ABSTRACT
Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.
ABSTRACT
Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.
ABSTRACT
Objective To compare the effects of remifentanil and fentanyl in urologic surgery under endoscopic anesthesia and the incidence of adverse reactions in patients.Methods A total of 170 patients undergoing urological surgery admitted to the Second People 's Hospital of Jinzhong from February 2015 to April 2016 were randomly divided into the study group and control group according to the digital table ,with 85cases in each group. Remifentanil and fentanyl was used in the study group and control group respectively .The preoperative anesthesia was performed in the patients who received anesthesia before and after tracheal intubation and before and after tracheal intubation,and the time of induction of anesthesia ,the operation time and the time of postoperative wakefulness were compared between the two groups.Pressure and heart rate changes ,the incidence of adverse reactions were recorded and compared between the two groups.The amount of anesthesia ,anesthesia surgery costs and the amount of bleeding during surgery were compared.Results The induction time of anesthesia in the study group was significantly shorter than that in the control group (9.8min vs.6.9min,t＝12.029,P＜0.05).The mean arterial pressure and heart rate in the study group were significantly larger than those in the control group ( all P＜0.05).The incidence rate of adverse reactions in the study group was significantly lower than that in the control group (5.9% vs.12.9%,χ2＝7.935,P＜0.05).The cost and blood loss of the study group were significantly lower than those of the control group (2 871.4 CNY vs.3 014.9 CNY;23.4mL vs.32.7mL,t＝20.391,17.907,all P＜0.05).Conclusion The application of remifentanil in preoperative anesthesia of urologic surgery can save time ,reduce the economic burden of patients and the incidence of adverse reactions in patients.It is worthy of widely recommended in clinic.
ABSTRACT
Objective To explore the effect of various information means in the training of newly recruited nurses and to provide a practical basis for comprehensive and thorough development of the training. Methods Nurses who are enrolled in 2015 were chosen as the test group. Its applications can be in the form of Mobile APP,office software,online software and We Chat public platform. Afterwards,the effect of various information means can be judged by comparing the test results with the nurses who are enrolled in 2013 (the control group). The nurses in the test group were surveyed in the form of questionnaires to evaluate the training effect. Results The scores of theory ex amination and nasal feeding in the test group were higher than those of control group(P<0.01). The 93.8 percent of the nurses in test group believe that training is beneficial to the understanding and consolidation of knowledge as well as to improve the ability of self-learning. Also the training effect is prominent. Conclusion The various information means in the training of newly recruited nurses can improve training efficiency and enhance training effectiveness.