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Gustafsson IL, Rask M, Schildmeijer K, Elmqvist C. Patients experience of warmth and coldness in connection with surgery - a phenomenological study. Int J Qual Stud Health Well-being 2021; 16:1858540. [PMID: 33308102 PMCID: PMC7738308 DOI: 10.1080/17482631.2020.1858540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose: The aim was to describe patients’ lived experience of warmth and coldness in connection with surgery. Methods: A reflective lifeworld research (RLR) approach founded on phenomenology and the methodological principles of openness, flexibility, and bridling were used. The data consisted of 16 in-depth interviews with patients from four hospitals in Sweden. Results: Warmth and coldness in connection with surgery means an expectation to maintain one´s daily life temperature comfort. When patients’ needs of temperature comfort is fulfilled it give a sense of well-being and calmness. Despite the body is covered there are feelings of vulnerability. When patients have the ability to change their own temperature comfort, they feel independent. Conclusion: The individual feeling of temperature comfort could be affected or changed to discomfort during the perioperative context, and an intervention is required to avoid suffering due to the care. An ability to independently influence one´s own temperature comfort can strengthen the patient, whereas the opposite entails suffering in silence. The phenomenon is also related to feelings of confidence about receiving the best care as well as being exposed and vulnerable. When the patient´s need of comfortable temperature is met then feelings of security and sense of well-being emerged.
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Affiliation(s)
- Ingrid L Gustafsson
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Centre of Interprofessional Cooporation and Joint Use Whitin Emergency Care (CICE), Linnaeus University , Vaxjo, Sweden
| | - Mikael Rask
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Centre of Interprofessional Cooporation and Joint Use Whitin Emergency Care (CICE), Linnaeus University , Vaxjo, Sweden
| | - Kristina Schildmeijer
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Centre of Interprofessional Cooporation and Joint Use Whitin Emergency Care (CICE), Linnaeus University , Kalmar, Sweden
| | - Carina Elmqvist
- Research County Council, Department of Health and Caring Sciences, Centre of Interprofessional Cooporation and Joint Use Whitin Emergency Care (CICE), Linnaeus University , Vaxjo, Sweden
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Munday J, Higgins N, Mathew S, Dalgleish L, Batterbury AS, Burgess L, Campbell J, Delaney LJ, Griffin BR, Hughes JA, Ingleman J, Keogh S, Coyer F. Nurse-Led Randomized Controlled Trials in the Perioperative Setting: A Scoping Review. J Multidiscip Healthc 2020; 13:647-660. [PMID: 32821111 PMCID: PMC7419608 DOI: 10.2147/jmdh.s255785] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/28/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Nurses provide care at each phase of the complex, perioperative pathway and are well placed to identify areas of care requiring investigation in randomized controlled trials. Yet, currently, the scope of nurse-led randomized controlled trials conducted within the perioperative setting are unknown. This scoping review aims to identify areas of perioperative care in which nurse-led randomized controlled trials have been conducted, to identify issues impacting upon the quality of these trials and identify gaps for future investigation. METHODS This scoping review was conducted in reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Searches were conducted in PubMed, Embase, Cumulative Index for Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials, with a date range of 2014-19. Sources of unpublished literature included Open Grey, and ProQuest Dissertation and Theses, Clinical Trials.gov and the Australian and New Zealand Clinical Trials Registry. After title and abstract checking, full-text retrieval and data extraction, studies were appraised using the Joanna Briggs Institute Critical Appraisal Checklists for randomized controlled trials. Data were synthesized according to the main objectives. Key information was tabulated. RESULTS From the 86 included studies, key areas where nurses have led randomized controlled trials include patient or caregiver anxiety; postoperative pain relief; surgical site infection prevention: patient and caregiver knowledge; perioperative hypothermia prevention; postoperative nausea and vomiting; in addition to other diverse outcomes. Issues impacting upon quality (including poorly reported randomization), and gaps for future investigation (including a focus on vulnerable populations), are evident. CONCLUSION Nurse-led randomized controlled trials in the perioperative setting have focused on key areas of perioperative care. Yet, opportunities exist for nurses to lead experimental research in other perioperative priority areas and within different populations that have been neglected, such as in the population of older adults undergoing surgery.
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Affiliation(s)
- Judy Munday
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Department of Health and Nursing Science, University of Agder, Grimstad, 4879, Norway
- Mater Research Institute-UQ, South Brisbane, QLD4101, Australia
| | - Niall Higgins
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Herston, QLD4029, Australia
| | - Saira Mathew
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Lizanne Dalgleish
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Herston, QLD4029, Australia
| | - Anthony S Batterbury
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Herston, QLD4029, Australia
| | - Luke Burgess
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Mater Research Institute-UQ, South Brisbane, QLD4101, Australia
| | - Jill Campbell
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Herston, QLD4029, Australia
| | - Lori J Delaney
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Colleges of Health and Medicine, Australian National University, Acton, ACT2601, Australia
| | - Bronwyn R Griffin
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - James A Hughes
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Herston, QLD4029, Australia
| | - Jessica Ingleman
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Samantha Keogh
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Herston, QLD4029, Australia
- Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, QLD, 4111, Australia
| | - Fiona Coyer
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Royal Brisbane and Women’s Hospital, Herston, QLD4029, Australia
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Wistrand C, Nilsson U, Sundqvist AS. Patient experience of preheated and room temperature skin disinfection prior to cardiac device implantation: A randomised controlled trial. Eur J Cardiovasc Nurs 2020; 19:529-536. [DOI: 10.1177/1474515119900062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Clinically, patients often comment on the coolness of the skin disinfectant. However, scarce evidence is available regarding patients’ experience during intraoperative skin disinfection. Aims: The aim of this study was to describe and compare intraoperative patient experiences with preheated and room temperature skin disinfectant. Method: This randomised controlled trial included 220 patients undergoing cardiac device implantation. Patients allocated to preheated (36°C) or room temperature (20°C) chlorhexidine in 70% ethanol verbally answered an open-ended question regarding their experience with the skin disinfection. Results were assessed using a qualitative approach with comparative quantification. Results: The analysis resulted in nine categories describing the patients’ experiences with preheated and room temperature skin disinfection. Most of the patients described the skin disinfection process as a negative experience, which consisted of six categories: cold, smell, change in temperature, unpleasant, wet and painful. In addition, two neutral categories of response (nothing in particular and neither pleasant nor unpleasant) and one positive response (pleasant) emerged through the analysis. Preheated skin disinfection yielded significantly fewer negative experiences in the category cold (85% vs. 15%, P<0.0001) and significantly more positive experiences (66% vs. 34%, P<0.002). Neutral categories (neither pleasant nor unpleasant 65% vs. 35%, P=0.01, nothing in particular 74% vs. 26%, P<0.001) dominated after preheated skin disinfection. Conclusion: The use of preheated skin disinfection promotes a positive patient experience with skin disinfection. Trial registration: ClinicalTrials.gov registration number NCT02260479 ( https://clinicaltrials.gov/ct2/results?cond=preheated+skin+disinfection ).
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Affiliation(s)
- Camilla Wistrand
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Sweden
- Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Sweden
| | - Ulrica Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Sweden
| | - Ann-Sofie Sundqvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Sweden
- Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Sweden
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Wistrand C, Falk-Brynhildsen K, Nilsson U. National Survey of Operating Room Nurses' Aseptic Techniques and Interventions for Patient Preparation to Reduce Surgical Site Infections. Surg Infect (Larchmt) 2018; 19:438-445. [PMID: 29672240 DOI: 10.1089/sur.2017.286] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Surgical site infection (SSI), the third most common type of nosocomial infection in Sweden, is a patient injury that should be prevented. Methods of reducing SSIs include, for instance, disinfecting the skin, maintaining body temperature, and ensuring an aseptic environment. Guidelines for most of these interventions exist, but there is a lack of studies describing to what extent the preventive interventions have been implemented in clinical practice. We describe the daily clinical interventions Swedish operating room (OR) nurses performed to prevent SSIs following national guidelines. METHODS A descriptive cross-sectional study using a Web-based questionnaire was conducted among Swedish OR nurses. The study-specific questionnaire included 32 items addressing aspects of the interventions performed to prevent SSI, such as preparation of the patient skin (n = 12), maintenance of patient temperature (n = 10), and choice of materials (n = 10). The response format included both closed and open-ended answers. RESULTS In total, 967 nurses (43% of the total) answered the questionnaire; of these, 77 were excluded for various reasons. The proportions of the OR nurses who complied with the preventive interventions recommended in the national guidelines were high: skin disinfection solution (93.5%), sterile drapes (97.4%) and gowns (83.8%) for single use, and the use of double gloves (73.0%). However, when guidelines were lacking, some interventions differed, such as the frequency of glove changes and the use of adhesive plastic drapes. CONCLUSION To standardize OR nurses' preventive interventions, implementing guidelines seems to be the key priority. Overall, OR nurses have high compliance with the national guidelines regarding interventions to prevent bacterial growth and SSIs in the surgical patient. However, when guidelines are lacking, the preventive interventions lose conformity.
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Affiliation(s)
- Camilla Wistrand
- 1 Department of Cardiothoracic and Vascular Surgery, University Hospital, Örebro University , Örebro, Sweden
| | - Karin Falk-Brynhildsen
- 2 School of Health Sciences, Faculty of Medicine and Health, Örebro University , Örebro, Sweden
| | - Ulrica Nilsson
- 1 Department of Cardiothoracic and Vascular Surgery, University Hospital, Örebro University , Örebro, Sweden .,3 Centre for Perioperative Nursing , Örebro University
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