4R危机理论的护理风险管理在老年髋部骨折患者中的应用效果

The application effect of nursing risk management based on 4R crisis theory in elderly patients with hip fractures

目的探究4R危机理论的护理风险管理在老年髋部骨折患者中的应用效果。方法选取在该院2021年1月至2022年12月就诊的128例老年髋部骨折患者为研究对象,按入院时间不同分为对照组(69例,2021年1-12月)与研究组(59例,2022年1-12月)。对照组进行常规护理,研究组在此基础上进行4R危机理论的护理风险管理。比较两组骨折愈合时间、术中出血量、首次下床时间、体温、凝血功能、并发症、生活质量及满意度。结果研究组骨折愈合时间及首次下床时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。研究组术中体温高于对照组,术后纤维蛋白原(FIB)水平低于对照组,术后凝血酶原时间(PT)及活化部分凝血活酶时间(APTT)长于对照组,差异均有统计学意义(P<0.05)。研究组围术期低体温及并发症总发生率分别为18.64%、8.47%,低于对照组的55.07%、23.19%,差异均有统计学意义(P<0.05)。两组术后社会功能、心理功能、躯体功能及物质生活状态评分高于术前,且研究组高于对照组,差异均有统计学意义(P<0.05)。研究组总满意率为96.61%,明显高于对照组的85.51%,差异均有统计学意义(P<0.05)。结论对老年髋部骨折患者进行4R危机理论的护理风险管理可预防其围术期低体温,提高其术后生活质量。

Objective To explore the application effect of nursing risk management based on the 4R crisis theory in elderly patients with hip fractures.Methods A total of 128 elderly patients with hip fractures who visited Mianyang Hospital Affiliated to Medical College of University of Electronic Science and Technology of China from January 2021 to December 2022 were selected as objects,and divided into control group(69 cases,from January to December 2021)and study group(59 cases,from January to December 2022)based on different admission time.The control group received routine nursing care,while the study group received nursing risk management based on the 4R crisis theory.Compare the fracture healing time,intraoperative bleeding volume,first time out of bed,body temperature,coagulation function,complications,quality of life,and satisfaction between two groups.Results The results showed that the fracture healing time and first time of getting out of bed in the study group were shorter than those in the control group,and the intraoperative body bleeding was less than that in the control group(P<0.05).The study group had higher intraoperative temperature,lower postoperative fibrinogen(FIB)level,longer postoperative Prothrombin time(PT)and activated partial thromboplastin time(APTT)than those in the control group(P<0.05).The total incidence of perioperative hypothermia and complications in the study group were 18.64% and 8.47% respectively,which were lower than 55.07% and 23.19% in the control group(P<0.05).The postoperative social function,psychological function,physical function,and material life status scores of the two groups were h igher than before surgery,and which in the study group were higher than those in the control group(P<0.05).The total satisfaction rate of the study group was 96.61%,which was higher than 85.51% in the control group(P<0.05).Conclusion Nursing risk management based on the 4R crisis theory for elderly patients with hip fractures can prevent perioperative hypothermia and improve their postoperative quality of life.