Journal of post anesthesia nursing
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The administration of intravenous conscious sedation for patients undergoing minor procedures has increased in many settings throughout health care. Recognizing this, managers are challenged to develop policies to standardize the quality of patient care delivery. Consumer interest and knowledge in health care has increased dramatically in the last few years. ⋯ Quality improvement teams were developed to look at processes crossing departmental boundaries. Teams facilitate dialogue, understanding, and knowledge, and use the scientific method to design, streamline, and improve processes. The authors share strategies for policy development using a 7-step quality improvement process with a multidisciplinary team approach.
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Postoperative nausea and vomiting (PONV) are common side effects after surgery and have numerous patient factors and etiologies. Although self-limiting, PONV is not without risks and complications. ⋯ It is believed that ondansetron binds at the serotonin receptor both in the vagal afferents of the gastrointestinal tract and in the chemoreceptor trigger zone. The reported side effects from ondansetron are minor compared with those of the more commonly used antiemetics such as droperidol and metoclopramide and include headache, dizziness, musculoskeletal pain, drowsiness and sedation, and shivers.
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The purpose of this article is to provide an overview of completed studies that consider visitors in critical care areas. Studies from coronary care, intensive care, pediatric PACUs, and adult PACUs are reviewed.
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Special procedures are performed with increasing frequency in the PACU. One procedure, the epidural corticosteroid injection, is commonplace in many PACUs. The author reviews the rationale, technique, and nursing considerations of this procedure.
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Trauma in children claims more lives than any other childhood disease; (8,000 deaths were reported in the United States in 1989). The peculiar anatomy and physiology of the young body is responsible for the different pattern and distribution of injuries in children than in adults. For instance, 75% of multiply injured children suffer from head trauma. ⋯ Recent research indicates that care delivered by specially trained teams results in decreased morbidity associated with prehospital care and transport of these patients. Inpatient care of injured children ranges from highly sophisticated resuscitation and life support to postoperative pain control and tactful communication with distressed families. Physicians and nurses involved in trauma care must direct their efforts to further the education of medical personnel and the lay public regarding management of accident victims.