ABSTRACT
BACKGROUND@#Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery.@*METHODS@#One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (>10 mm) of DLT was compared between the groups.@*RESULTS@#DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (p = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (p = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, p = 0.906).@*CONCLUSION@#Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.
ABSTRACT
BACKGROUND: Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery. METHODS: One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (>10 mm) of DLT was compared between the groups. RESULTS: DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (p = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (p = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, p = 0.906). CONCLUSION: Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.
Subject(s)
Adult , Humans , Bronchi , Bronchoscopy , Incidence , Intubation, Intratracheal , Lung , One-Lung Ventilation , Polyvinyl Chloride , Polyvinyls , Posture , Silicon , Silicones , Supine Position , Thoracic Surgery , Thoracic Surgical ProceduresABSTRACT
PURPOSE: Clinical competence among nurses is an essential requirement for the provision of safe and effective patient care. This study aims to classify types of professional quality of life experienced by Korean nurses, and examine the relationship between demographic and professional characteristics and clinical competence among nurses experiencing each type. METHODS: A total of 335 nurses completed questionnaires assessing professional quality of life, clinical competence, and demographic and professional characteristics. Following identification of the underlying factors of professional quality of life, we classified participants into three clusters. RESULTS: There were significant differences in age, marital status, religion, educational status, and position between clusters. Results also revealed that nurses with high compassion satisfaction and low compassion fatigue (burnout, secondary traumatic stress) tended to have higher clinical competence. CONCLUSIONS: This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Attitude of Health Personnel , Clinical Competence , Cross-Sectional Studies , Job Satisfaction , Nurses/psychology , Quality of Life , Republic of Korea , Stress, PsychologicalABSTRACT
PURPOSE: This study was performed to identify the effects of self-leadership and job involvement on clinical competence in general hospital nurses. METHODS: The participants in this study were 443 staff nurses working in general hospitals and having more than 6 months of nursing experience. Data were collected using self-administered questionnaires. RESULTS: There were significant positive correlations between nurses' self-leadership and job involvement, and between nurses' self-leadership and clinical competence. In the multiple regression analysis, clinical career, type of department and self-leadership were significant predictors in explaining nurses' clinical competence and accounted for 28% of the variance in nurses' clinical competence. CONCLUSION: Study findings suggest that nurses' self-leadership is defined as having an important influence on nurses' clinical competence. In order to strengthen nurses' clinical competence, there is a need to develop education programs to increase nurses' self-leadership.