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Objective To construct a perioperative and postoperative home nutritional intervention regimen for children with hepatoblastoma, and to evaluate its clinical application effect. Methods Semi-structured interviews, literature research, and Delphi methods were used to construct a perioperative and postoperative nutritional intervention regimen for children with he-patoblastoma. A total of 31 children with hepatoblastoma who underwent surgery in our hospital from January 2019 to August 2021 were enrolled as control group, and 31 children with hepatoblastoma who underwent surgery from September 2021 to December 2023 were enrolled as experimental group. The children in the control group received routine diagnosis, treatment, and nursing, and those in the experimental group received the nutritional intervention regimen in addition to the intervention in the control group. The two groups were compared in terms of nutritional status, blood biochemical parameters (serum albumin, serum prealbumin, and blood hemoglobin), body height, body weight, and body mass index at 1 week before surgery and at 1 week, 1 month, and 3 months after surgery, and the clinical guiding significance and practical effect of the nutritional intervention regimen was assessed. Results At 1 and 3 months after surgery, compared with the control group, the experimental group had a significant reduction in the numbers of children with mild-to-moderate malnutrition and severe malnutrition (Z=-2.799,-3.697,P

Objective To investigate the effect of care bundles based on the concept of enhanced recovery after surgery in perioperative nursing of patients undergoing laparoscopic cholecystectomy. Methods A total of 260 cases of laparoscopic cholecystectomy were randomly divided into observation group (n=130, received routine nursing care) and control group (n=130, received care bundles based on the concept of enhanced recovery). Postoperative recovery condition, incidence of complications and postoperative pain were compared between the two groups. Results At 2, 6 and 24 h after surgery, the Visual Analogue Scale of pain in the observation group were lower than those in the control group, with a significant difference(P＜0. 05). The time to first postoperative exhaustion, time to off-bed activities and hospital stays in the observation group were shorter than those in the control group (P＜0. 05). The incidence of vomiting, incision infection, and bile leakage in the control group was significantly higher than that in the observation group, with a significant difference (P＜0. 05). Conclusion The application of care bundles based on the concept of enhanced recovery after surgery are conducive to the postoperative recovery of patients undergoing laparoscopic cholecystectomy, as well as the improvement of postoperative quality of life. (目的 探讨基于加速康复外科理念的集束化干预措施在腹腔镜胆囊切除患者围术期护理中的应用效果。方法 选取2021年1月—2023年1月某三甲肝胆专科医院收治的260例行腹腔镜胆囊切除术的患者为研究对象, 随机分为两组: 对照组(n=130)围手术期间给予常规护理; 观察组(n=130)实施基于加速康复外科理念的集束化干预措施。比较两组术后恢复情况、并发症发生率以及术后疼痛情况。结果 术后2 h、6 h、24 h观察组患者疼痛视觉模拟(VAS)评分低于对照组, 差异有统计学意义(P＜0. 05)。与对照组相比, 观察组患者术后排气时间、下床时间和住院天数均缩短, 差异有统计学意义(P＜0. 05)。对照组呕吐、切口感染与胆漏发生率高于观察组, 差异有统计学意义(P＜0. 05)。结论 基于加速康复外科理念的集束化干预措更有利于患者术后康复, 提高术后生活质量 。)

Abstract Background Effective feedback is fundamental in clinical education, as it allows trainers to constantly diagnose the trainees’ condition, determine their weaknesses, and intervene at proper times. Recently, different feedback-based approaches have been introduced in clinical training; however, the effectiveness of such interventions still needs to be studied extensively, especially in the perioperative field. Therefore, this study sought to compare the effects of apprenticeship training using sandwich feedback and traditional methods on the perioperative competence and performance of Operating Room (OR) technology students. Methods Thirty final-semester undergraduate OR technology students taking the apprenticeship courses were randomly allocated into experimental (n = 15) and control (n = 15) groups through the stratified randomization approach. The students in the experimental group experienced Feedback-Based Learning (FBL) using a sandwich model, and the students in the control group participated in Traditional-Based Training (TBT) in six five-hour sessions weekly for three consecutive weeks. All students completed the Persian version of the Perceived Perioperative Competence Scale-Revised (PPCS-R) on the first and last days of interventions. Also, a blinded rater completed a checklist to evaluate all students’ performance via Direct Observation of Procedural Skills (DOPS) on the last intervention day. Besides, the students in the FBL filled out a questionnaire regarding their attitude toward the implemented program. Results The mean total score of the PPCS-R was significantly higher in the FBL than in the TBT on the last intervention day (P

Abstract Objective: to analyze the effectiveness of auriculotherapy for decreasing anxiety and stress of perioperative nursing professionals. Method: mixed methods research, embedded experimental model. In the quantitative stage, a randomized, triple-blind clinical trial was conducted with perioperative nursing professionals, who answered a characterization questionnaire, the List of Signs and Symptoms of Stress, and the General Anxiety Disorder-GAD 7. The participants attended eight auriculotherapy sessions with semi-permanent needles. The qualitative stage was exploratory and descriptive, in which data were collected through semi-structured interviews. Data were mixed with the incorporation of qualitative findings to examine the intervention in the experimental study. Results: 13 professionals participated in the intervention group and 14 in the control group. Anxiety and stress levels decreased significantly within groups, though no statistical difference was found between groups (p>0.05). The central category, “Auriculotherapy as an intervention to treat anxiety and stress,” emerged from the qualitative data, which was subdivided into a base unit and three categories concerning the therapy’s benefits. Conclusion: applying real and sham auriculotherapy had the same effect on the participants’ anxiety and stress levels; the reports reinforced such evidence. Non-pharmacological interventions, such as auriculotherapy, are essential for recovering and promoting the health of perioperative nursing professionals. Brazilian Clinical Trials Registry: RBR-3jvmdn.

Objective: to analyze the evidence on applying the Risk Assessment Scale for the Development of Injuries Resulting from Surgical Positioning in the perioperative period. Methods: an integrative review was conducted by searching four health databases and gray literature. A reference manager was used to import the identified records and remove duplicate publications. The Rayyan web application was used to select primary studies. Data analysis and synthesis were carried out in descriptive form. Results: the sample consisted of 17 surveys. In 15, the authors applied the scale in health services to investigate the risk of developing injuries resulting from surgical positioning and the occurrence of injuries; for example, pressure injury. In one study, the scale was adopted to analyze the concurrent validity of the Munro scale and, in another, for the translation and validation of the scale in Turkey. Conclusion: the scale was applied mainly to assess the risk of injuries in different surgical environments. Contributions to practice: the evidence generated supports the use of the scale in health services and indicates the need to conduct more robust research.

ABSTRACT Objective: To describe the development, content validation, and usability of an application to orient surgical patients and ensure their safety. Method: Methodological study, carried out between July and August 2023, developed in three stages: (1) selection of relevant content based on a review of scientific literature; (2) development of the application; and (3) validation of the content and usability of the software, evaluated using two validated instruments, which were sent to eight nurse judges from the states of São Paulo, Minas Gerais, and Santa Catarina, and eight professional information technology judges from Minas Gerais. Results: The contents of the “Minha Cirurgia” application included information based on relevant scientific literature regarding patient safety, preoperative guidelines, timing of surgery, and post-surgical care. Its content was classified as “superior” and its usability was classified as “the best possible” by the judges. Conclusion: The application was approved by nurses and IT professionals regarding its content and usability. It will be available for free download in the Play Store. The tool is expected to be useful in the education of surgical patients, allowing them to acquire knowledge that supports them in the search for safe care.

ABSTRACT Objectives: to map available evidence on telenursing use in the postoperative period and its impact on patient outcomes. Methods: a scoping review, conducted according to the JBI model and the PRISMA-ScR checklist. The search was carried out in the CINAHL, Embase, LILACS, PubMed, Web of Science, SciELO, Scopus and Cochrane Library databases. Results: twelve studies were included, published between 2011 and 2023, 66.6% of which were in developed countries. Of the positive outcomes, we highlight improved levels of disability, autonomy and quality of life, lower rates of post-operative complications, pain and reduced costs. Telephone monitoring was the most widely used modality, but there were few studies in the pediatric context and in Brazil. Conclusions: of the studies, 11 (91.6%) identified at least one positive outcome in telenursing use and none showed negative aspects in the postoperative period. The role of nurses in digital health needs further study.

Objective: to analyze the safety attitudes of health and support areas professionals working in Surgical Center. Method: sequential explanatory mixed methods study. The quantitative stage covered 172 health and support professionals in eight Surgical Centers of a hospital complex. The Safety Attitudes Questionnaire/Surgical Center was applied. In the subsequent qualitative stage, 16 professionals participated in the Focus Group. Photographic methods were used from the perspective of ecological and restorative thinking, and data analysis occurred in an integrated manner, through connection. Results: the general score, by group of Surgical Centers, based on the domains of the Safety Attitudes Questionnaire/Surgical Center, reveals a favorable perception of the safety climate, with emphasis on the domains Stress Perception, Communication in the Surgical Environment, Safety Climate and Perception of Professional Performance. The overall analysis of the domain Communication and Collaboration between Teams appears positive and is corroborated by data from the qualitative stage, which highlights the importance of interaction and communication between healthcare teams as fundamental for daily work. Conclusion: the perception of safety attitudes among health and support professionals was positive. The perception of the nursing team stands out as closer or more favorable to attitudes consistent with the safety culture.

Objectives: this study aimed at estimating and comparing the reliability of temperature measurements obtained using a peripheral infrared temporal thermometer, a central cutaneous thermometer (“Zero-Heat-Flux Cutaneous thermometer”) and an esophageal or nasopharyngeal thermometer among elective surgical patients in the intraoperative period. Method: a longitudinal study with repeated measures carried out by convenience sampling of 99 patients, aged at least 18 years old, undergoing elective abdominal cancer surgeries, with anesthesia lasting at least one hour, with each patient having their temperature measured by all three methods. Results: the intraclass correlation coefficient showed a low correlation between the measurements using the peripheral temporal thermometer and the central cutaneous (0.0324) and esophageal/nasopharyngeal (-0.138) thermometers. There was a high correlation (0.744) between the central thermometers evaluated. Conclusion: the data from the current study do not recommend using infrared temporal thermometers as a strategy for measuring the body temperature of patients undergoing anesthetic-surgical procedures. Central cutaneous thermometers and esophageal/nasopharyngeal thermometers are equivalent for detecting intraoperative hypothermia.

This paper summarized the nursing management of simultaneous surgery of cesarean section and brain tumor resection in a 37 week pregnant woman with brain tumor. The simultaneous surgery of cesarean section and brain tumor resection under general anesthesia had increased the surgical risk and requirements of surgical nursing. Based on the analysis of patient’s illness condition, a nursing plan considering difficulty in surgical cooperation, surgical duration, intraoperative monitoring and multi-disciplinary collaboration were established. Enhanced safety management, surgical cooperation, psychological care and other interventions were carried out to ensure the safety of patient during surgery period and improve postoperative recovery. (本文总结1例孕37+4周合并脑肿瘤患者剖宫产术同期行脑肿瘤切除手术的护理体会。全麻下同期完成宫产术和脑肿瘤切除手术增加患者手术风险, 同时也提高手术室护理配合的要求。结合患者病情特点, 从手术配合难点、手术时长、术中观察、多学科协作等角度入手制定护理计划, 加强患者围手术期安全管理、手术护理配合、心理护理干预等, 确保围手术期安全, 促进术后康复。)

Objective To investigate the effect of gradual adjustment of surgical position in prevention of complications of thyroid surgery. Methods Totally 100 patients undergoing surgical treatment for thyroid diseases were divided into the control group and observation group, with 50 cases in each group. Conventional surgical position was in the control group, while the surgical position was gradually adjusted in the observation group. The incidence of postoperative complications and patient satisfaction with nursing service were measured and compared between two groups. Results The incidence rats of postural syndrome, circulatory complications, muscle tissue complications and ocular complications in the observation group were lower than those in the control group(P＜0. 05). The scores of service attitude assessment and patient satisfaction assessment in the s in the observation group were higher than those in the control group(P＜0. 05). Conclusion Gradual adjustment of surgical position is potentially effective to reduce the postoperative complications of thyroid surgery and improve the quality of surgical nursing. (目的 探究渐进式体位在降低甲状腺手术并发症中的应用效果。方法 选取2022年7月—12月医院收治的甲状腺疾病行手术治疗的100例患者为研究对象, 分为对照组和观察组, 各50例。对照组采用常规手术方式和手术体位, 观察组基于常规术式及体位的基础上进行渐进式体位调整。对比两组术后并发症发生和患者对围手术期护理的评价。结果 观察组术后体位综合征、循环系统并发症、肌肉组织并发症和眼部并发症发生率均低于对照组, 差异有统计学意义(P＜0. 05)。观察组患者服务态度评分和护理满意度评分均高于对照组(P＜0. 05)。结论 运用渐进式体位变换改良传统甲状腺手术体位, 可以降低术后并发症的发生率, 有利于优化甲状腺手术护理工作, 提升手术治疗质量。)

This paper investigate the effect of enhance recovery after surgery (ERAS) in perioperative nursing of pediatric patients undergoing modified artificial partial knee-joint prosthesis replacement for osteosarcoma around the knee joint. The clinical data of 8 pediatric patients with osteosarcoma around the knee joint were retrospectively analyzed. Based on the concept of ERAS, enhanced health education, nutrition support and psychological care were carried out before surgery. In addition to routine postoperative nursing, efforts were made to improve the positioning management, function exercise and prevention of postoperative complications. All pediatric patients were followed up and recovery with good walking posture. ERAS-based nursing intervention is effective to improve the functional recovery of knee joint and reduce the postoperative complications in modified artificial partial knee-joint prosthesis replacement for osteosarcoma around the knee joint. (本文探讨快速康复护理模式在儿童膝关节周围骨肉瘤改良型人工半膝关节假体置换手术围手术期护理中的应用效果。回顾性分析2018年1月—2019年12月医院收治的8例膝关节周围骨肉瘤患儿的临床资料。遵循快速康复理念, 术前加强围手术期健康宣教、营养支持和心理干预; 术后在常规护理基础上, 完善体位护理、功能锻炼和并发症预防。出院后随访, 患儿步态良好, 基本满足日常生活需求。基于快速康复护理理念的护理干预能够促进患儿膝关节功能恢复, 减少术后并发症, 提高患儿生活质量。)

This paper summarized the nursing management for 33 patients with verrucous epidermal nevi. Psychological guidance and health education were carried out before surgery. Nurses had enhanced the intraoperative coordination and monitoring of illness condition. Key issues of postoperative nursing included wound care, body position care, perineal care; nutrition support, medical care and health education before discharge form hospital. The comprehensive perioperative nursing interventions could effectively improve the wound healing, reduce the risk of complications and improve patients’ quality of life. (本文总结33例疣状表皮痣手术患者的围手术期护理经验。术前做好心理辅导和健康教育, 完善术前准备; 术中密切配合、积极观察患者生命体征; 术后开展创面护理、体位护理、会阴部护理、饮食护理、用药护理等全面护理; 出院前给予健康指导。护士通过实施精细的围术期护理, 能有效促进创面愈合, 降低并发症风险, 提高患者生活质量。)

Objective To investigate the effect of f fine nursing management for patients undergoing simultaneous bilateral lobectomy. Methods Totally 52 patients under simultaneous bilateral lobectomy were randomly divided into the control group and observation group, with 26 cases in each group. The control group received routine nursing interventions during perioperative period. The observation group was given fine nursing management. The indwelling time of catheter, length of postoperative hospital stay, hospitalization costs and postoperative complications were recorded. Results The indwelling time of drainage tube and length of postoperative hospital stay in the observation group were shorter than those in the control group(P＜0. 05). There was a case of pneumothorax, 1 case of stage I pressure injury, 5 cases of arrhythmia, 2 cases of breathing difficulties and 2 cases of incision infection in the observation group. There was a case of pneumothorax, 3 cases of stage I pressure injury, 5 cases of arrhythmia, 1 case of breathing difficulties, 5 cases of incision infection and 1 case of death in the control group. Conclusion Implementation of fine nursing management is effective to shorten indwelling time of drainage tube and length of postoperative hospital stay of patients undergoing simultaneous bilateral lobectomy. (目的 探讨同期双侧肺叶切除围手术期实施精细化护理干预的效果。方法 选取2015年1月—2021年12月医院收治的行同期双侧肺叶切除患者52例, 随机分为对照组和观察组, 各26例。对照组围手术期采取常规护理, 观察组围术期采取精细化护理干预。记录和分析两组患者引流管留置时间、术后平均住院日、住院费用和术后并发症。结果 观察组患者引流管留置时间、术后平均住院日较对照组缩短, 差异有统计学意义(P＜0. 05)。观察组术后发生气胸1例, I期压疮1例, 心律失常5例, 呼吸困难2例, 切口感染2例; 对照组术后气胸1例, I期压疮3例, 心律失常5例, 呼吸困难1例, 切口感染5例, 死亡1例。结论 同期双侧肺叶切除围手术期实施精细化护理干预, 能缩短患者引流管留置时间和术后平均住院日, 对促进患者术后康复具有积极意义。)

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.

Background: Perioperative nursing plays an important role in the success of any surgery. In Malawi, pre-service training is the only source of perioperative knowledge for nurses. In order to ensure that nurses are adequately prepared with perioperative knowledge and skills, an effective assessment of perioperative competence is required. The Perceived Perioperative Competence Scale-Revised (PPCS-R) is a scientifically developed and psychometrically validated tool for assessing perioperative nurses’ competence. Therefore, this study aimed to adapt and evaluate the psychometric properties of the Perioperative Competence Scale-Revised (PPCS-R) for use on undergraduate student nurses in Malawi. Methods: The adaptation of the PPCS-R involved a review by a panel of experts for content validity followed by an evaluation of Psychometric properties through a confirmatory factor analysis. The confirmatory factor analysis evaluated the reliability coefficient and factor loading for the scale based on data from 100 former nursing students. Results: Content analysis led to the exclusion of six items while twelve items were revised. The confirmatory Factor Analysis yielded 6 factors with Cronbach’s alpha ranging between 0.811 to 0.879. Conclusion: The Malawian student version of the PPCS-R has good reliability, validity, and psychometric properties. This will enable nurse educators, preceptors, clinical nurses, and even student nurses to assess perioperative nursing competency for undergraduate student nurses in Malawi.

Background and objectives: As novice nurses transition into the workforce, they often experience transition shock as they assimilate into a new role, causing cause significant stress, anxiety and job dissatisfaction. This phenomenon is commonly observed within the perioperative nursing speciality. The development of transition support programs is aimed at assisting novice nurses' transition by providing fundamental knowledge, socialisation, support, and training.This review aimed to uncover the support programs and their components available to nurses transitioning into the perioperative speciality. The research question that provided guidance for this review was ‘What are the transition support arrangements, and their characteristics, to support new graduate nurses and novice nurses who are transitioning into perioperative nursing?'. Literature search: Arksey & O'Malley's’ five-step scoping review framework was used. The researchers performed a comprehensive literature search of PubMed, Proquest, CINHAL and SCOPUS with no limit on publication date until April 2023. A blinded screening process was undertaken, and the data extraction was tabulated. Data was presented as a narrative synthesis following thematic analysis. Results: The initial search identified 537 publications. Screening and duplicate removal led to the exclusion of 512 publications. Of the 25 publications included in this review, two were primary research publications, while the other 23 were discussion papers. Analysis indicated that program approaches and components of programs were frequently described. Conclusion: The findings highlight the significance of transition programs within the perioperative speciality area. However, the paucity of empirical evidence on the pedagogical underpinnings and evaluation of effectiveness indicates the need for further research. Conducting further research within perioperative transition to practice will enable programs to be designed based on theoretically-sound and evidence-based approaches to support nursing transition to practice within the speciality perioperative environment.

Abstract Background To minimize the risk of perioperative hypothermia, it is recommended that healthcare professionals be familiar with heat conservation measures and use passive and active warming methods, in line with international guidelines. However, there is a low level of adherence perioperatively to the use of heat conservation measures. To understand why, there is a need to capture the nurse anesthetists’ perspective. The aim is to describe nurse anesthetists’ perceptions of heat conservation measures in connection with surgery. Methods An inductive descriptive design with a phenomenographic approach was chosen. A total of 19 nurse anesthetists participated and were interviewed. Data were analyzed according to Larsson and Holmström’s phenomenographic seven-step model. Results Six ways of understanding the phenomenon heat conservation measures in connection with surgery were found: the preventive, the useable, the untenable, the caring, the adaptive, and the routine care approach. These approaches were related to each other in a flexible way, allowing for several to co-exist at the same time, depending on the situation. Conclusions Nurse anesthetists want to prevent the patients’ heat loss and maintain normothermia, regardless of the type of surgery. This willingness, motivation, and intention enable the use of heat conservation measures. However, there are perceptions that have an impact, such as doubts and uncertainty, access, time and financial constraints, preconditions, routines or habits, and lack of availability of education/training. These barriers will require support from an organizational level to promote lifelong education and guidelines. As well as offer education at the nurse anesthetists’ program.

This paper summarized the multicultural nursing management for a patient with giant left ventricular pseudoaneurysm. Based on the self-management and clinical application of postoperative power-assisted enveloped-type special garment, health guidance and nursing interventions were carried out to improve the clinical outcomes of the patient and avoid the rupture of the pseudoaneurysm. During the perioperative period, the multicultural nursing theory was used to analyze the advantages and disadvantages of self-management. Aiming for prevention of adverse factors, the multicultural nursing team led by the primary nurse participated in the formulation of patient self-management, provided nursing care consistent with the patient's culture and health education, and made full preparation for the patient with standardized nursing behavior. (本文回顾1例左心室巨大假性室壁瘤(LVPA)患者的多元文化护理体会。为患者制定自我管理目标和方案, 应用实用新型专利(术后助力环抱式专用衣)提升术后患者伤口恢复及自理能力, 护理人员给予引导和积极干预, 患者各方面得到改善, 避免巨大LVPA破裂的发生。围手术期运用多元文化护理理论, 分析自我管理的有利因素和不利因素, 针对不利因素目标分析, 以责任护士为主导的多元文化护理团队参与制定患者的自我管理, 提供与患者文化相一致的护理以及健康教育工作, 以规范的护理行为, 为患者做好充分术前准备, 促进术后康复。)

The effect of Donabedian three-dimensional quality evaluation model is explored for the high-quality nursing during perioperative period of endoscopic mucosal dissection in early gastric cancer male patients. Seventy-eight early gastric cancer male patients were randomly grouped as 39 cases in control having received routine care, while 39 in the intervention group having received routine care combined with the three-dimensional quality evaluation model. Clinical recovery indicators including anxiety, depression, pain, life quality and complications were compared for the two groups. The intervention group’s clinical nursing recovery indicator scored higher than that of the control. The scores of each the short-form 36 item health survey questionnaire (SF-36) dimension were better than those of control, and the differences were statistically significant (p < 0.05). The incidence of complications in intervention group was 5.12%, and that in the control was 20.5%. The intervention group experienced less complications than the control, and the difference was statistically significant (p < 0.05). Treating early gastric cancer male patients with endoscopic mucosal dissection using three-dimensional quality evaluation model can improve clinical recovery and life quality, and reduce anxiety, depression, pain and complications.

This paper summarized the cluster nursing management for a patient with lumbar disc herniation induced low back pain combined with hyperglycemia. The patient received lumbar paravertebral nerve block, and was diagnosed with hyperglycemia before the surgery. Based on the nursing risk assessment, the cluster nursing management including perioperative blood sugar monitoring, postoperative observation and health education were carried out to ensure the surgical safety and improve the prognosis and postoperative rehabilitation of the patient. (本文总结1例腰椎间盘突出症腰痛合并血糖升高患者的集束化护理管理体会。患者接受椎旁神经单次阻滞镇痛治疗, 治疗前发现血糖升高。在完善护理评估的基础上, 加强围手术期血糖监测、术后观察和健康宣教, 旨在确保患者围手术期安全, 改善预后, 促进康复。)

Objective This article aims to study the effect of endovascular treatment of Budd-Chiari syndrome (BCS) and perioperative nursing experience. Methods The clinical data of 139 patients with BCS who received endovascular treatment in our hospital from December 2012 to December 2019 were retrospectively analyzed. In this article, the technical procedure was described in detail, and the perioperative complications and follow-up results were summarized. Results Totally 128 patients received endovascular therapy successfully, with a technical success rate of 92. 09%(128/139). Among them, 112 cases were simply balloon dilated and 16 cases were stent implanted. The average pressure of inferior vena cava decreased from (29. 80±6. 20) mmHg before operation to (8. 90±2. 00) mmHg after operation. Postoperative complications occurred in 9 patients, including 2 cases of pulmonary embolism, 1 case of cardiac tamponade, 1 case of vena cava rupture, 5 cases of left heart failure and pulmonary edema, and 3 cases of perioperative all-cause death (2. 16%). 114 patients were followed up after operation, with an average follow-up of 36 months. The 1-year restenosis rate after simple ball expansion was 22. 45%(22/98), and the 1-year restenosis rate after stent implantation was 12. 50%(2/16); the 3-year survival rate of patients was 90. 35%(103/114). Conclusion Endovascular technique is a safe and effective method for the treatment of BCS. The first choice for treatment is simple balloon molding. If elastic retraction and restenosis occur after balloon expansion, stent implantation can be considered. Close cooperation with perioperative nursing of BCS can promote the rapid recovery of patients. (目的 总结介入治疗布-加综合征(BCS)的效果及围术期护理体会。方法 回顾性分析2012年12月—2019年12月医院收治的139例接受介入治疗的BCS患者的临床资料。详细阐述该技术操作流程, 总结围手术期并发症及随访结果。结果 128例患者成功接收腔内介入治疗, 技术成功率92. 09%(128/139)。其中单纯球囊扩张112例, 支架植入16例。下腔静脉平均压力由术前(29. 80±6. 20)mmHg 降至术后(8. 90±2. 00)mmHg。9例患者出现术后并发症, 肺栓塞2例, 心包填塞1例, 腔静脉破裂1例, 左心衰、肺水肿5例, 围术期全因死亡3(2. 16%)例。术后114例患者得到随访, 平均术后随访36个月, 单纯球囊扩张术后1年再狭窄率22. 45%(22/98), 支架植入术后1年再狭窄率12. 50%(2/16); 患者3年的生存率90. 35%(103/114)。结论 腔内技术用于治疗BCS征是一种安全、有效的方法, 治疗首选单纯球囊成型, 如果球囊扩张后出现血管弹性回缩、再狭窄, 可考虑植入支架治疗。做好BCS围手术期护理工作, 可促进患者的快速康复。)

This paper summarized the nursing measures for a critically ill patient undergoing transcatheter aortic valve replacement combined with coronary stent implantation. Giving the increasing surgical risk caused by issues such as advanced age and concomitant diseases, the one-stop minimally invasive surgery was carried out, in combination of transcatheter aortic valve replacement combined with coronary stent implantation. The endotracheal intubation and temporary pacemaker implantation were performed intraoperatively. The intra- aortic ballon pump (IABP) insertion and extracorporeal membrane oxygenation (ECMO) were performed as rescue mechanical support for maintenance of blood pressure. Given the upper gastro-intestinal bleeding and other complications after surgery, comprehensive nursing interventions were carried out including preoperative evaluation and psychological care, vital signs monitoring, medical equipment maintenance, wound care and prevention of complications. The patient (报告1例危重症患者行一站式经导管主动脉瓣置换术(TAVR)联合冠状动脉支架植入术的护理体会。患者基础疾病较多, 年龄偏大, 手术难度及风险增加。术中采用一站式微创手术, 同时将冠状动脉支架植入术及TAVR联合进行, 术中行气管插管, 临时起搏器植入术。由于患者血压无法维持, 在主动脉内球囊反搏(IABP)及体外膜肺氧合(ECMO)支持及辅助下进行。术后患者合并消化道出血等因素, 增加术后护理难度。医护团队加强术前评估和心理护理, 术后严密监测患者生命体征, 做好各种仪器设备护理、伤口及并发症观察护理等。)

ABSTRACT Objectives: to analyze and determine the effect of a combination intervention of early ambulation and dhikr therapy on intestinal peristaltic recovery in post-open cholecystectomy patients. Methods: a pre-experimental design with one group pre and post-test design was used. The samples were 15 post-open cholecystectomy patients which were selected using the purposive sampling technique. The data were collected using the instrument observation sheet and analyzed using the Wilcoxon test. Early ambulation used standard operational procedure in the hospital and dhikr therapy was carried out at 2 hours post-operation for 10-15 minutes. Results: there was an effect of early ambulation and dhikr therapy on intestinal peristaltic recovery in post-open cholecystectomy patients with general anesthesia (Z=-3.442; p=0.001). Conclusions: a combination of early ambulation and dhikr therapy can be recommended as interventions to improve intestinal peristaltic in a post-open cholecystectomy patient with general anesthesia.

ABSTRACT Objective: To develop and validate an instrument to assist in the systematization of perioperative nursing care in robotic surgery. Methods: Methodological study developed in four phases: content survey; textual elaboration; content validation by the group of expert judges and target audience; and elaboration of the electronic instrument layout. Results: Eleven expert judges and seven evaluators of the target audience participated. For validation, the Content Validity Index (CVI) was used with a 0.78 cutoff point. The instrument total CVI after evaluation was 0.90 by the expert judges and 0.88 by the target audience. Conclusion: The tool built was proved satisfactory for the systematization of perioperative nursing care. The instrument construction was based on the updated scientific literature and validated by the expert judges and target audience.

This paper summarized the treatment and nursing measures for an octogenarian patient with acute inferior myocardial infarction combined with sick sinus syndrome. Patient had the Adams-Stokes syndrome after percutaneous coronary intervention, and was implanted with a permanent pacemaker after emergency PCI with temporary pacemaker. Key issues of nursing included continuous ECG monitoring to enable timely detection and management of the condition, postoperative renal function monitoring, defecation care, observation of the condition after temporary pacemaker implantation and permanent pacemaker implantation, health education on pacemaker implantation, management of postoperative complications and psychological care. (本文总结1例急性下壁心肌梗死合并病态窦房结综合征高龄患者的治疗措施和护理经验。患者行急诊经皮冠状动脉介入治疗术后发生阿-斯综合征, 行临时起搏器后植入永久心脏起搏器。护理要点包括: 给予患者持续心电监护, 及时发现和处理病情; 术后加强肾功能监测, 做好排便护理; 临时起搏器植入和永久起搏器植入后的病情观察; 起搏器植入健康教育, 术后并发症的管理和心理护理。)

The perioperative nursing experience of an emergency case of incarcerated complete rectal prolapse was summarized. The key points of nursing include protecting the wound and improving preoperative preparation actively; Rapid establishment of intraoperative venous access; Postoperative recurrence avoidance, diet nursing, disease observation, fluid management, etc. (总结1例急诊完全性直肠脱垂嵌顿患者的围手术期护理经验。护理要点包括保护创面、积极完善术前准备; 术中快速建立静脉通路; 术后避免复发、饮食护理、病情观察、液体管理等。)

To explore the application and nursing cooperation of endoscopic retrograde cholangiopancreatography (ERCP) combined with intraductal ultrasonography (IDUS) in differential diagnosis of benign and malignant biliary stricture. From January 2015 to December 2020, 208 patients with biliary stricture of unknown origin were treated with ERCP combined with IDUS. The operation was successfully completed in all 208 cases. The diagnosis was confirmed by biopsy, operation and follow-up. There were 87 cases of malignant stricture, including 50 cases of cholangiocarcinoma (21 cases in the lower segment, 19 cases in the middle segment, 10 cases in the upper segment / hilar), 15 cases of pancreatic cancer, 12 cases of ampullary cancer, 10 cases of other metastatic tumor invasion, and 121 cases of benign stricture. There were 92 cases of hyperamylasemia and 1 case of delayed bleeding, no perforation was reported. After fasting, anti-inflammatory, hemostasis, enzyme inhibition and rehydration, they were all improved and discharged. Psychological guidance and perfect preparation before operation, tacit cooperation during operation, prevention and observation of complications, and careful nursing after operation are key issues to ensure the successful completion of the examination. (探讨经内镜逆行性胰胆管造影术(ERCP)联合胆管腔内超声(IDUS)在良恶性胆管狭窄鉴别诊断中的应用和护理配合。回顾性分析2016年1月—2021年12月医院收治的208例不明原因胆管狭窄行ERCP联合IDUS治疗的患者的临床资料。208例均成功完成操作, 通过活检病理、手术及随访确定诊断, 恶性狭窄87例, 其中胆管癌50例(下段21例、中段19例、上段／肝门部10例), 胰腺癌15例, 壶腹癌12例, 其他转移肿瘤侵犯10例; 良性狭窄121例。术后并发高淀粉酶血症92例, 发热20例, 迟发性出血1例, 无术后穿孔情况。患者给予禁食、抗炎、止血、抑酶、补液治疗后均好转出院。术前做好心理指导和完善的准备, 术中默契配合, 做好并发症的预防和观察, 术后精心护理, 是保障检查顺利完成的重要环节。)

Objective To investigate the application effect of enhanced recovery after surgery in perioperative nursing of patients with choledochojejunostomy. Methods Totally 80 patients undergoing choledochojejunostomy were randomly divided into the control group and observation group, with 40 cases in each group. Patients in the control group received routing care during the treatement, and those in the observation group received perioperative nursing interventions based on the theory of enhanced recovery after surgery. Primary outcomes were first anal exhaust time, length of hospital stay, hospitalization costs and incidence of postoperative complications. Secondary outcomes were time to remove the gastric tube, time to remove the urinary catheter, time to food-taking, time to off-bed activity and volume of fluid infusion. Results The first anal exhaust time and length of hospital stay in the observation group were shorter than those in the control group (P＜0. 01). The hospitalization costs in the observation group was lower than that in the control group (P＜0. 01). The time to remove the gastric tube, time to remove the urinary catheter and time to off-bed activity in the observation group were shorter than those in the control group (P＜0. 01). The volume of fluid infusion in the observation group was less than that in the control group (P＜0. 01). The incidence rate of complications in the observation group was lower than that in the control group (P＜0. 05). Conclusion The enhanced recovery after surgery is effective and safe in perioperative nursing of patients with choledochojejunostomy, it has a positive effect on reducing the incidence of postoperative complications. (目的 探讨基于加速康复外科理念的护理干预在胆肠吻合术患者中的应用方法及效果。方法 选择2018年1月—2020年8月住院行胆肠吻合术的80例患者为研究对象, 按照随机分组方法将患者分为对照组和观察组, 各40例。对照组给予常规护理, 观察组实施基于加速康复外科理念的护理干预。主要指标: 首次肛门排气时间、住院时间、住院费用、并发症的发生率; 次要指标: 拔除胃管时间、尿管时间、进食时间、下床时间、输液量。结果 观察组首次肛门排气时间、住院时间均较对照组缩短, 差异有统计学意义(P＜0. 01), 观察组住院费用较对照组减少, 差异有统计学意义(P＜0. 01)。观察组拔除胃管时间、拔尿管时间、进食时间以及下床时间较对照组缩短, 差异有统计学意义(P＜0. 01), 观察组输液量也明显少于对照组, 差异有统计学意义(P＜0. 01)。观察组并发症发生率低于对照组, 差异有统计学意义(P＜0. 05)。结论 在胆肠吻合术患者围术期护理中的应用加速康复外科理念安全有效, 对降低术后并发症发生率具有积极意义。)

This paper summarized the perioperative nursing management for a patient who underwent surgical excision of Adrenocortical adenoma. Comprehensive interventions including preoperative preparation, postoperative vital signs observation, appropriate catheter maintenance, prevention of complications were carried out to reduce the surgical risks, relieve mental stress and pain, and improve the recovery of the patient. (本文总结1例肾上腺皮质腺瘤切除术患者的围手术期护理经验。通过完善术前准备, 术后严密观察病情, 妥善维护管路, 积极预防并发症, 减少手术风险, 缓解患者心理压力和疼痛, 促进患者康复。)

Objective To compare the efficacy of dual-frequency dual-pulse laser lithotripsy under endoscopic retrograde cholangiopancreatography (ERCP) and traditional endoscopic mechanical lithotripsy in the treatment of patients with common bile duct stones, and summarize perioperative nursing measures. Methods From May 2018 to May 2022, the clinical data of 200 patients with common bile duct stones who underwent ERCP treatment and lithotripsy were retrospectively analyzed, of which 69 patients were treated with dual-frequency dual-pulse laser lithotripsy (Laser group) and 131 patients were treated with mechanical lithotripsy (Mechanical group), and the success rate of stone extraction, operation time, postoperative hospital stay time and complications of two groups of patients were compared. Results There was no significant difference in baseline data such as general conditions and preoperative clinical data between two groups (P＞0. 05). Neither neither Laser group nor Mechanical group had reported the perioperative death case. There were no significant difference in postoperative bleeding, postoperative pancreatitis and perforation complication rates in the two groups (P＞0. 05). The surgical time in the Laser group was significantly longer than that in the Mechanical group (P＜0. 05). The postoperative hospital stay was shorter in the Laser group than that in the Mechanical group(P＜0. 05), and the total complication rate and stone residue rate were lower in the Laser group than those in the Mechanical group (P＜0. 05). Conclusion The treatment of common bile duct stones by dual-frequency dual-pulse laser lithotripsy has better efficacy and lower complication rate than traditional surgical mechanical lithotripsy, but there is still room for improvement in the operation time. (目的 比较内镜逆行胰胆管造影术(ERCP)下双频双脉冲激光碎石与内镜下传统机械碎石治疗胆总管结石患者的效果, 总结护理经验。方法 回顾性分析2018年5月—2022年5月在北京中医药大学东方医院消化内镜中心行ERCP治疗并碎石的200例胆总管结石患者的临床资料, 其中69例患者采用双频双脉冲激光碎石术(激光组), 131例患者采用机械碎石(机械组)。比较两组患者的取石成功率、手术时间、术后住院时间、并发症等情况。结果 两组患者一般情况、术前临床资料等基线资料比较, 差异无统计学意义(P＞0. 05)。激光组和机械组均无围术期死亡患者。两组患者术后出血、术后胰腺炎、穿孔并发症率比较差异无统计学意义(P＞0. 05)。与机械组相比, 激光组的手术时间较长(P＜0. 05), 术后住院时间更短(P＜0. 05), 总并发症率和结石残留率更低(P＜0. 05)。结论 ERCP下双频双脉冲激光碎石治疗胆总管结石具有比传统手术机械碎石更好的效果及更低的并发症率, 但手术时间仍有改进的空间。)

This paper summarized the experience of patient positioning and nursing cooperation in a case who underwent arthroscopic surgery of the shoulder. Key issues of nursing cooperation included preoperative preparation, key points of positioning, postoperative handover. A scientific patient positioning may help improve patient satisfaction and reduce the risk of complications. (本文总结1例肩关节镜手术患者体位摆放的护理经验, 包括术前准备、术中体位摆放要点、术后交接等围手术期护理措施。通过科学摆放体位, 提高患者舒适度, 预防相关并发症。)

This paper summarized the preoperative skin preparation and perioperative comprehensive nursing for a patient undergoing surgery for intracranial aneurysm. Based on the theory of enhanced recovery after surgery, the preoperative skin preparation was adopted. Perioperative comprehensive nursing interventions such as surgical positioning care, illness condition observation, incision management, catheter maintenance, dietary care, medication care, prevention of complications and health education were carried out to reduce the postoperative complications and improve the recovery of the patient. (本文总结1例颅内动脉瘤行手术治疗患者术前局部备皮方法和围手术期综合护理经验。通过配合快速康复外科处理, 给予患者局部备皮, 同时开展术前护理、体位护理、病情观察、切口护理、管路护理、饮食干预、用药指导、并发症护理以及健康指导等围手术期综合护理措施, 缓解患者不良情绪, 积极防治术后并发症, 促进术后恢复。)

Objective To explore the application effect of enhanced recovery after surgery (EARS) in gynecological laparoscopy. Methods Totally 87 patients who underwent gynecological laparoscopy were retrospectively analyzed. According to the sequence of hospital admissions, 45 patients in control group received routine perioperative care, and another 42 patients in ERAS group were given EARS-based nursing interventions. Primary outcomes included intraoperative indexes (operation time, intraoperative blood loss and decrease in hemoglobin, postoperative indexes (first time of postoperative off-bed activities, anus exhausting time, length of stay, Visual Analogue Scale on pain at 12 hours after surgery) and postoperative complications such as nausea and vomiting, should and neck pain, abdominal distension. Results The operation time in the ERAS group was shorter than that in the control group (P＜0. 05). Patients in the ERAS group had shorter first time of postoperative off-bed activities, anus exhausting time, length of stay, and lower score of VAS pain at 12 hours after surgery compared with those in the control group(P＜0. 01). Incidences of nausea and vomiting, should and neck pain, abdominal distension in the ERAS group were lower than those in the control group (P＜0. 05). Conclusion The EARS-based nursing is potentially effective to improve the postoperative recovery of patients who underwent gynecological laparoscopy, it may reduce the postoperative pain and complications, and shorten the length of stay of patients. (目的 探讨术后加速康复(ERAS)在妇科腹腔镜手术患者中的应用效果。方法 回顾性收集2020年7月—2021年6月医院妇科行腹腔镜手术治疗的患者87例。2020年7月—2020年12月收治的45例患者为对照组, 2021年1月—6月收治的42例患者为ERAS组。对照组实施常规围手术期护理干预, ERAS组实施基于ERAS的护理干预。记录两组患者术中相关指标: 者手术时间、术中出血量和血红蛋白(Hb)减少量, 术后相关指标: 术后首次下床活动时间、肛门排气时间、住院时间、术后12 h疼痛视觉模拟评分(VAS), 以及术后并发症(恶心呕吐、肩颈酸痛、腹胀)发生情况。结果 ERAS组手术时间短于对照组, 差异有统计学意义(P＜0. 05)。 ERAS组术后肛门排气时间、术后首次下床活动时间和住院时间短于对照组, 术后12 h的VAS评分低于对照组, 差异有统计学意义(P＜0. 01)。 ERAS组术后恶心呕吐、肩膀酸痛和腹胀的发生率低于对照组, 差异有统计学意义(P＜0. 05)。结论 给予妇科腹腔镜手术患者ERAS快速康复护理, 能够有效促进患者术后康复时间, 降低术后疼痛和并发症发生风险, 缩短患者住院时间。)

Transcatheter aortic valve replacement (TAVR) is a multidisciplinary collaborative procedure in which close coordination between the doctor and nursing care is the key. This article summarized the experience of perioperative nursing of TAVR, and provided reference for guiding the clinical practice. (经导管主动脉瓣置换术(TAVR)是一种多学科合作的手术, 医生和护理密切的配合是手术成功的关键。本文总结TAVR术前护理准备、术中配合及术后护理的围手术期护理经验, 以期为临床TAVR围术期的护理提供指导和参考。)

Objective To investigate the application effect of the procedural sedation protocol for patients with traumatic brain injury, and summarized related nursing management. Methods Totally 64 patients with traumatic brain injury were randomly divided into the control and study group, with 32 cases in each group. Patient in the control group received conventional therapy for sedation, and those in the study group were given a procedural sedation protocol. The Glasgow Coma Scale (GCS), Sedation-agitation Scale(SAS), dosage of sedatives and length of hospital stays were measured and compared between two groups. Results There was no significant difference in the GCS and SAS scores between two groups before intervention(P＞0. 05). Patients in the study group had a higher score of GCS and lower score of SAS compared with those in the control group after intervention(P＜0. 01). Shorter length of hospital stay and lower dosage of sedatives were observed in the study group than those in the control group(P＜0. 01). Conclusion The procedural sedation protocol is potentially effective to reduce the dosage of sedatives and shorten the length of hospital stay in patients with traumatic brain injury. (目的 探讨神经外科颅脑损伤患者实施程序化镇静的效果, 总结护理流程。方法 选取2019年3月—2020年2月昆明医科大学第二附属医院神经外科收治的颅脑损伤患者64例, 采用随机数表法分为对照组和研究组, 各32例。对照组患者给予常规镇静治疗, 研究组实施程序化镇静治疗。比较两组患者的格拉斯哥昏迷评分(GCS)、Riker镇静躁动评分(SAS)、药物用量和平均住院天数。结果 治疗前两组患者GCS评分和SAS评分比较, 差异无统计学意义(P＞0. 05); 治疗后研究组患者GCS评分高于对照组, SAS评分低于对照组, 两组比较差异有统计学意义(P＜0. 01)。研究组患者的平均住院天数、药物用量低于对照组, 差异有统计学意义(P＜0. 01)。结论 对颅脑损伤患者应用程序化镇静治疗能减少镇静药物用量, 缩短患者住院天数, 进一步确保患者安全。)

Enhancement of perioperative nursing plays an important role in helping the recovery of elderly patients undergoing surgery for lung cancer. This paper summarized the application of enhanced recovery after surgery (ERAS) in perioperative nursing of elderly patients undergoing surgery for lung cancer, and provided reference for quality improvement of clincal practice. (老年肺癌患者的围手术期护理对促进其术后康复有着重要作用。本文主要总结了快速康复外科(ERAS)理念在老年肺癌患者围手术期护理中的应用进展, 以期为临床进一步完善相关护理提供参考。)

Abstract Background Game-based training is increasingly implemented in different nursing fields, as it allows students to learn experientially, with the flexibility to regulate their training based on their personal progresses and abilities. This study aimed to compare the effects of virtual training by the “Playing with Surgical Instruments (PlaSurIn)” game and the lecture on the surgical instruments setup knowledge and performance of Operating Room (OR) novices. Methods This study was conducted on 51 s-semester undergraduate OR technology students taking the course “An Introduction to Surgical Instruments and Equipment.” An additional virtual training session was held via a learning management system using two different methods. The students of the Game Training Group (GTG, n = 27) played individually with the “PlaSurIn” game during a week, while the students of the Lecture Training Group (LTG, n = 24) received the lecture-based training during a week. To measure knowledge, all the students participated in a theoretical test with 10 multiple-choice questions before and immediately after the training. They also participated in an Objective Structured Clinical Examination (OSCE) after the training, and their performance was evaluated by the remained time for setup completion and the scores, errors, and bonuses. Results The mean score of the theoretical test was significantly higher in the GTG than in the LTG after the training (p = 0.040). Additionally, the GTG participants had higher scores (p = 0.016), fewer errors (p = 0.001), and higher bonuses (p = 0.011) compared to the LTG ones. The remained time for setup completion was also significantly longer in the GTG than in the LTG (p

Objective To investigate the application effect of health education based on precede-proceed model in perioperative functional exercise for patients with lung cancer. Methods Totally 104 patients undergoing video-assisted thoracoscopic resection for lung cancer were randomly divided into the observation group and control group, with 52 cases in each group. All patients received routine care and health education, and the precede-proceed model was used in health education about perioperative functional exercise in the observation group. The compliance with functional exercise, level of knowledge about lung cancer and quality of life after surgery were evaluated and compared between two groups. Results The score of Functional Exercise Compliance Assessment Scale in the observation group was higher than that in the control group after intervention (P＜0. 01). Patients in the observation group were more knowledgeable about lung cancer disease compared with those in the control group (Z=-3. 498, P＜0. 01). Patients in the observation group had higher score of Functional Assessment of Cancer Therapy-Lung (FACT-L) and dimensional score of lung cancer specific module after intervention compared with those in the control group (P＜0. 01). Conclusion Health education based on precede-proceed model is effective to improve the functional exercise compliance, disease awareness and postoperative quality of life in patients with lung cancer. (目的 探讨基于格林模式的健康教育在肺癌患者围手术期功能锻炼中应用的效果。方法 选择104例行电视胸腔镜下肺癌根治术的肺癌患者为研究对象, 随机分为观察组和对照组, 各52例。对照组实施常规健康教育, 观察组在常规护理的基础上应用格林模式进行健康教育。比较两组患者功能锻炼依从性评分、出院前肺癌疾病相关知识的掌握程度和术后生活质量。结果 干预后, 观察组患者功能锻炼依从性量表总分高于对照组, 差异有统计学意义(P＜0. 01)。出院前, 观察组患者肺癌疾病相关知识掌握程度优于对照组, 差异有统计学意义(Z=-3. 498, P＜0. 01)。干预后, 观察组FACT-L量表总分和肺癌特异性模块维度评分高于对照组, 差异有统计学意义(P＜0. 01)。结论 基于格林模式的健康教育有助于提高肺癌患者围手术期功能锻炼依从性, 改善患者对自身疾病的认识, 有利于改善术后生活质量。)

Objectives: This study aimed to determine the validity and reliability of an Objective Structured Clinical Examination (OSCE) developed for the summative assessment of the practical credit of the course titled “Principles and Techniques of Circulating and Scrub Persons’ Practice.” Methods: This applied descriptive study was conducted on 63 first-semester undergraduate Operating Room (OR) technology students. Totally, 17 circulating and scrub skills were incorporated in four 7-min OSCE stations. The content validity of the examination was assessed by an expert panel (n = 14). Additionally, its concurrent validity was evaluated by Intra-Class Correlation (ICC) through measuring the correlation between the total score of OSCE and grade point average, grades of the practical and theoretical credits of the course that were obtained by multiple-choice tests, and the total grade of the course (achieved by the grades of the practical and theoretical credits tests). The Inter-Rater Reliability (IRR) was also calculated by the correlation between the scores recorded by two examiners at each OSCE station using ICC. Meanwhile, the internal consistency across stations (item-total correlation) and across items within a station was determined by Cronbach's alpha (α). Results: The OSCE was deemed to fulfill the content validity criteria. The total score of OSCE showed a significant correlation with the concurrent validity criteria (ICC = 0.66–0.85, p

Abstract Objective: to evaluate evidence on risk factors for the development of surgical site infection in bariatric surgery. Method: integrative review. The search for primary studies was performed in four databases. The sample consisted of 11 surveys. The methodological quality of the included studies was assessed using tools proposed by the Joanna Briggs Institute. Data analysis and synthesis were performed in a descriptive manner. Results: surgical site infection rates ranged from 0.4% to 7.6%, considering the results of primary studies, in which patients underwent laparoscopic surgery. In surveys of participants undergoing surgical procedures with different approaches (open, laparoscopic or robotic), infection rates ranged from 0.9% to 12%. Regarding the risk factors for the development of this type of infection, antibiotic prophylaxis, female sex, high Body Mass Index and perioperative hyperglycemia are highlighted. Conclusion: conducting the integrative review generated a body of evidence that reinforces the importance of implementing effective measures for the prevention and control of surgical site infection, by health professionals, after bariatric surgery, promoting improved care and patient safety in the perioperative period.

Abstract Objective: to explore and describe how perioperative nurses assess and interpret the child’s behavior before entering the operating room, identifying the strategies they use to reduce anxiety and the proposals for improvements. Method: descriptive qualitative study using semi-structured interviews and participant observation of daily routines. Thematic analysis of data. This study follows the recommended criteria for publication of articles of the qualitative methodology Consolidated Criteria for Reporting Qualitative Research. Results: four topics emerged from the data: a) assessment of anxiety or close communication with the child and their family; b) evaluating what was observed; c) managing anxiety and d) improving the assessment or proposals for improvements in daily practice. Conclusion: nurses assess anxiety in their daily practice through observation using their clinical judgment. The nurse’s experience is decisive for the appropriate assessment of the preoperative anxiety in child. Insufficient time between waiting and entering the operating room, lack of information from child and their parents about the surgical procedure, and parental anxiety make it difficult to assess and properly manage anxiety.

BackgroundBlood glucose disorder is a common perioperative problem in patients with pancreatectomy. However, current perioperative blood glucose management for pancreatic resection patients in China is mostly based on experience and lack of evidence-based basis.ObjectiveTo summarize the best evidence for perioperative blood glucose management in patients undergoing pancreatectomy.MethodsA systematic literature search of BMJ Best Practice, Up to Date, Guideline International Network, International Diabetes Federation, World Health Organization, National Guideline Clearinghouse, American Diabetes Association, the National Institute for Health and Care Excellence, New Zealand Guidelines Group, Canadian Diabetes Association, Australian Diabetes Society, Scottish Intercollegiate Guidelines Network, PubMed, Web of Science, EMBase, CINAHL Database, Cochrane Library, the Joanna Briggs Institute Evidence-based Health Care Center, Medlive.cn, Wanfang Data, CNKI, and Chinese Biomedical Database was conducted to screen the literature on perioperative blood glucose management in patients with pancreatectomy published from inception to December 2020. The AGREE Ⅱ scale updated in 2009 by the International AGREE Collaboration Organization was used to assess the quality of guidelines. The quality assessment of the expert consensus used the 2017 version of the expert consensus evaluation standard of the Australian JBI Evidence-based Health Care Center. The Jadad scale was used to assess the quality of randomized controlled trials (RCTs) .ResultsA total of 6 637 studies were retrieved, and 13 of them were finally included, of which 7 were clinical practice guidelines, 4 were expert consensus, and 2 were RCTs. The results of quality assessment showed that 3 of the 7 clinical practice guidelines were rated grade A, and the remaining 4 were rated grade B. In assessing the quality of the 4 expert consensuses, the answers of raters for all items were "yes" , except that their answers for the item "Is there a reasonable explanation for the point of view inconsistent with other literature?" were "unclear" . Both the two RCTs were rated high. A total of 62 pieces of best evidence were collected, mainly related to perioperative organization and management, admission evaluation and treatment, blood glucose control goals, blood glucose monitoring, preoperative, intraoperative and postoperative blood glucose management strategies, management of emergency conditions, and discharge guidance.ConclusionClinical medical workers can develop individualized and holistic perioperative blood glucose management plans for patients with pancreatectomy, based on the above-mentioned 9 aspects of best evidence.

This paper summarized the key issues of nursing in the Mohs micrographic surgery. It is required to enhance the preoperative preparation and postoperative observation on surgical incisions. Guidance of taking observation of disease recurrence and regular check after surgery is provided. In consideration of surgical site, depth of tumor invasion, proper suture closure method and targeted nursing measures are suggest and proved to reduce the trauma caused by surgery. (本文就Mohs显微描记术的围手术期的护理要点进行总结。术前完善各项准备工作, 术后做好直接缝合、皮瓣缝合、植皮患者取皮区直接缝合切口以及植皮区皮片移植区、二期愈合创面的切口观察与护理, 指导患者观察疾病有无复发, 告知患者定期复查。根据手术的位置、面积、肿瘤侵犯深度不同, 采取针对性的缝合方式和护理措施, 降低手术对患者的损伤。)

Objective: explore thirst perception of a burnt surgical patient and its management in the preoperative and immediate postoperative period. Case report: study with a qualitative and exploratory approach, named as case study. Inclusion criteria were: inpatient at burnt treatment unit, undergone surgical procedure or balneotherapy, experienced thirst in the preoperative or postoperative period and received thirst management. For data collection, semi-structured interviews were performed, recorded and transcribed. Female patient, 32 years old, admitted with second degree burns in extension of thorax, upper limbs and neck due to attempted self-extermination with alcohol. Underwent six procedures and was hospitalized for 15 days until the data collection. Experienced thirst discomfort during preoperative and postoperative fasting, which was considered intense and very stressful during his hospitalization. Conclusion: since the identification of thirst discomfort, the ice popsicle was used as a strategy, which made difference in her treatment. The thirst management model is pioneer in care of burnt patients and has benefits to alleviate thirst.

Abstract Aim The aim of this study was to investigate operating theatre nurses (OTNs) with managerial responsibility, and their self‐rated clinical competence and need for competence development in perioperative nursing. Design A cross‐sectional study was applied using a modified version of Professional Nurse Self‐Assessment Scale of Clinical Core Competence I. Method Data were collected from 303 OTNs in Sweden, 80 of whom indicated that they had managerial responsibility. Statistics analysis was used to identify the relationships between background variables to compare OTNs with and without managerial responsibility and their need for competence development. Results OTNs with an academic degree and managerial responsibility self‐rated their clinical competence higher compared with OTNs without an academic degree. It also turned out that OTNs with RN education and 1‐year advanced nursing in theatre care, and master's 60 credits had a lower need for competence development in cooperation and consultation, professional development and critical thinking.

This paper summarized the perioperative nursing management of a patient with stent-graft infection and aortoesophageal fistula after thoracic endovascular aortic repair (TEVAR). Nurses had enhanced the prevention of stent-graft infection and evaluated the influence of stent implantation on trachea and esophagus before surgery. Key issues of postoperative nursing included maintaining effective circulating volume, esophageal repair management, nutrition support, functional rehabilitation exercise, psycho-social support. (本文总结1例主动脉腔内修复术后支架感染并发主动脉食管瘘患者的围术期护理经验和体会。护理要点包括: 术前加强移植物感染的护理, 评估支架对周围气管食管的影响; 术后维持有效循环, 完善食管修补术后护理、营养支持、功能锻炼康复护理、心理社会支持等。)

Background: Nurse-surgeons have been performing surgeries for decades. Yet, their impact on perioperative clinical outcomes has not been explored in detail. Objective: To investigate the impact of nurse-surgeons on patient-centred outcomes. Design: Systematic review Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram and checklist for systematic reviews were used as the screening and reporting guideline. CINAHL, Cochrane Library, MEDLINE, and PubMed databases were searched for articles that fit the review's eligibility criteria. A combination of Medical Subject Headings, keywords and filters for each database were used. Following screening and full text review, the Mixed Methods Appraisal Tool was used for quality assessment and the Grading of Recommendations, Assessment, Development and Evaluations framework for certainty and confidence assessment. Narrative synthesis was used to report the findings due to the design heterogeneity of the included studies. Results: Forty-eight (n = 48) patient-centred outcomes were identified from 25 included studies. These outcomes were grouped into four categories: patient satisfaction and experience; waiting list; perioperative complications; and quality of surgical care. Patient satisfaction and experience was rated high to very high in 16 studies; none reported patient dissatisfaction. Waiting lists improved in eight studies. Perioperative complications were none to very low in nine studies. Mortality rates in the nurse-surgeon group were better than the physician group in three studies. The quality of care in the performance of surgeries by nurse-surgeons was either similar or better than physicians in ten studies. Conclusions: Nurse-surgeons performed safe, satisfactory, and high-quality surgeries with minimal perioperative complications similar to physicians. The use of nurse-surgeons has significantly reduced waiting lists regardless of surgical speciality. Policies around nurse-surgeon practice needs to be developed at national and international levels to streamline the delivery of much needed surgical services amidst the coronavirus pandemic in the areas of cancer diagnostic surgeries, emergency surgeries, minor surgeries, and remote and rural health.

Resumen: Las lesiones por presión (LPP), antes denominadas úlceras por presión (UPP), son uno de los eventos adversos relacionados a la calidad en la atención sanitaria. Los pacientes quirúrgicos poseen factores de riesgo específicos que los hacen especialmente susceptibles al desarrollo de LPP. Actualmente existe creciente literatura acerca de su prevalencia e incidencia, siendo escasa a nivel local, no lográndose identificar datos epidemiológicos en pacientes perioperatorios en Chile. Pese a esto, la información disponible sustenta la implementación de medidas preventivas, considerando a los pacientes sometidos a cirugías traumatológicas prolongadas como de especial riesgo. El objetivo de esta revisión narrativa es explorar, describir y discutir aquellos factores de riesgo y medidas preventivas en pacientes perioperatorios en base a la literatura actual. Se revisaron las bases de datos Elsevier, PubMed, Lilacs y Google Scholar, en búsqueda de artículos en español, inglés y portugués publicados en los últimos 10 años, encontrándose 24 relacionados. Sin duda, se requieren mayores estudios que permitan abordar este tema, vislumbrándose entonces un nuevo desafío para enfermería; quedando además claro que la evaluación del riesgo y la adopción de medidas específicas para este tipo de pacientes son parte de la responsabilidad de la enfermería perioperatoria, pero compartida con el equipo quirúrgico. Summary: Pressure injuries (PI), formerly known as pressure ulcers (PU), are one of the adverse events related to quality in health care. Surgical patients have specific risk factors that make them especially susceptible to the development of PI. Currently there is a growing literature about its prevalence and incidence, which is scarce at the local level, and epidemiological data in perioperative patients in Chile is not readily available. Despite this, the available information supports the implementation of preventive measures, considering patients subjected to prolonged trauma surgeries as of special risk. The objective of this narrative review is to explore, describe and discuss those risk factors and preventive measures in perioperative patients based on the current literature. The Elsevier, PubMed, Lilacs and Google Scholar databases were reviewed in search of articles in Spanish, English and Portuguese published in the last 10 years, finding 24 related documents. Undoubtedly, further studies are required to address this issue, thus envisioning a new challenge for nursing; it is also clear that risk assessment and the adoption of specific measures for this type of patient are part of the responsibility of perioperative nursing, as well as the surgical team.

Objective To explore the effect of perioperative nursing interventions based on fast-track surgery (FTS) for patients undergoing neuroendoscope-assisted microvascular decompression (EMVD) for trigeminal neuralgia. Methods Totally 100 patients undergoing EMVD for trigeminal neuralgia were enrolled and randomly divided into control group and observation group, with 50 cases in each group. The control group received routine care during the operative period, and the observation group received nursing interventions based on FTS theory. The anxiety status was evaluated by Self-rating Anxiety Scale (SAS), and incidence of postoperative complications such as nausea and vomiting was compared between two groups. Results The score of SAS in the observation group was lower than that in the control group before and after surgery (P＜0. 05). The incidences of nausea and vomiting, urinary tract infection in the observation group was lower than those in the control group (P＜0. 05). Conclusion Nursing interventions based on FTS concept can effectively relieve the anxiety status of patients undergoing EMVD for trigeminal neuralgia, and reduce the risk of postoperative complications such as nausea and vomiting. (目的 探讨快速康复外科(FTS)理念在完全神经内镜下微血管减压术患者围术期护理中的应用效果。方法 100例接受完全神经内镜下三叉神经微血管减压术治疗的患者随机分成对照组和观察组, 各50例。围手术期间, 对照组接受常规护理, 观察组接受基于FTS理念的护理干预。评估2组患者焦虑状况, 统计恶心、呕吐等并发症发生情况。结果 观察组术前和术后SAS评分均低于对照组, 差异有统计学意义(P＜0. 05)。观察组恶心呕吐、尿路感染发生率低于对照组, 差异有统计学意义(P＜0. 05)。结论 基于FTS理念的护理干预可有效缓解完全神经内镜下微血管减压术患者的焦虑情绪, 减少术后并发症发生风险。)