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1.
Rev. enferm. UFSM ; 13: 28, 2023.
Article in English, Spanish, Portuguese | LILACS, BDENF | ID: biblio-1451175

ABSTRACT

Objetivo: avaliar a intensidade e o desconforto provocados pela sede em pacientes em pós-operatório imediato. Método: estudo exploratório-descritivo, desenvolvido com pacientes internados na sala de recuperação pós-anestésica de um hospital público paranaense. Avaliaram-se indivíduos maiores de 18 anos, de ambos os sexos, com cognitivo preservado, internados de junho de 2021 a janeiro de 2022. A intensidade e o desconforto da sede foram mensurados por escalas específicas. Resultados: avaliaram-se 150 pacientes, com média de 43,9 anos. A maioria era do sexo masculino (65,3%), sem comorbidades (68,7%), submetida à raquianestesia (58%) e cirurgia ortopédica (59,3%), com soroterapia em curso (92,7%). O tempo médio de cirurgia foi 1,5 hora e 14,6 horas de jejum; 72,7% da amostra verbalizou sede, sendo que 37,6% queixaram-se de forma espontânea. Conclusão: os participantes de pesquisa apresentaram intensidade (6,6) e desconforto (7,6) moderados de sede no pós-operatório, tornando-se necessário discutir protocolos institucionais de intervenção para diminuir tal evento.


Objective: to evaluate the intensity and discomfort caused by thirst in patients in the immediate postoperative period. Method: exploratory-descriptive study developed with patients hospitalized in the post-anesthetic recovery room of a public hospital in Paraná. Individuals over 18 years of age, of both sexes, with preserved cognitive function, hospitalized from June 2021 to January 2022, were evaluated. Thirst intensity and discomfort were measured by specific scales. Results: 150 patients were evaluated, with a mean of 43.9 years. Most were male (65.3%), without comorbidities (68.7%), underwent spinal anesthesia (58%) and orthopedic surgery (59.3%), with ongoing serotherapy (92.7%). The mean surgery time was 1.5 hours and 14.6 hours of fasting; 72.7% of the sample verbalized thirst, and 37.6% complained spontaneously. Conclusion: the research participants presented moderate intensity (6.6) and discomfort (7.6) of thirst in the postoperative period, making it necessary to discuss institutional intervention protocols to reduce such event.


Objetivo: evaluar la intensidad y el malestar causado por la sed en pacientes en el postoperatorio inmediato. Método: estudio exploratorio-descriptivo, desarrollado con pacientes internados en la sala de recuperación postanestésica de un hospital público de Paraná. Se evaluaron personas mayores de 18 años, de ambos sexos, con habilidades cognitivas conservadas, hospitalizadas entre junio de 2021 y enero de 2022. Se midió la intensidad y el malestar de la sed mediante escalas específicas. Resultados: Se evaluaron 150 pacientes, con una edad media de 43,9 años. La mayoría eran hombres (65,3%), sin comorbilidades (68,7%), con anestesia espinal (58%) y cirugía ortopédica (59,3%), con sueroterapia en curso (92,7%). El tiempo promedio de cirugía fue de 1,5 horas y 14,6 horas de ayuno; El 72,7% de la muestra verbalizó sed, con un 37,6% quejándose espontáneamente. Conclusión: los participantes de la investigación presentaron moderada intensidad (6,6) y malestar (7,6) de la sed en el postoperatorio, siendo necesario discutir protocolos de intervención institucional para la reducción de ese evento.


Subject(s)
Humans , Postoperative Period , Recovery Room , Perioperative Nursing , Thirst , Symptom Assessment
2.
Psicol. ciênc. prof ; 43: e248738, 2023. tab, graf
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1431135

ABSTRACT

A recuperação de vítimas de queimaduras é longa e dolorosa e afeta diversas esferas da vida do paciente. A resiliência, que se refere à capacidade humana de enfrentar e se adaptar a eventos adversos, exerce grande importância no processo de recuperação da queimadura. Logo, este trabalho objetiva avaliar a capacidade de resiliência de pacientes queimados, no momento da admissão e da alta hospitalar, em um hospital de emergência e urgência de Goiânia. Trata-se de um estudo descritivo, quantitativo e transversal que utiliza a Escala de Resiliência de Connor-Davidson (CD-RISC) como instrumento de mensuração. Na admissão hospitalar, a média da resiliência foi de 71,35, tendo sido observada uma relação significativa entre o fator Amparo da escala CD-RISC e a presença do(a) companheiro(a). O escore de resiliência encontrado nesta pesquisa é consistente com outros achados da literatura científica internacional e nacional referente à expressão da resiliência em vítimas de queimaduras e outros adoecimentos. A relação entre o fator Amparo e a presença de um(a) companheiro(a) enfatiza a importância da rede de apoio familiar na reabilitação do paciente queimado.(AU)


The recovery of burned patients is long and painful and impacts on different areas of people's lives. Resilience, which refers to the human capacity to face and adapt to adverse events, plays a major role in the process of recovery from burns. Therefore, the present study aims to assess the resilience of burned patients, on admission and hospital discharge, in an emergency and urgency hospital in Goiânia. This is a descriptive, quantitative and cross-sectional study that uses the Connor-Davidson Resilience Scale (CD RISC) as a measuring instrument. At hospital admission, the mean resilience was 71.35, with a significant association between the Support factor on the CD RISC scale and the presence of a partner. The resilience score found in the present study is consistent with other findings in the international and national scientific literature regarding the expression of resilience in victims of burns and other illnesses. The relationship between the Support factor and the presence of a partner emphasizes the importance of the family support network in the rehabilitation of the burned patient.(AU)


La recuperación de los pacientes quemados es larga y dolorosa e impacta en diferentes esferas de la vida de las personas. La resiliencia, que se refiere a la capacidad humana para enfrentar y adaptarse a eventos adversos, juega un papel importante en el proceso de recuperación de las quemaduras. Por tanto, el presente estudio tiene como objetivo evaluar la resiliencia de los pacientes quemados, en el momento del ingreso y el alta, en un hospital de emergencia y urgencia en Goiânia. Se trata de un estudio descriptivo, cuantitativo y transversal que utiliza la Escala de Resiliencia Connor-Davidson (CD RISC) como instrumento de medida. Al ingreso hospitalario, la resiliencia media fue de 71,35, con associación significativa entre el factor Amparo de la escala CD RISC y la presencia de pareja. El puntaje de resiliencia encontrado en el presente estudio es consistente con otros hallazgos en la literatura científica nacional e internacional sobre la expresión de resiliencia en víctimas de quemaduras y otras enfermedades. La relación entre el factor Amparo y la presencia de pareja enfatiza la importancia de la red de apoyo familiar en la rehabilitación del paciente quemado.(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Social Support , Burns , Resilience, Psychological , Anxiety Disorders , Pain , Preceptorship , Prejudice , Psychological Phenomena , Psychology , Recovery Room , Rehabilitation Centers , Safety , Self Concept , Skin , Social Perception , Stress Disorders, Post-Traumatic , Suicide , General Surgery , Surgery, Plastic , Tissues , Baths , Wounds and Injuries , Behavior , Behavior and Behavior Mechanisms , Technical Cooperation , Unified Health System , Body Image , Traumatology , Burn Units , Burns, Chemical , Burns, Electric , Accidents, Home , Accidents, Occupational , Accidents, Traffic , Explosive Wastes , Inflammable Wastes , Mental Health , Morbidity , Cicatrix , Nursing , Panic Disorder , Employment, Supported , Statistics, Nonparametric , Human Body , Intuition , Wit and Humor , Hydrogels , Counseling , Critical Care , Disaster Vulnerability , Personal Autonomy , Death , Stress Disorders, Traumatic, Acute , Depression , Discrimination, Psychological , Education , Empathy , Humanization of Assistance , User Embracement , Ethics , Breakthrough Pain , Activation, Metabolic , Physical Appearance, Body , Trauma and Stressor Related Disorders , Psychological Trauma , Accidental Injuries , Psychological Distress , Social Comparison , Functional Status , Self-Compassion , Accident Prevention , Health Services Accessibility , Helping Behavior , Homicide , Amputation, Traumatic , Hospitalization , Individuality , Intensive Care Units , Interpersonal Relations , Life Change Events , Mental Disorders , Negativism , Nursing Assistants , Nursing Care
3.
Rev. SOBECC (Online) ; 27: 1-8, 01-01-2022.
Article in Portuguese | LILACS, BDENF | ID: biblio-1381463

ABSTRACT

Objetivo: Relatar a implantação de um processo de automatização de cobrança de uso de equipamentos e procedimentos no perioperatório. Método: Relato de experiência sobre processo de implantação com automatização de cobrança de uso de equipamentos e procedimentos no periopera-tório com uso do prontuário eletrônico, realizada em abril de 2020 em um hospital de grande porte, filantrópico, localizado no município de São Paulo. Resultados: Realizou-se a inserção de equipamentos com associação de cobrança automatizada no prontuário eletrônico, bem como a cobrança de pro-cedimentos associada à prescrição de enfermagem e anotação de admissão na recuperação anestésica. A construção desse processo automatizado para equipamentos envolveu revisão com auditoria, apresentação da tela com checkbox e cálculo de horas automático. Conclusão: A implantação da auto-matização do processo de cobrança foi concluída com sucesso e contribuiu para o aumento de 13% da receita da unidade, o que levou à ampliação da estratégia para demais unidades da instituição.


Objective: To describe the implementation of an automation process for charging equipment use and procedures in the perioperative period.Method: Experience report on the implementation process with automation of charging for equipment use and procedures in the perioperative period through electronic medical records, carried out in April 2020 in a large, philanthropic hospital, located in the city of São Paulo. Results: The pieces of equipment were associated with automated billing in the electronic medical record, and the billing of procedures was associated with the nursing pre-scription and annotation of admission in the anesthetic recovery room. The creation of this automated process for equipment involved an audit, screen presentation with checkboxes, and automatic calculation of hours. Conclusion: The implementation of billing process automation was successfully completed and contributed to a 13% increase in the unit's revenue, being expanded to other units of the institution.


Objetivo: Relatar la implementación de un proceso de automatización para el cobro del uso de equipos y procedimientos en el período perio-peratorio. Método: Relato de experiencia sobre el proceso de implementación con automatización del cobro por uso de equipos y procedimientos en el período perioperatorio con el uso de la historia clínica electrónica, realizado en abril de 2020 en un gran hospital filantrópico, ubicado en la ciudad de São Paulo. Resultados: Se realizó la inserción de equipos con asociación de facturación automatizada en la historia clínica electrónica, así como la factu-ración de procedimientos asociados a prescripción de enfermería, y anotación de ingreso en la recuperación anestésica. Esa construcción para equipos involucró revisión con auditoría, presentación de pantalla con checkbox y cálculo automático de horas. Conclusión: La implementación de la automati-zación del proceso de cobranza se completó con éxito y contribuyó para un aumento del 13% en los ingresos de la unidad, lo que llevó a la expansión de la estrategia para otras unidades de la institución.


Subject(s)
Humans , Automation , Surgicenters , Equipment and Supplies , Recovery Room , Health Strategies , Perioperative Period
4.
Rev. SOBECC (Online) ; 27: 1-7, 01-01-2022.
Article in Portuguese, French | LILACS, BDENF | ID: biblio-1372995

ABSTRACT

Objetivo: Descrever a construção e a implantação dos protocolos PEWS e NEWS na recuperação anestésica com recurso da automação robó-tica. Método: Relato de experiência sobre a construção e a implantação de protocolos de deterioração clínica na recuperação anestésica em um hospital filantrópico de grande porte localizado no município de São Paulo. O processo de trabalho envolveu a determinação dos protocolos, a construção das regras operacionais para o sistema, o desenvolvimento do sistema eletrônico e a implantação com treinamento da equipe assistencial. Resultados: Foi implantado o processo de deterioração clínica com os protocolos PEWS e NEWS de forma automatizada e sinalizado o acionamento por meio de um iconograma no painel da sala de recuperação pós-anestésica. Conclusão: A implantação dos protocolos foi concluída com sucesso; o uso da automação robótica pode simplificar os fluxos de trabalho e o tempo de coleta de sinais vitais para fornecer uma pontuação do escore. Protocolos de deterioração clínica auxiliam na tomada de decisão das enfermeiras da recuperação anestésica, desde que aplicados em conjunto com o julgamento clínico.


Objective: To describe the development and implementation of the PEWS and NEWS protocols in post-anesthesia recovery using robotic automation. Method: Experience report on the development and implementation of clinical deterioration protocols in post-anesthesia recovery in a large philanthropic hospital located in the city of São Paulo, Brazil. The work involved the determination of protocols, construction of operational rules for the system, development of the electronic system and implementation with training of the assistance team. Results: Prediction of clinical deterio-ration was implemented with the PEWS and NEWS protocols in an automated way, and activation was signaled through an iconogram in the panel of the post-anesthesia care unit. Conclusion: The implementation of the protocols was successfully completed; the use of robotic automation can simplify workflows and reduce the time to collect vital signs to provide a score. Clinical deterioration protocols help nurses' decision-making in anesthesia reco-very, as long as they are applied in conjunction with clinical judgment.


Objetivo: Describir la construcción e implementación de los protocolos PEWS y NEWS en recuperación anestésica utilizando automatiza-ción robótica. Método: Relato de experiencia sobre la construcción e implementación de protocolos de deterioro clínico en la recuperación anestésica en un gran hospital filantrópico de la ciudad de São Paulo. El proceso de trabajo implicó la determinación de protocolos, construcción de reglas de fun-cionamiento del sistema, desarrollo en sistema electrónico e implementación con capacitación del equipo de asistencia. Resultados: Signos de deterioro clínico utilizando los puntajes PEWS y NEWS, lo construimos de forma automatizada e identificamos mediante un signo compuesto por una iconogra-fía en el panel multiprofesional de la unidad, de forma visible para cualquier miembro del equipo. Conclusión: La implementación de los protocolos se completó con éxito, el uso de la automatización robótica puede simplificar los flujos de trabajo y el tiempo de recopilación de signos vitales para pro-porcionar una puntuación. Los protocolos de deterioro clínico auxilian la toma de decisiones del enfermero en la recuperación anestésica, siempre que sean aplicados en conjunto con el juicio clínico.


Subject(s)
Humans , Recovery Room , Anesthesia , Nurses , Powders , Automation , Robotics
5.
Acta Paul. Enferm. (Online) ; 35: eAPE02931, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1364230

ABSTRACT

Resumo Objetivo Identificar a prevalência e intensidade da sede de crianças no pós-operatório imediato e seus fatores associados. Métodos Estudo transversal e analítico. A amostra consistiu-se de 78 crianças de quatro a doze anos em sala de recuperação anestésica no pós-operatório imediato. A presença de sede, bem como seus atributos e sinais foi identificada por questionamento da pesquisadora e/ou autorrelato da criança e seu cuidador. A intensidade de sede foi mensurada por meio da escala de faces. As variáveis desfecho foram presença e intensidade da sede. A razão de prevalência foi calculada por regressão de Poisson, com variância robusta. Resultados A prevalência de sede foi de 88,5% sendo que 39,7% referiram sede no pós-operatório e 48,7% desde o pré-operatório. Quanto à intensidade, 20,5% referiram sede forte e 37,2 % sede intensa. Adicionalmente, mais da metade das crianças (59%) a verbalizou de forma espontânea. Os fatores associados à maior intensidade da sede foram: sexo feminino (RP=1,27); queixa espontânea (RP=1,29); referir sensação de boca seca (RP=1,93) e de saliva grossa (RP=1,43); a idade apresentou associação inversa com a intensidade da sede, ou seja, quanto menor a idade, maior a intensidade da sede (beta= -0,053; p=0,01). Conclusão A sede na criança cirúrgica apresenta elevada prevalência e intensidade. A criança é capaz de identificar os sinais relacionados à sede e a verbaliza espontaneamente. Sexo, queixa espontânea, idade, boca seca e saliva grossa apresentaram associação com a intensidade. Estes resultados sinalizam a necessidade de intervenções intencionais para reduzir a sede da criança na prática clínica.


Resumen Objetivo Identificar la prevalencia e intensidad de la sed de niños en el posoperatorio inmediato y los factores asociados. Métodos Estudio transversal y analítico. La muestra fue formada por 78 niños de 4 a 12 años en sala de recuperación anestésica en el posoperatorio inmediato. La presencia de sed, así como sus atributos y señales, fue identificada mediante cuestionario de la investigadora o autorrelato del niño y su cuidador. La intensidad de la sed fue medida mediante escala de expresiones faciales. Las variables de resultado fueron presencia e intensidad de la sed. La razón de prevalencia fue calculada por regresión de Poisson, con varianza robusta. Resultados La prevalencia de sed fue del 88,5 %, de los cuales el 39,7 % relató sed en el posoperatorio y el 48,7 % desde el preoperatorio. Con relación a la intensidad, el 20,5 % relató sed fuerte y el 37,2 % sed intensa. Además, más de la mitad de los niños (59 %) la verbalizó de forma espontánea. Los factores asociados con una mayor intensidad de sed fueron: sexo femenino (RP=1,27), queja espontánea (RP=1,29), relatar sensación de boca seca (RP=1,93) y de saliva espesa (RP=1,43), la edad presentó asociación inversa respecto a la intensidad de la sed, es decir, cuanto menor la edad, mayor la intensidad de la sed (beta= -0,053; p=0,01). Conclusión La sed en niños quirúrgicos presenta una elevada prevalencia e intensidad. Los niños son capaces de identificar las señales relacionadas con la sed y la verbalizan espontáneamente. Sexo, queja espontánea, edad, boca seca y saliva espesa presentan asociación con la intensidad. Estos resultados indican la necesidad de intervenciones intencionales para reducir la sed de los niños en la práctica clínica.


Abstract Objective To identify the prevalence and thirst intensity in children in the immediate postoperative period and its associated factors. Methods This is a cross-sectional and analytical study. The sample consisted of 78 children aged four to twelve years in the post-anesthesia care unit in the immediate postoperative period. Thirst presence, as well as its attributes and signs, were identified by questioning by the researcher and/or self-report of children and their caregivers. Thirst intensity was measured using the face scale. The outcome variables were thirst presence and intensity. Prevalence ratio was calculated by Poisson regression, with robust variance. Results The prevalence of thirst was 88.5%, with 39.7% reporting thirst in the postoperative period and 48.7% since the preoperative period. As for the intensity, 20.5% reported strong thirst and 37.2% intense thirst. Additionally, more than half of the children (59%) reported it spontaneously. The factors associated with greater thirst intensity were: female sex (PR=1.27); spontaneous complaint (PR=1.29); reporting feeling of dry mouth (PR=1.93) and thick saliva (PR=1.43); age was inversely associated with thirst intensity, i.e., the younger the age, the greater the thirst intensity (beta= -0.053; p=0.01). Conclusion Thirst in surgical children has a high prevalence and intensity. Children are able to identify the signs related to thirst and spontaneously reports it. Sex, spontaneous complaints, age, dry mouth and thick saliva were associated with intensity. These results signal the need for intentional interventions to reduce child thirst in clinical practice.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Postoperative Care , Recovery Room , Surgical Procedures, Operative , Thirst , Intensive Care Units , Postoperative Period , Cross-Sectional Studies , Multivariate Analysis
6.
Mali Médical ; 28(3): 63-68, 30/09/2022. Figures, Tables
Article in French | AIM | ID: biblio-1397771

ABSTRACT

Aim: To assess the COVID-19 patients' treatment duration according to the place of treatment at the Dermatology Hospital of Bamako (DHB). Methods: This was a cross-sectional study comparing the management of COVID-19 PCR-positive patients in the hospital to that of those managed at home from March 2020 to April 2021 until two consecutive negative PCR 48 hours apart. Results: Among the 1109 patients, 369 were hospitalized, 497 followed at home. As of April 31, 2021, 81.2% (900/1109) of the patients recovered, 1.3% (14/1109) were transferred to another health structure, and 2.5% (28/1109) died. No statisticallysignificant difference was observed between the meanduration of the treatment for patients treated at home (10 days) in (95% CI, 9.69-10.3) and those managedathospital (10 days95% CI, 9.76-10.23) (Mantel-Cox test, p= 0.060). Conclusion: These results suggest that the place of treatment do not influence the time to recovery. This is particularly important given the current burden of COVID-19 management on the health workforce


Objectif: Evaluer la durée du traitement des patients COVID-19 selon le lieu de pris en charge à l'Hôpital de Dermatologie de Bamako (HDB). Méthodologie : Il s'agissait d'une étude transversale comparant la prise en charge des patients COVID-19 PCR-positifs à l'hôpital à celle à domicile de mars 2020 à avril 2021 jusqu'à l'obtention de deux tests PCR négatifs consécutifs à 48 heures d'intervalle. Résultats : Parmi les 1109 patients, 369 ont été hospitalisés, 497 suivis à domicile. Au 31 avril 2021, 81,2% (900/1109) des patients se sont rétablis, 1,3% (14/1109) ont été transférés dans une autre structure de santé et 2,5% (28/1109) sont décédés. Aucune différence statistiquement significative n'a été observée entre la durée moyenne du traitement pour les patients traités à domicile (10 jours) en (IC 95 %, 9,69-10,3) et ceux pris en charge à l'hôpital (10 jours IC 95 %, 9,76-10,23) (test de Mantel Cox, p= 0,060). Conclusion: Ces résultats suggèrent que le lieu de traitement n'influence pas le temps de récupération. Ceci est particulièrement important étant donné la charge actuelle de la gestion des COVID-19 sur le personnel de santé


Subject(s)
Dermatology , Duration of Therapy , COVID-19 , Recovery Room , Hospitals
7.
Belo Horizonte; s.n; s.n; 2021. 109 p. ilus, tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1369659

ABSTRACT

Hypothermia is one of the main events and consequently nursing diagnoses found in patients undergoing anesthetic-surgical procedures. The consequences caused by hypothermia directly interfere with the individual's recovery after the surgical anesthetic procedure, which can cause an increase in cardiac and respiratory morbidity, an increase in the rate of infections and an increase in the hospital stay. It aimed to evaluate the patient's warm-up using the Forced Air Heating System, during the post-anesthetic recovery period. The method used was a clinical trial, randomized-controlled, without blinding, following the recommendations of the Consolidated Standards of Reporting Trials, carried out from August to October 2020, in a large, public Municipal Hospital in the city of Belo Horizonte, Minas Gerais. The sample consisted of 66 patients, 33 belonging to the Control Group (standard care of the Institution) and 33 to the Experimental Group (heating intervention by Forced Air Heating System), allocated by systematic probabilistic sampling technique, associated with random sampling simple. Data were collected with sociodemographic, clinical, surgical aspects and parameters evaluated in the post-anesthetic recovery period. The research project followed all ethical principles and was submitted to the Brazilian Registry of Clinical Trials. The Chi-square test, Fisher's exact test, Mann-Whitney test and the Generalized Equations Estimating method were used. The software used in the analyzes was R (version 4.0.2). The results demonstrate that the patient heating as a forced air system was not efficient and did not reestablish the normothermic state, but other benefits related to the heating were evidenced. The mean temperature of the patients at the exit of the post-anesthetic recovery room was higher for the experimental group (35.78ºC) than for the control group (35.60ºC), but this difference was not significant (p = 0.274); the experimental group shows a higher mean time of permanence in the post-anesthetic recovery room (96.97 minutes) than the control group (82.67 minutes) (p = 0.011); the mean body temperature of the patient's entry into the post-anesthetic recovery room was higher in patients in the control group (34.91ºC) than in the experimental group (34.57ºC), this difference being significant (p = 0.003); the mean difference in body temperature in and out of the post-anesthetic recovery room was higher in the experimental group (1.21ºC) than in the control group (0.69ºC); the control group patients present a higher mean systolic blood pressure in the 15 minutes (p = 0.043) and 90 minutes (p = 0.007) of anesthetic recovery and more episodes of hypertension and hypotension (p <0.001) than the patients in the experimental group; the patients of the control group present more episodes of mild and moderate hypoxemia (p <0.001) than the patients of the experimental group; and only the patients in the experimental group presented reports of improvement in the sensation of cold and tremors.


Subject(s)
Postanesthesia Nursing , Perioperative Care , Hypothermia , Recovery Room , Randomized Controlled Trial , Academic Dissertation , Vital Signs , Hospitals, Public
8.
Rev. SOBECC ; 25(4): 241-246, 21-12-2020.
Article in Portuguese | BDENF, LILACS | ID: biblio-1141402

ABSTRACT

Objetivo: Identificar a frequência, o perfil e o tempo de permanência de pacientes intensivos admitidos na sala de recuperação pós-anestésica (SRPA). Método: Estudo transversal e retrospectivo, realizado com base em registros de admissões na SRPA de um hospital público no Rio Grande do Sul, entre julho de 2012 e julho de 2017. Resultados: No período estudado, admitiram-se no setor 22.333 pacientes, sendo 717 (3,2%) pacientes intensivos por indisponibilidade de leito na unidade de terapia intensiva. Destes, 67,6% eram do sexo feminino, 61,2% em idade adulta, submetidos à neurocirurgia (61,5%). O tempo de permanência médio no setor foi de 10,7 horas, e 4,1% dos pacientes foram a óbito. Conclusão: A permanência de pacientes intensivos na SRPA requer adequação do setor em sua estrutura física e operacional, especialmente no que diz respeito à equipe assistencial tanto em quantidade de pessoal quanto em capacitação técnica necessária para assegurar uma assistência de qualidade.


Objective: To identify the frequency, profile, and length of stay of intensive care patients admitted to the post-anesthesia care unit (PACU). Method: This is a retrospective cross-sectional study based on PACU admission records of a public hospital in Rio Grande do Sul, Southern Brazil, between July 2012 and June 2017. Results: In the study period, 22,333 patients were admitted to the PACU; 717 (3.2%) of them were intensive care patients due to the unavailability of beds in the intensive care unit. Among them, 67.6% were women, 61.2% were adults, and 61.5% were individuals submitted to neurosurgery. The mean length of stay in the unit was 10.7 hours, and 4.1% of patients died. Conclusion: The stay of intensive care patients in the PACU requires adapting the physical and operational structure of the unit, particularly in aspects related to the care team, including the number of personnel and the technical training necessary to ensure the quality of care.


Objetivo: Identificar la frecuencia, perfil y tiempo de estancia de los pacientes de cuidados intensivos ingresados en la Sala de Recuperación Posanestésica (SRPA). Método: Estudio transversal y retrospectivo, realizado a partir de los registros de ingreso en la UCPA de un hospital público de Rio Grande do Sul, entre julio de 2012 y julio de 2017. Resultados: En el período estudiado ingresaron al sector 22.333 pacientes, 717 (3,2%) pacientes de cuidados intensivos por indisponibilidad de camas en la Unidad de Cuidados Intensivos. De estos, el 67,6% eran mujeres, el 61,2% adultos, sometidos a neurocirugía (61,5%). La estancia media en el sector fue de 10,7 horas y falleció el 4,1% de los pacientes. Conclusión: La permanencia de los pacientes de cuidados intensivos en la SRPA requiere la adecuación del sector en su estructura física y operativa, especialmente en lo que se refiere al equipo asistencial, tanto en el número de personal como en la formación técnica necesaria para asegurar una atención de calidad.


Subject(s)
Humans , Quality of Health Care , Anesthesia Recovery Period , Anesthesia , Recovery Room , Residence Time , Length of Stay
9.
Rev. SOBECC ; 25(3): 159-170, 30-09-2020.
Article in Portuguese | LILACS | ID: biblio-1122703

ABSTRACT

Objetivo: Discutir a implementação dos protocolos para o cuidado ao paciente na sala de recuperação pós-anestésica, considerando a disposição afetiva da equipe de enfermagem no seu cotidiano, em um hospital da região oeste de Santa Catarina. Método: Pesquisa qualitativa, com base na etnografia e na observação participante. Os sujeitos da pesquisa foram nove profissionais da enfermagem. Os dados foram coletados no primeiro semestre de 2019, considerando-se a análise de conteúdo de Bardin, de onde emergiram três categorias. Resultados: Os profissionais de enfermagem compreendem a importância da disposição afetiva no cuidado aos pacientes na recuperação, elencando a alta demanda de atividades e cirurgias e o número de funcionários insuficiente como dificuldades para um cuidado afetivo, efetivo e empático em seu cotidiano. Há baixa adesão aos protocolos assistenciais disponibilizados no setor, apesar do reconhecimento de sua importância no cuidado direcionado aos pacientes. Conclusão: Como fatores determinantes apresentaram-se a alta demanda diária do setor, o quantitativo de funcionários inadequado e o atendimento a pacientes críticos por longos períodos na recuperação anestésica


Objective: The aim of this study was to discuss the implementation of protocols for patient care in the postanesthesia care unit, considering the provision of compassionate care by the nursing team in their daily routine, in a hospital in the western region of Santa Catarina, Brazil. Method: Qualitative study based on ethnography and participant observation. The research subjects were nine nursing professionals. Data were collected in the first half of 2019, considering Bardin's content analysis, from which three categories emerged. Results: Nursing professionals understand the importance of providing compassion in patient care during recovery, listing the high demand for activities and surgeries and the insufficient staff as difficulties for providing compassionate and effective care in their daily routine. There is low adherence to the assistance protocols available in this unit, despite the recognition of their importance in patient care. Conclusion: Limiting factors for compassionate care of patients in postanesthesia recovery were the high daily demand in this unit, inadequate staff and care of critical patients for long periods.


Objetivo: Discutir la implementación de protocolos para el cuidado del paciente en la sala de recuperación postanestésica, considerando la disposición afectiva del equipo de enfermería en su vida diaria, en un hospital en el oeste de Santa Catarina. Método: Investigación cualitativa, basada en etnografía y observación participante. Los sujetos de investigación fueron nueve profesionales de enfermería. Los datos se recopilaron en la primera mitad de 2019, considerando el análisis de contenido de Bardin, del cual surgieron tres categorías. Resultados: Los profesionales de enfermería entienden la importancia de la disposición afectiva en la atención al paciente en recuperación, enumerando la alta demanda de actividades y cirugías y el número insuficiente de empleados, como dificultades para la atención afectiva, efectiva y empática en su vida diaria; baja adherencia al uso de protocolos de atención disponibles en el sector, a pesar del reconocimiento de su importancia en la atención dirigida a los pacientes. Conclusión: Como factores determinantes fueron la alta demanda diaria en el sector, el número inadecuado de empleados y la atención de pacientes críticos durante largos períodos en la recuperación anestésica.


Subject(s)
Humans , Recovery Room , Anesthesia Recovery Period , Attitude of Health Personnel , Affect , Nurse Practitioners/psychology , Nursing Care/standards
11.
Rev. latinoam. enferm. (Online) ; 28: e3321, 2020. tab, graf
Article in English | BDENF, LILACS | ID: biblio-1115734

ABSTRACT

Objective: to elaborate, validate and evaluate the reliability of the Safety Protocol for Pediatric Thirst Management in the immediate postoperative period. Method: methodological quantitative research, based on the assumptions on measurement instrument development. The protocol was elaborated after literature review, interview with specialists and observation of the child's anesthetic recovery. The judges performed theoretical validation through apparent, semantic and content analysis. Content Validity Index was calculated for content validation, whose minimum established concordance was 0.80. Protocol's reliability was evaluated in children between three and 12 years old in the Post Anesthesia Care Unit. Results: in its final version, the protocol consisted of five evaluation criteria: level of consciousness, movement, airway protection, breathing pattern and nausea and vomiting. It presented easy comprehension and relevant content, and all indexes exceeded the minimum agreement of 0.80. Pairs of nurses applied the protocol 116 times to 58 children, resulting in a high reliability index (kappa general = 0.98) Conclusion: the unprecedented protocol developed is valid and is a useful tool for use in anesthetic recovery, aiming to assess safety for reducing the thirst of infant patients.


Objetivo: elaborar, validar e avaliar a fidedignidade do Protocolo de Segurança para o Manejo da Sede Pediátrica no pós-operatório imediato. Método: pesquisa metodológica, quantitativa, baseada nos pressupostos para elaboração de instrumentos de mensuração. Elaborou-se o protocolo após revisão de literatura, entrevista com especialistas e observação da recuperação anestésica da criança. Juízes realizaram a validação teórica por meio de análise aparente, semântica e de conteúdo. Calculou-se o Content Validity Index na validação de conteúdo, cuja concordância mínima estabelecida foi de 0,80. Avaliou-se a fidedignidade do protocolo em crianças entre três e 12 anos em sala de recuperação anestésica. Resultados: em sua versão final, o protocolo foi constituído por cinco critérios de avaliação: nível de consciência, movimentação, proteção de vias áreas, padrão respiratório e náusea e vômito. Apresentou fácil compreensão e conteúdo pertinente e relevante, e todos os índices superaram a concordância mínima de 0,80. Duplas de enfermeiros aplicaram o protocolo 116 vezes em 58 crianças, resultando em elevado índice de fidedignidade (kappa geral = 0,98) Conclusão: o protocolo inédito elaborado tem validade e é ferramenta útil para utilização na recuperação anestésica, visando avaliar a segurança para a redução da sede do paciente infantil.


Objetivo: elaborar, validar y evaluar la confiabilidad del Protocolo de Seguridad para el Manejo de la Sed Pediátrica en el postoperatorio inmediato. Método: investigación cuantitativa, metodológica, basada en los presupuestos para la elaboración de instrumentos de medición. El protocolo se elaboró después de la revisión de la literatura, entrevista con especialistas y observación de la recuperación anestésica del niño. Los jueces realizaron la validación teórica a través del análisis aparente, semántico y de contenido. El Content Validity Index se calculó para la validación de contenido, cuya concordancia mínima fue de 0,80. La fiabilidad del protocolo se evaluó en niños entre tres y 12 años en la sala de recuperación anestésica. Resultados: en su versión final, el protocolo consistió en cinco criterios de evaluación: nivel de conciencia, movimiento, protección de las vías respiratorias, patrón respiratorio y náuseas y vómitos. Presentó fácil comprensión, con contenido pertinente y relevante, siendo que todos los índices excedían la concordancia mínima de 0,80. Parejas de enfermeros aplicaron el protocolo 116 veces a 58 niños, lo que resultó en un índice de alta confiabilidad (kappa general = 0,98). Conclusión: el protocolo desarrollado, que reviste carácter inédito, es válido y puede considerarse como herramienta útil para su uso en la recuperación anestésica, con el objetivo de evaluar la seguridad para reducción de la sed del paciente infantil.


Subject(s)
Humans , Child , Operating Room Nursing , Recovery Room , Thirst , Clinical Protocols , Postanesthesia Nursing , Validation Study
12.
Rev. SOBECC ; 24(4): 231-237, 30-12-2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1096096

ABSTRACT

Objetivo: Identificar o conhecimento de acadêmicos de enfermagem relacionado aos cuidados e às ações desenvolvidas pelo enfermeiro em sala de recuperação pós-anestésica com vistas à segurança do paciente. Método: Estudo descritivo-exploratório, de abordagem qualitativa, realizado com 30 acadêmicos de enfermagem de uma instituição privada de ensino superior da Região Sul do Brasil. A coleta de dados ocorreu no mês de outubro de 2018, mediante aplicação de questionário semiestruturado. Empregou-se a análise de conteúdo de Bardin para tratamento dos dados. Resultados: Com base nos depoimentos dos entrevistados, emergiu a seguinte categoria: Cuidados e ações do enfermeiro para segurança do paciente, em sala de recuperação pós-anestésica, percebidos pelos acadêmicos de enfermagem. Cuidados rotineiros e mecanicistas, comunicação, liderança, aplicação do processo de enfermagem e uso de protocolos e escalas foram reconhecidos pelos acadêmicos como fundamentais para a segurança do paciente na recuperação. Conclusão: Os acadêmicos de enfermagem reconheceram elementos promotores do cuidado seguro relacionados à assistência de enfermagem na recuperação anestésica.


Objective: To identify the knowledge of nursing students about nursing care and actions in the post-anesthesia care unit regarding patient safety. Method: This is an exploratory descriptive study with a qualitative approach, conducted with 30 nursing students from a private higher education institution in Southern Brazil. Data were collected by administering a semi-structured questionnaire in October 2018. We adopted Bardin's content analysis for data processing. Results: The following category emerged based on the interviewees' statements: Nursing care and actions in the post-anesthesia care unit regarding patient safety, perceived by nursing students. The students acknowledge routine and mechanistic care, communication, leadership, nursing process application, and use of protocols and scales as fundamental for patient safety when recovering. Conclusion: Nursing students identified safe care elements related to nursing care in anesthesia recovery


Objetivo: identificar el conocimiento de los estudiantes de enfermería relacionados con la atención y las acciones desarrolladas por las enfermeras en la sala de recuperación postanestésica, con miras a la seguridad del paciente. Método: Este es un estudio descriptivo y exploratorio con un enfoque cualitativo, realizado con 30 estudiantes de enfermería de una institución privada de educación superior en el sur de Brasil. La recopilación de datos tuvo lugar en octubre de 2018, mediante la aplicación de un cuestionario semiestructurado. El análisis de contenido temático de Bardin se utilizó para el procesamiento de datos. Resultados: surgió la siguiente categoría: Atención de enfermería y acciones para la seguridad del paciente en una sala de recuperación postanestésica, según lo perciben los estudiantes de enfermería. Los cuidados académicos y de rutina, la comunicación, el liderazgo, la aplicación del proceso de enfermería y el uso de protocolos y escalas fueron reconocidos por los académicos como críticos para la seguridad del paciente en la recuperación. Conclusión: los estudiantes de enfermería reconocieron elementos que promueven la atención segura, relacionados con la atención de enfermería en la recuperación anestésica


Subject(s)
Humans , Recovery Room , Nursing , Anesthesia , Perioperative Nursing , Anesthesia Recovery Period , Patient Safety
13.
Rev. colomb. anestesiol ; 47(3): 162-168, July-Sept. 2019. tab
Article in English | LILACS, COLNAL | ID: biblio-1013885

ABSTRACT

Abstract Introduction: Postoperative nausea and vomiting (PONV) negatively impact patients undergoing surgical procedures under anesthesia. The scientific evidence on the risk factors for PONV after antiemetic prophylaxis is unsatisfactory, so there is a need to identify the factors associated with the occurrence of PONV. Objective: To identify the factors associated with failed prophylaxis for PONV in patients at Fundación Valle del Lili in 2017. Methods: Case-control study. Patients admitted to the post anesthesia care unit after having undergone surgery under general anesthesia were included. The cases were patients who, despite receiving antiemetic prophylaxis, had PONV, and those who did not develop these symptoms after prophylaxis, were considered the control group. A bivariate analysis was conducted using the Mann-Whitney U test, Fisher's exact test, or x2, according to the type of variable. Finally, crude odds ratios were estimated and subsequently adjusted via a logistic regression. Results: A total of 80 cases and 332 controls were included. The median age for all patients was 47 years. Women represented 61.6% (n = 254). The variables associated with PONV were age (odds ratio [OR] = 0.98, 95% confidence interval [CI] 0.96-0.99, P = 0.013), female (OR = 3.02, 95% CI 1.66-5.47, P < 0.001) and the use of desflurane during surgery (OR = 2.82, 95% CI 1.097.30, P < 0.032). Conclusion: Female sex and the use of desflurane during surgery increase the odds of experiencing PONV, regardless of pharmacological antiemetic prophylaxis. Moreover, elderly patients show lower odds of developing this complication.


Resumen Introducción: La náusea y el vómito posoperatorios impactan negativamente en los pacientes sometidos a procedimientos quirúrgicos bajo anestesia. La evidencia científica sobre los factores de riesgo para náusea y vómito posoperatorios después de profilaxis antiemética es insatisfactoria, por lo que es necesario identificar los factores asociados con su presentación. Objetivo: Establecer los factores asociados con la profilaxis fallida de náusea y vómito posoperatorios en pacientes de la Fundación Valle del Lili en el 2017. Métodos: Se realizó un estudio de casos y controles. Se incluyeron los pacientes que ingresaron a la unidad de cuidados posanestésicos luego de haber sido intervenidos quirúrgicamente bajo anestesia general. Los casos fueron los pacientes que a pesar de recibir profilaxis antiemética presentaron náusea y/o vómito posoperatorio, mientras los controles fueron aquellos que no presentaron estos síntomas después de la profilaxis. Se realizó un análisis bivariado con la U de Mann-Whitney, el test exacto de Fisher o X2, según el tipo de variable. Finalmente, se estimaron odds ratios crudos que después fueron ajustados por medio de una regresión logística. Resultados: Se incluyeron 80 casos y 332 controles. La mediana de edad para todos los pacientes fue 47 años. Las mujeres representaron el 61.6% (n = 254). Las variables asociadas con náusea y vómito posoperatorios fueron: edad (OR=0.98, IC 95% 0.96-0.99; p = 0.013), ser mujer (OR = 3.02, IC 95% 1.66-5.47; p < 0.001) y el uso de desflurano durante el procedimiento quirúrgico (OR = 2.82, IC 95% 1.09-7.30; p <0.032). Conclusiones: El sexo femenino y el uso de desflurano durante el procedimiento quirúrgico aumentan la oportunidad de tener náusea y vómito posoperatorios, a pesar de una profilaxis farmacológica antiemética. Por otra parte, en pacientes con edades mayores se observa una disminución de la oportunidad de presentar esta complicación.


Subject(s)
Humans , Surgical Procedures, Operative/adverse effects , Risk Factors , Postoperative Nausea and Vomiting , Recovery Room , Therapeutics , Colombia , Anesthesia, General
14.
Journal of Dental Anesthesia and Pain Medicine ; : 295-300, 2019.
Article in English | WPRIM | ID: wpr-764392

ABSTRACT

Complex regional pain syndrome (CRPS) is rare, characterized by pain from diverse causes, and presents as extreme pain even with minor irritation. General anesthesia may be required for dental treatment because the pain may not be controlled with local anesthesia. However, treatment under general anesthesia is also challenging. A 38-year-old woman with CRPS arrived for outpatient dental treatment under general anesthesia. At the fourth general anesthesia induction, she experienced severe pain resulting from her right toe touching the dental chair. Anesthesia was induced to calm her and continue the treatment. After 55 minutes of general anesthesia, the patient still complained of extreme toe pain. Subsequently, two administrations for intravenous sedation were performed, and discharge was possible in the recovery room approximately 5 h after the pain onset. The pain was not located at the dental treatment site. Although the major factor causing pain relief was unknown, ketamine may have played a role.


Subject(s)
Adult , Female , Humans , Anesthesia , Anesthesia, General , Anesthesia, Local , Complex Regional Pain Syndromes , Dental Care , Ketamine , Outpatients , Pain Management , Recovery Room , Toes
15.
Anesthesia and Pain Medicine ; : 364-369, 2019.
Article in English | WPRIM | ID: wpr-762263

ABSTRACT

BACKGROUND: Gender and age are known factors that affect postoperative pain. The purpose of this study was to investigate the effect of gender and age on postoperative pain and analgesic consumptions after laparoscopic cholecystectomy. METHODS: We studied 240 adult patients (120 female patients and 120 male patients) who underwent elective 3-port laparoscopic cholecystectomy under general anesthesia. The numerical rating scale (NRS) scores were assessed before surgery, when the patient arrived in the recovery room, and at 8, 16, and 24 h after surgery. Analgesic consumptions in the recovery room and at 24 h postoperatively were evaluated. We compared the NRS scores and quantity of analgesics between the gender groups and the age groups (20–45, 46–64, and ≥ 65 years old). RESULTS: Compared to male patients, female patients had higher NRS scores (6 [5, 7] vs. 5 [4, 6]; P = 0.001) and required a higher dose of fentanyl (0.94 ± 0.47 µg/kg vs. 0.79 ± 0.41 µg/kg; P = 0.011) in the recovery room. The younger female patients (20–45 and 46–64 years old) required a higher dose of fentanyl than those older than 65 years of age in the recovery room. CONCLUSIONS: Female patients exhibit higher NRS scores and greater consumptions of analgesics than male patients immediately postoperatively. Younger female patients require more analgesics than elderly patients in the recovery room.


Subject(s)
Adult , Aged , Female , Humans , Male , Analgesics , Anesthesia, General , Cholecystectomy, Laparoscopic , Fentanyl , Observational Study , Pain, Postoperative , Prospective Studies , Recovery Room
16.
Journal of Dental Anesthesia and Pain Medicine ; : 55-66, 2019.
Article in English | WPRIM | ID: wpr-739994

ABSTRACT

BACKGROUND: Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. METHODS: Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl 700 µg was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. RESULTS: Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were 4.4 ± 2.0 and 3.7 ± 1.9 in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was 10.7 ± 13.7 and 8.6 ± 8.5, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. CONCLUSION: Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.


Subject(s)
Humans , Analgesia, Patient-Controlled , Analgesics, Opioid , Fentanyl , Fracture Healing , Gastrointestinal Tract , Incidence , Nefopam , Orthognathic Surgery , Pain, Postoperative , Passive Cutaneous Anaphylaxis , Postoperative Nausea and Vomiting , Prospective Studies , Recovery Room
17.
Rev. gaúch. enferm ; 40(spe): e20180398, 2019. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1004107

ABSTRACT

Resumo OBJETIVO Descrever a implantação de um fluxograma de transferência do cuidado de pacientes em pós-operatório, a partir de um modelo de classificação de risco. MÉTODO Relato de experiência sobre a implantação de projeto piloto entre sala de recuperação pós-anestésica e unidade de internação cirúrgica, desenvolvido entre dezembro/2016 e março/2017, visando a transferências do cuidado de pacientes com baixo risco de mortalidade pós-operatória, em um hospital universitário do Sul do Brasil. RESULTADOS O projeto possibilitou agilizar a alta do paciente da Sala de Recuperação Pós-Anestésica para a unidade de internação cirúrgica, qualificar os registros quanto aos cuidados de enfermagem e otimizar o tempo dos enfermeiros, em ambas unidades, para as atividades assistenciais. CONCLUSÃO A implementação de um fluxograma de transferência do cuidado a partir da classificação de risco para pacientes em pós-operatório contribuiu para uma comunicação mais efetiva, culminando em melhorias na segurança do paciente.


Resumen OBJETIVO Describir la implantación de un diagrama de flujo de transferencia del cuidado de pacientes en postoperatorio a partir de un modelo de clasificación de riesgo. MÉTODO Relato de experiencia sobre la implantación de un proyecto piloto entre sala de recuperación postanestésica y unidad de internación quirúrgica, desarrollado entre diciembre/2016 y marzo/2017, con vistas a transferencias del cuidado de pacientes con bajo riesgo de mortalidad postoperatoria, en un hospital universitario del sur de Brasil. RESULTADOS El proyecto posibilitó mayor agilidad del alta del paciente para la unidad de internación quirúrgica, calificación de los registros y cuidados de enfermería referentes al cuadro clínico del paciente, y optimización del tiempo de los enfermeros, en ambas unidades, para las actividades asistenciales. CONCLUSIÓN La implementación de un diagrama de flujo de transferencia del cuidado a partir de la clasificación de riesgo para pacientes en postoperatorio contribuyó a una comunicación más efectiva, culminando en mejoras en la seguridad del paciente.


Abstract OBJECTIVE Describe the implementation of care transfer flow chart in postoperative, based on a risk classification model. METHOD Experience report on the implementation of a pilot project between the post-anesthetic recovery room and the surgical hospitalization unit, developed between December/2016 and March/2017, aimed at transferring s the care of patients with low risk of postoperative mortality, in a university hospital in the South of Brazil. RESULTS The project made it possible to expedite the discharge of the patient from the Post-Anesthetic Recovery Room to the surgical hospitalization unit, to qualify the records regarding nursing care and to optimize the time of nurses in both units for care activities. CONCLUSION The implementation of a care transfer flow chart from the risk classification for postoperative patients contributed to a more effective communication, culminating in improvements in patient safety.


Subject(s)
Humans , Hospitals, University/organization & administration , Postoperative Care/nursing , Postoperative Care/mortality , Recovery Room , Software Design , Brazil , Pilot Projects , Hospital Records , Nursing Records , Risk , Patient Transfer/methods , Hospital Units
18.
Anesthesia and Pain Medicine ; : 401-406, 2019.
Article in English | WPRIM | ID: wpr-785370

ABSTRACT

BACKGROUND: This study was conducted to identify the types and incidence of adverse events associated with midazolam, which is the most widely used drug to induce conscious sedation during gastrointestinal endoscopy, and to analyze the factors associated with hypoxemia and sedation failure.METHODS: Of 87,740 patients who underwent gastrointestinal endoscopy between February 2015 and May 2017, the electronic medical records of 335 who reportedly developed adverse events were retrospectively reviewed, and analysis was performed to determine the risk factors for hypoxemia and sedation failure, the two most frequent adverse events among those manifested during gastrointestinal endoscopy.RESULTS: The overall adverse event rate was 0.38% (n = 335); hypoxemia was most frequent, accounting for 40.7% (n = 90), followed by sedation failure (34.8%, n = 77), delayed discharge from the recovery room (22.1%, n = 49), and hypotension (2.2%, n = 5). Compared with the control group, the hypoxemia group did not show any significant differences in sex and body weight, but mean age was significantly older (P < 0.001) and a significantly lower dose of midazolam was administered (P < 0.001). In the group with sedation failure, the mean rate was higher in men (P < 0.001) and a significantly higher dose of midazolam was administered (P < 0.001), but no age difference was found.CONCLUSIONS: Midazolam-based conscious sedation during gastrointestinal endoscopy can lead to various adverse events. In particular, as elderly patients are at higher risk of developing hypoxemia, midazolam dose adjustment and careful monitoring are required in this group.


Subject(s)
Aged , Humans , Male , Hypoxia , Body Weight , Conscious Sedation , Electronic Health Records , Endoscopy, Gastrointestinal , Hypotension , Incidence , Midazolam , Recovery Room , Retrospective Studies , Risk Factors
19.
The Ewha Medical Journal ; : 8-12, 2018.
Article in English | WPRIM | ID: wpr-742003

ABSTRACT

OBJECTIVES: The insulin-like growth factor binding proteins (IGFBP) regulate the bioavailability and bioactivity of insulin-like growth factor. We aimed to evaluate whether the IGFBP-3 level undergo major changes during perioperative periods according to the different kind of anesthetic agents. METHODS: Eighteen adults scheduled for elective total abdominal hysterectomy were enrolled. The patients were randomly assigned to have either propofol or isoflurane for maintenance of general anesthesia. A venous sample was taken for analysis of IGFBP-3 at the following time points: before induction, at the time of peritoneal closure, 1 hour after extubation at recovery room, and 2 and 5 postoperative days. The samples were analyzed by enzyme linked immunosolvent assay. RESULTS: Demographic data were similar between groups. In the both groups, the IGFBP-3 concentration decreased after anesthesia induction, reaching a nadir at the time of peritoneal closure without a significant difference between groups. In analysis between groups, the IGFBP-3 concentration in the isoflurane group on the postoperative 5th day was recovered to preoperative value and significantly higher than that in the propofol group (P < 0.05). CONCLUSION: This is the first study to show that the anesthetics used for general anesthesia affect the IGFBP-3 level during perioperative periods. The decrease of IGFBP-3 level following anesthesia induction in the isoflurane group was recovered to preoperative value, whereas that observed in the propofol group was not recovered on the postoperative 5th day. Further study is needed to establish the definitive effect of general anesthetics on IGFBP-3 and provide a comprehensive interpretation.


Subject(s)
Adult , Humans , Anesthesia , Anesthesia, General , Anesthetics , Anesthetics, General , Biological Availability , Hysterectomy , Insulin-Like Growth Factor Binding Protein 3 , Insulin-Like Growth Factor Binding Proteins , Isoflurane , Perioperative Period , Propofol , Recovery Room
20.
Journal of Dental Anesthesia and Pain Medicine ; : 245-254, 2018.
Article in English | WPRIM | ID: wpr-739973

ABSTRACT

BACKGROUND: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives. METHODS: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved. RESULTS: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312). CONCLUSIONS: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.


Subject(s)
Adult , Humans , Anesthesia , Anesthesia, General , Autistic Disorder , Blindness , Cerebral Palsy , Dental Offices , Down Syndrome , Epilepsy , Hypnotics and Sedatives , Intellectual Disability , Midazolam , Premedication , Recovery Room , Restraint, Physical , Retrospective Studies , Triazolam
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