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.

Effectiveness of Comprehensive Nursing Management in Enhancing Blood Donation Outcomes and Donor Experience: A Comparative Study

Objective:To assess the management effect of comprehensive nursing management on blood donation services in blood stations.Methods:Sixty-four individuals who donated blood at a blood station between September 2021 and September 2023 were selected and randomly assigned into two groups of 32 each.The first group received comprehensive nursing management,while the second group received routine nursing management.Blood donation indexes and observational indexes such as adverse reactions were compared between the groups.Results:The total blood donation volume and qualified blood donation volume were higher in the first group than in the second group.The amount of discarded blood and the rate of blood discards were lower in the first group compared to the second group(P<0.05).Additionally,the adverse reaction rate in the first group was lower,the blood donation comfort scores were higher,the psychological state scores were lower,and the quality of care scores were higher than those in the second group(P<0.05).Conclusion:Comprehensive nursing management can improve the efficiency of blood donation,reduce the rate of blood discards,decrease the incidence of adverse reactions,alleviate negative psychological states of blood donors,and enhance both the comfort level of blood donation and the quality of care provided.

Application of Specialized Group Management in the Quality Control of Perioperative Nursing

Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.

Effects of comprehensive nursing with cognitive behavioral therapy in orthodontic osteodilated arch treatment

BACKGROUND This work explored the effects of cognitive behavior therapy(CBT)-based comprehensive nursing intervention(CNI)mode in arch expansion to treat patients with orthodontic osteodilated arch(OOA).AIM To explore the application effect of CBT-based CNI model in orthodontic expansion arch treatment.METHODS Using convenient sampling method,81 patients with OOA were selected and rolled into a control group(Ctrl group,40 cases)and an observation group(Obs group,41 cases).During the treatment,patients in the Ctrl group received routine nursing intervention mode,and the those in the Obs group received CBT mode on the basis of this.Before and after intervention,the incidence of oral mucositis,the mastery rate of correct arch expansion method,self-rating anxiety scale score,soft scale index,and plaque index were compared for patients in different groups.In addition,satisfaction and complications were comparatively analyzed.RESULTS Incidence of oral mucositis in the Obs group was lower(14.6%vs 38.5%),and the mastery rate of correct arch expansion method was obviously higher(90.2%vs 55.0%)was obviously higher(all P<0.05).Meanwhile,the soft scale index and plaque index in the Obs group were much lower(P<0.05).The compliance(90.24%)and satisfaction(95.12%)in the Obs group were greatly higher(P<0.05).CONCLUSION The CBT-based CNI mode greatly improved the mastery rate of correct arch expansion method during arch expansion in treating patients with OOA and enhanced the therapeutic effect of arch expansion and the oral health of patients,improving the patient compliance.

Implementation of a risk management plan in a hospital operating room

A risk management program based on ASeNZS4360 risk management standards was developed and implemented in the operating room of Peking University Third Hospital.To accomplish this task,we developed a risk quantification matrix and a risk register form to identify potential risks in the operating room,and then implemented operating room policies designed to reduce or eliminate those risks.We also established a consultation mechanism and risk monitoring system designed to minimize risks to operation room nurses.Finally,we continuously seek to improve our operating room risk management capabilities,so we can continue to improve the quality of service provided and guarantee the safety of surgical patients.

Corroborative Activities and Recognition Between Community Comprehensive Care Unit’s Nurses and Care Managers in Supporting Discharge of Elderly from Hospital - A Secondary Publication

Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the elderly from the hospital. Methods: A total of 300 nurses working in community comprehensive care wards and 360 care managers working in B City in A Prefecture were surveyed using an anonymous self-administered questionnaire. Results: The highest percentage of responses regarding necessary collaborative activities with multiple professions in supporting hospital discharge were the same for Ns and CMs. The items regarding practice with the highest percentages were “relationship as a team” for Ns, and “user-centered awareness” for CM. While these professionals were willing to share information about their patients’ lives after discharge, the percentage of those explaining their expertise was low. It is thought that collaborative activities focusing on these aspects would lead to more appropriate discharge support.

TOPCARES-CDIO与目标导向管理在手术室新护士培训中的应用

目的探讨以目标为导向的计算机教育改革-构思、设计、实施、运行(target oriented project centered authenticity enhanced reform of computer education based on-conceive,design,implement,operate,TOPCARES-CDIO)理念结合目标导向管理在手术室新进护士教育培训中的应用效果。方法采用前后对照研究设计,选取2019年1月—2023年6月于河北大学附属医院手术室工作不足1年的60名新进护士,随机分为对照组与试验组,每组30名。对照组采用传统的教育培训模式,试验组采用TOPCARES-CDIO理念结合目标导向管理的教育培训模式。比较2组新进护士培训前后的核心能力、护理实践行为、职业获益感、技能能力、护理质量和医患满意度等指标的变化。结果培训后,2组新进护士的核心能力、护理实践行为、职业获益感、技能能力、护理质量和医患满意度得分高于护理前,且试验组高于对照组,差异有统计学意义(P<0.05)。结论TOPCARES-CDIO理念结合目标导向管理的教育培训模式能有效提高手术室新进护士的核心能力、护理实践行为、职业获益感、技能能力、护理质量和医患满意度,有利于促进手术室新进护士的专业发展和团队协作。

Analysis of the Effect of Infection Control in Hospital Operation Room

Objective:To explore the implementation effect of nursing management in operating room for hospital infection control.Methods:100 cases of patients who received surgical treatment in our hospital from 2019 to 2020 were selected and divided into observation group and control group according to different nursing management methods in operating room.Patients in the control group received routine nursing management services,while patients in the observation group received systematic and highquality comprehensive management services based on routine nursing management services.Results:The air colony count and hand colony count of the observation group were significantly better than those of the control group.At the same time,the incidence probability of infection in the observation group was also significantly lower than that of the control group,with significant difference between the groups,with statistical value(P<0.05).Conclusions:In view of the occurrence of nosocomial infection,the implementation of high-quality operating room nursing service can effectively control it,reduce the probability of occurrence,and ensure the safety of patient treatment,which is worthy of clinical application.

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。

广东省二、三级医疗机构延续护理部门设立及运作现况调查

目的:了解广东省二、三级医疗机构延续护理部门的设立及运作情况,为医疗机构建设延续护理部门、开展延续护理提供参考和借鉴。方法:采用便利抽样法于2023年5月4日—19日选取广东省110所二、三级医疗机构的护理管理人员进行调查,调查其所在医疗机构延续护理部门的建立情况、运作情况、阻滞因素及相关建议。结果:110所医疗机构中有35所(31.82%)设立了延续护理部门,58所(52.73%)拟计划开展延续护理服务,17所(15.45%)暂无设立延续护理部门及开展延续护理的计划。已开展延续护理的35所医疗机构中,2010年前设立延续护理部门的有3所(8.57%),2010—2018年有9所(25.71%),2019年至今有23所(65.71%)。35所医疗机构延续护理运作情况良好,但在医疗收费、医院-社区联动及延续护理质量指标设置方面需进一步加强和完善。51所(46.36%)医疗机构认为设立延续护理部门开展延续护理服务无障碍,59所(53.64%)认为存在障碍,障碍因素主要包括人力资源短缺(79.66%)、经济效益受限(76.27%)、实施场地缺乏(54.24%)、不知如何开展(32.20%)、院领导不支持(23.73%)等。结论:因缺乏统一、规范的标准及指南,广东省二、三级医疗机构延续护理部门的设立及运作情况参差不齐且存在多方面争议、困惑及不足。建议从“相关政策制度、部门组织架构、信息共享与协调机制、服务收费与支付机制、延续护理质量评价指标、工作人员绩效”等方面完善延续护理部门的设立及运作,从而推进延续护理的发展,助力实施健康中国战略。

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。

基于九宫格思维模型的手术室护理管理在胸腔镜手术中的应用效果

目的探究基于九宫格思维模型的手术室护理管理在胸腔镜手术中的应用效果。方法选取2021年1月—2023年1月医院收治的接受胸腔镜手术的患者104例为研究对象,按照组间基线资料可比的原则分为对照组和观察组,各52例。对照组采取常规模式管理,观察组在对照组基础上给予九宫格思维模型的护理管理。比较两组患者的手术效率、护理质量、患者和手术医师对手术室护理工作的满意度。结果观察组患者手术准备时间、手术操作时间、连台手术周转时间均短于对照组,差异有统计学意义(P<0.05)。观察组患者手术配合、无菌操作、文书记录、危急病处理、心理护理、专科知识、健康教育等护理质量评分均高于对照组,差异有统计学意义(P<0.05)。观察组患者对心理疏导、入室宣教、护理水平、体位干预、服务态度等手术室护理工作的满意度高于对照组,差异有统计学意义(P<0.05)。观察组手术医师对手术器械与物品准备、手术配合、应急能力、特殊器械的保管及使用、术中器械传递、护理工作态度、无菌操作、护理技能、责任意识、仪器操作水平等手术室护理工作的满意度高于对照组,差异有统计学意义(P<0.05)。结论基于九宫格思维模型的手术室护理管理在胸腔镜手术中应用效果明显,有助于提高手术效率、护理质量及患者、手术医师对手术室护理工作的满意度。

手术室实习护生人文关怀能力评价量表评分的影响因素分析

目的调查手术室实习护生人文关怀能力评价量表(CAI)评分的影响因素。方法选取2021年6月至2022年1月于川北医学院第二临床医学院/南充市中心医院手术室实习的135名护生作为研究对象。评估手术室实习护生CAI评分情况,采用多因素Logistic回归分析CAI评分的影响因素。结果135名手术室实习护生的CAI总分为(179.63±15.74)分,耐心维度得分为(55.32±7.83)分,理解维度得分为(68.63±8.12)分,勇气维度得分为(57.98±7.54)分。多因素Logistic分析结果显示,男性、未担任学生干部、无个人职业规划、工作年限≤5年、对护理专业的态度为不喜欢、性格内向、未接受过人文关怀相关培训、不经常参加集体活动均为手术室实习护生CAI评分低的影响因素(P<0.05)。结论男性、未担任学生干部、无个人职业规划、工作年限≤5年、对护理专业的态度为不喜欢、性格内向、未接受过人文关怀相关培训、不经常参加集体活动均为影响手术室实习护生CAI评分低的影响因素,临床上应注意对高危人群实施相应的改善和干预措施,提高手术室实习护生的人文关怀能力,为患者提供更好更优质的护理服务。

手术室口诀式项目管理预防原位肝移植患者术中获得性压力性损伤的效果

目的探讨手术室口诀式项目管理预防原位肝移植患者术中获得性压力性损伤(intraoperative acquired pressure injury,IAPI)的效果。方法选取2022年1月-2023年10月于笔者所在医院行肝移植手术的64例患者为研究对象。按照入院先后顺序,将2022年1月-12月的32例患者设为对照组,将2023年1月-10月的32例患者设为观察组。对照组实施术中IAPI风险常规管理,观察组采用“一看、二定、三查、四准、五巡”的口诀式项目管理,比较2组IAPI预防措施落实情况及IAPI发生率。结果观察组IAPI预防措施落实得分高于对照组(t=6.920,P<0.001),IAPI发生率低于对照组(χ2=6.093,P=0.014)。结论手术室口诀式项目管理可以促进肝移植患者IAPI预防措施的落实,降低术中获得性压力性损伤发生率,值得临床推广应用。

以人文关怀理念为指导的综合护理在肝胆结石手术患者护理中的应用效果分析

目的:分析以人文关怀理念为指导的综合护理在肝胆结石手术患者护理中的应用效果。方法:选取2022年8月—2023年5月于兰州市第二人民医院行肝胆结石手术的患者88例作为研究对象,随机分为两组,各44例。对照组实施常规护理,观察组实施以人文关怀理念为指导的综合护理。比较两组护理效果。结果:观察组首次下床时间、首次排气时间、首次进食时间早于对照组,住院时间短于对照组,差异有统计学意义(P<0.001)。护理后,两组焦虑、抑郁评分低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05)。护理后,两组认知功能、躯体功能、社会功能、情绪功能评分高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P=0.018)。结论:以人文关怀理念为指导的综合护理在肝胆结石手术患者护理中的应用效果显著,可促进患者康复,缓解患者负性情绪,提高生活质量,降低并发症发生率。

PDCA循环方法在介入手术室护理安全管理中的实施效果

目的探讨介入手术室护理采用策划-实施-检查-措施(planning-implementation-inspection-measures,PDCA)循环方法做安全管理的实施效果及临床应用价值。方法选取2022年1-12月聊城市人民医院采取介入手术做疾病治疗患者80例,采用奇偶数形式随机分为2组,各40例。参比组做常规介入手术室护理安全管理,观察组以PDCA循环方法行介入手术室护理安全管理。对比2组的手术室护理缺陷事件发生率、手术室护理管理质量、护理满意度及术中应激反应发生率。结果观察组手术室护理缺陷事件发生率为5.00%,低于参比组的22.50%(χ^(2)=5.165,P<0.05)。观察组手术室护理管理质量使用自制量表评分高于对照组(P<0.05)。观察组护理满意度各项均高于参比组(P<0.05)。观察组术中应激反应发生率低于参比组(P<0.05)。结论介入手术室护理安全管理采用PDCA循环方法,能够有效管控手术室护理缺陷事件发生率,手术室护理管理质量良好,有较高管理干预有效性。

能力素质冰山模型管理在手术室护理管理中的应用效果

目的:观察能力素质冰山模型管理在手术室护理管理中的应用效果。方法:选取2022年1—6月该院手术室76名护理人员实施常规手术室护理管理,选取2022年7—12月该院手术室76名护理人员实施能力素质冰山模型管理。比较两组护理管理质量[服务质量量表(SERVQUAL)]评分、管理前后护理人员核心能力[注册护士核心能力量表(CIRN)]评分、手术室不良事件发生率和患者满意度。结果:观察组有形性、可靠性、响应性、保证性、移情性等SERVQUAL各维度评分均高于对照组,差异有统计学意义(P<0.05);管理后,观察组批判性思维与科研、临床护理、领导能力、人际关系、法律与伦理实践、专业发展、教育与咨询等CIRN各维度评分均高于对照组,差异有统计学意义(P<0.05);观察组患者手术室不良事件发生率为3.00%(3/100),低于对照组的10.00%(10/100),差异有统计学意义(P<0.05);观察组患者满意度为97.00%(97/100),高于对照组的90.00%(90/100),差异有统计学意义(P<0.05)。结论:能力素质冰山模型管理应用于手术室护理管理可提高护理管理质量评分、护理人员核心能力评分和患者满意度,降低手术室不良事件发生率,效果优于常规手术室护理管理。

细节护理联合PDCA管理模式在手术室护理管理中的应用

目的探讨细节护理联合PDCA管理模式在手术室护理管理中的应用。方法选取2020年10月至2021年10月进行手术的患者共90例作为研究对象。按照简单数字表法将其随机分为对照组(n=45)和观察组(n=45),对照组患者给予常规护理管理,观察组患者采用细节护理联合PDCA管理模式。比较2组的消毒合格率、护理质量、风险事件发生情况以及护理满意度。结果观察组消毒合格率明显高于对照组(P<0.05)。观察组患者切口感染发生率明显低于对照组(P<0.05)。观察组患者对护理质量的评分高于对照组(P<0.05)。对照组患者的护理风险事件发生率为13.34%,观察组患者的护理风险事件发生率2.22%,观察组显著低于对照组(P<0.05)。观察组的护理满意度为88.89%,对照组的护理满意度为62.23%,观察组高于对照组(P<0.05)。结论细节护理联合PDCA管理模式提高了手术室患者的护理质量,减少了护理风险的发生率,提升了患者的护理满意度,值得在临床推广。

手术室细节护理在手术患者护理中的应用效果

目的分析手术室细节护理在手术患者护理中的应用效果。方法对某院2022年2月至2024年1月收治的158例手术患者进行研究,采用随机数字表法将患者分为对照组与观察组,每组79例。对照组给予手术室常规护理,观察组给予手术室细节护理。比较两组护理7 d后的护理质量评分、护理安全评分、住院期间并发症发生情况以及护理满意度。结果护理7 d后,观察组患者对护理人员的服务态度、安全管理、风险意识及器械准备的评分均高于对照组(均P<0.05);观察组对风险防范、并发症护理、及时改进护理不足以及护理纠纷处理的评分均高于对照组(均P<0.05);住院期间观察组并发症发生率低于对照组(P<0.05);护理7 d后观察组护理满意度高于对照组(P<0.05)。结论在手术室护理中,细节护理不仅能够有效提升护理质量、护理安全,还能降低并发症发生率,促进患者术后康复,从而有利于提高患者满意度。

手术室强化式护理干预在鼻内镜鼻窦手术患者中的应用

目的探讨手术室强化式护理干预在鼻内镜鼻窦手术患者中的应用价值。方法回顾性分析,采集2023年1—6月于郑州大学第一附属医院接受常规护理干预的50例鼻内镜鼻窦手术患者资料,纳入对照组;采集2023年7—12月于医院接受手术室强化式护理干预的50例鼻内镜鼻窦手术患者资料,纳入观察组。患者疾病资料、手术资料、干预资料等资料均保存完整。整理患者资料,记录并对比两组患者情绪状态[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]、苏醒期躁动发生情况[Richmond镇静躁动评估量表(RASS)评估]、术后恢复时间(苏醒时间、拔管时间、苏醒室停留时间)。结果干预前,两组患者的HAMA、HAMD评分对比,差异无统计学意义(P>0.05);干预后,两组患者的HAMA、HAMD评分均降低,且观察组低于对照组(P<0.05)。相较于对照组,观察组苏醒期躁动发生率较低,且苏醒时间、拔管时间、苏醒室停留时间均较短(P<0.05)。结论为鼻内镜鼻窦手术患者实施手术室强化式护理干预,可以改善患者不良情绪,减少苏醒期躁动的发生,缩短术后恢复时间。