Postoperative Nursing Intervention Research Articles

Effect of the postoperative pain management model on the psychological status and quality of life of patients in the advanced intensive care unit

Objectiveit was to explore the influence of the postoperative pain management mode on the psychological state, quality of life (QOL), and nursing satisfaction of late patients in the intensive care unit (ICU) and improve the nursing effect of late patients in the ICU.Methodsseventy patients who were admitted to the postoperative ICU for gastric cancer and received treatment in our hospital from March 2021 to May 2022 were selected. The patients were assigned into a research group and a control (Ctrl) group according to a random number table, with 70 cases in each group. The Ctrl group received routine nursing intervention, while research group received nursing intervention based on routine nursing intervention with postoperative pain management mode and received psychological care. Good communication was established with the patients, and the postoperative pain assessment was well conducted. The general information, state-trait anxiety (STAI) score, World Health Organization’s Quality of Life Instrument (WHO QOL-BREF) score, and care satisfaction were compared.Resultsthe general information differed slightly, such as sex, age, and ward type, between groups, with comparability (P > 0.05). S-AI scores (13.15 ± 1.53 vs. 16.23 ± 1.24) and T-AI scores (14.73 ± 3.12 vs. 18.73 ± 3.16) in research group were inferior to those in Ctrl group (P < 0.05). The scores of patients in research group in the physiological field (78.9 ± 6.1 points vs. 72.3 ± 5.6 points), social relationship field (76.9 ± 4.5 points vs. 71.3 ± 4.8 points), psychological field (78.6 ± 6.2 points vs. 72.4 ± 5.3 points), environmental field (78.6 ± 6.7 points vs. 73.5 ± 6.4 points), and total QOL (79.5 ± 7.4 points vs. 71.6 ± 5.4 points) were higher than those in Ctrl group (P < 0.05). The total satisfaction rate with nursing care in research group (82.85%) was dramatically superior to that in Ctrl group (62.85%) (P < 0.05).Conclusionthe adoption of a postoperative pain management model in postoperative nursing interventions for patients in advanced ICUs can alleviate anxiety and depression, improve patients’ QOL and nursing satisfaction, and have clinical promotion value.

Effects of minimally invasive surgery combined with specialized pain management nursing care on postoperativepain improvement and life quality after spinal injury.

To determine the impacts to research the impacts of pain's Specialized Pain Management Nursing Care in the perioperative period on pain symptoms and life quality of patients experiencing minimally invasive surgery for spinal injury. Eighty patients with a spinal injury who underwent minimally invasive surgery in the Department of Orthopedics of Baoding No.1 Hospital from January 2018 to December 2021 were retrospectively analyzed. They were split into two groups following different nursing methods (n=40 each group). Specialized Pain Management Nursing Care were given to patients in the observation group. Those in the control group were given treated with routine care. Their pain score and nursing effect were compared, after which their quality of life, daily living ability and complication rate compared and analyzed. The pain degree in the control group was considerably more than that in the observation group in the 1st postoperative period. The pain degree, which decreased in both groups, slumped more significantly in the observation group on the 2nd and 3rd postoperative days. The postoperative hospital stays and pain duration in the observation group were shorter than those in the control group (P<0.05), and the nursing effect was significantly better than that in the control group (P<0.05). After postoperative nursing intervention. Minimally invasive surgery integrated with the Specialized Pain Management Nursing Care can remarkably ameliorate pain after spinal injury surgery, reducing complications' incidence, and improving the life quality for patients.

Factors Related to Functional Capacity Deterioration in Surgical Lung Cancer Patients: A Systematic Review.

A decline in functional capacity is anticipated after lung resection. However, the factors related to functional capacity deterioration in surgical lung cancer patients have not been systematically reviewed. To investigate the factors related to functional capacity deterioration and the trajectory of functional capacity after lung cancer surgery. PubMed, CINAHL, Scopus, and SPORTDiscus were searched between January 2010 and July 2022. Two reviewers conducted a critical appraisal of individual sources. Twenty-one studies met the inclusion criteria. This review presents evidence for risk factors related to functional capacity deterioration after lung cancer surgery, including patient characteristics (age), preoperative clinical factors (vital capacity, quadriceps force, B-type natriuretic peptide level), surgery-related factors (surgical procedure, duration of chest tube drainage, postoperative complications), and postoperative clinical factor (C-reactive protein level). Most patients had a significant decline in functional capacity in the short term (≤1 month from surgery). In the medium term (1 to ≤6 months from surgery), although the functional capacity did not return to the preoperative level, the decline became insignificant. This study is the first to review factors related to functional capacity in lung cancer patients. The findings can help clinicians to better identify patients at risk of functional capacity decline and allocate clinical resources more efficiently. The risk factors related to the functional capacity decline in surgical lung cancer patients should be evaluated routinely during perioperative nursing assessments. Preoperative and postoperative nursing interventions can potentially improve modifiable risk factors and prevent functional capacity deterioration.

Improved Compliance With Postoperative Neurosurgical SSI Preventative Measures.

Background: Pediatric neurosurgical patients at Children’s Memorial Hermann Hospital (CMHH) were experiencing a high rate of surgical site infections (SSIs) at the end of 2020. At this time, the neurosurgical SSI National Healthcare Safety Network Standard Infection Ratio had an overall rate of 1.30 (N = 11), and it was noted that previous work to prevent SSIs in this population had centered specifically on care of the patients preoperatively and intraoperatively versus postoperatively. Objectives: Given that initial efforts to prevent neurosurgical SSIs had focused on preoperative and intraoperative care the objective became to identify postoperative interventions. The interventions would help to create and maintain consistent postoperative care for pediatric neurosurgical patients. The overall goal was to decrease the pediatric neurosurgical SSI Standard Infection Ratio to below 1 by the end of 2021. Methods: A multidisciplinary taskforce made up of peri anesthesia and perioperative nursing staff, infection control, hospital quality, and pediatric neurosurgical providers was developed. The taskforce worked together using the “Voice of the Customer” and a fishbone diagram to identify postoperative nursing interventions, specifically around patient hygiene and cleansing (bathing, shampooing, and surgical site care), to help prevent postoperative neurosurgical SSIs. After educating the bedside staff on the taskforce recommended interventions, there was not a noticeable decrease in the amount of postoperative neurosurgical SSIs. An audit revealed low nursing compliance with the recommended interventions. The taskforce realized an opportunity with this lack of compliance and developed a postoperative pediatric neurosurgical order set/bundle using the identified recommended postoperative interventions. The finalized order set went live in August 2021, after the completion of nursing and provider education. Monthly compliance regarding physician order entry and nursing documentation of ordered interventions started immediately after go-live. Results: With the creation and implementation of the postoperative order set, postoperative provider order entry increased from 21% to 63%. There was an overall pediatric neurosurgery SSI rate drop from 1.30 in 2020 to 0.51 in 2021, and the number of cases of infection decreased significantly (Fig. 1) while the number of cases performed stayed relatively the same (Fig. 2). Conclusions/Implications: The work this taskforce did emphasizes how important a postoperative bundle, staff education, and bundle ordering compliance is to helping decrease pediatric neurosurgery SSI rates. Having an established order set will lead to increased compliance with the ordering and implementation of postoperative nursing interventions. In turn, postoperative neurosurgical patients will experience more consistent care across all hospital based units. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.Fig. 1.: neurosurgical infections by year.Fig. 2.: neurosurgical procedures by year.

Significance of Continuous Nursing of Omaha System in Children after Hypospadias Surgery and Its Influence on Infection Complications.

Objective The aim of the research article is to explore the significance of continuous nursing of the Omaha system in children after hypospadias surgery and its influence on infection complications. Methods From April 2019 to April 2021, Anhui Provincial Children's Hospital treated 76 children with hypospadias and they were selected as the research objects. In the light of the random number table method, children were classified into the control group and the study group, with 38 cases in each group. The control group applied routine postoperative nursing intervention, while the study group received Omaha system continuous nursing intervention based on the control group. The Omaha system outcome evaluation, complication rate, quality of life, and nursing satisfaction were recorded and discussed in all children. Results The levels of physiological and psychological environment and health behavior in both groups after intervention were significantly higher than those before the intervention, and the levels of all dimensions in the study group were significantly higher than those in the control group (P < 0.05); the complication rate in the study group was 10.53% significantly lower than that in the control group (28.95%). After intervention, the physiological function, psychological and social function, emotional function, social interaction, and school status of the two groups were significantly higher than before intervention, and the score of each dimension in the study group was significantly higher than that in the control group (P < 0.05); the overall satisfaction of nursing in the study group was 94.74% significantly better than in the control group (81.59%) (P < 0.05). Conclusion The continuous nursing intervention of the Omaha system for children with hypospadias can significantly improve the clinical condition of children, reduce the risk of infection complications, improve children's physical and mental health status, and improve nursing satisfaction, which is worthy of clinical practice.

Assessment of Nurses Knowledge toward Pre and Post Nursing Interventions Laparoscopic Cholecystectomy at AL-Imam AL-Hussein Teaching Hospital in AL-Nasiriya City

Background: Laparoscopic cholecystectomy is the gold standard treatment for gallstones. Because of the numerous advantages of open surgery, such as limited incisions, short hospital stay, no drainage tube and stomach tube use, fewer analgesic and fewer complications. Aims of the study: This study aimed at assess nurses knowledge towards pre and post nursing interventions laparoscopic cholecystectomy; and determine the relationship between nurses knowledge and their socio-demographic data. Methodology: A descriptive study was conducted for the periods of December 21th 2020 to June 1st 2021. The study is carried out at the AL-Imam AL-Hussein Teaching Hospital in AL- Nasiriya city. Non-probability purposive sample was selected of nurses who working at surgical wards. The sample consists of (50) nurses. The validity of questionnaire achieved through a panel of experts and reliability achieved through a pilot study. By used the questionnaire, data were collected and analyzed through the application of descriptive and inferential statistics. Results: Findings demonstrated that the nurses were moderately knowledge related to gallbladder and laparoscopic cholecystectomy, interventions before and after the laparoscopic cholecystectomy at mean equal 1.43, 1.47, and 1.39 respectively. There were no-significant relationship between nurses knowledge and their demographic data at p-value &gt;0.05. Conclusion: Nurses who working at surgical wards were express unsatisfactory knowledge pre and post nursing interventions laparoscopic Cholecystectomy due to low level of education and lack of training. Recommendations: The study recommended that special training session, concerning all nurses' surgical wards for postoperative nursing interventions (Laparoscopic Cholecystectomy Patient) at inside or outside Iraq, and booklets should be designated and presented to all nurses' surgical wards, in addition to increasing the number of professional nurses' graduate of the colleges of nursing to the enrolled in surgical wards.

Effectiveness of an Educational Program on Nurses Knowledge toward Pre and Post Nursing Interventions Laparoscopic Cholecystectomy at Surgical Ward in AL-Imam AL-Hussein Teaching Hospital in Al Nasiriya City

Background: Laparoscopic cholecystectomy is the gold standard treatment for gallstones. Because ofthe numerous advantages of open surgery, such as limited incisions, short hospital stay, no drainagetube and stomach tube use, fewer analgesic and fewer complications.Aims: This study aimed at determine the effectiveness of an educational program on nurses knowledgetoward pre and post-operative nursing intervention for patient with laparoscopic cholecystectomy; andidentify the relationship between study findings and selected variables (age, level of education, andyears of experience).Methods: A pre-experimental design one group (pre-post test) is conducted for the periods of December26th 2020 to Jun 1st 2021. The study is carried out at the at AL-Imam AL-Hussein Teaching Hospital inAL- Nasiriya city. By non-probability purposive sample is selected from nurses who in surgical wardsbefore and after implementing educational program, data were collected and analyzed through theapplication of descriptive and inferential statistics.Results: Findings indicate that nurses age at mean 24.2, (54%) females, (52%), nursing diplomagraduated (46.0%) have 1-5 years of experience and no participated in training sessions. Knowledgestatistically significance differences between pre and post -test for study group at (P &lt; 0.05). There werestatistically significances differences between (level of educational, years of experience and number ofyears of work in surgical wards) and effectiveness of educational program among the two period (Preand Post-Test).Conclusion: More years of experience in training the staff nursing in surgical wards by local officialshelp raising professionals’ nurses. Provide the health resources and exploiting young energies of nurseswhich indeed helps to develop their knowledge.

Effect of an Educational Program on Nurses' Performance Regarding Nursing Intervention for Infants Undergoing Inguinal Hernia Repair

Background Inguinal Hernia (IH) occurs when the contents of the abdomen usually fat or part of thesmall intestine bulge through a weak area in the groin region. Inguinal hernia is the most commonsurgical problem in infancy period. Nursing care is an integral part of managing infants undergoing IHrepair. The study aimed to evaluate the effect of an educational program on nurses' performanceregarding nursing intervention for infants undergoing inguinal hernia repair. Design: A quasiexperimental design was used to conduct this study. Setting: The study was conducted at pediatricsurgery units of Benha Specialized Pediatric Hospital. Sampling: A Convenient purposive sample wascomprised of 30 nurses and a convenient sample of 283 infants who were undergoing inguinal herniarepair at the previously mentioned study setting. Tools of Data Collection: Two tools were used: tool(I): a structured interviewing questionnaire sheet included three parts, tool (II): nurses’ observationalchecklists included pre and postoperative nursing intervention. The results of this study revealedthat, the majority of the studied nurses had good level of knowledge, and competent level of practicepost program intervention with highly statistical significant improvement as compared to preprogramintervention. Moreover, there were positive correlation between the studied nurses’ total knowledgeand practice scores regarding pre and postoperative nursing care for infants undergoing inguinal herniarepair pre and immediately post program intervention and follow up intervention. The studyconcluded that, educational program was effective in improving nurses' performance regardingnursing intervention for infants undergoing inguinal hernia repair. The study recommended: Inservice training programs should be conducted periodically for teaching the nurses the basic knowledgeand clinical skills for infants undergoing IH and other surgeries

Effect of Progressive Muscle Relaxation Technique on Post-Operative Pain and Quality of Recovery among Patients with Abdominal Surgeries

Background: Abdominal surgery is considered one of the most painful surgical procedures as the site's proximity to the diaphragm and extensive cross-innervations in the area increasing the post-operative pain. Progressive Muscle Relaxation (PMR) is a promising intervention for these complains. Aim of the study was to determine the effectiveness of progressive muscle relaxation technique on post-operative pain and postoperative quality of recovery. Research design: A quasi experimental research design with a pretest-posttest control group was utilized. Setting: at surgical departments at Damanhour National Medical Institute. Subjects: A purposive samples of 80 adult patients who are undergoing abdominal surgery were selected according to eligibility criteria. They were divided into two equal groups 40 in each study group and control group. Tools of data collection: four tools were used for data collection: Demographic and clinical Data Structured Interview Schedule, Visual Analogue Pain Scale, A modified Behavioral Pain Scaleand Post-Operative Quality of Recovery Score. Results: After the intervention, PMR significantly decreased pain severity among study group compared to the control group. The severe pain intensity significantly absent from the entire study group, while it was significantly present among 42.5% of the control group. All of the study subjects had a good post-operative quality of recovery compared to only7. 5% of subjects in the control group. Conclusion: PMR significantly decreased post-operative pain and improve post-operative quality of recovery among patients after abdominal surgeries. Recommendation: PMR should be incorporated in post-operative nursing intervention protocols.

The effects of immediate programmed cryotherapy and continuous passive motion in patients after computer-assisted total knee arthroplasty: a prospective, randomized controlled trial

BackgroundThe postoperative nursing intervention with immediate cryotherapy and continuous passive motion (CPM) remains elusive regarding the postoperative pain and range of motion (ROM) for patients undergoing computer-assisted total knee arthroplasty (CAS-TKA).MethodsA prospective, randomized controlled trial with a purposive sampling method was utilized. Sixty patients scheduled for a unilateral CAS-TKA at a medical center were randomly assigned to the intervention group (n = 30) and control group (n = 30). The intervention group applied programed cryotherapy and CPM within 1 h while returning to the ward on the day of surgery, while the control group did not. Data were analyzed using mixed models to compare the numeric rating scale (NRS) for pain, ROM, and swelling at postoperative day (POD) 4.ResultsThere was no significant difference in the NRS score between the groups (p = 0.168). The intervention group had significantly higher ROM than the control group (98° vs. 91°, p = 0.004) at POD 4. Although no significant difference in joint swelling was found between groups (p = 0.157), the intervention group had lower mean joint swelling (32.2 cm) than the control group (33.9 cm).ConclusionsImmediate programmed cryotherapy and continuous passive motion could help to improve ROM quickly after CAS-TKA. It should be incorporated into the daily nursing plan for patients undergoing CAS-TKA.Trial registrationClinicalTrials.gov, NCT04136431. Registered 23 October 2019—retrospectively registered

Application of high quality nursing intervention model in nursing of subcutaneous tunnel type lumbar cistern catheter

Objective To observe and evaluate the application effect of high quality nursing intervention model in nursing of subcutaneous tunnel type lumbar cistern catheter. Methods From January 2017 to April 2019, 86 patients without intracranial infection and with indwelling lumbar cistern external drainage catheter indication were randomly divided into two groups according to the method of digital table. 43 cases in the control group were given routine nursing methods, 43 cases in the observation group were given high quality nursing intervention on the basis of routine nursing methods, including psychological nursing intervention, intraoperative nursing intervention, postoperative nursing intervention, prevention of infection, nursing intervention before and after extubation. The nursing effect and nursing satisfaction of the two groups were compared. Results The incidence of adverse events in the observation group was significantly lower than that in the control group (4.65% vs.25.58%) (χ2=7.340, P=0.007), the scores of SDS and SAS in the observation group were significantly lower than those in the control group (t=21.133, 19.051, P=0.000, 0.000), and the satisfaction rate of nursing service in the observation group was significantly higher than that in the control group (97.67% vs.81.40%) (χ2=4.468, P=0.035). Conclusion The application of high quality nursing intervention model in subcutaneous tunnel type lumbar cistern catheterization and after operation can reduce the risk of catheter nursing, effectively reduce the incidence of adverse events, significantly alleviate the negative mood of patients, improve the satisfaction of patients on nursing service, and is worth popularizing and applying in catheter nursing service. Key words: High quality nursing intervention; Subcutaneous tunnel type; Lumbar cistern external drainage; Nursing satisfaction

Factors Affecting the Postoperative Pain and Length of Hospital Stay of Liver Transplantation Donors

Purpose: This study was performed to investigate the factors affecting postoperative pain and length of hospital stay of liver transplantation donors. Methods: This is a retrospective study using the Electronic Medical Records (EMR) of 91 patients operated on at a tertiary hospital in Seoul, Korea in 2016. The collected data were analyzed using descriptive statistics, t-test, Mann-Whitney U test and Kruskal-Wallis test, Spearman's rank correlation, and multiple regression analysis. Results: The average age of the donors was $35.7{pm}12.2$ years, and all donors were family members. PCA was applied for control pain in all patients, and 40.7% of PCA-related side effects were observed. The average length of hospital stay was $9.24{pm}2.52$ days. The factors influencing the length of hospital stay were operative methods, pain control methods, and postoperative complications. The length of hospital stay was 1.29 days shorter if donors had no complication, 1.43 days shorter when only PCA was used, and 1.19 days shorter when laparoscopic resection was performed (Adjusted $R^2=0.17$, F=4.67, p&lt;.05). Conclusion: The results of this study can be used as basic data for practical and effective postoperative nursing education and intervention of living liver donors.

Influence of comprehensive nursing intervention on the self-care ability and rehabili-tation of anal fistula surgical patients

Objective To explore and analyze the influence of comprehensive nursing intervention on the self-care ability and rehabilitation of anal fistula surgical patients. Methods A total of 112 anal fistula surgical patients received in this hospital from February, 2013 to May, 2015 were selected, divided into experimental group and control group randomly.In addition, usual nursing mode was applied to the patients of control group to have postoperative nursing intervention, but comprehensive nursing intervention measures were conducted to the patients of experimental group to clinically observe the self-care ability and rehabilitation of patients in both groups. Results The self-concept, health knowledge level, self-responsibility and other self-care scores of patients in control group were significantly lower than the patients in experimental group.With regard to the data comparison of patients in both groups, the difference had statistical significance(P<0.05). VAS score measured 3 days before surgery of patients in experimental group was significantly lower than the patients in control group.The first voiding time of patients in experimental group was shorter than it of control group.In addition, catheterization rate, uroschesis occurrence rate and urinary irritation occurrence rate of patients in experimental group were significantly lower than it of control group.The hospital stay of patients in control group was significantly longer than it of experimental group.Moreover, the nursing satisfaction of patients in experimental group was higher than it of control group.With regard to the data comparison of patients in both groups, the difference had statistical significance(P<0.05). Conclusions The self-care ability and rehabilitation can have better clinical effect after comprehensive nursing intervention is conducted to anal fistula surgical patients, by which it can largely reduce postoperative pain and uroschesis occurrence rate for the patients. Meanwhile, it also improves the nursing satisfaction with patients, which is worth popularizing and applying clinically. Key words: Comprehensive nursing; Anal fistula; Retention of urine; Postoperative pain

Qualitative research of postoperative real experience of colostomy patients on ostomy management

Objective To deeply understand the postoperative real experience of colostomy patients on ostomy management, and try to explore the difficulties and needs after discharge in order to provide theoretical basis for postoperative nursing intervention. Methods By using phenomenological research method, 10 colostomy patients were interviewed face-to-face, and the content was analyzed by Colaizzi method. Results Three themes were concluded: self-care obstacle related to ostomy; self-growth brought by ostomy; expectations for social support and family care. Conclusions Colostomy patients have to face so many problems after operation on ostomy management, and hospital, society and family have responsibility to help patients adapt to ostomy as soon as possible and improve their quality of life. Key words: Enterostomy; Ostomy management; Real experience; Qualitative research

ASSESSING PREDICTIVE ABILITY OF A PREOPERATIVE SCREEN TO IDENTIFY OLDER ADULTS AT RISK FOR DELIRIUM FOLLOWING ELECTIVE ORTHOPEDIC SURGERY

Objective: Post-surgical nursing interventions can reduce but not eliminate the risk of delirium. A preoperative screen for delirium risk which discriminates between those persons at lower versus higher risk of delirium may help future research efforts develop a subject pool for intensive interventions to reduce delirium incidence. The aim of this study is to assess the ability of a previously developed and tested delirium screening tool, the Cleveland Clinic Confusion Score (CCCS), to predict delirium in a select population. Design: Prospective, observational study. Setting/Participants: Convenience sample of 111 adults aged 50 years or older presenting to a preoperative orthopedic clinic. Intervention: We integrated the CCCS into the preoperative evaluation for elective hip and knee surgery. Postoperatively, clinical care nurses screened patients for delirium twice daily using the Nursing Delirium Screening Scale (Nu-DESC). Research nurses gathered additional data regarding postoperative confusion from the chart and family after discharge. Measurements: Primary outcome was the predictive value of the CCCS for delirium. Results: Of the 111 subjects, a positive preoperative CCCS screen was recorded in 31 individuals (27.9%) and postoperative delirium was identified in 12 individuals (10.8%). CCCS assessment in this population had a positive predictive value of 29% and a negative predictive value of 96%. Conclusion: When a delirium screening tool is incorporated into the preoperative process and coupled with a nursing tool for delirium detection, clinicians can identify a subset of older elective orthopedic surgery patients unlikely to develop postoperative delirium. Preoperative delirium screening may help clinicians focus perioperative interventions on higher risk individuals to further reduce delirium risk beyond current, postoperative nursing interventions.

The effect of implement active nursing intervention in patients with anorectal sur-gery

Objective To analyze the effect of implement active nursing intervention in patients with anorectal surgery .Methods A total of 120 anorectal surgery patients were divided into control and observation groups , 60 cases of each group , patients of control group were given postoperative routine nursing methods and the patients of observation group were given postoperative active nursing intervention , the clinical effect of two groups were analyzed.Results The incidence of dysuria of observation group was （10.00%） and the incidence of bowel problems was （31.67%）, which were obviously lower than those of control group （36.67%, 31.67%）.The incidence of adverse reactions of patients＇posttreatment of observation group （10.00%） was obviously lower than that of control group （40.00%）.The satisfac-tion degree of observation group （90.00%） was better than that of control group （53.33%）, （P〈0.05） .Conclusions Implement ac-tive nursing intervention in patients with anorectal surgery could achieve good clinical effect , reduce the incidence of adverse reactions of pa-tients after treatment , and improve the satisfaction of patients .. Key words: Anorectal surgery Active intervention Effect analysis

Postoperative nursing analysis of traditional Chinese medicine and Western medicine in necrotizing pancreatitis

Objective To study the clinical efficacy of the postoperative nursing of traditional Chinese medicine and Western medicine in necrotizing pancreatitis .Methods Totals of 98 patients with necrotizing pancreatitis treated by operation and traditional Chinese medicine and Western medicine in our hospital during the period from May 2010 to May 2013 were divided into the control group （ postoperative routine nursing ） and the observation group （ postoperative nursing intervention ） . The clinical efficacy and the incidence of postoperative complications in the two groups were observed and compared .Results The effective rate in the observation group accounted for 95.5%.In the control group, the effective rate accounted for 67.4%.There was a statistically significant difference between the two groups （χ2 =13.34,P〈0.05）.Two patients in the observation group had pancreatic fistula , accounting for a complication rate of 4.1%.In the control group, one patient （2.0%） had shock, five patients （10.2%） had multi-organ failure, and nine patients had pancreatic fistula, accounting for 30.6%.There was a statistically significant difference between the two groups （χ2 =12.03,P 〈0.05）.Conclusions The effective postoperative nursing intervention can increase the clinical efficacy in patients with necrotizing pancreatitis and improve the prognosis quality . Key words: Pancreatitis,acute necrotizing; Postoperative complication; Traditional Chinese medicine and Western medicine; Nursing

Developing standards of post-operative nursing interventions for lower limb amputated patients

Limb amputation usually refers to the removal of part of or the entire upper or lower limb with a defined surgical approach. In the united states there is an estimated 1,7 million people living with an amputation in 2008 and approximately 135,000 new amputations occurring each year. The aim of this study was to develop standards of post-operative nursing interventions for lower limb amputated patient. Subjects and method: research design descriptive exploratory study was utilized. Setting the study was carried out at trauma unit and vascular surgery department at Assiut University Hospital. The study sample divided into two groups: GroupI: It includes all baccalaureate nurses (4) who working in vascular surgery department and trauma unit. Group II: It includes all diploma nurses (60) who working in vascular surgery department and trauma unit. Tools It utilized for data collection were Tool I post operative cognitive assessment sheet, Tool II post operative competencies opinionnaire sheet, Tool III standards of post operative practice sheet. Results showed that; more than half of nurses had fair knowledge regarding standards of post operative interventions for lower limb amputated patients. The majority of nurses had agreed as regarding prepare the trauma unit and vascular surgery with the necessary equipment, prepare the car/ table with basic instruments according to patient's condition, ensure that continuous monitoring and recording are followed for post operative patients, ensure that all infection control measures are properly followed in all procedures, ensure that all health team are properly attired for patient care, ensure that safety for each patient during transportation from operating room to unit, ensure that all staff members follow ethics and patient rights in the trauma unit and vascular surgery department.. Nurses showed inadequacy in their practice about standards of post operative interventions for lower limb amputated patients. Conclusion: Formulation of standards is the first step toward evaluating nursing care delivery. Recommendation: Implementation of standards of post operative nursing interventions for lower limb amputated patient is necessary for trauma unit and vascular surgery

Quality of recovery from two types of general anesthesia for ambulatory dental surgery in children: a double‐blind, randomized trial

Pediatric dental procedures are increasingly performed under general anesthesia because of the inability to cooperate, situational anxiety, or other behavioral problems. Volatile anesthetics have been associated with emergence delirium in children, whereas the use of propofol for anesthetic maintenance has been shown to reduce the incidence of emergence delirium after other types of surgeries. The aim of this study is to compare a sevoflurane-based anesthetic with a propofol-based technique as it relates to the incidence of emergence delirium and the quality of recovery after pediatric dental surgery, in patients who present with risk factors for perioperative behavioral issues. We prospectively collected data of 179 pediatric patients scheduled for ambulatory dental surgery using a double-blind and randomized trial design. Subjects were anesthetized following standardized protocols for either a sevoflurane- or a propofol-based technique. The incidence of emergency delirium, as measured by the Pediatric Anesthesia Emergence Delirium score, was the primary outcome. Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), number of nursing interventions in the recovery room, time to discharge readiness, and parental satisfaction. We found no difference in the incidence of emergence delirium after both types of anesthesia. However, use of sevoflurane significantly increased both the risk of PONV and the number of postoperative nursing interventions. Discharge criteria were met about 10 min earlier in patients anesthetized with sevoflurane. Parental satisfaction was equally high with both anesthesia regimens. A propofol-based anesthetic technique did not lead to a lower incidence of emergence delirium after dental surgery in children but did result in significantly less PONV and fewer postoperative nursing interventions.

A Pilot Study of a Nursing Intervention Protocol to Minimize Maternal-Infant Separation After Cesarean Birth

To pilot test a standardized intraoperative and postoperative nursing intervention protocol to minimize maternal-infant separation after Cesarean. Randomized-controlled trial. A 250-bed acute care community hospital labor/delivery/recovery/postpartum unit with approximately 150 repeat Cesarean deliveries per year. Fifty women having a live, term, singleton, repeat Cesarean delivery and their newborns. A standardized nursing intervention protocol was designed and administered to minimize the amount of maternal-infant spatial, tactile, olfactory, auditory, and visual separation post-Cesarean. Maternal outcomes included maternal pain, anxiety, and childbirth perception. Infant outcomes included respiratory rate, temperature, stress (infant salivary cortisol), and breastfeeding rates. Compared with the control group, the intervention group experienced earlier first physical contact and feedings and a longer interval until the infant first bath. Differences were found between treatment groups for infant temperatures and respiratory rates. Three infants in the control group experienced suboptimal temperatures. Infants in the intervention group had significantly higher salivary cortisol levels but were within the normal upper level range. No differences were noted in maternal pain, maternal anxiety, or perception of birth experience among treatment groups. The pilot was valuable in examining intervention feasibility, appropriate outcome measures, and data collection strategies. The standardized intervention protocol shows promise for positively affecting maternal-infant outcomes after Cesarean delivery and merits further testing.