Thesis (M.S.)--University of Wisconsin--Madison, 1982. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 70-73).

A Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree Of Masters of Science in Nursing Johannesburg 2018 / Background: Despite the availability of policies, procedures and clinical guidelines developed to improve patient safety in correctly completing the pre-operative assessment records, there is poor adherence to compliance. Therefore the aim of this study was to determine if the introduction of an in-service education programme will improve the completion of the pre-operative assessment records. Objective: The objective of the study was to improve the completion of the pre-operative assessment records in two private hospitals in Gauteng. Method: The setting for this study was two private hospitals in the Gauteng Province; each hospital conducting approximately 900 surgical procedures over a three monthly period. A one group pre-test-post-test design and a survey were conducted in this study. A retrospective chart review was conducted using a simple random sampling method in the pre-and post-test selection of the pre-operative assessment records. The pre-test was conducted between September and October 2016 and the post-test between May and June 2017. The researcher audited (n=187) pre-operative assessment records in the pre-and post-test. The data were collected using an approved audit tool currently in use at both Private Hospitals included in the current study. The data obtained in the first chart review (pre-test audit) was used to develop and implement the in-service education programme for the nursing staff at the two private hospitals where the study was conducted. The in-service education programme was conducted in February 2017 following the gaps identified in the incompleteness of the pre-operative assessment records in the first chart review. The second chart review (post-test audit) was conducted after the introduction of the in-service education programme to evaluate if the education programme had positively influenced the improvement of the completion of the pre-operative assessment records. A survey was designed by the researcher and was completed by the respondents that had attended the in-service education programme. The aim of the survey was to explore the respondents’ satisfaction of the training programme. The data obtained from the questionnaire was captured on an excel spread sheet and analysed by descriptive statistics and presented on frequency tables. Results: Eleven of the 16 discrete variables tested in the course of the pre-and post-test analysis in Hospital A and B, demonstrated significant (p<0.05) change following the in-service education programme. In each instance the change represented improved recording of the pre-operative assessment records, which is an important finding and one in which evidences the need for and value continued in-service education. The criteria that showed recording improvement post-education programme were: patient received in theatre noted (44.9%); booked procedure same as patients’ description (12.8%); premedication administered (41.2%); patient kept nil per mouth (23%); identity band applied (20.3%); signatures with handover (10.2%); fluid start and end times (11.7%); fluid volumes start and completion (20.9%); fluid running total (18.7%); intravenous site checked (25.6%).The results provide evidence that the education programme did influence the compliance in some of the criterion in completing the pre-operative assessment records correctly. Of the completed feedback questionnaires received (n=45: an overall response rate of 96.1%), 14 discrete answers were collated and 28% of the respondents answered the questions, including the respondents who indicated “nothing” as an answer. All respondents indicated the nurses who attended the training felt it was beneficial, with 35.7% indicating that the training should be repeated and held frequently; ensuring that the Doctors and agency nursing staff attended alongside the nurses was deemed important by 28.6% of the respondents. Additional training on the pre-operative assessment process and care was requested by 14.3% of the nurses and post-operative care was specifically noted by 21.4% of those respondents. Conclusion: This study provided evidence that after the introduction of the education programme to the nurses there was an overall improvement in the completion of the pre-operative assessment records. Although there was a disappointing note of compliance in completing the fluid balance record, the results indicated and overall improvement of the compliance in completion in most of the criterion of the pre-operative assessment records partially fulfilling the aims of this study. However it is strongly indicated that there is a need for further improvement in completing the pre-operative assessment records. Keywords: Pre-operative Assessment; Patient Safety; Patient Records; In-Service Educational Programme; Improving Quality. / E.K. 2019

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1992.

A visita prÃ-operatÃria à o primeiro passo para a SistematizaÃÃo da AssistÃncia de Enfermagem PerioperatÃria â SAEP, representando valioso instrumento para a humanizaÃÃo da assistÃncia de enfermagem. A utilizaÃÃo de um instrumento permite nortear esta visita, em que serÃo registradas as necessidades biopsicossociais e espirituais do paciente e estabelece uma comunicaÃÃo entre os enfermeiros da clÃnica e do bloco cirÃrgico, garantindo a continuidade da assistÃncia perioperatÃria. Este estudo teve como objetivo construir e validar um instrumento de coleta de dados para a visita prÃ-operatÃria de enfermagem (VPOE) de cirurgia de mama, fundamentado no modelo Conjunto de Dados de Enfermagem PerioperatÃria (PNDS â Perioperative Nursing Data Set), que padroniza diagnÃsticos de Enfermagem nos domÃnios seguranÃa, respostas fisiolÃgicas e respostas comportamentais do paciente e famÃlia. Para a construÃÃo do instrumento de coleta de dados foram consideradas quatro fases: 1) revisÃo da literatura e identificaÃÃo dos itens importantes; 2) elaboraÃÃo do instrumento de coleta de dados; 3) avaliaÃÃo por especialistas da Ãrea; 4) validaÃÃo de aparÃncia e conteÃdo, e 5) reduÃÃo final do instrumento e anÃlise estatÃstica. Para a busca dos artigos, nas bases de dados selecionadas, as palavras utilizadas como descritores foram: mama, prÃ-operatÃrio, perioperatÃrio e enfermagem, realizando-se todas as combinaÃÃes possÃveis. ApÃs essa busca, foi elaborada a primeira versÃo do instrumento de coleta de dados para a VPOE de cirurgia de mama, composto por 47 itens, organizado em trÃs seÃÃes - dados estruturais, elementos de dados da Enfermagem e dados de Enfermagem prÃ-operatÃria, distribuÃdos da seguinte maneira: domÃnio seguranÃa (06), domÃnio respostas fisiolÃgicas (28) e respostas comportamentais (13). Para a validaÃÃo do conteÃdo, os instrumentos foram encaminhados para a apreciaÃÃo de 22 juÃzes, expertos na Ãrea do construto, sendo 15 enfermeiras assistenciais, quatro docentes e trÃs trabalhavam na assistÃncia e na docÃncia. A concordÃncia entre os juÃzes foi analisada pelo teste binomial, como mÃtodo de anÃlise de proporÃÃo que compara as visÃes e opiniÃes entre os expertos a respeito das mesmas questÃes. O nÃvel de significÃncia considerado foi de 5% (p>0,05). Para a anÃlise de concordÃncia das respostas dos juÃzes para o instrumento, realizou-se a anÃlise das frequÃncias das respostas (discordo totalmente, discordo, concordo parcialmente, concordo, concordo totalmente), bem como se efetivou a anÃlise descritiva das sugestÃes de alteraÃÃes dos juÃzes. A construÃÃo deste instrumento nortearà a visita prÃ-operatÃria, contribuindo na assistÃncia de Enfermagem perioperatÃria, assegurando um cuidado humanizado ao paciente cirÃrgico. / The preoperative visit is the first step for the Systematization of Perioperative Nursing Care - SPNC, representing a valuable tool for humanizing nursing care. The use of an instrument allows guiding this visit, where will be recorded the biopsychosocial and spiritual needs of the patient and establishes a communication between the nurses and the surgical clinic, ensuring continuity of perioperative care. This study aimed to develop and validate an instrument to collect data for the preoperative visit nursing (PVN) breast surgery, based on the model Data Set Perioperative Nursing (PNDS - Perioperative Nursing Data Set), which standardized nursing diagnoses in the areas: safety, physiological and behavioral responses of the patient and family. For the construction of the instrument of data collection were considered four phases: 1) literature review and identification of key items, 2) development of the instrument for data collection, 3) evaluation by experts; 4) validation of appearance and content and 5) final reduction of the instrument and statistical analysis. To search for articles in the databases selected, the words used as descriptors were: breast cancer, preoperative, perioperative nursing, performing all possible combinations. After this search, was drafted the first version of the instrument for data collection for VPOE breast surgery consists of 47 items, organized into three sections: structural data, data elements of nursing and nursing data preoperative distributed follows: security area (06), domain physiological responses (28) and behavioral responses (13).To validate the contents, instruments were referred for assessment of 22 judges, experts in the area of the construct: 15 assistant nurses, 04 teachers and 03 of them worked in care and teaching. The agreement among the judges was analyzed by the binomial test as a method of analysis that compares the ratio of views and opinions among experts about the same issues. The level of significance was set at 5% (p >0.05). For the analysis of the concordance of judges responses for the instrument, the analysis of the frequencies of responses was conducted (strongly disagree, disagree, partially agree, agree, strongly agree), and the descriptive analysis of the suggested changes of the judges. The construction of this instrument will guide the preoperative visit, contributing to perioperative nursing care, ensuring a humanized care to surgical patients.

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (MSc)--University of Stellenbosch, 2007. / Bibliography. Also available via the Internet.

No description available.

There are a myriad of risk factors for surgical mortality, intraoperative and postoperative complications, and prolonged length of stay. Effectively identifying possible risk factors in the preoperative patient profiles that may impact the outcome of elective open intestinal resection has significant implications on the quality of care, the safe delivery of surgical care, and the speedy recovery of patients undergoing elective open intestinal resection. Few studies specifically focused on the construction of individual preoperative patient risk profile used only preoperative patient profiles in elective open intestinal resection. A retrospective cohort predictive study was conducted to assess the impact of preoperative patient profiles on surgical outcomes in patients undergoing elective open intestinal resection using 2009-2011 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) databases. This study aimed to identify independent predictors in the preoperative patient profiles for the development of preoperative patient risk profiling tool for the construction of an individual preoperative patient risk profile for risk stratification, surgical planning, and care coordination for patients undergoing elective open intestinal resection. The results of this study showed that independent predictors in the preoperative patient profiles could predict the risks of increased adverse surgical outcomes in terms of in-hospital mortality, in-hospital complications, and prolonged length of stay in patients undergoing elective open intestinal resection. Independent predictors of increased adverse surgical outcomes were identified in the personal domain, the social history domain, and the comorbidity domain of preoperative patient profiles. In the personal domain profile, advanced age was an independent predictor of increased in-hospital mortality, prolonged length of stay (LOS), and six of the eight categories of in-hospital complications studied, except mechanical wound complications and infection complications. The 18 to 39 age group was more likely to develop the latter two complications. Male gender was an independent predictor of in-hospital mortality, prolonged LOS, and six of the eight in-hospital complications except intraoperative complication and systemic complications. Asian/Pacific Islanders were more likely to have intraoperative bleeding complication while black patients were more likely to have gastrointestinal complications and prolonged LOS compared to white patients. In the social history domain profile, patients with alcohol abuse were more likely to suffer pulmonary complications and have prolonged LOS. Patients with illicit drug abuse were more likely to have prolonged LOS as well. Four comorbidities, fluid and electrolyte disorders, weight loss, coagulopathy, and congestive heart failure, were identified as the strongest independent predictors of increased adverse surgical outcomes overall, except in the cardiovascular complications. Pulmonary circulation disorders were the strongest independent predictors of cardiovascular complications. Other comorbidities that were statistically significant and unique predictors of adverse outcomes were also identified. Patients without comorbidity were less likely to have increased in-hospital mortality, prolonged LOS, and in-hospital complications. These findings have significant implications in developing preoperative patient risk profiling tools for the construction of an individual preoperative patient risk profile for risk stratification, surgical planning, and care coordination in patients undergoing elective open intestinal resection.