Värmebevarande insatser utifrån patientens och operationsteamets perspektiv

Sammanfattning: Aim: The overall aim was to map and describe experiences of heat conservationmeasures (HCM) for the patient in connection with surgery from the patientʼsand the surgical teamʼs perspectives. The four studies aimed to: determinewhether nurse anesthetists have access to, knowledge of, and adhere torecommended guidelines to maintain normal body temperature during theperioperative period (I), describe the patientʼs lived experience of warmth andcoldness in connection with surgery (II), describe the nurse anesthetistʼsperceptions of heat conservation measures in connection with surgery (III),describe the surgical team memberʼs experience of communication regardingheat conservation measures during surgery (IV).Methods: The four studies had both descriptive and explorative designs.Participants included the head of department and nurse anesthetists atoperating departments in Sweden (I), 16 patients (II), 19 nurse anesthetists(III), and 29 surgical team members (IV). Data were collected via twoquestionnaires (I), individual interviews (II, III, IV), and narratives (IV). Datawere analyzed by descriptive statistics and content analysis (I), reflectivelifeworld research (II), phenomenography (III), and deductive content analysis(IV).Results: There are two sides to the same coin when it comes to HCM. One sideis temperature comfort and the other side is body temperature and temperaturemeasurement. Patients expect that their individual needs for temperaturecomfort will be fulfilled and when it is, they felt calmness and well-being. Thereis, however, an interdependence between the patient, the surgical team, andteam members. Patients do not dare to speak up about their needs and adapt tothe HCM they have been provided. The nurse anesthetist is dependent on thedialogue with the patient to be able to provide the right HCM and also on teammembersʼ communication and attitude towards HCM. The surgical team is inturn dependent on each other’s competencies when communicating aboutHCM which often happens in several small team constellations and sparinglyin the whole surgical team. Overall, there is a lack of a common guidelines,knowledge of HCM and especially redistribution, and full access to HCM.Conclusion: It is of importance to reach the patientʼs individual needs to avoidsuffering and promote well-being and patient safety. The nurse anesthetistʼsgoal is to protect the patient by avoiding heat loss and maintaining normal bodytemperature. There is a need to highlight the patient’s role in the surgical team, whose goal is to provide the patient with the best care, there might however, bedifferent perspectives on HCM. Furthermore, the surgical team needs supportfrom their organizational management regarding the right preconditions asaccess to HCM and a common platform for education to provide HCM, toincrease patient safety during surgery.

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