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ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession/and or Patient Care Reporting Method Patient or Public Contribution The study aimed to examine factors associated with the perceived feeling of safety and postoperative recovery in patients who have undergone orthopaedic day surgery under regional anaesthesia.The design was quantitative, descriptive, and cross‐sectional. The study participants comprised a consecutive sample (n = 209) of patients who underwent orthopaedic day surgery under regional anaesthesia.A questionnaire was sent to the home addresses of the study population approximately 3 weeks postoperatively. The questionnaire included the Feeling Safe During Surgery Scale (FSS), the Swedish version of the post‐discharge surgical recovery scale (S‐PSR), and questions concerning background variables. Multivariate regression models were used to examine the association of different variables with both feeling safe and postoperative recovery.The only factor associated with the feeling of safety was preoperative anxiety; higher levels of preoperative anxiety were associated with lower levels of perceived safety during surgery. The factors associated with postoperative recovery were the recovery process itself and the patient's feeling of safety. Higher levels of postoperative anxiety were associated with a lower level of postoperative recovery. Higher levels of perceived safety during surgery were associated with higher postoperative recovery.The perceived feeling of safety in the perioperative period could not be explained by factors such as age, gender, or level of education. Based on the results of this study, postoperative recovery was associated with the perceived feeling of safety in the perioperative period. Anxiety in the perioperative period was associated with patients' perceived feeling of safety and their postoperative recovery. Thus, this study's results emphasise the importance of ensuring that people undergoing surgery feel safe to promote their recovery. Based on previous research, the nurse–patient relationship seems to be an important part of making patients feel safe, which ultimately affects their recovery.This study examines the association between perceived feeling of safety in the perioperative period and patients' postoperative recovery after undergoing orthopaedic day surgery under regional anaesthesia. Previous research has shown that the nurse–patient relationship and patients' possibilities to participate in their care are important for them to feel safe. This study further emphasises the importance of fostering relationships in the perioperative period and making patients an active part in decision‐making, as it may positively impact their recovery. Creating a feeling of safety for the patient should be prioritised, as it benefits their perioperative experience and postoperative recovery.This research is reported in accordance with the STROBE guidelines.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Enhanced recovery after surgery (ERAS) protocols are proposed to enhance perioperative care, but their impact on various surgical outcomes requires further insight. Objective: This extensive meta-analysis aimed to systematically estimate the effectiveness of ERAS in reducing postoperative complications and improving recovery metrics. Materials and Methods: We meticulously searched multiple databases and rigorously screened studies, ultimately including 16 high-quality research articles in our meta-analysis. We carefully assessed heterogeneity using the Cochran Q test and I2 index. Results were visualized using forest plots, displaying effect sizes and 95% confidence intervals (CIs). Results: The current meta-analysis reveals compelling evidence of ERAS protocols' impact on postoperative effects. Lung infection rates were significantly reduced, with an odds ratio (OR) of 0.4393 (95% CI: 0.2674; 0.7216, p = 0.0012), highlighting the protocols' effectiveness. Although the reduction in surgical site infections (SSIs) was not significant, with an OR of 0.8003 (95% CI: 0.3908; 1.6389, p = 0.5425), the data suggests a trend toward benefit. Urinary tract infections (UTI) also showed a promising decrease, with an OR of 0.4754 (95% CI: 0.2028; 1.1143, p = 0.0871), revealing ERAS protocols may mitigate UTI risks. No significant effects were observed on postoperative anastomotic leakage or ileus, with ORs indicating neutrality. The incidence of readmission was similarly unaffected, with an OR of 1.4018 (95% CI: 0.6860; 2.8647, p = 0.3543). These outcomes underscore the selective efficacy of ERAS protocols, advocating for their strategic implementation to optimize surgical recovery. Conclusions: This meta-analysis offers compelling evidence supporting the implementation of ERAS in mitigating specific post-surgical conditions. It underscores the potential of ERAS to enhance recovery experiences and improve healthcare efficiency. Further targeted research is warranted to fully understand the impact of ERAS on SSI, anastomotic leakage, ileus, and readmissions and to optimize its benefits across diverse surgical populations. [ABSTRACT FROM AUTHOR]

Background: Quality nursing care and ethical responses to patient pain and suffering are very important in the preoperative period. However, few studies have addressed these variables. Objective: This study aimed to examine the relationship between compassionate care and preoperative anxiety from the perspective of hospitalized patients. Methods: The current study was a cross-sectional descriptive one. The participants were selected using convenience sampling. The data were collected using a demographic questionnaire, Burnell Compassionate Care Tool, and Amsterdam Preoperative Anxiety and Information Scale (APAIS). The collected data were analyzed with SPSS software (version 22) through descriptive and inferential statistics at a significance level of 0.05 (p <.05). Participants and setting: This study was conducted on 704 candidates for surgery in the internal and surgical wards of a large teaching hospital located in the south of Iran from December 2022 to March 2023. Ethical considerations: The protocol for this study was reviewed and approved by the University Ethics Committee. Findings: The patients' average age was 36.61 ± 13.07. The average preoperative anxiety and need for information scores were 13.80 ± 2.66 and 7.44 ± 1.47, respectively. The average score of importance was 3.03 ± 0.19, and the average score of the extent of compassionate care provision was 1.22 ± 0.15. There was a significant relationship between preoperative anxiety with importance and the extent of compassionate care provision (r = 0.68, p <.001), r = −0.72, p <.001, respectively). A comparison of the demographic characteristics, need for information, importance, and provision of compassionate care showed that the extent of compassionate care provision had the greatest contribution in explaining preoperative anxiety (β = 0.50; p <.001). Conclusion: Even though patients' preoperative anxiety was high and providing compassionate care in the preoperative period had a great role in relieving their anxiety, many participants appear to have received little compassionate care. To this end, nursing managers should pay attention to the quality of compassionate care in the preoperative stage. Besides, healthcare staff should receive the necessary training in compassionate nursing care. [ABSTRACT FROM AUTHOR]

Purpose: Maintaining normothermia during the perioperative period is crucial for preventing complications, such as surgical site infections, prolonged hospital stays, and adverse cardiovascular events. This study aimed to elucidate methods of perioperative temperature management by integrating Western and traditional Chinese medicine (TCM) approaches. By combining advanced techniques of Western medicine with holistic and preventative practices of TCM, we aimed to provide a comprehensive strategy for effective perioperative thermal regulation. Methods: And a comprehensive literature review was conducted to analyze the causes of perioperative hypothermia and methods of perioperative temperature management from both Western and traditional Chinese medicine (TCM) perspectives. Special emphasis was placed on evaluating the underlying factors contributing to perioperative hypothermia, as well as the effectiveness, selection criteria, indications, contraindications, adverse reactions, and potential complications associated with various temperature management techniques. Results: Effective prevention and management strategies include preoperative risk assessment, physical warming measures, environmental temperature control, pharmacological interventions, perioperative temperature monitoring, comprehensive warming protocols, and postoperative warming and monitoring. Integrating traditional Chinese medicine provides additional methods to enhance overall effectiveness and patient outcomes. By combining these approaches, healthcare providers can significantly reduce the incidence of inadvertent perioperative hypothermia (IPH) and its associated complications, improving patient safety and recovery. Conclusion: For IPH, a complex and challenging medical condition, both traditional Chinese medicine and Western medicine have established their own theoretical bases and developed corresponding prevention and treatment methods. However, it is important to note that although each of these methods has unique value and potential, they also have specific indications and unavoidable limitations. Therefore, by integrating and combining the complementary strengths and resources of traditional Chinese medicine and Western medicine, we can achieve a more comprehensive and effective prevention of IPH, ultimately improving the health and well-being of those affected. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) cautions against unnecessary prolongation of postoperative antibiotics to prevent surgical site infections (SSI), however this practice is still common in many countries. This study aims to describe drivers of prolonged postoperative antibiotic prescribing and clinicians' perspectives on antibiotics resistance and stewardship in Ethiopia. Methods: We conducted semi-structured interviews of 16 surgeons and nine surgical ward nurses at three academic referral hospitals in Addis Ababa. Audio recordings were transcribed verbatim and coded. Codes were inductively and iteratively derived between two researchers, tested for inter-rater reliability (IRR), and the codebook was consistently applied to all transcripts. Thematic analysis was performed to understand drivers of prolonged prophylactic antibiotic use in surgical patients. Results: Interviews revealed factors contributing to postoperative prophylactic antibiotics overprescribing, including inadequate infection prevention and control (IPC) practices, wide variability in local prescribing practices, and distrust in the applicability of WHO guidelines. Antimicrobial resistance was also identified as a major concern by staff. Barriers to improving stewardship included a lack of multidisciplinary teamwork to inform prescribing decisions, while solutions included constructing appropriate context-specific guidelines and improving evidence-based practices through input from local stakeholders, including surgeons, clinical pharmacists, and nurses. Conclusions: Study participants perceived that existing evidence and guidelines did not apply in their settings due to high rates of surgical site infections and gaps in perioperative IPC practices (e.g., availability of water for handwashing, sterility breaches). These gaps were a key contributor to prophylactic antibiotic overprescribing, reinforcing the need to strengthen upstream and perioperative surgical antisepsis processes. The findings of this study underscore the importance of engaging multidisciplinary teams in strengthening antimicrobial stewardship efforts, aligning processes to achieve compliance with best practices, and the need for rigorous, contextually appropriate studies from these settings to inform policy. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusions Impact Patient and Public Contribution The aim of this secondary analysis was to explore newly graduated perioperative nurses' experiences of transitioning to clinical practice to gain more in‐depth knowledge of this phenomenon.A qualitative explorative study of secondary data was used, and this study was reported following the Consolidated Criteria for Reporting Qualitative Research checklist.A secondary analysis of data collected between March 2019 and November 2020 via 16 semi‐structured interviews with newly graduated perioperative nurses. The interviews were conducted 3 to 5 months after they graduated from five different educational institutions in Norway and entered clinical practice as perioperative nurses. A three‐step phenomenological hermeneutical analysis inspired by Ricoeur's theory was applied: naïve reading, structural analysis and comprehensive understanding.We identified three themes: expectations of competence, facilitation for newly graduated perioperative nurses and the transition from being a student to a newly qualified perioperative nurse.Newly graduated perioperative nurses emphasised the critical role of supportive facilitation, manageable expectations and support from leaders and colleagues, which seemed essential for a successful transition to clinical practice.This study addresses knowledge essential for universities, universities colleges and clinical practice, specifically healthcare organisations, to understand the transition process for newly graduated perioperative nurses. This can support the establishment of improved practices to ensure patient safety via more specific education and mentoring and more accurate expectations of competence.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: The operating room is a high-risk environment where proper patient positioning is crucial for minimizing injury and ensuring optimal access to surgical sites. This process requires effective collaboration among surgical team members, particularly operating room nurses who play a vital role in patient safety. Despite advancements in technology, challenges such as pressure injuries persist, with a significant incidence rate. Video-based training (VBT) emerges as a promising educational tool, enhancing knowledge retention and fostering a learner-centered approach. This study aims to evaluate the impact of VBT on adherence to surgical positioning standards, highlighting its potential to improve safety protocols in the operating room. Methods: In this clinical trial, 62 qualified operating room nurses (50 women, 12 men, average age: 28.90 ± 3.75 years) were randomly divided into control and intervention group (n = 31 in each group). The control group only received positioning recommendations, but in the intervention group, in addition to the recommendations, video-based surgical positioning training was performed for 1 month, at least 3 times a week. The performance of nurses in both groups was evaluated through a researcher-made checklist at baseline and post-intervention. Results: Based on findings, there was no significant difference between the two groups in compliance with surgical positioning standards at baseline (p = 0.07). However, after the intervention, compliance scores significantly improved in the VBT group compared to the control group (p < 0.001). The VBT group showed a mean improvement of 62.12 points, while the control group improved by 10.77 points (p < 0.001). Conclusions: This preliminary study demonstrated a notable improvement in compliance with surgical positioning standards among operating room nurses following VBT intervention. Despite the promising results, the small sample size and preliminary nature of the research necessitate further studies to confirm these findings and assess long-term outcomes. These initial insights highlight the potential of innovative training methods in enhancing surgical practices. [ABSTRACT FROM AUTHOR]

Introduction: Estimated blood loss (EBL) is an important part of the perioperative process. This project aims to determine the accuracy of perioperative team members to estimate blood volume on drapes and the operating room floor. Methods: Aliquots of unused human blood were used to create surgical scenarios, and standardized pictures and videos were taken. Physicians, residents, nurses, medical students, and surgical technicians were surveyed and asked to estimate the blood volume for each series. Accuracy and consistency of responses was analyzed. Results: One hundred and forty five responses were recorded: 57 attending physicians, 36 residents, 27 registered nurses, 17 medical students, and seven circulating surgical techs. Median percent error (PE) for all cases was 211.11%, demonstrating a global overestimation of blood volume. PE for the 150 mL images was statistically significantly lower than that of the 50 and 100 mL images. Circulating Surgical Technicians were the most accurate group, with a median PE of 125%, followed closely by Medical Students (PE = 158.33%). The most accurate specialty was Orthopedics (PE = 168.06%). The least accurate groups were Attending Physicians (PE = 286.11%) and General surgery (GSGY) (PE = 327.78%). The most accurate orthopedic surgery and GSGY subspecialties were Hand (PE = 237.64%) and Vascular (PE = 108.33%), respectively. Statistical analyses showed no significant differences by clinical role, surgical specialty, or subspecialty. Conclusion: This study demonstrates a global overestimation of blood volume when using the visual method, with improved accuracy at higher volumes. Our findings highlight the limitations of visual estimation methods for EBL. [ABSTRACT FROM AUTHOR]

Background and Objectives: By optimizing erythropoiesis, patient blood management (PBM) programmes can reduce transfusions, lower mortality and provide cost‐effective care. While definitions of anaemia have historically varied by sex, for the purposes of PBM, anaemia is defined as a haemoglobin <130 g/L. Our objective was to describe whether perioperative anaemia and transfusion rates in the PBM setting vary by sex. Materials and Methods: We conducted a retrospective study of the Ontario Nurse Transfusion Coordinators Program (ONTraC) database from 2018 to 2022. ONTraC collects data from 25 Ontario hospitals which together account for >70% of Ontario's provincial blood use (~400,000 units per year). We collected data on patients undergoing elective isolated coronary artery bypass graft surgery (CABG), open heart valve replacement, CABG plus valve replacement, single‐knee arthroplasty and single‐hip arthroplasty. Results: From 2018 to 2022, 17,700 patients were included in the ONTraC program; 47% were females (N = 8376). Across almost all years and procedures, females were found to have a significantly lower pre‐operative, nadir and discharge haemoglobin as compared with males, irrespective of PBM interventions. Transfusion rates were significantly higher for females; this was most pronounced in cardiac surgery. Conclusion: Females experienced more perioperative anaemia and higher transfusion rates. Historic sex‐specific definitions of anaemia may contribute to a greater tolerance of anaemia in females. Prioritizing females for multimodal PBM and consistently achieving a pre‐operative haemoglobin >130 g/L may reduce the amount of red blood cell (RBC) transfusions that female patients receive. [ABSTRACT FROM AUTHOR]

The Competencies and Recommendations for Educating undergraduate Nursing Students (CARES) was originally designed for nursing students' palliative and end-of-life care education. The competencies were later revised to align with the 2021 American Association of Colleges of Nursing Essentials core competencies for baccalaureate nursing education. This project aimed to (1) review the courses in an accelerated baccalaureate nursing program for alignment with CARES, (2) determine any gaps, and (3) make program recommendations. The CARES competencies and Essentials were mapped according to the nursing program's 12 core curriculum courses and evaluated. Three CARES competencies were not met, and 12 were partially met. Areas of improvement were identified across the curriculum. Results of the mapping included palliative concepts needing earlier program introduction, reflective journaling was recommended for clinical practice courses, and incorporation of palliative care simulations was proposed to bridge the gaps. [ABSTRACT FROM AUTHOR]

Previable and periviable preterm prelabor rupture of membranes are challenging obstetrical complications to manage given the substantial risk of maternal morbidity and mortality, with no guarantee of fetal benefit. The following are the Society for Maternal-Fetal Medicine recommendations for the management of previable and periviable preterm prelabor rupture of membranes before the period when a trial of neonatal resuscitation and intensive care would be considered appropriate by the healthcare team and desired by the patient: (1) we recommend that pregnant patients with previable and periviable preterm prelabor rupture of membranes receive individualized counseling about the maternal and fetal risks and benefits of both abortion care and expectant management to guide an informed decision; all patients with previable and periviable preterm prelabor rupture of membranes should be offered abortion care, and expectant management can also be offered in the absence of contraindications (GRADE 1C); (2) we recommend antibiotics for pregnant individuals who choose expectant management after preterm prelabor rupture of membranes at ≥24 0/7 weeks of gestation (GRADE 1B); (3) antibiotics can be considered after preterm prelabor rupture of membranes at 20 0/7 to 23 6/7 weeks of gestation (GRADE 2C); (4) administration of antenatal corticosteroids and magnesium sulfate is not recommended until the time when a trial of neonatal resuscitation and intensive care would be considered appropriate by the healthcare team and desired by the patient (GRADE 1B); (5) serial amnioinfusions and amniopatch are considered investigational and should be used only in a clinical trial setting; they are not recommended for routine care of previable and periviable preterm prelabor rupture of membranes (GRADE 1B); (6) cerclage management after previable or periviable preterm prelabor rupture of membranes is similar to cerclage management after preterm prelabor rupture of membranes at later gestational ages; it is reasonable to either remove the cerclage or leave it in situ after discussing the risks and benefits and incorporating shared decision-making (GRADE 2C); and (7) in subsequent pregnancies after a history of previable or periviable preterm prelabor rupture of membranes, we recommend following guidelines for management of pregnant persons with a previous spontaneous preterm birth (GRADE 1C). [ABSTRACT FROM AUTHOR]

Background/Objectives: In perioperative nursing practice, nursing students can engage in direct, in-person clinical experiences in perioperative environments; however, they face limitations due to infection and contamination risks. This study aimed to develop and evaluate educational content for perioperative clinical practice for nursing students using virtual reality (VR) and haptic technology. Methods: The program, based on the Unity Engine, was created through programming and followed the system development lifecycle (SDLC) phases of analysis, design, implementation, and evaluation. This program allows nursing students to engage in perioperative practice using VR and haptic technology, overcoming previous environmental limitations and enhancing practical and immersive experiences through multi-sensory stimuli. Results: Expert evaluations indicated that the developed content was deemed suitable for educational use. Additionally, a usability assessment with 29 nursing students revealed high levels of presence, usability, and satisfaction among the participants. Conclusions: This program can serve as a foundation for future research on VR-based perioperative nursing education. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions Implications for nursing practice The objectives of this study were to refine and validate the NANDA‐I nursing diagnosis risk for perioperative hypothermia (RPH) (00254).A quantitative, descriptive study was carried out according to the adapted diagnostic content validation model by Fehring. Data from a previously conducted literature study were triangulated with expert validation data to examine the nursing diagnosis RPH as well as potentially suggested new factors resulted from the literature review. In addition, the Wisdom of Crowds model was also considered. A nonprobability sampling technique, including purposive and snowball sampling methods, was used to recruit a panel of nurse experts. An anonymous and standardized questionnaire was developed in three languages for data collection. For validation, descriptive statistics, weighted ratios, and a one‐sample T‐test were used.Ninety‐two nurse experts from seven countries and three continents participated in this study. Fifty‐eight nurse experts (63%) were female, and 33 (36%) were male, with a mean age of 42.26 years and 19.22 years of working experience. The diagnosis label, definition, 4 out of 5 risk factors (RF), 6 out of 14 at‐risk populations (ARPs), and 5 out of 9 associated conditions (ACs) were classified as major. One RF, eight ARP, and four ACs were considered minor. In addition, the experts validated 1 RF, 5 ARP, and 12 ACs from a previous literature study at least minor.The nursing diagnosis RPH (00254) could be confirmed by specialized experts. No RF, ARP, or AC of the current nursing diagnosis needed to be rejected, and the added diagnostic indicators increased the robustness of the diagnosis.A precise concept of the nursing diagnosis RPH improves nurses' clinical reasoning and strengthens an individualized, evidence‐based care plan. [ABSTRACT FROM AUTHOR]

Objective To explore the application effect of operating room nursing based on quality control group management mode in laparoscopic surgery for pediatric hernia. Methods A total of 100 children with hernia admitted to the hospital from January 2021 to December 2022 were selected and randomly divided into the observation group and the control group using a random number table method, with 50 cases in each group. The children in the observation group were given operating room nursing based on quality control group management mode, while the children in the control group were given routine nursing. Both groups continued nursing until the children were discharged from hospital. The perioperative index level, adverse events, quality of life and family satisfaction were compared between the two groups. Results The operation time, hospitalization time [ (17. 24±4. 96) min, (3. 17±0. 41) d] in the observation group were shorter than those in the control group [ (27. 21±5. 33)min, (4. 68±0. 45) d], and the blood loss during the operation [ (5. 24±1. 23) mL] was less than that of the control group [ (9. 33±2. 05) mL], and the differences were statistically significant (P＜0. 05). The incidence of adverse events in the observation group (4. 00%) was lower than that in the control group (16. 00%), and the difference was statistically significant (P＜0. 05). Compared with the control group after nursing, the children in the observation group scored higher in all dimensions of quality of life, with statistical significance (P＜0. 05). The family satisfaction in the observation group (96. 00%) was higher than that in the control group (84. 00%), and the difference was statistically significant (P＜0. 05). Conclusion The operating room nursing based on the quality control group management mode has a good application effect in laparoscopic surgery for pediatric hernia, which is beneficial for shortening the surgical time and hospital stay, reducing intraoperative bleeding, reducing the risk of adverse events, improving quality of life, and have high family satisfaction. [ABSTRACT FROM AUTHOR]

The advent of fluoroscopically guided cardiology procedures has greatly improved patient outcomes but has also increased occupational radiation exposure for healthcare professionals, leading to adverse health effects such as radiation-induced cataracts, alopecia, and cancer. This emphasizes the need for effective radiation safety training. Traditional training methods, often based on passive learning, fail to simulate the dynamic catheterization laboratory environment adequately. Virtual Reality (VR) offers a promising alternative by providing immersive, interactive experiences that mimic real-world scenarios without the risks of actual radiation exposure. Our study aims to assess the effectiveness of VR-based radiation safety training compared to traditional methods. We conducted a prospective cohort study involving 48 healthcare professionals in a catheterization lab setting. Participants underwent a 1-hour self-directed VR training session using Virtual Medical Coaching's RadSafe VR software, which simulates real-world clinical scenarios. Pre- and post-intervention radiation dose levels were measured using personal dosimeters at the eye, chest, and pelvis. Knowledge and skills were assessed through tests, and feedback was gathered through surveys and interviews. Statistical analysis revealed significant reductions in radiation exposure across all professional groups after VR training. For cardiologists, the eye dose dropped by 21.88% (from 2.88 mSv to 2.25 mSv), the chest dose decreased by 21.65% (from 4.11 mSv to 3.22 mSv), and the pelvis dose went down by 21.84% (from 2.06 mSv to 1.61 mSv). Perioperative nurses experienced similar reductions, with eye doses decreasing by 14.74% (from 1.56 mSv to 1.33 mSv), chest doses by 26.92% (from 2.6 mSv to 1.9 mSv), and pelvis doses by 26.92% (from 1.3 mSv to 0.95 mSv). Radiographers saw their eye doses reduced by 18.95% (from 0.95 mSv to 0.77 mSv), chest doses by 42.11% (from 1.9 mSv to 1.1 mSv), and pelvis doses by 27.63% (from 0.76 mSv to 0.55 mSv).Participants reported enhanced engagement, improved understanding of radiation safety, and a preference for VR over traditional methods. A cost analysis also demonstrated the economic advantages of VR training, with significant savings in staff time and rental costs compared to traditional methods. Our findings suggest that VR is a highly effective and cost-efficient training tool for radiation safety in healthcare, offering significant benefits over traditional training approaches. [ABSTRACT FROM AUTHOR]

Background: Globally, there is increasingly high prevalence of mental disorders across all age groups and social classes with more being projected by 2030, but without commensurate resources for mental health care delivery especially in developing countries. Purpose: This study examined the impacts of clinical psychiatric posting on career choice in psychiatry among nursing students in Ebonyi state, Nigeria. Methods: A prospective cohort research design was used and data were collected using attitude towards psychiatry (ATP), mental illness clinician attitude scale (MICA-4) and researcher developed questionnaires on career choice in pre and post clinical posting approach. This study was conducted between November, 2023 to May 2024. A sample size of 400 students (with data collected before posting and after posting) were involved in the study. Data were coded, cleaned and analyzed using SPSS version 26. McNemar Test was used to determine effects of clinical posting on career choices in psychiatry. Simple and multiple logistic regressions were used to analyze data on determinants of career choices in psychiatry. The hypotheses (Null and alternative hypotheses) were tested at p-value < 0.05. Results: Psychiatric and mental health nursing was one of the least preferred specialty, 21(6%) respondents showed interest before clinical posting and 25(7.1%) after the posting. Commonly preferred specialty was pediatric nursing (20.5%), community health nursing (17.1%) and midwifery (17.7%). McNemer test showed no statistically significant differences in choice of psychiatry before and after clinical posting. Key determinants of career choices were interest in psychiatry (AOR = 16.06(95% CI = 1.10, 14.96) P = 0.009), interest in community services (AOR = 4.01(95% CI = 1.32, 12.20)P = 0.014), family influence(AOR = 13.76(95% CI = 1.74, 108.57)p = 0.013) and job satisfaction(AOR = 0.10(95% CI = 0.03, 0.26)P < 0.001). Conclusion: The researcher therefore concluded that clinical psychiatric posting has no significant impacts on career choices in psychiatry among nursing students in Nigeria. Interest of the students, family influence and job satisfaction were significantly associated with career choices among the respondents. [ABSTRACT FROM AUTHOR]

Introduction: Numerous pedagogical practices ought to be contemplated for the acquisition of practical aptitudes imperative to postgraduate operating room nursing education. The employment of digital technologies has emerged as a strategic focus in higher education and learning paths exhibit potential as a digital approach in nursing education. Objective: This study aimed to investigate the experiences of postgraduate OR nursing students who underwent a blended learning approach, which combines digital learning paths with skills training, and to explore how this approach prepares students to attain specific learning outcomes during their internship period. Methods: This qualitative study employed a descriptive, exploratory design and utilized focus group interviews facilitated by an interview guide to gather qualitative data. A purposive sampling strategy was employed, and the collected data were analyzed using a systematic text condensation approach. Results: The analysis of the data revealed two main categories and five subgroups. The first category, "Blended learning serves as adequate preparation for internship," includes subgroups that highlight the advantages of diverse learning activities that aid in the development of a strong foundation in practical skills. The positive influence of peer collaboration fosters improved learning through social interaction, while the organization of the curriculum has a significant impact on students' learning experiences. The second category, "The importance of skills training and behaving in an operating theater context," consists of subgroups that emphasize the necessity of progressing from basic technical skills training to simulation pedagogy to ensure appropriate behavior in the operating room. Small group sizes, close monitoring, and assessment by educators contribute to effective learning. Conclusion: The integration of digital learning paths with skills training fosters a problem-solving approach and encourages active and collaborative learning. Skills training in small groups, timely feedback, and coordination among subject managers to handle the students' workload can create an optimal learning environment. [ABSTRACT FROM AUTHOR]

Background: Postoperative pain delays ambulation, extends hospital stay, reduces the probability of recovery, and increases risk of long-term functional impairment. Pain management in hip fractured patients poses a challenge to the healthcare teams. Older adults are more vulnerable to opioid-associated side effect and it is primordial to minimize their exposure to opioids. Acetaminophen is associated with reduced opioid use so we need to focus on acetaminophen use in first-line analgesia. Methods: We conducted a controlled before/after study to assess the ability of an audit and feedback (A&F) intervention built with nurses to improve the quality of perioperative pain management in older patients hospitalized for hip fracture in an orthogeriatric unit (experimental group) versus a conventional orthopedic unit (no A&F intervention). The primary endpoint was the percentage of patients who received 3 g/day of acetaminophen during the three postoperative days, before and after the A&F intervention. Secondary endpoints included nurses' adherence to medical prescriptions, clinical data associated with patients and finally factors associated with intervention. The significative level was set at 0.05 for statistical analysis. Results: We studied data from 397 patients (mean age 89 years, 75% female). During the postoperative period, 16% of patients from the experimental group received 3 g/day of acetaminophen before the A&F intervention; the percentage reached 60% after the intervention. The likelihood of receiving 3 g/day of acetaminophen during the postoperative period and adhering to the medical prescription of acetaminophen were significantly increased in the experimental group as compared with the control group. The patient's functional status at discharge (assessed by Activities of Daily Living scores) was significantly better and the length of hospital stay significantly reduced after the A&F intervention. Conclusion: Our controlled before/after study showed that an A&F intervention significantly improved perioperative pain management in older adults hospitalized for hip fracture. Involving teams in continuous education programs appears crucial to improve the quality of pain management and ensure nurses' adherence to medical prescriptions. [ABSTRACT FROM AUTHOR]

Purpose: To assess existing knowledge of anesthesia and perioperative information needs/preferences in parents (parent, caregiver) of patients with special health care needs (SHCN) undergoing general anesthesia (GA) for dental procedures, and analyze the relations between caregiver anesthesia knowledge, health literacy level, and preoperative anxiety. Methods: Parents of patients with SHCN requiring GA for dental treatment completed an online survey with closed- and open-ended items assessing preferences and interest in perioperative information and educational resources, anesthesia knowledge, anxiety, and health literacy. Pearson product-moment correlation coefficients and descriptive statistics were used to summarize the findings. Results: Fifty-two parents completed the survey. Over two-thirds of the sample identified as having "high information" perioperative requirements, 423 percent of respondents exhibited elevated levels of perioperative anxiety, and 67.4 percent had adequate health literacy levels that were positively associated with anesthesia knowledge. Ratings of importance and interest in learning more about GA for dental treatment were high. Facilitating increased caregiver involvement before, during, and after surgery was the highest-rated resource format. Conclusions: Parents of patients with special health care needs are generally interested in receiving more information and resources about general anesthesia for dental treatment. Identified gaps in anesthesia knowledge and preferences for content and format of resources can be used to inform the development of tailored educational resources for families regarding perioperative management to ensure that parents have a complete understanding of their patients' anesthetic management and surgical care. [ABSTRACT FROM AUTHOR]

Continuous learning in clinical settings is essential for optimum quality of care. This study examines the lived experiences of post-basic nursing students specialising in critical care, emergency care, and peri-operative care in a tertiary university hospital. Using a descriptive phenomenological approach, three focus group interviews were conducted with 23 purposively sampled post-basic critical care nursing students. Four overarching themes emerged from the data analysis: (1) the programme's benefits to students; (2) feedback on programme implementation; (3) avenues for future improvement; and (4) challenges encountered during the programme. The findings emphasise the critical role of ongoing education in clinical contexts, particularly in post-basic critical care nursing education. Students' lived experiences underscore the programme's positive effects on their knowledge, skills, and organisational benefits, emphasising the crucial role of continuous education in enhancing the quality of nursing care. The identified themes offer valuable insights into the advantages, obstacles, and areas needing improvement in post-basic critical care nursing education. They showed the importance of a sustained commitment to continuous learning to ensure the delivery of high-quality care in clinical practice. This study contributes to the existing body of knowledge on nursing education and offers valuable insights for educators, administrators, and policymakers to optimise the training and development of nurses to achieve quality patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: Quality monitoring is a necessity in ambulatory surgery and is increasingly common. Since nurses are the health professionals that patients encounter most during the short time they spend in the hospital, the effect of their quality of care on patient outcomes should be determined. This study aimed to evaluate the relationship between ambulatory surgery patients' perceptions of readiness for discharge and the quality of perioperative nursing care. Methods: This descriptive and correlational study included 124 patients who underwent ambulatory surgery at a training and research hospital in İstanbul between October 2023 and March 2024. Data were collected using the Good Perioperative Nursing Care scale (GPNCS) and Readiness for Hospital Discharge scale (RHDS) before patients were discharged. Results: The mean age of the patients in the study was 43.14±15.88 years, of which 56.5% were male and 62.1% were married. The mean total GPNCS and RHDS scores of the patients were 117.48±20.79 and 7.26±1.48, respectively. It was determined that 50.8% of the patients were not ready for discharge, and there was a significant relationship between not being ready for discharge and the adequacy of discharge education. A statistically significant, positive, and moderate relationship was found between the GPNCS and RHDS total score averages (r=0.633, p<0.001). Conclusion: Findings showed that patients after ambulatory surgery, and the quality of perioperative nursing care affected the perception of readiness for discharge. In this regard, to facilitate patient recovery, nurses should plan appropriate interventions to improve the quality of perioperative care. [ABSTRACT FROM AUTHOR]

Around 1.7 billion children lack access to surgical care worldwide. To reinvigorate the efforts to address these disparities and support work to address global challenges in surgery, anesthesia, emergency, and critical care, the World Health Assembly passed World Health Organization Resolution World Health Assembly 76.2: Integrated emergency, critical and operative care for universal health coverage and protection from health emergencies (ECO) in 2023. This resolution highlights the integral role of surgery, anesthesia, and perioperative care in health systems. However, understanding how best to operationalize this resolution is challenging. We review the ECO resolution and highlight points that the pediatric surgical and anesthesia community can leverage to advocate for its recommendations for operative care. [ABSTRACT FROM AUTHOR]

In China, healthcare has lagged relative to its economic boom during the past 40 years. While the top tier hospitals offer pediatric perioperative care like high‐income countries, lower‐tier hospitals deliver lesser services of variable quality and safety related to equipment, supplies, clinician education, and availability. The national residency training program and the pediatric anesthesia fellowship program was established in 2013 and 2018 respectively. Increasing clinician workload from patient demand and a lack of consistency in quality and capability between rural and urban areas remain challenging. [ABSTRACT FROM AUTHOR]

Background: In the last 30 years, significant advances have been made in pediatric medical care globally. However, there is a persistent urban‐rural gap which is more pronounced in low middle‐income countries than high‐income countries, similar urban‐rural gap exists in India. While on one hand, health care is on par or better than healthier nations thriving international medical tourism industry, some rural parts have reduced access to high‐quality care. Aim: With this background, we aim to provide an overview of the present and future of healthcare in India. Methodology: With the cumulative health experience of the authors or more than 100 years, we have provided our experience and expertise about healthcare in India in this narrative educational review. This is supplemented by the government plans and non government plans as appropriate. References are used to justify as applicable. Results: With the high percentage of pediatric population like other low to middle‐income countries, India faces challenges in pediatric surgery and anesthesia due to limited resources and paucity of specialized training, especially in rural areas. Data on the access and quality of care is scarce, and the vast rural population and uneven resource distribution add to the challenges along with the shortage of pediatric surgeons in these areas of specialized care. Addressing these challenges requires a multi faceted strategy that targets both immediate and long‐term healthcare needs, focusing on improving the facilities and training healthcare professionals. Solutions could include compulsory rural service, district residency programs, increasing postgraduate or residency positions, and safety courses offered by national and international organizations like Safer Anesthesia from Education Pediatrics, Vital Anesthesia Simulation Training, and World Federation of Society of Anesthesiologists pediatric fellowships. Conclusion: India has achieved great strides in perioperative health care and safety. It has become the major international medical industry due to high‐quality care, access and costs. Crucially, India needs to establish local hubs for pediatric perioperative care training to enhance healthcare delivery for children. [ABSTRACT FROM AUTHOR]

Background: Feedback‐based learning (FBL) focuses on guiding the learning process according to educational objectives and the student's needs. This study aimed to investigate surgical nursing students' perceptions and explore their experiences of FBL. Method: The present study used a mixed‐methods sequential explanatory design that was conducted in the quantitative and qualitative phases. Surgical nursing students participated in the quantitative phase (n = 105). In the first phase, students completed two questionnaires about FBL and clinical feedback. Semi‐structured face‐to‐face interviews were used to collect qualitative data in the second phase. Graneheim and Lundman's inductive approaches were used to analyse the qualitative data. Results: The mean (SD) score for students' perception of FBL was 3.99 ± 0.70. The qualitative results were explored in two themes, "motivational support for improvement" and "unpleasant learning". Conclusion: In this study, the positive and negative aspects of FBL were explained. FBL is perceived as a motivational support mechanism to improve students' capabilities during their academic courses and also prepare them for future careers. Conversely, FBL may experience unpleasant learning due to negative feedback and negative emotions. [ABSTRACT FROM AUTHOR]

Procedural sedation is the administration of medication to obtund, dull, or reduce the intensity of pain or awareness associated with a therapeutic or diagnostic procedure. Because registered nurses play a key role in ensuring patient safety during procedural sedation, it is essential they have the requisite knowledge and skills to provide safe, quality care. This paper describes the development, implementation, and outcomes of a course designed for nurses providing care to patients undergoing procedural sedation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing & Health is the property of Journal of Nursing & Health (JONAH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pain is a complex and challenging phenomenon. People have different pain experiences, but everyone has the right to effective pain management. Pain assessment and management are integral components of a nurse's role. Aim: To assess the knowledge and attitudes of nurses in Qatar about adult post-operative patients' pain assessment and management, and the factors that may be associated with such knowledge and attitudes. Methods: Post-operative registered nurses from all peri-operative areas at Hamad Medical Corporation participated in a cross-sectional online survey using a self-administered questionnaire. A knowledge and attitudes (K&A) score was calculated. Associations between K&A and potential explanatory variables were assessed using t-tests and one-way ANOVA. Results: A total of 151 post-operative nurses participated in the study. The mean knowledge and attitudes (K&A) score was 19.6 ± 4.5 out of 41 (48%), indicating a large deficit in nurses' knowledge and attitudes about adult post-operative pain. There were no statistically significant differences in the mean K&A scores of participants based on gender, nationality, education level, marital status, workplace facility, current job designation, or hours of pain education. Conclusions: There is a significant deficit in post-operative nurses' knowledge and attitudes about pain across the nursing workforce in post-operative care. Implications for nursing education and policy: Evidence-based, innovative nursing education courses are needed to improve nurses' knowledge and attitudes about pain assessment and management. Health service policy is required to ensure that evidence-based in-service education on pain management is compulsory for all nurses. This study was not registered. [ABSTRACT FROM AUTHOR]

The article discusses the implementation of national quality improvement programs for emergency surgery patients in the UK, focusing on hip fracture and emergency laparotomy cases. These programs, such as the UK National Hip Fracture Database (NHFD) and the UK National Emergency Laparotomy Audit (NELA), have led to improved outcomes and reduced mortality rates for patients. However, there are concerns about unintended consequences, resource allocation, and potential impacts on other patient groups. The need for a nuanced systems understanding of the effects of standardized care pathways is emphasized, highlighting the importance of balancing quality improvement efforts with broader healthcare considerations. [Extracted from the article]

Background: Assessing the learning environment provides an overview of the current educational status and aids in identifying areas of concern. This study aimed to understand the students’ perceptions of the educational environment at the Paramedical Faculty of Ilam University of Medical Sciences in 2021.Methods: This cross-sectional research was conducted at Ilam University of Medical Sciences, where 300 paramedical students were recruited by census. The Dundee Ready Education Environment Measure (DREEM) was used as the data collection tool. An independent t-test and one-way analysis of variance were used to investigate the relationships between demographic variables and each dimension of the questionnaire. Data analysis was performed using SPSS-26 software.Results: The sample studied included 166 female and 134 male students with an average age of 24.68±7.837 years. The mean and SD of the perception of the educational environment were 112.34 (24.63). There was a significant relationship between marital status, education level, age, and academic semester with students’ understanding of the educational environment (P≤0.05). Twenty percent of the items in the questionnaire indicated a “problematic” situation, while the rest were in a “need of attention” status.Conclusion: The results of this study showed that paramedical students have a positive perception of the educational environment. The lowest mean and SD of the dimensions of the questionnaire were observed in students’ understanding of learning and social self-perception. The other dimensions were in a more satisfactory condition.

Aims Design Data Sources Results Conclusion Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution To map the existing literature describing medical device‐related pressure injuries in patients during surgery, including investigation of the incidence, types of medical devices, risk factors and strategies for preventing medical device‐related pressure injuries.A scoping review.In April 2023, three databases were searched. Studies about adult patients undergoing surgery, from 2014 onwards, in English and Chinese were included. Data were extracted about study characteristics and data related to research questions. The Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework were used to synthesize findings.Two different types of evidence were included in this review; 14 research studies and two quality improvement studies. The incidence of medical device‐related pressure injuries in the operating room was 0.56%–24.5% and respiratory devices were the most common medical devices investigated. Length of surgery, age and BMI were risk factors for medical device‐related pressure injuries in a few studies. The application of a prophylactic dressing and dressing maintenance was the most common prevention strategy.Ongoing research is needed to confirm the incidence of, and risk factors for, medical device‐related pressure injuries in the operating room. Additionally, more high‐quality evidence is needed to underpin current prevention strategies.Operating room nurses need to be aware of the risks of medical device‐related pressure injuries and assess and plan prevention strategies accordingly. Once more high‐quality evidence is available, operating room nurses could implement prevention strategies like prophylactic dressings.Scoping Reviews (PRISMA‐ScR) checklist.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim. This study aims to explore contributing factors, impacts, and strategies to address perioperative nursing shortages. Background. Health facilities worldwide are experiencing nursing shortages, especially in specialty fields such as perioperative nursing. Evaluation. This integrative review is reported according to the PRISMA guidelines. The title, abstract, and full article screening, as well as the quality appraisal process, were performed by two independent reviewers, with a third for disagreement. This review focused on empirical and theoretical research published from 2013 to 2023 using databases including CINAHL, Embase, Emcare (via OVID), Medline (via EBSCOhost), Scopus, Web of Science, ProQuest Dissertations and Theses Global, Overton, and GreyNet. Key Issues. This study thoroughly reviewed 84 articles. The perioperative domain confronts significant staffing challenges due to increased demand, lack of experienced nurses, insufficient new entrants, high turnover, and an aging workforce. Notably significant are the deficiencies in recruiting new nurses and the elevated turnover levels, potentially amendable issues. The shortages negatively impact the remaining nurses, patient care quality, and hospital revenue. Strategies to address perioperative nursing workforce challenges include promoting the specialty to undergraduate nursing students, bolstering recruitment efforts, and retaining experienced perioperative nurses. However, none of the studies examined in this review adopted a comprehensive approach. Furthermore, the effectiveness of these strategies relative to one another remains uncertain due to a lack of reliable measurements. Conclusion. Perioperative nursing faces considerable challenges, including an aging workforce, limited new recruits, and high turnover rates. Present strategies primarily prioritise workforce preparation over supporting current staff. Mitigating the perioperative nursing shortages requires comprehensive approaches integrating preparation, recruitment, retention, and retirement plans. In addition, these strategies must be adapted to the diverse regulatory environments of different countries, recognising the absence of a one‐size‐fits‐all solution to perioperative nursing shortages globally. Implication for Nursing Management. Perioperative nursing managers are vital in reducing shortages. [ABSTRACT FROM AUTHOR]

Introduction: Venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, is a common and potentially fatal post-surgery complication. Research has shown that 50% of VTE causes are intraoperative, with the risk of occurrence highest during and immediately post-surgery. Therefore, strategies for early assessment and prevention should be established. Objective: To identify optimal equipment selection, compression protocols, and strategies for complication prevention and management during intraoperative intermittent pneumatic compression (IPC), this study aims to synthesize the best available evidence. The objective is to inform accurate risk assessment and facilitate early mechanical prophylaxis against venous thrombosis. Methods: The Practical Application to Clinical Evidence model proposed by the Joanna Briggs Institute was utilized. Indicators were identified using the available best evidence from January 2023 to October 2023, and a baseline review was conducted. Negative factors were identified based on clinical evidence-based practice. The implementation rates of different indicators before (n = 372) and after (n = 405) evidence-based practice, the incidence rates of intraoperative IPC-related adverse events and VTE, and the risk of venous thrombosis before (n = 50) and after (n = 50) practice were identified and compared. Furthermore, medical staff's knowledge of best practices for intraoperative IPC was assessed through pre- and post-intervention surveys involving 109 operating room personnel. Results: All review indicators significantly improved (P < 0.01) after the evidence-based practice, and 9 reached 100%. Two intraoperative venous thrombosis events occurred before the evidence-based practice, with an incidence rate of 0.53%; no intraoperative venous thrombosis event occurred after the evidence-based practice, with no significant difference (X2 = 2.171, P = 0.141 > 0.05). However, there were significant differences in intraoperative venous blood hemodynamics before and after the practice (P < 0.05). Moreover, 9 IPC-related adverse events, including 4 cases of skin pressure, 3 cases of skin allergy, and 2 cases of lower limb circulation disorders, were reported before the evidence-based practice, with an incidence rate of 2.4%. Notably, no intraoperative IPC-associated adverse events occurred after the evidence-based practice(X2 = 9.913, P < 0.01). Meanwhile, the score of comprehension of the standard utilization of IPC for preventing venous thrombosis by medical staff in the operating room was 93.34 ± 3.64 after the evidence-based practice, which was higher than that (67.55 ± 5.45) before the evidence-based practice. Overall, the clinical practice was significantly improved the evidence-based practice. Conclusions: Applying intraoperative IPC utilization standards based on the best evidence in clinical practice effectively reduces the intraoperative IPC-associated adverse event rate and the risks of intraoperative venous thrombosis. It also improves the execution rates and compliance with mechanical prevention standards in the operating room by medical staff. Future research should prioritize the development and refinement of best clinical practices for intraoperative venous thrombosis prevention, with a particular emphasis on the integration of mechanical prophylaxis strategies. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of collaborative nursing based on Roy Adaptive Mode (RAM) on postoperative functional reconstruction, soft tissue pain and quality of life in patients with femoral intertrochanteric fracture. Methods: A retrospective matched control method was used in this study. A total of 96 patients with femoral intertrochanteric fracture admitted to our hospital from July 2018 to September 2021 were selected. According to different nursing methods, the patients were divided into a collaborative group and a routine group, with 48 cases in each group. Patients in both groups were treated with intramedullary nail surgery. The routine group was given routine perioperative nursing intervention, and the collaborative group was given collaborative nursing intervention on this basis. The hip function recovery and quality of life before and after the intervention were compared between the two groups. The preoperative and postoperative pain degree, and the perioperative complications of the two groups were recorded. Logistic multivariate regression analysis was used to analyze the risk factors affecting the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation, thereby constructing a risk prediction model. ROC curve was used to analyze the clinical value of influencing factors in predicting postoperative hip function recovery in patients with femoral intertrochanteric fracture. Results: Harris score each dimension after intervention in the collaborative group was obviously higher than that of before intervention and the conventional group (P < 0.05). After intervention, the excellent and good rate of hip joint function the collaborative group was 83.33%, which was significantly higher than 60.42% in the routine group (P < 0.05). Postoperative VAS scores each time point in the collaborative group was obviously lower than that in the routine group (P < 0.05). After intervention, the scores of physiological function, physiological role, body pain and general health in the collaborative group were significantly higher than those in the routine group (P < 0.05). The incidence of complications in the collaborative group was 6.25%, which was significantly lower than 22.92% in the routine group (P < 0.05). There were statistically significant differences in age, preoperative ASA grade, internal fixation method, osteoporosis grade and perioperative nursing methods between the excellent hip recovery group and the poor hip recovery group (P < 0.05). Logistic multivariate regression analysis showed that age, preoperative ASA grade, internal fixation method and osteoporosis grade were the risk factors affecting the recovery of hip joint function after operation, and perioperative nursing method was the protective factor (P < 0.05). Among the influencing factors, the internal fixation method and the grade of osteoporosis had certain clinical value in predicting the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation. Conclusion: The RAM model-based collaborative nursing method may effectively restore the hip joint function of patients with femoral intertrochanteric fracture after operation, and may reduce the perioperative pain degree of patients, improve the quality of life of patients and reduce the incidence of complications, which can be popularized and applied in clinical practice. In addition, there are many factors influencing the recovery of hip joint function in patients with femoral intertrochanteric fracture after operation, and targeted measures should be taken according to the influencing factors to improve the effect of intramedullary nail treatment. [ABSTRACT FROM AUTHOR]

This study investigated the influence of early nutritional nursing on gastrointestinal function and stress responses in patients undergoing laparoscopic cholecystectomy. A total of 84 patients at Ankang Central Hospital from March 2019 to March 2020 were divided into the control group and treatment group using the numerical table method. The control group received routine nursing after laparoscopic cholecystectomy, and the treatment group received early nutritional nursing. The visual analogue scale and general comfort questionnaire scores of the treatment group were lower than those of the control group at 1, 3, and 5 days after surgery. The time to first feed, the time to first passage of gas, and the recovery time of intestinal sounds were significantly shorter in the treatment group compared to the control group. Abdominal distension and gastrointestinal reaction scores were significantly lower, while generic quality of life inventory-74 scores, Newcastle satisfaction with nursing scale scores, and Chinese version of the Conor--Davidson resilience scale scores were significantly higher in the treatment group compared to the control group. The levels of inflammatory factors and stress hormones were significantly lower in the treatment group than in the control group, while arm muscle circumference, body weight, and transferrin, hemoglobin, albumin, and prealbumin levels were significantly higher (P < 0.05). Overall, early nutritional nursing can effectively relieve postoperative pain and improve gastrointestinal function, quality of life, nutritional status, and nursing satisfaction in patients after laparoscopic cholecystectomy. [ABSTRACT FROM AUTHOR]

An arbitrary gestational age limit of viability cannot be set, and in clinical practice the focus should be on a periviability interval—the so‐called "gray zone" of prognostic uncertainty. For cases within this interval, the most appropriate decision‐making process remains debatable and periviability has emerged as one of the greatest challenges in bioethics. Universally recognized ethical principles may be interpreted differently due to socioeconomic, cultural, and religious aspects. In the case of periviability, there is considerable uncertainty over whether interventions result in a greater balance of clinical good over harm. Furthermore, the fetus or neonate is unable to exercise autonomy and the physicians and parents will act as patient surrogates. When parents and physicians disagree about the infant's best interest, a dialogue without paternalistic attitudes is essential, whereby physicians should only offer, but not recommend, perinatal interventions. Parental choice, based on thorough information, should be respected within the limits of what is medically feasible and appropriate. When disagreements between parents and physicians occur, how is consensus to be achieved? Professional guidelines can be helpful as a framework and starting point for discussion. In reality, however, guidelines only rarely draw categorical lines and in many cases remain vague and ambiguously worded. Local ethics committees can provide counseling and function as moderators during discussions, but ethics committees do not have decision precedence. Counseling assumes the most significant role in periviability discussions, taking into consideration the particular fetal and maternal characteristics, as well as parental values. Several caveats should be observed relative to counseling: message fragmentation or inconsistence should be minimized, prognosis should preferably be presented in a positive framing, and overreliance on statistics should be avoided. It is recommended that decisions regarding neonatal resuscitation in the periviability interval be made before birth and not conditional on the newborn's appearance at birth. Regardless of decision, it is important to assure pre‐ and postnatal coherence. The present article describes how individual physicians, centers, and countries differ in the approach to the decision to initiate or forgo intensive care in the periviability interval. It is impossible to provide a global consensus view and there can be no unifying ethical, moral, or practical strategy. Nevertheless, ethically justified, quality care comprises early involvement of the obstetric and neonatal team to enable a coherent, comprehensible, nonpaternalistic, and balanced plan of care. Ultimately, physicians will need to adjust the expectations to the local standards, local outcome data, and local neonatal support availability. Synopsis: Ethically justified, quality care comprises early involvement of the obstetric and neonatal team to enable a coherent, comprehensible, nonpaternalistic, and balanced plan of care. [ABSTRACT FROM AUTHOR]

Aim: To identify the roles of nurse‐surgeons in the provision of surgical care. Design: Scoping review. Methods: This scoping review adhered to the JBI guideline for scoping reviews and EQUATOR Network's PRISMA‐ScR checklist. Searches were performed from May 2022 to July 2022 using a combination of MeSH headings, keywords and filters via database and hand searching based on the eligibility criteria. Keywords included nurse‐surgeon, nurse endoscopist, nurse hysteroscopist and nurse cystoscopist. Data sources were CINAHL, Cochrane, Google Scholar, PubMed and Scopus. Descriptive analysis was used to report the findings. Results: Ninety‐six included records indicated nurse‐surgeon practice in 26 countries. Forty‐one nurse‐surgeon titles were found, the majority of which were types of nurse practitioner. A total of 5,684,198 surgeries were performed by nurse‐surgeons varying from laparotomies to biopsies. Nine records reported that nurse‐surgeons perform surgeries safely and on par with physicians with zero to minimal complications. Nineteen records reported improved surgical care efficiency by nurse‐surgeons in terms of patient access to surgery, waiting times, surgery times, patient show rates, patient education, physician workload and junior physicians' training. Seven records reported high patient satisfaction. Nurse‐surgeons were cost‐effective according to five records. Thirteen records recommended the standardization of nurse‐surgeon practice. Conclusion: Nurse‐surgeons performed millions of surgeries worldwide assisting in easing the global surgical burden. This review identified the roles and benefits nurse‐surgeons play in global surgical care. Research gaps on nurse‐surgeon roles were discovered including the ambiguity in nurse‐surgeon titles and the need to regulate nurse‐surgeon practice. Impact: This research addressed the clinical safety, quality, contribution to timely surgical access and cost efficiency of nurse‐surgeon performed surgeries, as well as the need to standardize nurse‐surgeon practice and use a more consistent nurse‐surgeon title to ensure role identification and monitoring. [ABSTRACT FROM AUTHOR]

Gynecological cancers are prevalent malignancies among females, and surgical intervention is the primary therapeutic approach offering the possibility of a definitive cure. Recent research has highlighted the susceptibility of gynecological cancer patients to experiencing anxiety symptoms during the perioperative and postoperative phases, with this psychological condition being linked to suboptimal recovery following surgery. Nevertheless, certain interventions have shown promise in mitigating perioperative and postoperative anxiety in gynecological cancer patients. In this study, we conducted a comprehensive review to collect the existing evidence on this subject. Through a systematic search across six common databases, we screened and included 28 pertinent studies. The current review emphasizes the elevated occurrence of perioperative and postoperative anxiety among patients with gynecological cancers (i.e., uterine, cervical, ovarian, endometrial, and vulval cancers). Specific nursing interventions (i.e., crisis intervention nursing, multidisciplinary collaborative continuous nursing, psychological nursing, comprehensive psychological nursing, reminiscence therapy involved care, cognitive behavioral stress management, hospital-family integrated continuation nursing, high-quality nursing care, relaxation-focused nursing program, and relaxation/counseling intervention) and psychotropic medications may serve as dependable approaches to mitigate perioperative and postoperative anxiety. This study represents a novel contribution to the literature by providing a characterization of perioperative and postoperative anxiety in the context of gynecological oncology. The findings underscore the significance of addressing perioperative and postoperative anxiety as a critical clinical concern for individuals with gynecological cancers, emphasizing the need for further research to develop effective interventions. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health & Nursing Management / Sağlık ve Hemşirelik Yönetimi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Pneumatic tourniquets (PTs) play a crucial role in hemostasis during orthopedic surgery. This study aimed to investigate the current knowledge, attitudes, and practices (KAP) of orthopedic operating room personnel concerning the use of PTs. Methods: This cross-sectional study was conducted from Jul. 2023 to Aug. 2023. An online questionnaire was used to collect demographic information and KAP score data of the orthopedic operating room personnel from Hangzhou Regional Hospitals. Results: A total of 336 participants included orthopedic physicians (37.8%), orthopedic nurses (31.5%), anesthesiologists (8.9%), operating room nurses (19.9%) and medical students (1.8%). The median knowledge score was 28.5 (24, 32), with a maximum score of 38; the median attitude score was 31 (28, 35), of a maximum of 35; the median practice score was 41 (36, 44), of a maximum of 45. Correlation analysis showed links between knowledge and attitude (r = 0.388, p<0.001), knowledge and practice (r = 0.401, p<0.001), and attitude and practice (r = 0.485, p<0.001). Multivariate logistic regression analysis confirmed that female gender (OR = 0.294, 95% CI: 0.167–0.520; p<0.001), working in a specialized hospital (OR = 0.420, 95% CI: 0.219–0.803; p = 0.009), and occupation as a surgical anesthesiologist (OR = 3.358, 95% CI: 1.466–7.694; p = 0.004) were associated with better knowledge scores. A higher educational degree (OR = 0.237, 95% CI: 0.093–0.608; p = 0.003) was associated with better practice scores. No previous training was associated with lower knowledge (OR = 0.312, 95% CI: 0.187–0.520; p<0.001) and practice (OR = 0.325, 95% CI: 0.203–0.521; p<0.001) scores. Conclusion: Orthopedic personnel in this study had acceptable knowledge, attitude, and practice concerning the use of PTs; additional training and guidance might enhance proficiency. [ABSTRACT FROM AUTHOR]

Background Aim Methods Findings Conclusions Implications for nursing and health policy Turkey has faced a notable escalation in earthquake disasters in the last two decades. Despite initiating a health and disaster management system, nurses' pivotal roles and experiences in handling such crises have been disregarded.This qualitative study analyzed nurses' experiences before, during, and after deployment in response to the 2023 Turkey earthquakes to enhance disaster‐response efforts.This descriptive qualitative study was conducted between March and May 2023 using semistructured interviews with 15 nurses purposively  sampled among those who volunteered to work in the earthquake zone. The MIRACLE and COREQ guidelines were followed for reporting qualitative research.The analysis exposed five main themes for pre‐tasking: moral obligation, motivation, insufficient experience, balancing responsibilities, and preparation challenges. The peri‐task themes include responsibilities, skills, bravery and characteristics, workload management, teamwork, and outcomes. Post‐tasking has three themes: competence assessment, career goals and aspirations, and support. Training and coping with anxiety and stress are common themes for all phases.Disaster relief requires a comprehensive and coordinated response from healthcare organizations, government agencies, and support systems. Providing adequate training, ensuring safety protocols, offering mental health support, and fostering a fair and supportive work environment are crucial steps in mitigating the adverse effects on nurses and, by extension, the patient care process in earthquake‐affected areas.Nurse training in disaster preparedness should cover various response methods and involve multiple disciplines. Managers can help by arranging drills, simulations, online courses, and workshops and promoting partnerships for improved collaboration. Psychological support should be included to address emotional challenges. Regularly updating response policies based on past experiences is crucial for preparedness and efficiency. [ABSTRACT FROM AUTHOR]

Background: Undergraduate training in hand hygiene is a keystone of infection control. Several studies have shown overconfidence effects in hand hygiene practices, which can impair metacognition. We hypothesized that overconfidence might be prevalent in the early education stages of nursing students and that these effects could be reduced through frequent interactive learning formats, such as learning groups. Methods: We conducted a multicenter cross-sectional questionnaire with 196 German nursing students, including general, surgical, and anesthetic nursing specializations. Results: Overconfidence was observed in nursing students across all specialties and years of education. The cluster analyses showed three different types of learners: two characterized by overconfidence and one demonstrating justifiable confidence. Furthermore, the moderation analysis indicated that providing feedback and promoting metacognition regarding students' learning achievements could mitigate overplacement, particularly through the frequent implementation of interactive teaching formats. Discussion: Despite some limitations, these findings highlight the prevalence of overconfidence effects in nursing students, the presence of different learning profiles, and the importance of incorporating feedback within interactive learning formats concerning hand hygiene. Accordingly, educators need to be trained and supervised to deliver these learning formats and provide feedback to students effectively. [ABSTRACT FROM AUTHOR]

Background: Transgender and nonbinary (TNB) people experience obstacles that create barriers to accessing health care, including stigmatization and health inequities. Our intention was to describe the lived experiences of TNB patients and identify potential gaps in the education of health care professionals. Methods: We conducted a qualitative descriptive study influenced by phenomenology by interviewing with TNB adults who underwent surgery in Canada within the previous 5 years. We recruited participants using purposeful and snowball sampling via online social networking sites. Audio recordings were transcribed. Two authors coded the transcripts and derived the themes. Results: We interviewed 21 participants, with a median interview duration of 49 minutes. Participants described positive and negative health care encounters that led to stress, confusion, and feelings of vulnerability. Major themes included having to justify their need for health care in the face of structural discrimination; fear and previous traumatic experiences; community as a source of support and information; and the impact of interactions with health care professionals. Interpretation: Participants detailed barriers to accessing care, struggled to participate in shared decision-making, and desired trauma-informed care principles; they described strength in community and positive interactions with health care professionals, although barriers to accessing gender-affirming care often overshadowed other aspects of the perioperative experience. Additional research, increased education for health care professionals, and policy changes are necessary to improve access to competent care for TNB people. [ABSTRACT FROM AUTHOR]

Background: To investigate the impact of perioperative rapid rehabilitation nursing on pelvic floor function of patients during transvaginal natural cavity endoscopic hysterectomy using perineal Four-dimensional (4D) ultrasound imaging technique. Materials and Methods: A total of 60 patients undergoing natural cavity endoscopic hysterectomy were evenly divided into control group (CG) and observation group (OG). The CG adopted perioperative nursing mode, and the OG adopted rapid rehabilitation nursing on the basis of the CG. The perineal 4D ultrasound imaging technology was used to evaluate the postoperative pelvic floor function parameters and the incidence of pelvic floor function abnormalities in the two groups. Results: During anal retraction, the OG exhibited a substantially higher urethral rotation angle and bladder neck mobility compared to the CG (P < 0.05). Under resting conditions, the ultrasonic parameters of the two groups did not differ significantly (P > 0.05). The OG's ultrasonography parameters were substantially lower than the CG's under the highest Valsalva condition (P < 0.05). The incidence of internal urethral orifice infundification did not differ between the two groups (P > 0.05). Compared to the OG, the CG had a considerably higher incidence of cystocele (P < 0.05). There was a clear difference in pelvic prolapse distance between the two groups (P < 0.05). Conclusion: 4D ultrasound is conducive to accurately identifying the morphological structure and function of the pelvic floor in patients with hysterectomy, and provides guidance for the formulation of the rehabilitation treatment plan for the pelvic floor muscle of the patients. [ABSTRACT FROM AUTHOR]

Background and Aims: Anesthesiologists' services extend to many critical areas of any healthcare setup. However, there needs to be more understanding among the public regarding their crucial role. Preanesthesia evaluation (PAE) visits can disseminate information about anesthesiologists and services. We aimed to evaluate patient's knowledge and the impact of interview-based surveys on increasing knowledge about anesthesiologists and anesthesia services. Methodology: It was a single-center, cross-sectional survey involving 550 patients aged 18-65 undergoing elective surgeries. Pre- and postoperative interviewer-assisted questionnaires were administered to assess patients' baseline knowledge and perception of anesthesia and anesthesiologists. Statistical analysis focused on demographic, educational, and previous anesthesia exposure among subgroups; a P-value <0.05 was considered significant. Results: Less than half comprehended anesthesia's role as a specialist in inducing unconsciousness. 55.3% were unaware of general anesthesia, and 69.6% were unaware of regional anesthesia as a technique. Higher education and previous anesthesia exposure correlated with better awareness with regard to the perioperative role of anesthesiologists and their fields of work (P < 0.05). The postoperative survey indicated good satisfaction with anesthesiologists' services, which might be attributable to the survey-based interaction. Conclusion: A significant need for more understanding regarding anesthesia and anesthesiologists' roles still prevails. Interview-based effective communication during PAE visits, perioperative period, and shared decision-making (SDM) improves patients' knowledge, comprehension, and satisfaction. [ABSTRACT FROM AUTHOR]

The 7th National Audit Project of the Royal College of Anaesthetists (NAP7) recommended that an emergency call system be immediately accessible in all anaesthesia locations. It is essential that all theatre team members can rapidly call for help to reduce the risk of patient harm. However, the ability of staff to activate this system in a timely manner can be affected by cluttered or unfamiliar environments and cognitive overload. One proposed strategy to enable rapid identification and activation of emergency call systems is to install a red vertical painted stripe on the wall from the ceiling to the activation button. We investigated the effect of introducing this vertical red line on activation times in operating theatres in the UK and Australia. Operating theatre team members, including anaesthetists, surgeons, anaesthetic nurses, surgical and theatre nurses, operating theatre practitioners, and technicians, were approached without prior warning and asked to simulate activation of an emergency call. Vertical red lines were installed, and data collection repeated in the same operating theatres 4–12 months later. After installation of vertical red lines, the proportion of activations taking >10 s decreased from 31.9% (30/94) to 13.6% (17/125, P =0.001), and >20 s decreased from 19.1% (18/94) to 4.8% (6/125, P <0.001). The longest duration pre-installation was 120 s, and post-installation 35 s. This simple, safe, and inexpensive design intervention should be considered as a design standard in all operating theatres to minimise delays in calling for help. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has transformed our understanding of aerosol transmissible disease and the measures required to minimise transmission. Anaesthesia providers are often in close proximity to patients and other hospital staff for prolonged periods while working in operating and procedure rooms. Although enhanced ventilation provides some protection from aerosol transmissible disease in these work areas, close proximity and long duration of exposure have the opposite effect. Surgical masks provide only minimal additional protection. Surgical patients are also at risk from viral and bacterial aerosols. Despite having recently experienced the most significant pandemic in 100 yr, we continue to lack adequate understanding of the true risks encountered from aerosol transmissible diseases in the operating room, and the best course of action to protect patients and healthcare workers from them in the future. Nevertheless, hospitals can take specific actions now by providing respirators for routine use, encouraging staff to utilise respirators routinely, establishing triggers for situations that require respirator use, educating staff concerning the prevention of aerosol transmissible diseases, and providing portable air purifiers for perioperative spaces with low levels of ventilation. [ABSTRACT FROM AUTHOR]