Category Archives: Perioperative care

Are there studies on management of pain not related to surgery in postoperative patients?

Posted on by
Reply

There are no studies addressing management of pain not related to surgery in postoperative patients.

Search Method

Searched PubMed, CINAHL, and EMBASE for different combinations of these concepts:

  • Pain – etiology, drug therapy, prevention and control
  • Postoperative period or postoperative care
  • Rehabilitation OR physical therapy OR physiotherapy
  • Factors that interfere with rehabilitation (looked for these terms:  interfere* OR delay* OR prohibit*)
  • Arthroplasty/rehabilitation
  • Comparative study or clinical trial or cohort study or prospective study

Reviewed 4/29/2014 ldt

 

What is the evidence on use of surgical counting systems to prevent errors?

Posted on by
Reply

Stawicki SP, et al. Retained surgical items: a problem yet to be solved. J Am Coll. Surg. 2013;216(1):15-22.
This study analyzed 59 cases of retained surgical items (RSIs) as well as 118 matched controls. Incorrect counts during a procedure elevated the risk of RSI. An odds ratio of 20 for RSI risk was found for any incorrect surgical count.

Cima RR, et al. Incidence and characteristics of potential and actual retained foreign object events in surgical patients. J Am Coll Surg. 2008;207(1):80-87.
Thirty-four cases of actual retained foreign objects (RFOs) in 21 patients occurred when the count had been reported as correct.

Jackson S, Brady S.  Counting difficulties:  retained instruments, sponges, and needles.  AORN.  2008;87(2): 513-21.
This review article discusses prevention of errors and references Association of Perioperative Registered Nurses (AORN) recommended practices.

Egorova NN, et al.  Managing the prevention of retained surgical instruments: what is the value of counting?  Ann Surg. 2008 Jan;247(1):13-8.
Reviews data on count prevalence of discrepancies in 153,263 operations. There were 1062 count discrepancies, and 1 in every 70 discrepancy cases had a retained item. Final count discrepancies prevented 54% of retained items. Due to the low incidence of retained foreign bodies, the positive predictive value of a count discrepancy for an actual retained foreign body was only 1.6.

Reviewed and updated 4/15/2014 ldt

What can happen if patients’ intake and output is not properly monitored after surgery?

Posted on by
Reply

Bottom line: Monitoring and documenting intake and output after surgery is important for detecting conditions, such as postoperative urinary retention (POUR), which is associated with risk of overdistention and permanent detrusor muscle damage, leading to difficulties with urination.  Decreased output can also be an indicator of a urinary tract infection.

Summary:  Feliciano T, et al.  A retrospective, descriptive, exploratory study evaluating incidence of postoperative urinary retention after spinal anesthesia and its effect on PACU discharge.  J Perianesth Nursing.  2008; 23(6): 394-400.

Postoperative care.  In:  Lippincott’s Nursing Procedures and Skills.  Revised October 4, 2013.

Reviewed and updated 4/11/2014 ldt

Communicating about evidence-based practice in patient care

Posted on by
Reply

Welcome. This blog facilitates communication on issues of evidence-based practice by Emory Healthcare Nursing Quality Initiatives teams. Questions posed by the teams and information to address those questions will be documented in these posts.