[Nursing practice of care to patients undergoing elective surgery in the immediate preoperative period]. / Prática do enfermeiro no cuidado ao paciente no pré-operatório imediato de cirurgia eletiva.

Research that aimed to analyze the care of nurses to patients, in the daily professional practice, provided in the preoperative period for patients undergoing elective surgery. It is a descriptive research with a qualitative approach that involved 15 nurses from Surgical Units and two nurses from the Surgical Centre of a hospital in the southern region of Brazil. Data was collected in semi-structured interviews conducted from April to July 2011. Data was analyzed using the Collective Subject Discourse (CSD) technique. The information obtained generated three CDS focused on the following ideas: administrative care, instruction in the preoperative period and surgical care in the immediate preoperative period. The results showed that caring consists mostly of giving instructions to the patient in the preoperative period. It is concluded that the care was directed to the physical aspects to the detriment of the psychological, in disagreement with the assistance methodology adopted in the hospital, supported by the Theory of Basic Human Needs.

Prática do enfermeiro no cuidado ao paciente no pré-operatório imediato de cirurgia eletiva / Práctica del enfermero en el cuidado al paciente en el preoperatorio inmediato de cirugía electiva / Nursing practice of care to patients undergoing elective surgery in the immediate preoperative period

A pesquisa objetivou analisar os cuidados dos enfermeiros com os pacientes, no cotidiano da prática profissional, no período pré-operatório imediato de cirurgia eletiva. Trata-se de uma pesquisa descritiva com abordagem qualitativa, em que participaram 15 enfermeiros das unidades cirúrgicas e dois do centro cirúrgico de um hospital da Região Sul do Brasil. Os dados foram coletados no período de abril a julho de 2011, por meio de entrevista semiestruturada. Para análise dos dados, utilizou-se o Discurso do Sujeito Coletivo (DSC). As informações deram origem a três DSCs com as ideias centrais: cuidados administrativos, orientação no pré-operatório e cuidados cirúrgicos no pré-operatório imediato. Os resultados mostram que grande parte dos cuidados se refere à orientação do paciente no pré-operatório. Conclui-se que os cuidados foram direcionados aos aspectos físicos em detrimento do psicológico, em discordância com a metodologia assistencial adotada no hospital, sustentada pela Teoria das Necessidades Humanas Básicas.

Investigación que examinó los cuidados de enfermeros a pacientes, en la práctica profesional cotidiana, en período preoperatorio inmediato de cirugía electiva. Se trata de una investigación descriptiva cualitativa, con la participación de 15 enfermeros de Unidades Quirúrgicas y dos del Centro Quirúrgico de un hospital de la región sur de Brasil. La recolección de datos ocurrió desde abril a julio de 2011 por medio de entrevista semiestructurada. Para el análisis de estos se utilizó el Discurso del Sujeto Colectivo (DSC). Las informaciones originaron tres DSC con las ideas centrales: cuidados administrativos, orientación preoperatoria y cuidados quirúrgicos en el preinmediato. Los resultados retratan que gran parte de los cuidados se refiere a la orientación del paciente en el preoperatorio. Se concluye que la atención se ha dirigido a los aspectos físicos en detrimento del psicológico, en desacuerdo con la metodología de la asistencia aprobada en el hospital, apoyada por la Teoría de las Necesidades Humanas Básicas.

Research that aimed to analyze the care of nurses to patients, in the daily professional practice, provided in the preoperative period for patients undergoing elective surgery. It is a descriptive research with a qualitative approach that involved 15 nurses from Surgical Units and two nurses from the Surgical Centre of a hospital in the southern region of Brazil. Data was collected in semi-structured interviews conducted from April to July 2011. Data was analyzed using the Collective Subject Discourse (CSD) technique. The information obtained generated three CDS focused on the following ideas: administrative care, instruction in the preoperative period and surgical care in the immediate preoperative period. The results showed that caring consists mostly of giving instructions to the patient in the preoperative period. It is concluded that the care was directed to the physical aspects to the detriment of the psychological, in disagreement with the assistance methodology adopted in the hospital, supported by the Theory of Basic Human Needs.

Does preoperative scalp shaving result in fewer postoperative wound infections when compared with no scalp shaving? A systematic review.

Preoperative scalp shaving has been a well-established practice among neurosurgeons based on the belief that hair removal prevents postoperative infections. Apart from aiding in improved visualization of the incision line, ease of closure, and dressing application, there are concerns that the presence of hair at the surgical site may interfere with the surgical procedure. Preoperative scalp shaving is a controversial practice, and many neurosurgeons are moving toward not removing any hair or clipping minimal hair along the incision line rather than shaving the scalp. The following is a systematic review of articles related to preoperative scalp shaving before cranial surgeries and the implications for postoperative wound infections. Eighteen articles were identified as potentially relevant based on the search criteria. These articles were selected based on the inclusion and exclusion criteria to provide concise background information and an explanation of scalp-shaving practices in neurosurgery leading to the clinical question posed. An evidence table was compiled to organize the study data and identify key points. The review brings strong evidence that preoperative scalp shaving does not confer any benefit against postoperative wound infection and, paradoxically, may lead to higher rates of infection. Because hair removal neither contributes benefits to the surgery itself nor decreases the risk of wound infection but has considerable cosmetic value for the patient, many of the authors recommended that cranial surgeries should be done without hair shaving.

Changing behavior: evidence based practice supporting hair removal with clippers.

Evidence based practice demonstrates using clippers immediately before surgery, when perioperative hair removal is necessary, results in the fewest surgical site infections (Kjonniksen, Andersen, Sondenaa, & Segadal, 2002). In addition, one of The Joint Commission's national patient safety goals for 2008 is "to reduce the risk of healthcare associated infections" (The Joint Commission, 2008, Goal 7). Therefore, a project was undertaken to change perioperative nursing care in a large teaching hospital from using razors for hair removal in the perioperative setting to using clippers. Change is difficult and encompasses many interdisciplinary areas. A description of the process of utilizing evidence to change behavior in the perioperative setting and its outcomes will be provided in this paper. Klevens, et al., (2007) reported that 22% of healthcare associated infections were the result of surgical site infections (SSIs). Changing practice to utilizing clippers for hair removal is an extrinsic factor of SSIs that can be easily modified. Otorhinolaryngology (ORL) patients that require hair removal before surgery (i.e., acoustic neuroma, cranial-facial resections, and head and neck reconstruction) may benefit from this change in practice. Perioperative nurses are in a prime position to reduce the incidence of SSIs in ORL patients.

Surgical site infection, preoperative body washing and hair removal.

Estimates suggest one in 20 patients develop an infection following surgery, costing the NHS around pounds 1bn each year (SSHAIP 2004). This article discusses surgical site infections and the commonest bacteria which cause them. It then explores two practices, preoperative body washing and preoperative hairremoval, and their effect on bacterial reduction and surgical site infection.

Maximizing nurses' advocacy role to improve patient outcomes.

Perioperative nurses are eminently situated, academically prepared, and professionally qualified to positively affect patient outcomes. Increasing efficiency and justifying the need for an RN in the perioperative milieu revolve around nurses' role as patient advocates. Perioperative nurses can take many measures to maximize this role, including reducing surgical site infections by enabling the timely administration of antimicrobial prophylaxis and by ensuring that surgical staff members realize the documented risks of removing hair from the surgical site.

Comparing treatment outcomes between physician and nurse treated patients in laser hair removal.

OBJECTIVE: The purpose of this study was to determine whether there were differences in outcome between patients treated by a trained physician and patients treated by a trained, supervised nurse. STUDY DESIGN/MATERIALS AND METHODS: A total of 100 patients were treated for unwanted body hair using the Cynosure long-pulsed alexandrite laser: 50 patients were treated by a physician and 50 by a nurse. RESULTS: The measured average reduction in hair counts was 74 +/- 8% in the physician-treated group and 70 +/- 6% in the nurse-treated group (NS). Transient skin changes (i.e. pigmentation changes and blistering) were comparable between the two groups. Patient satisfaction measured by an assessment scale of 1 (excellent) to 5 (poor) was 1.6 +/- 0.3 and 1.4 +/- 0.3 in the physician- and nurse-treated groups respectively (NS). CONCLUSION: Using treatment efficacy, complication rate, and patient satisfaction as variables, this study concluded that properly trained physicians and nurses achieved parallel results in laser hair removal.

Hair removal with the ruby laser (694 nm).

Hair removal with the ruby laser is one of the newest uses of laser technology. The laser seeks melanin in the hair shaft, and melanin content is highest during the growth phase of the hair follicle. Nursing care focuses on preparing the patient for the procedure, maintaining a safe operative environment, and teaching the patient skin care after the laser therapy.