Articles: postoperative.
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Observational Study
Impact of intravenous acetaminophen on reducing opioid use after hysterectomy.
To examine the impact of intravenous acetaminophen on the total quantity of opioids (in morphine equivalents) administered within the first 48 hours postoperatively and perioperatively, while still affording patients adequate analgesia, in women who underwent total abdominal hysterectomies. ⋯ The multimodal approach to perioperative analgesic management, which includes concurrent administration of intravenous acetaminophen and opioids, is effective in reducing the total average amount of opioids administered on postoperative days 1-2 and perioperatively. Limitations of this study include its short duration, retrospective design, and single-site setting. These results may not be generalized to patients undergoing other types of obstetric-gynecologic surgeries.
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To obtain expert consensus on essential criteria required to assess patient readiness for discharge from the postanaesthetic care unit. ⋯ The findings of this study have informed the development of an evidence-based tool to be piloted in a subsequent funded study of nursing assessment of patient readiness for discharge from the postanaesthetic care unit.
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Following total knee replacement (TKR) surgery, patients frequently experience intense levels of pain, stress, and anxiety that may reduce their self-efficacy and thus affect their postoperative recovery. Relaxation intervention is beneficial to help patients manage physical pain and emotional tension. However, evidence for the efficacy of relaxation intervention on patients following TKR is still inconclusive. ⋯ Following the intervention, participants reported significantly lower pain, stress, and anxiety and greater perceived relaxation and self-efficacy. Findings from this study contribute to both nursing science and clinical practice. The relaxation intervention can be offered as part of standard care for patients following TKR in hospitals.
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Worldviews Evid Based Nurs · Dec 2014
Instituting best practice for monitoring for opioid-induced advancing sedation in hospitalized patients.
Adverse events related to opioid-induced unintended advancing sedation and respiratory depression in hospitalized patients are occurring with increased frequency, and these adverse events can have a negative impact on quality and cost outcomes. ⋯ Nurse executives and nurse managers assume accountability for ensuring that patient care is aligned with the best evidence, practices, and regulatory mandates. The framework presented in this paper can help prevent opioid-induced advancing sedation and respiratory depression, and assist nurse leaders in implementation strategies to guide policies and practice.
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Pacing Clin Electrophysiol · Dec 2014
Implantable device to monitor cardiac activity with sternal wires.
Sternal wires are used to close the thoracic cavity and facilitate healing after median sternotomy (MS). We invented an implantable device that uses these wires as sensors to monitor cardiac electrical activity and tested its utility in collecting electrocardiography (ECG) data in vivo. ⋯ These initial results showed that our novel device can use sternal wires as electrodes in vivo to monitor cardiac electrical activity and safely capture physiologic signals after surgical placement.