• Journal of Korean Clinical Nursing Research
• /
• v.15 no.1
• /
• pp.93-106
• /
• 2009

Purpose: The purpose of this study was to develop a valid and reliable instrument to explore and measure job satisfaction as perceived by perioperative nurses, specifically from the perspective of contemporary perioperative nursing in Korea. Method: Items (69) were developed from the responses to two open-ended questions by 168 perioperative nurses in one teaching hospital; (a) reasons that make work enjoyable, (b) reasons that make work unpleasant. Finally 55 items were selected, excluding items with lower correlation with the total scale. The instrument was completed by 885 perioperative nurses from 89 different hospitals nationwide who were attending the annual conference of the Korean Association Operating Room Nurses (KAORN), yielding a response rate of 95.6%. Results: Ten factors were extracted by factor analysis, which explained 60.0% of the total variance; Reliability and internal consistency were established (Cronbach's alpha=.95). A smaller sample of 39 perioperative nurses completed the instrument on two occasions, with a 2-week interval between. Mean scores were computed and two sets of scores were analyzed by Weighted Kappa (W-Kappa=0.680, p=.029). Conclusion: This instrument is a concise, highly practical and flexible tool, which can be used for the perioperative nurse in a wide range of hospital settings.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.23 no.4
• /
• pp.179-192
• /
• 2023

Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes.

• Journal of Yeungnam Medical Science
• /
• v.29 no.1
• /
• pp.9-13
• /
• 2012

Lung resection has various and commonly occurring postoperative complications. Pulmonary complication is well known as one of the most important among them, exerting a negative influence on the postoperative course and resulting in mortality. Thus, the prevention of pulmonary complication after lung resection is very important. To prevent postoperative pulmonary complication, the perioperative management must be optimal. Perioperative management begins long before the surgery and does not end until the patient leaves the hospital. The goal of perioperative management is to identify the high-risk patients, to provide appropriate intervention, to prevent postoperative complications, and to obtain the best outcomes.

• Journal of Yeungnam Medical Science
• /
• v.37 no.4
• /
• pp.321-328
• /
• 2020

Background: This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery. Methods: A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding. Results: The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.9%; three strokes and one systemic embolization) and three major bleeding events (1.4%) were observed. The high CHA₂DS₂-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA₂DS₂-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events. Conclusion: Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

• The Korean Journal of Medicine
• /
• v.99 no.4
• /
• pp.192-198
• /
• 2024

Due to their increasing role, many hospitalists will in the future encounter perioperative patients, either through surgical co-management or when an admitted patient requires surgery. If given the responsibility, hospitalists should focus not only on assessing and addressing daily acute issues related to medical comorbidities, but also possess basic knowledge of the typical physiological responses after surgery, prediction, evaluation, and management of perioperative bleeding, and identification of postoperative complications. Understanding these topics may help mitigate complications and improve the management of perioperative patients.

• Journal of Korean Academy of Nursing Administration
• /
• v.8 no.2
• /
• pp.283-293
• /
• 2002

Purpose: The purpose of this study was to define cost-countable perioperative nursing activities and to analyze the cost of each nursing activities based on the Resource-Based Relative Value Scale (RBRVS). Method: Researcher and 3 research assistants observed and documented the 83 operating patients in order to measure nursing time for each of the perioperative nursing activities. And then, 35 operating room nurses with at least one year of perioperative nursing experience were observed for the RBRVS of perioperative nursing activities. Finally, the direct and indirect nursing costs were estimated. Result: Nursing costs of 25 nursing activities were estimated using the RBRVS. Most expensive nursing activities were delivery of the instrument and implement for OP team (9,780 won per hour) and behavior of wash, pack, disinfect the instrument (6,770). Conclusion: Based on the relative values of each perioperative nursing activities estimated in this study, proper medical reimbursement system should be established in a near future.

• Journal of Korean Academy of Nursing
• /
• v.48 no.6
• /
• pp.679-691
• /
• 2018

Purpose: This study was aimed at identifying the types of perceptions of ethical issues among perioperative nurses. Methods: Q-methodology focusing on individual subjectivity was used with data collected in November 2016. Thirty-four Q-statements were selected and scored by the 35 participants on a 9-point scale with normal distribution. Participants were perioperative nurses working in advanced general hospitals and general hospitals. The data were analyzed using the PC-QUANL program. Results: A total of 35 perioperative nurses were classified into 4 factors based on the following viewpoints: self-centered (type 1), onlooking and avoiding (type 2), patient-centered (type 3), and problem-centered (type 4). The 4 factors accounted for 57.84% of the total variance. Individual contributions of factors 1, 2, 3, and 4 were 41.80%, 7.18%, 5.20%, and 3.66%, respectively. Conclusion: The major contribution of this study is the clarification of perioperative nurses' subjective perceptions of ethical issues. These findings can be used in formulating effective strategies for nursing educators, professional nurses, and nursing administrators to improve ethical decision-making abilities and to perform ethical nursing care by the appropriate management of ethical issues in everyday nursing practice.

• The Korean Journal of Pain
• /
• v.36 no.2
• /
• pp.149-162
• /
• 2023

Chronic postsurgical pain (CPSP) is a multifactorial condition that affects a significant proportion of patients undergoing surgery. The prevention and management of CPSP require the identification of preoperative risk factors to screen high-risk patients and establish appropriate perioperative pain management plans to prevent its development. Active postoperative pain management should be provided to prevent CPSP in patients with severe pain following surgery. These tasks have become important for perioperative team members in the management of CPSP. This review article provides a comprehensive overview of the latest research on the role of perioperative team members in preventing and managing CPSP. Additionally, it highlights practical strategies that can be employed in clinical practice, covering the definition and risk factors for CPSP, including preoperative, intraoperative, and postoperative factors, as well as a risk prediction model. The article also explores various treatments for CPSP, as well as preventive measures, including preemptive analgesia, regional anesthesia, pharmacological interventions, psychoeducational support, and surgical technique modification. This article emphasizes the importance of a comprehensive perioperative pain management plan that includes multidisciplinary interventions, using the transitional pain service as an example. By adopting a multidisciplinary and collaborative approach, perioperative team members can improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs. However, further research is necessary to establish targeted interventions to effectively prevent and manage CPSP.

• Archives of Plastic Surgery
• /
• v.44 no.4
• /
• pp.276-282
• /
• 2017

Perioperative hypertension is a phenomenon in which a surgical patient's blood pressure temporarily increases throughout the preoperative and postoperative periods and remains high until the patient's condition stabilizes. This phenomenon requires immediate treatment not only because it is observed in a majority of patients who are not diagnosed with high blood pressure, but also because occurs in patients with underlying essential hypertension who show a sharp increase in their blood pressure. The most common complication following facelift surgery is hematoma, and the most critical risk factor that causes hematoma is elevated systolic blood pressure. In general, a systolic blood pressure goal of <150 mm Hg and a diastolic blood pressure goal of >65 mm Hg are recommended. This article discusses the causes of increased blood pressure and the treatment methods for perioperative hypertension during the preoperative, intraoperative, and postoperative periods, in order to find ways to maintain normal blood pressure in patients during surgery. Further, in this paper, we review the causes of perioperative hypertension, such as anxiety, epinephrine, pain, and postoperative nausea and vomiting. The treatment methods for perioperative hypertension are analyzed according to the following 3 operative periods, with a review of the characteristics and interactions of each drug: preoperative antihypertensive medicine (atenolol, clonidine, and nifedipine), intraoperative intravenous (IV) hypnotics (propofol, midazolam, ketamine, and dexmedetomidine), and postoperative antiemetic medicine (metoclopramide and ondansetron). This article focuses on the knowledge necessary to safely apply local anesthesia with IV hypnotics during facelift surgery without the assistance of an anesthesiologist.

• Journal of Korean Academy of Nursing Administration
• /
• v.16 no.1
• /
• pp.86-100
• /
• 2010

Purpose: This study was done to examine the relationship of job satisfaction and organizational commitment of perioperative nurses. Method: The subjects of this study were 500 perioperative nurses from 11 hospitals. The data were collected by self-reporting questionnaires from Sep. 19 to Sep. 27, 2009. Results: There was statistically significant relationship among the five variables. The analyses of covariance of these five variables revealed overall significant (p<.05). Stepwise linear multiple regression analyses were used to examine the influence of these five variables. Results indicated that the variables for verbal abuse (p<.01), workplace climate (p<.01), internal marketing (p<.001), and job transfer (p<.001) contributed significantly to the job satisfaction (adjusted R square=.426), while the verbal abuse (p<.01), internal marketing (p<.01), leadership style (p<.001) and workplace climate (p<.001) did to the organizational commitment (adjusted R square=.351). Canonical correlation analyses revealed that internal marketing and workplace climate contributed most significantly both to job satisfaction and organizational commitment. Conclusion: This study found that all these five nursing managerial factors were important influential on both job satisfaction and organizational commitment of perioperative nurses. Addressing these factors with further research will surely improve the commitment of these nurses and ultimately lead to better perioperative nursing care.