Healthcare staff as promoters of parental presence at anesthetic induction:Net Promoter Score survey

BACKGROUND Surgical intervention is usually a traumatic event that causes stress and anxiety in the pediatric patient and the family environment.To reduce the harmful effects of presurgical anxiety,parental presence during induction of anesthesia(PPIA)is one of the more notable interventions used in medical centers.However,data on this measure are difficult to evaluate and often face resistance from healthcare staff.AIM To analyze the perception of the healthcare workers after the implementation of a PPIA program.METHODS A survey was developed and sent by email to all the healthcare staff working in the children’s area of a tertiary hospital.It consisted of 14 items divided into positive aspects of PPIA and negative aspects of PPIA evaluated with the use of a Likert scale(1 to 5).The demographics of the respondents were included in the data collected.The answers to the questions were interpreted through the Net Promoter Score(NPS).The statistical analysis compared the differences in the responses to each question of the survey made by the different groups of health personnel included.RESULTS A total of 141 surveys were sent out,with a response rate of 69%.Of the total number of responses,68%were from women and 32%from men.The average age of the participants was 42.3±10.6 years.As for the positive questions about the PPIA,83%had an NPS>50,and only one had a score between 0 and 50,which means that the quality of the service was rated as excellent or good by 100%of the respondents.On the other hand,100%of the negative questions about the PPIA had a negative NPS.Responses to the question“PPIA increases patient safety”were significantly different(P=0.037),with a lower percentage of pediatric surgeons(70%)thinking that PPIA increased patient safety,compared with anesthesiologists(90%),nursing(92%),and other medical personnel(96%).CONCLUSION The personnel who participated in the PPIA program at our center were in favor of implementation.There were no validated arguments to support worker resistance to the development of the PPIA.

PPIP辅助笑气—七氟醚序贯吸入麻醉诱导的效果研究

目的:探讨小儿麻醉诱导期家长陪同在笑气—七氟醚序贯吸入模式的应用及护理对策。方法:选择择期手术患儿,随机分为观察组和对照组,观察组为家长陪同下笑气—七氟醚序贯吸入麻醉诱导,对照组则无家长陪同常规麻醉诱导程序,观察两组患儿麻醉诱导前的血压、心率、呼吸、血氧饱和度及情绪变化,通过问卷方式调查两组患儿术后心理行为、家长满意度。结果:对照组患儿麻醉诱导期血压及心率、呼吸显著高于观察组,血氧饱和度低于观察组(P<0.01),观察组术后心理行为明显优于对照组,观察组家长满意度提高。结论:PPIP辅助笑气—七氟醚序贯吸入麻醉诱导患儿安静合作、生命体征稳定,术后心理行为正常,家长满意。

父母陪伴式麻醉诱导对学龄前手术患儿术前焦虑及麻醉诱导配合度的影响

目的探讨父母陪伴式麻醉诱导对学龄前手术患儿术前焦虑及麻醉诱导配合度的影响。方法采用历史对照设计匹配纳入武汉市某三级甲等医院进行手术治疗的101例患儿为研究对象,其中陪伴组50例和对照组51例。陪伴组进行父母陪伴式麻醉诱导,包括父母术前麻醉诱导陪伴宣教和家庭参与式陪伴;对照组按常规由医护人员抚慰患儿。采用协方差分析比较2组手术当日在术前等待间10 min(T1)和麻醉诱导时(T2)时的焦虑水平及T2时麻醉诱导配合程度。结果 2组患儿的基线特征除了手术台次外均具有可比性,在T1时刻,2组焦虑均上升,2组调整前、调整后差异均无统计意义(P>0.05)。在T2时刻,2组焦虑进一步上升,组间调整后差异为11.03(95%CI:2.06~20.00),差异有统计意义(P=0.02)。陪伴组在T2时麻醉诱导得分为1.04,对照组2.09,调整后差异为0.96(95%CI:0.12~1.78,P=0.03)。结论父母陪伴式麻醉诱导可降低学龄前手术患儿的术前焦虑,提高手术患儿麻醉诱导合作度,可为下一步构建标准化父母陪伴式麻醉诱导方案提供依据。

小儿麻醉诱导期家长陪同在手术室的应用及护理

目的探讨小儿麻醉诱导期家长陪同（PPIP）在手术室的应用及护理。方法择期行全麻手术的患儿86例，随机分成观察组和对照组，每组43例。观察组患儿术前在护士的指导下由家长陪同麻醉诱导，对照组则不需家长陪同，由护士直接带入手术室进行麻醉诱导；观察两组麻醉诱导前后的血压及脉搏变化，了解术前患儿及家长的情绪状况，调查术后家长对PPIP的满意度。结果对照组患儿进入手术室前后血压及脉搏显著高于观察组（P〈0.01），95％的患儿希望家长在麻醉前陪同，93．7％的家长希望参与PPIP，PPIP实施后满意度调查为95％。结论PPIP可缓解麻醉前患儿的恐惧、焦虑及家长的不安情绪，减少麻醉前用药量，有利于麻醉诱导和医患合作，是值得在手术室推广应用的一种诱导模式。

父母陪伴麻醉诱导的研究进展

背景父母陪伴麻醉诱导（parent presence at the induction of anesthesia, PPIA）是指为了缓解患儿麻醉诱导期焦虑和痛苦、提高患儿麻醉诱导期的依从性而采取的医疗干预措施。目的就PPIA的研究进展进行综述。内容讨论PPIA的发展、优点、潜在风险及PPIA联合其他干预措施的发展。趋向PPIA联合其他干预措施效果更好，但最优联合方式仍需进一步研究。

家长陪同在小儿麻醉诱导期中的应用

目的探讨小儿麻醉诱导期优质护理服务中增加家长陪同的效果。方法回顾性分析178例接受全麻下手术治疗患儿的临床资料，将89例麻醉诱导期由家长陪同的患儿作为实验组，89例由护士直接带入手术室进行麻醉诱导的患儿作为对照组，比较两组患儿麻醉诱导前后血压与脉搏的变化，麻醉诱导时的情绪状况，患儿家长的心理反应以及对护理工作的满意度。结果实验组患儿80．9％平静、合作，13．5％不安、尚能合作，5．6％焦躁、哭闹；对照组患儿52．8％平静、合作，36．1％不安、尚能合作，18．1％焦躁、哭闹；实验组麻醉诱导时的情绪状况要优于对照组，差异有统计学意义（x2=16．010，P〈0．05）。麻醉诱导前，实验组血压、脉搏较基础值升高加％以上的患几分别为34．8％，43．8％；对照组分别为58．4％，68．5％；两组比较差异有统计学意义（x2值分别为9．955，11．045；P〈0．05）；实验组患儿家长术前情绪反应与对术前护理的满意度均优于对照组，差异有统计学意义（P〈0．01）。结论家长陪同能够有效缓解麻醉诱导期患儿与家属双方的焦虑情绪，对手术的顺利进行有着积极的作用。