Aparecida de Cássia Giani Peniche

Algumas considerações sobre o paciente cirúrgico e a ansiedade

This study aims at giving theoretical aspects of the anxiety and discussing about the difficulty faced by nurses to evaluate the emotional state of the patient, considering that the theoretical basis of the nurse is not enough to interfere in this situation.

Enfermagem em centro cirúrgico: trinta anos após criação do Sistema de Assistência de Enfermagem Perioperatória

Objective: To identify, review, and describe publications of Brazilian operation room nurses. Methods: An integrated review approach was used to summarize main aspects of research articles on operation room nursing published in Brazilian journals indexed in LILACS, DEDALUS, and SciELO from 1978 through 2006. Fifty six research articles were retrieved and classified on the following six themes: preoperative visit, intraoperative care; postoperative recovery room care; postoperative visit; instrument development and validation, and perceptions of the patient. Results: The research articles addressed issues that facilitated or impeded quality transoperative nursing care. Humanized and individualized transoperative care was found to be important. Conclusion: Findings from this review contribute to knowledge development and may influence quality transoperative nursing care to the patient and his or her family.OBJECTIVE: To identify, review, and describe publications of Brazilian operation room nurses. METHODS: An integrated review approach was used to summarize main aspects of research articles on operation room nursing published in Brazilian journals indexed in LILACS, DEDALUS, and SciELO from 1978 through 2006. Fifty six research articles were retrieved and classified on the following six themes: preoperative visit, intraoperative care; postoperative recovery room care; postoperative visit; instrument development and validation, and perceptions of the patient. RESULTS: The research articles addressed issues that facilitated or impeded quality transoperative nursing care. Humanized and individualized transoperative care was found to be important. CONCLUSION: Findings from this review contribute to knowledge development and may influence quality transoperative nursing care to the patient and his or her family.

A influência da ansiedade nas estratégias de enfrentamento utilizadas no período pré-operatório

This study aims at characterizing the population analyzed regarding socio-demographic aspects, identifying the anxiety level of patients undergoing surgery and the most used coping strategies during the pre-operative period, as well as observing the relation between anxiety level and coping strategies over the same period. The population was comprised of 40 patients undergoing surgery. For data collection, two self-applicable instruments were employed: Spielbergers anxiety level inventory and Lazarus, Folkmans coping strategies inventory. Data were collected over the pre-operative period. Most patients were women averaging 46-years old, with low level of schooling, previous surgery experience set before, and no previous intercurrence. The coping strategies more commonly used were social support and problem resolution. In regards to anxiety and coping strategies there was found a negative correlation between anxiety level, social support and problem resolution.This study aims at characterizing the population analyzed regarding socio-demographic aspects, identifying the anxiety level of patients undergoing surgery and the most used coping strategies during the pre-operative period, as well as observing the relation between anxiety level and coping strategies over the same period. The population was comprised of 40 patients undergoing surgery. For data collection, two self-applicable instruments were employed: Spielbergers anxiety level inventory and Lazarus, Folkmans coping strategies inventory. Data were collected over the pre-operative period. Most patients were women averaging 46-years old, with low level of schooling, previous surgery experience set before, and no previous intercurrence. The coping strategies more commonly used were social support and problem resolution. In regards to anxiety and coping strategies there was found a negative correlation between anxiety level, social support and problem resolution.

Assistência de Enfermagem no período de recuperação anestésica: revisão de literatura

Apos constatacao de que os pacientes submetidos aos mais diversos procedimentos cirurgicos, ao serem admitidos na unidade de recuperacao anestesica, apresentavam seus prontuarios com dados relevantes mal registrados, de forma desorganizada e incompletos, foi realizado um levantamento bibliografico nacional no periodo 1990 a 2002 para identificar e analisar como a assistencia de enfermagem em sala de recuperacao anestesica e documentada. Utilizou-se o sistema informatizado de busca LILACS (Literatura Latino Americana de Ciencias da Saude), PERIENF (Acervo de Periodicos da Escola de Enfermagem da Universidade de Sao Paulo) e BDENF (Biblioteca J. Baeta Viana da Universidade Federal de Minas Gerais). Os indexadores foram: assistencia de enfermagem, recuperacao anestesica e periodo pos-operatorio imediato. Encontrou-se 16 artigos referentes a este tema, apesar da importância dada a continuidade do cuidado ao paciente neste periodo.ABSTRACT The present study wasundertaken after it wasobserved that patientssubmitted to surgicalprocedures arrived inrecovery room withincomplete records, thuscomplicating continuingnursing care. The goal of thepresent study is to analyzebibliographic data from1990 to 2002 on recoveryroom nursing care. The datawas obtained from LILACS(Latin America Literatureabout Health Science),PERIENF (Nursing SchoolLibrary of the University ofSao Paulo) and BDENF(Library of FederalUniversity of Minas Gerais).The key words were nursingcare, recovery room andimmediate post-operativeperiod. Only 16 articles werefound, indicating a shortageof literature on this topic. The recovery room period isan important period ofhospitalization and thedata are essential forcontinuous care. KEYWORDS Nursing care.Anesthesiarecovery period.Immediatepostoperative period. RESUMEN Despues de constatarse quelos pacientes sometidos a losmas diversos procedimientosquirurgicos, al ser admitidosen la unidad de recuperacionanestesica, tenian historiasclinicas con los datosrelevantes mal registrados, deforma desorganizada yincompletos, fue que se realizouna revision bibliograficanacional en el periodo de 1990al 2002 para identificar yanalizar como es documentadala asistencia de enfermeria ensala de recuperacionanestesica. Se utilizo el sistemainformatizado de busquedaLILACS (Literatura LatinoAmericana de Ciencias de laSalud) PERIENF (Acervo dePeriodicos de la Escuela deEnfermeria de la Universidadde Sao Paulo) y BDENF(Biblioteca J. Baeta Viana de laUniversidad Federal de MinasGerais). Los indexadoresfueron: asistencia deenfermeria, recuperacionanestesica y periodo postoperatorio inmediato. Seencontraron 16 articulosreferentes a este tema, a pesarde la importancia dada a lacontinuidad del cuidado alpaciente en este periodo.

Nurse interventions and the complications in the post-anesthesia recovery room

Este estudio objetivo identificar las complicaciones prevalentes en la Sala de Recuperacion Postanestesica (SRPA); relacionar las complicaciones a las intervenciones de enfermeria realizadas; relacionar el esquema de jornada de trabajo de los enfermeros con las complicaciones. La muestra estuvo compuesta de 400 fichas de pacientes mayores de 18 anos, sometidos a procedimientos quirurgicos de grande y medio porte, admitidos en la unidad de SRPA, con tiempo de permanencia superior a una hora. Las complicaciones prevalentes fueron: dolor e hipotermia. Complicaciones que presentaron relacion estadisticamente significativa con la intervencion de enfermeria - dolor: rutina, oxigenoterapia, medicacion y curativo; agitacion/ansiedad: rutina y oxigenoterapia; hipotension: hidratacion, examenes complementares y observacion; hipertension: observacion; tremor: manta termica, transfusion sanguinea; nauseas/vomitos: rutina, medicacion y sondaje vesical de alivio; hemorragia: rutina, medicacion y curativos; hipoxemia: rutina y oxigenoterapia; hipotermia: rutina, manta termica y medicacion. El dolor, nauseas/vomitos, agitacion y hemorragia obtuvieron relacion estadisticamente significativa con el enfermero fijo en SRPA.

As intervenções do enfermeiro e as complicações em sala de recuperação pós-anestésica

Este estudio objetivo identificar las complicaciones prevalentes en la Sala de Recuperacion Postanestesica (SRPA); relacionar las complicaciones a las intervenciones de enfermeria realizadas; relacionar el esquema de jornada de trabajo de los enfermeros con las complicaciones. La muestra estuvo compuesta de 400 fichas de pacientes mayores de 18 anos, sometidos a procedimientos quirurgicos de grande y medio porte, admitidos en la unidad de SRPA, con tiempo de permanencia superior a una hora. Las complicaciones prevalentes fueron: dolor e hipotermia. Complicaciones que presentaron relacion estadisticamente significativa con la intervencion de enfermeria - dolor: rutina, oxigenoterapia, medicacion y curativo; agitacion/ansiedad: rutina y oxigenoterapia; hipotension: hidratacion, examenes complementares y observacion; hipertension: observacion; tremor: manta termica, transfusion sanguinea; nauseas/vomitos: rutina, medicacion y sondaje vesical de alivio; hemorragia: rutina, medicacion y curativos; hipoxemia: rutina y oxigenoterapia; hipotermia: rutina, manta termica y medicacion. El dolor, nauseas/vomitos, agitacion y hemorragia obtuvieron relacion estadisticamente significativa con el enfermero fijo en SRPA.

Algumas considerações sobre avaliação do paciente em sala de recuperação anestésica

A preocupacao com a qualidade de assistencia ao paciente tem sido uma constante ainda maior, quando relacionada a alta complexidade que envolve o cuidado do paciente em, sala de recuperacao anestesica (SRA). Acreditando ser necessario uma, avaliacao segura e eficaz, que considere tambem as alteracoes endocrinas e metabolicas decorrentes do trauma anestesico-cirurgico do paciente, sugere-se a criacao de padroes e criterios de avaliacao para a assistencia prestada: ao paciente em SRA e a validacao dos mesmos.: The quality in patient assistance concern has been more constant than the high complexity of patient treatment needed in an anaesthetic recovery room. Thinking that is necessary to have assurance and efficiency in any evaluation, which has to consider all endocrine and metabolic variations resulting from patient surgical trauma, may be suggested the standardization and criterization of evaluation methods to patient assistance, and of course the validation of them.

Content validity of an instrument to document recovery of patients in post anesthesia care unit

OBJECTIVE: To determine the content validity of an instrument to document the assessment and recovery of surgical patients in post anesthesia care unit (PACU). METHODS: Delphi technique was used to conduct this two-phase study. RESULTS: Items on admission and vital signs, Audrete and Kroulik index, pediatric index, nursing orders, and progress notes reached 100% consensus among expert judges. Items regarded as being repetitive by 79% of experts were revised or excluded from the instrument. Following this procedure, items of the instruments were again evaluated by the experts and new revisions were made as appropriate to achieve minimum agreeement among experts as recommended by Delphi technique. CONCLUSION: The instrument was validated regarding its content and format. Further analysis might be necessary according to hospital and type of patient admitted to the PACU.

Dor pós-operatória: combinações analgésicas e eventos adversos

O controle da dor e seus eventos adversos sao focos de profissionais e gestores das instituicoes de saude para obtencao de desfechos assistenciais. O estudo teve como objetivos analisar a prevalencia de combinacoes e interacoes medicamentosas da terapia analgesica e verificar a associacao dessa com os eventos adversos conferidos. Trata-se de estudo descritivo, exploratorio e retrospectivo. A amostra foi composta por 260 prontuarios de pacientes submetidos a hemorroidectomia, com idade de ate 60 anos higidos. Os resultados mostraram que as associacoes medicamentosas mais utilizadas foram a dipirona+omeprazol (33,7%), dipirona+cetoprofeno (23,6%) e cetoprofeno+lactulose (22,8%). Observou-se que cetoprofeno+ omeprazol (p=0,001) e cetoprofeno+ lactulose (p=0,03) estiveram significativamente relacionados com sangramento. Concluiu-se que, com excecao do cetoprofeno, as outras associacoes medicamentosas identificadas no estudo se mostraram seguras para serem utilizadas no periodo pos operatorio.

Estudo retrospectivo das complicações pós-operatórias em cirurgia primária de lábio e palato

Estudo retrospectivo das complicacoes de cirurgias primarias de labio e palato, do Hospital de Reabilitacao de Anomalias Craniofaciais da Universidade de Sao Paulo, teve como objetivos identificar as complicacoes mais frequentes, e verificar a associacao entre as complicacoes identificadas e as variaveis demograficas. Foram verificados 555 prontuarios de pacientes submetidos a cirurgia de labio e/ou palato em um periodo de seis meses, destes foram excluidos pacientes sindronicos, aqueles que tiveram complicacoes intra-operatorias e com os prontuarios incompletos, resultando numa amostra de 484 prontuarios. Obteve-se o predominio do sexo masculino (60,5), a etnia branca (91,9%), eutrofica com media de idade de 37 meses, a fissura mais incidente foi a transforame (64,5%) e a cirurgia predominante foi a queiloplastia (56,6%). A dor foi a complicacao mais frequente seguida da desaturacao de oxigenio e taquicardia. Nao houve associacao estatisticamente significante entre as complicacoes identificadas e o sexo, estado nutricional e procedimento cirurgico.This retrospective study addressed the complications of primary lip and palate surgeries, and was carried out at Craniofacial Anomalies Rehabilitation Hospital at University of São Paulo. The present study aimed to identify the most frequent complications, as well as verifying the rela-tions between demographic variables and the complications observed. The sample comprised the records of 484 patients submitted to primary lip and palate surgery during the period of November 2000 to April 2001. The results demonstrated predominance of white male individuals with a median age of 12 months. The most frequent type of cleft was complete cleft lip and palate, and cheiloplasty was the most prevalent surgery. Of the 484 patients included in the study, 58.05% presented at least one or more postoperative complications. Pain was the most frequent problem in the evaluated group, followed by oxygen desaturation and tachycardia.