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At least 451 records · Page 25Linked to original sources
PubMed1994

Putting patient-focused care into practice.

Patient-focused care relies on a framework supported by staff member empowerment and cross training, decentralization, patient care teams, and computerization. Decisions are made based on what is best for the patient rather than what is best for the staff members. How patient-focused care is applied is influenced by the basic structure, beliefs, and values of the institution. Empowering staff members and physicians and creating specialty cluster teams were our first steps toward a patient-focused care model. Cross training ancillary personnel to perform all tasks reduced nursing staff members' overtime and allowed for quicker response times during emergencies. Switching to a computerized documentation system enhanced departmental efficiency, removed much of the paperwork burden from nurses, and reduced costs. Patient-focused care is measurable. We have reduced operating expenses, reduced staff turnover, increased productivity, and increased patient and physician satisfaction.

Hospital-Patient Relations↗
PubMed1999

Incorporating music into the surgical environment.

Responsibility for patient comfort has always been the concern of the nurse. Conscious sedation and or local anesthesia are commonly becoming the primary method of anesthesia for a variety of outpatient plastic surgical procedures. These surgical methods require the nurse to become aware of nonchemical adjuncts that can assist in providing a safe comfortable atmosphere for the patients. Furthermore, many patients now request nonchemical adjuncts for anxiolysis and sedation as well as for analgesia in the surgical suite. This article will provide the nurse with a basic overview of one such alternative, music, including a brief historical review, relevant research, and guidelines for use of music with the operative client.

Choice Behavior↗
PubMed1991

Staffing formulas determine correct levels.

In this time of nursing shortages and cost containment, OR managers must determine the correct staffing for their hospital. They cannot afford to be overstaffed, nor can they risk being understaffed. This article will describe two staffing formulas and discuss RN-to-technologist ratios and personnel assigned per room.

Models, Theoretical↗
PubMed1995

Suggested set-up and layout of instruments and equipment for advanced operative laparoscopy.

Crucial elements that ensure the organization and smoothness of a laparoscopic procedure are clear communication among well-trained endoscopy team members, properly maintained equipment, and a sensible layout of the instruments. The team consists of the surgeon, surgical assistant, circulator, scrub nurse, laser nurse, and anesthesiologist. To promote continuity and interaction and to ensure a systematic, pleasant pace for laparoscopic procedures, the team should establish a specific routine, as well as set-up and layout of tables, equipment, and instruments. Key ingredients for advanced operative laparoscopy to be performed with optimum efficiency and effectiveness are the best organization and placement of the equipment, instrumentation, and team in a particular setting in the operating room.

Anesthesiology↗
PubMed2004

[Comparative study of anxiety in informed and non-informed patients in the preoperative period].

Operation anxiety constitutes a significant phenomenon, detectable in numerous sleep related and psychological symptoms, as in its impact on the patient's health, the operation and post-operation process. For decades this problem (almost unknown in Lebanese scientific research), was the object of a vast theoretical project and numerous North American and European studies. Within the framework of this investigation, we studied the influence of structured information, provided by operating room nurses, on the patient's anxiety during the preparatory stage. The problem is all the more significant and relevant given that it is all but ignored in Lebanese hospitals. By adopting the basic hypothesis that "structured preparatory information diminishes the patient's anxiety" we wanted to examine the eventual links between the patient's anxiety level and his/her personal, socio-cultural and psycho-medical characteristics (sex, age, marital status, education, standard of living, medical history, type of surgery, type of anesthesia, etc.). Using the same methodological approach, we adopted Spielberger's steps in measuring anxiety after having acquired the proper authorization from Professor Spielberger himself, who furnished us with the certified Arabic version of these steps and their interpretation. A questionnaire allowed the identification of test groups' characteristics. We chose our setting the operating theatre at the Nini hospital in Tripoli, North Lebanon. Our investigation essentially began in September/October 2003. We formulated a sample of sixty patients within the operating community by means of a random sampling technique and a well-defined exclusion criteria. With the same technique we divided two groups of thirty patients: group A1 which was informed and A2 which was uninformed and used as test subjects. The data gathered by the investigation was incorporated into the SPSS software. The results of the comparative analysis operating between the two groups' anxiety scores confirmed the afore-mentioned hypothesis. However, these results did not establish any significant links between anxiety levels and the majority of the test groups' characteristics. By confirming the hypothesis that preparatory information reduces the patient's anxiety, this investigation has opened the door to important practical consequences leading to the following recommmendation: quality health-care in Lebanese hospitals would greatly improve by adopting a protocol of information booklets and preparatory meetings with the patient, with the added benefit of valorizing the role of the operating room nurse. At present, the absence of any structured preparatory information represents a significant deficiency in Lebanese hospitals.

Adolescent↗
PubMed1989

Thioethers, mutagens, and D-glucaric acid in urine of operating room personnel exposed to anesthetics.

Mutagenic hazards related to occupational exposure to nitrous oxide and enflurane was studied in the personnel of five operating rooms using a coupled environmental and biological monitoring approach. The environmental monitoring revealed air concentrations of the two anesthetics exceedings the TLVs by 10-15-fold. These values were correlated individually with the concentrations of the two anesthetics in the expired air of the exposed subjects. The biological monitoring was carried out by determining two parameters associated with mutagen exposure (urinary mutagenicity and thioethers) and a parameter associated with the enzymatic induction (D-glucaric acid) in the urine of exposed and unexposed subjects (N = 64 and N = 37, respectively). The results showed no difference in the two groups for urine mutagenicity and D-glucaric acid, but urine thioethers were significantly increased among highly exposed subjects.

Adult↗
PubMed1978

Monitoring of occupational exposure to nitrous oxide.

The occupational exposure of operating room personnel to nitrous oxide was investigated by using multiple spot sampling, integrated personal sampling and end-tidal sampling in an operating room which had no ventilation system. The effect of passive scavenging on occupational exposure was determined. The study showed that all three methods to determine occupational exposure can yield representative time-weighted exposure patterns. However, the integrated personal sampling was considered the preferable method as it involved considerable saving of time and labour compared with taking and analyzing multiple end-tidal and spot samples. Passive scavenging of waste anaesthetic gases led to a three-fold to six-fold reduction of exposure of operating room personnel to nitrous oxide.

Air Pollutants↗
PubMed2005

Effect of volatile anesthetics on oxidative stress due to occupational exposure.

Possible health hazards from long-term exposure to inhalation anesthetics cannot yet be definitively excluded. One of the adverse effects of general anesthetics is the exogen sources of reactive oxygen radicals that are responsible for several diseases. We designed the present study to determine the effect of volatile anesthetics on oxidative stress due to occupational exposure. We enrolled 30 anesthesia and surgery personnel who had been exposed to inhalation anesthetics for 3 years and 30 healthy volunteer personnel who had not been exposed to inhalation anesthetics at any period of their life as the control group. Blood samples were taken from both groups for determination of superoxide dismutase, glutathione peroxidase, and their cofactors, which are selenium, copper, and zinc levels. Our results revealed that plasma and erythrocyte antioxidant activity and trace element levels were significantly lower in operating room personnel compared to that in the control groups. We concluded that the antioxidant defense system was affected by free radical injury in anesthesia and surgery personnel who had been exposed to inhalation anesthetics chronically. Therefore, minimizing occupational exposure to volatile anesthetics is important for protecting operation room personnel from hazards. Operating room personnel should also take antioxidant supplements.

Adult↗
PubMed2006

Side errors in neurosurgery.

Eight cases of neurosurgical operations being performed on the wrong side were studied. Safeguards of confidentiality were used. In seven cases side marking was not done and the surgeons felt that had it been done, the mistake would have or may have been prevented. In all but one case the surgeon's normal side check was omitted. Distracting circumstances contributed to the checks being omitted in these seven cases. In the one case where the check was carried out the mistake was made because the patient had been marked on the wrong side. In no case was the mistake made because of ambiguous or absent site data in the imaging or notes. It is concluded that to prevent these mistakes emphasis should be placed on ensuring that the preoperative site check is completed more than on ensuring that unambiguous side information is available in the notes and imaging.

Diagnostic Imaging↗