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.
We reported two cases of nursing in dogs that showed noticeable adverse effects after opioid administration(fentanyl or morphine)for anesthesia. Case 1 was a 5 -year-old casted male miniature ...dachshund, weighing 4.7 kg and with a body condition score(BCS)of 4 /9. It was administered fentanyl at a constant rate infusion for anesthesia and pain management during and after hemilaminectomy. It showed notable salivation and bradycardia post-surgery. Case 2 was a 3 -year- old intact female Shih Tzu, weighing 5.9 kg and with a BCS of 4 /9, that received intravenous morphine for pain management. It presented with significant salivation, bradycardia, and decreased body temperature after cystotomy. We wiped the saliva frequently off the coat and skin and padded the inside of the Elizabeth collar to maintain the coat around oral cavity dry and clean. We dealt with the hypothermia by placing an electric heating pad into the hospital cage, with careful prevention of low temperature burn in the wet environment. For the bradycardia, heart rate, arterial blood pressure, and color of the visible mucous membrane were continuously monitored. The significant adverse effects caused by the opioid administration were safely managed in both cases by nursing interventions for maintaining good hygiene, normalbody temperature, and normal cardiovascular function.
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.
A pretest and posttest design compared patient perceptions of and satisfaction with pain management education before and after the introduction of scripted education.
An independent t test was applied to measure differences between groups.
The postscripting group responses indicated that pain education was helpful in managing postoperative pain at a significant (P = 0.03) level.
Use of scripted dialog, along with specific written patient education, has a positive impact on postoperative patient satisfaction with pain management.
Aim. To synthesise the evidence available in the literature on the effectiveness of the ultrasound bladder scanner in reducing the risk of urinary tract infection.
Background. Acute urinary ...retention is the inability to empty the bladder notwithstanding it being full and is frequent in the postoperative period. Using the ultrasound bladder scanner for the measurement of urinary residue, nurses are able to evaluate the presence of urinary retention, monitor the volume and the excessive relaxation of the bladder and avoid unnecessary catheterisations. The association between urinary catheterisation and urinary tract infection is well documented in the literature.
Design. A meta‐analysis was conducted.
Method. An extensive review was carried out by two researchers using multiple databases, including all articles published from 1 January 1986–8 February 2008. No restrictions were adopted with regard to language. Studies on (1) documenting hospitalised patients with a need to evaluate bladder urinary volume, (2) comparing the use of the ultrasound bladder scanner vs. the clinical judgment of the nurses in the evaluation of acute urinary retention followed by a decision regarding whether or not to apply a bladder catheter and (3) those documenting the impact on urinary tract infection associated with catheterisation were included.
Results. A total of 61 articles were retrieved, of which 58 were excluded because they did not meet the inclusion criteria. The overall effectiveness of the bladder ultrasound scanner in the reduction of urinary tract infection associated with catheterisation was OR 0·27 (IC95% 0·16–0·47; p‐value 0·00000294, variance 0·08, weight 12·50).
Discussion. The ultrasound bladder scanner helps to define and monitor bladder urinary volume and therefore, to catheterise patients only when necessary. Although there were numerous factors affecting the clinical heterogeneity of the included studies, the reduction in risk of urinary tract infection associated with catheterisation was consistent.
Conclusion. The use of the ultrasound bladder scanner for evaluating and monitoring the residue volume in immediate postoperative patients, aged 18 or above, reduces unnecessary catheterisations and therefore the risk of urinary tract infection associated with catheterisation.
Relevance to clinical practice. The systematic use of the ultrasound bladder scanner in the peri‐operative period could increase the appropriateness of catheterisation and reduce patient discomfort, costs and days of hospitalisation associated with urinary tract infection associated with catheterisation.
Severe calcific aortic stenosis (AS) is a progressive cardiac disease that predominantly affects elderly adults. The hallmark symptoms of AS include exertional dyspnea, angina, and syncope. Adults of ...advanced age do not usually seek treatment for symptoms until their quality of life is greatly diminished. The 2 standard treatments for severe AS are open aortic valve replacement and percutaneous valvuloplasty. As adults age, their comorbid medical conditions often make them too high of a surgical risk for traditional aortic valve replacement, and percutaneous valvuloplasty, although less invasive, often produces only temporary relief of AS symptoms. To provide severe AS patients with alternative less risky treatment options in their later years, transcatheter aortic valve implantation (TAVI) devices were developed. Through this overview of the disease progression of AS and the different TAVI devices and the insertion procedures, a better understanding of the initial postoperative nursing care associated with postoperative TAVI patient management will be achieved.
Despite the fact that Italian nurses have only recently gained autonomy when making health-care decisions, there is little evidence available regarding the decisions actually taken in clinical ...practice.
Exploring the patterns that guide the nurses’ decision-making process in weaning and extubating the patient after cardiac surgery.
We have adopted a qualitative ethnographic approach. The study was conducted in the Cardiosurgical Intensive Care Unit (CICU) in a Teaching and Research Hospital (Milan) and was first created using participant non-directive observation in which decisions about weaning and extubation were observed. Through aimed sampling until saturation, 18 nurses at both expert and novice professional stages, the nurse manager and the anaesthesiologist director were interviewed.
The pattern of a nurse's decision-making process in weaning and extubation is based on three themes: (a) collect data and suggest a decision, (b) standardise the competence and (c) maintain adherence to unwritten rules. The nurses would never take the initiative to start weaning and extubating the patient by themselves: they collect data, consult with other nurses and then propose decisions which are ultimately authorised by the physicians.
The near-decision-making process of nurses expressed a pattern determined by personal factors, clinicians, organisations, structures and cultural reported unwritten rules. To ensure that the nurses become responsible and independent decision makers, it is necessary to pay particular attention to structural and cultural conditions in order to help them reach their full potential in the future.
The aim of this article is to provide information about preoperative and postoperative nursing care for patients with insulinoma. The content is based on a literature review and the author's clinical ...experience. It describes insulinoma and provides concrete nursing measures for patients with the disease, who face problems of anxiety, risk of injury, risk of infection, nutrition and fluid volume deficit, information provision and emotional support before and after surgery.
