麻醉苏醒室的建立与应用体会

目的：保障全身麻醉恢复期患者的安全,降低全身麻醉手术后并发症的发生率,便于连台手术的衔接。方法：建立拥有10张监护床位的麻醉苏醒室,并建立一套完整的麻醉苏醒室管理体系,对所有接受全身麻醉手术的患者实施常规麻醉后监护及相应护理措施。结果：对1575例全身麻醉手术患者实施麻醉恢复期管理,及时发现和处理了麻醉手术后并发症34例次,取得满意效果。结论：麻醉苏醒室的建立为全身麻醉手术后患者的平稳过渡提供了安全保障。减少了患者在手术室逗留的时间,加快了外科手术进度,提高了手术室利用率和工作效率。     

婴幼儿麻醉恢复室的监护体会

麻醉恢复室( Post-Anesthetic Care Unit ,PACU )是收治全麻术后未苏醒者和非全身麻醉后患者情况尚未稳定或神经功能未恢复者,监护和治疗在此阶段内出现的生理功能紊乱,保障患者在麻醉恢复期间的安全,减少术后并发症的发生[1]。尤其是婴幼儿患者,由于其生理解剖及体形的特点,且其不能将自己的某些反应正确表述,全麻术后对婴幼儿的呼吸与循环的监测至关重要,PACU室对婴幼儿麻醉恢复护理有更高的要求,我院自2012年1月至今,对248例患儿进行监护,通过严密观察,精心护理,均使患儿平稳度过麻醉恢复期。现将护理体会报告如下。     

基层医院麻醉苏醒室的建立与应用体会

目的　为保障全身麻醉恢复期病人的安全 ,杜绝全身麻醉手术后并发症的发生。方法　建立拥有 5张监护床位的麻醉苏醒室 ,并建立一套完整的麻醉苏醒室管理体系 ,对所有接受全身麻醉手术的病人实施常规麻醉后监护。结果　对 662例全身麻醉手术病人实施麻醉恢复期管理 ,及时发现和处理了麻醉手术后并发症 2 8例次 ,取得满意效果。结论　麻醉苏醒室的建立为全身麻醉手术后病人的平稳过渡提供了安全保障。     

麻醉恢复室护理管理模式浅析

为加强围手术期病人的护理管理，减少和预防麻醉相关并发症和意外的发生，我院成立了麻醉恢复室，经过不断总结和探索，形成了一套规范的麻醉恢复室护理管理模式，有力地保障了麻醉术后病人的安全恢复，加快了手术病人的周转，提高了手术室的利用率。     

麻醉恢复室护理管理模式浅析

为加强围手术期病人的护理管理,减少和预防麻醉相关并发症和意外的发生,我院成立了麻醉恢复室,经过不断总结和探索,形成了一套规范的麻醉恢复室护理管理模式,有力地保障了麻醉术后病人的安全恢复,加快了手术病人的周转,提高了手术室的利用率.     

麻醉恢复室全麻术后病人发生低氧血症的护理71例

麻醉恢复室(post-anesthesia care unit,简称 PACU)的任务是在术后恢复早期,针对病人的不同情况给予必要的监护和治疗,这对于减少术后意外和并发症,保证手术和麻醉的安全具有重要意义[1].对全麻手术后病人在PACU统一监护管理,可以及早发现手术和麻醉相关并发症如低氧血症等,提高抢救成功率.2002年5～12月,进我院PACU监护的全麻病人为4 991例,及时发现低氧血症病人共71例(发生率1.42%),经迅速抢救,全部成功,无1例死亡,现报告如下.     

中等规模医院麻醉复苏室运作的初步探索

总结了本院麻醉复苏室的运作管理流程,主要包括对麻醉后复苏患者进行监护、治疗与护理,使患者苏醒后安全返回病房。认为麻醉复苏室科学化、规范化的运作管理能够有效保障麻醉手术后患者的快速恢复和生命安全,提高手术室利用率及患者满意度。     

麻醉恢复室病人的监测和护理

麻醉恢复室即麻醉后监测治疗室(PACU),是麻醉科的重要组成部分之一.主要任务是保障病人在麻醉恢复期的安全,监护和治疗在此阶段内出现的生理功能紊乱[1].本文分析了我院麻醉恢复室初创期收治288例患者的监测和护理.     

自制标识牌在麻醉恢复室中的应用

麻醉恢复室(postanesthesia care unit,PACU)是继续观察术后患者病情、减少患者术后并发症,使其由全麻状态逐渐苏醒、由手术室安全回到病房的中转站。我院有手术间30个,麻醉恢复室床单位10张,日手术量100多例,恢复室日收治患者50多例,由于麻醉恢复室患者多、人流动量大、病种较     

儿童腺样体切除术后在麻醉恢复室的护理

目的 探讨小儿腺样体全麻术后在恢复室的护理要点,减少术后并发症的发生。方法 对70例腺样体切除术后患儿进行严密监护, 在麻醉恢复室(PACU)平均监护时间64.29min,动态记录患儿的生命体征、血氧饱和度,严格掌握好拔管的指征,离PACU的标准,针对护理隐患预见性护理。结果 麻醉恢复期发生各种并发症41例（58.57%）,其中舌后坠12例（17.14%）,轻度喉痉挛2例（2.86%）,躁动26例（37.14%）,寒战1例（1.43%）。腺样体切除术后患儿护理效果满意,均安全度过麻醉恢复期。结论 儿童腺样体切除术后易发生躁动、气道梗阻, 应加强安全防护以及呼吸道的管理,以利于减少患儿麻醉后的并发症,提高手术安全性。     

Common errors made in resuscitation of respiratory and cardiac arrest.

The information contained in this article is based on the personal experience of the author and her colleagues. The author's experience includes: staff nurse in medical surgical and critical care nursing, midnight shift supervisor of six medical surgical nursing units in an urban teaching hospital (responsibilities included attending all codes in the department), staff nurse in a combined inpatient/outpatient postanesthesia care unit, nurse clinician/educator for multiple preoperation and postanesthesia care units, and attendance at numerous mortality and morbidity conferences held by the department of anesthesia. Research for this article included interviews with several colleagues with experience in medical surgical and critical care nursing as staff nurses, supervisors (responsible to attend codes), and staff educators. One colleague interviewed is also a regional faculty member of the American Heart Association and also a member of the CPR Committee of a large metropolitan teaching institution. The purpose of this article is to assist nurses in becoming more confident and comfortable in providing the interventions required by patients during resuscitation.     

Using Simulation Training to Improve Perioperative Patient Safety

Simulation learning provides medical and nursing personnel with the opportunity to develop and refine their skills without putting patients at risk. Faced with ensuring the competence of a large number of new staff members, the management team at one facility implemented a simulation training program. Surgical team members are able to participate in an ongoing program of simulated scenarios involving surgical drape fires and airway fires, cardiac arrest of patients in the supine position and prone position, respiratory depression in the postanesthesia care unit, and malignant hyperthermia. The simulations help OR staff members identify problems that can happen during real emergencies and help them work as a team to prepare for events that may represent life-threatening situations for patients.     

麻醉复苏室护理标识牌的设计与应用

目的:探讨护理标识牌的设计制作过程以及其在麻醉复苏室中的应用效果。方法:根据我院麻醉复苏室的特点和需要,制作相应的护理标识牌。结果:保证了患者的安全,提高了护理质量,患者满意度达98%以上。结论:自制护理标识牌制作简单,经济实用,可保证医疗护理安全,值得临床推广应用。     

分析层级管理模式对内科护理质量的影响

目的：探讨内科实施层级管理对护理质量的影响。方法：自2021年6月至2022年6月在我院内科实施层级管理模式护理管理,筛选内科30名护理人员进行研究,设置2020年6月-2021年5月为分层管理前,实施常规护理管理模式。比较管理前后护理质量评分和护理人员工作满意度。结果：相较于管理前,管理后内科护理质量评分各方面均显著提升(P<0.05);相较于管理前,管理后内科护理人员工作满意度显著提高(P<0.05)。结论：在内科护理管理中应用层级管理模式的效果显著,能够促进内科护理工作质量的提升,调动工作人员积极性,认可度较高。     

In-situ simulation for nursing students' professional competence development in postanesthesia care: A quasi-experimental study

AimTo evaluate the differences in professional competence development between nursing students in routine clinical practice and those who experienced four additional in-situ simulations.BackgroundThe amount of clinical practice time available to nursing students is limited. Occasionally, clinical settings do not provide all of the content that nursing students are expected to acquire. In high-risk clinical scenarios, such as the postanesthesia care unit, clinical practice may not provide sufficient context for students to develop the professional competence.DesignThis was a non-blinded, non-randomized, quasi-experimental study. The study was conducted in the postanesthesia care unit of a tertiary hospital in China between April 2021 and December 2022. Nursing students' self-assessed professional competence development and faculty-assessed clinical judgment were used as indicators.MethodsA total of 30 final year undergraduate nursing students were divided into two groups according to the time they arrived at the unit for their clinical practice. Nursing students in the control group followed the routine teaching protocol of the unit. Students in the simulation group received four additional in-situ simulations during the second and third weeks of their practice in addition to the routine program. Nursing students self-assessed their postanesthesia care unit professional competence at the end of the first and fourth weeks. At the end of the fourth week, the nursing students were evaluated on their clinical judgment.ResultsNursing students in both groups scored higher on the professional competence at the end of the fourth week than at the end of the first week and there was a trend of higher competence improvement in the simulation group than in the control group. For clinical judgment, nursing students in the simulation group scored higher than the control group.ConclusionsIn-situ simulation contributes to the development of professional competence and clinical judgment of nursing students during their clinical practice in the postanesthesia care unit.     

Safe Handling of Cytotoxic Agents: A Team Approach

The use of cytotoxic medications has become increasingly prevalent in the OR for the treatment of bladder tumors. Perioperative nursing staff members in the day surgery unit, OR, and postanesthesia care unit at St Mary's General Hospital, Kitchener, Ontario, Canada, expressed concern about their lack of knowledge in the safe handling of cytotoxic medications and contaminated wastes.Facility educators recognized this as an area of risk for the hospital and a learning need for staff members. As a result, they formed a committee with members representing nursing, pharmacy, infection control, occupational health, and environmental safety to develop a policy and protocol for the safe use of cytotoxic medications. AORN J 90 (November 2009) 731-740. © AORN, Inc, 2009.     

Implementation Science: Incorporating Obstructive Sleep Apnea Screening and Capnography Into Everyday Practice

PurposeThis article describes the implementation and maintenance of obstructive sleep apnea (OSA) screening and capnography monitoring.DesignA quality improvement project.MethodsA multidisciplinary team provided staff education to three perianesthesia care units. Using the STOP-Bang screening tool, five or more positive responses indicated high risk for OSA. A postanesthesia care unit audit tool tracked STOP-Bang scores, capnography use, hypoventilation events, nursing interventions, and respiratory complications.FindingsAmong 314 patients with OSA, 36% were identified as high risk. Nurses used capnography on 76% of OSA patients and were able to readily identify hypoventilation and intervene. Respiratory complications occurred in 10.8% (n = 34) requiring a higher level of care. Postimplementation, all six postanesthesia care units employ this best practice.ConclusionsPerianesthesia nurses found OSA screening and capnography easy to incorporate into nursing practice. This process can reduce respiratory complications in the surgical patient with OSA. An Evidence-Based Practice Fellowship Program facilitated this practice change.     

ECT in the PACU? It's possible

Follow how this facility established and supported an electroconvulsive therapy program in its postanesthesia care unit, including multidisciplinary communication and patient and staff education.     

建立规范麻醉恢复室管理流程对降低苏醒期并发症的效果研究

目的探讨建立规范麻醉恢复室管理流程对降低苏醒期并发症及患者满意度的影响。方法选取206例入住麻醉恢复室的患者为研究对象,按入院日期分为观察组与对照组,各103例,对照组给予常规护理模式,观察组通过建立规范麻醉恢复室管理流程加强麻醉恢复室控制管理,分别记录两组患者的苏醒时间、麻醉苏醒期并发症及护理满意度。结果观察组患者全身麻醉停药后,呼之睁眼时间、呼之握拳时间、拔管时间均较对照组提前,差异具有统计学意义(P0.01或P0.05);低血压、高血压、寒颤、躁动、恶心、呕吐发生率和躁动程度均明显减少(P0.01或P0.05);患者满意度提高(P0.01)。结论规范麻醉恢复室管理有效降低苏醒期并发症,提高患者满意度,有利于在麻醉恢复室护理工作中推广应用。     

上海新型冠状病毒肺炎重症病房的护理管理实践

目的探讨上海市应急重症病房应对新型冠状病毒性肺炎患者护理管理模式。方法及时启动突发公共卫生事件应急预案,健全应急病房护理组织体系,明确工作职责,即时优化护理人力资源管理,完善物资储备及供应,保障护理人员权益,保证护理工作科学有效的开展。结果总结岀一套较为成熟的重症护理应急管理模式。结论新冠肺炎救治过程中科学地运用护理应急管理体系,保证新冠肺炎防控工作的顺利完成。