Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Apr 2002
Statistical power analysis to estimate how many months of data are required to identify PACU staffing to minimize delays in admission from ORs.
When each nurse in the Phase I setting is caring for the maximum number of patients allowed by hospital staffing standards (typically 2 per ASPAN standards), patients may have to be held in the OR until a PACU nurse becomes available. Previously, the authors described a statistical method to determine the process of scheduling existing nurses without increasing staffing hours (Dexter et al. Anesth Analg. 92:947-949, 2001). ⋯ There was a marked improvement in the performance of the staffing solutions at preventing "PACU hold" by increasing from 20 to 80 historical workdays of data, a slight but statistically significant improvement between 80 and 100 workdays, but no significant improvement in further increasing the number of workdays of data. PACU nurse managers should use at least 4 months of data when choosing a staffing solution to minimize the chance of patients waiting in ORs for PACU admission. Tampering with PACU staffing more often than every 4 months is unlikely to result in improvements in OR efficiency and may harm recruitment and retention of nursing staff.
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Without proper management, postoperative pain can grow to intolerable levels and interfere with functioning and healing. Historically, morphine had no equal for postoperative pain management. Its side effects, however, are troubling. ⋯ Nevertheless, a single drug with an efficacy comparable with morphine remains elusive. In this article, the physiology of pain is reviewed and ketorolac is compared with morphine. Perianesthesia nurses are given pertinent information to enhance their ability to provide the best pain relief available for the patients in their care.
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The most common fear expressed by preanesthesia patients is experiencing awareness while under general anesthesia. Although extremely rare, awareness during anesthesia does occur and patients have recalled explicit details and conversations that occurred while they were under general anesthesia, including described recall of the intubation process. The Bispectral Index Monitor (BIS) was developed by Aspect Medical System of Newton, MA, to measure patient response to the administration of potent sedative, hypnotic agents. The BIS monitor is intended to decrease the risk of intraoperative awareness by providing the anesthetist with a quantitative assessment regarding the hypnotic state of the patient.
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J. Perianesth. Nurs. · Dec 2001
ReviewPatient care after discharge from the ambulatory surgical center.
An important and often forgotten aspect of postoperative care occurs after the patient is discharged from the ambulatory surgical center. With more than 60% of all surgeries and procedures occurring on an ambulatory basis, what happens after the patient is no longer in continuous professional care is of concern to the ambulatory nurse. Numerous physical postoperative complaints are common and expected sequelae of anesthesia and surgery in the ambulatory patient. In this article, important postdischarge complications are reviewed and contemporary management options discussed. The information contained in this review article is valuable to the provider in educating patients regarding their anticipated course of postoperative recovery. ⋯ -Based on the content of this article, the reader should be able to (1) identify important postdischarge complications to provide patients with comprehensive discharge instructions regarding their continued recovery at home; (2) discuss contemporary management options available to treat postdischarge complications; (3) realize the incidence of specific postdischarge complications and how that relates to patient satisfaction with the surgical experience; (4) recognize signs and symptoms of postdischarge complications; and (5) identify risk factors of patients for developing specific complications in the postoperative phase.
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The preanesthesia assessment is an important tool for both the perianesthesia team and the patient. A complete and thorough preoperative assessment prepares the perianesthesia team to form the best possible patient care plan. By using the preanesthesia assessment as an opportunity to provide comprehensive teaching about the entire perianesthesia process, the patient is prepared and motivated for the best possible outcome.