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Cai J, Huang X, He L. An evidence-based general anaesthesia and prone position nursing checklist: Development and testing. Nurs Open 2022; 10:1340-1349. [PMID: 36168198 PMCID: PMC9912415 DOI: 10.1002/nop2.1382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 03/02/2022] [Accepted: 09/04/2022] [Indexed: 11/05/2022] Open
Abstract
AIM Prone positioning during general anaesthesia is one of the most difficult practices for the perioperative nurse. Patients in this position are vulnerable to many preventable complications. However, no studies have developed an evidence-based tool to improve nursing practice during general anaesthesia and prone positioning. This study aimed to develop and test a general anaesthesia and prone position nursing checklist for use by the circulating nurse. DESIGN A prospective pre-post study was performed between October 2020 and March 2021. METHODS The WHO checklist development model and evidence-based methods guided the checklist development process. We prospectively observed circulating nurses that attended to prone general anaesthesia during posterior lumbar spine surgery for 3 months before and after the introduction of the general anaesthesia and prone position nursing risk checklist. The main outcomes were successful delivery of essential prone positional nursing practices during each surgery and the nurse's opinion of the checklist's efficacy and utility. RESULTS A general anaesthesia and prone position nursing checklist comprised of 4 pause points and 22 necessary nursing practices was developed. Seventy-two nurses participated in this study. Use of the checklist significantly increased the average performance of essential practices during each surgery from 72.72%-95.45%. Three measures had a compliance rate of 100%. The delivery rate of 14 measures was significantly improved, 91.7% of nurses considered the checklist easy to use, and 94.4% nurses would want the checklist to be used if they underwent a prone position and general anaesthesia operation.
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Affiliation(s)
- Jianshu Cai
- Operating Room Department, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhouChina
| | - Xiaoling Huang
- Operating Room Department, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhouChina
| | - Lifang He
- School of NursingXiang Nan UniversityChenzhouChina
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Bodon G, Kiraly K, Baksa G, Barany L, Kiss M, Hirt B, Pussert A, Timothy J, Stubbs L, Khajavi K, Braly B. Applied anatomy and surgical technique of the lateral single-position L5-S1 fusion. Clin Anat 2021; 34:774-784. [PMID: 33909306 DOI: 10.1002/ca.23733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/03/2021] [Accepted: 03/11/2021] [Indexed: 11/11/2022]
Abstract
The latest development in the anterior lumbar interbody fusion (ALIF) procedure is its application in the lateral position to allow for simultaneous posterior percutaneous screw placement. The technical details of the lateral ALIF technique have not yet been described. To describe the surgical anatomy relevant to the lateral ALIF approach we performed a comprehensive anatomical study. In addition, the preoperative imaging, patient positioning, planning of the skin incision, positioning of the C-arm, surgical approach, and surgical technique are discussed in detail. The technique described led to the successful use of the lateral ALIF technique in our clinical cases. No lateral ALIF procedure needed to be aborted during these cases. Our present work gives detailed anatomical background and technical details for the lateral ALIF approach. This teaching article can provide readers with sufficient technical and anatomical knowledge to assist them in performing their first lateral ALIF procedure.
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Affiliation(s)
- Gergely Bodon
- Department of Orthopaedic Surgery and Traumatology, Klinikum Esslingen, Esslingen am Neckar, Germany.,Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embriology, Semmelweis University, Budapest, Hungary.,Clinical Anatomy Tübingen, University of Tübingen, Tübingen, Germany
| | - Kristof Kiraly
- Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embriology, Semmelweis University, Budapest, Hungary
| | - Gabor Baksa
- Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embriology, Semmelweis University, Budapest, Hungary
| | - Laszlo Barany
- Laboratory for Applied and Clinical Anatomy, Department of Anatomy, Histology and Embriology, Semmelweis University, Budapest, Hungary
| | - Mate Kiss
- Department of Orthopaedic Surgery and Traumatology, Klinikum Esslingen, Esslingen am Neckar, Germany
| | - Bernhard Hirt
- Clinical Anatomy Tübingen, University of Tübingen, Tübingen, Germany
| | - Arndt Pussert
- Department of Orthopaedic Surgery and Traumatology, Klinikum Esslingen, Esslingen am Neckar, Germany
| | - Jake Timothy
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Lenny Stubbs
- Oklahoma Heart Hospital, Oklahoma City, Oklahoma, USA
| | - Kaveh Khajavi
- Georgia Spine & Neurosurgery Center, Atlanta, Georgia, USA
| | - Brett Braly
- The Spine Clinic of Oklahoma City, Oklahoma City, Oklahoma, USA
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