Postoperative Nursing Care Research Articles

Postoperative nursing in robot‐assisted urologic surgery: Are there any platform‐based differences?

AbstractMany robotic platforms are currently available for urologic surgery, each with its technical characteristics. It can be hypothesised that these characteristics might affect postoperative nursing, as they affect several aspects of surgery. They could, therefore, impact the surgical outcomes and wound characteristics, involving aspects of postoperative care such as mobilization, nutrition and length of stay. Although data are available on surgical technique aspects and intraoperative nursing, studies have yet to offer insights and considerations about the potential effect of having different robotic platforms on postoperative nursing care. We aimed to verify whether the technical features of the available robots could impact postoperative nursing. We conducted an integrative review on PubMed, CINAHL and Scopus, using Medical Subject Headings (MeSH) and free‐text terms; wildcards and boolean operators were also used. Studies of any design were included. Fifteen papers were retrieved; the key themes emerging from the literature regard trocar setup, technical characteristics of the robots (e.g. single or multiple ports), pneumoperitoneum and Trendelenburg degree. According to the literature, none of these characteristics produce differences in postoperative nursing. The fundamental concepts of postoperative care in surgical inpatients stay the same no matter the robotic platform used. Having competing platforms able to ensure reduced complications without impacting postoperative nursing allows health care facilities to adopt the newest technologies without the need for differentiated nursing protocols. This is an advantage in times of global nursing shortage as it avoids the need for additional platform‐based nursing training.

Reducing Opioid Consumption and Length of Stay After Bariatric Surgery: A Nonpharmacologic ERAS Intervention Bundle

PurposeTo reduce opioid consumption and decrease length of stay (LOS) in bariatric surgical patients by implementing an evidence-based, nonpharmacologic enhanced recovery after surgery (ERAS) intervention bundle. DesignEvidence-based practice project. MethodsWe developed and implemented a nonpharmacologic ERAS bundle from existing American Society of PeriAnesthesia Nurses Standards and bariatric and subspecialty surgical ERAS protocols to standardize the postoperative nursing care of bariatric patients. The bundle consisted of early ambulation, immediate initiation and prolonged use of oxygenation, prevention of nausea and vomiting, frequent use of incentive spirometry, and application of ice packs to surgical sites. The two project outcomes were opioid consumption and patient LOS. We used descriptive statistics to summarize opioid consumption and LOS among surgical bariatric patients at baseline and post intervention and independent samples t tests to determine the statistical significance of pre- or post-LOS changes. FindingsAfter implementing the ERAS bundle in 31 bariatric surgical patients, we found that the percentage of patients given an opioid substantially decreased by 13.8%, with both fentanyl and hydromorphone (Dilaudid) consumption meaningfully decreasing by 11.0% and 25.6%, respectively. The average LOS significantly decreased (P = .015) by 23 minutes per patient following the intervention, from 1 hour and 58 minutes to 1 hour and 35 minutes, representing a 19.5% reduction in total patient time in the PACU. ConclusionsUse of a nonpharmacologic ERAS bundle and standardizing postoperative care decreased overall PACU bariatric surgical patient opioid consumption and significantly reduced PACU LOS. Optimizing pain management for bariatric patients in the PACU could lead to improved pain control and reduced reliance on opioids during their entire hospital stay, enhancing health care outcomes and improving patient safety. Perioperative leaders and educators can use our example to develop initiatives that decrease opioid use and LOS to improve care for the high-acuity bariatric patient population.

Postoperative challenges addressed through nursing care of patients receiving lower extremity tumor prosthesis

BackgroundPatients with primary Bone Sarcoma and Giant Cell Tumors in the lower extremities often require major surgery involving tumor prostheses. The postoperative course for this patient group can be complex and influenced by various factors and challenges that demand careful nursing care. This study aims to identify challenges related to the nursing care of individuals with primary bone tumors following surgery for tumor prostheses in the lower extremities.MethodsA retrospective cohort study of 15 patients treated at Rigshospitalet, Copenhagen, Denmark, between November 5. 2016, and April 1. 2020 was conducted by medical record review, focusing on challenges related to postoperative nursing care. All patients with the surgery code “Bone Excision” were identified within the surgery booking system and screened for eligibility.ResultsPatients experienced postoperative challenges such as severe pain, prolonged time to mobilization (mean: 4 days), and defecation (mean: 5 days). The mean length of stay at the Rigshospitalet was 13 days. Furthermore, eleven patients (73%) reported disrupted sleep and nausea.ConclusionPatients undergoing tumor prosthesis surgery in the lower extremities face considerable postoperative challenges that contribute to a prolonged hospital stay. These challenges, including severe pain, delayed mobilization, and gastrointestinal issues, significantly impact recovery. The findings highlight the urgent need for targeted nursing interventions to address these issues effectively. Enhanced pain management protocols, early mobilization strategies, and comprehensive postoperative care plans are essential to improve patient outcomes and reduce the length of hospital stays. Addressing these challenges through dedicated nursing care is crucial for optimizing the recovery process for patients receiving lower extremity tumor prostheses.

Post Bariatric Surgery Nursing Care

Morbid obesity is defined as having a body mass index (BMI) above 40 or having a BMI of 35 and comorbidities along with obesity. Bariatric surgeries can be grouped into three. These are restrictive surgeries, malabsorption (impairing absorption) surgeries, and both restrictive and malabsorption surgeries. In bariatric surgery, restrictive surgeries such as vertical band gastroplasty (VGB), adjustable gastric banding (AGB) surgeries, malabsorption surgeries such as biliopancreatic diversion (BPD)/duodenal switch (DS) surgeries, and both restrictive and malabsorption surgeries such as Roux-en-Y gastric bypass (RYGB) surgeries, are commonly performed. Post-bariatric surgery care should include a multidisciplinary team consisting of a surgeon, an endocrinologist, a psychiatrist, a dietitian, and a nurse specializing in bariatric surgery. Nursing care after obesity surgery is evaluated as early postoperative care (1-3 days) and late postoperative care. Close observation, careful and complete evaluation are important in the specialist nursing care of bariatric surgery patients. In bariatric surgery, patients are provided with routine post-operative nursing care such as oxygen and hemodynamic monitoring, pain management, mobilization, wound care, deep vein thrombosis prophylaxis, early and frequent ambulation, drain care, fluid balance nutrition, training, and emotional support.

Effect of rapid rehabilitation nursing on improving clinical outcomes in postoperative patients with colorectal cancer.

Surgical resection is the cornerstone treatment for colorectal cancer. Rapid rehabilitation care predicated on evidence-based medical theory aims to improve postoperative nursing care, subsequently reducing the physical and mental traumatic stress response and helping patients who undergo surgery recover rapidly. To assess the effect of rapid rehabilitation care on clinical outcomes, including overall postoperative complications, anastomotic leaks, wound infections, and intestinal obstruction in patients with colorectal cancer. We searched the PubMed, Web of Science, Embase, Elsevier Science Direct, and Springer Link databases from January 1, 2010, to January 1, 2024, to screen eligible studies on rapid rehabilitation care among patients who underwent colorectal cancer surgery. Patients were screened based on the inclusion and exclusion criteria. RevMan 5.4 software was used for statistical analysis of the data. Twelve studies were enrolled, which included 2420 patients. The results showed that rapid rehabilitation care decreased the incidence of overall postoperative complications (OR: 0.44, 95%CI: 0.26-0.74, P = 0.002), anastomotic leaks (OR: 0.68, 95%CI: 0.41-1.12, P = 0.13), wound infections (OR: 0.45, 95%CI: 0.29-0.72, P = 0.0007), and intestinal obstruction (OR: 0.54, 95%CI: 0.34-0.86, P = 0.01) compared to conventional care. Further trials and studies are needed to confirm these results. Rapid rehabilitation care decreased the occurrence of postoperative complications, anastomotic leaks, wound infections, and intestinal obstruction compared to conventional care in patients who underwent colorectal surgery. Therefore, promoting the application of rapid rehabilitation care in clinical practice cannot be overemphasized.

Tingkat Kecemasan Preoperasi pada Anak di Instalasi Bedah Sentral Rumah Sakit Brayat Minulya Surakarta

Introduction: Preoperative is the initial stage of perioperative care which begins when the patient enters the reception room and ends when the patient is transferred to the operating table for surgery. At this stage, most people who undergo it will feel anxious, including pediatric patients. Pediatric patients often exhibit preoperative anxiety that influences intra- and postoperative nursing care. Mapping preoperative children's anxiety levels as a basis for determining preoperative treatment strategies for pediatric patients in the IBS Hospital reception room. Brayat Minulya needs to be done. Purpose: This study aims to identify the preoperative anxiety level of school-aged children in hospitals. Brayat Minulya Surakarta. Method: This research design is a descriptive study with a survey approach. Data collection was carried out using the Hamilton Anxiety Rating Scale (HARS) questionnaire. Sampling used total sampling with a sample size of 62 respondents who had adjusted to the inclusion and exclusion criteria. Data were analyzed using quantitative descriptive analysis methods. Results: Description of anxiety in preoperative school age children with no anxiety as many as 5 respondents (8.06%), mild anxiety as many as 21 respondents (33.87%), moderate anxiety as many as 27 respondents (43.55%), severe anxiety as many as 9 respondents (14.52%), and no respondents had very severe anxiety/panic. Conclusion: The number of children with moderate levels of anxiety is the largest, namely 43.55%. Future research can measure the relationship between gender and surgical experience with children's preoperative anxiety levels and use the gold standard, the State-Trait Anxiety Inventory for Children (STAIC) to measure children's anxiety levels.

Perioperative Nursing Considerations for Transurethral Resection Prostatectomy

The present article was an overview of transurethral resection prostatectomy (TURP) and its prevalence, emphasizing the critical role of perioperative nursing in enhancing patient safety and outcomes. Preoperative nursing assessment was explored, covering the importance of patient history and risk assessment, diagnostic tests and evaluations, patient counseling, and informed consent, as well as preoperative optimization and preparation. The intraoperative nursing management section outlines key responsibilities in setting up the operating room, maintaining infection control, preventing specific clinical risk of TURP, managing anesthesia, ensuring surgical team coordination and communication, and adhering to evidence-based guidelines. Postoperative nursing care focused on immediate recovery and monitoring, pain management strategies, urinary catheter care, early ambulation, complication prevention, and patient education. Emerging trends and innovations in perioperative nursing were discussed, including advancements in surgical techniques, integration of new technologies, telemedicine, and the adoption of holistic care approaches. The present article also addressed the challenges facing perioperative nurses, such as workforce shortages and burnout, research gaps in TURP nursing, and the importance of promoting ongoing education and training. By examining these key elements, the present article provided a comprehensive resource for perioperative nurses, healthcare providers, and researchers, aimed to enhance understanding, improved patient care, and stimulated further advancements in the field.

Post-operative nursing care for patients receiving abdominal hysterectomy at the Obstetrics and Gynecology Department of Bach Mai Hospital in 2023

Objective: To describe post-operative nursing care for patients receiving abdominal hysterectomy at the Obstetrics and Gynecology Department of Bach Mai Hospital in 2023. Method: A Cross-sectional descriptive study was conducted using an instrument developed based on 12 professional tasks of patient care prescribed in Circular 31/2021/TT-BYT by the Ministry of Health. The study included 119 patients who had undergone abdominal hysterectomy to assess the care outcomes. Results: Among the participants, 69.7% had undergone their first surgery, while 30.3% had undergone surgery two or more times. Most patients (94.1%) had undergone a complete hysterectomy. Post-operative complications, including wound bleeding, urinary retention and drug allergies, were reported in 5% of the participants. The percentage of patients receiving good nursing care after abdominal hysterectomy was 74.8%. Conclusion: The study found that 5% of patients experienced post-operative complications following abdominal hysterectomy. Additionally, 74.8% of patients received good nursing care, while 25.2% received average care.

Post-operative nursing of a feline patient after hypophysectomy surgery

This case report documents the surgical treatment of a 6-year-old feline patient with hypersomatotropism. The surgical intervention, a hypophysectomy, is a relatively novel treatment option for this condition and the post-operative nursing care is imperative to ensure a positive outcome. The patient underwent this surgery and spent 2 days in the intensive care unit of a referral hospital for close monitoring of his blood glucose and electrolytes.

Nursing Students' Views on the Virtual Escape Room Application

Background: Using the gamification method, which transforms information into a game, is important in increasing the students' motivation and ensuring their active participation. The escape room application, an innovative method and one of the examples of gamification that can be used in the education process, will contribute to the skill development of nursing students. Objectives: This research was planned to determine the students' opinions about the virtual escape room application in postoperative patient care. Design: This study is of descriptive and cross-sectional type. Methods: This study was conducted with 3rd and 4th year nursing students who took the surgical diseases course at the Faculty of Health Sciences of a foundation university in Istanbul between February 2021 and May 2021. Data were collected with Postoperative Nursing Care Form and Personal Information Form. Chi-square analysis was used to determine the relationship between the number percent distribution and the categorical variable in the data analysis. Results: The mean age of the study participants was 21.74±0.94. 51.1% of the students are women, and 61.8% are 3rd-grade students. They stated that 100% of the students liked the virtual escape game, 32.6% found it fun, and showed knowledge about the surgery lesson. Students did not choose the items I am undecided, disagree, and completely disagree on this 5-point Likert-type scale. Conclusion: The results obtained from this study showed that nursing students' views about the virtual escape room were positive. They also said they learned and had fun during the virtual escape room game.

Holistic conditions after colon cancer: A randomized controlled trial of systematic holistic care vs primary care.

Study showed that systemic holistic care not only aids in disease treatment and physical recovery to a certain extent but also effectively enhances patient psychological well-being, social support, and overall quality of life (QoL). To assess systematic holistic care impact on the recovery and well-being of postoperative patients with colon cancer. Our randomized controlled trial included 98 postoperative patients with colon cancer admitted to our hospital from June 2021 to June 2022. Patients were divided into control and study groups. The control group received conventional postoperative nursing care, whereas the study group received systematic holistic nursing care. We monitored gastrointestinal function recovery, and recorded changes in serum albumin (ALB), prealbumin (PA), psychological state, self-management, self-efficacy, QoL, and the occurrence of complications in patients before, at discharge, and 2 wk post-discharge. Spearman analysis assessed correlations between psychological state, self-management, self-efficacy, and QoL of patients in the study group 2 wk post-discharge. Following the nursing intervention, we observed significantly shorter postoperative bowel sound recovery time, anal exhaust time, and defecation time in the study group than in the control group (P < 0.05). Patient ALB and PA levels, psychological status, self-management ability, self-efficacy and QoL at discharge and 2 wk post-discharge significantly improved, with greater improvements observed in the study group (P < 0.05). Both groups experienced complications post-interventions, but the intervention group had significantly lower complication rate (3/49, 6.12%) (P < 0.05). In the study group, patient anxiety, depression, self-management and QoL scores at 2 wk post-discharge exhibited a significant negative correlation (3/49, 6.12%) with QoL scores, with correlation coefficients of r = -0.273, -0.522, -0.344, and P < 0.01, respectively. Conversely, patient self-efficacy scores 2 wk post-discharge showed a positive correlation with QoL scores (r = 0.410, P = 0.000). Systemic holistic nursing significantly benefits postoperative patients with colon cancer by promoting gastrointestinal recovery, improving post-operation well-being, reducing complications, and enhancing QoL.

Comparison of Mean Pain Score in Patients Undergoing Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy

Background: Laparoscopic hysterectomy becomes a preferred option all over the world because it is related with less post-operative pain, short hospital stay and earlier recovery as compared with total abdominal hysterectomy. Objective: To compare the mean pain scores between patients undergoing total laparoscopic hysterectomy and total abdominal hysterectomy. Study Design: Randomized control trial. Settings: Department of Obstetrics &amp; Gynecology, Allied Hospital, Faisalabad Pakistan. Duration: 8th March 2019 to 7th September 2019. Methods: Total 60 patients, 40-75 years of age undergoing hysterectomy were selected. Patients with history of pelvic or abdominal irradiation, endometriosis or pelvic inflammatory disease, history of cardiac or pulmonary disease or previous pelvic surgery were excluded. Patients in group A, total laparoscopic hysterectomy was performed where as in group B, total abdominal hysterectomy was performed. All patients were followed for mean post-operative pain for first 24 hours. Results: Our study showed that stratification of pain scores with respect to age in 40-60 years age group was significant where as in 61-75 years age group it was nonsignificant. Another effect modifier in the study was BMI, which showed significant p-value i.e. 0.0001 in both groups (&lt;25 and &gt;25BMI). Postoperative mean pain score in both group of patients were assessed at 2hr, 4hr, 8hr, 12hr and 24hr, which were significant. Conclusion: Standardized technique, patients counselling, relatively younger age group, lower BMI and appropriate post-operative nursing care plays vital role in maintaining pain scores in TLH.

Postoperative nursing care of a pediatric patient with spastic cerebral palsy

Postoperative nursing care of a pediatric patient with spastic cerebral palsy

Postoperative nursing care of a patient with lumbar disc herniation

Postoperative nursing care of a patient with lumbar disc herniation

A multi-national survey to identify health professionals' opinions for the appropriate frequency of urine output monitoring in post-operative patients.

Urine output is an important clinical measurement and oliguria may highlight the development of acute kidney injury (AKI) earlier than serum creatinine (sCr). Despite the importance of urine output monitoring, there are no definitive guidelines or recommendations for best practice. A survey was sent to healthcare professionals with a specialist interest in AKI to gather opinions of what constitutes a good standard of urine output monitoring and by corollary missed care, post- major surgery. Data was gathered from 221 respondents. Results will inform audit and improvement projects in post-operative nursing care.

Electrical stimulation plus biofeedback improves urination function, pelvic floor function, and distress after reconstructive surgery: a randomized controlled trial

PurposeThis study is aimed at assessing the effect of postoperative electrical stimulation (ES) plus biofeedback therapy on patient rehabilitation after pelvic floor reconstructive surgery.MethodsPatients with pelvic organ prolapse (POP) who had received pelvic floor reconstructive surgery were randomly allocated to the intervention group and the control group at a 1:1 ratio. Patients in the control group received routine postoperative nursing care. Patients in the intervention group underwent ES plus biofeedback therapy. The outcomes included the recovery of urination function, the improvement of pelvic floor muscle (PFM) strength, and the change of Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20) scores. The study outcomes were evaluated at pre-intervention (T0, 2 months after surgery), 3 months after surgery (T1), and 6 months after surgery (T2).ResultsA total of 60 patients with POP were included in this study. For the urination function evaluation, the intervention group had a higher recovered rate than the control group at the time point of T2 (p = 0.038). For the EMG results, the changes of flick-max and tonic-mean values from T0 to T2 were much higher in the intervention group comparing to the control group. Corresponding to the EMG results, digital palpation showed that intervention group had a much higher proportion of patients who had elevated PFM strength. Furthermore, the intervention group also had more significant PFDI-20 score improvements compared with control group.ConclusionsPostoperative ES plus biofeedback therapy could significantly improve urination function, PFM strength, and patient’s reported QoL.Trial registrationClinical registration number: hiCTR2000032432.

The effectiveness of simulation game on nursing students’ surgical nursing knowledge—a quasi-experimental study

Student nurses need diverse learning experiences throughout their studies to learn surgical nursing. Interactive virtual simulations for hybrid education in the COVID-19 postpandemic era provide new opportunities to learn knowledge through practical patient scenarios. The aim of this study was to evaluate the effectiveness of a simulation game on nursing students’ surgical nursing knowledge. A quasi-experimental design was used, including a pre- and post-test and experimental (simulation game) group (n = 140) and a control (theoretical self-study material) group (n = 136). The level of surgical nursing knowledge was assessed with the surgical nursing knowledge (SNK) test. The data were collected in three universities of applied sciences in Finland. Both groups had better surgical nursing knowledge after the intervention than before. The change of surgical nursing knowledge was greater in the experimental group than in the control group. The simulation game was an effective approach to learning surgical knowledge. Simulation games as an interactive and motivating tool may add value in hybrid education by combining theoretical pre- and postoperative nursing care content and practical skills.

Nursing care after hand replantation based on Roy's adaptation model: A case report

BackgroundHand injuries are very complex and worrying in terms of hindering activities of daily living, functionality and self-care skills. Hand injuries are caused by traumatic events, resulting in a partial or complete loss. The focus of acute treatment is surgical replantation. AimIn this study, nursing care and nursing experiences of a patient who was replanted as a result of hand trauma were discussed in the light of the Roy Adaptation Model. CaseThe male patient admitted to the emergency room due to traumatic amputation was a 49-year-old farmer. He lost his hand to an agricultural tool while working the land and was taken to the hospital within 4 h. He was taken up for emergency surgery for replantation. He has a history of diabetes mellitus. Nursing follow-up and interventions were applied by evaluating the data according to four adaptation modes (physiological needs, self-concept, role function and interdependence) within the scope of the Roy Adaptation Model. Conclusionand Suggestions: Patients experience difficulties (loss of function, financial problems, loss of role, psychological traumas) due to disability after injury. Therefore, nurses should know the underlying physiological risks, complications, and interventions to recognize and respond to situations that cause the loss of the reattached limb. Nursing models can identify patients' needs and problems, prevent complications, provide quality care, and manage the process. This study discussed the postoperative nursing care of a patient based on Roy's Adaptation Model.

Nursing Experience After the Third Complex Liver Transplantation: A Case Report

Liver transplantation is an effective method for treating end-stage liver disease, and repeated or repeated liver transplantation is an effective method for treating transplanted liver failure caused by various reasons. Repeated or repeated liver transplantation not only poses great surgical difficulties, but also poses significant challenges in postoperative care. Good postoperative care can significantly reduce the incidence of postoperative complications in patients and improve human/liver survival rate. This article summarizes the nursing experience of a patient with liver failure after liver transplantation undergoing a third complex liver transplantation. The key points of nursing include: closely monitoring changes in the condition; First aid and care for bleeding; Prevention of infection and anti rejection treatment; Postoperative nursing care to prevent portal vein thrombosis; Nursing care for postoperative ballistic complications; Strengthen nutritional support. Multi angle and comprehensive nursing to ensure postoperative rehabilitation of patients. After reasonable treatment and care, the patient in this case successfully recovered and was discharged on the 18th day after surgery. This article analyzes the nursing process of this special case and summarizes the nursing experience after the third complex liver transplantation, providing corresponding reference for clinical nursing work of multiple liver transplants.

Application of a specialist nurse-led multidisciplinary team model in the perioperative care of patients undergoing simultaneous pancreas and kidney transplantation: randomized controlled trial.

Simultaneous pancreas and kidney transplantation (SPKT) is an effective treatment option for individuals who suffer from both diabetes mellitus and renal failure. However, experiments exploring nurse-led multidisciplinary team management during the perioperative management of patients undergoing SPKT are currently limited. This study aims to explore the clinical performance of a transplant nurse-led multidisciplinary team (MDT) in the perioperative management of SPKT patients. A total of 218 patients who underwent SPKT were randomly assigned to either a control group (n=116) receiving conventional care or an intervention group (n=102) managed through a transplant nurse-led MDT approach. The incidence of postoperative complications, hospital stay, total hospitalization cost, readmission rate, and postoperative nursing quality were compared between these 2 groups. The intervention and control groups showed no significant differences in age, gender, and body mass index. Compared with the control group, the intervention group had a significantly lower incidence of postoperative pulmonary infection and gastrointestinal (GI) bleeding (27.6% vs. 14.7% and 31.0% vs. 15.7%, respectively, both P<0.05). Compared to the control group, the intervention group had significantly lower hospitalization costs, length of hospital stay, and readmission rate 30 days after discharge (32.98±9.10 vs. 36.78±15.36, 26.47±13.4 vs. 31.03±11.61 and 31.4% vs. 50.0%, respectively, all P<0.05). Additionally, the intervention group had significantly better quality of postoperative nursing care than the control group (11.61±0.69 vs. 9.64±1.42, P<0.01), the availability of infection control and prevention measures (11.74±0.61 vs. 10.53±1.11, P<0.01), the effectiveness of health education (11.73±0.61 vs. 10.41±1.06, P<0.01), the effectiveness of rehabilitation training (11.77±0.54 vs. 10.37±0.96, P<0.01), and the patient satisfaction with nursing care (11.83±0.42 vs. 10.81±1.08, P<0.01). The nurse-led MDT model for transplant patients can reduce complications, shorten hospital stays, and save costs. It also provides clear guidelines for nurses, improving care quality and aiding patient recovery. Chinese Clinical Trial Registry ChiCTR1900026543.