Roadmap for integrating the AACN essentials with perioperative nursing.

Faculty members teaching in pre-licensure nursing programs are entrusted with revising nursing education to meet the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education. Colleges of nursing faculty experience difficulty establishing enough clinical sites as healthcare facilities continue to overcome staffing challenges since the start of the COVID-19 pandemic. Perioperative nursing is an underutilized area despite the potential for students to attain valuable nursing competencies and experiences in perioperative areas. An opportunity exists for faculty, regardless of having perioperative nursing experience or not, to use perioperative environments for clinical experiences in didactic and simulation courses. Our aim is to provide a roadmap for nursing faculty to include perioperative nursing in the pre-licensure nursing curriculum. Perioperative education exemplars aligned with the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education domains are included for adoption in any college of nursing.

Factors impacting early mobilization according to the Enhanced Recovery After Surgery guideline following gastrointestinal surgery: A prospective study.

AIM: Evidence shows that early mobilization according to the Enhanced Recovery After Surgery guideline promotes postoperative recovery in gastrointestinal cancer patients undergoing gastrointestinal surgery. However, compliance with the guideline in clinical settings remains low. This study aimed to investigate the factors influencing early mobilization after surgery. METHODS: A prospective research design was used. Data from 470 patients with gastrointestinal cancer who underwent gastrointestinal surgery between February 2021 and July 2022 were collected. RESULTS: More than half (53.6%) of the patients met the criteria for early mobilization. Females (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.02-2.29), age 〉70 years (OR, 1.76; 95% CI, 1.09-2.86), low level of education (OR, 1.98; 95% CI, 1.12-3.95), and ≥4 catheters (OR, 1.86; 95% CI, 1.25-2.76) were barriers to early mobilization. CONCLUSIONS: Sex, age, education, and the number of catheters were found to be significant factors associated with non-early mobilization after gastrointestinal surgery. Geriatr Gerontol Int 2024; 24: 234-239.

A case report of the treatment and care of decubitus ulcers in macaques with spinal cord injury.

Decubitus ulcers are a common spinal cord injury (SCI) complication that puts patients' lives in danger and has emerged as a more prevalent issue in modern clinical rehabilitation and care. Decubitus ulcers in humans can currently be treated in a number of different ways, but there are fewer studies on how to treat and care for decubitus ulcers in macaques. To treat a 20-year-old adult male macaque monkey with SCI and decubitus ulcers after a quarter transection of the thoracic spinal cord, a number of scientific care procedures and pharmaceutical treatments, such as dietary changes and topical or intravenous administration of medication, were carried out and continuously monitored in real-time. In comparison to the untreated group, we observed a significant improvement in decubitus wound healing in the macaques. In this article, we provide a good protocol for decubitus ulcer care after SCI and suggest that future experimental animal modeling needs to focus on issues such as care for postoperative complications.

Effectiveness and methods of cryotherapy in reducing swelling after total knee arthroplasty: A systematic review on randomized controlled trials.

AIM: This study aims to investigate the effect and methods of cryotherapy in reducing swelling after total knee arthroplasty. DESIGN: Systematic review. METHODS: We searched PubMed, Embase, CINAHL, Cochrane Library, KoreaMed, KERIS and National Science Digital Library for randomized controlled trials on 19 August 2021. This systematic review was conducted according to the PRISMA 2009 checklist. RESULTS: A total of eight randomized controlled trials were systematically reviewed to determine the effect and methods of cryotherapy on reducing postoperative swelling. The effects were not significantly different in six studies. Application time per cryotherapy session was 10-20 min when using an ice pack and up to 48 h when using an automated device. The duration ranged from 2 days to 1 week or until discharge, and the frequency varied from 2 to 72 times per day.

Potential uses of AI for perioperative nursing handoffs: a qualitative study.

Objective: Situational awareness and anticipatory guidance for nurses receiving a patient after surgery are keys to patient safety. Little work has defined the role of artificial intelligence (AI) to support these functions during nursing handoff communication or patient assessment. We used interviews to better understand how AI could work in this context. Materials and Methods: Eleven nurses participated in semistructured interviews. Mixed inductive-deductive thematic analysis was used to extract major themes and subthemes around roles for AI supporting postoperative nursing. Results: Five themes were generated from the interviews: (1) nurse understanding of patient condition guides care decisions, (2) handoffs are important to nurse situational awareness, but multiple barriers reduce their effectiveness, (3) AI may address barriers to handoff effectiveness, (4) AI may augment nurse care decision making and team communication outside of handoff, and (5) user experience in the electronic health record and information overload are likely barriers to using AI. Important subthemes included that AI-identified problems would be discussed at handoff and team communications, that AI-estimated elevated risks would trigger patient re-evaluation, and that AI-identified important data may be a valuable addition to nursing assessment. Discussion and Conclusion: Most research on postoperative handoff communication relies on structured checklists. Our results suggest that properly designed AI tools might facilitate postoperative handoff communication for nurses by identifying specific elevated risks faced by a patient, triggering discussion on those topics. Limitations include a single center, many participants lacking of applied experience with AI, and limited participation rate.

Postoperative nursing care of a child with pulmonary artery displacement combined with slide tracheobronchial plasty.

Generally, pulmonary artery sling operation involves the pulmonary artery transplantation to be cut off. Nursing care is focused on the postoperative pulmonary vascular anastomosis, respiratory tract, and blood pressure after surgery. We report the case of an infant who underwent pulmonary artery tracheal transposition combined with Slide keratoplasty, where the pulmonary artery transplantation was not cut off. We highlight that postoperative pulmonary artery blood flow to the unobstructed airway and airway reconstruction surgery should be focused on to help children recover and ensure successful surgery. This case study reports the postoperative nursing experience of one patient with pulmonary artery sling undergoing pulmonary tracheal transposition combined with Slide arthroplasty. This demonstrates that throughout the postoperative care, airway management should be focused on to maintain circulation stability in the early postoperative period, and corresponding measures such as posture management, atomization inhalation, and improved chest physical therapy should be applied according to the special surgical method of the case in order to reduce airway complications and to improve the surgical success rate of children with pulmonary artery sling undergoing pulmonary tracheal transposition combined with Slide arthroplasty. In similar cases, after pulmonary tracheal transposition and Slide angioplasty, the doctors and nurses should pay attention to early circulation stability and focus on airway management through careful treatment and nursing, so as to promote the child's recovery.

The current and future role of nurses within enhanced recovery after surgery pathways.

BACKGROUND: Enhanced recovery after surgery (ERAS) pathways have been proven to expedite recovery after many procedures and reduce lengths of stay in hospital and surgical complications. However, improvements are still needed, especially in postoperative ERAS components delivered by nurses such as early mobilisation and oral feeding. This article summarises the current and possible future role of nurses within ERAS, and recommends areas for future research. DISCUSSION: Nurses are the professionals who spend the most time with patients throughout the perioperative pathway and are known to play a vital role in delivering many components of an ERAS pathway. They frequently co-ordinate care across disciplines and ensure continuity of care. However, there is a paucity of ERAS research specific to nurses compared to other professional groups. Continual training on ERAS will be required to ensure nurses are highly educated and for the best possible ERAS implementation. In certain types of surgery, nurses may fulfil extended roles in the postoperative period, such as taking over responsibility and leadership for co-ordinating pain management, mobilisation and discharge. However, this requires a well-defined care programme, a clear definition of nursing responsibilities from surgeons, agreed discharge criteria and highly qualified nurses, along with the collection and analysis of data to test safety and efficacy. CONCLUSION: Increasing nurse involvement in ERAS research is vital to drive improvements in care and to develop nursing roles. Nurses should have a major role in the preoperative clinic, the early postoperative phase and the follow-up post-discharge period, where the benefits of ERAS need to be further documented.

Comparison of health-related quality of life of women undergoing robotic surgery, laparoscopic surgery or laparotomy for gynecologic conditions: A cross-sectional study.

OBJECTIVE: To assess and compare the health-related quality of life of women undergoing robotic gynecologic surgery, laparoscopic gynecologic surgery or laparotomy for benign and cancerous conditions. METHODS: Cross-sectional study design was used. The present study was carried out with 240 women, who underwent gynecologic surgery (robotic 48, laparoscopic 96, and laparotomy 96) in a tertiary care hospital. Instruments included a participant description questionnaire and Medical Outcomes Study Short Form-36. The data were collected 4 weeks after surgery, at the first postoperative visit of women to the clinic. Pearson χ2 test, one-way analysis of variance, and regression analysis were used to assess the data. RESULTS: Over half of the women in each group had surgery because of gynecologic cancer. All the subscale scores of Medical Outcomes Study Short Form-36 were significantly higher in the robotic group than the other surgical groups (P < 0.05). Women in the robotic group had better quality of life in terms of both the physical component and the mental component after surgery. CONCLUSIONS: Knowledge of health-related quality of life in the recovery period after surgery is important for healthcare providers to provide adequate preventive measures, information, and follow up.

The effects of immediate programmed cryotherapy and continuous passive motion in patients after computer-assisted total knee arthroplasty: a prospective, randomized controlled trial.

BACKGROUND: The postoperative nursing intervention with immediate cryotherapy and continuous passive motion (CPM) remains elusive regarding the postoperative pain and range of motion (ROM) for patients undergoing computer-assisted total knee arthroplasty (CAS-TKA). METHODS: A prospective, randomized controlled trial with a purposive sampling method was utilized. Sixty patients scheduled for a unilateral CAS-TKA at a medical center were randomly assigned to the intervention group (n = 30) and control group (n = 30). The intervention group applied programed cryotherapy and CPM within 1 h while returning to the ward on the day of surgery, while the control group did not. Data were analyzed using mixed models to compare the numeric rating scale (NRS) for pain, ROM, and swelling at postoperative day (POD) 4. RESULTS: There was no significant difference in the NRS score between the groups (p = 0.168). The intervention group had significantly higher ROM than the control group (98° vs. 91°, p = 0.004) at POD 4. Although no significant difference in joint swelling was found between groups (p = 0.157), the intervention group had lower mean joint swelling (32.2 cm) than the control group (33.9 cm). CONCLUSIONS: Immediate programmed cryotherapy and continuous passive motion could help to improve ROM quickly after CAS-TKA. It should be incorporated into the daily nursing plan for patients undergoing CAS-TKA. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04136431 . Registered 23 October 2019-retrospectively registered.

Evaluación del dolor postquirúrgico y el uso de terapias complementarias por enfermería / Evaluation of postoperative pain and the use of complementary therapies by nursing

RESUMEN Fundamento: el dolor es uno de los factores que más afecta dentro del proceso de recuperación, al influir en la evolución satisfactoria del paciente, el mismo produce sufrimiento físico y mental, trastornos del sueño, efectos cardiovasculares, respiratorios y retraso en la movilización; al ser el personal de enfermería el encargado del cuidado y el responsable de identificar los factores que ponen en riesgo la salud. Objetivo: evaluar el dolor posquirúrgico y la aplicación de terapias complementarias por el personal de enfermería. Métodos: se realizó un estudio longitudinal de enfoque cuantitativo, en los pacientes atendidos en el centro quirúrgico del Hospital General Santo Domingo, de Santo Domingo de los Tsáchilas de enero a febrero de 2018. El universo de estudio estuvo constituido por 91 pacientes sujetos a cirugía ambulatoria. Resultados: de los 91 pacientes evaluados, 34 de ellos para un 37,4 % refirieron dolor en el posquirúrgico, de estos el 23,5 % corresponden a ocho personas del género masculino y 26 para un 76,5 % son femenino. El rango de intensidad del dolor que más prevaleció fue el leve en 22 pacientes. De los cuales 10 manifestaron no sentir dolor después de la aplicación de terapias complementarias, mientras que 10 pacientes se mantuvieron en el mismo rango pero con menor intensidad y los dos restantes no presentaron mejoría. Conclusiones: se evidenció un buen manejo del dolor por parte del personal de enfermería, se demostró que la utilización de las terapias complementarias fue favorable, puesto que los pacientes manifestaron alivio, donde el frío local fue el que mayor aceptación y beneficios mostró.

ABSTRACT Background: pain is one of the factors that mostly affects the process of recuperation by influencing the progress of the patient. Pain produces physical and mental suffering, sleep disorders, effects on the cardiovascular and respiratory systems and delays in movement. As nursing personnel are responsible for the care of patients, it is their responsibility to identify factors that put patients' health at risk. Objective: to evaluate post-surgical pain and application of complementary therapies by the nursing personnel. Methods: a longitudinal-cuantitative study was done among patients attended at the surgical ward of the Hospital General Santo Domingo of Santo Domingo de los Tsáchilas from January to February 2018. The universe to be studied consisted of 91 patients subjected to outpatient surgery. Results: out of 91 patients evaluated, 34 patients or 37.4% referred post-surgical pain, 23.5% or 8 patients were male and 26 or 76.5% were female. The intensity range of pain that prevailed the most was mild which was reported by 22 patients. Out of those 22 patients, 10 patients manifested not having felt any pain after the application of complementary therapy, while 10 patients maintained the same range of pain but with minor intensity and 2 patients did not present any improvement at all. Conclusion: good management of pain was shown by the nursing staff through the use of complementary therapies that was found to be favorable as patients reported pain relief. Application of local cold showed the most acceptance and proved to be the most beneficial amongst patients.

The Impact of Scripted Pain Education on Patient Satisfaction in Outpatient Abdominal Surgery Patients.

PURPOSE: Practice guidelines for acute pain management in perioperative patients recommend providing consistent perioperative pain education that includes medication and behavioral techniques to control pain. However, literature indicates that most nurses deliver patient education based on personal preferences, time limitations, and availability of teaching aids. The purpose of this study was to evaluate patient satisfaction with scripted preoperative pain management education for patients undergoing outpatient abdominal surgery. DESIGN: A pretest and posttest design compared patient perceptions of and satisfaction with pain management education before and after the introduction of scripted education. METHODS: An independent t test was applied to measure differences between groups. FINDINGS: The postscripting group responses indicated that pain education was helpful in managing postoperative pain at a significant (P = 0.03) level. CONCLUSIONS: Use of scripted dialog, along with specific written patient education, has a positive impact on postoperative patient satisfaction with pain management.

Learning Needs of Women Who Undergo Robotic Versus Open Gynecologic Surgery.

OBJECTIVES: To compare the learning needs of women undergoing robotic versus open (laparotomy) gynecologic surgery for benign and cancerous conditions. DESIGN: Descriptive exploratory study. SETTING: A tertiary care hospital in Orlando, Florida. PARTICIPANTS: Women undergoing gynecologic surgery (N = 226; n = 71 laparotomy and n = 155 robotic). METHODS: All consenting procedures and data collection occurred in two study visits. Instruments included a demographics questionnaire and the Patient Learning Needs Scale. Bivariable sociodemographic and clinical differences between surgical groups were assessed with Pearson's chi-square test. Multiple linear regression was used to assess differences in total Patient Learning Needs Scale scores and subscores between surgical groups and to evaluate the association of demographic and clinical variables with total Patient Learning Needs Scale scores within surgical groups. RESULTS: White and non-Hispanic women were more likely to receive robotic surgery. Women who underwent robotic surgery were more likely to ambulate and have their first oral intake on the day of surgery. Women in the robotic surgery group were also significantly more likely to have a hospital length of stay of 1 day or less (90.3% vs. 4.2%, p < .001). At discharge, participants in the robotic surgery group had significantly more learning needs overall (179.67 vs. 159.66, p < .001) and for the subscales of Medication, Activities of Daily Living, Feelings Related to Condition, Treatment/Complications, Quality of Life, and Skin Care than participants in the laparotomy group. For women in the robotic surgery group, those with a hospital length of stay longer than 1 day had significantly greater learning needs. For women in the laparotomy group, Asian women had greater learning needs than White women. CONCLUSION: Participants who underwent robotic gynecologic surgery had greater learning needs than those who underwent laparotomy. Nurses and other health care providers may perceive robotic surgery as a less invasive procedure with fewer adverse effects, shorter length of stay, and faster recovery that requires fewer postoperative care instructions.

Perceptions and experiences of nutritional care following the overwhelming experience of lower extremity amputation: A qualitative study.

INTRODUCTION: Good nutritional care of people following major lower extremity amputation is essential as poor nutritional status can lead to delayed wound healing. Working with patients to identify their perspectives on food, views on nutritional care and the need for dietary counselling enables the development of optimised nutritional care. AIMS AND OBJECTIVES: To explore hospital patients' perspectives on food, dietary counselling and their experiences of nutritional care following lower extremity amputation. DESIGN: A qualitative, explorative study design was employed. METHOD: An inductive content analysis of semi-structured interviews with a purposive sample of 17 people over 50 years of age, who had recently undergone major lower extremity amputation, was undertaken. The study was reported according to the consolidated criteria for reporting qualitative research guideline. FINDINGS: Three themes emerged: responsible for own dietary intake, diet based on preferences and experiences with dietary counselling and feeling overwhelmed. The participants expressed motivation to ensure their nutritional needs were met but described feeling emotionally overwhelmed by the experience of amputation. They appeared not to expect nursing staff to focus on nutritional issues as they expressed belief that they themselves were solely responsible for their dietary intake. They described being motivated to receive nutritional counselling but indicated advice should be compatible with their lifestyle and eating habits. CONCLUSION: Lower extremity amputation can be an overwhelming experience which affects nutritional intake. People appear to consider themselves responsible for their nutritional care and describe not experiencing or expecting nursing staff to engage in this aspect of care. Dietary counselling by nurses who respect and incorporate patient preferences and experiences following amputation has the potential to enhance nutritional care. RELEVANCE TO CLINICAL PRACTICE: This study illustrates that nurses caring for people who undergo lower extremity amputation need to recognise that nutritional care is an essential component of nursing and should focus on working in partnership with the patient.

Observation of mirabilite-bag navel nursing in improvement of gastrointestinal dysfunction in patients after surgery of colon cancer / 中国实用护理杂志

Objective To observe the clinic effects of mirabilite- bag navel nursing in gastrointestinal dysfunction patients after surgery for colon cancer. Methods During Janurary 2013 to Janurary 2016, 80 hospitalized patients with gastrointestinal dysfunction after surgery for colon cancer were randomly allocated to the observation group and the control group, with 40 cases in each group. On the basis of routine nursing, the patients in the control group accepted traditional abdominal bandage nursing, patients in the observation group accepted mirabilite-bag navel nursing. Time to recovery of bowel sound and anal exhaust within 72 hours after surgery, main symptoms within 14 days after surgery such as abdominal pain, abdominal distention, loss of appetite and inflammatory marker C-react protein were observed. Results Within 72 hours after surgery: time to recovery of bowel sound and anal exhaust in the observation group were (26.2±3.3) h and (39.1±8.6) h, respectively, they were significantly shorter than the control group (35.6±6.7) h and ( 65.7±10.9) h, respectively (t=9.42, 11.67, P＜0.01). And there was a higher total effective rate of 90.0% (36/40) in the observation group compared with the total effective rate of 52.5% (21/40) in the control group (χ2=12.14, P＜0.01).Within 14 days after surgery: the total effective rats of improving main symptoms such as abdominal pain, abdominal distention and loss of appetite in the observation group were 90.0%(36/40), 95.0%(38/40), 90.0%(36/40), respectively, all of which were superior to those of the control group, 52.5% (21/40), 40.0% (16/40), 50.0% (20/40), respectively, χ2=12.14, 16.82, 12.75, P＜0.01). Under the nursing interventions, patients′ CRP level in both group were lessened, in the observation group, from (76.91 ± 7.23) mg/L before the intervention to (19.73±5.68)mg/L after the intervention (t=28.43, P<0.05); in the control group, from (77.12±8.09) mg/L before the intervention to (60.33 ± 6.21) mg/L after the intervention (t=6.79, P<0.05). The difference between the two groups also showed statistical significance (t=23.085, P<0.05). Conclusion Mirabilite-bag navel nursing can promote the recovery of gastrointestinal function, lessen inflammatory reaction, improve the main symptoms in patients after surgery of colon cancer.

Patient participation in postoperative pain assessment after spine surgery in a recovery unit.

AIMS AND OBJECTIVES: To explore how patients undergoing spine surgery participated in postoperative pain assessment in a recovery unit. BACKGROUND: Despite advances in medicine, pharmaceutical and technical knowledge, patients report considerable postoperative pain after spine surgery. Research shows that patients require efficient individual pain treatment and that their participation has a positive effect on pain treatment. DESIGN: This study was based on a phenomenological hermeneutic design. METHODS: Fifteen qualitative interviews were conducted in 2014. Meaning condensation was used to analyse data. RESULTS: Three themes emerged: (1) communication and knowledge; anaesthesia, analgesics and severe pain affected patients' ability to assess and communicate their pain. (2) Pain assessment using a numerical rating scale; this theme was characterised by individual differences in rating perception. Also, new postoperative pain sensations were described as different kinds of pain and variation in the pain intensity during activity. (3) Patient-nurse relationship; this theme was characterised by reports of frequent and direct contact on the part of the nurses about pain assessment. Patients' lack of knowledge about pain treatment resulted in inactivity and uncertainty of when to ask for analgesics. CONCLUSION: This study indicates that nurses and patients would benefit from building a mutual understanding of pain perceptions and numerical rating scale as this would pave the way for a more accurate pain assessment. Patients' ability to participate in pain assessment was affected by anaesthesia, analgesics and severe pain. Patients needed knowledge about complications and needed to understand when they should ask for analgesics. RELEVANCE TO CLINICAL PRACTICE: Results indicate that patient perceptions of numerical rating scale and variation in patients' ability to communicate in the initial postoperative period should be given more attention to underpin patients' pain assessment. This may be a key factor in ensuring patient participation in pain assessment and thereby improving postoperative pain management.

Effects of a surgical ward care protocol following open colon surgery as part of an enhanced recovery after surgery programme.

AIMS AND OBJECTIVES: To investigate the effects of a standardised care protocol as part of an enhanced recovery after surgery programme on the management of patients who underwent open colon surgery at the University Hospital, South Korea. BACKGROUND: Patients who undergo open colon surgery often have concerns about their care as they prepare for hospitalisation. By shortening hospital stay lengths, enhanced recovery after surgery programmes could reduce the number of opportunities for patient education and communication with nurses. Therefore, our surgical team developed an enhanced recovery after surgery programme, applied using a care protocol for patients with colorectal cancer, that spans the entire recovery process. DESIGN: A retrospective, comparative study was conducted using a care protocol as part of an enhanced recovery after surgery programme. Comparisons were made before and after the implementation of an enhanced recovery after surgery programme with a care protocol. METHODS: Records of 219 patients who underwent open colon surgery were retrospectively audited. The records were grouped according to the care protocol used (enhanced recovery after surgery programme with a care protocol or traditional care programme). The outcomes, including postoperative bowel function recovery, postoperative pain control, recovery time and postoperative complications, were compared between two categories. RESULTS: Patients who were managed using the programme with a care protocol had shorter hospital stays, fewer complications, such as postoperative ileus wound infections, and emergency room visits than those who were managed using the traditional care programme. CONCLUSION: The findings can be used to facilitate the implementation of an enhanced recovery after surgery programme with a care protocol following open colon surgery. RELEVANCE TO CLINICAL PRACTICE: We present a care protocol that enables effective management using consistent and standardised education providing bedside care for patients who undergo open colon surgery. This care protocol empowers long-term patient self-care capacity, which contributes to increasing the effectiveness of clinical nursing care.

Advantages of foley catheter for nephrostomy tube after minimally invasive percutaneous nephrolithotomy / 中南大学学报(医学版)

Objective:To assess the advantages and nursing experience of foley catheter for nephrostomy tube after minimally invasive percutaneous nephrolithotomy (mPCNL).Methods:From October 2015 to April 2016,the clinical data of 137 patients,who were diagnosed with upper urinary tract calculi and need to perform mPCNL,were collected and randomized into 2 groups:a foley catheter group (research group,n=69) and a normal nephrostomy tube group (control group,n=68).The patients in research group used foley catheter for nephrostomy tube,while those in the control group used normal nephrostomy tube.Bleeding volume,the days of bleeding,pipes shedding and pain degree were compared,and the experience of the nursing process was summarized.Results:The bleeding volume,the days of bleeding in the research group were significantly lower than those in the control group (both P＜0.01).The pipes shedding rate in the research group were lower than that in the control group (P＜0.05).There was no significant difference in postoperative pain scores between the 2 groups (P＞0.05).There was no other complications and discomfortable symptoms in the experimental group.Conclusion:The use of foley catheter for nephrostomy tube after mPCNL is safe,and it can decrease the bleeding volume and pipes shedding rate.It doesn't increase the patient's postoperative pain and can reduce the difficulty and risk for postoperative nursing.

Improvement of nutritional care after colon surgery: the impact of early oral nutrition in the postanesthesia care unit.

PURPOSE: The purpose of this study was to evaluate the impact of implementing early oral nutritional supplements in the postanesthesia care unit (PACU) after colon surgery. DESIGN: A randomized controlled intervention study. METHODS: Patients admitted for elective colon surgery were randomly assigned to either a group receiving early oral nutritional supplements (n=24) or traditional treatment with water or lemonade (n=22) in the PACU. FINDING: On the second postoperative day, patients in the early nutritional supplement group had a higher cumulative intake of energy (P=.019) and protein (P=.015) compared with the traditional treatment. Postoperative nausea and vomiting, pain, length of stay in the PACU, and need of a nasogastric tube did not differ significantly between the groups. CONCLUSIONS: The nutritional course for patients undergoing colon surgery can be improved by implementing early oral nutritional supplements in the PACU.

Standardizing documentation for postoperative nausea and vomiting in the electronic health record.

Postoperative nausea and vomiting (PONV) remains a common postoperative complication that causes patient discomfort and increases health care costs. Clinicians use the American Society of PeriAnesthesia Nurses (ASPAN) guideline to help prevent and treat PONV. However, the lack of standardized terminology in the electronic health record (EHR) and the lack of clinical decision support tools make it difficult for clinicians to document guideline implementation and to determine the effects of nursing care on PONV. To address this, we created a concept map of the Perioperative Nursing Data Set (PNDS) that illustrates the relationship between elements of this standardized nursing terminology and the ASPAN guideline, using the Systematized Nomenclature of Medicine-Clinical Terms multidisciplinary terminology to fill any gaps. This mapping results in a standardized dataset specific to PONV for use in an EHR, which links nursing care to nursing diagnoses, interventions, and outcomes. The mapping and documentation in the EHR also allows standardized data collection for research, evaluation, and benchmarking, which makes perioperative nursing care of patients who are at risk for or experiencing PONV measureable and visible. Distributing this information to perioperative and perianesthesia nursing personnel, in addition to implementing risk assessment tools for PONV and clinical support alerts in electronic documentation systems, will help support implementation of the PONV clinical practice guideline in the EHR.