Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Oct 2011
Surgical cancellations: a review of elective surgery cancellations in a tertiary care pediatric institution.
The purpose of this two-phase quality improvement audit was to analyze elective surgery cancellations in a tertiary pediatric care institution and identify and recommend nursing practice changes in the preoperative assessment clinic (POAC) to potentially influence the overall cancellation rate. A prospective review of cancellation data was conducted over a 6-month period in 2008 and again in 2010. ⋯ Cancellations at or between the preoperative assessment and the day of surgery may be viewed as POAC successes that may have otherwise increased the day-of-surgery cancellation rate. Educating families on the prevention of illness in the perianesthesia period may be a critical nursing role in the prevention of surgical cancellations.
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Delirium occurs in 14% to 56% of postoperative, hospitalized elderly persons, making it one of the most common postoperative complications for the older patient. The aim of this study was to determine factors associated with recovery of delirium from postoperative day one (POD 1) to postoperative day two (POD 2). The hypothesis was that those with less pain are more likely to recover from delirium by POD 2. ⋯ Patients with lower pain levels (NRS ≤4) were also more likely to recover from delirium on POD 2. The type of postoperative pain therapy (the use or nonuse of patient-controlled analgesia) was not related to delirium recovery. The results suggest that aggressive pain management in the first 48 hours postoperatively may be important in promoting recovery from postoperative delirium.
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J. Perianesth. Nurs. · Jun 2011
Esophageal, tympanic, rectal, and skin temperatures in children undergoing surgery with general anesthesia.
The purpose of this study was to determine the degrees of agreement between various sites of temperature measurement and examine the trend of body temperature in children during surgery under general anaesthesia. Thirty-six consecutive children who underwent surgery with general anaesthesia, had temperatures measured at the oesophagus, skin, ear canal and rectum at baseline, every 15 minutes for the first hour and every 30 minutes thereafter. Spearman correlation and Bland-Altman analyses were used to compare data and trends of mean differences assessed by line graphs. ⋯ Bland-Altman plots showed that the least difference (bias) at baseline (0.3°C) was between the oesophageal and tympanic temperatures while at 1 hour (0.13°C ) was between the oesophageal and rectal temperatures. The oesophageal site was the closest to rectal for monitoring core temperature while the skin was the least reliable site in the study population. In the situation where oesophageal probe is not routine or functioning, rectal or tympanic temperatures may be used.
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J. Perianesth. Nurs. · Jun 2011
Agreement between temporal artery, oral, and axillary temperature measurements in the perioperative period.
This study examined agreement in temperature readings preoperatively and postoperatively between temporal artery and electronic oral/axillary thermometers as well as the seconds required to obtain temperature readings across the three measuring modes. Using a repeated measures design, 86 adult subjects had temporal artery, oral, and axillary temperatures taken upon admission to the surgical area and upon admission to the PACU. ⋯ Seconds to temperature measurement was significantly different both preoperatively and postoperatively, with temporal artery measurement the fastest, followed by oral and then axillary. Results support the use of the temporal artery thermometers as an alternative for perioperative noninvasive temperature monitoring.