Search Results (49)

Background/Objectives: In spinal surgery, it is especially crucial to insert implants in the correct location. Intraoperative fluoroscopy is often necessary to safely perform spinal surgery because of serious complications that can occur if the screw deviates. However, the use of intraoperative fluoroscopy comes at the cost of radiation exposure to the surgeons and operating room staff. Therefore, it is desirable for spinal surgeons to understand the characteristics of radiation in order to minimize patient and medical staff exposure. This study aimed to create an aerial radiation dose distribution map for lateral fluoroscopy, a commonly used technique for posterior spinal fusion. Methods: A human body-equivalent phantom was placed in a prone position on the Jackson Table. The measurement method used was a lateral fluoroscopic evaluation, assuming posterior spinal fusion. Measurements were taken at three levels: 80 (gonadal), 100 (thoracoabdominal), and 150 cm (lens and thyroid). Results: The highest radiation doses were received by primary surgeons. The scrub nurse was the next most exposed. Conclusions: We developed an aerial dose distribution map for lateral fluoroscopy in posterior spinal fusion. Radiation exposure was the highest among primary surgeons. Full article

Background/Objectives: Individualized nursing care allows for systematic assessment and intervention; considers a patient’s preferences, values, and context; and contributes to a positive care trajectory. However, its operationalization has proven to be challenging. This research aimed to evaluate nurses’ perceptions of individualized care and analyze their relationship with sociodemographic variables. Methods: A cross-sectional study was conducted on 122 eligible and registered nurses at a Hospital Center, in the Ophthalmology (operating room and inpatient ward) service, the Cardiology service, the Internal Medicine service, and the Medical Emergency Unit, for adults/older adults in Portugal. The nursing version of the Individualized Care Scale (ICS-Nurse) was used for the assessment, including three sub-dimensions: clinical situation, personal life situation, and decisional control over care-related decisions. Cronbach’s alpha and principal component analysis were used for the data analysis. The STROBE checklist was used to report this study. Results: No statistically significant differences were found based on the age, gender, level of education, or years of professional experience of the nurses within the sub-dimensions of individualization. The nurses overall had a good perception of the importance of individualized care (4.06 ± 0.46 ICS-A-NURSE) but faced difficulties in its implementation during the last shift they worked (3.97 ± 0.49 ICS-B-NURSE). Conclusions: The items considered to be of greatest importance were the response to the physical and emotional needs arising from illness and assistance in decision-making through educational instructions. Aspects related to the personal lives of patients, such as family inclusion in an individual’s care plan, everyday habits, and previous experiences of hospitalization, received the lowest scores. Recognizing priority areas for improvement in the individualization of nursing care can contribute to developing training programs and policies that promote a holistic approach. Future studies should consider patient outcomes related to their needs for individualization. Full article

In the construction sector, hospitals are the buildings with the highest energy consumption. Due to the high demand for energy, hospitals’ energy efficiency is becoming very important. This study aims to examine the trends and factors that determine energy consumption in Polish hospitals from 2010 to 2019, highlighting the impact of hospital size and medical activities on energy efficiency. The analysis was carried out using data from 3061 hospital reports obtained from the e-Health Center, a state budgetary unit established by the Minister of Health. To measure and compare the efficiency of energy usage in hospitals, we developed eight energy usage efficiency indexes based on hospital size and medical activity. The size of the hospitals was described by the number of beds, operation rooms, doctors, nurses, and fixed assets value. Hospital activity was measured by the number of person-days, patients, and operations. Statistical analysis was carried out using StatSoft Statistica software version 13.3. The results show that larger hospitals are more energy efficient across various measures of energy use than smaller hospitals. The findings revealed also several important relationships between energy usage and factors connected with size and hospital activity, such as the number of beds, patients and person-days, medical staff, operations, and fixed asset values, underscoring the necessity for customizing energy efficiency strategies. This research contributes empirical insights that can guide policymakers and hospital administrators in their endeavors to improve energy efficiency and promote sustainability within healthcare facilities. Full article

Introduction: The recovery room (RR) is a hospital area where patients are monitored in the early postoperative period before being transferred to the surgical ward or other specialized units. The utilization of scores in the RR context facilitates the assignment of patients to the appropriate ward and directs necessary monitoring. Some scoring systems allow nurses to select patients who can be discharged directly to their homes. Aim and methods: The aim of this narrative review was to describe and compare the scoring systems employed to discharge postoperative patients from RR, with a focus on item characteristics. Results: Nine scoring systems were identified and discussed: the “Aldrete Score System” and its modified version, the “Respiration, Energy, Alertness, Circulation, Temperature Score”, the “Post Anesthetic Discharge Scoring System”, the “White and Song Score”, the “Readiness for Discharge Assessment Tool”, the “Anesthesia and Perioperative Medicine Service Checklist”, the “Post-Anesthetic Care Tool”, the “Post-operative Quality Recovery Scale”, and the “Discerning Post Anesthesia Readiness for Transition” instrument. Discussion and conclusions: To obtain a comprehensive overview, the items included in the scoring systems were compared. Despite the availability of guidelines for patients’ discharge readiness from the RR, there is no universally recommended scoring system. Next-generation scores must be improved to ease their use, minimize errors, and increase safety. The main goals of the scores included in this narrative review were to be simple to use, feasible, intuitive, comprehensive, and flexible. However, these goals frequently conflict because patient assessment takes time, and a smart and comprehensive score may not consider some clinical parameters that may be crucial for the discharge decision. Therefore, further research should be conducted on this topic. Full article

Registered nurses in the operating room require specialized competencies that surpass basic educational training. Existing national and international documents attempt to outline these competencies but often lack comprehensive details. To address this, a repertoire of technical and professional competencies for operating room nurses, aligned with European and National Qualifications Frameworks, is proposed. Aim: Develop a repertoire of technical and professional competencies for perioperative and perianesthesiological specialist nursing roles. Methods: An at-home ethnography design was employed, utilizing participant observation, interviews to the double, and focus groups. Convenience sampling included 46 participants from a university and a public hospital in northern Italy. Data were collected from September 2021 to June 2023 and analyzed using inductive content analysis and data triangulation. Results: Identified 17 specialized technical professional competencies for perioperative and perianesthesiological nursing, divided into 6 areas of activity. These competencies encompass 19 learning outcomes, 152 tasks, 222 knowledge elements, and 218 skills. Conclusions: This competency repertoire aids in the public recognition of qualifications and serves as a valuable tool for identifying, validating, and certifying competencies. Future research should focus on exploring the competencies of central sterilization nurses and transversal competencies. Full article

Escape room games are educational gamification technologies that consist of introducing a team of players into a physical or digital space in search of clues to answer puzzles, riddles or enigmas and solve a mystery or problem. This study aims to determine the effectiveness of escape room games on the training of nursing students in an international context. A systematic review was carried out in MEDLINE, WOS, SCOPUS, CINAHL and LILACS databases using the MeSH terms “Education, Nursing” and “Educational Technology”, and the free term “Escape room”, combined with Boolean operators AND/OR. Intervention studies in Spanish, English and Portuguese were included, without limitation for the year of publication. Selection and critical appraisal were conducted by two independent reviewers. A total of n = 13 interventional studies were included (n = 2 Randomized Clinical Trials and n = 11 quasi-experimental design). Escape rooms are a recent and growing educational methodology, increasingly used in academia and in the training of nurses and nursing students. However, it is necessary to expand their use and the quality of the studies in a greater number of contexts. Furthermore, it is necessary to homogenize and standardize validated instruments to evaluate the effectiveness of escape rooms in the nursing education area. Full article

Background. Music evokes positive emotions and reduces stress and anxiety. Operating room (OR) staff face various challenges which can lead to high levels of stress. The aim of the study is to assess whether listening to music during intraoperative phases improves the work environment by reducing anxiety and stress in the entire surgical team. Methods. A prospective observational study was conducted from February to September 2023, involving medical personnel, nursing staff, and nursing students. They were divided into two groups: Group 1 with music during surgical procedures, and Group 2 without music. Participants were administered two validated instruments: the Zung Anxiety Self-Assessment Scale (SAS) to measure anxiety, and the Positive and Negative Affect Schedule to assess emotions generating stress. Additional items were included for demographics, job satisfaction, and the organization method. Results. Music did not impact anxiety, but increased positive emotions while reducing negative ones. Music had an ancillary effect, highlighting the need for significant organizational interventions aimed at increasing operator satisfaction, including offering voluntary instead of mandatory assignments to nursing staff. Conclusions. Music appears to reduce stress in the intraoperative team when supported by a positive work environment in which assigned operators have chosen to work in the OR. Full article

Background: Robotically assisted cardiac surgery is performed in a team setting and is well known to be associated with learning curves. Surgeon and operative team learning curves are distinct entities, with total operative time representing the entire operative team (surgery, anesthesia, nursing, and perfusion) and cross-clamp time representing mainly the surgical team. Little is known about how a team learning curve evolves when an experienced surgeon transitions from one surgical center to another. This study investigates the dynamics of the team learning curve expressed as total operative time in the case of a surgeon with previous experience transitioning to a new team. Methods: A retrospective analysis was conducted on robotic cardiac surgeries performed by a surgeon who transitioned from one experienced surgical center to another. Operative time data were collected and categorized to assess the evolution of the learning curve. Statistical analysis, including learning curve modeling and linear regression analysis, was used to evaluate changes in total time in the operating room per case. Results: 103 cases were included in Weill Cornell Medicine (2019–2023). The median patient age was 63 years, 68% were males, 90.3% of cases were repaired for degenerative mitral valve disease, and the median body mass index was 23.87. Operative time (ORT) decreased from a median of 5.00 h [95%CI: 4.76, 6.00] in the first 30 cases to 4.83 [95%CI: 4.10, 5.27] thereafter, with the apparent curve plateauing indicative of the adaptation period to the new surgical environment (p = 0.01). Subgroup analysis among mitral cases (n = 93) showed a decrease in ORT from 5.00 [95%CI: 4.71, 5.98] in the first 26 cases to 4.83 [95%CI: 4.14, 5.30] (p = 0.045). There was no difference between the initial 30 cases and subsequent cases regarding cardiopulmonary bypass time, myocardial ischemia time, reoperation for bleeding, prolonged ventilation, reintubation, renal failure, need for an intra-aortic balloon pump, readmission to the ICU, reoperation for valvular dysfunction within 30 days, pneumonia, and deep venous thrombosis. Multivariate significant predictors of longer operative time were the first 30 cases, resection-based repairs, and MAZE as a concomitant procedure. Conclusions: Total operative time can be expected to decrease after about 30 cases when an experienced robotic surgeon moves between centers. Complications and cross-clamp times are less susceptible to a learning curve phenomenon in such a circumstance, as these depend primarily on the operating surgeon’s level of experience. Understanding these dynamics can inform the planning and management of surgical transitions, ensuring optimal patient care and continued improvement in surgical outcomes. Full article

Pediatric anesthesia requires the rapid creation, communication, and execution of anesthesia orders, and there is a risk of human error. The authors developed an order-assisted mobile application (app) to reduce human error during pediatric anesthesia preparation. The authors conducted an observational study that compared the effects of the application by comparing anesthesiologists’ errors, nurses’ errors, nurses leaving the operating room, and delays in surgery, between the Conventional group (n = 101) and the App group (n = 101). The app was associated with reduced human error by anesthesiologists and nurses, and it lowered the frequency and duration of nurses leaving the operating room during anesthesia. In addition, the authors surveyed anesthesia nurses regarding the effectiveness of the app. The nurses confirmed that the app was convenient and reduced human error. This study revealed that the order-assisted mobile app developed by a pediatric anesthesiologist could reduce human errors by anesthesiologists and nurses during pediatric anesthesia preparation. Full article

Vein blood sampling is a method of mass blood sampling that involves drawing blood from a vein for blood type discrimination, confirmation of various physiological indicators, disease diagnosis, etc.; it is the most commonly used blood sampling method. An important aspect of vein blood sampling is the search for the exact location of the vein for insertion of the syringe to draw blood. This is influenced by obesity as well as skin and blood vessel conditions in the patient and the experience of the clinical technologist, nurse, and resident who performs the blood sampling. Frequent practice is required to effectively perform blood sampling techniques. However, due to the many limitations of the practice room or laboratory, there is a problem of using only a limited environment and model for clinical practice. As a result, many medical educational institutions have situations in which only fragmentary clinical practices are performed, and it is difficult to practice many blood sampling skills, so they do not provide enough experience to understand the actual skill field. In this paper, we propose a virtual-reality-based vein blood sampling simulator that allows the practice of blood sampling techniques without limitation. The proposed vein blood sampling simulator can operate a 3D model related to vein blood sampling using an HMD controller and a haptic device in a virtual space for vein blood sampling practice by wearing an HMD (head-mounted display). Vein blood sampling can also be practiced through interaction with the patient 3D model. In addition, the effectiveness of a simulator developed for dental students was verified, and as a result of the verification, the potential of the proposed vein blood sampling simulator was confirmed. Full article

Background: Operating rooms (ORs) are healthcare areas that are high-risk regarding patient safety (PS). The prevention of PS errors such as wrong-site surgery, medication errors, and patient falls is important in the OR. Causes such as having insufficient information, not taking enough care and precautions, and inattention may lead to errors. Ensuring PS in an organization depends on the composition of a PS culture. Method: This study, as equivalent-control-group pretest–posttest research, aimed to develop and apply a simulation-based patient safety education program for operating room nurses and then to examine the influence of the program on patient safety management and compliance. Participants included a total of 45 operating room nurses: 22 in the experimental group and 23 in the control group. In the program, each member of the experimental and control groups underwent two 60 min sessions for a total of 120 min. Person-to-person individual lectures and simulation-based practice were provided to the experimental group, whereas booklets and person-to-person individual lectures were provided to the control group. Compliance with patient safety, the perception of patient safety culture, and satisfaction were measured using a structured Likert questionnaire. Intervention effects were analyzed using a t-test and ANCOVA. Results: As a result of the analysis, we found that the experimental group was significantly higher in terms of compliance with patient safety (p = 0.021), the perception of patient safety culture (p = 0.039), and education satisfaction (p < 0.001) than the control group. Conclusions: The results indicate that implementing a simulation-based patient safety education program can improve the patient safety competency of operating room nurses and, ultimately, prevent patient safety accidents in the operating room. Full article

Robots are defined as programmable machines that can perform specified tasks. Medical robots are emerging solutions in the field of cardiology leveraging recent technological innovations of control systems, sensors, actuators, and imaging modalities. Robotic platforms are successfully applied for percutaneous coronary intervention, invasive cardiac electrophysiology procedures as well as surgical operations including minimally invasive aortic and mitral valve repair, coronary artery bypass procedures, and structural heart diseases. Furthermore, machines are used as staff-assisting tools to support nurses with repetitive clinical duties i.e., food delivery. High precision and resolution allow for excellent maneuverability, enabling the performance of medical procedures in challenging anatomies that are difficult or impossible using conventional approaches. Moreover, robot-assisted techniques protect operators from occupational hazards, reducing exposure to ionizing radiation, and limiting risk of orthopedic injuries. Novel automatic systems provide advantages for patients, ensuring device stability with optimized utilization of fluoroscopy. The acceptance of robotic technology among healthcare providers as well as patients paves the way for widespread clinical application in the field of cardiovascular medicine. However, incorporation of robotic systems is associated with some disadvantages including high costs of installation and expensive disposable instrumentations, the need for large operating room space, and the necessity of dedicated training for operators due to the challenging learning curve of robotic-assisted interventional systems. Full article

Background: We believe that parental presence before the induction of anesthesia for surgery among children with a cleft palate/lip would be effective in mitigating their preoperative anxiety. Objective: We assessed the states of patients with a cleft palate/lip when their parents accompanied them into operating rooms and clarified their and their parents’ cognition using a questionnaire. Methods: Data were collected via nursing observation when patients and their parents entered the operating room. Furthermore, an anonymous questionnaire was administered to patients and parents after the operation regarding their feelings about parental presence in the operating room. Results: In total, nine patients cried when they entered the surgical room. Furthermore, six patients and three parents reported preoperative anxiety. In addition, eight patients agreed that they were satisfied with the presence of their parents before induction. Conclusion: Approximately half of the patients cried. However, the presence of parents before the induction of anesthesia was effective in reducing anxiety among most patients and their parents. Full article

The decrease in average hospitalisation time and the increase in outpatient surgery in some types of breast cancer represent gains for the reduction of the negative impact of hospitalisation in women with breast cancer but are also a challenge for the organisation of nursing care to prepare women for surgery, reduce anxiety about the interventions, and ensure continuity of care in the postoperative period. The aim of this study is to identify nursing interventions present in the care provided to patients with breast cancer during the perioperative period. A scoping review was the method chosen to answer the research question: What are the specialised nursing interventions in the perioperative pathway of the patient with breast cancer? Inclusion and exclusion criteria were defined for the articles that were identified in the CINAHL and MEDLINE databases; later, additional sources were identified from the list of bibliographic references for each selected study. The final bibliographical sample consisted of seven articles, which allowed the identification of three key moments of nursing interventions in the perioperative period of patients with breast cancer: the preoperative consultation, the reception of the patient in the operating room, and the postoperative consultation. Factors such as psychological, emotional, and spiritual support, communication and patient-centred care, health education and surgical safety, and the definition of a perioperative pathway for these patients contribute significantly to patients’ satisfaction and the improvement of their quality of life. The results of this study make it possible to establish recommendations for practise and for research, increasing the range of nurses’ actions. Full article

Since first reported in December 2019 in Wuhan, China, COVID-19 caused by Severe Acute Respiratory Syndrome (SARS) Corona virus2 (SARS CoV-2) quickly spread to become a pandemic that has caused significant morbidity and mortality. The rapidity of the spread of the virus and the high mortality at the outset threatened to overwhelm health systems worldwide, and, indeed, this significantly impacted maternal health, especially since there was minimal experience to draw from. Experience with Covid 19 has grown exponentially as the unique needs of pregnant and labouring women with COVID-19 infection have become more evident. Managing COVID-19 parturients requires a multidisciplinary team consisting of anaesthesiologists, obstetricians, neonatologists, nursing staff, critical care staff, infectious disease and infection control experts. There should be a clear policy on triaging patients depending on the severity of their condition and the stage of labour. Those at high risk of respiratory failure should be managed in a tertiary referral centre with facilities for intensive care and assisted respiration. Staff and patients in delivery suites and operating rooms should be protected by enforcing infection protection principles such as offering dedicated rooms and theatres to SARS CoV-2 positive patients and using personal protective equipment. All hospital staff must be trained in infection control measures which should be updated regularly. Breastfeeding and care of the new-born must be part of the healthcare package offered to COVID-19 parturient mothers. Full article