Nursing care for patients undergoing transoral robotic surgery.

Otorhinolaryngologists began developing new operative techniques to minimize open surgical resections of the head and neck. While striving to reduce the morbidity and mortality associated with head and neck surgery and decrease the many psychosocial issues facing these patients, a new procedure defined as Transoral Robotic Surgery (TORS) was developed. With the development of new surgical techniques, nursing care must also change to meet the needs of the patient. As the TORS procedure becomes fully defined, so is nursing's role in the care of the patient. This paper aims to define TORS and discuss the nursing care of the patient undergoing this new surgical procedure.

Lending an ear. Interview by Carol Davis.

A new role as clinical nurse specialist in paediatric ear, nose and throat nursing has given Alison Flynn the opportunity to improve services for children and their families. Families have a single point of contact. Nurse-led pre-admission clinics have been set up. Ms Flynn obtains informed consent to surgery. Study days on the tracheostomy care have been established. An educational video is planned.

Pediatric anxiety: child life intervention in day surgery.

Although many hospitals offer a surgical preparation program to children and families, minimal research has been conducted specifically on preparation by child life specialists. The purpose of this double-blind intervention study was to determine if children prepared for day surgery by a child life specialist exhibited less anxiety than those who received routine standard of care. One hundred forty-two children, aged between 5 and 11 years old, undergoing elective otolaryngology surgery completed the study. The "Child Drawing: Hospital" instrument developed by Clatworthy, Simon, and Tiedeman [Clatworthy, S., Simon, K., & Tiedeman, M. E. (1999). Child Drawing: Hospital - An instrument designed to measure the emotional status of hospitalized school-aged children. Journal of Pediatric Nursing, 14, 2-9] was used to determine children's anxiety levels preintervention and postintervention. Eighty children received formal preparation for their surgeries by a child life specialist and 62 received no intervention. The data were analyzed using a repeated-measures model with intervention, age, sex, and level of surgery for main effects. The anxiety score change was significantly better for the patients in the child life intervention group than for those in the nonintervention group, F(1,135) = 4.24, p = .04. The increase in anxiety scores in the nonintervention group suggests that children could benefit from preoperative preparation. Health professionals, including nurses, may impact children's abilities to cope with a surgical process. The information in this study will be useful in deciding whether all children, not just those with a perceived need, should be prepared prior to an elective day surgery.

Utilization and perceived benefits of postoperative otology in-service training for inpatient nurses.

This study examined the perceived effectiveness of in-service training (IST) to improve the nursing care of post-operative otology patients as a function of nursing experience. IST was administered to four distinct units in a large university hospital, examining nurses with a range of experiences in otology care. An eight-item IST evaluation instrument was developed, administered, and validated for this study. The results of this study indicate the following: a variation existed among units in the receptiveness to IST; a 15-20-minute IST session significantly improved the perceived ability to deliver quality patient care; similar effectiveness of the IST was observed for all otology care groups; and an oral IST approach was more effective than a self-study approach. Further, we found that IST increased awareness and utilization of specialty support services.

Step-down beds in ENT and maxillofacial surgery.

The organisation and delivery of critical care services have come under scrutiny in recent years with media attention focusing on a shortage of intensive care beds and a lack of appropriately trained nurses to staff them (Wright 2000). The provision of these services is under review nationally, prompting a new approach to the organisation of intensive care and high dependency beds (DoH 2000, Scottish Executive 2000). In Lanarkshire in the specialties of ear, nose and throat (ENT) and maxillofacial surgery, access to these facilities was restricted and not always available or appropriate for these patients' needs. This article illustrates how nurses brought about real change by proposing a possible solution to establish two step-down beds in the ward. Establishing these beds not only provided many benefits for patients, but also gave nurses the opportunity to gain advanced skills and ultimately increased job satisfaction.

Participaçäo da enfermeira em cirurgias otorrinolaringológicas: timpanomastoidectomia e timpanoplastia / Participation of the nurse in otorhinolaryngology surgeries: tympanomasteidectomy and timpanoplasty

A otorrinolaringologia vem se destacando como uma área que tem gerado satisfaçäo devido à qualidade de assistência proporcionada. A enfermeira, como integrante da equipe multiprofissional da especialidade, também contribui para a melhoria dos pacientes submetidos às cirurgias otorrinolaringológicas. O presente artigo tem como finalidade divulgar a intervençäo de enfermagem no campo da prática, aos pacientes submetidos às cirurgias de timpanoplstia e timpanomastoidectomia, observandoos aspectos bio-psico-sócio-espiritual; avaliaçäo de sinais e sintomas como parâmetros de controle nos períodos pré e pós-operatórios; o fornecimento de oroientaçöes para satizfazer as expectativas do paciente no período pós-operatório; diminuiçäo do risco de infecçäo do sítio cirúrgico; e o oferecimento de assistência adequada e especializada durante o período transoperatório.