PURPOSE: The purpose of this study was to develop a performance appraisal tool (PAT) for postoperative anesthesia care unit (PACU) nurses. METHODS: This study was a descriptive, non-experimental methodological study. The PAT was developed through a literature review and tests for validity and reliability. RESULTS: Subsequent to a review of the literature on nursing performance of PACU nurse, a 63 item questionnaire was developed. Through factor analysis, 61 items in 3 domains with 8 factors were derived. Cronbach's α coefficient of the final instrument was .99. CONCLUSION: This tool is an efficient PAT for PACU providing meaningful feedback for professional growth in PACU nurses.
Anesthesia* ; Methods ; Nursing ; Postanesthesia Nursing ; Reproducibility of Results

OBJECTIVETo investigate the effect of exchange of tracheal tube for a laryngeal mask airway (LMA) on intratracheal extubation stress response under deep anesthesia level after surgery in elderly patients with hypertension.

METHODSFrom October 2008 to June 2009, 40 hypertension patients aged from 65 to 78 years scheduled for upper abdominal surgery were randomly divided into 2 groups, one was extubated intratracheal tube when being awake (group TT, n = 20) and the other was extubated and exchanged for LMA under deep anesthesia (group LM, n = 20). The American Society of Anesthesiologists (ASA) of the patients were I o rII. The data of mean arterial pressure (MAP), heart rate(HR), pulse oxygen saturation (SPO(2)), end-tidal carbon dioxide tension (P(ET)CO(2)) and rate pressure product(RPP) were recorded before induction of anesthesia (T(0)), suction (T(1)) and at 0 (T(2)), 5(T(3)), and 10 (T(4)) and 15 min (T(5)) after extubation tracheal tube or LMA in two groups. The indices mentioned above also were recorded before and after extubation in group LM. Blood samples were taken at T(0), skin incision, T(2), T(3), for determination of serum concentrations of blood glucose and cortisol. The airway adverse events in the recovery period were recorded.

RESULTSCompared with group LM, MAP, HR and RPP were significantly higher at T(1), T(2), T(3) than T(0) in group TT (P < 0.05). There was no significant difference in the indices mentioned above during extubated intratracheal tube and exchanged for LMA under deep anesthesia in group LM (P > 0.05). The incidence rate of glossoptosis in group TT was significantly higher than those in group LM (P < 0.01), while complications, such as cough, bucking, breath holding during the recovery stage in group TT were more than those in group LM (P < 0.05). Compared with the baseline value, blood glucose and cortisol concentration level were significantly increased in group TT than in group LM (P < 0.01).

CONCLUSIONSExchange of tracheal tube for LMA under deep anesthesia during recovery stage can decrease the stress response during the recovery stage and attenuate the harmful response of respiratory tract. It is suitable for the elderly patients with hypertension.

Aged ; Anesthesia, General ; Device Removal ; methods ; Female ; Humans ; Hypertension ; physiopathology ; Intubation, Intratracheal ; Laryngeal Masks ; Male ; Postanesthesia Nursing ; Stress, Physiological

PURPOSE: The objectives of this study were to assess the influence of family presence in the PACU (Post Anesthesia Care Unit) on anxiety, emergency delirium, pain and length of stay in the recovery room for elderly patients undergoing surgery for which general anesthesia has been used. METHODS: The study was a nonequivalent control group pre-post test design. Eighty elderly patients over 65 years who underwent surgery under general anesthesia were recruited. Forty were assigned to the experiment group, patients together with a family member and 40 to the control group, with no family member present. Patients' anxiety, emergency delirium, pain and length of time in the recovery room were evaluated at 10 minute and 30 minute after arrival in the PACU. RESULTS: Patients with family members in the PACU showed significantly decreased levels of anxiety at 10 and 30 minutes and significantly lower levels of emergency delirium and pain at 30 minutes. However there was no difference between the 2 groups for length of time in the recovery room. CONCLUSION: The results of this study indicate that being with family members in the PACU after surgery under general anesthesia is effective for reducing elderly patients' anxiety, delirium and pain during time in the recovery room.
Aged* ; Anesthesia ; Anesthesia, General ; Anxiety* ; Delirium* ; Emergencies ; Evaluation Studies as Topic ; Humans ; Length of Stay ; Postanesthesia Nursing ; Recovery Room*

PURPOSE: This study investigated the effects of active warming using a Warm Touch warming system or a cotton blanket in postoperative patients after general anesthesia for abdominal surgery.METHODS: This quasi-experimental study utilized two experimental groups and one control group: a cotton-blanket group (n = 25) were warmed with a cotton blanket and a sheet; a forced-air warming group (n = 24) were warmed with a Warm Touch warming system, a cotton blanket, and a sheet; and a control group (n = 25) were warmed with a sheet. Measurement variables were postoperative pain, body temperature, and thermal discomfort. Data were analyzed using a one-way ANOVA, χ2-tests, Fisher's exact test, and a repeated measures ANOVA.RESULTS: The effects of active warming using a Warm Touch warming system and a cotton blanket on postoperative patients was significant in reducing pain (F = 13.91, p < .001) and increasing body temperature (F = 12.49, p < .001).CONCLUSION: Active warming made a significant difference in pain and body temperature changes. Active warming methods may help patients' postoperative recovery and prevent complications. Further research is needed to explore the effects and side effects of active warming on recovering normothermia.
Anesthesia, General ; Body Temperature ; Body Temperature Changes ; Humans ; Non-Randomized Controlled Trials as Topic ; Pain, Postoperative ; Postanesthesia Nursing

PURPOSE: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. METHODS: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. RESULTS: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. CONCLUSION: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.
Adolescent ; Anesthesia Recovery Period ; Anesthesia, General ; *Anxiety ; Child ; *Delirium ; Female ; Humans ; Male ; *Pain ; *Pain Measurement ; Parents ; Patient Education as Topic ; Postanesthesia Nursing ; Preoperative Care ; Recovery Room