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Intraoperative Monitoring from the Nurse Anaesthetist’s Perspective, a Qualitative Study

Artikel i vetenskaplig tidskrift
Författare Pether Jildenstål
Margareta Warrén Stomberg
jan Jakobsson
Publicerad i Journal of Anesthesia & Intensive Care Medicine
Volym 2
Nummer/häfte 5
Sidor 5
ISSN 2474-7653
Publiceringsår 2018
Publicerad vid Institutionen för vårdvetenskap och hälsa
Sidor 5
Språk en
Länkar https://juniperpublishers.com/jaicm...
Ämnesord Keywords : Nurse Anaesthetist; Depth of Anaesthesia; Pain; Monitoring of vital signs
Ämneskategorier Omvårdnad, Anestesiologi, Anestesi och intensivvård

Sammanfattning

Monitoring is essential for safe anaesthesia to reduce the occurrence of adverse events by early detection of deviations in the patient’s condition. Changes in vital parameters are the basis of early warning signs but needs to be put in a context. The integration of patients’ preoperative physiology, medical history, the surgical trauma, and anaesthetic drugs use is complex. A key part of the nurse anaesthetist’s professional work is to ensure that the patient is in appropriate depth of anaesthesia during the entire clinical course and that homeostasis is secured. The aim of the present study was to describe nurse anaesthetists’ monitoring and assessment of patients undergoing general anaesthesia, focusing on physiological indicators of pain and depth of anaesthesia. An additional aim was to relate these findings to previous findings about intraoperative monitoring and assessment. Method: This is a qualitative semi-structured interview based study with nurse anaesthetists conducted in April 2017. Eight nurse anaesthetists working full for more than five years in western Sweden were interviewed. Results: The nurse anaesthetists´ emphasize their value by having an integrated overview of the individual patient. Combining the patients’ medical history, pre-existing status and individual intraoperative responses to anaesthesia and surgery, monitored as well as clinical. The nurse anaesthetist role subsequently being to provide and ensure adequate depth of anaesthesia, assure no experience of pain and maintaining basic homeostasis. They found that available basic monitoring modalities are sufficient and expressed no need for further monitoring techniques. Clinical work experience provides the main basis for their skill. Conclusion: The nurse anaesthetists studied were confident with their skill in integrating patient baseline information and monitoring of vital signs for the provision of effective and safe anaesthesia. There is however room for further studies to gain further in depth insight to the nurse anaesthetist assessment and decision process.

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