• Title/Summary/Keyword: Postoperative care

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Factors Influencing Performance of Delirium Care for Postoperative Delirium of Elderly Patients among Recovery Room Nurses (노인환자의 수술 후 섬망에 대한 회복실 간호사의 간호수행과 영향요인)

  • Koo, Hyunjoo;Yang, Jinhyang
    • The Journal of Korean Academic Society of Nursing Education
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    • v.22 no.3
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    • pp.387-395
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    • 2016
  • Purpose: The purpose of this study was to identify factors associated with performance of nursing care for postoperative delirium of elderly patients among recovery room nurses. Methods: The research was a cross-sectional, descriptive design using questionnaires. The participants were 99 nurses from five urban recovery rooms. Data were analyzed using descriptive statistics, t-test, ANOVA and multiple regression with SPSS WIN 21.0. Results: The performance level of delirium nursing care was low because its mean score was 3.80 out of 5. Performance of nursing care was significantly positively correlated with the importance of nursing care and self-efficacy. Stepwise multiple regression analysis for performance of nursing care revealed that the most powerful predictor was the importance of nursing care. The importance of nursing care and self-efficacy explained 32.3% of the variance. Conclusion: The results indicate a need to enhance the performance of nursing care for postoperative delirium of elderly patients among recovery room nurses. The findings also suggest that consideration be given to strategies for improving the importance of nursing care and self-efficacy in developing programs to enhance the performance level of nursing care for elderly patients with postoperative delirium.

Critical Care after Lung Transplantation

  • Kim, Song Yee;Jeong, Su Jin;Lee, Jin Gu;Park, Moo Suk;Paik, Hyo Chae;Na, Sungwon;Kim, Jeongmin
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.206-215
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    • 2018
  • Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.

Critical Care Management Following Lung Transplantation

  • Jeon, Kyeongman
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.325-331
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    • 2022
  • Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.

The Effects of Structured Preoperative Instruction on Anxiety and Self-care Compliance in Patients with Cataract Surgery (구조화된 수술 전 교육이 백내장 수술 환자의 불안과 자가간호 수행에 미치는 효과)

  • Choi, Mi Jung;Park, Jeong Sook
    • Korean Journal of Adult Nursing
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    • v.25 no.4
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    • pp.473-482
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    • 2013
  • Purpose: The purpose of this study was to investigate the effects of a structured preoperative instruction upon anxiety and postoperative self-care compliance. Methods: A randomized control group pre-post design was used. Sixty subjects undergoing cataract surgery were randomly assigned to one of two groups. The instruction consisted of cataract surgery procedure, sensory information, deep breathing, use of eye drop, and post op self-care regimen and was provided to the experimental group with control group receiving an usual treatment. State anxiety NRS, pulse, BP, and self-care compliance scale developed by Cho & Rho were used. Data were collected at two time periods: on the day of surgery in the clinic and prior to anesthesia in the operating room. The postoperative self-care compliance scores were measured at their second visits to the hospital after surgery. Data were analyzed using Kolmogorov Smirnov test, t-test, and Mann-Whitney U test. Results: There were significant differences between the two groups in the postoperative state anxiety (t=-3.57, p=.001) and the postoperative self-care compliance score (t=3.92, p<.001). There were no significant difference between the two groups in the postoperative blood pressure and pulse rate. Conclusion: The results of this study suggest that the structured preoperative instruction could be a nursing intervention for cataract surgery patients.

Influence of general anesthesia on the postoperative sleep cycle in patients undergoing surgery and dental treatment: a scoping review on the incidence of postoperative sleep disturbance

  • Terumi Ayuse;Shinji Kurata;Gaku Mishima;Mizuki Tachi;Erika Suzue;Kensuke Kiriishi;Yu Ozaki-Honda;Takao Ayuse
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.2
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    • pp.59-67
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    • 2023
  • General anesthesia may influence the postoperative sleep cycle; however, no clinical studies have fully evaluated whether anesthesia causes sleep disturbances during the postoperative period. In this scoping review, we explored the changes in postoperative sleep cycles during surgical procedures or dental treatment under general anesthesia. We compared and evaluated the influence of general anesthesia on sleep cycles and sleep disturbances during the postoperative period in adult and pediatric patients undergoing surgery and/or dental treatment. Literature was retrieved by searching eight public databases. Randomized clinical trials, observational studies, observational case-control studies, and cohort studies were included. Primary outcomes included the incidence of sleep, circadian cycle alterations, and/or sleep disturbances. The search strategy yielded six studies after duplicates were removed. Finally, six clinical trials with 1,044 patients were included. In conclusion, general anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery.

Immediate Postoperative Care in the General Thoracic Ward Is Safe for Low-risk Patients after Lobectomy for Lung Cancer

  • Park, Seong-Yong;Park, In-Kyu;Hwang, Yoo-Hwa;Byun, Chun-Sung;Bae, Mi-Kyung;Lee, Chang-Young
    • Journal of Chest Surgery
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    • v.44 no.3
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    • pp.229-235
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    • 2011
  • Background: Following major lung resection, patients have routinely been monitored in the intensive care unit (ICU). Recently, however, patients are increasingly being placed in a general thoracic ward (GTW). We investigated the safety and efficacy of the GTW care after lobectomy for lung cancer. Materials and Methods: 316 patients who had undergone lobectomy for lung cancer were reviewed. These patients were divided into two groups: 275 patients were cared for in the ICU while 41 patients were care for in the GTW immediately post-operation. After propensity score matching, postoperative complications and hospital costs were analyzed. Risk factors for early complications were analyzed with the whole cohort. Results: Early complications (until the end of the first postoperative day) occurred in 11 (3.5%) patients. Late complications occurred in 42 patients (13.3%). After propensity score matching, the incidence of early complications, late complications, and mortality were not different between the two groups. The mean expense was higher in the ICU group. Risk factors for early complications were cardiac comorbidities and low expected forced expiratory volume in one second. The location of postoperative care had no influence on outcome. Conclusion: Immediate postoperative care after lobectomy for lung cancer in a GTW was safe and cost-effective without compromising outcomes in low-risk patients.

Effects of Postoperative Oral Care Using Cold Therapy on Nausea, Vomiting and Oral Discomfort in Patients with Laparoscopic Myomectomy (냉요법을 이용한 수술 후 구강간호가 복강경 자궁근종절제술 환자의 오심, 구토 및 구강 불편감에 미치는 효과)

  • Jung, Mi-Young;Choi, Hyo-Sun;Park, Kyung-Yeon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.3
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    • pp.292-301
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    • 2012
  • Purpose: The purpose of the study was to evaluate the effects of postoperative oral care using cold therapy on nausea, vomiting and oral discomfort after laparoscopic myomectomy. Method: The study was conducted with an experimental group (n=29) and a control group (n=35) sampled from patients admitted to a women's hospital in a metropolitan city in Korea. Data were collected between October 10, 2011 and January 31, 2012 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANCOVA with SPSS/WIN 19.0. Results: After the intervention, postoperative nausea (p<.001) and oral discomfort for patients in the experimental group were significantly lower than in the control group. There were significant differences in the presence of vomiting between both groups at 12 hours (p<.001) and 24 hours (p=.003) after leaving the recovery room. Conclusion: Oral care using cold therapy was found to be an effective nursing intervention for reducing postoperative nausea, vomiting and oral discomfort up to 24 hours after recovery in patients with laparoscopic myomectomy.

Interventional Radiology Treatment for Postoperative Chylothorax

  • Jun, Hoyong;Hur, Saebeom
    • Journal of Chest Surgery
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    • v.53 no.4
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    • pp.200-204
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    • 2020
  • Postoperative chylothorax is a rare occurrence after various thoracic surgical procedures, but it poses a substantial risk of morbidity and mortality. Thoracic duct embolization (TDE) is currently deemed the optimal treatment due to its safety and efficacy. This review offers an introduction to interventional options in this setting, detailing the steps of TDE for the edification of those engaged in postoperative care.

Effects of Preoperative Psychological fare on Postoperative Recovery - An Exploratory Experiment - (수술 전 심리간호가 회복에 미치는 효과에 관한 실험적 연구)

  • 김조자
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.97-113
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    • 1971
  • The purpose of this study was to investigate the preoperative anxiety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesics used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital. This study me based on a sample of 51 patients who were scheduled for abdominal surgery. They were assigned alternately to experimental and control groups. Patients assigned to the experimental group were given nursing care by the writer, using an experimental nursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery. This process was performed by use of the following steps: 1. The nurse approached the patient with interest and concern, and observed the patient's behavior to determine the presence of anxiety. 2. The nurse explored further to find out what was causing the anxiety and what was needed too relieve it. 3. The nurse listened carefully lo the patient. 4. The nurse gave an opportunity for expression of individuality. 5. The nurse showed friendliness and reassured the patient 6. The nurse gave instruction about deep berating, turing and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety- The findings of this study are as follows: 7. The investigation of preoperative anxiety through observing and interviewing revealed patients were concerned about the following: a. Length of stay in the hospital 69.7% (31 cases) b. Condition unimproved o. worse 48.,8% (30 cases) c. Postoperative pain and discomfort .56.8% (29 cases) 2. The results of the study regarding the four hypothesis were as follows: a. Preoperative psychological care not reduce the number of analysis needed during the 48 hour period following surgery. b. Preoperative psychological care did not reduce the Postoperative incidence of vomiting c. Preoperative psychological care had no influence on voiding ability following surgery. d. Preoperative psychological care significantly reduced the number of postoperative days in tile hospital. The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization (improving rate of healing). This study has demonstrated further that the relief of anxiety (emotional distress) is part of the nurse's professional role. In order to be sure psychological care is given it is important to make a nursing care plan which .includes a plan for the psychological care needed by the patient. As this care is given it can be charted off by each nurse just as medication and treatments are checked after they are given.

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Effects of Essential Oil Gargling and Purified Water Gargling on Thirst, Oral Condition and Halitosis of Postoperative Patients (에센셜오일 가글링과 정수 가글링이 수술 후 환자의 갈증, 구강상태 및 구취에 미치는 효과)

  • Jeon, Bo Ra;Chun, Chung Sook;Lee, Ji Yeon;Park, Kyoung Won
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.2
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    • pp.200-210
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    • 2014
  • Purpose: The main purpose of this study was to effect oral care methods between essential oil gargling and purified water gargling for postoperative patients who had general surgery or orthopedic surgery. Methods: The postoperative patients were assigned to one of two groups. One group gargled with essential oil and the other with purified water. All group gargled three times interval 2 hours. Each patients thirst, oral condition and halitosis were assessed four times. Results: After oral care was provided once, there were significant differences in thirst level between two groups. when oral care was provided once and three times, there were significant differences in oral condition between two groups. but there were no significant differences in halitosis between two groups. Conclusion: The results show that essential oil gargling is a more effective intervention than purified water gargling for post operative patients oral care in reducing the thirst level and improving the condition of the oral cavity.