Introduction to the safe patient handling and movement series

Musculoskeletal injuries can occur when the physical work demanded by a job exceeds a worker's ability to respond safely. In perioperative nursing, and nursing in general, patient handling and movement demands commonly lead to injury and are considered high-risk activities. In 2005, the AORN Workplace Safety Task Force was charged with identifying high-risk tasks performed in the perioperative area and developing evidence-based solutions to help establish an ergonomically safe workplace. The work of the task force was incorporated into the “AORN guidance statement: Safe patient handling and movement in the perioperative setting,” which includes seven ergonomic tools to help determine best practices for safe movement and handling of patients, supplies, and equipment in the OR. Members of the AORN Perioperative Environment of Care Task Force have collaborated to author seven articles that help explain the rationale behind and use of these ergonomic tools. The articles will appear in the Journal beginning in this issue.     

Reducing the risk of unplanned perioperative hypothermia

Maintaining normothermia is important for patient safety, positive surgical outcomes, and increased patient satisfaction. Causes of unplanned hypothermia in the OR include cold room temperatures, the effects of anesthesia, cold IV and irrigation fluids, skin and wound exposure, and patient risk factors. Nurses at Riddle Memorial Hospital in Media, Pennsylvania, performed a quality improvement project to evaluate the effectiveness of using warm blankets, warm irrigation fluids, or forced-air warming on perioperative patients to maintain their core temperature during the perioperative experience. Results of the project showed that 75% of patients who received forced-air warming perioperatively had temperatures that reached or were maintained at 36° C (96.8° F) or higher within 15 minutes after leaving the OR.     

择期性手术病人的心理应激及护理对策

观察了６００例普通外科、泌尿外科及妇科的择期性手术病人的心理应激反应的一般特点和变化规律，以及采用以提供程序性和感觉性信息为主，以其他方法为辅的心理护理措施对手术病人应激反应产生影响。其中实验组３００例、两个对照组各１５０例。结果表明：（１）病人入院后，随着手术时间的逼近，应激反应逐渐加剧，手术前夜的焦虑、恐惧与血压水平显著升高；手术开始后则急剧下降；病人术后所感受到的疼痛、痛苦与不适显著高于术中。（２）实验组在手术前夜、术中及术后的各项心理指标的应激反应水平显著低于两个对照组（Ｐ＜０．０５，Ｐ＜０．０１，Ｐ＜０．００１），显示了心理护理的积极影响。结果说明本法对维护手术病人康宁具有一定的实用价值。     

Development of the Impact of Nighttime Urination (INTU) questionnaire to assess the impact of nocturia on health and functioning

Aims

This study describes development of the Impact of Nighttime Urination (INTU) questionnaire to assess nocturia impacts on health and functioning.

Methods

Development of the questionnaire followed an iterative patient‐directed process as recommended by current guidance for patient‐reported outcome (PRO) measures. An initial 15‐item questionnaire was devised based on reviewing the published literature, and then modified through four rounds of semi‐structured interviews of 28 individuals with nocturia. In each round, open‐ended concept elicitation, followed by cognitive debriefing, was used to assess the questionnaire. Items were modified based on participants’ responses and incorporated into the next round of interviews.

Results

In all rounds, participants reported that their experiences were easy to recall and report on a daily basis and that the burden of completing the questionnaire was low. The final questionnaire has a same‐day recall period. It includes six daytime impact items—having limited concentration, a sense of feeling tired, difficulty getting things done, irritability, not feeling rested, and drowsiness—and four items that measure the nighttime impact of nocturia—patient concern, waking up too early, difficulty getting enough sleep, and feeling bothered by having to get up at night to void. Responses follow a 5‐ or 4‐point scale. The final INTU captures the key concepts associated with nocturia as confirmed by cognitive debriefing.

Conclusions

Development of the 10‐item INTU, a nocturia‐specific PRO measure, was based on direct input and feedback from patients and has demonstrated that it captures the patient‐reported impacts of nocturia.