Analysis of the Role of Nursing Intervention in Operating Room in the Prevention of Incision Infection in Orthopedic Aseptic Surgery

Objective:To explore and analyze the role of nursing in the operating room in the prevention of incision infection in aseptic orthopedic surgery.Methods:68 patients that underwent aseptic orthopedic surgery in our hospital from January 2021 to December 2022.They were divided into a research group(n=34)and a control group(n=34)by the random number table method.The patients in the control group received conventional nursing intervention in the operating room,and the patients in the study group received the optimized and modified nursing intervention in the operating room;then,the related indicators of nursing intervention of the two groups were compared.Results:The incidence of incision infection in the study group was lower than that of the control group(P<0.05);the average duration of surgery and length of stay the study group were lower than those in the control group(P<0.05);the stress response indexes of patients in the study group were lower than those in the control group 24 hours after operation(P<0.05);the degree of satisfaction of the patients in the study group to the services provided by the nursing staff was significantly higher than that of the control group(P<0.05).Conclusion:High-quality nursing intervention in the operating room for aseptic orthopedic surgery patients can significantly reduce the incidence of incision infection,reduce the stress response caused by surgery,shorten the duration of surgery and length of stay,and improve nursing satisfaction,which makes it worthy of popularization.

Analysis of the Influence of Operating Room Nursing Care Management on the Incidence Rate of Nosocomial Infection in Orthopedic Surgery Patients

Objective:To analysis the influence of operating room nursing care management on the incidence rate of nosocomial infection in orthopedic surgery patients.Methodology:Fifty six orthopedic surgery patients who admitted into the hospital between January to December 2018 were enrolled into this study and randomly divided into two groups,which were the control group(under general management)and the observation group(under the operating room nursing care management).Further,the incidence rate of nosocomial infections,the incidence rate of irregular nursing care phenomena,the satisfaction score of nursing care management,and the quality of life score were observed and recorded.Result:The incidence rate of nosocomial infection,the incidence rate of irregular nursing care management,the satisfaction score of nursing care management,and the quality of life score of the observation group were compared to that of the control group,and the result showed P<0.05,indicates the statistical significance between the data indicators.Conclusion:The use of operating room nursing care management in patients with orthopedic surgery has shown a significant effect.

The Application of Forward Control Nursing in Anesthesia, Recovery, and Rehabilitation of Thoracoscopic Lung Cancer Radical Surgery

Objective: To explore the clinical application effect of formulating the operating room nursing work procedure sheet for elderly lung cancer patients in thoracoscopic radical surgery. Methods: A total of 85 elderly patients with lung cancer treated in our hospital from May 2022 to May 2023 were included as the study population for this research. They were divided into a study group of 42 cases and a regular group of 43 cases. The regular group of elderly patients received routine nursing care, while the study group of elderly patients was provided with the operating room nursing care work procedure sheet. The surgical duration, intraoperative blood loss, time to mobilization, and postoperative complication rate were compared and analyzed between the two groups. Results: Compared to the regular group, the study group had significantly shorter surgical duration and time to mobilization, as well as less intraoperative blood loss (P < 0.05). The overall incidence of postoperative complications in the study group (4.76%) was significantly lower than that in the regular group (19.05%) (P Conclusion: Formulating the operating room nursing work procedure sheet for elderly lung cancer patients can effectively improve surgical efficiency, reduce the incidence of postoperative complications, and promote patient prognosis in thoracoscopic radical surgery. Therefore, this model is worth promoting and adopting in clinical practice.

Effect of Nursing Intervention in Operating Room for Patients with Gastric Cancer during Anesthesia Recovery Period

Objective: To analyze the effect of nursing intervention in operating room for gastric cancer patients in anesthesia recovery period. Methods: From June 2021 to December 2021, 78 patients who underwent gastric cancer surgery in our hospital were selected for research. Combined with the random number table method, they were divided into the control group (providing routine nursing care in operating room) and the observation group (providing nursing intervention in operating room) with 39 patients in each group respectively. The body temperature of the two groups during operation, during abdominal closure and after operation, the time of leaving anesthesia room, extubation, postoperative wakefulness and hospitalization, degree of satisfaction with nursing work was compared. Results: Compared with the control group, the body temperature in the observation group tended to be more normal during operation, during abdominal closure and after operation (P 0.05). The time of leaving anesthesia room, extubation, postoperative wakefulness and hospitalization in the observation group were shorter than those in the control group (P 0.05). The satisfaction degree of the observation group with nursing work was higher than that of the control group (P 0.05). Conclusion: Nursing intervention in operating room is effective for gastric cancer patients in anesthesia recovery period, which can maintain their perioperative temperature stability, promote their postoperative recovery and enhance their satisfaction with nursing work. It is worth adopting.

Establishment and application of eye surgery preparation room

This paper aims to discuss the application of eye surgery preparation room( ESPR),also called eye preoperative holding area,in nursing safety assessment and the surgery preparation before ophthalmologic operation. The establishment and application of ESPR optimizes the process of ophthalmologic surgery as w ell as decreases the surgery-w aiting time of patients and turnover period of surgical operations,w hich improves the utilization efficiency of surgery operating room. In addition,the application of ESPR also guarantees the safety of patients during surgical operations and enhances the doctors' satisfaction of cooperation and coordination in surgery operating room.

手术室精细化护理对心脏手术患者切口感染及护理满意度的效果分析

探讨手术室精细化护理对降低心脏手术患者术后切口感染程度以及护理满意度的效果,以减少心脏手术患者的切口感染率、提高患者对护理工作的满意度。根据非概率抽样方法选取在XXX医院心血管外科进行心脏手术治疗的64例患者为研究对象,将其分为治疗组和对照组,每组各32例。治疗组采取手术室精细化护理,对照组采用手术室常规护理。比较两组患者的病原菌检测、切口感染率及感染控制率、护理工作满意度等。结果表明,治疗组病原菌检出率、切口感染率显著低于对照组,感染控制率显著高于对照组(P<0.05),治疗组对手术室精细化护理的满意度显著好于对照组(P<0.05)。说明手术室精细化护理可有效预防心脏手术患者的术后切口感染,促进其愈合,并提高患者对护理工作的满意度。

骨科患者术中下肢深静脉血栓风险增高的血流变化及影响因素

目的探讨骨科患者术中下肢深静脉血栓(DVT)风险增高的血流变化特点并分析其影响因素,为手术室护理干预提供临床指导。方法选取151例骨科择期手术患者为研究对象,术中使用多普勒超声诊断仪观察下肢血流改变特征,并收集患者基本资料、手术相关资料、术前实验室检查指标等,患者手术结束24 h内采血行D-二聚体凝血功能检测。结果D-二聚体检测结果显示,DVT高风险患者70例(46.36%),低风险81例(53.64%)。手术结束后DVT高风险患者下肢平均血流速度、血管内径显著低于或小于低风险患者(均P<0.05)。logistic回归分析显示,手术时间>120 min、凝血酶原时间(PT)>13.1 s、术中发生低体温和术中失血量>100 mL是骨科患者术中DVT风险增高的独立危险因素(均P<0.05)。结论骨科手术患者术中DVT发生风险较高,存在明显血流动力学改变。手术室护理人员需针对性地开展手术效率管理、术中低体温监测和预防、维持术中血容量稳定,有效降低骨科手术患者术中DVT发生风险。

手术沙滩椅体位摆置标准作业程序的建立及应用

目的研究手术沙滩椅体位(beach chair position,BCP)摆置标准作业程序(standard operation procedure,SOP)的建立及应用。方法采用方便抽样的方法,选取2020年10—12月厦门大学附属第一医院收治的16例肩关节镜手术患者为对照组,以对等原则选取2021年1—3月收治的16例患者为观察组。对照组按常规手术体位摆置;观察组按BCP摆置SOP实施摆置。比较2组摆置时间、团队协作熟悉度及医生满意度,并就对手术BCP摆置SOP进行评价。结果观察组手术体位摆置时间为(471.81±52.41)s,短于对照组的(719.13±66.94)s(P<0.05);观察组手术医生的满意度高于对照组,手术团队协作熟悉度评分高于对照组,差异有统计学意义(P<0.05)。2组麻醉医生满意度比较,差异无统计学意义(P>0.05)。团队成员对手术BCP摆置SOP评价认可度均较高。结论手术BCP摆置SOP的建立及应用使手术体位护理规范化、标准化、同质化,有效提高手术室护理质量和工作效率。

机器人手术护理配合中国专家共识(2024版)

由于具有3D高清可放大的手术视野、震颤自动过滤系统及7个自由度的可转腕手术器械,机器人手术系统可以极大地提高手术的准确度和安全性,进一步加强手术的精细化和微创化,所以在临床外科手术中的应用越来越广泛。机器人辅助手术的优势既与医生专业技能水平、手术适应证的选择相关,也与手术护理配合密切相关。本共识从制度体系建设,手术前、中、后护理配合,机器人手术安全管理5个方面规范了机器人手术护理技术,旨在进一步提高机器人手术护理的规范化和标准化。

手术室整体干预模式对肝癌介入手术患者负性情绪、并发症、生活质量及护理满意度的影响

目的探讨手术室整体干预模式对肝癌介入手术患者的负性情绪、并发症发生情况、生活质量及护理满意度的影响。方法依据干预模式的不同将120例接受介入手术的肝癌患者分为对照组(n=56)和观察组(n=64)。对照组患者围手术期给予手术室常规干预模式,观察组患者围手术期给予手术室整体干预模式。比较两组患者的负性情绪[焦虑自评量表(SAS)和抑郁自评量表(SDS)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]、并发症发生情况及护理满意度[纽卡斯尔护理满意度量表(NSNS)]。结果术后,两组患者的SAS、SDS评分均明显低于本组术前,观察组患者的SAS、SDS评分均明显低于对照组,差异均有统计学意义(P﹤0.01);观察组患者术后并发症总发生率为17.19%,低于对照组患者的35.71%,差异有统计学意义(P﹤0.05);术后,两组患者的EORTC QLQ-C30评分均明显高于本组术前,观察组患者的EORTC QOL-C30评分明显高于对照组,差异均有统计学意义(P﹤0.01)。出院时,观察组患者的护理满意度为98.44%,高于对照组患者的85.71%,差异有统计学意义(P﹤0.05)。结论手术室整体干预模式能明显减轻肝癌介入手术患者的焦虑、抑郁情绪,降低术后并发症发生率,提高患者的生活质量及护理满意度。

基于ERAS理念的手术室护理模式在全髋关节置换术患者中的应用效果

目的探讨基于加速康复外科(ERAS)理念的手术室护理模式在全髋关节置换术患者中的应用效果。方法选取2021年7月至2022年7月于本院接受诊治的80例全髋关节置换术患者作为研究对象,以随机数字表法将其分为对照组和观察组,各40例。对照组予以常规手术室护理,观察组予以基于ERAS理念的手术室护理模式。比较两组的术后恢复指标、并发症发生情况、髋关节功能、疼痛程度以及应激反应指标。结果观察组的术后下地活动时间、首次排气时间、首次排便时间以及住院时间均短于对照组,并发症总发生率低于对照组(P<0.05)。护理后,观察组的Harris评分高于对照组,视觉模拟评分法(VAS)评分低于对照组(P<0.05)。护理后,两组的去甲肾上腺素(NE)、C反应蛋白(CRP)、皮质醇(Cor)水平均升高,但观察组低于对照组(P<0.05)。结论基于ERAS理念的手术室护理模式能明显降低全髋关节置换术患者术后疼痛感及应激反应,改善髋关节功能,促进康复,提升预后效果。

机器人辅助手术的护士培训方案构建及应用

目的构建机器人辅助手术(robotic-assisted surgery,RAS)的护士培训方案并探讨其应用效果。方法基于文献回顾法和半结构式访谈法构建RAS的护士培训方案初稿。于2022年2月—4月,运用专家函询法对26名专家进行2轮函询,形成RAS的护士培训方案。采用便利抽样法,将2022年4月—7月在某三级甲等医院接受RAS配合培训的32名手术室护士作为对照组,将2022年8月—11月在该院接受同类培训的32名手术室护士作为试验组。对照组接受常规培训,试验组接受基于RAS的护士培训方案打造的培训,比较两组培训效果。结果2轮专家函询的问卷有效回收率均为100%;专家权威系数为0.933;肯德尔协调系数分别为0.261、0.312(P<0.001)。最终构建的RAS的护士培训方案由6个模块及其下设的85个条目构成。培训后,试验组理论考核得分、RAS系统无菌罩安装时间、RAS系统内镜校准操作时间、RAS系统入位操作时间、RAS系统入位一次成功率、RAS术前截石位摆放操作考核得分优于对照组(均P<0.05)。结论RAS的护士培训方案较为科学、可靠,其运用有助于提升护士配合RAS的知识与技能水平,提高培训效果。

HFMEA在腹腔镜手术中转开放手术配合中的应用

目的探讨医疗失效模式与效应分析(healthfailuremode and effect analysis,HFMEA)在腹腔镜手术中转开放手术配合中的应用效果。方法选取2022年1—6月厦门大学附属第一医院收治的718例腹腔镜手术患者作为实施前;选取2022年7—12月厦门大学附属第一医院收治的662例腹腔镜手术患者作为实施后。2022年6月组建跨专业的多学科小组,梳理腹腔镜手术中转开放手术实施的关键环节,对中转开放手术实施过程中可能出现的失效模式进行严重度、发生的可能性、探测的可能性评分,根据危害评分矩阵评估风险优先指数(risk priority number,RPN),针对RPN>125分的5项失效模式进行改进。比较实施前后的RPN和应急抢救配合满意度。结果腹腔镜手术中转开放手术安全管理体系中包括手术间管理不符合要求、人员管理不符合要求、临床实施操作不规范、仪器及设备运行失效、手术护理记录不规范5个方面17个风险点;其中有8个风险点需要采取措施进行控制,实施控制措施后,8个风险点的RPN值均有下降,且均<8分。手术医护团队对于实施腹腔镜手术中转开放手术管理策略的实践均表示认可。结论基于HFMEA对腹腔镜手术中转开放手术配合应急抢救进行风险识别及评估,建立腹腔镜手术中转开放手术配合安全管理机制,可有效降低腹腔镜手术中转开放手术配合应急抢救RPN,保障腹腔镜手术中转开放手术配合顺利,保障患者安全。

BOPPPS结合模拟手术教学模式在手术室腹腔镜专科护士培训中的应用

为探讨BOPPPS结合模拟手术教学模式在手术室腹腔镜专科护士培训中的应用及效果,选取在中国医科大学附属盛京医院手术室工作的护士36人,他们既往未受过有关腹腔镜手术的系统培训。随机将其分成观察组和对照组进行培训,对照组依照传统教学方式进行培训教学,观察组除了传统教学,还定期采用BOPPPS结合模拟手术教学模式,利用实验用猪进行腹腔镜模拟手术培训教学。分别于培训初始时、培训后进行理论和操作考核,培训结束后同时对两组学员进行自主学习能力问卷调查。研究表明,BOPPPS结合模拟手术教学模式具有显著的效果,能够提高学员的操作技能和专业能力,增强他们的学习兴趣和主动学习能力,并培养团队合作和沟通能力。

手术室护理管理对骨科手术患者医院感染发生率的影响研究

目的分析手术室护理管理对骨科手术患者医院感染发生率的影响。方法研究选取泉州市第一医院2022年1月至2023年1月临床收治骨科手术患者100例为研究对象,随机分组方式将其划分为对照组(常规管理,50例)和观察组(常规管理+手术室护理管理,50例),比较不同管理模式下,两组医院感染率、护理管理评估、患者满意度、焦虑自评表(SAS)、抑郁自评量表(SDS)得分及生活质量水平。结果护理后,观察组医院感染发生率以及SAS、SDS评分均低于对照组(均P<0.05);观察组患者各项护理管理评分、SF-36评分以及护理满意度均高于对照组(均P<0.05)。结论手术室护理管理能显著降低临床骨科手术患者院内感染发生率,提升临床手术室管理质量及患者满意度,且患者心理状态更优、患者生活质量水平更高。

手术室针对性护理在血管外科介入手术预防老年患者迷走神经反射的应用效果

探讨手术室针对性护理在血管外科介入手术中预防老年患者迷走神经反射的应用效果。将接受血管外科介入手术的500例≥65岁的患者按照住院先后顺序分为对照组和观察组。对照组采用围术期常规护理,观察组在对照组的基础上采用手术室针对性护理,比较两组患者术中迷走神经反射的发生率。对比分析结果显示,观察组术中迷走神经反射发生率显著低于对照组(P<0.05);观察组术后疼痛程度、抑郁焦虑情绪、术后护理满意度均显著优于对照组(P<0.05),说明采用手术室针对性护理可降低血管外科介入手术老年患者迷走神经反射发生率,减轻其生理应激反应,缓解患者的不良心理状态。

手术室实习护理学生出科考试试卷分析与教学思考

目的通过对手术室实习护理学生的出科考试试卷进行分析,以进一步提高手术室实习护士的教学质量。方法收集2021—2022学年莆田学院附属医院手术室完成实习轮转的164名护理实习学生的出科试卷答题情况,并进行统计分析。结果164名手术室实习护理学生的考试成绩为(87.94±10.07)分,优良率达81.71%,对试卷得分检测Cronbach'sα系数为0.684;KMO值0.744;高分段成绩为(96.90±2.19)分,低分段成绩为(74.82±8.66)分,差异有统计学意义(P<0.001)。结论本套试卷难度普通,试题的可信度尚佳,效度好,区分度好,提示该套出科考试试卷能够客观地反映学生的轮转期间知识掌握程度。

精细化手术室护理对宫腔镜下电切手术患者体温控制和应激反应的影响

目的探究精细化手术室护理对宫腔镜下电切手术患者体温控制和应激反应的影响。方法选取在本院开展宫腔镜下电切手术治疗的患者48例为研究对象,按照随机信封法将其分为两组,每组24例。对照组患者采用常规护理,观察组患者采用精细化手术室护理。比较两组患者麻醉前、麻醉5min、手术15min与麻醉清醒后的体温水平,以及术中应激反应指标(心率、平均动脉压)。结果两组患者麻醉前、麻醉5min体温比较差异无统计学意义(P>0.05),观察组手术15min与麻醉清醒后体温高于对照组,差异有统计学意义(P<0.05)。观察组术中心率及平均动脉压低于对照组,差异有统计学意义(P<0.05)。结论精细化手术室护理应用在宫腔镜下电切手术患者护理中的效果显著,对患者体温控制与应激反应具有积极影响,可保证患者手术效果,值得临床推广与应用。

ERAS理念下手术室护理对腹腔镜肝切除术患者围手术期护理的影响

目的 探讨加速康复外科(ERAS)理念下手术室护理对腹腔镜肝切除术患者围手术期护理的影响。方法 选取2021年1月至2022年12月安徽省黄山市人民医收治的腹腔镜肝切除术患者82例进行前瞻性研究,按随机数字表法将其分为对照组和干预组,每组41例。对照组应用常规护理干预,干预组接受ERAS理念下的手术室护理。比较两组围手术期相关指标、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、视觉模拟评分法(VAS)评分及依从性评分情况,并对两组术后并发症进行统计。结果 干预组手术、拔管、意识恢复、进食、胃肠恢复、下床、住院时间短于对照组,术中出血量少于对照组(P<0.05)。整体分析发现:两组术中体温组间比较、时间点比较及交互作用比较,差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:两组手术各时间点体温比较,差异有统计学意义(P<0.05);组间比较:干预组手术15、30 min,以及手术结束时体温低于对照组(P<0.05)。干预后,两组SAS、SDS、VAS评分低于干预前,且干预组均低于对照组(P<0.05)。干预后,两组运动、感知、用药及饮食评分高于干预前,且干预组高于对照组(P<0.05)。干预组并发症总发生率低于对照组(P<0.05)。结论 ERAS理念下的手术室护理对腹腔镜肝切除术患者的围手术期相关指标、焦虑抑郁情绪及依从性均具有明显的改善作用,可明显降低其术后并发症,值得推广。

宫腔镜手术治疗黏膜下子宫肌瘤的手术室护理配合分析

目的 分析宫腔镜手术治疗黏膜下子宫肌瘤中采取改良手术室护理配合的应用价值。方法 纳入本院2019年1月至2022年12月收治的行宫腔镜手术治疗的黏膜下子宫肌瘤患者73例,以随机数字表法分组,对照组36例采取常规手术室护理,观察组37例采用改良手术室护理配合,比较两组术后恢复时间(卧床时间、首次排气时间、住院时间),分析两组护理前后手术应激(皮质醇、心率)、心理状态(SAS、SDS评分)、生存质量(SF-36评分)及患者对护理的满意度。结果 术后恢复时间,观察组短于对照组(P <0.05);护理后,观察组手术应激状态、SAS、SDS、SF-36评分均优于对照组(均P <0.05)。观察组患者对护理的满意度高于对照组(P <0.05)。结论 基于传统手术室护理基础上的加强手术室护理配合能够有效减轻患者应激反应,缓解不良情绪,缩短术后恢复时间,提高术后生存质量。