Operating Room Care Research Articles

Summary of surgical experience of an elderly patient who underwent simultaneous dual minimally invasive TA-TAVR and McKeown procedures

BackgroundCases of simultaneous TA-TAVR and Mckeown dual minimally invasive surgery are very rare. A retrospective analysis of the clinical features, perioperative surgical cooperation and care of an elderly patient with esophageal cancer combined with moderate-to-severe aortic regurgitation. MethodsAn elderly patient with esophageal cancer combined with moderate to severe aortic valve regurgitation was admitted to the Department of Thoracic Surgery, West China Hospital, Sichuan University in September 2022. Through preoperative MDT discussion, two minimally invasive surgical options were identified and analyzed to develop personalized and standardized perioperative operating room care and surgical coordination. Informed written consent and institutional review board approval were both obtained (No. 2021-879; July 25, 2022) for the surgery and the publication of the study data. ResultsAfter a thorough preoperative MDT discussion and the development of a personalized and standardized operating room care plan, the two surgeries lasted a total of 5h 35mins with a total bleeding volume of 150 ml. The surgeries went smoothly, and the patients were sent to the ICU and transferred back to the general ward on the second day after surgery without complications. ConclusionThe simultaneous performance of dual minimally invasive level IV surgery is indeed a high-risk procedure, which is a new challenge for both patients and health care workers. Standardized OR care planning and surgical coordination are also important aspects of MDT, reflecting that OR care is an indispensable role in the surgical team as well.

Observation of the Application Effect of Comfort Care in Operating Room Nursing

Observation of the Application Effect of Comfort Care in Operating Room Nursing

Application Effect Analysis of Operating Room Detailed Nursing Based on Medical Big Data in Patients Undergoing Gastrointestinal Tumor Surgery.

With the continuous development of internet information computing, the continuous improvement of medical and health systems, and the continuous increase of medical big data, traditional operating room care also needs to be further optimized. Medical big data is a forum data set for medical industry healthcare, electronic medical record information, clinical case record information, medical financial data, remote patient monitoring data, clinical decision support data, medical insurance data set, online consulting platform, and so on. Gastrointestinal tumors are currently one of the largest malignant tumors. Compared with ordinary patients, the presence of fear, depression, irritability, and other unhealthy emotions in patients with gastrointestinal tumors will reduce the therapeutic effect. Without careful care, the use of chemotherapy and other treatments makes patients vulnerable to various side effects. This article aims to study the use of medical big data intelligent algorithms to perform detailed care for patients during gastrointestinal tumor surgery and analyze the effects of care. This paper proposes an improved DNN algorithm; the DNN algorithm is to use several weight coefficient matrices and bias vectors to perform a series of linear operations and activation operations with the input value vector, starting from the input layer, backward calculation layer by layer, until the operation reaches the output layer, and the output result is obtained. This algorithm is used to study the theory, use mathematical formulas for method calculation and model design, and use the model to carry out detailed nursing experiments in the relevant operating room. The results of the experiment show that patients who have performed detailed care have a 27.2% improvement in treatment and rehabilitation effects than those who have not, and the level of detailed care has an obvious positive relationship with the rate of condition conversion. In the end, the hospital's detailed care quality evaluation index, which is QEI, increases by 1 point, which can increase the rate of condition conversion by 0.4.

Application Effect of Humanized Care in Operating Room Nursing

Application Effect of Humanized Care in Operating Room Nursing

Effect of Nursing Intervention in the Operating Room Based on Simple Virtual Reality Augmented Technology on Preventing Gastrointestinal Surgical Incision Infection.

Gastrointestinal surgery is currently a common gastrointestinal surgery in clinical practice. In recent years, the incidence of gastrointestinal diseases has gradually increased and increased as the lifestyle of modern people has developed and changed. Both physical health and quality of life have a serious impact. In the actual process, it was found that multiple links in operating room care may increase the risk of postoperative infections for patients. Therefore, this article proposes nursing in operating room based on simple virtual reality augmented technology. This article mainly studies the effect of nursing intervention on preventing gastrointestinal surgical incision infection, and hopes to provide help for preventing gastrointestinal surgical incision infection. In this trial, 80 patients with gastrointestinal surgery were randomly divided into two groups, each with 40 people. The experimental group was treated with an operating room nursing intervention combined with traditional treatment methods. Controls were treated with traditional nursing combined with traditional treatment, and both groups were analyzed for acceptance of nursing intervention in the operating room, poor mood, various indicator levels, postoperative complications, and postoperative incisional infections. The experiment proved that the postoperative rehabilitation indexes of the experimental group were better than those of the control group, the excellent rate of wound healing reached 92.5%, and the incidence of wound infection was only 5%, which was lower than that of the control group. This demonstrates that nursing intervention in the operating room can help to reduce the infection rate at the patient's incision site, increase the level of surgical indicators, promote healing of the incision site as quickly as possible, and significantly improve the safety of clinical treatment.

Study on the influence of psychological empowerment on the innovation ability of nurses in operating room

Objective To investigate the status of psychological empowerment and innovation ability of nurses in operating room, analyze the influence of psychological empowerment of nurses in operating room on innovation ability, and provide reference for improving the innovation ability of nurses in operating room. Methods A total of 220 nurses in the operating room of Qingdao City, Shandong Province were selected and investigated using the psychological authorization scale and the innovation ability evaluation scale. Results The average score of psychological empowerment of nurses in the operating room was 3.61±0.55, and the average score of innovation ability of nurses was 3.09±0.27. The psychological empowerment of nurses was positively correlated with the ability of innovation (P<0.05). Hierarchical regression analysis showed that the three dimensions of work significance, self-efficacy and autonomy in psychological empowerment could independently explain 23.7% variation of innovation ability. Conclusions Managers should improve the quality of operating room care services for the operating room nurses in an environment that facilitates psychological empowerment, proper authorization, and reasonable authorization to enhance the innovative ability of the operating room nurses. Key words: Nurses; Operating room; Psychological empowerment; Innovation ability

Research progress on development of sensitive quality indicator for operating room nursing

In recent years, the research on the quality indicator of operating room nursing has gained more and more attention by the industry. In 2016, the former National Health and Family Planning Commission Hospital Management Research Center published the Handbook of Nursing Sensitive Quality Indicators and released 13 sensitive indicators. The new operating room care quality control indicators in Operating Room Care Practice Guide (2018) included the implementation rate of surgical site marker, the incidence of intraoperative skin pressure injury in hospitalized patients, and the incidence of sharp instrument injury in operating room nurses. However, these still do not meet the practical needs of quality management of operating room specialist care. This paper introduces the background and development methods of nursing sensitive quality indicators, summarizes the current situation of the construction of sensitive quality indicators in operating room, and puts forward the shortcomings in the existing research in order to provide a basis for further research on the development of sensitive quality indicators for operating room care. Key words: Review; Operating room care; Nursing sensitive quality indicator; Operating room nursing care control

Practice and Effect of Specialized High Quality Nursing Care in Operating Room

This study aimed to explore the practical effect and reasonable evaluation methods of specialized high quality nursing care in operating room. Stratified random sampling was used to select 93 nurses from the operating rooms of two affiliated hospitals of Kunming Medical University in Yunnan Province. A set of “Specialized High Quality Nursing Care Items in Operating Room” was implemented in the operating rooms of the two hospitals simultaneously. The “Task Performance and Contextual Performance Scale” was used to measure and collect data of nurses in operating room before and after the implementation of the items. After the “Specialized High Quality Nursing Care Items in Operating Room” was implemented, the task performance total score and dimension scores of patient care, nursing information provision and specialized nursing skills were (58.59±1.77), (19.27±1.16), (19.50±1.11), (19.80±0.70), respectively, higher than the respective scores (37.21±1.92), (5.55±0.70), (13.78±1.12), (17.87±0.98) before the implementation, and the differences were statistically significant (t=−82.48 to −15.15, P<0.01). After the “Specialized High Quality Nursing Care Items in Operating Room” was implemented, the contextual performance total score and dimension scores of mutual support among colleagues, extra burden outside work tasks, and support to the organization were (70.43±2.94), (28.23±1.21), (18.52±1.29), (23.67±1.86), respectively, higher than the respective scores (36.20±1.79), (15.52±1.94), (7.33±1.11), (13.34±0.87) before the implementation, and the differences were statistically significant (t=−91.99 to −46.68, P<0.01). In conclusion, the “Specialized High Quality Nursing Care Items in Operating Room” is a series of nursing care that can improve task performance and contextual performance of nurses in operating room and promote the quality of high-quality nursing in operating room. The task performance and contextual performance can also comprehensively and effectively evaluate the implementation effect of specialized high quality nursing care in operating room.

Construction of nursing quality evaluation criteria for operating theatre basing on the three-dimensional quality assessment model

Objective To construct nursing quality evaluation criteria for operating theatres, basing on the three-dimensional quality assessment model, so as to provide scientific basis for objectively evaluating the quality of care in operating rooms. Methods From August to November 2016, a total of 30 medical and nursing specialists from the 2nd Affiliated Hospital of Harbin Medical University were investigated with two rounds of questionnaires by Delphi method, in order to construct the nursing room quality evaluation standard. Results The response rates of the two rounds of questionnaires were 93.33% and 100.00%. The authority coefficient (Cr) of the experts was 0.87 and the degree of expert coordination was good (P<0.001) . The final operating room care quality evaluation criteria include 3 one-level indicators, 19 two-level indicators, and 51 three-level indicators. Conclusions The final nursing quality evaluation criteria were reliable and valid, which can provide standard for the nursing quality evaluation and management of operating room. Key words: Operating rooms; Three-dimensional quality assessment model; Delphi

Causal Analysis of World Health Organization's Surgical Safety Checklist Implementation Quality and Impact on Care Processes and Patient Outcomes: Secondary Analysis From a Large Stepped Wedge Cluster Randomized Controlled Trial in Norway.

We hypothesize that high-quality implementation of the World Health Organization's Surgical Safety Checklist (SSC) will lead to improved care processes and subsequently reduction of peri- and postoperative complications. Implementation of the SSC was associated with robust reduction in morbidity and length of in-hospital stay in a stepped wedge cluster randomized controlled trial conducted in 2 Norwegian hospitals. Further investigation of precisely how the SSC improves care processes and subsequently patient outcomes is needed to understand the causal mechanisms of improvement. Care process metrics are reported from one of our earlier trial hospitals. Primary outcomes were in-hospital complications and care process metrics, e.g., patient warming and antibiotics. Secondary outcome was quality of SSC implementation. Analyses include Pearson's exact χ test and binary logistic regression. A total of 3702 procedures (1398 control vs. 2304 intervention procedures) were analyzed. High-quality SSC implementation (all 3 checklist parts) improved processes and outcomes of care. Use of forced air warming blankets increased from 35.3% to 42.4% (P < 0.001). Antibiotic administration postincision decreased from 12.5% to 9.8%, antibiotic administration preincision increased from 54.5% to 63.1%, and nonadministration of antibiotics decreased from 33.0% to 27.1%. Surgical infections decreased from 7.4% (104/1398) to 3.6% (P < 0.001). Adjusted SSC effect on surgical infections resulted in an odds ratio (OR) of 0.52 (95% confidence interval (CI): 0.38-0.72) for intervention procedures, 0.54 (95% CI: 0.37-0.79) for antibiotics provided before incision, and 0.24 (95% CI: 0.11-0.52) when using forced air warming blankets. Blood transfusion costs were reduced by 40% with the use of the SSC. When implemented well, the SSC improved operating room care processes; subsequently, high-quality SSC implementation and improved care processes led to better patient outcomes.

Effect of operating room care combined with home care for the postoperative rehabilitation and prognosis of gastric cancer patients with low PTEN gene expression.

The aim of the present study was to analyze the effect of operating room (OR) care combined with home care on postoperative rehabilitation and prognosis of gastric cancer patients with low PTEN gene expression. Ninety-six gastric cancer patients with low PTEN gene expression, who underwent surgical treatment in our hospital were recruited. PTEN expression was measured by semi-quantitative polymerase chain reaction. Participants were randomized into the observation and control groups, with 48 cases each. Participants in the two groups received the same preoperative examination, gastric cancer surgery, postoperative drug therapy, and general care, while observation group participants were provided more comprehensive OR care combined with home care. After 1 year of home care, the self-rating anxiety scale (SAS) and Hamilton anxiety scale (HAMA) scores, rehabilitation status, overall quality of life, and Family Adaptability and Cohesion Scale were applied to compare postoperative rehabilitation and prognosis status in both groups. Data were statistically analyzed. Patients were followed up for 3 years, and survival time was analyzed. The operative time and bleeding volume between the two groups were not significantly different (p>0.05). The time of extubation and postoperative recovery time in the observation group were shorter than in the control group (p<0.01). The postoperative SAS and HAMA scores in both groups were significantly decreased compared with those preoperatively (p<0.01). Additionally, these scores were significantly lower in the observation than in the control group (p<0.01). The rehabilitation status of body function in the observation group was better than in the control group (p<0.01). Regarding the overall quality of life score and family adaptability and cohesion score, the observation group was better than the control group (p<0.01). In conclusion, OR care combined with home care was effective for the care of gastric cancer patients with low PTEN expression. Improving patient mood and mental state played a positive role in postoperative rehabilitation and prognosis.

Application of target management on pressure ulcer prevention in surgical patients

Objective To explore the effects of target management on pressure ulcer prevention in surgical patients. Method The patients with selective operation were selected as study objects from January 2013 to December 2015. The traditional nursing for pressure ulcer prevention was carried out for operation patients from January 2013 to December 2013. The target management for pressure ulcer prevention was carried out for operation patients from January 2014 to December 2015. And then, we compared the incidence of pressure ulcer, that of patients with high risk of pressure ulcer, annual incidence rate of pressure ulcer of patients with lying position for surgery, distribution of ulcer stage and so on before and after target management. Results The annual incidence rate of pressure ulcer of 2013, 2014, 2015 was 0.23%, 0.11%, 0.07%. The incidence rate of pressure ulcer of 2014 and 2015 was lower than that of 2013 with significant differences (χ2=24.23, 43.32 ; P 0.05). The incidence rate of pressure ulcer of patients with high risk of pressure ulcer in 2013 and 2014 was also higher than that in 2015 with significant differences (χ2=13.00, 4.88; P<0.05). At the same time, the incidence rate of pressure ulcer of patients with lying position for surgery in 2013, 2014, 2015 was 6.00%, 3.53%, 1.06%. The incidence rate of pressure ulcer of patients with lying position for surgery in 2014 and 2015 was lower than that in 2013 with significant differences (χ2=7.63, 47.05; P<0.05). Conclusions The implementation of target management can reduce the incidence of pressure ulcer, that of patients with high risk of pressure ulcer, that of patients with lying position for surgery, guarantee the safety of patient and improve the quality of nursing care in operating room. Key words: Pressure unclear; Operating room; Target managements

Effects of WeChat group in teaching of standardized training among Operating Room nurses

Objective To explore the effects of WeChat group in teaching of standardized training among Operating Room nurses. Methods A total of 28 nurses accepting standardized training in Operating Room were selected as control group (standardized training) from July 2011 to December 2012. A total of 28 nurses accepting standardized training in Operating Room were selected as intervention group (standardized training & WeChat group teaching ) from January 2013 to July 2014. What was compared after intervention among nurses between two groups included theoretical knowledge, the score of operation skill, nurses′ satisfaction with training, the satisfaction degree of patients and family members and surgeons′ satisfaction with nurses. Results After the intervention with WeChat group teaching, scores of theoretical knowledge and technical knowledge were (96.3±3.6) and (94.5±4.6) in intervention group which were higher than those in control group with significant differences (t=-8.652, -7.254; P 0.05). Scores of suture needle, aseptic technique, transferring equipment in operation, arranging surgical position, surgery cooperation were (92.1±6.2), (91.6±5.2), (95.6±3.3), (96.2±3.6), (97.1±2.6) in intervention group which were higher than those in control group with significant differences (t=-4.125, -4.526, -3.856, -5.846, -9.032; P<0.01). Satisfaction degrees of nurses with training, surgeons with nurses, patients′ family members with treatment in intervention group were obviously better than those in control group with significant differences (P<0.01). Conclusions Training with WeChat group in nurses can visibly improve nurses′ study enthusiasm, theoretical knowledge, operation skill, satisfaction degrees of nurses with training, surgeons with nurses, patients and their family members with treatment and improve the quality of care in operating room at the same time. Key words: Operating Room; Standardized training; WeChat group

Development and application of micro courses on instruction of nursing care in Operating Room

Objective To discuss application effects of nursing micro course on instruction of nursing care in Operation Room and to improve the quality of teaching. Methods Development team of micro courses was set up. And then, micro courses of Operating Room were developed, produced and applied. Nursing micro courses of Operating Room were applied to 81 student nurses in Operating Room based on one-to-one model of teaching. Results Questionnaire investigations on the evaluation of teaching mode were carried on after the end of the internship of Operating Room. 91.4% of them agreed that the education based on micro courses could improve self-regulated learning ability; 88.9% of them thought this kind of method could improve learning efficiency as well as learning interest; 97.5% of them thought this kind of method could make learning time sufficient and free; 93.8% of them also thought that this method could improve learning and made them have a sense of accomplishment; 80.2% of them thought it made the communication with teachers better. A semi-structured interview was also carried out in 9 teachers about the development and application of micro curriculum in Operating Room. 66.7% and 33.3% of teachers thought their knowledge, working skills and teaching skills had a certain extent and great improvement; 88.9% of teachers thought this way realized the standardization teaching in Operating Room; 55.6% of them indicated that students could quickly adapt to their job roles. Conclusions Application of micro courses in clinical education of Operating Room can improve practice quality of student nurses and improve their satisfaction with self-learning and clinical teaching. Key words: Hospital, education; Operating Room; Nursing; Micro course

Nursing coordination of lung resection under thoracoscopy

Objective To discuss the nursing care experience of lung resection under thoracoscopy in order to provide a useful reference for reducing complications and improving quality of life for patients. Methods Totals of 72 patients with lung cancer were selected from January to December 2012 and divided into the intervention group and the control group, with 36 patients in each. The control group used conventional care methods, and the intervention group had more detailed and humane care in the perspectives of preoperative visiting, operative reports, relaxation training, postural training, operating room care, surgery care, postoperative care and so on. After admission and 7 days after surgery, the Quality of Life Scale-C30 (QLQ-C30) was used to carry out the investigation. Results The hospital stay of patients in the intervention group was (10.2±1.8) days, the extubation time was (56.3±7.6) hours, which were significantly lower than (17.4±3.9) days and (64.9±8.1) hours in the control group (t=-10.057, -4.646, respectively; P 0.05). The quality of life and symptom scores of two groups in the time of admission had no statistically significant differences. After the treatment, the overall health status, role, emotion, cognition, society of patients in the intervention group and control group were statistically significant (t=2.109, 2.547, 2.047, 2.141, respectively; P<0.05). Conclusions Good nursing care in the periods of lung resection under thoracoscopy can reduce the rate of complications which is critical to patients’ recovery. Key words: Thoracoscopy; Lung resection; Nursing care; Postoperative complications; Quality of life

Effect of parent presence recovery program on recovery from general anesthesia in children

Objective To study the effect of parent presence recovery program (PPRP) on recovery from general anesthesia in children.Methods 180 cases of children of the general surgery as the research object,were randomly divided into observation group (n=90) and the control group (n=90),and the control group was given regular operating room care,the observation group used PPRP mode.Results Two groups successfully completed surgery,restless rate of the observation group was significantly lower than that of the control group,parents' anxiety levels were also significantly lower than those of the control group (x2=8.057,P＜0.01; t=11.884,P＜0.01).Conclusion PPRP mode has positive significance in reducing restless for the children,alleviating patients' anxiety and promoting the standard operation,which is worth of clinic application promotion. Key words: Children; Recovery from general anesthesia; Nursing

Interpretation of the Association Between Frequency of Self-Reported Medical Errors and Faculty Supervision of Anesthesiology Residents

Interpretation of the Association Between Frequency of Self-Reported Medical Errors and Faculty Supervision of Anesthesiology Residents

Contemporary Issues in Operating Room Care: A Critical Incident

During my training to become an Operating Department Practitioner (ODP) I experienced a situation which could have endangered a patient. I have reflected upon this incident using the Gibbs reflective cycle (see Jasper 2003) to help me analyse how the situation arose, how it could have been prevented and what I can learn from it. During the incident I was undertaking the circulating role in an orthopaedics case.

Sex differences in operating room care giver perceptions of patient safety: a pilot study from the Veterans Health Administration Medical Team Training Program

BackgroundAchieving a culture of safety is believed to be an important mechanism for improving patient safety. The Safety Attitudes Questionnaire (SAQ) measures provider perceptions of patient safety culture across six...

An American contribution to German anesthesia.

An American contribution to German anesthesia.