Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Dec 2007
ReviewSafe staffing for the post anesthesia care unit: weighing the evidence and identifying the gaps.
Postanesthesia nursing care and standards are continually evolving. ASPAN has the professional responsibility to develop standards of nursing practice to promote a safe environment of care. Currently, ASPAN's recommended staffing ratios are based on the best available evidence: expert opinion and consensus. ⋯ This expert panel critically weighed the nursing evidence on staffing ratios, workload intensity, patient acuity, nursing-sensitive outcomes, and nursing-sensitive indicators, including appropriate critical care studies because of the scarce number of postanesthesia studies. The outcome of this dynamic initiative revealed the need to develop nursing-sensitive perianesthesia indicators that can provide patient outcomes used to assess the effectiveness of staffing ratios. Finally, research gaps were identified and the next steps in the generation of knowledge needed to build safe staffing evidence were identified in ASPAN's Strategic Research Staffing Plan.
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J. Perianesth. Nurs. · Oct 2007
Review Case ReportsDelayed postoperative agitation in a child after preoperative midazolam.
We present a case report of a 5-year-old boy who had severe agitation after PACU discharge after midazolam premedication for minor otologic surgery. He was treated over several hours in the emergency department with several doses of midazolam and phenobarbital, without resolution of the agitation. ⋯ The incidence and potential mechanisms for postoperative agitation are discussed, with a focus on the potential for midazolam-induced behavioral reactions. This information has nursing implications for postoperative discharge instructions and follow-up.
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J. Perianesth. Nurs. · Oct 2007
Review Case ReportsSevere needle phobia in the perianesthesia setting.
Needle phobia is a peculiar type of specific phobia, with unique clinical features, that may be encountered in some surgical patients. It may present a serious acute problem to the perianesthesia care team and requires careful psychological and/or pharmacological management. This article provides a clinical report and detailed discussion of severe needle phobia in the perianesthesia setting.