The addition of clonidine to 0.125% bupivacaine prolongs the duration of post-operative analgesia without any respiratory or haemodynamic side-effects.

No abstract

Background: Adverse events are often encountered in surgical intensive care units (ICUs), and most of them occur due to preventable errors. Establishment of a patient safety culture is recommended for preventing and reducing these errors.Aims: This study was performed to investigate the relationship between surgical ICU nurses' patient safety culture and adverse events.Design: This was a cross-sectional descriptive study. Methods:The study was performed in the surgical ICUs of four university hospitals in Izmir province, Turkey and was conducted in accordance with the Declaration of Helsinki and approved by an Ethics Committee. The sample comprised 113 nurses working in the surgical ICUs of the hospitals between November 2018 and February 2019. Data were collected using a questionnaire that comprised a demographic form, adverse events form, and patient safety culture hospital questionnaire. Student's t test, one-way analysis of variance, and logistic regression analyses were used to evaluate the data. P values <.05 were considered significant.Results: At the end of the study, nurses' level of patient safety culture was found to be intermediate (65.5%), with the highest average positive response rate (PRR) obtained for teamwork within the units (65.5%) and the lowest average PRR obtained for the frequency of adverse event reporting (25.3%). There was a significant correlation between patient safety culture and adverse events (r = 0.027, P < .05).Conclusions: Surgical ICUs nurses' level of patient safety culture was average, and there was a significant correlation between patient safety culture and adverse events.Relevance to clinical practice: Managers should establish a reliable system for reporting adverse events and encourage ICU nurses to report them. It is very important to adopt a non-punitive approach at instances when an adverse event is reported.

It is recommended that training is provided that includes recognition, assessment and application of appropriate interventions to minimise the incidence of delirium.

Aims  Time of showering after surgery is still a controversial issue for surgical patients and health professionals. We evaluated the effects of showering in 48–72 h after median sternotomy on sternal wound infections, pain due to sternotomy, patient comfort, and satisfaction levels. Methods and results  The study was a randomized controlled clinical trial. Fifty-one patients were randomly allocated (1:1) to the shower (n = 26) or non-shower group (n = 25). The patients in the shower group (intervention group) showered in the first 48–72 h after surgery and the patients in the non-shower group (control group) were not allowed to shower until their chest tube sutures were removed. They were instructed to shower on the next day after removal of the chest tube sutures. The rate of sternal wound infections was significantly lower in the shower group (n = 2, 7.7%) than in the non-shower group patients (n = 8, 32.0%; P = 0.038). A logistic regression analysis showed that early post-operative showering was protective and significantly reduced the risk of sternal wound infections independently of other variables [odds ratio (OR): 0.177; 95% confidence interval (CI): 0.033–0.940; P = 0.042]. The pain severity score was significantly lower in the shower group patients. Also, comfort and satisfaction scores were significantly higher in this group (P &lt; 0.05). Conclusion  Early showering after sternotomy was found to be protective against sternal wound infections and had a positive effect on pain, comfort, and satisfaction. Trial registration  Clinical Trials.gov registration number NCT04250961 (https://clinicaltrials.gov/ct2/show/NCT04250961).