Knee arthroscopy: positioning and draping

Knee arthroscopy: positioning and draping

In knee arthroscopy (often referred to as a type of keyhole surgery), the surgeon needs the patient to be placed in a very specific way. The patient is positioned supine (face up) on the table. The injured knee must be in a leg holder and the foot of the table is lowered. The leg holder is placed around the thigh, allowing the surgeon to move the leg to valgus and varus (from one side to another) during the intervention. 

The patient´s extremity has to be prepared and draped. Draping involves using impervious stockinet and a standard knee arthroscopy drape with a waterproof surface and a fluid pouch.  

The surgeon needs an inflow fluid system to expand the knee, which makes it easier for the surgeon to see inside the joint. Therefore the sheath of the arthroscope has an inflow (for the fluid) and an outflow (for the suction).

The surgeon accesses the knee joint through two small incisions.  By the anterolateral portal, the surgeon introduces the arthroscope into the knee joint and begins the inspection of the joint.  The arthrocope is connected to a camera to allow the image to be viewed by the medical team (and the patient) on flat screen TV monitors. Through the other incision, the surgeon introduces specific instruments: probe hook, graspers, cutting grasper, motorised shaver, etc.

Dr. Enrique Galindo Andújar does this type of surgery with local anesthetic (only anesthetizing the knee) in several private Hospitals in Madrid, ensuring the best possible patient care with latest optimum conditions to achieve successful knee surgery. 

Elena Miguel Poza - Nurse, nursing coordinator & trainer - Enfermera coordinadora y profesora de enfermería - IMTRA Instituto Madrileño de Traumatologia (Madrid Spain)
Tel: (0034) 915545405 Email: elena@imtra.es Web site in English: http://www.imtra.eu Web site in Spanish: www.imtra.biz

Summer is to enjoy, but take care!

Summer is to enjoy, but take care!

In summer, we have more free time. We can spend more time outside and we can share more time with our family and friends.

We change our place of residence and activities. This is very nice but we have to take a number of precautions about:

a) Sun exposure with caution:

·      Sunscreen creams,

·      Hats,

·      Summer clothes,

·      Sunglasses,

·      Choice of appropriate time for exercise etc.

b) Drink plenty of liquids:

·      Water is the best,

·      Not too many sweet drinks,

·      Natural drinks are better, etc.

c) Sport in summer:

·      Gradual increase in levels of physical activity,

·      Muscle warming before physical activity,

·      Muscle stretching after physical activity,

·      Appropriate equipment, footwear, etc.

d) A balanced diet:

·      A variety of healthy foods,

·      Food handling care (washed vegetables and fruit)

e) Proper use of clothing and footwear depending on the situation: beach, mountain, sea, city, etc.

Summer is fun, but be careful!

Elena Miguel Poza - Nurse, nursing coordinator & trainer - Enfermera coordinadora y profesora de enfermería - IMTRA Instituto Madrileño de Traumatologia (Madrid Spain)
Tel: (0034) 915545405 Email: elena@imtra.es Web site in English: http://www.imtra.eu Web site in Spanish: www.imtra.biz

Professional Competences of Nursing in Spain

Professional Competences of Nursing in Spain

Valuing the work of Spanish nursing, we can ask:

·      Can any nursing professional work in any area?

·      Is the nursing performance evaluated?

·      Is the professional development and training of the nurses recognised?

Is professional competence recognised?

At this point, it is essential to define the word “Competence”. It is the combination of necessary:

1.     Knowledge, 
2.     Skills, 
3.     Capacity, 
4.     Attitude, and 
5.      Motivation

for successful occupation of a role or a particular job (Lyle M Spencer y Signe M Spencer 1993).

In Spain, the competence development is a right and an obligation of the nursing professionals. There are several laws that establish the obligation to prove the competence in the nursing work:

•       Ley Ordenación Profesiones Sanitarias 44/2003: Titulo I. Del ejercicio de las profesiones sanitarias. Artículo 4.6:
•        Ley 16/2003, de 28 de mayo, de cohesión y calidad del Sistema Nacional de Salud. Artículo 40 y Articulo 42. Desarrollo profesional.

It is essential the development of knowledge and skills through the Continuing Accredited Education.

Nursing is a profession in constant change and requires constant updating. It is necessary to:

•       Promote the training of Nursing;

•       Develop nursing skills;

•       Define standards of clinical practice; and

•       Minimize the variability in nursing practice and its adverse effects.

Elena Miguel Poza - Nurse, nursing coordinator & trainer - Enfermera coordinadora y profesora de enfermería - IMTRA Instituto Madrileño de Traumatologia (Madrid Spain)
Tel: (0034) 915545405 Email: elena@imtra.es Web site in English: http://www.imtra.eu Web site in Spanish: www.imtra.biz

Nursing and Information & Communications Technology (ICT)

Nursing and Information & Communications Technology (ICT)

The concept of Information and Communications Technology (ICT) is very large but currently everybody uses this technology at work and in the private life.

Who does not know Whatsapp, email, Facebook or Google?  Who does not use mobile apps on Smartphones, tablets and mobile devices?

Nurses can use ICT to benefit and improve their professional work.

In this environment, e-Health was born. This term is used for healthcare practice supported by electronic processes and communication.

Possibilities of work with ICT are very wide, including in the areas of:

•        Education
•        Information
•        Diagnosis
•        Patient tracking
•       Technical support, etc.

And it is possible to use:

•        Radio
•       Television
•        Applications (Apps- software)
•        Social network
•        Videoconferencing
•        Distance learning, etc.

In last Congress of the Spanish Traumatology and Orthopaedic Nursing Association (AEETO) held in April 2015 in Alicante, we had the opportunity to receive presentations about several Nursing Apps developed by Nurses to solve daily nursing problems:

·      Enfermería Med IV (indication of medicines, compatibilities, calculation of perfusion, access to the technical specifications of the drug. Nursing techniques based on evidence.

·      Tradassan (TRADuctor para la ASistencia SANitaria). This App facilitates communication between works of a health service and foreign users who have difficulties with the local language.

It is necessary to incorporate all kinds of professional support into our daily health care work and to open our mind to new alternatives.

Links:

Enfermería Med IV is available at the following link on the Googleplay store for Android mobile devices and tablets:

https://play.google.com/store/apps/details?id=appinventor.ai_probledoc.Enfermeria&hl=es

Please note that it is not yet available for the iPhone or  iPad on iTunes.

Tradassan is available at the following link:   or for iPhone and iPad on iTunes:

https://itunes.apple.com/es/app/tradassan/id897901563?mt=8

and for Android mobile devices and tablets on the Googleplay store:

https://play.google.com/store/apps/details?id=org.gobiernodecanarias.sanidad.scs.Tradassan&hl=es

Elena Miguel Poza - Nurse, nursing coordinator & trainer - Enfermera coordinadora y profesora de enfermería - IMTRA Instituto Madrileño de Traumatologia (Madrid Spain)
Tel: (0034) 915545405 Email: elena@imtra.es Web site in English: http://www.imtra.eu Web site in Spanish: www.imtra.biz