Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
-
J. Perianesth. Nurs. · Feb 2013
Implementing a regional anesthesia block nurse team in the perianesthesia care unit increases patient safety and perioperative efficiency.
A lack of standardized nursing procedures regarding the management of patients receiving preoperative regional anesthesia in the perianesthesia setting raises a number of issues for perianesthesia nurses. In January 2010, Duke University Hospital's perianesthesia care unit implemented a regional anesthesia "block nurse" team in the preoperative holding area as a patient safety initiative. ⋯ Results indicated that the implementation of the block nurse team not only increased patient safety but also increased perioperative efficiency and productivity, and decreased delays to operating room start times. This article describes the role of the regional anesthesia block nurse, the development of a block nurse team, and the early benefits of implementing a dedicated regional anesthesia block nurse team in the perianesthesia setting.
-
J. Perianesth. Nurs. · Dec 2012
Randomized Controlled Trial Comparative StudyBacteriostatic normal saline compared with buffered 1% lidocaine when injected intradermally as a local anesthetic to reduce pain during intravenous catheter insertion.
Pain associated with intravenous (IV) catheter insertion commonly causes fear and anxiety in presurgical patients. To reduce pain, a common procedure is intradermal injection of a local anesthesia. The aim of this study was to determine whether there is a significant difference in a patient's pain level after intradermal injection and IV catheter insertion when comparing intradermally injected bacteriostatic normal saline with 0.9% benzyl alcohol (a preservative added with an anesthetic component) with buffered 1% lidocaine to numb the IV line site. ⋯ Females reported higher IV pain scores than males only in the buffered 1% lidocaine group (P=.001). No statistically significant differences were found between the two anesthetics with intradermal and IV pain scores for IV placement side, site, IV within 30 days, needle gauge, previous IV experience or problems, vein visibility, or study nurse. This study determined that buffered 1% lidocaine was more effective than bacteriostatic normal saline in reducing pain during IV catheter insertion.
-
Discharge of patients from the postanesthesia care unit (PACU) is often delayed for nonclinical reasons. This includes organizational issues such as patient transport, times of heavy workload for the ward and PACU nursing staff, surgical wards being unable to admit the patient, and clerical or administrative delays. We undertook a prospective study to evaluate PACU patient flow and the incidence and reasons behind delayed PACU discharge for nonclinical reasons in a tertiary referral hospital. ⋯ The most common reasons for delayed discharge of the patient to the ward were no bed in the designated postoperative ward for admittance (52%), ward nurses too busy to accept the patient (32%), and ward nurses' meal breaks (10%). Delayed PACU discharge for nonclinical reasons is common and occurs predominantly because of discharge planning and organizational and staffing issues in postoperative surgical wards. Improved discharge planning, restructured staffing, and alterations in operating room scheduling may minimize these nonclinical discharge delays.
-
Examining the care of patients with obstructive sleep apnea (OSA) is forefront in perianesthesia nursing. The issue of how to effectively manage patients with OSA emerges as the patient presents for surgery. ⋯ With the introduction of preoperative screening, we can more readily identify and facilitate communication of the presence of OSA. Staff education and an increase in postoperative monitoring time help to ensure that all patients with OSA receive safe, consistent, quality care while recovering from anesthesia.
-
J. Perianesth. Nurs. · Oct 2012
An evidence-based checklist for the postoperative management of obstructive sleep apnea.
Obstructive sleep apnea (OSA) can present significant challenges in providing postoperative care. OSA policies have been developed and are in place within many facilities; however, a standard OSA protocol ensuring the safe delivery of postoperative care has not been universally accepted into practice. ⋯ These interventions include guidelines for postoperative assessment, continuous monitoring, extubation readiness, pain management, sleep positioning, respiratory monitoring, and continuous positive airway pressure therapy. The implementation of this checklist with the synergistic effect of the combined interventions may lead to a greater improvement in the care, safety, satisfaction, and clinical outcomes of OSA patients.