Engaging in Policy During Graduate Training.
Authors: Sells JR, Taylor DA, Sbrocco T
PMID: 30568019 [PubMed - in process] (Source: Annual review of nursing research)
Source: Annual review of nursing research - December 22, 2018 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
A Policy Apprenticeship in the Office of U.S. Senator Daniel K. Inouye.
Authors: Squellati R
PMID: 30568020 [PubMed - in process] (Source: Annual review of nursing research)
Source: Annual review of nursing research - December 22, 2018 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Wet or Dry? A Review of Intravenous Fluid Administration in Anesthesia Practice.
Authors: D'Angelo M, Hodgen RK
Abstract
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of anesth...
Source: Annual review of nursing research - December 14, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Preparing Anesthetists to Manage Cannot Intubate/Cannot Ventilate Situations.
Authors: Wofford KA
Abstract
Cannot intubate/cannot ventilate (CICV) situations during anesthesia are rare, potentially catastrophic to the patient, and difficult to predict. Widely adopted practice guidelines advocate an algorithmic approach to CICV situations in which the anesthetist: (a) recognizes the CICV situation, (b) calls for help, (c) steadily progresses through a variety of methods to ventilate the patient and secure the airway, (d) restores ventilation via an infraglottic airway if the patient cannot be safely awakened prior to becoming moribund. Despite widespread consensus that rapid progress...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Anesthetic Implications of Obesity and Obstructive Sleep Apnea.
Authors: Greenwood J
Abstract
The incidence of morbid obesity has tripled within the past 25 years in developed countries, with the highest rate of growth noted among people with body mass index (BMI) greater than 50. The physiologic derangements that accompany obesity affect almost every organ system leading to a vast array of comorbid conditions including obstructive sleep apnea (OSA). This review focuses on the unique perioperative management considerations that the nurse anesthetist must address when caring for these patients as well as the impact of obesity and OSA on postoperative complications and m...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Lung-Protective Ventilation.
Authors: Marley RA, Simon K
Abstract
Historically, mechanical ventilation of the lungs utilizing relatively large tidal volumes was common practice in the operating room and intensive care unit (ICU). The rationale behind this treatment strategy was to yield better patient outcomes, that is, fewer pulmonary complications, and a reduction in morbidity and mortality. As evidence-based practice has evolved, potential harmful effects of traditional, nonphysiological mechanical ventilation (ventilation with larger tidal volumes and the tolerance of high airway pressures) even in shortterm treatment have been sh...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Communication in the Operating Room Setting.
Authors: Osborne-Smith L, Kyle Hodgen R
Abstract
Ideal and effective communication consists of a clear, audible, and focused message from a transmitter that is delivered to an attentive, undistracted receiver, and consists of both verbal and nonverbal types. Communication in the health care setting is highly complex and dynamic, involving multiple settings, participants, and unique challenges. Effective communication in the perioperative environment is a requirement for safe patient care delivery and an important element of teamwork. A message must be accurately delivered in a uniquely high-risk and time-s...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Anesthesia Information Management Systems.
Authors: Davis TC
Abstract
Anesthesia information management systems (AIMS) are rapidly gaining widespread acceptance. Aggressively promoted as an improvement to manual-entry recordkeeping systems in the areas of accuracy, completeness, quality improvement, billing, and vigilance, these systems record all patient vital signs and parameters, providing a legible hard copy and permanent electronic record. With well-documented financial incentives, as well as government subsidies, AIMS are becoming adopted at an unprecedented rate. With the goals of the federal government to enhance the use of the electronic m...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Chronic Postsurgical Pain.
Authors: Wooden SR
Abstract
Chronic postsurgical pain (CPSP) is defined as a persistent pain state that exists more than 2 months postoperatively and cannot be explained by other causes such as recurrence of disease, apparent inflammation, or other nonsurgical related factors. CPSP is a type of persistent pain condition that often complicates recovery from surgical procedures. It is thought to be caused by surgical nerve injury, but the fact that an identifiable nerve injury can be found in only one-third of CPSP patients suggests that the problem may be far more complex than a simple surgically created ne...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Acupuncture and Chronic Pain Management.
Authors: Eshkevari L
Abstract
According to National Institute of Health Pathways to Prevention Workshop (2014), chronic pain affects an estimated 100 million Americans, with approximately 25 million people experiencing moderate to severe chronic pain, which negatively impacts their ability to function leading to a diminished quality of life. Pain is the primary reason Americans are on disability, which adds to the economic and social burden of suffering for the nation. Chronic pain costs are estimated to be between 560 and 630 billion per year. An estimated 5 to 8 million Americans use opioids for long-ter...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Anesthesia Involvement in Palliative Care.
Authors: Faircloth AC
Abstract
Palliative care teams require multidisciplinary support. While this is an emerging area in anesthesia practice, there are many avenues for certified registered nurse anesthetists (CRNAs) to share their unrivaled clinical knowledge. CRNAs may become involved with or consult on palliative sedation, medical management, interventional pain management, terminal wean/extubation, and organ donation. Additionally, CRNAs need to understand the unique needs of this patient population so that they can appropriately care for palliative care patients presenting to the operating room for p...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Treatment and Prevention of Spinal-Induced Hypotension in the Cesarean Section Patient: What Does the Evidence Say?
Authors: Pellegrini JE
Abstract
Most anesthesia providers prefer to do a subarachnoid block (SAB) for cesarean section because of its rapid onset and reliability to provide adequate anesthesia. However an effect of the SAB is that it causes a spinal-induced hypotension (SIH) in up to 85% of the population. There have been multiple studies that assessed fluid administration, vasopressor administration, maternal positioning, or serotonin blockers given prophylactically to attenuate the SIH response. Despite these multiple studies, the method to prevent and treat SIH remains varied from one anesthesia practic...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Forced-Air Warmers and Surgical Site Infections in Patients Undergoing Knee or Hip Arthroplasty.
Authors: Austin PN
Abstract
The majority of the evidence indicates preventing inadvertent perioperative hypothermia reduces the incidence of many perioperative complications. Among the results of inadvertent perioperative hypothermia are increased bleeding, myocardial events, impaired wound healing, and diminished renal function. Most researchers agree there is an increased incidence of surgical site infections in patients who experience inadvertent perioperative hypothermia. Forced-air warming is effective in preventing inadvertent perioperative hypothermia. Paradoxically, forced-air warmers have been imp...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
The Neurotoxicity of General Anesthetic Drugs: Emphasis on the Extremes of Age.
Authors: Biddle C, Ford V
Abstract
A substantial body of research suggests that anesthetic exposure to patients who are very young or very old may impair cognitive, behavioral, and emotional development or recovery. In lower animal models of pre- and postnatal age, anesthetic exposure may impact inflammation, synaptogenesis, neuronal apoptosis, and glial cell development. To date, research in humans is inconclusive regarding the long-term cognitive and behavioral sequelae of general anesthesia in the young child. In older adults, postoperative cognitive dysfunction and cognitive delirium are identified as ...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
Wet or Dry? A Review of Intravenous Fluid Administration in Anesthesia Practice.
Authors: D'Angelo M, Kyle Hodgen R
Abstract
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of an...
Source: Annual review of nursing research - December 11, 2016 Category: Nursing Tags: Annu Rev Nurs Res Source Type: research
