护士在快速通道关节外科围手术期的作用

The Role of Nursing in Fast Track Arthroplasty

目的探讨护士快速通道关节外科围手术期的作用。方法 1首先灌输FTA的理念;2迅速制定FTA的护理操作程序;3有效实施FTA各环节的护理措施,包括:门诊院前检查中心工作;术前准备(术前医护、患者及家属的沟通;术前护理评估与术前访视;术前禁食时间的改变及术前用药);术中配合(快通道麻醉的配合;术中保温;术后苏醒室观察);术后护理(合理限制液体输入;疼痛评估及镇痛效果评价;血栓预防;缩短引流管放置时间;快速恢复正常饮食;术后早期功能锻炼);出院前教育和出院后随访及家庭康复锻炼。结果 2015年,本院率先将快速通道关节外科的理念及技术应用于骨科医院关节外科。结论随着快速关节通道理念和技术的应用,逐步将该理念及技术推广至外科其他领域。

Objective To explore the role of nursing in fast track arthroplasty （FTA）. Method Propagate the concept of FTA at first, and then establish FTA nursing procedure. Once the procedures have been established, the nurses should implement all of these procedures in all aspects, which include examination in out - patient department before admission, preoperative preparation （ including communication with patients and their family members preoperatively, preoperative nursing assessment and preoperative visit, and alteration of duration of preop- erative fasting time and premedication）, intraoperative coordination （including fast track anesthesia, intraoperative warming and observation in postoperative recovery room） , postoperative nursing （including controlling fluid infusion, pain assessment and evaluation of analgesia, thromboprophylaxis, shortening drain time, fast recovery of normal diet, and postoperative functional training at early stage）, education before discharge, and follow - up and family rehabilitation after discharge. Result Our hospital, has taken the lead in applying the concept of fast track arthroplasty in Department of Joint Surgery. Conclusion With the application and progress of fast track arthroplasty, it will be spread and extended to other surgical departments.