scholarly journals Nurse competence in the post-anaesthesia care unit in Sweden: a qualitative study of the nurse’s perspective

BMC Nursing ◽  
2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Karuna Dahlberg ◽  
Ann-Sofie Sundqvist ◽  
Ulrica Nilsson ◽  
Maria Jaensson

Abstract Background To enable safe and successful recovery for surgery patients, nurses working in post-anaesthesia care units need competence in postoperative care. No consensus defines what this specific competence includes, and it has not been studied from the perspective of nurses working in post-anaesthesia care units. The aim of this study is twofold: 1) To explore and describe nurses’ perception of the competence needed to work in post-anaesthesia care units. 2) To explore and describe nurses’ perception of what characterizes an expert nurse in post-anaesthesia care units. Methods This qualitative inductive study uses individual interviews. Sixteen nurses were recruited from two post-anaesthesia care units located in different parts of Sweden. Inclusion criteria were nurses employed in the post-anaesthesia care units for ≥1 years. Semi-structured individual interviews were conducted; data were analysed using thematic analysis. Results The interview analysis identified six subthemes and three themes. The themes being adaptable in an ever-changing environment and creating safe care represent the overarching meaning of competence required when working as a nurse in a Swedish post-anaesthesia care unit. Nurses must possess various technical and nontechnical skills, which are core competences that are described in the sub-themes. The theme seeing the bigger picture describes the nurse’s perception of an expert nurse in the post-anaesthesia care unit. Conclusions Nurse competence in post-anaesthesia care units entails specific knowledge, acknowledging the patient, and working proactively at a fast pace with the patient and team to provide safe, high-quality care. An expert nurse in post-anaesthesia care units can see the bigger picture, helping share knowledge and develop post-anaesthesia care. The expert competence to see a bigger picture can be used in supervising novices and creating a knowledge base for postgraduate education in order to promote safe, high-quality post-anaesthesia care.

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 89-97
Author(s):  
Karin Yeung ◽  
Jonas Peter Eiberg ◽  
Henrik Kehlet ◽  
Eske Kvanner Aasvang

Abstract. Background: Arterial surgery for lower limb ischaemia is a frequently performed procedure in patients with severe cardio-pulmonary comorbidities, making them high-risk patients for acute postoperative complications with a need for prolonged stay in the post-anaesthesia care unit (PACU). However, detailed information on complications during the PACU stay is limited, hindering mechanism-based interventions for early enhanced recovery. Thus, we aimed to systematically describe acute complications and related risk factors in the immediate postoperative phase after infrainguinal arterial surgery. Patients and methods: Patients transferred to the PACU after infrainguinal arterial surgery due to chronic or acute lower limb ischaemia were consecutively included in a six-month observational cohort study. Pre- and intraoperative data included comorbidities as well as surgical and anaesthetic technique. Data on complications and treatments in the PACU were collected every 15 minutes using a standardised assessment tool. The primary endpoint was occurrence of predefined moderate or severe complications occurring during PACU stay. Results: In total, 155 patients were included for analysis. Eighty (52 %) patients experienced episodes with oxygen desaturation (< 85 %) and moderate or severe pain occurred in 72 patients (47 %); however, circulatory complications (hypotension, tachycardia) were rare. Preoperative opioid use was a significant risk factor for moderate or severe pain in PACU (59 vs. 38 % chronic vs. opioid naïve patients (P = 0.01). Conclusions: Complications in the PACU after infrainguinal arterial surgery relates to saturation and pain, suggesting that future efforts should focus on anaesthesia and analgesic techniques including opioid sparing regimes to enhance early postoperative recovery.


2021 ◽  
pp. 0310057X2097240
Author(s):  
Anthony D Hade ◽  
Satomi Okano ◽  
Anita Pelecanos ◽  
Adrian Chin

Peripheral nerve blocks can provide surgical anaesthesia as well as excellent postoperative analgesia. When questioned postoperatively, however, some patients report low levels of satisfaction with their nerve block experience. At our hospital, patients undergoing regional anaesthesia have their patient characteristics, block characteristics and postoperative feedback routinely recorded in a block registry. We analysed data from 979 consecutive patients undergoing peripheral nerve block for orthopaedic surgery to identify factors associated with low levels of patient satisfaction. The primary outcome was patient satisfaction with their peripheral nerve block (scale 1–5: 4–5 is ‘satisfied’, 1–3 is ‘not satisfied’). Eighty-nine percent (871/979) of patients reported being ‘satisfied’ with their block. Factors negatively associated with patient satisfaction were rebound pain (adjusted odds ratio (aOR) 0.19, 95% confidence interval (CI) 0.04 to 0.85 for moderate rebound pain; aOR 0.11, 95% CI 0.03 to 0.48 for severe rebound pain), discomfort during the block (aOR 0.37, 95% CI 0.16 to 0.82 for moderate discomfort; aOR 0.19, 95% CI 0.05 to 0.76 for severe discomfort) and pain in the post-anaesthesia care unit (aOR 0.30, 95% CI 0.17 to 0.55 for pain ≥8/10). Only 24% (26/108) of patients who reported being ‘not satisfied’ stated that they would be unwilling to undergo a hypothetical future nerve block. Rebound pain of at least moderate intensity, procedural discomfort of at least moderate intensity and severe pain in the post-anaesthesia care unit are all negatively associated with patient satisfaction. Of these factors, rebound pain occurs most frequently, being present in 52% (403/777) of our respondents.


1995 ◽  
Vol 41 (7) ◽  
pp. 969-975 ◽  
Author(s):  
Helen R. Winefield ◽  
Timothy G. Murrell ◽  
Julie Clifford

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Mallory D. Woiski ◽  
Evelien Belfroid ◽  
Janine Liefers ◽  
Richard P. Grol ◽  
Hubertina C. Scheepers ◽  
...  

2003 ◽  
Vol 11 (4) ◽  
pp. 209-215 ◽  
Author(s):  
Keng Chen ◽  
Stephen Shumack ◽  
Richard Wootton

2013 ◽  
Vol 18 (1) ◽  
pp. 4-13
Author(s):  
Michael Clark ◽  
Clare Hilton ◽  
Wendy Shiels ◽  
Carole Green ◽  
Christina Walters ◽  
...  

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