Evidências para a Sistematização da Assistência de Enfermagem Perioperatória (SAEP) de pacientes oncológicos / Evidence for the Systematization of Perioperative Nursing Care (SAEP) for cancer patients

A Sistematização da Assistência de Enfermagem no Perioperatório (SAEP) refere-se especificamente ao período perioperatório, visando a satisfação do paciente e realização de um serviço de maior qualidade, envolvendo e motivando os profissionais de enfermagem. O objetivo geral da presente revisão será analisar evidências nacionais e internacionais sobre a sistematização da SAEP do paciente oncológico, posteriormente, atualizando e unificando um instrumento para registro da SAEP do paciente oncológico, com base nas evidências nacionais e internacionais sobre a temática. O método adotado foi uma Revisão Integrativa (RI), realizada em seis etapas. Para a definição da pergunta considerou-se a estratégia População, Intervenção, Comparação, Desfecho e Tempo (PICOT): Quais as evidências acerca da sistematização da assistência de enfermagem perioperatória destinada a pacientes oncológicos visando a atendimento aos resultados esperados na SAE? As buscas foram realizadas no mês de fevereiro de 2022 e carregadas no aplicativo de organização de revisões online Rayyan, utilizando-se vocabulário controlado e palavras-chave, nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), PubMed®, Cummulative Index to Nursing and Allied Health Literature (CINAHL), SciVerse Scopus e Web of Science (WOS). Foram incluídos artigos primários, de 2018 a 2022 e os dados foram extraídos mediante a utilização de instrumento validado e a avaliação da qualidade metodológica utilizou os sete níveis de evidência proposta por Melnyk e Fineout-Overholt e a ferramenta Escala de Evaluación de Artículos con Metodologías Heterogéneas para Revisiones Integrativas. Seguiu-se ainda as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Como resultados a amostra contou com 37 artigos, de um universo identificado de 667 registros. Quanto a proveniência dos estudos assinala-se: Estados Unidos da América, Brasil, Índia, Itália, Japão, Coreia do Sul, Holand, Turquia, Dinamarca, Singapura, Austrália, Jordânia, China, França, Canadá e Egito. A interpretação respeitou os eixos de debate "Período pré-operatório" (15 artigos com evidências nível VI, IV e III), "Período intraoperatório" (05 artigos com evidências IV, VI, II e III) e "Período pós-operatório" (17 artigos com evidências com IV e VI). Geraram-se Diagnósticos de Enfermagem (DE) para o Período pré-operatório: Hipertermia, Padrão respiratório ineficaz, Nutrição desequilibrada: menor que as necessidades corporais, Identidade pessoal perturbada, Imagem corporal perturbada, Padrão de sono perturbado, Constipação, Diarreia, Dor crônica, Risco de trombose, Risco de integridade da membrana mucosa oral prejudicada; no Período intraoperatório: Risco de infecção no sítio cirúrgico, Risco de hipotermia perioperatória, Risco de lesão por posicionamento perioperatório, Risco de lesão (unidade de eletrocirurgia); no Período pós-operatório imediato: Risco de infecção no sítio cirúrgico, Dor aguda, Náuseas, Constipação, Padrão respiratório ineficaz, Risco de sangramento; no Período pós-operatório mediato: Dor aguda, Fadiga, Nutrição desequilibrada: menor que as necessidades corporais, Recuperação cirúrgica retardada. Em suma, a RI embasará uma SAEP segura além de um plano de cuidados perioperatórios condizente com os usuários oncológicos, o instrumento empregado no Centro de Alta Complexidade em Oncologia foi unificado e atualizado, incluso com DE para o pré-operatório, algo não existente na versão inicial, o produto deste estudo secundário favorecerá cirurgias mais seguras e um cuidado qualificado pelas evidências

The Systematization of Perioperative Nursing Care (SPNC) refers specifically to the perioperative period, aiming at patient satisfaction and providing a higher quality service, involving and motivating nursing professionals. The general objective of this review will be to analyze national and international evidence on the systematization of SPNC for cancer patients, subsequently updating and unifying an instrument for recording SPNC for cancer patients, based on national and international evidence on the subject. The method adopted was an Integrative Review (IR), carried out in six stages. For the definition of the question, the Population, Intervention, Comparison, Outcome, and Time (PICOT) strategy was considered: What is the evidence about the systematization of perioperative nursing care aimed at cancer patients to meet the expected results in the SAE? The searches were carried out in February 2022 and uploaded to the Rayyan online review organization application, using controlled vocabulary and keywords, in the databases: Latin American and Caribbean Literature in Health Sciences (LILACS), PubMed®, Cummulative Index to Nursing and Allied Health Literature (CINAHL), SciVerse Scopus and Web of Science (WOS). Primary articles from 2018 to 2022 were included and data were extracted using a validated instrument the methodological quality assessment used the seven levels of evidence proposed by Melnyk and Fineout-Overholt and the tool Escala de Evaluación de Artículos con Metodologías Heterogéneas for Integrative Reviews. The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were also followed. As a result, the sample had 37 articles, from an identified universe of 667 records. As for the origin of the studies, it is noted: the United States of America, Brazil, India, Italy, Japan, South Korea, Holland, Turkey, Denmark, Singapore, Australia, Jordan, China, France, Canada, and Egypt. The interpretation respected the axes of debate "Preoperative period" (15 articles with evidence level VI, IV, and III), "Intraoperative period" (05 articles with evidence IV, VI, II, and III), and "Postoperative period" (17 articles with evidence with IV and VI). Nursing Diagnoses (ND) were generated for the preoperative period: Hyperthermia, Ineffective breathing pattern, Imbalanced nutrition: less than body needs, Disturbed personal identity, Disturbed body image, Disturbed sleep pattern, Constipation, Diarrhea, Chronic pain, Risk of thrombosis, Risk of impaired oral mucous membrane integrity; in the intraoperative period: Risk of surgical site infection, Risk of perioperative hypothermia, Risk of perioperative positioning injury, Risk of injury (electrosurgery unit); in the immediate postoperative period: Risk of surgical site infection, Acute pain, Nausea, Constipation, Ineffective breathing pattern, Risk of bleeding; in the mid-postoperative period: Acute pain, Fatigue, Imbalanced nutrition: less than body needs, Delayed surgical recovery. In short, the IR will support a safe SPNC in addition to a perioperative care plan consistent with oncology users, the instrument used at the Center for High Complexity in Oncology was unified and updated, including an ND for the preoperative period, something that does not exist in the initial version, the product of this secondary study will favor safer surgeries and evidence-qualified care

Psychological care combined with enhanced recovery after surgery management in perioperative nursing care of andrological patients: A randomized controlled study / 中华男科学杂志

Objective@#To evaluate the validity of psychological care combined with enhanced recovery after surgery (PC+ERAS) management in perioperative nursing care of andrological patients.@*METHODS@#A total of 300 male patients undergoing andrological surgery were included in this study, 150 given PC+ERAS and the other 150 receiving routine nursing care as controls. We evaluated anxiety and depression of all the patients on admission and discharge using Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), and compared post-operative hospital days, off-bed time, first passage of flatus, Visual Analog Scale (VAS) score and satisfaction with nursing care between the two groups of patients.@*RESULTS@#On discharge, significant improvement was observed in SAS and SDS scores in the PC+ERAS group compared with the baseline, even more significant than in the control group (P 0.05). The patients in the PC+ERAS group also achieved a significantly shorter post-operative hospital stay, earlier post-operative off-bed time and passage of flatus, lower VAS score, and higher satisfaction with nursing care than those in the control group (P < 0.05).@*CONCLUSIONS@#Psychological care combined with ERAS management deserves wide application in the perioperative nursing care of andrological patients, which can significantly improve the patients' anxiety and depression, shorten post-operative hospital stay, reduce VAS score, and increase their satisfaction with nursing care.

Construction of sensitive index for perioperative nursing quality in liver transplantation / 中国实用护理杂志

Objective To build a scientific, practical and sensitive index for liver transplantation perioperative nursing quality, and to provide reference for liver transplantation perioperative nursing evaluation and monitoring. Methods Based on the"structure-process-result"three dimensional quality evaluation model, the methods of literature review and evidence based analysis were adopted to summarize the sensitive index for perioperative nursing quality in liver transplantation, including name, connotation, calculation formula and data collection methods. The indicators were discussed and adjusted using Delphi method. Results Nineteen liver transplantation perioperative nursing quality sensitivity indexes were established, including the correct use of immunosuppressive agents, the qualified rate of transplanted liver function monitoring method, nutritional risk screening ration, incidence of low body temperature, etc. For the two rounds of questionnaire, the valid rate was 88.89％and 91.67％, the authority score was 0.88 and 0.89, coefficient of variation of the importance of index was 0.06-0.28. Conclusion The liver transplantation perioperative nursing quality sensitivity indexes based on Delphi method are scientific and practical,which could be applied to clinical utilization.

Application of fast-track surgery concept in the perioperative nursing care of andrological patients: A randomized controlled study / 中华男科学杂志

<p><b>Objective</b>To evaluate the application of the fast-track surgery (FTS) concept in the nursing care of andrological patients during the perioperative period.</p><p><b>METHODS</b>A total of 200 males to be treated by andrological surgery were included in a control group and another 200 in an observation group, the former received conventional perioperative nursing care, while the latter underwent an FTS nursing care procedure including a variety of proven effective methods to reduce surgical stress and achieve a quick recovery during the perioperative period. Comparisons were made between the two groups of patients in the postoperative enterokinesia time, anal exhaust time, eating time, off-bed time, defecating time, bowel preparation complications, and degree of comfort and satisfaction.</p><p><b>RESULTS</b>Compared with the controls, the patients in the observation group showed significantly earlier postoperative enterokinesia time (［5.8±0.9］ vs ［4.4±1.4］ h, P<0.01), anal exhaust time (［10.8±1.8］ vs ［7.7±2.0］ h, P<0.01), eating time (［12.9±0.7］ vs ［6.3±0.7］ h, P<0.01), off-bed time ［14.3±2.7］ vs ［8.2±1.4］ h, P<0.01), and defecating time (［49.2±2.6］ vs ［39.6±2.5］ h, P<0.01), a lower incidence of bowel preparation complications (P<0.01), and a higher degree of comfort (P<0.01) and satisfaction (［97.5±0.7］% vs ［99.4±+0.3］ %, P<0.01).</p><p><b>CONCLUSIONS</b>The FTS concept can be safely and effectively applied to the perioperative nursing care of andrological patients to achieve a faster recovery and higher degree of comfort and satisfaction postoperatively.</p>

Perioperative nursing care of congenital heart disease underwent minimally invasive occlusion surgery via subaxillay incision / 中国实用护理杂志

Objective To explore the perioperative nursing method and effect of doing minimal invasive occlusion to children with congenital heart disease via subaxillary incision.Methods The data of 86 children patients with congenital heart disease underwent minimally invasive occlusion via right subaxillary incision were retrospectively analyzed and summarized nursing points including preoperative and postoperative mental nursing,postoperative postural care and sedative care,observing whether the occluder moved or detached and mechanical hemolysis,monitoring ECG and blood pressure,and preventing hemorrhage and thrombogenesis.Results One case of infracristal ventricular septal defect with frequent premature ventricular beat after occlusion was converted to thoracotomy surgery;one case of mixed atrial septal defect with heart rate increasing and dyspnea after 12 hours of occlusion was found occluder detached and immediately converted to remove the occluder and fix the atrial septal defect;The other children were successfully recovered and been discharged.Conclusions Full understanding and strengthened perioperative nursing care of complications of children with congenital heart disease after surgical minimally-invasive surgical closure is the key point to avoid the occurrence of fatal complications and ensure the children recover safely and smoothly.

A assistência de enfermagem perioperatória na visão do enfermeiro e do paciente cirúrgico idoso / Perioperative nursing care: nurses and elderly patients perceptions

Este estudo teve como objetivos: analisar a percepção do enfermeiro, no período perioperatório, em relação à assistência de enfermagem prestada ao paciente cirúrgico idoso; analisar a percepção do paciente cirúrgico idoso, no período perioperatório, em relação à assistência de enfermagem, e finalmente, comparar a percepção do enfermeiro e do paciente idoso, em relação à assistência de enfermagem, no período perioperatório. Participaram deste estudo 30 enfermeiros e 50 pacientes cirúrgicos idosos. Foram utilizados dois formulários para os pacientes: o primeiro para a avaliação do estado mental e o segundo para a realização da pesquisa propriamente dita. Foi utilizado um formulário para os enfermeiros da U.I. e outro para os enfermeiros do C.C. Os resultados possibilitaram as seguintes conclusões: a percepção dos enfermeiros da U.I. e C.C., em relação à assistência prestada aos idosos, está voltada, em maior percentual, para os aspectos emocionais dos pacientes; a assistência sugerida pelos enfermeiros da U.I. para os pacientes idosos, no período pós-operatório, está voltada para o aspecto físico- específico; os enfermeiros do C.C. sugeriram, para os pacientes idosos, uma assistência voltada para o aspecto físico e emocional. Em relação à assistência de enfermagem da U.I. e do C.C, os pacientes cirúrgicos idosos tiveram a percepção relacionada aos aspectos físicos. A percepção dos pacientes idosos no P.O.I. foi relacionada ao aspecto expressivo da assistência de enfermagem. Comparando-se a percepção dos enfermeiros da U.I. com a dos pacientes cirúrgicos idosos, na U.I. no período pré-operatório, verifica-se que a percepção dos primeiros em relação à assistência está voltada para os aspectos emocionais (66,67%), enquanto a dos últimos para os aspectos físicos (70,00%). Comparando-se a percepção dos enfermeiros do C.C. com a dos pacientes cirúrgicos idosos, no C.C., no período transoperatório, ) verifica-se que a percepção dos primeiros em relação à assistência está voltada para os aspectos emocionais (41,67%), enquanto a dos últimos para os aspectos físicos (62,00%). Comparando-se a percepção dos enfermeiros no P.O.I., com a dos pacientes cirúrgicos idosos no P.O.I., verifica-se que a percepção dos primeiros em relação à assistência está voltada para os aspectos físicos (66,67%), enquanto a dos últimos para os aspectos emocionais (52,00%). A partir dos resultados fizeram-se sugestões nas áreas de assistência, ensino e pesquisa.

This report has as objectives the analysis of the nurse's perception during the perioperative nursing care provided to elderly surgical patients, analyze the elderly surgical patient's perception of nursing care during the perioperative period and finally compare the perception of nurses and elderly surgical patients in respect to nursing care during the perioperative period. 50 elderly surgical patients and 30 nurses took part in this research. Two forms were used for the patients, one for the assessment of their mental status and the second to realize the research itself. For nurses, a from was used for those on Surgical Ward and another one for the Operating Room nurses. The results permitted the following conclusions: The perception of the Operating Room and Surgical Ward nurses in respect to the nursing care provided to the elderly is about emotional aspects of patients; the care suggested by the Surgical Ward nurses for elderly patients in the post-surgical period is directed towards the physical-specific and the Operating Room nurses suggested for elderly patients a care directed towards the physical and emotional aspects. In respect to the nursing care on Surgical Ward and Operating Room, the elderly surgical patients related their perception to the physical aspects. The perception of elderly patients on the immediate postoperative surgical period, was related to the expressive aspect of nursing care. Comparing the perception of Surgical Ward nurses with that elderly surgical patients on Surgical Wards during the preoperative period, it was verified that the former's perception in respect to care was directed towards the emotional aspect (66.67%), while the latter's was directed to the physical aspect (70%). Comparing the perception of Operating Room nurses with that of elderly surgical patients in the Operating Room for the introperative period, it was verified that the former's perception in respect to care was directed towards the emotional aspect (41.67%) while the latter's was directed towards the physical aspect (62.00%). Comparing the nurses perception during the immediate postoperative period with that of elderly surgical patients during the same period it was verified that the former's perception in respect to care was direct towards the physical aspects (66.67%), while the latter's was directed towards the emotional aspects (52%). From these results, recommendations on the areas of care, education and research were made.