Discussion on the application of nursing intervention in operating room in orthopedic incision infection
Objective To explore the application effect of nursing intervention in operating room in preventing orthopedic incision infection. Methods May 2004, 2065438+ was selected. From 20 15 to 10, 88 orthopedic patients admitted to Ningjin County Hospital were randomly divided into control group and experimental group, with 44 cases in each group. The control group was given routine nursing, while the experimental group was given nursing intervention in the operating room. The incidence of incision infection and nursing satisfaction of the two groups were observed. Results The incidence of incision infection in the experimental group was lower than that in the control group, and the nursing satisfaction was higher than that in the control group, with statistical significance (P < 0.05). Conclusion Nursing intervention in the operating room has a significant effect on preventing orthopedic incision infection, which can effectively reduce the infection rate and improve nursing satisfaction.
Hospital; Orthopedics; Incision infection; Operating room nursing
Incision infection is the main complication of surgical operation with high incidence. Incision infection is not only caused by patients themselves, but also hospital infection [1]. There are many kinds of orthopedic surgery and different nursing methods. The operating room is the place for operation and rescue, and the nursing intervention in the operating room will affect the operation effect. Inadequate nursing care in orthopedic surgery will lead to incision infection and increase the infection rate of incision [2]. It is the focus of current research to find out the nursing intervention methods to prevent orthopedic incision infection in operating room and provide effective and scientific nursing intervention programs for strengthening orthopedic surgery to prevent incision infection. Strengthening nursing intervention in operating room on the basis of routine nursing can help patients to eliminate negative emotions, actively face the changes brought by diseases, improve patients' treatment cooperation and medication compliance, strengthen communication between doctors and patients, and improve nursing satisfaction [3]. The purpose of this study is to explore the application effect of nursing intervention in operating room in preventing orthopedic incision infection. The report is as follows.
1 data and methods
1. 1 inclusion criteria and exclusion criteria
Inclusion criteria [4]: All operations were sterile and general anesthesia was used; Both patients and their families have signed informed consent forms. Exclusion criteria [5]: open fracture surgery and emergency surgery; Patients with infectious diseases, patients with multiple fractures, and patients with severe cardiopulmonary and renal diseases.
1.2 general data selection
May 20 14? From 20 15 to 10, 88 orthopedic patients admitted to Ningjin County Hospital were randomly divided into experimental group and control group, with 44 cases in each group. There were 29 males and 65438 05 females in the control group. The age ranged from 23 to 76, with an average age (49.8? 5. 1) years. There were 27 males and 65438 07 females in the control group. The age ranged from 25 to 77, with an average age (49.0? 6.3 years old. There was no significant difference in general data between the two groups (P & gt0.05), which was comparable.
Methods The control group was given routine nursing.
The experimental group carried out nursing intervention in the operating room, as follows:
(1) Preoperative nursing intervention:
Nursing staff visited the patients before operation, instructed them to wash with antibacterial soap solution 1d before operation, and instructed them to prepare for skin preparation. For patients who can't take a bath, disinfect the surgical site with 2% chlorhexidine alcohol. Actively communicate with patients, inform the operation process in advance, let patients and their families know about the operation-related knowledge, and encourage and comfort patients. Informing patients to enter the sterile area of operating room can reduce the incidence of incision infection. Nurses used antibiotics 0.5~2.0h before operation to inform patients with indwelling catheter and incision drainage tube of its significance, so as to improve patients' cooperation.
(2) Operating room preparation:
Wet cleaning and disinfection are used to disinfect various instruments, floors and countertops in the operating room. Nursing staff and medical staff in the operating room should reduce the frequency of walking around and entering and leaving the operating room. Strengthen the nursing intervention of air quality in operating room, and control the indoor temperature at 22 ~ 25℃ and humidity at 40% ~ 60%.
(3) Intraoperative nursing intervention:
Disinfect the skin of the patient's incision and prepare surgical instruments and surgical clothes. Preoperative 15 minutes to warm up the operating table, use a constant temperature blanket to keep the patient warm during the operation, and cover the parts of the patient that do not need surgery with articles. The washing liquid and liquid medicine used in the operation are heated in advance and kept at about 37℃.
(4) Postoperative nursing intervention:
Strengthen the protection of surgical incision, strictly follow the standard operation of dressing change, and nurses should disinfect their opponents after dressing change to avoid cross-infection. When changing the dressing, the incision should be about 10cm to disinfect the skin. If the patient's incision exudation is found, the incision exudation should be cultivated in time and treated symptomatically. Strengthen the management of ward environmental sanitation to provide patients with a good ward environment. After being sent back to the ward, the patient was asked to turn over.
(5) Discharge guidance and health guidance:
Provide dietary guidance to patients after discharge and pay a return visit when necessary.
1.4 observation index
The incidence of incision infection and nursing satisfaction were compared between the two groups. The comparison of nursing satisfaction was analyzed by the self-made nursing satisfaction questionnaire in the hospital, and the score was >; 95 is very satisfied, 80 ~ 94 is satisfied and 60 ~ 79 is basically satisfied.
1.5 statistical method
SPSSl9.0 statistical software is used for data processing, and? 2 check; Measurement data in x? S stands for t test. P < 0.05 was statistically significant.
Two results
2. 1 Comparison of the incidence of incision infection between two groups
The infection rate of incision in the control group was 65438 03.6% (6/44). The infection rate of incision in experimental group was 2.3%( 1/44). The infection rate of incision in experimental group was lower than that in control group, and the difference was statistically significant (? 2=6.345，P & lt0.05)。
2.2 Comparison of nursing satisfaction between the two groups
The nursing satisfaction of the experimental group was higher than that of the control group, and the difference was statistically significant (? 2=8.938，P & lt0.05。
3 discussion
Surgical site infection is one of the most important nosocomial infections, accounting for about 14.0% ~ 16.0% of all inpatients. Preventing and reducing postoperative incision infection rate is an important topic for medical staff. Orthopedic surgery has its particularity. There are many kinds of orthopedic surgery, but it is usually repair surgery or reconstruction surgery, such as spinal internal fixation surgery, orthopedic surgery, joint replacement surgery and so on. This kind of surgery generally requires the use of internal fixation materials to fix the bone in the relevant parts. Therefore, patients are prone to postoperative infection if they are not careful, and orthopedic surgery patients are also prone to infection of pathogens through incisions because of their decreased resistance to postoperative stress response. At the same time, because the patient's skin is not clean, he did not pay attention to protecting the surgical site and incision, resulting in infection [6]. In order to reduce the infection rate of incision and improve the satisfaction of patients, nurses need to apply scientific and effective nursing methods to care for patients. Operating room nursing intervention adopts reasonable and standardized operating room nursing intervention measures to strengthen skin cleaning, disinfection and protection before, during and after operation [7-8], which effectively reduces the incision infection rate of orthopedic patients and improves nursing satisfaction. Related research shows that preoperative skin preparation, the administration time of preventive antibiotics and the duration of operation are the main factors affecting the prevention of postoperative incision infection in operating room. Incision infection in orthopedic surgery is the result of many reasons, so the prevention of incision infection focuses on all aspects and links. Comprehensive nursing intervention on the risk factors of each link can effectively prevent postoperative incision infection, thus improving the prognosis and quality of life of patients. Li et al.' s research [8] shows that standardized nursing intervention in operating room can effectively prevent postoperative incision infection. In this study, nursing intervention in operating room was strengthened from three stages: preoperative nursing, intraoperative nursing and postoperative nursing. Preoperative care focuses on preparation and provides a good intraoperative environment for patients. During the operation, the nursing staff should disinfect the hands of the medical staff and the skin of the patient's incision in strict accordance with the requirements of aseptic operation, ensure that the dressing around the incision is dry and clean, and make preparations for conventional surgical instruments and surgical gowns. Nursing intervention method of shortening operation time was adopted during operation to reduce the infection rate of patients' incision. Take heat preservation measures to avoid the decline of patients' resistance caused by hypothermia. Postoperative nursing intervention strengthens the protection of surgical incision, at the same time strengthens the environmental hygiene of ward and reduces the infection rate of incision. The results of this study show that the infection rate of incision in the experimental group is lower than that in the control group, and the satisfaction is higher than that in the control group, with significant difference. It shows that the application effect of nursing intervention in operating room in preventing orthopedic incision infection is remarkable, which can effectively reduce infection rate and improve nursing satisfaction, and is worthy of clinical promotion.
refer to
[1] Guo Liubo. Clinical application of nursing intervention in preventing surgical incision infection in operating room [J]. Dr. China Hyundai, 20 14, 19(2 1):77-79.
[2] Zhu Jing. Observation on the effect of comprehensive nursing intervention to prevent infection of operation incision in operating room [J]. chinese medicine guides, 2015,57 (35): 238.
[3] Wei and Li. The application of nursing intervention in operating room to effectively prevent the infection of orthopedic operation incision [J]. china medical engineering, 20 16,11(1):17-19.
[4] Lei Xinhua, He Yunxiang. Analysis of related factors of incision infection in orthopedic aseptic surgery and nursing intervention in operating room [J]. China Rural Health, 2015,23 (1): 50-52.
[5] Bai. Clinical application of nursing intervention in preventing wound infection outside the operating room [J]. World Latest Medical Information Abstracts, 2015,25 (9):184.
[6] Cai Jianfen, Lee Hyo Ri. Analysis of the preventive effect of nursing intervention on incision infection in operating room [J]. China Modern Doctor, 2014,29 (21): 70-73.
, stone,. Clinical application value of nursing intervention in the prevention of surgical incision infection in operating room [J]. World Latest Medical Information Abstracts, 2015,52 (92): 281-282.
Li, Gu and Chen. Analysis of the preventive effect of nursing intervention in operating room on orthopedic incision infection [J]. chinese medicine guides, 20 13,11(1): 31-32.
Discussion on Orthopedic Nursing Paper Model No.2 Humanized Orthopedic Nursing
Abstract: With the development of society, nursing work has gradually become humanized. Orthopedics is an important part of hospital departments. In order to improve the quality of orthopedic care and further highlight the importance of nursing work, the orthopedic ward of our hospital has specially set up related work with humanization as the nursing theme, which has been solidly promoted in the work, and achieved good results in humanized management of nursing work, laying a foundation for our hospital to better occupy the market.
Key words: orthopedic nursing; Humanization; operate
Introduction to 0
With the development of society, the nursing mode is constantly improving. The current nursing mode pays more attention to humanized nursing, which is a very optimized nursing mode. Humanized nursing is patient-centered, and all nursing services are for patients, so that patients can get the most comfortable experience in physical, psychological and social aspects, and all kinds of negative reactions of patients can be significantly reduced, so that patients can actively cooperate with treatment and achieve better curative effect. Orthopedics is an important part of hospital departments. In order to improve the quality of orthopedic care and further highlight the importance of nursing work, the orthopedic ward of our hospital has specially set up related work with humanization as the nursing theme, which has been solidly promoted in the work and achieved good results in humanized management of nursing work, which is worthy of clinical popularization and application.
1 Promotion and education of humanistic nursing concept
In order to better carry out humanized nursing, it is necessary to ask nurses to understand the concept of humanized nursing and the connotation of humanized nursing in detail, so as to better carry out humanized service in orthopedics. In this regard, according to the basic situation of nurses, our hospital has carried out relevant knowledge training of humanized nursing, and regularly carried out some courses of humanized nursing, so that nurses can truly understand what humanized nursing is and its development trend. On this basis, it also evaluates the effect of nurses' practical implementation of humanized nursing, finds out the problems existing in practical work and solves them in time.
2. Humanized nursing in orthopedic wards [1]
2. 1 Humanized nursing at admission
The vast majority of patients admitted to orthopedic wards are fracture patients, and their lives may be in danger when their condition is serious. At the initial stage of hospitalization, the patient is usually accompanied by severe pain, and the patient suddenly changes from a healthy person to a patient who is unfamiliar with the treatment environment. Patients and their families often feel worried that the disease will not be cured, or the sequelae will fall in the future. Some patients are treated with bone traction or external fixation with plaster or splint after hospitalization, and some seriously ill patients go directly to the operating room for treatment, which will make patients (family members) feel scared. Therefore, nurses should communicate with patients (family members) more, understand their thoughts and treat patients (family members) with a cordial and enthusiastic attitude. It is necessary to explain the relevant situation of the disease to patients (family members) in time, so that they can have a comprehensive understanding of their own diseases, answer the problems caused by patients (family members) in time, try their best to meet their reasonable requirements, so that patients can maintain a good attitude and actively cooperate with treatment and nursing.
2.2 Perioperative humanized nursing measures
2.2. 1 preoperative care
Before the operation, patients should try to relax and enhance their self-confidence. Nurses should explain health knowledge to patients, so that patients can master it comprehensively, stabilize their emotions and enhance their confidence in surgery. Nurses should explain the related matters of surgery to patients in easy-to-understand language, let patients know the treatment process in detail, and tell patients that the medical staff who operated on him have rich experience in surgery, so as to reassure patients. If the patient is too nervous to relieve, sedatives can be given to help the patient relax.
postoperative care
After the operation, the patient should be pushed back to the ward after waking up from anesthesia. The nurse should immediately go to the patient ward and make a good handover with the anesthesiologist. The nurse should talk to the patient kindly and tell him that the operation has been done and it was a success. Nurses should observe patients more, understand their emotional changes and meet their reasonable needs in time. At ordinary times, we should carefully observe the patient's condition, report it to the doctor in time, and perform various operations according to the doctor's advice to improve the quality of nursing and achieve the best treatment effect [2].
2.3 Humanized nursing and functional exercise
Timely and early postoperative functional exercise is very necessary for the rehabilitation of orthopedic patients. Nurses should correctly master the methods of functional exercise and explain to patients the importance and necessity of early and timely functional exercise after operation. Patients will feel pain at the beginning of exercise, so some patients can't persist. Nurses should encourage patients to keep exercising and not give up, so as to enhance patients' confidence.
2.4 Language should be humanized.
Nurse's language is very important in humanized nursing, and language has two-way function. Friendly language can enhance patients' confidence and courage in treatment, so that patients can actively cooperate with treatment with relaxed mood. On the contrary, impolite and indifferent language will make patients suffer bad stimulation and bring negative effects to patients. In clinical work, nurses should communicate more with patients and their families, talk to patients (their families) in a polite tone, and use positive and encouraging language when patients are anxious, which can make patients relax and achieve better results.
3 Humanized management of nursing staff
Humanized management of nursing staff is to put people first in daily work, and to fully mobilize and stimulate people's enthusiasm and creativity as the fundamental means to achieve the purpose of improving treatment efficiency and promoting people's continuous development.
4. Implement humanized management for nursing staff, and continuously deepen the process of humanized management.
Humanized management is not equal to slack management. Head nurses should be people-oriented, implement humanized management on the basis of scientific concept of human nature, set an example, empathize, be fair and just, encourage more with less criticism, lead nurses to keep learning, and constantly improve team cohesion.
5 abstract
To sum up, with the development of society, the nursing model is constantly improving. The current nursing mode pays more attention to humanized nursing, which is a very optimized nursing mode. Humanized nursing is patient-centered, and all nursing services are for patients, so that patients can get the most comfortable experience in physical, psychological and social aspects, and all kinds of negative reactions of patients can be significantly reduced, so that patients can actively cooperate with treatment and achieve better curative effect. Orthopedics is an important part of hospital departments. In order to improve the quality of orthopedic care and further highlight the importance of nursing work, the orthopedic ward of our hospital has specially set up related work with humanization as the nursing theme, which has been solidly promoted in the work and achieved good results in humanized management of nursing work, which is worthy of clinical popularization and application.
refer to
[1] He Yuehua. Application of humanized nursing mode in orthopedic surgery ward [J]. Jilin Medical College, 2010 (11):134-135.
[2] Qin Zhou. Application of humanized nursing in orthopedic wards [J]. China Contemporary Medicine, 20 1 1(27):47-48.
Discussion on the application of integrated medical care model in orthopedic nursing —— The third orthopedic nursing model
Objective To analyze the application of holistic medical nursing mode in orthopedic nursing. Methods 20 15 ~ 20 16 orthopedic patients 100 in our hospital were selected as the research object and randomly divided into control group and experimental group, with 50 cases in each group. The control group was given routine care, such as related examination and doctor's advice. Results The appointment time of the control group was 2.78? 0.52)d, abnormal result feedback time (10.52? 0.58)min, the incidence rate (28.32%) and the examination appointment time (0.68? 0. 14)d, abnormal result feedback time (6.78? 0.38)min, the incidence rate (10.23%) was significantly increased. At the same time, the satisfaction of the experimental group to the nursing staff is as high as 90%, while the satisfaction of the control group is only 50%. Conclusion The application of integrated medical nursing mode in orthopedic nursing can not only effectively reduce patients' waiting time for appointment, abnormal result feedback time and disease occurrence probability, but also improve patients' satisfaction with nursing staff, which is worth popularizing.
Key words: combination of medical care and nursing; Orthopedic nursing; applied analysis
Introduction to 0
With the continuous promotion and innovation of nursing mode, an integrated medical nursing mode has also been put forward. Holistic medical model is a more effective nursing model. It is not simply that doctors and nurses work together, but that doctors and nurses achieve the common goal of nursing and treatment through reasonable division of labor and mutual cooperation. Its implementation and execution can effectively improve patients' satisfaction with medical staff, and better cooperate with medical staff to carry out related treatment, thus improving the treatment effect [1]. In order to study the effect of the combination of medical care and nursing, our hospital also made the following analysis on the application of the combination of medical care and nursing in orthopedic nursing:
1 data and methods
1. 1 general information.
20 15 to 20 16 10 orthopedic patients 10 in our hospital were selected as the research objects and randomly divided into two groups, the control group and the experimental group, with 50 cases in each group. In the control group, there were 35 males and 5 females/kloc-0, with an average age (4 1.24? 3.4) years old; There were 33 males and 65438 07 females in the control group, with an average age (40.22? 3.0) years old. Through investigation and comparison, it is found that there is no obvious difference in sex and age between the two groups (P & gt0.05), which is comparable.
1.2 method.
The control group used routine nursing such as related examination and doctor's advice, while the experimental group used the nursing mode of combining medical care with nursing. The specific implementation method is as follows:
1.2. 1 Establish a team combining medical care with nursing care:
Choose doctors and nursing staff with higher qualifications and experience to form the orthopedic medical care integration group in our hospital. The main purpose of this group is to be responsible for the formulation, implementation and supervision of the integration of medical care and nursing. After the patient was admitted to the hospital, the nursing staff made a comprehensive inquiry and understanding of the patient's name, age, gender and medical history, and then the doctor made relevant examination and evaluation of the patient's condition, and wrote down the hospitalization log.
1.2.2 Implementation of comprehensive medical rounds:
During the patient's hospitalization, medical staff need to make rounds every morning and evening to master and understand the patient's condition changes. The contents of the examination specifically include the patient's diet, medication, changes in his condition and psychological changes. After the examination, the nursing staff will reflect the specific situation to the doctor, and then the doctor will make a specific diagnosis of the patient's condition according to the investigation of the nursing staff, and then formulate relevant measures and treatment plans, and finally the nursing staff will implement these measures.
1.2.3 implementation and implementation of the combination of medical care and nursing:
In the process of implementing the combination of medical care and nursing care, relevant medical personnel must ensure the implementation and implementation of the combination of medical care and nursing care, and cooperate closely with each other to complete various nursing work. Before the operation, doctors can tell patients and their families the specific process of the operation, tell them the problems that need attention and the possible risks, so that patients and their families can have a specific understanding and psychological preparation. In the process of communication, we can learn from previous successful surgical cases and increase patients' confidence in surgical treatment.
1.3 evaluation index.
The clinical indexes of the two groups were compared and analyzed, including the waiting time for appointment, the incidence probability and the feedback time of abnormal results. Then, patients' satisfaction with medical staff was investigated by questionnaire, which was divided into general, satisfactory and very satisfactory (satisfaction = satisfaction+very satisfactory).
1.4 statistical method:
Chinese software SPSS 17.0 was used for data processing, significance t test was used for measurement data, and counting data was used. 2 test, p
Two results
Through investigation and comparison, it was found that the waiting time, incidence probability and feedback time of abnormal results in the experimental group were significantly lower than those in the control group (P < 0.05), which was statistically significant. By investigating the satisfaction of two groups of patients with nurses, it was found that the satisfaction of the experimental group was as high as 90%, while that of the experimental group was only 50%.
3 discussion
With the development of clinical medicine, people's understanding of medicine has also improved to a certain extent, and patients have also put forward higher requirements for relevant nursing staff. Therefore, how to improve patients' satisfaction with nursing to ensure patients get better treatment has become a common concern [3]. According to the investigation of this study, the examination appointment time, abnormal result feedback time and disease occurrence probability of the conventional nursing control group are obviously improved compared with those of the integrated medical model experimental group, which also shows that the integrated medical model can effectively reduce the waiting time of patients, the probability of disease occurrence and the time of abnormal result feedback, which also gives medical staff. Moreover, through the questionnaire survey, we found that there were obvious differences in the satisfaction of the two groups of patients with nursing staff. The satisfaction of the experimental group to the nursing staff was as high as 90%, while the satisfaction of the experimental group was only 50%. It can be seen that the integrated patient medical care model can effectively improve patients' satisfaction with nursing staff, and then make patients better cooperate with treatment. To sum up, the application of integrated medical nursing mode in orthopedic nursing can not only effectively reduce the waiting time of patients' appointment, the feedback time of abnormal results and the incidence probability, but also improve patients' satisfaction with nursing staff, which is worth popularizing.
refer to
Hou Xiaoling, Zhang Lin, Ren Li. Application and effect evaluation of integrated medical model in orthopedic surgery medical record management [J]. chinese nursing management, 2014,7 (6): 651-653.
[2] Liu. Analysis of the effect of integrated medical ward round in orthopedics [J]. Contemporary Medicine, 20 14,14 (20):120-121.
[3] Shi Lili, Chen, Ye Chunlan. Effect of medical integration on patients' satisfaction after hip replacement [J]. China Health Nutrition, 20 16, 1(2):8-9.
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