objectives and program content. It was observed between the teaching strategies using interactive methodologies towered over traditional methodologies and teachers felt the need to work more innovative methodologies in perioperative nursing. The teaching resources used by teachers in the course of their teaching activities are presented compatible related to teaching strategies. The references are between 2005-2015 and the period prior to 2004. There was no predominance of publication being nine references 2005-2015 nine previous to 2004. It was found that item the existence of journals, scientific papers, theses and dissertations, and other sites. The views of teachers on the teaching of perioperative nursing potentiated the analysis in as difficulties, weaknesses, expectations and suggestions were expressed. Conclusion. The teaching of perioperative nursing in higher education institutions - public HEI is present in nursing education, however it needs actions that qualify the prospect of meeting the National Curriculum Guidelines - DCNs and health needs of the population. In this perspective we present suggestions for HEIs and for teachers as a contribution of the study performed.
Introdução. A enfermagem perioperatória pode ser entendida como a assistência de enfermagem prestada ao paciente que será submetido a um procedimento cirúrgico e que está inserido nos períodos pré, trans e pós-operatório. Os conteúdos de enfermagem perioperatória estão contidos nos Cursos de Graduação em Enfermagem em atividades curriculares que abordam o indivíduo em seu ciclo vital e em estágios do processo de formação. Esses conteúdos tornam-se importante para a formação dos profissionais de enfermagem em razão do que representam os procedimentos cirúrgicos em relação ao quadro nosológico do país. Objetivo: Analisar o ensino da enfermagem perioperatória nos cursos de graduação de enfermagem de Instituições de Ensino Superior públicas na cidade Manaus. Metodologia: Estudo de caráter exploratório e descritivo de abordagem qualitativa, realizado em duas universidades públicas de Manaus, Estado do Amazonas, tendo como sujeitos seis docentes que ministram conteúdos de Enfermagem Perioperatória. Utilizou-se como técnica para a coleta de dados entrevista, grupo focal e análise de documentos. Os instrumentos de dados foram questionário, roteiro para o grupo focal e roteiro para análise dos planos de ensino. Resultados: A análise dos dados indica que o ensino da Enfermagem Perioperatória nos cursos de graduação de Instituições de Ensino Superior públicas de Manaus, mostrou que os docentes em sua maioria eram do sexo feminino e tem experiência tanto na docência quanto na assistência na Enfermagem Perioperatória. Os planos de ensino permitem uma visão parcial sobre como se dá o ensino da Enfermagem Perioperatória uma vez que os conteúdos desse campo estão diluídos em quatro disciplinas. Verificou-se que das quatro disciplinas três possuem carga horária teórico-prática e uma só prática na disciplina de Estágio Curricular Urbano. As ementas, o conteúdo de Enfermagem Perioperatória está presente em duas disciplinas de maneira explicita e em duas de maneira implícita. Os objetivos estavam presentes explicitamente em três disciplinas. No quesito conteúdo programático observou-se que estão direcionados a Enfermagem Perioperatória. Notou-se um desacordo entre objetivos e conteúdos programático. Observou-se entre as estratégias de ensino o uso de metodologias interativas sobressaíram em relação as metodologias tradicionais e que os docentes sentem a necessidade de trabalhar com metodologias mais inovadora na enfermagem perioperatória. Os recursos de ensino utilizados pelos docentes no decorrer de suas atividades pedagógicas apresentaram-se compatíveis relacionados com as estratégias de ensino. As referências bibliográficas situam-se entre 2005 a 2015 e período anterior a 2004. Não houve predominância de publicação estando nove referências bibliográficas de 2005 a 2015 e nove anterior a 2004. Não se constatou nesse item a existência de periódicos, artigos científicos, teses e dissertações, sites e outros. A opinião dos docentes sobre o ensino da enfermagem perioperatória potencializou a análise na medida que dificuldades, fragilidades, expectativas e sugestões foram expressas. Conclusão. O ensino da enfermagem perioperatória nas Instituições de Ensino superior - IES públicas está presente na formação do enfermeiro, entretanto precisa de ações que qualifiquem na perspectiva de atender as Diretrizes Curriculares Nacionais - DCNs e as necessidades de saúde da população. Nessa perspectiva apresentamos sugestões para as IES e para os docentes como contribuição do estudo realizado

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Camargo, Tamara Carolina de. "Eficácia da esterilização a vapor de instrumental laparoscópico montado versus desmontado: um estudo experimental." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-20042007-140745/.

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A vídeo-laparoscopia é uma inovação tecnológica que trouxe indiscutíveis vantagens e também novos desafios, incluindo nestes, as diretrizes para o reprocessamento adequado dos instrumentais e seus acessórios. A autoclavação dos instrumentais laparoscópicos desmontados é mais segura, uma vez que a condução térmica é facilitada. No entanto, são artigos complexos, compostos por múltiplas peças e a sua remontagem no momento da cirurgia traz transtornos às equipes cirúrgicas, correndo o risco do não funcionamento ou de danos às peças pela montagem inadequada. Existe um arraigado conceito, entre os profissionais da saúde, que para o sucesso da esterilização ser alcançado, é necessário o contato direto do vapor com todas as superfícies dos materiais submetidos à autoclavação sem considerar também o raciocínio do calor latente. A destruição microbiana por meio da esterilização pelo vapor está essencialmente relacionada ao calor latente, gerado pela condensação deste em contato com a superfície fria do material, promovendo a termocoagulação das proteínas microbianas. É uma prática comum nos hospitais brasileiros a realização da autoclavação de instrumentos previamente montados, apesar de não haver comprovação científica consistente dessa prática. Isto posto, esta investigação teve o objetivo de avaliar a eficácia do processo de esterilização a vapor dos instrumentais laparoscópicos previamente montados, comparando os seus resultados com os desmontados, considerada neste estudo a melhor prática. Tratou-se de uma pesquisa experimental, laboratorial, com abordagem quantitativa. Foram selecionados dois modelos de maior complexidade dentre os instrumentos laparoscópicos para realização do estudo, sendo eles: trocarte com válvula tipo janela rosqueada de 5mm, composto por cinco peças desmontáveis e pinça para dissecção de 5mm, composta por quatro peças desmontáveis. Cada peça dos instrumentais foi considerada como uma unidade amostral na análise microbiológica. Este estudo teve então como Grupo Montado: instrumentais laparoscópicos montados; Grupo Desmontado: instrumentais laparoscópicos desmontados; Grupo Contagem Microbiana: instrumentais laparoscópicos submetidos aos procedimentos de contaminação desafio, encaminhados diretamente para o teste de contagem microbiana. O inóculo para a contaminação desafio constitui-se de suspensão do Geobacillus stearothermophilus, na forma esporulada, acrescido de sangue de carneiro desfibrinado esterilizado. Todos os instrumentais foram contaminados desmontados com o inóculo desafio. Os grupos Montado e Desmontado foram submetidos aos processos de limpeza manual, complementada pela limpeza automatizada em lavadora ultra-sônica com retrofluxo, enxágüe em água corrente e sob pressão. Por fim, foi realizado o enxágüe com água destilada esterilizada e secagem com ar comprimido medicinal. Na seqüência, foi realizado sorteio para composição dos Grupos Montado e Desmontado. Os instrumentais foram embalados individualmente em papel grau cirúrgico e submetidos à esterilização a vapor em autoclave com pré-vácuo. Após a esterilização, os instrumentais foram avaliados quanto à eficácia da esterilização, por meio dos resultados dos testes de cultura microbiológica, utilizando o método de inoculação direta. No Grupo Montado foram recuperados os microrganismos teste em três peças de uma mesma pinça (3/48) e em três peças de um mesmo trocarte (3/60), enquanto que no Grupo Desmontado o microrganismo teste não foi recuperado nas unidades amostrais estudadas. Nas condições desse experimento, os resultados obtidos refutaram a hipótese inicial da pesquisa quanto à segurança da autoclavação das pinças e dos trocartes utilizados em cirurgia laparoscópica previamente montados
The video laparoscopy is a technological innovation that brought unquestionable advantages and, also, new challenges, like: the policies for the adequate reprocessing of the instruments and its permanent accessories. The steam sterilization of disassembled laparoscopic instruments is much safer, once that the thermal conduction is facilitated. However, laparoscopic instruments are quite complex articles; they are composed by many parts and the reassemblage in site at the moment of the surgery brings many inconveniences to the surgical team, like the possibility of the instruments malfunctioning or non functioning at all, or even damages to the instruments due to inadequate assembling. There is a strong belief among the Healthcare Professionals about the necessity of the direct contact of the steam with all the surface of the materials submitted to the steam sterilization, which is correct, however it doesn´t consider the latent heat assumption as well. The destruction of the microbiological material throughout the steam sterilization is essentially related to the latent heat, created by the vapor condensation when in contact with the instrument´s cold surface, promoting the thermal-coagulation of microbiological proteins. Many hospitals use the steam sterilization of previously mounted instruments, although there´s not any consistent scientific evidence about the efficiency of this practice. Once stated this point, this investigation´s aim was: evaluate the effectiveness of the steam sterilization process of the previously mounted, permanent laparoscopic instruments. It was an experimental laboratorial research, using a quantitative approach. Two models of permanent laparoscopic instruments of major complexity were chosen for the experiments: a trocar with a 5mm screw window valve, composed by five dismountable parts and a 5mm dissection clamp, composed by four dismountable parts. Each part of the instruments was considered as a sample unit on the microbiological analysis. This study it had the Assembled Group was: mounted laparoscopic instruments; the Disassembled Group was: disassembled laparoscopic instruments; the Microbiological Counting Group was: laparoscopic instruments submitted to the - challenge contamination - procedures, being directed straight to the test of microbiological counting. The inoculants material used for the challenge contamination consisted on the suspension of the Geobacillus stearothermophilus, in its spore form, plus defibrinated and sterilized sheep blood. All the instruments were contaminated, disassembled with the challenge inoculants material. The Assembled and Disassembled groups were submitted to the manual cleaning processes, enhanced by the automatic cleaning in an ultrasonic washer with retro-flux, rinsed in running and under pressure water. At last, a rinsing with distilled water was performed; the drying process was made with medicinal compressed air. Then, a sorting was performed to decide about the composition of the Assembled and Disassembled groups. The instruments were individually packed in surgical paper and submitted to the steam sterilization in a pre-vacuum sterilizer machine. After the sterilization, the instruments were evaluated according to sterilization effectiveness throughout the microbiological culture test´s results, using the straight inoculation method. In the Assembled Group the microorganism´s tests were recovered in three parts of one same clamp (3/48) and in three parts of the same trocar (3/60), in the Disassembled Group the test microorganism wasn´t recovered in any of the sample unities. The results, under the conditions of the experiment, refuted the hypothesis of safety in the usage of the steam sterilization in previously mounted used clamps and trocar in laparoscopy

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Ekman, Jakob, and Benjamin Bernroth. "Liten tuva stjälper ofta stort lass : Bakteriell kontamination över tid av operationsinstrument vid öppen neurokirurgi." Thesis, Umeå universitet, Institutionen för omvårdnad, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-115892.

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Bakgrund: Postoperativa sårinfektioner orsakar lidande för den drabbade patienten och kostnader för patienten, vården och samhället. Intraoperativ kontamination av operationsinstrumenten är en av källorna till dessa infektioner. Operationssjuksköterskan är ansvarig för aseptiken och operationsinstrumenten. Syfte: Syftet med denna pilotstudie var att mäta graden av bakteriell kontamination över tid på operationsinstrument som används vid öppen neurokirurgi samt observera utvalda källor till kontamination under samma tid. Metod: Denna studie designades som en kvantitativ icke-experimentell observationsstudie. Datainsamlingen skedde under hösten 2015 och bestod av omhändertagandet av specifika instrument som använts av operatören under operationen efter förutbestämd åtgången knivtid. Bakterieodlingar på dessa instrument skedde sedan på laboratorium enligt en förutbestämd metod och graden av kontamination mättes genom observation av mängden colony forming units (CFU). Resultaten presenteras i form av förändringar av mängden CFU. Resultat: Fem operationer observerades och tio odlingar utfördes på tio instrument. Totalt tio CFU registrerades under samtliga observationer. Ingen signifikant ökning av antal CFU kunde observeras från en till två timmars knivtid (P=0,156). Antal dörröppningar ökade från 3,4 till 9,0 och antal personer på operationssalen ökade från 5,4 till 5,8. Slutsats: Trots det ringa antal observationer som ingick i denna studie tyder resultaten på god aseptik och minimal bakteriell kontamination på operationsinstrumenten under operationens två första timmar. Ytterligare forskning med längre observationer, fler observationer och observationer kring annan typ av kirurgi behövs.
Background: Post-operative surgical site infections (SSI) cause suffering for the afflicted patient and is a great cost for the patient, the health care system and society. Intra-operative contamination of surgical instruments is one of the sources of these infections. The operating room nurse is responsible for preventing infections. Purpose: The purpose of this pilot-study was to measure the degree of bacterial contamination over time on surgical instruments used in open neurosurgery as well as to observe specific sources of contamination during this time. Method: The design was a quantitative nonexperimental observational study. The data collection took place during autumn 2015 and consisted of the sampling of specific instruments used by the surgeon during surgery after preset elapsed operating times. Bacterial culturing on these instruments was then carried out at a laboratory according to a preset routine and the degree of contamination was measured by observing the amount of colony forming units (CFU). The results are presented as changes in CFU. Results: Five operations were observed and ten bacterial culturings were conducted on ten instruments. A total of ten CFU was registered during all observations. No significant increase in the number of CFU could be observed from one to two hours of elapsed surgery (P=0,156). The amount of door openings increased from 3,4 to 9,0 and the number of personnel in the operating room increased from 5,4 to 5,8. Conclusion: Despite the small number of observations included in this study the results indicate good aseptics and minimal bacterial contamination on the surgical instruments during the first two hours of surgery. Further research with longer observations, more observations and observations on other forms of surgery is needed.

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Macedo, Rolanda. "Integração de Enfermeiros no Bloco Operatório: O Primeiro Passo para Cuidados de Excelência." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2015. http://hdl.handle.net/10400.26/10454.

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Relatório de Trabalho de Projeto apresentado para cumprimento dos requisitos à obtenção do grau de Mestre em Enfermagem Médico-Cirúrgica
O presente Relatório de Trabalho de Projeto surge no âmbito do 3º Curso de Mestrado em Enfermagem Médico-Cirúrgica da Escola Superior de Saúde do Instituto Politécnico de Setúbal e a sua construção, apresentação e discussão pública visam a obtenção do grau de Mestre nesta área científica. Os objetivos deste relatório passam por apresentar o PIS – Projeto de Intervenção em Serviço e o PAC – Projeto de Aprendizagem Clínica, e descrever e analisar o desenvolvimento das competências adquiridas como Enfermeira Especialista e Mestre em Enfermagem Médico-Cirúrgica. No âmbito dos estágios realizados no Bloco Operatório do Centro Hospitalar X foram desenvolvidos, segundo a metodologia de trabalho de projeto, dois projetos: um Projeto de Intervenção em Serviço sobre “Integração de Enfermeiros no Bloco Operatório – O Primeiro Passo para Cuidados de Excelência”, cuja realização nos permitiu criar e implementar um programa de integração de novos enfermeiros no Bloco Operatório, com o objetivo de melhorar a qualidade e a segurança das integrações, sendo que foi um contributo para uma eficaz integração, facilitadora e potenciadora de uma prestação de cuidados de excelência; e um Projeto de Aprendizagem Clínica, centrado no desenvolvimento dos domínios nas áreas da prevenção e controlo de infeção, da resposta na catástrofe e emergência multivítima e do cuidar da pessoa em situação crítica e em situação crónica e paliativa. Ambos os projetos contribuíram para o desenvolvimento das competências comuns e específicas do Enfermeiro Especialista em Enfermagem Médico- Cirúrgica, designadamente em Enfermagem em Pessoa em Situação Crítica e em Pessoa em Situação Crónica e Paliativa, bem como as competências de Mestre em Enfermagem Médico-Cirúrgica. Ao longo do Relatório, descrevemos o percurso efetuado no Curso e respetivos estágios, analisando os seus aportes no desenvolvimento de competências especializadas e de mestre em enfermagem, contribuindo para a melhoria contínua da qualidade dos cuidados prestados, dentro do alvo desejável da excelência na profissão de Enfermagem.
Abstract: This Project Work Report comes out as part of the 3rd edition of the Medical- Surgical Nursing Master’s degree in the School of Health, Polytechnic Institute of Setúbal. Its construction, presentation and public discussion aims the achievement of a Master’s degree in this scientific area. The objectives of this report are to present the IPS – Intervention Project in Service – and the CLP – Clinic Learning Project – and describe and analyze the development of skills acquired as Specialist Nurse and Master in Medical-Surgical Nursing. Two projects were carried out during the internship: an Intervention Project in Service entitled as "Integration – The First Step to Excellence Care", which allowed us to create and implement a program for the integration of new nurses in the operating room, which has been a contribution to an effective integration, promoting and enabling the provision of a care of excellence; and a Clinic Learning Project, aimed at developing the skills of a Specialist Nurse regarding the prevention and control of infections, the answer in disaster situations and multi victim emergencies, and the care of someone in critical and in chronic and palliative situations. Both projects contributed to the development of the common and specific skills of the Specialist Nurse in Medical-Surgical Nursing, namely in the care to the Patient in Critical Situation or in Chronic and Palliative Situation, as well as the development of the skills of Master in Medical-Surgical Nursing. Throughout the Report, we will describe the route followed during the Course and respective internships, analyzing their contributions to the development of expertise and mastership in Nursing, and to the continuous improvement of the quality of care provided within the desirable goal of excellence in the Nursing profession.

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Kingdon, Brenda. "Effects of Provider Education on Documentation Compliance in the O.R." UNF Digital Commons, 2009. http://digitalcommons.unf.edu/etd/310.

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Knowledge of The Joint Commission's National Patient Safety Goals and an effective provider cooperative practice involving communication and teamwork are essential for the delivery of safe and compliant patient care in the surgical setting. The purpose of this study was to assess the impact of an educational intervention for physicians and nurses designed to increase documentation of compliance with national patient safety standards. As events of noncompliance have impacted patient safety at the hospital where this project was conducted, measures were needed to assess barriers to compliance with standards of practice and to focus educational session plans on identified knowledge-base needs. The goal of this project involved bringing all surgical team members together for educational sessions on safety standards. Pre-intervention and post-intervention assessments of knowledge were administered to study participants. Additionally, random chart documentation audits were conducted before and after the intervention to assess the effectiveness of the education sessions on documentation compliance with the targeted standards. Outcomes of this study included improved knowledge of, and compliance with, national patient safety goals. Results may improve safe patient care at this hospital, reduce costs, and create mutual respect and teamwork, all contributing to the successful achievement of the organization's quality improvement goals.

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"Quality assurance in perioperative nursing practice." Thesis, 2015. http://hdl.handle.net/10210/14395.

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Higgins, Jackee. "Pacing integration newcomer nurses socialization into a perioperative nursing unit /." 2003. http://wwwlib.umi.com/cr/yorku/fullcit?pMQ82927.

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Thesis (M. Ed.)--York University, 2003. Graduate Programme in Education.
Typescript. Includes bibliographical references (leaves 109-112). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pMQ82927.

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Chard, Robin. "How perioperative nurses define, attribute causes of, and react to intraoperative nursing errors." 2006. http://etd1.library.duq.edu/theses/available/etd-11192006-213152/.

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Dissertations / Theses on the topic 'Perioperative, Operating Room and Surgical Nursing'

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