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Krzemińska Sylwia, Guzik Natalia, Borodzicz Adriana, Aendarczyk Marta. Assessment of mental workload of nurses anesthesia - preliminary study. Journal of Education, Health and Sport. 2017;7(12):517-530. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1123536 http://ojs.ukw.edu.pl/index.php/johs/article/view/5078 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.11.2017. Revised: 15.11.2017. Accepted: 21.12.2017. Assessment of mental workload of nurses anesthesia - preliminary study Sylwia Krzemińska ¹, Natalia Guzik ², Adriana Borodzicz ¹, Marta Aendarczyk ¹ ¹ Nursing Anesthesiology and Intensive Care Department of Health Sciences, Medical University Wroclaw. ² Anaesthesiology and Intensive Therapy Unit, IV Military Clinical Hospital in Wroclaw Summary Admission: Working nurse anesthesia ...

Good, quality and quality health services are one of the basic needs that everyone needs. Therefore, in the health world, the authority of anesthetist administrators within the scope of anesthesia services is direct, mandated, and collaborative where the mandate obtained from anesthetist administrators is not only from specialist doctors but also from the Government, as regulated in Article 14 Paragraph (1) and Paragraph (2) Ministry of Health Regulation No. 18 of 2016 concerning Licensing and Implementation of Anesthesia Administrator Practices. Now the delegation based on government assignments is carried out if there is no anesthetist in an area. The authority falls to the anesthetist in that area who has received training. This study aims to determine how the legal responsibility of anesthesia administrators in health services. The method used in this research is juridical normative, which examines legislation (statute approach) by examining all relevant regulations or statutory regulations and looking at the facts in the field. The research approach used is qualitative. This study's results indicate that anaesthesia services' general responsibility lies with anaesthetists in the practice of anesthesia services. What needs to be considered in the delegation of tasks from doctors to nurses is that the primary responsibility remains with the doctor who gives the assignment, nurses also have executive responsibility, delegation can only be carried out after the nurse has received sufficient education and competence to receive the delegation, delegation for the long term or continuously given to health nurses with special skills (specialist nurses), which are regulated by separate rules (standing orders). Anaesthetist administrators' role when carrying out health services to delegate authority according to these norms can only be performed by anaesthetist administrators who have received training.

Great diversity exists in the US population, therefore the US Department of Health and Human Services [HHS] has called for increased diversity among healthcare professionals as a means of improving public health outcomes. Males are consistently a minority group within the nursing profession and are disproportionately disciplined. The disproportionate discipline of male nurses and the loss of licensure often resulting from censure may have an impact on efforts to diversify the nursing sector of healthcare. Among certified registered nurse anesthetists [CRNAs], the ratio of males to females is more equal and little data exists examining the characteristics of disciplined CRNAs. The purpose of this study was to describe formal licensure discipline against CRNAs practicing in select states during a 33-year period (1983-2017). This descriptive study is a retrospective cohort study involving secondary data analysis of public records information. Disciplinary list data was generated via the database tools accessible on the government websites provided by each state department of health and/or BON. The disciplinary list data was then cross-referenced against the Nursys database maintained by the National Council of State Boards of Nursing (NCSBN) for greater detail and analysis. Of the CRNA licenses in the sample (n=4401), the rate of sanction was 1.20% (n=53). Males (n=26) were disciplined more often than women (n=27) at a ratio of 1.6:1. CRNAs in this study were six times more likely to commit an infraction related to substance abuse than any other single infraction type at 66% (n=35). Loss of licensure in some form resulted in approximately 51% (n=27) of cases.

The maternal mortality rate (MMR) is unconscionably high around the world, with women in low to middle income countries (LMICs) disproportionately passing away from potentially preventable causes. While this is a complicated and multifaceted problem, anesthesia has been identified as a contributing cause of death. From the moment the parturient enters the operating room, the anesthetist is responsible for their well-being. This integrative review was designed to further explore relationship between anesthesia and the MMR in LMICs. Twelve articles published within the last 15 years were selected through an extensive literature search using Medline and CINAHL. Each article was examined using the Polit and Beck (2017) assessment criteria followed by a cross table analysis. The results identified common themes across the studies including lack of infrastructure such as access to reliable power, water and oxygen, resources such as medications and basic anesthesia equipment, training focusing on maternal care and anesthesia and continuing education for providers. Knowing these deficiencies in anesthetic care, nurse anesthetists can assist in implementing changes to help reduce the MMR. Recommendations include encouraging hospitals and governments to make updating hospital infrastructure a priority, reaching out to groups such as the World Health Organization who help fund basic equipment such as pulse oximeters, establishing relationships with medical institutions in other regions to provide training and guidance, and focusing on the development of non-physician anesthetist programs to increase the number of proficient providers.

Background: One of the services provided by the hospital is surgery in the operating room carried out by a team of doctors and nurses. The application of the Surgical Safety Checklist adopted from the World Health Organization (WHO) is used in the operating room to increase the safety of operations and reduce errors in surgical procedures. Goals: To find out the development and implementation of the Surgical Safety Checklist on Nurse compliance at the Central Surgical Installation of Bethesda Hospital Yogyakarta. Research Methods: This research is a mixed method. The sample in this study were all nurses who served in the operating room at the Central Surgical Installation of Bethesda Hospital Yogyakarta, consisting of 40 respondents as instrument nurses, circular nurses and anesthesia nurses. The data that had been collected were then analyzed using the Fisher exact test statistical test. Research Result: There is a significant relationship between work tenure and knowledge p = 0.048 (p <0.05). There is a significant relationship between age and work tenure on compliance with the application of the Surgical Safety Checklist (p <0.05). There is a significant relationship between knowledge and compliance p = 0.0001 (p <0.05). Conclusion: The development and application of the Surgical Safety Checklist on the level of knowledge and compliance of nurses at Bethesda Hospital Yogyakarta, the majority in the good category and the implementation of the Surgical Safety Checklist has been running optimally. Bethesda Hospital is developing electronic medical records, on process medical and nursing assessment, Integrated Patient Progress Record (CPPT), and nursing care, response from the implementation of the new version of SSC is quite good.

Testimony issued by the Government Accountability Office with an abstract that begins "Certified registered nurse anesthetists (CRNA), registered nurses who have completed a master's degree program in nurse anesthesia, provide the majority of anesthesia care in the Department of Veterans Affairs (VA) medical facilities. There are approximately 500 VA-employed CRNAs (VA CRNA) who provide care to veterans in VA medical facilities. While the demand for CRNAs has increased, many employed by VA are nearing retirement eligibility age. Concerns have been raised about the challenges VA may face in making VA CRNA salaries competitive in order to maintain its VA CRNA workforce, particularly in local markets that can be highly competitive. This testimony is based on GAO work reported in VA Health Care: Many Medical Facilities Have Challenges in Recruiting and Retaining Nurse Anesthetists, (GAO-08-56, Dec. 13, 2007). This testimony (1) identifies workforce challenges that VA medical facilities experience related to VA CRNAs, and (2) identifies a key mechanism that VA medical facilities have to help make VA CRNA salaries competitive and the extent to which VA facilities use this mechanism. For the December 2007 report, GAO analyzed surveys sent to VA chief anesthesiologists, VA human resources officers, and VA CRNAs. GAO also visited eight VA medical facilities and interviewed facility officials about efforts to recruit and retain VA CRNAs."

In 2001, the U.S. government released a rule that allowed states to 'opt-out' of the federal requirement that a physician supervise the administration of anesthesia by a nurse anesthetist. To date, 17 states have opted out. The majority of the opt-out states cited increased access to anesthesia care as the primary rationale for their decision. In this study, we assess the impact of state opt-out policy on access to and costs of surgeries and other procedures requiring anesthesia services. Our null hypothesis is that opt-out rule adoption had little or no effect on surgery access or costs. We estimate an inpatient model of surgeries and costs and an outpatient model of surgeries. Each model uses data from multiple years of U.S. inpatient hospital discharges and outpatient surgeries. For inpatient cost models, the coefficient of the opt-out variable was consistently positive and also statistically significant in most model specifications. In terms of access to inpatient surgical care, the opt-out rules did not increase or decrease access in opt-out states. The results for the outpatient access models are less consistent, with some model specifications indicating a reduction in access associated with opt-out status, while other model specifications suggesting no discernable change in access. Given the sensitivity of model findings to changes in model specification, the results do not provide support for the belief that opt-out policy improves access to outpatient surgical care, and may even reduce access to outpatient surgical care (among freestanding facilities).

Philosophical foundations of applied and professional ethics / Pamela Grace -- Nursing ethics / Pamela Grace -- Advanced practice nursing: general ethical concerns / Pamela Grace -- Professional responsibility, human rights, and injustice / Pamela Grace -- Collaborative relationships: promoting patient good / Deborah Guglietti -- Research ethics: advanced practice roles and responsibilities / Pamela Grace -- Nursing ethics and advanced practice: neonatal issues / Margaret Settle -- Nursing ethics and advanced practice: children and adolescents / Nan Gaylord -- Nursing ethics and advanced practice: women's health / Katharine Smith -- Nursing ethics and advanced practice: adult health / Jane Flanagan -- Nursing ethics and advanced practice: psychiatric and mental health issues / Pamela Grace and Pamela Terreri -- Nursing ethics and nurse anesthesia practice / Greg Sheedy -- Nursing ethics and advanced practice: gerontology and end of life issues / Pam Grace

ABSTRACT Objective: to report the experience of resident nurses performing preoperative visits. Method: descriptive study, experience report type, based on the performance of preoperative visits by resident nurses in a military hospital of Rio de Janeiro, RJ, Brazil,. Results: when patients are instructed, they become calmer and thus they tend to have better recovery. The presence of informed family members/caregivers become a component that help in the work of the nursing staff. Conclusion: the performance of visits provides the residents with the opportunity of deepening in the studies on surgery and anesthesia types, and perioperative care, in addition to stimulate and facilitate the contact with patients/family members. The preoperative visit is increasingly necessary in hospital practice and nurses need to be able to perform it. Descriptors: Perioperative Nursing; Visits to Patients; Non-Medical Internship. RESUMO Objetivo: relatar a experiência dos residentes de enfermagem na realização da visita pré-operatória. Método: estudo descritivo, tipo relato de experiência, baseado na realização de visita pré-operatória em um hospital militar do Rio de Janeiro, RJ, pelo residente de enfermagem. Resultados: o paciente quando está instruído torna-se mais tranquilo e, desta forma, tende a ter melhor recuperação. A presença do familiar/acompanhante orientado torna-se um componente que vem a ajudar o trabalho da equipe de enfermagem. Conclusão: a realização das visitas propiciam ao residente a oportunidade de aprofundamento nos estudos sobre os tipos cirúrgicos e anestésicos, os cuidados perioperatórios, além de estimular e facilitar o contato com o paciente/familiar. A visita pré-operatória faz-se cada vez mais necessária na prática hospitalar e o profissional enfermeiro precisa estar apto para executá-la. Descritores: Enfermagem Perioperatória; Visitas a Pacientes; Internato Não Médico. RESUMEN Objetivo: relatar la experiencia de los residentes de enfermería en la realización de la visita preoperatoria. Método: estudio descriptivo, tipo relato de experiencia, basado en la realización de visita preoperatoria por residentes de enfermería en un hospital militar de Rio de Janeiro, RJ, Brasil. Resultados: cuando el paciente está instruido se tranquiliza y por lo tanto tiende a tener una mejor recuperación. La presencia de familiares/acompañantes orientados se convierte en un componente que ayuda en el trabajo del personal de enfermería. Conclusión: la realización de visitas proporcionan al residente la oportunidad de profundizar en los estudios sobre los tipos quirúrgicos y anestésicos y los cuidados perioperatorios, además de estimular y facilitar el contacto con los pacientes/familiares. La visita preoperatoria es cada vez más necesaria en la práctica hospitalaria y los enfermeros deben ser capaces de ejecutarlo. Descriptores: Enfermería Perioperatoria; Visitas a Los Pacientes; Internado No Médico. ; RESUMO Objetivo: relatar a experiência dos residentes de enfermagem na realização da visita pré-operatória. Método: estudo descritivo, tipo relato de experiência, baseado na realização de visita pré-operatória em um hospital militar do Rio de Janeiro, RJ, pelo residente de enfermagem. Resultados: o paciente quando está instruído torna-se mais tranquilo e, desta forma, tende a ter melhor recuperação. A presença do familiar/acompanhante orientado torna-se um componente que vem a ajudar o trabalho da equipe de enfermagem. Conclusão: a realização das visitas propiciam ao residente a oportunidade de aprofundamento nos estudos sobre os tipos cirúrgicos e anestésicos, os cuidados perioperatórios, além de estimular e facilitar o contato com o paciente/familiar. A visita pré-operatória faz-se cada vez mais necessária na prática hospitalar e o profissional enfermeiro precisa estar apto para executá-la. Descritores: Enfermagem Perioperatória; Visitas a Pacientes; Internato Não Médico. ABSTRACT Objective: to report the experience of resident nurses performing preoperative visits. Method: descriptive study, experience report type, based on the performance of preoperative visits by resident nurses in a military hospital of Rio de Janeiro, RJ, Brazil,. Results: when patients are instructed, they become calmer and thus they tend to have better recovery. The presence of informed family members/caregivers become a component that help in the work of the nursing staff. Conclusion: the performance of visits provides the residents with the opportunity of deepening in the studies on surgery and anesthesia types, and perioperative care, in addition to stimulate and facilitate the contact with patients/family members. The preoperative visit is increasingly necessary in hospital practice and nurses need to be able to perform it. Descriptors: Perioperative Nursing; Visits to Patients; Non-Medical Internship. RESUMEN Objetivo: relatar la experiencia de los residentes de enfermería en la realización de la visita preoperatoria. Método: estudio descriptivo, tipo relato de experiencia, basado en la realización de visita preoperatoria por residentes de enfermería en un hospital militar de Rio de Janeiro, RJ, Brasil. Resultados: cuando el paciente está instruido se tranquiliza y por lo tanto tiende a tener una mejor recuperación. La presencia de familiares/acompañantes orientados se convierte en un componente que ayuda en el trabajo del personal de enfermería. Conclusión: la realización de visitas proporcionan al residente la oportunidad de profundizar en los estudios sobre los tipos quirúrgicos y anestésicos y los cuidados perioperatorios, además de estimular y facilitar el contacto con los pacientes/familiares. La visita preoperatoria es cada vez más necesaria en la práctica hospitalaria y los enfermeros deben ser capaces de ejecutarlo. Descriptores: Enfermería Perioperatoria; Visitas a Los Pacientes; Internado No Médico.

The relationship between physicians and nurses in the delivery of anesthesia care is politically and financially charged, and hotly debated. Against this backdrop, federal regulators have proposed dropping a Medicare requirement that nurse anesthetists be supervised by a physician. Proponents note that the new regulations would resolve inconsistencies between Medicare supervisory requirements and state law, while opponents voice concerns for patient safety. This Issue Brief describes the current controversy, and summarizes a newly published study that suggests differences in patient outcomes depending on the nature and level of anesthesiologist involvement in surgical care.

Recognizing unsafe abortion as a serious health problem, the government of Senegal adopted a national health strategy in 1997 that aims to halve the number of unsafe abortions by 2001. In 1997, the Center for Training and Research in Reproductive Health (CEFOREP) and the Obstetrics and Gynecology clinic (CGO) at Le Dantec University Teaching Hospital in Dakar introduced new clinical techniques to improve emergency treatment for women with complications from miscarriage or abortion. CGO and two other teaching hospitals served as pilot sites. Physicians, nurses, and midwives at the three sites received training in manual vacuum aspiration, family planning, and counseling. To measure the impact of the training, CEFOREP interviewed 320 women receiving emergency treatment and 204 providers before the intervention, and 543 patients and 175 providers after. This brief states that improving postabortion care services can result in shorter hospital stays, decreased patient costs, better communication between providers and patients, increased acceptance of contraceptive use by women treated for abortion or miscarriage, and that local anesthesia is needed for pain control.

BACKGROUND: Standard monitoring during anaesthesia is a core element of patient safety and practice of safe anesthesia has reduced morbidity and mortality worldwide. The main objective of this study was to assess the practice of standard monitoring during anaesthesia in the hospitals of North Kivu, so as to establish a baseline overview of the situation, and orientate plans towards safe anaesthesia in the region. METHODS: This study was a cross-sectional survey of health facilities of the Health Antenna of Butembo in Democratic Republic of Congo and was conducted from October to December 2018. Questionnaires were brought to anaesthesia providers in the health facilities. The study included 1 answer from the anaesthesia practitioners who accepted to participate. The practices of standard monitoring in the health facilities were compared to WHO-WSFA guidelines. Data was captured and analyzed with Epi Info 7. RESULTS: Forty out of 90 health facilities (44.4%) of 10 health zones responded on the questionnaire. Twenty-three health facilities (57.5%) were from private sector and 17 (42.5%) from public sector. Sixteen health facilities (40.0%) were from the Butembo health zone. The median number of anaesthesia providers was 2 per health facility. Of all the anaesthesia providers, none were physicians, 47.5% were nurses practicing anaesthesia without any training in anaesthesia and 47.5% were nurse anaesthetists. All the health facilities were providing general anaesthesia whereas spinal anaesthesia was provided in 22 out of 40 centers (55%). Seventy percent (28/40) of the facilities were below standard according to WHO-WSFA guidelines. Only 40% (16/40) were using a pulse oximeter and 10% (4/40) declared that ECG was occasionally used. CONCLUSION: The practice of standard monitoring is poor in health facilities of the Health Antenna of Butembo. Efforts should be made to improve monitoring which is a key element of safe anaesthesia.

Contents; Series Editors' Foreword; Acknowledgments; 1 The Ideological Work of Gender; 2 Scenes of Indelicate Character: The Medical Treatment of Victorian Women; 3 Covered but Not Bound: Caroline Norton and the 1857 Matrimonial Causes Act; 4 The Man-of-Letteres Hero: David Copperfield and the Professional Writer; 5 The Anathematized Race: The Governess and Jane Eyre; 6 A Housewifely Woman: The Social Construction of Florence Nightingale; Conclusion; Notes; Bibliography; Index