Desarrollo e implantación de un protocolo perioperatorio de enfermería en cirugía plástica mamaria ambulatoria.

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Bibliographic Details
Title:	Desarrollo e implantación de un protocolo perioperatorio de enfermería en cirugía plástica mamaria ambulatoria.
Alternate Title:	Development and implantation of a perioperative nursing protocol in outpatient breast plastic surgery.
Authors:	Magdalena-Díaz, M. L.¹ luzcolloto@gmail.com, Caragol-Urgellés, L.¹, Solé-Magdalena, A.², Fueyo-Lorente, A.³, Sopena-Zubiria, L. A.⁴, Camporro-Fernández, D.⁵
Source:	Cirugía Plástica Ibero-Latinoamericana. ene-mar2014, Vol. 40 Issue 1, p21-28. 8p.
Abstract (English):	Perioperative nursing cares place the patients in the best possible conditions for their recovery at home. This fact together with the blocking of the thoracic paravertebral and pectoral nerves as well as with a depurated surgical technique, have enabled the implantation of the breast plastic surgery program in the outpatient system. We elaborate a perioperative nursing care protocol developing the following documents: preoperative nursing interview, presurgical check list, preoperative, intraoperative and postoperative cares, nursing cares and recommendations sheet, protocolized medical treatment sheet, telephonic follow up sheet to evaluate the observance of the treatment, pain, fever, main drain and breast tension. Later an anonymous survey was made to evaluate patients' satisfaction degree. From April 2012 to December 2013, 35 operations with different pathologies were performed in outpatient surgery under thoracic paravertebral anesthesia: 5 patients needed hospitalization, 2 because of pain, 2 because of bleeding and 1 because of vomiting and bleeding. All patients observed the treatment. In the first 24 hours after surgery 28 patients (93,3 %) had ≤3 points of pain in a numeric scale from 0 to 10 and after 48 hours all patients had ≤3 points of pain. Twenty seven patients (90%) reported that the satisfaction degree with the process was very good. To dispose of a perioperative nursing care protocol in outpatient breast plastic surgery with thoracic paravertebral anaesthesia assures the standarization of nursing practice increasing patient safety at home and improving their degree of satisfaction with all the process and with a very good evaluation. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Los cuidados perioperatorios de enfermería sitúan al paciente en las mejores condiciones posibles para su recuperación en el domicilio. Junto a la aplicación de los bloqueos paravertebral torácico y de nervios pectorales y una depurada técnica quirúrgica, hacen que sea posible la implantación de un programa de cirugía plástica mamaria en régimen ambulatorio. Nos planteamos como objetivo estandarizar la práctica asistencial de enfermería en este tipo de cirugía, garantizar la seguridad domiciliaria de las pacientes mediante el seguimiento telefónico y evaluar el grado de satisfacción utilizando una encuesta anónima. Elaboramos un protocolo de cuidados perioperatorios desarrollando los documentos de: entrevista preoperatoria de enfermería, listado de verificación prequirúrgica, cuidados preoperatorios,, intraoperatorios y postoperatorios, hoja de cuidados y recomendaciones de enfermería, hoja protocolizada de tratamiento médico, hoja de seguimiento telefónico para evaluar el cumplimiento del tratamiento, dolor, control del drenaje, fiebre y tensión mamaria. Posteriormente realizamos una encuesta anónima entre las pacientes para evaluar su grado de satisfacción. Recogimos 35 intervenciones por diferentes patologías mamarias llevadas a cabo entre abril del 2012 y diciembre del 2013 de forma ambulatoria y bajo anestesia paravertebral torácica: 5 pacientes (14%) precisaron ingreso hospitalario, 2 por dolor, 2 por sangrado y 1 por vómitos y sangrado. Todas cumplieron el tratamiento prescrito; a las 24 horas, 28 pacientes (93,3 %) presentaron una puntuación de dolor ≤3 en una escala numérica de 0 a 10 y a las 48 horas todas presentaron una puntuación de dolor ≤ 3. Veintisiete pacientes (90%) manifestaron que el grado de satisfacción respecto al proceso fue muy bueno. Creemos que el disponer de un protocolo de cuidados perioperatorios de enfermería en cirugía plástica mamaria ambulatoria con anestesia paravertebral torácica asegura la estandarización de la práctica enfermera incrementando la seguridad de las pacientes en su domicilio y mejorando su grado de satisfacción respecto a todo el proceso cuya evaluación resulta ser muy buena. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Perioperative nursing cares place the patients in the best possible conditions for their recovery at home. This fact together with the blocking of the thoracic paravertebral and pectoral nerves as well as with a depurated surgical technique, have enabled the implantation of the breast plastic surgery program in the outpatient system. We elaborate a perioperative nursing care protocol developing the following documents: preoperative nursing interview, presurgical check list, preoperative, intraoperative and postoperative cares, nursing cares and recommendations sheet, protocolized medical treatment sheet, telephonic follow up sheet to evaluate the observance of the treatment, pain, fever, main drain and breast tension. Later an anonymous survey was made to evaluate patients' satisfaction degree. From April 2012 to December 2013, 35 operations with different pathologies were performed in outpatient surgery under thoracic paravertebral anesthesia: 5 patients needed hospitalization, 2 because of pain, 2 because of bleeding and 1 because of vomiting and bleeding. All patients observed the treatment. In the first 24 hours after surgery 28 patients (93,3 %) had ≤3 points of pain in a numeric scale from 0 to 10 and after 48 hours all patients had ≤3 points of pain. Twenty seven patients (90%) reported that the satisfaction degree with the process was very good. To dispose of a perioperative nursing care protocol in outpatient breast plastic surgery with thoracic paravertebral anaesthesia assures the standarization of nursing practice increasing patient safety at home and improving their degree of satisfaction with all the process and with a very good evaluation. [ABSTRACT FROM AUTHOR]
ISSN:	03767892
DOI:	10.4321/S0376-78922014000100004