Colocación de pulseras identificativas y de grupo sanguíneo en quirófano de ortopedia / Use of identification and blood type wristbands at the orthopedic surgery operating room

OBJETIVO: determinar si es correcta la identificación a través de las pulseras identificativas y de grupo sanguíneo en los pacientes intervenidos de cirugía ortopédica. MÉTODO: estudio descriptivo transversal. La población de estudio fueron los pacientes intervenidos de cirugía ortopédica de prótesis de rodilla y cadera en el Hospital Universitario de Burgos. Técnica de recogida de los datos: observación directa. Variables de estudio: sexo; edad; tipo de cirugía; lado de la cirugía; colocación de pulseras; portador de vía venosa; canalización de vía en quirófano; calibre; retirada de las pulseras; sustitución de las pulseras; tiempo sin pulseras; vía y pulsera en el mismo brazo y planta de origen. RESULTADOS: se analizaron 153 casos. El 100% de los pacientes contaba con una pulsera identificativa y el 98% tenía pulsera de grupo sanguíneo. Fue necesario retirar por colocación incorrecta el 27% de las pulseras identificativas y el 29% de las de grupo sanguíneo; todas fueron sustituidas. La media del tiempo que el paciente pasó en el quirófano sin pulsera con datos personales fue de 51,62 minutos y sin la pulsera de grupo sanguíneo de 50,36 minutos. CONCLUSIONES: la gran mayoría de los pacientes se encontraban correctamente identificados a través de las dos pulseras, aunque por necesidades de la cirugía en algunos casos debían retirarse quedando los pacientes sin identificar durante aproximadamente una hora. La comunicación e información con las enfermeras resulta fundamental para mejorar la calidad de los cuidados y la seguridad del enfermo

OBJECTIVE: to determine if there is an adequate use of identification and blood type wristbands in patients undergoing ortophedic surgery. METHOD: a cross-sectional descriptive study. The study population consisted of patients who had undergone orthopedic surgery for knee and hip prosthesis at the Hospital Universitario de Burgos. Data collection technique: direct observation. Study variables: gender, age, type of surgery, side of surgery, wristband placement, central venous line, IV line catheterization at the operating room, gauge, wristband removal, wristband replacement, time without wristbands, IV line and wristband in the same arm, and ward of origin. RESULTS: the study analyzed 153 cases; 100% of patients had an identification wristband, and 98% had blood type wristbands. It was necessary to remove 27% of the identification wristbands and 29% of the blood type wristbands due to incorrect placement; all of them were replaced. The mean time that the patient stayed at the operating room without a personal data wristband was 51.62 minutes, and 50.36 minutes without blood type wristband. CONCLUSIONS: the vast majority of patients were adequately identified through the two wristbands; though, for surgical requirements, in some cases these had to be removed, and patients were unidentified during approximately one hour. Communication and information with nurses becomes essential in order to improve the quality of care and patient safety

"Wow I had no idea"-How job rotation is experienced by nurses caring for elective orthopaedic patients: A qualitative study.

AIMS AND OBJECTIVES: To explore gains and impacts of job rotation through the experiences of involved nursing personnel responsible for different parts of care during the elective orthopaedic patient's pathway. BACKGROUND: When patients undergo elective orthopaedic surgery, they encounter nurses from different wards. So far, job rotation has only been described through the experiences of the job rotating nurses. This study includes all involved nursing personnel and bases the job rotation on the pathway of the elective orthopaedic patient. DESIGN: This study has an exploratory-descriptive and qualitative approach and follows the Consolidated Criteria for Reporting Qualitative Research guidelines. METHOD: A total of nine focus groups including 16 informants were conducted before, during and after a 5-month trial period. The data were analysed using thematic analysis. RESULTS: The findings show that existing work structures and work content combined with a lack of a common understanding of the job rotation impacted the expectations of the nursing personnel regarding (in)dependence, individual and collegial involvement and investment, as well as the collegial belongingness expressed through terminologies of "home" and "culture." The personal gains among the job rotating nurses showed increased knowledge, skills and influence. When knowledge was shared and exchanged, the job rotating nurses became "cultural translators" of the care to the elective orthopaedic patient. CONCLUSIONS: This study shows personal gains among the job rotating nurses through increased knowledge, skills and influence as well as collegial gains by sharing and exchanging knowledge. When this exchange was utilised, the job rotation was evaluated positively, and contrary, when not utilised the job rotation had a negative impact on the work environment. RELEVANCE TO CLINICAL PRACTICE: Job rotation among nurses following the care of the patient's pathway can be a way of promoting patient safety and quality through increased knowledge across wards by including every aspect and element of the patient's pathway.

Preoperative Education for Total Knee Replacement: A National Survey of Orthopaedic Nurses.

BACKGROUND: Preoperative education aids in reducing the incidence of poor outcomes after total knee replacement (TKR) and increasing patient readiness for discharge home but is not well described in the literature. PURPOSE: The purpose of the study is to describe the current design of preoperative education for TKR across the United States. METHODS: A large, national sample of orthopaedic nurses completed an online survey to describe preoperative education at their facilities. RESULTS: Most participants provided preoperative education as part of interprofessional teams in either a group format or combined group and individual education. Verbal instruction was the most common educational delivery method, followed by written instruction. Education typically lasted between 1 and 1.5 hours, was delivered in a single session, and included a variety of topics. CONCLUSION: Results of this study describe preoperative educational practices and can support future research to improve patient outcomes following TKR surgery.

Stress and Anxiety Management During the COVID-19 Pandemic (Lessons Learnt from a Cohort of Orthopaedic Registrars Redeployed to ITU).

BACKGROUND: Working during the coronavirus pandemic has had a significant impact on health care workers. A group of orthopaedic trainees at Royal Gwent Hospital, UK, were redeployed to intensive therapy unit for four weeks during COVID-19 pandemic. This study reviews our experience; focusing on causes of stress and anxiety, and how they were managed. The lessons learnt could be used as a framework for pre-emptive me-asures during future challenges. MATERIAL AND METHODS: Orthopaedic registrars were divided into two groups. Seven trainees (Redeployed group) moved to ITU for four weeks to support the critical care team. The other group (Retained group) of eight registrars continued to cover orthopaedic rota. A survey was done for anxiety levels comparing the two groups at three time points during these four weeks. RESULTS: Anxiety and stress in the ITU-redeployed group was comparatively less than the continuing group as time progressed during the redeployment. CONCLUSIONS: 1. The disruptive impact of the COVID-19 pandemic has been a source of massive stress and an-xiety for health care workers. 2. Our experience shows that stress is controllable with the correct strategies. 3. The main points are early identification of vulnerable groups, proper induction, active involvement, adequate explanation, appreciation, good communication, and available psychological support whenever needed. 4. These are essential to maintain a resilient workforce against upcoming waves of COVID-19.

Making collaboration work.

The Children's Hospitals Network (CHN) was formed in 2012 following a review of national specialist services. Oxford University Hospitals NHS Foundation Trust (OUH) and the University Hospital Southampton NHS Foundation Trust (UHS) collaborated in its formation, with the CHN hosting clinical and operational networks across more than 20 district general hospitals in the Thames Valley and Wessex regions.

Improving patient flow: role of the orthopaedic discharge sister.

Timely and well-planned discharge improves the patient's experience, contributes to patient safety and reduces the length of hospital stays. The role of orthopaedic discharge sister was developed at James Cook University Hospital in 2007 to provide safe, timely and efficient discharge for patients from the trauma and theatre centre, and to improve patient experience and flow. This article gives an overview of the role and describes how the sister works with colleagues to plan patient discharges from pre-assessment and emergency department admission through their hospital stay until their departure.

Who cares? A critical discussion of the value of caring from a patient and healthcare professional perspective.

BACKGROUND: This study was undertaken in order to discover and illuminate the essential caring behaviours valued by both patients and staff in an orthopaedic setting within a district general hospital in the United Kingdom. OBJECTIVES: This descriptive study was undertaken in order to acquire a greater understanding of perceptions of caring from both patient and orthopaedic healthcare professional perspectives. METHODS: A sample of 30 patients and 53 healthcare professionals consisting of doctors, nurses, physiotherapists and occupational therapists were asked to complete the Caring Behaviours Inventory (CBI) questionnaire (Wolf et al., 1994). Data were analysed using descriptive and inferential statistics. RESULTS: The findings revealed both similarities and differences relating to the importance of positive caring behaviours exhibited during caring interactions. Healthcare professionals working in the orthopaedic setting acknowledged the value of similar positive caring behaviours to those of the patient group but ranked the importance of these differently. DISCUSSION: Several important insights into perceptions of caring have been gained. These relate to an overall understanding of the caring behaviours that are considered of importance to patients and healthcare professionals; the differences that exist between the caring perceptions of both groups and the factors which influence these perceptions.

Rol de enfermería en la prevención del delirium en ancianos hospitalizados con fractura de cadera. Recomendaciones generales / The role of nursery in the prevention of the delirium in elderly hospitalized with hip fracture. General recommendations

Se realiza una revisión bibliográfica de la literatura en las principales bases biomédicas para identificar cuáles son los factores de riesgo modificables o controlables en ancianos hospitalizados con fractura de cadera, susceptible de padecer delirium, y crear un Plan de Actuación de Recomendaciones de Enfermería desde el ingreso hasta el alta en la unidad, basándonos en la prevención, con el propósito de fomentar el descenso en la frecuencia y consecuencias desfavorables del delirium. Son pocos y con gran disparidad numérica en los resultados obtenidos entre los diferentes trabajos que estudian la eficacia de adoptar medidas ambientales como estrategias en la prevención del delirium. Las acciones llevadas a fin, en as de la prevención, son primordialmente las que controlan los factores de riesgo como: el deterioro cognitivo y físico, inmovilidad, discapacidad visual y auditiva, deshidratación, desnutrición, desorientación, privación del sueño, polifarmacia y dolor. Al delirum no se le presta la importancia que requiere, a pesar de su alta frecuencia e impacto bio-psico-socio-económico en el paciente y su entorno. La prevención es la medida más eficaz y económica de abordar el delirium en su fase inicial y la enfermería contribuye en gran medida en esta labor. El anciano hospitalizado con fractura de cadera es un paciente de alto riesgo debido al gran número de factores de riego agregados a su situación clínica y contexto. Sería interesante en otras investigaciones futuras valorar la eficacia de las recomendaciones ofrecidas en esta revisión (AU)

A bibliographical revision of Literature is done in the main biomedical databases to identify which are the modifiable or controllable risk factors in elderly hospitalized with hip fracture, susceptible to suffer delirium, and to create a Plan of Action of Recommendations of Infirmary from the admission to the discharge in the unit, basing ourselves on the prevention, in order to promote the reduction in the frequency and unfavourable consequences of the delirium. They are few and with great numerical disparity the obtained results between the different works that study the effectiveness to adopt environmental measures like strategies in the prevention of the delirium. The taken actions to aim, in ace of the prevention, are fundamentally those that control the risk factors such as: the mental and physical deterioration, immobility, visual and auditory disability, dehydration, undernourishment, disorientation, deprivation of the dream, polypharmacy and pain. The delirium is not given the importance that requires in spite of its high frequency and the biological, psychological, social and economic impact in the patient and his/her environment. The prevention is the most effective and economic measure to approach the delirium in his/her starting phase and the nursery contributes to a great extent in this work. The elderly hospitalized with hip fracture are patients of high risk due to the great number of risk factors added to its clinical situation and contextIt would be interesting in other future investigations to value the effectiveness of the recommendations offered in this revision (AU)