scholarly journals Nurse-run preanaesthesia assessment clinics: an initiative towards improving the quality of perioperative care at the ambulatory care centre

2021 ◽  
Vol 10 (4) ◽  
pp. e001066
Author(s):  
Neethu Arun ◽  
Khalid Mohammed Ahmed Al-Jaham ◽  
Saadiya Ahmad Alhebail ◽  
Mohammad Jamal Abdallah Hassan ◽  
Refa Hanish Bakhit ◽  
...  

IntroductionNurse-run preanaesthesia assessment is well established in ambulatory surgery. However, in the Middle East the implementation of such a service is new and needed careful preparation. Aim of this audit is to assess the feasibility and the quality of preoperative assessments by the specially trained nurses, patient and nurse satisfaction and overall perioperative quality of recovery.MethodsThe nurses were selected and trained first in an accredited programme. Then an implementation period of 3 month was used for them to gain experience. Hereafter, we performed a four-step audit on the quality of preassessment, the patient’s satisfaction, the quality of recovery and adverse events if any. Finally, we also monitored the nurse’s satisfaction of their new advanced role.ResultsThe quality of preanaesthesia assessment was high as with 95% compliance to the accepted standards. In the patient satisfaction survey, all 152 patients were either highly satisfied or satisfied with the nurse-run service. The nurses were also highly satisfied and felt that they were either highly or moderately valued. All the patients who were operated at the ambulatory care services were followed up postoperatively by telephone calls which revealed that most of them were highly satisfied. No major or minor adverse events occurred.ConclusionOur specially trained nurses perform preoperative assessments on high standard without adverse events, while patient and staff satisfaction is very high. Future projects will focus on reducing the rate of cancellation of surgeries, investigating the cost-effectiveness of this approach as well as training the specialised nurses for paediatric preoperative anaesthesia assessments. This model of care could induce further nurse-run models of care in the Middle East.

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Yusheng Yao ◽  
Qiuyan Zhao ◽  
Cansheng Gong ◽  
Yihuan Wu ◽  
Ying Chen ◽  
...  

Background. We conducted this prospective, randomized, double-blind, placebo-controlled study to evaluate the effects of transcutaneous electric acupoint stimulation (TEAS) on the quality of recovery (QoR) and postoperative analgesia after gynecological laparoscopic surgery.Methods. 74 American Society of Anesthesiologists physical status (ASA) I or II patients undergoing gynecological laparoscopic surgery were randomly allocated to TEAS or control groups. The primary outcome was the quality of recovery, which was assessed on the day before surgery and 24 h after surgery using a 40-item questionnaire. Secondary outcomes included postoperative pain scores, the incidence of postoperative nausea and vomiting (PONV), duration of postanesthesia care unit (PACU) stay, and patient’s satisfaction.Results. The TEAS group had higher QoR scores than control group upon 24 h after surgery (177 versus 165;P<0.001). Compared with the control group, postoperative pain scores and the cumulative number of opioids administered were lower in the TEAS group patients (P=0.04). TEAS reduced the incidence of PONV and dizziness, as well as duration of PACU stay. Simultaneously, the patient’s satisfaction scores were higher in the TEAS group (P=0.002).Conclusion. Preoperative TEAS enhances QoR, improves postoperative analgesia and patient’s satisfaction, alleviates postoperative side effects, and accelerates discharge after general anesthesia for gynecological laparoscopic surgery.


2021 ◽  
Author(s):  
Xiaoqiang Zhang ◽  
Shuang Li ◽  
Jing Liu

Abstract Background: Remimazolam besylate is a new type of benzodiazepine that has the characteristics of quick effects, short maintenance and recovery times, and no accumulation. Compound opioids can have a sedative effect in some endoscopic examinations. This trial was conducted to confirm the efficacy and safety of remimazolam besylate versus propofol during hysteroscopy.Methods: Patients undergoing hysteroscopy were randomly assigned to either the remimazolam (Group R, n=41) or the propofol group (Group P, n=41). Group R was administered an induction dosage of 0.2 mg/kg/min and a maintenance dosage of 1 mg/kg/h. Group P was started at 1.5-2.0 mg/kg propofol for up to 60-100 s and then maintained at 3.0-6.0 mg/kg/h. In both groups, remifentanil was infused using a target-controlled infusion system with a target concentration of 1.5 ng/ml and titrated during the procedure. The incidence rates of body movement and various adverse events in both groups were compared.Results: Eighty-two patients were included in this study. The incidence of adverse events in Group R (8.5%) was significantly lower than that in Group P (36.6%) (P < 0.05). Injection pain, postoperative dizziness and low SpO2 were the most common adverse events (P < 0.05). Compared with Group P patients, Group R patients recovered faster, had a shorter residence time in the PACU, and exhibited a higher quality of recovery (P < 0.05).Conclusion: Remimazolam besylate can provide safe and effective sedation for hysteroscopy. The depth of sedation is sufficient and effective, and the quality of recovery is high. Moreover, adverse events such as haemodynamic fluctuation, excessive sedation depth, low SpO2 and injection pain caused by propofol are largely avoided.Trial registrationThis study was approved by the Clinical Research Ethics Committee of Mengcheng County No.1 People's Hospital (2020MYL20003) and registered at http:// www.chictr.org.cn (15/09/2020, ChiCTR-2000038252). The study protocol is performed in the relevant guidelines.


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