Investigation on current situation of core competence of anesthesiology nurses in China / 中华麻醉学杂志

Objective:To investigate the current situation of core competence of anesthesiology nurses in China, and to provide basis for formulating and perfecting the training curriculum of anesthesiology nurses.Methods:The cluster sampling method was used, and 231 nurses in the department of anesthesiology were investigated by using the general data questionnaire and the self-assessment form of core competence of specialized nurses in the department of anesthesiology.Results:Anesthesiology nurses scored (3.7±0.5) points in their core competencies, of which 43.2% and 36.4% had complete mastery of humanistic literacy, and communication and coordination skills, respectively, and only 4.3% of them had mastered scientific research ability.The core competence scores of anesthesiology nurses with the title of head nurse or above positions and deputy chief nurse or above titles were significantly higher than those of other positions and titles ( P<0.05). Conclusions:The self-evaluation of core competence of specialized nurses in anesthesiology department is at a medium level.There are differences in core competencies among nurses in the department of anesthesiology with different positions and titles.It is suggested that the training of specialized nurses should be guided by core competence.

Investigation and analysis of awareness of malignant hyperthermia among anesthesiology nurses in mainland China / 中华麻醉学杂志

Objective:To investigate and analyze the awareness of malignant hyperthermia (MH) in anesthesiology nurses in mainland China.Methods:From November 2021 to January 2022, anesthesiology nurses of secondary hospitals or above in Chinese mainland were enrolled by convenience sampling and investigated by a self-designed questionnaire on the awareness of MH.The system automatically recorded the situation of questionnaires.Results:A total of 2 058 anesthesiology nurses participated in the survey, distributed in 21 provinces, 2 autonomous regions (Ningxia Hui Autonomous Region, Guangxi Zhuang Autonomous Region) and 4 municipalities directly under the central government, and 2 049 questionnaires were effectively received with effective recovery of 99.56%.The correct answers to questions related to the treatment of MH, characteristics of the disease, classification, susceptible population, screening method of the susceptible population, genetic mode, inducing factors, the first symptoms and the best infusion time of dantrolene, preparation method of domestic dantrolene and the first dose were 86.58%, 82.33%, 58.18%, 50.90%, 50.76%, 50.42%, 45.73%, 32.89%, 51.25%, 48.32% and 46.51%, respectively.Only 27.13% of anesthesiology nurses expressed that dantrolene was available in their hospital.The scores of knowledge about MH among anesthesiology nurses in hospitals of province-level municipalities and provincial capital cities were significantly higher than those in other cities ( P<0.001). The scores of knowledge about MH among the anesthesiology nurses in secondary hospitals were significantly higher than those in tertiary hospitals ( P<0.05). There was no significant difference in the scores of knowledge about MH among anesthesiology nurses with different professional titles, educational backgrounds, and working years ( P>0.05). Conclusions:Anesthesiology nurses in mainland China have insufficient awareness of MH.Popularizing the knowledge about MH and strengthening the awareness of MH in medical staff in the department of anesthesiology throughout the country may be of great significance in improving the diagnosis and treatment of MH in China.

Effect of Critical Incident Reporting System on the quality of clinical anesthesia / 中华麻醉学杂志

Objective To evaluate the effect of Critical Incident Reporting System on the quality of clinical anesthesia.Methods Anesthesia-related critical incidents happened in the perioperative period were reported in voluntary,anonymous,no punishment and confidential manners.The data was collected,classified and documented by assigned professionals on a regular basis from September 2012 to August 2016.The critical incidents were retrospectively analyzed after the risk was assessed.The 4-year reporting rate was collected.The risk of critical incidents was assessed using severity and probability analysis,and the critical incidents-inducing risk factors were analyzed.Results The 4-year reporting rate of critical incidents was 0.551％.From 1st to 4th year,the reporting rates were 0.729％,0.598％,0.819％ and 0.368％,respectively,and the incidence of injury incidents was 0.112％,0.106％,0.133％ and 0.031％,respectively.The reporting rate of critical incidents and incidence and reporting rate of the injury incidents showed a decreasing trend for 1st and 2nd year,significantly increased for 3rd year and decreased for 4th year (P＜0.05).The first three critical incident categories were equipment use and respiratory system-and workflowrelated incidents.Patient injury during surgery was considered an extremely high risk incident;the factor of the medical staff in the department of anesthesiology is the first critical incidents-inducing risk factor.Conclusion Critical Incident Reporting System can discover and correct the system-related risk and the inducing factors in the department of anesthesiology and is an effective method of improving the service quality of clinical anesthesia.

Complicações pós-operatórias menores relacionadas à anestesia em pacientes de cirurgias eletivas ginecológicas e ortopédicas em um hospital universitário de Kingston, Jamaica / Minor postoperative complications related to anesthesia in elective gynecological and orthopedic surgical patients at a teaching hospital in Kingston, Jamaica / Complicaciones postoperatorias menores relacionadas con la anestesia en pacientes para cirugías electivas ginecológicas y ortopédicas en un hospital universitario de Kingston, Jamaica

JUSTIFICATIVA E OBJETIVOS: As complicações anestésicas pós-operatórias menores podem aumentar o desconforto e a insatisfação do paciente e retardar sua recuperação. Este trabalho procurou determinar a frequência das complicações menores relatadas nas primeiras 48 horas do período pós-operatório por pacientes de cirurgias eletivas (ginecológicas e ortopédicas) no University Hospital of the West Indies, Jamaica. A satisfação geral com os cuidados anestésicos e os possíveis fatores de risco para desenvolver complicações também foram avaliados. MÉTODOS: Um estudo prospectivo e descritivo de coorte foi realizado por meio de entrevistas com pacientes operados 24 e 48 horas após a anestesia. Os dados foram analisados usando SPSS versão 12 e avaliados pelo teste do χ2-quadrado e modelos de regressão logística múltipla. RESULTADOS: Foram incluídos 505 pacientes, sendo 374 do sexo feminino (74 por cento). A maioria era ASA I (55 por cento) ou ASA II (38 por cento) e foi submetida à anestesia geral (80 por cento). Um total de 419 (83 por cento) pacientes relataram pelo menos uma complicação pós-operatória. As complicações mais relatadas foram dor de garganta (44 por cento), náusea (30 por cento), vômito (24 por cento) e tromboflebite (20 por cento). A moda do Índice de Classificação Numérica Verbal (ICNV) para cada complicação variou entre 2 e 5, sugerindo que a maioria não causa desconforto grave. Idade inferior a 45 anos (OR 2,22, IC de 95 por cento 1,34-3,69, p = 0,002) e sexo feminino (OR 3,64, IC de 95 por cento 2,14-6,20, p < 0,001) foram identificados como variáveis independentes significativas. A maioria dos pacientes considerou sua experiência anestésica como excelente (51 por cento) ou muito boa (22 por cento). CONCLUSÃO: Este estudo mostrou uma incidência relativamente alta de complicações menores pós-operatórias (83 por cento), mas baixa gravidade dos sintomas relatados e um alto grau de satisfação geral. Deve ser dada atenção especial à redução dessas complicações menores por meio de técnicas anestésicas mais meticulosas.

BACKGROUND AND OBJECTIVES: Minor postoperative anesthetic complications may increase patient discomfort and dissatisfaction and delay recovery. This paper sought to determine the frequency of minor complications in the first 48 hours postoperatively reported by elective gynecological and orthopedic surgical patients at the University Hospital of the West Indies, Jamaica. Overall satisfaction with anesthetic care and possible risk factors for developing complications were also assessed. METHODS: A prospective, descriptive cohort study was undertaken with patient interviews 24 to 48 hours after anesthesia. Data were analyzed using SPSS version 12 and assessed using the χ2-square test and multiple logistic regression models. RESULTS: Five hundred and five (505) patients were included, with 374 females (74 percent). Most were ASA I (55 percent) or ASA II (38 percent) and had general anesthesia (80 percent). A total of 419 (83 percent) patients reported at least one complication postoperatively. The most frequently reported complications were sore throat (44 percent), nausea (30 percent), vomiting (24 percent), and thrombophlebitis (20 percent). The mode of the Verbal Numerical Rating Score (VNRS) for each complication ranged between 2 and 5, suggesting that most did not cause severe distress. Age less than 45 years (OR 2.22, 95 percent CI 1.34-3.69, p = 0.002) and female gender (OR 3.64, 95 percent CI 2.14-6.20, p < 0.001) were identified as significant independent variables. Most patients regarded their anesthetic experience as excellent (51 percent) or very good (22 percent). CONCLUSION: This study showed a comparatively high incidence of minor postoperative complications (83 percent), but low reported severity of symptoms and a high overall satisfaction rate. Special attention should be paid to reduce these minor complications through more meticulous anesthetic technique.

JUSTIFICATIVA Y OBJETIVOS: Las complicaciones anestésicas postoperatorias menores pueden aumentar la incomodidad y la insatisfacción del paciente y retardar la recuperación. Este trabajo intentó determinar la frecuencia de las complicaciones menores relatadas en las primeras 48 horas del período postoperatorio por pacientes de cirugías electivas (ginecológicas y ortopédicas), en el University Hospital of the West Indies, Jamaica. También se evaluaron, la satisfacción general con los cuidados anestésicos y los posibles factores de riesgo para desarrollar complicaciones. MÉTODOS: Un estudio prospectivo y descriptivo de cohorte fue realizado por medio de entrevistas con pacientes operados 24 y 48 horas después de la anestesia. Los datos fueron analizados usando SPSS versión 12 y evaluados por el test del χ2-cuadrado y modelos de regresión logística múltiple. RESULTADOS: Se incluyeron 505 pacientes, siendo que 374 eran del sexo femenino (74 por ciento). La mayoría era ASA I (55 por ciento) o ASA II (38 por ciento) y se sometió a la anestesia general (80 por ciento). Un total de 419 (83 por ciento) pacientes relataron por lo menos una complicación postoperatoria. Las complicaciones más relatadas fueron el dolor de garganta (44 por ciento), náusea (30 por ciento), vómito (24 por ciento) y tromboflebitis (20 por ciento). La moda del Índice de Clasificación Numérica Verbal (ICNV), para cada complicación varió entre 2 y 5, lo que sugiere que la mayoría no causa una grave incomodidad. La edad inferior a 45 años (OR 2,22, IC de 95 por ciento 1,34-3,69, p = 0,002) y el sexo femenino (OR 3,64, IC de 95 por ciento 2,14-6,20, p < 0,001), fueron identificados como variables independentes significativas. La mayoría de los pacientes consideró su experiencia anestésica como excelente (51 por ciento) o muy buena (22 por ciento). CONCLUSIONES: Este estudio mostró una incidencia relativamente alta de complicaciones menores postoperatorias (83 por ciento), pero con una baja gravedad de los síntomas relatados y un alto grado de satisfacción general. Debemos darle una atención especial a la reducción de esas complicaciones menores por medio de técnicas anestésicas más meticulosas.

Exposição ocupacional a poluição sonora em anestesiologia / Occupational exposure to noise pollution in anesthesiology / Exposición ocupacional a la contaminación sonora en anestesiología

JUSTIFICATIVA E OBJETIVOS: Os efeitos nocivos da poluição sonora em ambientes de trabalho são bem conhecidos e descritos na literatura. Os efeitos da exposição prolongada a ruídos em áreas que demandam alto nível de concentração, como as salas de operações, dependem da variabilidade nas respostas individuais e da intensidade das diferentes fontes geradoras. O objetivo deste trabalho é apresentar uma revisão sobre a exposição ocupacional a poluição sonora em Anestesiologia. CONTEÚDO: São discutidos os resultados dos principais artigos da literatura sobre o tema, envolvendo as fontes de poluição sonora e seus efeitos sobre os profissionais, em especial o anestesiologista. É dada ênfase a legislação e as recomendações para a minimização dos efeitos imputados à poluição sonora.

BACKGROUND AND OBJECTIVES: The harmful effects of workplace noise pollution are well known and described in the literature. The effects of prolonged exposure to noise in areas demanding high level of concentration, such as operating rooms, depend on the variability of individual responses and intensity of different generation sources. The aim of this paper is to present a review of occupational exposure to noise in anesthesiology. CONTENT: The results of the main articles in literature on the subject are discussed, concerning the sources of noise pollution and its effects on workers, particularly the anesthesiologist. Emphasis is given to legislation and recommendations to minimize the effects caused by noise.

JUSTIFICATIVA Y OBJETIVOS: Los efectos nocivos de la contaminación sonora en ambientes de trabajo son archiconocidos y están descritos en la literatura. Los efectos de la exposición prolongada a ruidos en las áreas que exigen un alto nivel de concentración como los quirófanos por ejemplo, dependen de la variabilidad en las respuestas individuales y de la intensidad de las diferentes fuentes generadoras. El objetivo de este trabajo, es presentar una revisión sobre la exposición ocupacional a la contaminación sonora en Anestesiología. CONTENIDO: Se discuten aquí los resultados de los principales artículos de la literatura sobre el tema, involucrando las fuentes de contaminación sonora y sus efectos sobre los profesionales, en especial, el anestesiólogo. Se le da un énfasis especial, a la legislación y a las recomendaciones para la minimización de los efectos acarreados por la contaminación sonora.

Relationship between the personality and occupation tension of anesthesiologists / 中华麻醉学杂志

Objective To analyse the relationship between the personality and occupation tension of anesthesiologists.Methods One hundred anesthesiologists working at different hospitals in Shenzhen volunteered to complete the questionnaire.Ninety-one valid questionaires were recovered.The questionnaire survey included the Eysenck Personality Questionnaire and Job Content Questionnaire and anesthesia events.The standard scores of internal and external factor,stubborn factor,emotional stability factor,social support,sense of personal achievement and work demand/control ratio (D/C) were calculated.Results Internal and external factor (E) and stubborn factor (P) were negatively correlated with demand/control ratio (D/C).The correlation coefficients were-0.7805and-0.2375.There was no correlation between emotional stability factor (N) and D/C.Social support and sense of personal achievement were negatively correlated with D/C.The correlation coefficients were-0.225 and -0.264.More than 50％ of the study subjects suffered from mental tension during op.eration and fatique after night shift,overtime work and emergency operation.Conclusion Occupation tension is lower in extroverted and higher in introverted anesthesiologists and is also relatively low in those with stubborn personality.Strong social support and deep sense of personal achievement can lower occupation tension.

Analysis of anesthesia residency training program dropout of West China Hospital / 中华麻醉学杂志

One hundred forty-four residents registered at department of anesthesia of West China Hospital from 1999 to 2010.The duration of residency training is 5 years (3 + 2).The residents enrolled during 1999-2002 were on the staff.They were assigned to work at this hospital after graduation from medical school and became staff anesthesiologist of this hospital after 5 year training.The residents enrolled during 2003-2010 were trainees and not on the staff.They had to apply for a job as anesthesiologist somewhere after 5 year training.After 3 year training the residents are qualified to undergo subspecialty training.Thirty-nine of the 144 residents dropped out of the training program.The reasons for their withdrawing from the program included finding a regular job,failing the qualifying examination,changing profession studying abroad and death.In order to reduce dropout rate,correct public opinion on the importance of residency training,raising the quality of the residents and improving income of the residents are needed.