Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Jun 2006
ReviewAdoption of the ASPAN clinical guideline for the prevention of unplanned perioperative hypothermia: a data collection tool.
Perioperative hypothermia remains a common occurrence despite the development and dissemination of a clinical practice guideline for the prevention of unplanned perioperative hypothermia by ASPAN. Unfortunately, a process for measuring compliance with and adoption of this guideline has yet to be developed. The purpose of this article is to describe a medical record abstraction method for determining the degree of adoption of the ASPAN Clinical Guideline for the Prevention of Unplanned Perioperative Hypothermia in the perianesthesia setting. Use of the instrument for future research is also explored.
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J. Perianesth. Nurs. · Jun 2006
ReviewEvidence-based perianesthesia care: accelerated postoperative recovery programs.
Prolonged stress response after surgery can cause numerous adverse effects, including gastrointestinal dysfunction, muscle wasting, impaired cognition, and cardiopulmonary, infectious, and thromboembolic complications. These events can delay hospital discharge, extend convalescence, and negatively impact long-term prognosis. Recent advances in perioperative management practices have allowed better control of the stress response and improved outcomes for patients undergoing surgery. At the center of the current focus on improved outcomes are evidence-based fast-track surgical techniques and what is commonly referred to as "accelerated postoperative recovery programs." These programs require a multidisciplinary, coordinated effort, and nurses are essential to their successful implementation.
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The Food and Drug Administration (FDA) issued a letter to health care providers on December 4, 2001, concerning the medication, droperidol. The purpose of the warning was to alert health care providers to the possible role of droperidol in the development of torsades de pointes (TdP) in susceptible patients. The purpose of this article is to explore the role of droperidol in the development of TdP in susceptible patients and current recommendations for the use of droperidol as an antiemetic.
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J. Perianesth. Nurs. · Apr 2006
ReviewThe surgical team and outcomes management: focus on postoperative ileus.
Postoperative ileus (POI) is defined as the impairment of bowel motility that occurs almost universally after major open abdominal procedures, as well as other abdominal and nonabdominal procedures. For the majority of affected patients, POI generally lasts approximately three to five days, but longer duration is not uncommon. The causes of POI are multifactorial, but can be broadly categorized into two groups: those related to the surgical procedure and those related to pharmacologic interventions (opioids). ⋯ Depending on the individual team member's role, different perspectives and strategies may be used to achieve improved outcomes, including but not limited to hospitalization costs related to care and length of stay, resource utilization, and, perhaps most critically, patient quality of life not only immediately after surgery but also after discharge. The ability to reliably and significantly decrease the duration of POI should be readily recognized as an important objective in the management of this condition. Opioids will continue to be a mainstay of postoperative care regimens, but new agents such as peripherally acting mu-opioid-receptor antagonists may offer a unique clinical advantage by helping to reduce the adverse gastrointestinal effects of opioids while preserving their desired benefits for postoperative analgesia.