Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
-
J. Perianesth. Nurs. · Jun 2009
ReviewUnintentional hypothermia: implications for perianesthesia nurses.
Everyday throughout the United States and globally, patients undergo surgery and anesthesia. Inadvertent hypothermia, a core body temperature less than 36 degrees C (96.8 degrees F), remains a significant concern for these patients. ⋯ Using best evidence to guide clinical practices aimed at promoting thermal balance in the surgery patient is critical to the provision of safe, quality care. This article will provide an overview of the physiology of intraoperative temperature fluctuation and risk factors associated with unintentional perioperative hypothermia, and suggest prevention and management strategies.
-
J. Perianesth. Nurs. · Jun 2009
Correlating an 11-point verbal numeric rating scale to a 4-point verbal rating scale in the measurement of pruritus.
Pruritus, the subjective sensation of itch, can be a difficult symptom to assess and treat. Evaluating levels of patient discomfort across populations has proven to be challenging because of a lack of a standardized measurement tool to quantify levels of itch. The most widely used tool is the 4-point verbal rating scale (VRS-4), but others use an 11-point verbal numeric rating scale (VNRS-11). ⋯ Each subject's level of pruritus was measured at five specific intervals after administration of intrathecal opioids. The scales were administered one minute apart in random order. Data analysis demonstrated a strong correlation between these two scales, (r=.910 to .853) indicating that each verbal descriptor on the VRS-4 could readily be substituted with a quantifiable range on the VNRS-11.
-
J. Perianesth. Nurs. · Apr 2009
Relationship of opioid analgesic protocols to assessed pain and length of stay in the pediatric postanesthesia unit following tonsillectomy.
After tonsillectomy and adenoidectomy in children, postoperative pain management is an essential, yet often challenging, task. In addition to discomfort, lack of pain management can lead to delays in oral intake of patients, resulting in extended stays and increased costs. ⋯ Nurses in the postanesthesia care unit retrospectively compared a fentanyl and morphine regimen with a morphine-only regimen to determine whether either protocol made a difference in length-of-stay or pain relief. Analysis of available data revealed no statistically significant differences in length of stay between the groups and trivial differences thought to be clinically irrelevant on other variables.
-
J. Perianesth. Nurs. · Apr 2009
Analysis of the application of cricoid pressure: implications for the clinician.
The application of cricoid pressure may reduce the incidence of pulmonary aspiration of gastric contents in at-risk patients. Cricoid pressure may be applied during intubation in a variety of settings including the operating room, postanesthesia care unit, intensive care unit, and emergency department. Significant deficits in cognitive knowledge and practical application skills have been demonstrated among medical personnel responsible for the application of cricoid pressure. ⋯ The descriptive aspect of the study revealed significant deficiencies in knowledge and application skills. Despite 57.7% of the study participants acknowledging having formalized training within the previous 8 months, the results demonstrated that they were no more likely to identify, correctly state, or apply the proper cricoid pressure when compared with participants who did not attend formalized training. Future studies should focus on determining effective approaches to formalized training programs and the optimal timing of competency-based testing/review for retention of knowledge and skills related to the application of cricoid pressure.
-
J. Perianesth. Nurs. · Feb 2009
ASPAN's Delphi study on national research: priorities for perianesthesia nurses in the United States.
Prudent nursing practice mandates the best, scientific evidence available. The complexity of perianesthesia practice, management, and education, coupled with required competencies within these domains, generate problems demanding answers. ASPAN's financial and human resources, however, are limited. ⋯ Questions were ranked for their priority. Research priorities focused on the following themes: evidence supporting ASPAN standards, staffing ratios, nurse fatigue, adverse patient outcomes, patient care issues related to intensive care unit (ICU) overflow, obstructive sleep apnea, pain management, glycemic control, and clinical critical care competencies. This study advances the mission of ASPAN by identifying the top national perianesthesia research priorities related to practice, management, and education, and should guide researchers in their continued exploration of the science of perianesthesia nursing.