scholarly journals Perioperative communication from the perspective of patients undergoing bariatric surgery

2014 ◽  
Vol 23 (2) ◽  
pp. 347-355 ◽  
Author(s):  
Caroline Lemes Pozza Morales ◽  
Jenefer Garcez Alexandre ◽  
Suzana Prim ◽  
Lúcia Nazareth Amante
Keyword(s):  
Bariatric Surgery ◽  
Multidisciplinary Team ◽  
Surgical Care ◽  
Perioperative Period ◽  
Communication Process ◽  
University Hospital ◽  
Southern Brazil ◽  
Individual Interviews ◽  
Surgical Unit

This was a qualitative and descriptive study that aimed to determine how patients understand instructions provided by a multidisciplinary team during perioperative periods of bariatric surgery. Data were collected through three individual interviews. Six patients admitted to a surgical unit of a university hospital in southern Brazil, in April and May 2012, participated in the study. Thematic analysis revealed three categories: communication in the perioperative period of bariatric surgery; quality of life and post- surgical care following bariatric surgery; and communication in the work process of the multidisciplinary team. The results showed satisfaction with the information received, but problems in the communication process and apprehension about life after surgery were highlighted. Furthermore, the absence of outpatient nursing care was demonstrated.

scholarly journals A porcine model for teaching surgical cricothyridootomy

2015 ◽  
Vol 42 (3) ◽  
pp. 193-196 ◽  
Author(s):  
Fernando Antonio Campelo Spencer Netto ◽  
Patricia Zacharias ◽  
Raphael Flavio Fachini Cipriani ◽  
Michael De Mello Constantino ◽  
Michel Cardoso ◽  
...  
Keyword(s):  
Medical Students ◽  
Surgical Technique ◽  
Porcine Model ◽  
Human Anatomy ◽  
University Hospital ◽  
Medical Residents ◽  
Practical Training ◽  
Southern Brazil ◽  
Anatomical Correlation

<sec><title>OBJECTIVE:</title><p> To evaluate the acceptability of an educational project using A porcine model of airway for teaching surgical cricothyroidotomy to medical students and medical residents at a university hospital in southern Brazil.</p></sec><sec><title>METHODS:</title><p> we developed a teaching project using a porcine model for training in surgical cricothyroidotomy. Medical students and residents received lectures about this surgical technique and then held practical training with the model. After the procedure, all participants filled out a form about the importance of training in airway handling and the model used.</p></sec><sec><title>RESULTS:</title><p> There were 63 participants. The overall quality of the porcine model was estimated at 8.8, while the anatomical correlation between the model and the human anatomy received a mean score of 8.5. The model was unanimously approved and considered useful in teaching the procedure.</p></sec><sec><title>CONCLUSION:</title><p> the training of surgical cricothyroidotomy with a porcine model showed good acceptance among medical students and residents of this institution.</p></sec>

scholarly journals Women and partners’ experiences of critical perinatal events: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037932
Author(s):  
Laura Emdal Navne ◽  
Stinne Høgh ◽  
Marianne Johansen ◽  
Mette Nordahl Svendsen ◽  
Jette Led Sorensen
Keyword(s):  
Parental Involvement ◽  
Healthcare Professionals ◽  
Postnatal Period ◽  
University Hospital ◽  
Individual Interviews ◽  
The Past ◽  
Qualitative Interview Study ◽  
Professional Resources ◽  
High Degree

ObjectiveThe aim of this study was to explore women and partners’ experiences following critical perinatal events.DesignThis is a qualitative interview study. We conducted semistructured individual interviews with women and their partners in separate rooms. Interviews were analysed thematically and validated by a transdisciplinary group of anthropologists, obstetricians and a midwife.SettingDepartment of obstetrics at a tertiary referral university hospital in Denmark.ParticipantsWomen and partners who had experienced a critical perinatal event within the past 3–12 months.ResultsWe conducted 17 interviews and identified three main themes: (1) ambivalence towards medicalisation, (2) the extended temporality of a critical birth and (3) postnatal loss of attention from healthcare professionals. Overall, participants expressed a high degree of trust in and quality of provided healthcare during the critical perinatal events. They experienced medicalisation (obstetric interventions) as a necessity, linking them to the safety of the child and their new role as responsible parents. However, some women experienced disempowerment when healthcare professionals overlooked their ability to stay actively involved during birth events. Postnatally, women and their partners experienced shortages of healthcare professional resources, absent healthcare and lack of attention.ConclusionsWomen and their partners’ experiences of critical perinatal events begin long before and end long after the actual moment of childbirth, challenging conventional ideas about the birth as being the pivotal event in making families. In future healthcare planning, it is important to to align expectations and guide parental involvement in birth events and to acknowledge the postnatal period as equally crucial.

A Process of Multidisciplinary Team Communication to Individualize Stroke Rehabilitation of an 84-Year-Old Stroke Patient

2016 ◽  
Vol 17 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Fukumi Hiragami ◽  
Shogo Hiragami ◽  
Yasuo Suzuki
Keyword(s):  
Multidisciplinary Team ◽  
Treatment Options ◽  
Communication Process ◽  
Knowledge Assessment ◽  
Team Members ◽  
Mobility Impairments ◽  
Patient Families ◽  
Initial Meeting

Previously, we have used a multidisciplinary team (MDT) approach to individualize rehabilitation of very old stroke patients as a means to establish intervention points for addressing impaired activities of daily living (ADL). However, this previous study was limited because of a lack in describing the communication process over time. This case study characterized the MDT communication process in the rehabilitation of an 84-year-old patient over the course of 15 weeks. The MDT consisted of 3 nurses, 1 doctor, 6 therapists, and the patient/families. Meetings (15 minutes each) were held at 4, 6, 8, and 15 weeks following the patient’s admission. To individualize the rehabilitation, the communication process involved gaining knowledge about ADL impairments, sharing assessments, providing treatment options, and reflecting on desired treatment outcomes—a process termed KATR. The knowledge, assessment, treatment, and reflection (KATR) process established intervention points focusing on specific ADL impairments. The team members focused the interventions on the impaired ADL identified in the KATR process, and individualized rehabilitation was generated from the MDT information-sharing knowledge. In the initial meeting (Week 4), intervention points derived from the KATR process focused on rehabilitation of self-care impairments. These impairments improved by Week 15. By the last meeting, the MDT intervention points focused on mobility impairments. Having an organized communication process (i.e., KATR) facilitates individualization of rehabilitation without lengthy and frequent MDT meetings and enhances the quality of rehabilitation after a stroke.

scholarly journals Intestinal Ostomies Created During Emergency Surgery Possess Unique Challenges

2020 ◽  
Author(s):  
Wibke Schulte ◽  
Ilhamiyya Aliyeva ◽  
Michael Knoop ◽  
Johann Pratschke
Keyword(s):  
Emergency Surgery ◽  
Online Survey ◽  
Elective Surgery ◽  
Surgical Care ◽  
Wound Dehiscence ◽  
University Hospital ◽  
Complication Rates ◽  
Emergency Patients ◽  
Artificial Opening

Abstract Background: The surgical creation of an artificial opening of the bowel, called ostomy, can become necessary for very different causative diseases. A special subgroup are ostomies created during emergency surgery, which pose particular challenges to affected patients. This work is dedicated to their detailed characterization.Methods: A retrospective analysis of surgical ostomy creations at an acute care university hospital and an online survey for patients with an ostomy were performed and evaluated.Results: In our study, about one third of all ostomies were created during emergency surgery (37.4%). Compared to patients who received an ostomy during elective surgery, emergency patients had a higher ASA score and diagnoses requiring acute surgical care. Patients undergoing emergency surgery were more likely to have inadequate preoperative medical education (60% vs. 33.3%, p=0.029), and rarely received preoperative ostomy marking (4% vs. 79.2%, p<0.001). Emergency patients underwent minimally invasive surgery less frequently (26.8% vs. 51.3%, p=0.001), and showed a higher rate of peristomal wound dehiscence (9.9% vs. 2.5%, p=0.028). Accordingly, emergency ostomies often resulted in an overall reduction in postoperative quality of life.Conclusion: Ostomies are often created during emergency surgery under suboptimal perioperative conditions. This results in higher complication rates and negative physical and psychological effects. Therefore, intensive interdisciplinary care is essential to provide the best possible care for patients affected by these artificially created intestinal outlets.

scholarly journals Costs of bariatric surgery in a teaching hospital and the financing provided by the Public Unified Health System

2010 ◽  
Vol 25 (2) ◽  
pp. 201-205 ◽  
Author(s):  
Wilson Salgado Júnior ◽  
Karoline Calfa Pitanga ◽  
José Sebastião dos Santos ◽  
Ajith Kumar Sankarankutty ◽  
Orlando de Castro e Silva Jr ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health System ◽  
Perioperative Period ◽  
University Hospital ◽  
Retrospective Evaluation ◽  
The Public ◽  
Unified Health System ◽  
The Government ◽  
The Cost ◽  
The University

PURPOSE: Analyze the effect of some measures on the costs of bariatric surgery, adopting as reference the remuneration of the procedure provided by the Unified Health System (SUS). METHODS: A retrospective evaluation conducted in the Costs Section of the University Hospital of Ribeirão Preto, of the costs involved in the perioperative period for patients submitted to bariatric surgery from 2004 to 2007. Changes in the routines and protocols of the service aiming at the reduction of these costs during the study period were also analyzed. RESULTS: Nine patients in 2004 and seven in 2007 submitted to conventional vertical banded "Roux-en-Y" gastric bypass were studied. All patients presented good postoperative evolution. The average cost with these patients was R$ 6,845.17 in 2004. Even though an effort was made to contain expenditures, the cost in 2007 was of R$ 7,525.64 because of the increase in the price of materials and medicines. The Government remuneration of the procedure in the two years was R$ 3,259.72. CONCLUSION: Despite the adoption of diverse measures to reduce the expenditures of bariatric surgery, in fact there was an increase in the costs, a fact supporting the necessity of permanent evaluation of the financing of public health.

scholarly journals Quality assessment of the wound dressing procedure in patients at a university hospital

2008 ◽  
Vol 16 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Eleine Aparecida Penha Martins Nonino ◽  
Maria Luiza Anselmi ◽  
José Carlos Dalmas
Keyword(s):  
Wound Dressing ◽  
Time Frame ◽  
University Hospital ◽  
Wound Dressings ◽  
Sectional Study ◽  
Logical Sequence ◽  
Activity Performance ◽  
Unit Organization ◽  
Surgical Unit

This observational and sectional study analyzed the quality of the wound dressing procedure performed on hospitalized patients at a medical surgical unit of a University Hospital, based on their classification according to the degree of care dependency and activity performance phases. Using a check list, 168 wound dressings were observed between October and December 2005. Procedure quality was analyzed based on the Positivity Index (IP) and values >70% were considered satisfactory.For the preparation, the IP was 68%, 63%, 73% and 75% for patients with degrees I, II, III and IV, respectively; for execution, 70%, 69%, 71% and 75% and, for unit organization, it was >70% for all degrees. However, the items: validity time frame checking, respect for aseptic principles and maintenance of logical sequence of procedures were compromised. Rigorous execution of procedures allows for risk decrease and assures benefic results for patients, conferring quality to nursing actions.

Adherence aspects after bariatric surgery

2010 ◽  
Vol 4 (2) ◽  
pp. 548
Author(s):  
Marianna Carla Lucena ◽  
Andressa Moreira Hazboun ◽  
Remerson Russel Martins ◽  
João Carlos Alchieri
Keyword(s):  
Bariatric Surgery ◽  
University Hospital ◽  
Calidad De Vida ◽  
High Adherence ◽  
El Sistema ◽  
Health Quality ◽  
Surgery Department ◽  
Transversal Study ◽  
The Coordinator

ABSTRACTObjective: to evaluate psychosocial aspects of personality wich can influence adherence in patients who underwent bariatric surgery. Method: this is an observational transversal study, from qualitative/quantitative approach, performed with 15 patients after surgery. Those were indicated by the nurses sector as the most assiduous and classified as low and high adherence by the coordinator of the Obesity and Related Disorders Surgery Department, after approved by the Research Ethical Committee of Onofre Lopes University Hospital n. 355/09. Data were collected in a public hospital located in Natal-RN (Brazil) by using a semi-structured questionnaire and the Zulliger test. Then, the questionnaire data were submitted to discourse analysis, according to Bardin parameters, and the Zulliger was analyzed by the Klopfer system. Results: the most of patients demonstrated satisfaction with surgery and improvements in different areas of life. Paradoxly, the low adherence group presented more proactive personality compared to the group with high adherence. Conclusion: there are difficulties in adherence evaluation, once active behaviors can be understood as low adherence, what may cause problems in the procedures. Descriptors: bariatric surgery; behavioral medicine; guideline adherence; obesity; feeding behavior; public health; quality of life.RESUMOObjetivo: verificar aspectos psicossociais e de personalidade que podem influenciar na adesão terapêutica de pacientes submetidos à cirurgia bariátrica. Método: estudo observacional, quantitativo e qualitativo, de corte transversal, realizado com 15 pacientes pós-cirúrgicos. Estes foram indicados pelo setor de enfermagem como mais assíduos e classificados em baixa e alta aderência pelo coordenador do Serviço de Cirurgia da Obesidade e Doenças Relacionadas. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa/Hospital Universitário Onofre Lopes n. 355/09 e os dados foram coletados em um hospital da rede pública de saúde de Natal-RN (Brasil), com um questionário semi-estruturado e de um teste projetivo (Zulliger). Posteriormente, foram submetidos à análise de conteúdo seguindo os parâmetros de Bardin e o Zulliger foi corrigido de acordo com o sistema Klopfer. Resultados: a maior parte dos pacientes demonstrou satisfação com a cirurgia e melhoras em diversas esferas da vida. Paradoxalmente, o grupo classificado como tendo baixa aderência apresentou características de personalidade proativa em relação ao grupo considerado de alta aderência. Conclusão: a avaliação da aderência faz-se dificultosa uma vez que comportamentos ativos podem ser compreendidos como baixa aderência, podendo gerar entraves nas condutas. Descritores: cirurgia bariátrica; medicina do comportamento; fidelidade a diretrizes; obesidade; comportamento alimentar; saúde pública; qualidade de vida.RESUMENObjetivo: determinar los aspectos psicosociales de la personalidad que pueden influenciar la adhesión en los pacientes sometidos a cirugía bariátrica. Método: estudio observacional cualitativo y cuantitativo, transversal, realizado con 15 pacientes después de la cirugía. Estos fueron identificados por el personal de enfermería como más frecuentes y clasificados como de alta y baja adhesión por el coordinador del Departamento de Cirugía de la Obesidad y Trastornos Relacionados. Este estúdio fue aprobado por el Comité de Ética del Hosptial Universitario Onofre Lopes n. 355/09 y los datos fueron recogidos en un hospital público de Natal-RN (Brasil), obtenidos a través de un cuestionario semiestructurado y el técnica proyectiva de Zulliger. Después, los datos del cuestionario fueron sometidos a análisis del discurso según Bardin, y el Zulliger se analizó en el sistema de Klopfer. Resultados: la mayoría de los pacientes estaban satisfechos con la cirugía y obtenieran mejoras en diversos ámbitos de la vida. Paradójicamente, el grupo clasificado como de baja adhesión mostró una personalidad más proactiva comparandose al grupo de alta adherencia. Conclusión: hay dificultades en la evaluación de la adhesión, a medida que el comportamiento activo puede ser entendido como baja adhesión, lo que puede causar problemas en los procedimientos. Descriptores: cirugia bariátrica; medicina de la conducta; adhesión a directriz; obesidad; conducta alimentaria; salud pública; calidad de vida. 

Supporting Caring Efficacy in Nurses through Standardization of Communication

2020 ◽  
Vol 1 (1) ◽  
pp. 26-36
Author(s):  
Glenn D. Pascual ◽  
Keyword(s):  
Patient Satisfaction ◽  
Communication Process ◽  
Improvement Project ◽  
Care Experience ◽  
Patient Satisfaction Scores ◽  
Significant Difference ◽  
Nursing Communication ◽  
Communication Methods ◽  
Surgical Unit

Background: Patient satisfaction scores are one of the measurements of performance and quality of care. Hospitals are facing up to two percent reward or penalty of their total Medicare reimbursement based on the results of clinical processes and patient experience measures. Local Problem: The staff addressed the lack of standardized care experience behaviors to facilitate and enhance nurse communication. Methods: Lewin’s change theory is the theoretical framework used for this project. Intervention: Behavior standards were developed and implemented on a 50-bed medical-surgical unit from August25 to November25, 2020, to support caring efficacy in nurses through standardization of communication. Results: Forty-eight nurses participated in this quality improvement project. A statistically significant difference was found between the pre-and post-Caring Efficacy Scale (CES) scores after the implementation of the behavior standard sp < .0001 (p = 3.8475E-10). Conclusion: The use of standardized behavior standards was an effective intervention to improve the nursing communication process. The intervention can be easily replicated and sustained in a strategic care experience program, while ensuring better patient outcomes and strategically improving nurse and patient satisfaction. Key Words: Behavior Standards; HCAHPS Scores; Nursing Communication; Patient Satisfaction

scholarly journals Perioperative safety indicators: surgery cancellation and immediate postoperative complications

2020 ◽  
Vol 42 ◽  
pp. e46808
Author(s):  
Sibéle da Silva ◽  
Bruna Kruczewski ◽  
Sirlei Fávero Cetolin ◽  
Andreia Dalla Vecchia ◽  
Vilma Beltrame
Keyword(s):  
Postoperative Complications ◽  
Surgical Procedures ◽  
Medical Records ◽  
Perioperative Period ◽  
University Hospital ◽  
Hospital Environment ◽  
Postanesthesia Care Unit ◽  
Perioperative Safety ◽  
Clinical Conditions

The perioperative period comprises the moments before, during and after surgery. Based on the concern about the care for and safety of patients in this process, this study sought to assess the quality of surgical procedures in a hospital environment. It is an epidemiological, descriptive and retrospective research conducted at Santa Terezinha University Hospital [Hospital Universitário Santa Terezinha], in the municipality of Joaçaba, Santa Catarina (SC). The investigation aimed to identify the reasons for surgical cancellation, as well as immediate postoperative complications that occur in the postanesthesia care unit. A total of 456 records from surgery cancellation daily maps and 361 medical records of patients in postoperative care were analyzed. Results show that the main cause for cancellation of surgeries was transfer or unscheduled procedure (23.1%), but 27% of the unscheduled surgeries did not have the reason for cancellation reported. Adult (over 80%) and female individuals were the majority for both cancelled surgeries and postoperative complications. The most frequent postoperative complication was hypotension. Among performed surgeries, thoracic ones (41.8%) were most prevalent, while abdominal/pelvic (49%) surgeries were the most cancelled.  It is concluded that a big portion of the cancelled surgical procedures could have been prevented, since only 6.8% of them were related to clinical conditions.

scholarly journals SERVIÇO DE TRANSPLANTE HEPÁTICO EM UM HOSPITAL UNIVERSITÁRIO: OLHAR DA BIOÉTICA SOCIAL

2017 ◽  
Vol 7 (3/4) ◽  
pp. 7-11
Author(s):  
Silvia Ferrazzo ◽  
Mara Ambrosina De Oliveira Vargas ◽  
Diana Coelho Gomes ◽  
Camila Ferrazzo Lodeyro ◽  
Daniele Lazzari ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Thematic Analysis ◽  
University Hospital ◽  
Southern Brazil ◽  
Differentiated Service ◽  
Structured Interviews ◽  
Financial Transfers ◽  
Politica Publica ◽  
Investigación Cualitativa

Objetivo: analisar os aspectos bioéticos intrínsecos de um serviço especializado no atendimento em transplante hepático em um hospital universitário da região Sul do Brasil. Método: pesquisa qualitativa exploratória, analítica, com coleta de dados realizada por entrevista semiestruturada com profissionais da equipe multiprofissional. A análise de dados deu-se por análise temática. Resultados: constatado que o paciente inserido no serviço de transplante hepático recebe atendimento diferenciado quando comparado aos demais pacientes atendidos na instituição. Conclusões: os atendimentos embasados na consolidada política pública dos transplantes de órgãos e os atrativos repasses financeiros aos procedimentos disparam a qualidade da assistência, em comparação aos atendimentos alicerçados em outras referências de remuneração.Descritores: Liver Transplantation. Bioethics; Public Health PracticeLIVER TRANSPLANT SERVICE AT A UNIVERSITY HOSPITAL: LOOK SOCIAL BIOET HICSObjective: to analyze the intrinsic bioethical aspects of a service specializing in care in liver transplant at a university hospital in southern Brazil. Method: qualitative research, analytical, with data collection performed by semi-structured interviews with professionals of the multidisciplinary team. Data analysis occurred by thematic analysis. Results: Found that the patient entered in the liver transplant service receives differentiated service compared to the other patients treated at the institution. Conclusions: the care grounded in the consolidated public policy of organ transplants and attractive financial transfers to the procedures, trigger the quality of care compared to grounded calls in other compensation references.Descriptors: HIV; Women’s rights; Breastfeeding; Full assistance to women’s health.SERVICIO DE TRASPLANTE DE HÍGADO EN UN HOSPITAL UNIVERSITARIO: MIRAR BIO ÉTICA SOCIALESObjetivo: analizar los aspectos bioéticos intrínsecas de un servicio especializado en el cuidado de trasplante de hígado en un hospital universitario en el sur de Brasil. Método: investigación cualitativa, analítica, con la recogida de datos se realiza por medio de entrevistas semiestructuradas con los profesionales del equipo multidisciplinario. El análisis de datos se produjo mediante el análisis temático. Resultados: encontrado que el paciente ingresó en el servicio de trasplante de hígado recibe servicio diferenciado en comparación con el resto de los pacientes tratados en la institución. Conclusiones: la atención basada en la política pública consolidada de los trasplantes de órganos y transferencias financieras atractivas a los procedimientos, desencadenar la calidad de la atención en comparación con las llamadas a tierra en otras referencias de compensación.Descriptores: Trasplante de Hígado; Bioética; Políticas Públicas de Salud.

Sign in / Sign up

Export Citation Format

Share Document