Surgical Ward Nurses Research Articles

Nurses' Recognition and Care of Thirst in Perioperative Patients in Japan.

Postoperative thirst is common and distressing to patients, as is pain and nausea. The causes of postoperative thirst are complex and include factors like preoperative fasting, perioperative fluid loss, and certain anesthesia medications. Effective care for postoperative thirst has been shown in post-anesthesia care units (PACUs), but many Japanese hospitals lack PACUs or do not address thirst in their PACUs. Therefore, cooperation between the operating room and ward nurses is crucial for providing proper care for postoperative thirst. The purpose of this study was to clarify the actual situation of ward nurses' and operating room nurses' recognition and care of thirst in postoperative patients. The study was a cross-sectional survey conducted using a self-administered questionnaire based on previous research. Study participants were nurses working in surgical wards and operating rooms of two university-affiliated hospitals. The survey items included (1) participants' characteristics, (2) recognition of thirst in perioperative patients, and (3) actual care provided to perioperative patients for thirst. Data were collected between September and October 2022 and subjected to descriptive and bivariate analysis. A total of 298 ward nurses and 43 operating room nurses were included in the study. Among the observation items, thirst was observed least frequently. Both ward nurses and operating room nurses recognized patient thirst based on complaints rather than physical observations. Sharing of information about patient thirst differed between ward nurses and operating room nurses. None of the participants used scales or scores to evaluate thirst. The most common postoperative care in the ward was "They were asked to do a mouthwash with water," while in the operating room, it was "Placed a moistened gauze against the mouth." The reasons for selecting a particular type of care were primarily based on "Because of the patient's wishes" and "I think it is effective," while the reasons for not providing care included "Because there is an instruction not to drink water," "Due to the possibility of aspiration," "I don't have the knowledge and don't know how," and "I'm busy with other work." Regarding the recognition of thirst, both ward nurses and operating room nurses recognized patient thirst most often when the patient directly reported feeling thirsty. They relied more on patients' verbal complaints than physical observations to recognize thirst. Both surgical ward nurses and operating room nurses provided care based on their experience.

Determination of the Incidence of Inadvertent Perioperative Hypothermia, Thermal Comfort, and Factors Affecting Thermal Comfort in Patients Undergoing Elective Surgery: A Cross-Sectional Study

ABSTRACT The aim of this study is to determine the incidence of hypothermia, thermal comfort, and factors affecting thermal comfort in patients undergoing elective surgery during the perioperative period. Conducted between October 1, 2020, and March 1, 2021, this cross-sectional study, approved ethically, involved 306 elective surgery patients. Data, collected during nine perioperative periods (T0-T8) by nurses in surgical wards and operating rooms, used a literature-based form. The reporting of the study utilized the STROBE checklist Statistical analysis with SPSS 22.0 set a significance level of p

Nurses’ Knowledge Regarding Laparoscopic Cholecystectomy

Background: The most effective treatment for gallstones is laparoscopic cholecystectomy due to the many benefits of open surgery, including fewer incisions, shorter hospital stays, the elimination of the need for a stomach tube and drainage tube, fewer analgesics, and fewer problems. Objectives: To identify nurses’ knowledge regarding laparoscopic cholecystectomy. Methods: A descriptive investigation was conducted between September 15, 2022, and July 20, 2023. The Al-Sader Teaching Hospital and the Basrah Teaching Hospital in Basrah City are the sites of the investigation. A deliberate non-probability sample of surgical ward nurses was chosen. Two hundred nurses make up the sample. A panel of specialists assessed the questionnaire's validity, and a pilot study proved its dependability. Data was gathered using the questionnaire, and the findings were analyzed using both descriptive and inferential statistics. Results: According to the table's findings, the majority of nurses (76%) have little understanding of cholecystectomy, 20% have medium knowledge, and 4% have strong knowledge, with a mean score and standard level deviation of 1.59+0.709. Conclusion: This study concluded, most of the study sample have low knowledge about cholecystectomy. Highlights: Laparoscopic cholecystectomy offers advantages over open surgery Assess nurses' knowledge on laparoscopic cholecystectomy Most nurses have low knowledge about cholecystectomy. Keywords: Nurses, Knowledge, Laparoscopic, Cholecystectomy

Knowledge, attitude and practices regarding standard precautions among registered nurses in medical and surgical wards: A cross-sectional study

Background: Hospital-acquired infections (HAIs) are a significant global challenge, particularly in low-income countries. Nurses play a crucial role in preventing and controlling HAIs by adhering to standard precautions. However, challenges persist in ensuring consistent implementation among health care workers. Aim: To assess the knowledge, attitudes, and practices (KAP) related to standard precautions among registered nurses posted in medical and surgical wards and to identify related factors. Materials and Methods: A descriptive cross-sectional study was conducted among 70 registered nurses at a district-level hospital in Northern India using a purposive sampling technique. Data were collected using a self-structured KAP questionnaire on standard precautions. Two-step cluster analysis was employed to categorise the study samples. Differences between the KAP groups were assessed using statistical tests. Multiple linear regression analysis was performed to identify factors influencing the KAP groups. Results: Most nurses (54.3%) belonged to the Poor KAP group, while the remaining 45.7% belonged to the Good KAP group. A significant variation in the KAP clusters was observed according to marital status (P<0.05). A weak negative correlation was found between the knowledge and attitude scores in both KAP groups (P<0.05). Multiple linear regression analysis indicated that nurses’ KAP was significantly influenced by their attitude and practice scores. Conclusions: Most nurses exhibited poor knowledge, attitudes, and practices towards standard precautions. Attitude and practices had a significant negative influence on nurses’ KAP, highlighting the need for targeted interventions to improve adherence to standard precautions and mitigate the risk of HAIs.

Qualitative drivers of postoperative prophylactic antibiotics use and resistance in Ethiopia.

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. 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. 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. 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.

The effect of clinical supervision model on nurses’ self-efficacy and communication skills in the handover process of medical and surgical wards: an experimental study

BackgroundThe handover process is a vital part of patient safety continuity, particularly conducted between nurses at the end of shifts. Nurses often face challenges in handover due to a lack of self-efficacy and inadequate communication skills. The clinical supervision model, by providing emotional, educational, and organizational support, aids in skill acquisition and instills confidence.ObjectiveThis study was conducted to investigate the effect of the clinical supervision model on nurses’ self-efficacy and communication skills in the handover process within medical and surgical wards.MethodThis experimental two-group (pre-and post-test) study was conducted in 2024 at selected hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran. Convenience sampling was used, and participants were randomly assigned to either the intervention or control group. Data were collected using the ISBAR communication checklist, communication clarity, the Sherer General Self-Efficacy Scale (GSES), the Visual Analog Scale (VAS) for handover self-efficacy, and the Manchester Clinical Supervision Scale (MCSS). The clinical supervision model and routine supervision were implemented in six sessions for the intervention and control groups, respectively. Data were analyzed using SPSS version 16, employing independent t-tests, covariance analysis, paired t-tests, chi-square tests, and repeated measures ANOVA with a significance level of p < 0.05.ResultsNo significant differences were observed between the intervention and control groups in terms of baseline characteristics. Inter-group analysis indicated that there were no significant differences in the scores of self-efficacy, ISBAR, and communication clarity between the control and intervention groups before the intervention (P > 0.05). According to the intra-group analysis, the ISBAR and communication clarity scores in the intervention group significantly increased over time (p < 0.001), whereas no such increase was observed in the control group. The intervention group showed a significant increase in general self-efficacy (p < 0.001) compared to the control group. Although both groups showed a significant improvement in handover self-efficacy, the mean scores of the intervention group were higher than those of the control group (p < 0.001). The mean score of the Manchester Clinical Supervision Scale in the intervention group was 128.98, indicating the high effectiveness of implementing the clinical supervision model.ConclusionThe findings indicated that the use of the clinical supervision model improves self-efficacy and communication skills in the handover process of nurses in medical and surgical wards. Therefore, it is recommended to use this model in handover training to enhance the quality of care and improve patient safety.

Registered general nurses' health assessment practices in a tertiary hospital: A focused ethnography study.

To explore the assumptions and values that influence nursing health assessment practices among registered general nurses in general medical and surgical wards. The study was designed as a focused ethnography. A semi-structured interview guide was used to explore prevailing nursing health assessment practices of 13 registered general nurses in an attempt to explore the assumptions and values influencing health assessment practices in the study setting. Data were analysed inductively using an interpretive qualitative content analysis method. Nursing health assessment practices, and underlying assumptions and values were underpinned by a central theme of a culture of low expectation relating to nursing health assessment. The culture of low expectation was highlighted in five themes: (1) Unsystematic Assessment of Health Status, (2) Purpose of Nursing Health Assessment, (3) The Role of Nursing Educational and Regulatory Institutions, (4) Ward Ethos and (5) The Role of Organizational and Ward Leadership. The adoption of a holistic nursing health assessment framework with a clearly defined purpose of aiding nursing diagnoses can guide patient-centred care delivery and facilitate early recognition of physiological deterioration. Thirteen registered general nurses were interviewed, and the initial findings returned to them for validation. The potential contribution of nursing health assessment to nursing practice and patient outcomes may not be fully realized if nursing health assessment is not situated within a holistic health assessment model with a clearly defined purpose for nursing practice.

Burnout and Its Related Risk Factors: A Comparison Study of Nurses Working in Two Different Wards

Background: Nursing is a physically and emotionally demanding job, making nurses highly susceptible to burnout. Burnout is associated with many deleterious consequences affecting health care outcomes. Objectives: We aimed to evaluate and compare burnout and its associated risk factors in nurses working in 2 different wards: Operating rooms and surgical wards. Methods: This cross-sectional analytical study was conducted on 100 operating room nurses and 100 surgical ward nurses at Vali-Asr Hospital, Tehran University of Medical Sciences. Data collection instruments included a demographic questionnaire and Maslach Burnout Inventory (MBI). Data were analyzed using SPSS version 22. Results: Overall, the burnout score in surgical ward nurses was 69.22, while it was 67.97 in nurses working in operating rooms (P = 0.449). Scores of emotional exhaustion, depersonalization, and personal accomplishment subscales in nurses of surgical wards were 54.66, 81.16, and 71.85, respectively. These rates for operating room nurses were 53.02, 80.44, and 70.47, respectively; however, these differences were not statistically significant. There was a significant correlation between working shifts and burnout (P = 0.002). Satisfaction with income was significantly associated with the working environment (P = 0.047). Conclusions: The levels of burnout were high in nurses in both operating rooms and surgical wards. Due to nurses' pivotal role in the health system, identifying burnout and eliminating its causes are highly crucial.

The effect of regular nursing rounds on patients' comfort and satisfaction, and violence against nurses in surgical ward

Patients' satisfaction and comfort are known as the quality indicators of nursing care. Nowadays, violence against nurses has an increasing trend. Regular nursing rounds are one of the caring programs that help improve these indicators. This study aimed to examine the effect of regular nursing rounds on patients' comfort, satisfaction, and violence against nurses. This quasi-experimental study was conducted in two groups consisting of 100 patients and 35 nurses in a surgery ward in the northwest of Iran. The satisfaction with nursing care quality questionnaire, Kolcaba's general comfort questionnaire, and work environment violence were used for data collection. In the present study, the control and intervention groups were selected using a simple sampling method. The control group received routine care only; however, the intervention group received a regular nursing round program every 2h from the second day of their admission for three days. The satisfaction questionnaire and comfort scale were completed on the second and fifth days of admission, and the evaluation of violence against nurses was performed from the second to the fourth day. The results were analyzed using chi-square, Fisher, independent t, and paired t tests. Before the intervention, no statistically significant difference was observed between the two groups in terms of demographic and dependent variables (p>0/05). After the intervention, statistically significant differences were observed among the mean scores of satisfaction with nursing care (p<0/001), comfort (p<0.001), and violence against nurses (p=0.041) between the two study groups, so that in the intervention group, the patients' satisfaction and comfort increased and violence against nurses reduced during the intervention period. The use of regular nursing rounds had a positive effect on the study results. Therefore, it is recommended that nurse managers design, implement, encourage, and evaluate regular nursing rounds to improve nursing care.

Nurses' viewpoints on factors affecting ostomy care: A qualitative content analysis.

Ostomy plays an important role in management of medical conditions, especially postoperative status of colorectal and bladder cancers. Nurses who have the highest contact level with these patients, face many situations while providing care and need to acquire adequate knowledge and practice responding to patients' needs. The aim of this study was to explore the lived experiences of nurses in caring of abdominal ostomy patients. A qualitative content analysis study. In this qualitative content analysis study, 17 participants were selected using purposeful sampling method and data were collected through in-depth and semi-structured interviews. Data analysis was done using conventional content analysis method. Analysis of the findings led to the emergence of 78 sub-subcategories, 20 subcategories and seven main themes, including 'Inefficient educational system', 'Nurse Characteristics', 'Workplace challenges', 'Nature of ostomy care', ' Counseling and preparation of patients for surgery', 'Acquaintance with ostomy complications', and 'Proper planning of patient education'. Results showed that nurses in surgical wards provide non-special ostomy care due to lack of sufficient knowledge and skills and absence of up-to-date and local clinical guidelines which is vital to provide evidence-based scientific care and avoid unfounded and arbitrary care.

Nurse job task analysis: a profile of medical and surgical nursing activities.

ObjectiveWe aim to examine the activities undertaken by medical and surgical ward nurses at a major health service in Victoria, Australia, to inform nursing and midwifery strategic workforce planning.MethodsThis descriptive, exploratory study was conducted on 17 wards from three acute care hospitals in one of Victoria's largest health services. The Work Observation Method by Activity Timing tool was used to enable participants to document the time spent in each of 10 nursing activity domains.ResultsData from 70 respondents across all shifts showed nurses spent one-third of their time in direct care. Registered nurses spent a lower proportion of time than enrolled nurses in direct care and medications overall. Compared with enrolled nurses, registered nurses spent less time in direct care on morning shifts and documentation on afternoon shifts, and more time on ward-related activities on afternoon shifts.ConclusionsMedical and surgical enrolled nurses and registered nurses spent comparable proportions of time engaged in specific activities. Further research is required to understand the influences on the time devoted to direct care and how time spent in direct care intersects with other activities, and the relationship with patient outcomes and quality of care indicators.

Nurses’ knowledge and attitudes toward patient-controlled analgesia for postoperative pain control in a tertiary hospital in South Korea

BackgroundThis study investigated the knowledge and attitude of surgical ward nurses toward patient-controlled analgesia (PCA) to develop educational material for nurses on the use of PCA.MethodsThis study was a cross-sectional study comprising 120 nurses from eight surgical wards in a tertiary hospital in South Korea. A questionnaire addressing 6 domains of knowledge of and attitudes towards PCA was conducted over 1 week and analyzed using descriptive and inferential statistical methods. Knowledge was measured on a categorical scale of 0 and 1 (20 points), and attitude was measured on a Likert scale of 1 to 4 points (60 points).ResultsThe total score quantifying the knowledge of and attitudes toward PCA of surgical ward nurses was 59.5 ± 5.5 out of 80.0 points. The average age of the subjects was 28.58 ± 5.68 years old, and nurses above the age of 28 had significantly greater knowledge and better attitudes (61.7 ± 5.5) than those below the age of 28 (57.9 ± 4.9) (p < .001). Nurses working on the upper abdominal surgical ward had significantly greater knowledge (16.2 ± 1.9) than nurses working on other wards (thorax: 14.0 ± 2.3, lower abdominal: 15.4 ± 1.9, and musculoskeletal: 14.5 ± 2.2) (p = .001). Nurses who received education about PCA had significantly better attitudes (45.3 ± 4.6) than those who did not (41.3 ± 3.5) (p < .001). The average correct answer rate for knowledge of opioid analgesics was lower (68.2%) than that for knowledge of the basic configuration of PCA equipment (73.3%) and areas to be identified and managed when using PCA (84.6%), and there was a significant correlation with attitudes toward side effect management (p < .05, r = .19).ConclusionsThere was a significant correlation between the knowledge and attitude of nurses regarding opioid use in PCA. Older nurses with greater clinical experience on the surgical wards who had received PCA education had a better attitude toward PCA. Therefore, newly trained nurses on surgical wards with no experience of PCA education should undergo an intensive education program on opioid analgesics used in PCA.

317 Preoperative Fasting in Adults – A Quality Improvement Project at Macclesfield District General Hospital

Abstract Aim Our primary endpoint was to evaluate staff awareness of preoperative fasting guidelines. Our secondary endpoint was to evaluate patient preoperative fasting times. Method Data were collected using online close-ended survey questions from surgical ward nurses and healthcare assistants before and after implementing a multimodal campaign to raise awareness. Data were collected for patient fasting times before and after the same interventions. Interventions: Results Staff: Our interventions increased staff awareness of preoperative fasting guidelines for food by 20.6% (from 50% to 70.6%) and for clear fluids by 28.8% (30% to 58.8%). Patients Average preoperative fasting times for food before and after intervention were 12.7 and 12 hours respectively (p=0.736). For clear fluids, average fasting times before and after intervention were 6.2 hours and 4.5 hours (p=0.415). Conclusions Staff were generally unaware of the guidelines and viewed preoperative fasting solely as a safeguard against aspiration, causing adoption of a risk-averse attitude. The benefits of adequate hydration and nutritional support before surgery were overlooked. Our interventions helped raise awareness in the short term. For our next cycle, we plan to assess the efficacy of implementing long-lasting changes such as local trust guidelines and improved staff training to drive a change in attitude and awareness of preoperative fasting.

A qualitative study of nurse-perceived barriers to body temperature management in postoperative patients.

Although evidence-based practices exist for preventing hypothermia in patients during surgery, few studies have focused on this concern in postoperative patients. The aim of this qualitative study was to explore the most challenging issues experienced by surgical ward nurses while managing the body temperature of adult surgical patients. To address this research gap, this study used a qualitative descriptive design to document barriers to body temperature management as reported by a sample of 16 perioperative nurses. The semi-structured, face-to-face interviews were digitally recorded, transcribed verbatim and analysed using inductive content analysis. The main barriers fell into three categories: professional nursing ability limitations, unfavourable working conditions and management of human resources. The eight subcategories were disadvantageous professional views, professional knowledge limitations, low motivation to provide nursing care, non-standard treatment environment, inadequate equipment and care protocols, heavy nursing care loads, inadequate staff training and ineffective staff supervision. These findings highlighted the importance of adequate resources, proper education and evidence-based care protocols in the effective delivery of body temperature management to postoperative patients.

THE EFFECT OF WORK STRESS AND WORKLOAD ON THE PERFORMANCE OF INPATIENT NURSES IN SURGICAL WARDS AND OBSTETRICS WARDS AT PKU MUHAMMADIYAH HOSPITAL KARANGANYAR, INDONESIA

This study aims to determine the effect of work stress and workload on the performance of inpatient nurses in the Surgical Ward and Obstetrics Ward at PKU Muhammadiyah Hospital, Karanganyar. The research approach used a quantitative approach with a cross sectional survey method. In this study, the population consisted of all inpatient nurses who worked in the Surgical Ward and Obstetrics Ward PKU Muhammadiyah Karanganyar Hospital, with a total sample size of 50 people. The normality test, multicollinearity test, and hypothesis testing were used in the data analysis. According to the findings of the study, work stress has a significant impact on the performance of inpatient nurses in the Surgical Ward and B at PKU Muhammadiyah Karanganyar Hospital (p &lt; 5%). The higher the stress, the worse the performance of inpatient nurses in PKU Muhammadiyah Karanganyar Hospital's Surgical Ward and Obstetrics Ward. The workload of nurses has a significant effect on the performance of inpatient nurses in the Surgical Ward and B at PKU Muhammadiyah Hospital Karanganyar (p &lt; 5%). The higher the workload, the worse the performance of inpatient nurses in PKU Muhammadiyah Karanganyar Hospital's Surgical Ward and Obstetrics Ward. Work stress and workload have a significant impact on employee performance at PKU Muhammadiyah Hospital Karanganyar, accounting for 71.7 percent of the total.

Nurses' attitudes towards hospitalized older adults in a tertiary care setting in Ghana.

IntroductionThe increasing population of older adults and rapid increases in co‐morbidities globally has necessitated the need for a healthcare delivery system that meets the multifaceted needs of the growing population of older adults. Concurrent with these rising complex health needs is the importance of positive, non‐judgmental attitudes of health services providers towards older adults. Moreover, this is particularly important in the nursing profession, given nurses' significant and crucial roles in healthcare settings.AimThe study aimed to evaluate nurses’ attitudes towards older adults in a tertiary hospital in Ghana.DesignIt employed a descriptive cross‐sectional quantitative design.MethodData were collected from 160 registered adult medical and surgical ward nurses using the Ageism Attitude Scale (AAS).ResultsFindings indicated that more than half of the participants had a diploma in general nursing. None of the nurses surveyed specialized in the care of older adults, and the mean age of participants was 30.14 (3.75) (minimum 24 and maximum 42 years). Female nurses had more positive attitudes than their male counterparts. Although the surveyed nurses reported a somewhat positive attitude towards older adults, there was no correlation between nurses' education levels and positive attitudes.

Effectiveness of an Instructional Program for Nurses' About Nursing Documentation at Pediatric Surgical Wards

Objectives: Evaluate the effectiveness of the instructional program for nurse's knowledge's about nursing documentation at pediatric surgical wards. Study design: A quasi-experimental design was implemented in the research to achieve the study goals by using pre- and post-tests for one group of nurses in pediatric surgical wards. in Baghdad city. The study has been carried out during the period extended from the 23th december 2021 to 20th July 2022. Data collection: It was done at three times: baseline data (before any instruction was provided to the study group), then post-test 1 after 21 days of starting to give the instructional program (in the study group), and post-test 2 after 2 months of starting to give the instructional program. Conclusion: Illustrated from this study, the nurses have poor knowledge regarding nursing documentation at pediatric surgical wards at pretest in study group. Association between nurses' knowledge and their (gender, level of education, years of experience and main source of information. Recommendations: Recommendations were made based on findings. for further research is imperative, that will pay more attention to the accuracy of nursing documentation, factors leading to variation in practice, flaws in nursing documentation quality and the effects of these on nursing practice and pediatric patient outcomes. Keywords: nurses, nursing documentation, pediatric surgical wards.

Gap between risk factors and prevention strategies? A nationwide survey of fall prevention among medical and surgical patients.

AimsThis study aimed to determine the extent to which nurses report assessing evidence‐based falls risk factors and implementing targeted prevention for medical and surgical patients in China.DesignThis study was a national online survey.MethodsThe respondents were registered nurses working in medical and surgical units in 662 Chinese hospitals. The data concerning the falls risk factor assessments and targeted interventions implemented by nurses were collected online by the Nursing Management Committee of the Chinese Nursing Association in China in 2019.ResultsIn total, 68 527 valid questionnaires were returned (95.0%). In medical and surgical units, nurses were most likely to report assessing balance, mobility and strength (81.6%) and orthostatic hypotension (76.4%) in falls patients and least likely to report assessing continence (61.3%) and feet and footwear (55.8%). Ensuring the use of appropriate footwear (79.3%) and managing syncope, dizziness and vertigo (73.8%) were the most common multiple interventions, while managing postural hypotension (48.8%) and cognitive impairment (48.4%) was the least common. Nine falls risk factors with clearly matched multifactorial interventions were identified in medical and surgical units (68.2%–97.1%).ConclusionsThe implementation of multifactorial interventions in medical and surgical wards is inconsistent as reported by nurses in medical and surgical wards. Throughout China, nurses are generally concerned about falls risk factors and prevention for their patients; however, limited attention has been focused on continence, feet and footwear assessment and the management of cognitive impairment. Evidence‐based falls prevention should be further tailored to the specific risk factors of each patient.ImpactBest practice guidelines for falls prevention in hospitals have been developed and published, and it is important for nurses to use these guidelines to guide practice. Our findings identify that in routine care, healthcare providers and hospitals can prevent falls.

Awareness under anaesthesia: The role of the perioperative nurse

Intra-operative awareness is very rare yet represents a serious complication of general anaesthesia. The ongoing consequences of such an event may cause significant distress and long-term effects such as insomnia, depression, anxiety and post-traumatic stress disorder (PTSD). To provide safer anaesthesia, it is critical to identify contributing factors related to both the patient and the anaesthesia to prevent intra-operative awareness in at-risk patients. It is also vital to provide education to Post Anaesthesia Care Unit (PACU) nurses and surgical ward nurses about the appropriate way to manage a situation when a patient reports intra-operative awareness following anaesthesia. General anaesthesia with neuromuscular blockade is still considered the highest risk factor for intra-operative awareness. Depth of anaesthesia monitoring has come under the spotlight to try and address this complication; however, there is yet to be a device or technique that provides 100 per cent accuracy in measuring depth of anaesthesia. It is the collective responsibility of all perioperative staff to identify patients at high risk of intra-operative awareness, manage the intra-operative complexities and offer support and expert counselling post-operatively when intra-operative awareness is reported.

Direct Hand Hygiene Observations and Feedback Increased Hand Hygiene Compliance Among Nurses and Doctors in Medical and Surgical Wards - An Eight-Year Observational Study

Direct Hand Hygiene Observations and Feedback Increased Hand Hygiene Compliance Among Nurses and Doctors in Medical and Surgical Wards - An Eight-Year Observational Study