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Objective:To study the application value of flipped classroom teaching mode in clinical teaching of gynecological operating room.Methods:A total of 146 cases of gynecological operating room intern nursing students in The People's Hospital of Liaoning Province from January 2020 to April 2020 were selected as the research objects and divided into two groups according to different time. Before the flipped classroom teaching mode was carried out from January 2020 to February 2020, 73 cases were included in the control group, and after the flipped classroom teaching mode was carried out from March 2020 to April 2020, 73 cases were included in the observation group. The theory and operation scores of the two groups before and after teaching were compared, and the satisfaction of the practice nurses to the teaching and the evaluation of the observation group to the flipped classroom teaching mode were observed. After the teaching, the performances of the two groups of nursing students and the teaching satisfaction were compared using SPSS 22.0 to conduct t test, chi-square test and rank sum test. Results:The theoretical results[(88.52±8.99) points] and operational results[(89.79±7.51) points] of the observation group were significantly higher than those[(72.40±7.45) points and (73.66±7.77) points] of the control group, with statistical significance ( P<0.05). The teaching methods and self-evaluation satisfaction of the observation group were significantly higher than those of the control group ( P<0.05). Conclusion:The application of flipped classroom teaching mode in the teaching of nursing students in gynecological operating room can improve the students' operation and theoretical level, and the students have a high degree of recognition and satisfaction with the teaching mode.
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The quality control of inguinal hernia is a key point of herniology development in China, which is on the basis of continuous clinical quality improvement. The standardized operation of inguinal hernia repair requires the tacit cooperation of surgeons and the operating room nursing team. According to the existing mature seven step method in inguinal hernia surgery, the authors summarize the seven step nursing process of operation, in order to provide smoother and better operation guarantee in open and laparoscopic hernioplasty.
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Objective:To explore the status and influencing factors of nurses′ cognitive ability of nursing interruptions in operating room.Methods:From March to May 2020, convenient sampling was conducted, a questionnaire was used to investigate the cognitive ability of operating room registered nurses in some provinces and cities in China. The influencing factors were analyzed by single factor analysis and multiple stepwise linear regression analysis.Results:Finally, 2 827 questionnaires were collected from 1 municipality directly under the central government and 15 provinces, involving 42 municipal and county hospitals. The nurses′ cognitive ability of nursing interruptions in operating room scored 105.73 ± 13.39, which was in the middle level. A total of 2 427 (87.37%) operating room nurses thought it necessary to receive training on nursing interruptions, but only 796 (28.16%) nurses had received training on nursing interruptions. Multiple stepwise linear regression analysis showed that different job categories ( B=-0.714, P<0.001), whether to pay attention to nursing interruptions ( B=5.449, P<0.001), the frequency of experience nursing interruptions ( B=-1.916, P<0.001)and whether to participate in the training of nursing interruptions ( B=-4.806, P<0.001) were the influencing factors of operating room nurses' cognitive ability of nursing interruptions. Conclusions:The operating room nurses' cognitive ability of nursing interruptions is in the middle level. The current situation of training is not good, but the training demand is high. Managers should strengthen the systematic training of nurses on nursing interruptions, especially those with junior nurses in operating room, to improve nurses' attention and cognitive ability of nursing interruptions.
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Las situaciones de crisis en la sala de operaciones son eventos poco frecuentes, con personal trabajando rápido y bajo presión, intentando sobrellevar el incidente con los menores riesgos para el paciente. Se expone un caso clínico en el marco del trabajo de una unidad de anestesia para cirugía de tórax en la cual se presenta una crisis asistencial abordada por un equipo de trabajo capacitado mediante simulación en la aplicación de la herramienta de "Manejo de los Recursos en Crisis (CRM)". Planteamos que la aplicación de esta herramienta por un equipo capacitado en su utilización contribuyó al éxito y buena evolución de un paciente crítico.
Crisis situations on the operation room seldom happen, with staff working fast and under pressure, trying to overcome the incident at the same time as reducing the risks for the patient. Here we expose a clinical case on the frame of work of an anesthesia unit assembled for thorax surgery during which an asistential crisis occurs and is managed by a group of coworkers trained by means of simulation on the appliance of the tool called "Crisis Resource Management (CRM)". We support the idea that the appliance of this tool by a team of professionals trained on its use, contributed to the success and good evolution on a critical patient.
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Humans , Male , Aged , Postoperative Complications , Biopsy/adverse effects , Anesthesiologists , Mediastinal Neoplasms/pathology , Case Management/standards , EmergenciesABSTRACT
Objective To analyze the prospective coping styles of nurses in operation room of plastic surgery department and its influencing factors. Methods A total of 169 nurses of two tertiary first-class hospitals and two secondary hospitals in Yuncheng city were selected as the research objects by convenient sampling from January 2016 to January 2017, their general data, dispositional hope, occupational expectations, occupational values, occupational maturity and prospective coping styles were analyzed. The influencing factors of prospective coping style were analyzed. Results The quality of hope was (31.78±4.24) points, occupational expectation was (72.41±7.24) points, professional values were (86.63 ± 7.02) points, professional maturity was (94.58 ± 6.25) points, and prospective coping style was (40.64 ± 6.13) points in the nurses in plastic surgery operation room. The results of multivariate linear regression model showed that the longer working time, high professional title, high degree of education, high monthly income, longer working hours in plastic surgery operation room, high hope quality, high career expectation, high occupational values and high career maturity were all the prospective coping styles of nurses in the operation room. Significant factors (P <0.05). Conclusions The nurses in the plastic surgery operation room have a certain prospective coping style, improve the treatment of nurses, set up their active work goals, improve their hope traits, career expectations, occupational values and career maturity, which can significantly enhance the level of prospective coping style.
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Objective To explore the application effect of Case-Based Learning(CBL) teaching mode based on WeChat public platform in nursing practice teaching in operating room. Methods From July 2016 to June 2018, 132 nursing students in the operating room of Shengjing Hospital of China Medical University were selected as experimental subjects. They were randomly divided into the traditional teaching group (control group, from July 2016 to June 2017) and WeChat public platform combined with CBL group (experimental group, from July 2017 to June 2018 ). On the basis of traditional teaching and based on the WeChat public platform, the experimental group were sent the content of the CBL case based on the syllabus of the courses to students one week before the internship. At the end of the teaching, a theoretical written examination and skill operative quiz were performed to assess the effects of teaching and satisfaction of the subjective learning experience. Results The scores of the theoretical and basic skills of the experimental group were (42.33 ± 8.26) and (45.17 ± 6.79) points, respectively. The control group was (37.28 ± 7.70) and (39.23 ± 5.43) points, respectively. The difference between the two groups was statistically significant (t=2.289 , 2.150, P<0.05). The overall satisfaction of the experimental group was 90.90％ (60/66), and the overall satisfaction of the control group was 57.58％ (38/66). The difference between the two groups was statistically significant (χ2=6.339, P <0.05). Conclusions The WeChat public platform assisted CBL teaching model in the operating room nursing practice improved the learning efficiency, helped to deepen understanding, and can be adopted gradually in large teaching hospitals for clinical practical teaching of operation room for nursing students.
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Objective To summarize the best evidence of risk assessment of pressure injury among surgical patients. Methods We searched JBI Library、Cochrane Library、NGC、SIGN、PubMed、CNKI, CBM, etc., to collect documents including guidelines, evidence summaries, best practice information sheets, systematic reviews and expert consensus. Three researchers independently reviewed studies and extracted data from the publications meeting inclusion criteria. Results 8 publications were recruited, including 5 clinical guidelines and 3 evidence summaries. Finally,12 items of best evidence were summarized, as follows. Health care professionals should involve in assessing of patients who are at risk of developing pressure ulcers, including pain related to pressure ulcers, complaints and skin inspections. Use a valid/reliable risk assessment tool in conjunction with the identifcation of additional risk factors (e.g., perfusion and oxygenation, increased body temperature, and advanced age), along with clinical judgment. Consider additional risk factors specific to individuals undergoing surgery including:duration of time immobilized before surgery, length of surgery, increased hypotensive episodes during surgery, low core temperature during surgery; and reduced mobility on day one postoperatively. Assess for intrinsic/extrinsic risk factors. Undertake a reassessment if there is any significant change in the individual′s condition. Include a comprehensive skin assessment as part of every risk assessment to evaluate any alterations to intact skin. Undertake a comprehensive skin assessment that includes skin temperature, color, edema, change in tissue consistency in relation to surrounding tissue, skin moisture, and skin integrity. Inspect the skin under and around medical devices at least twice daily for the signs of pressure related injury on the surrounding tissue. Assess and document physical characteristics including:location, category/stage, size, tissue types, color, periwound condition, wound edges, sinus tracts, undermining, tunneling, exudate, and odor. Staff education should be a core component of any quality improvement project aimed to improve the accuracy of pressure injury classification and quality of documentation. Health professionals should receive education regarding the prevention, assessment and management of pressure injury. The use of multi_component strategies or a computerized clinical decision support can be considered in quality improvement initiatives for improving pressure injury classification and documentation. Conclusions Medical institutions should strengthen training of nursing staff, especially pressure ulcer assessment and standardization of nursing records. It is also needed to raise awareness of relevant risks. Nursing staff should perform risk assessment dynamically and professionally, in order to timely identify the occurrence of pressure injuries to and ensure patients′safety. Since best evidence would be updated along with research project, researchers should selectively apply evidence based on clinical settings and hospital conditions.
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Objective@#To summarize the best evidence of risk assessment of pressure injury among surgical patients.@*Methods@#We searched JBI Library、Cochrane Library、NGC、SIGN、PubMed、CNKI, CBM, etc., to collect documents including guidelines, evidence summaries, best practice information sheets, systematic reviews and expert consensus. Three researchers independently reviewed studies and extracted data from the publications meeting inclusion criteria.@*Results@#8 publications were recruited, including 5 clinical guidelines and 3 evidence summaries. Finally,12 items of best evidence were summarized, as follows. Health care professionals should involve in assessing of patients who are at risk of developing pressure ulcers, including pain related to pressure ulcers, complaints and skin inspections. Use a valid/reliable risk assessment tool in conjunction with the identifcation of additional risk factors (e.g., perfusion and oxygenation, increased body temperature, and advanced age), along with clinical judgment. Consider additional risk factors specific to individuals undergoing surgery including: duration of time immobilized before surgery, length of surgery, increased hypotensive episodes during surgery, low core temperature during surgery; and reduced mobility on day one postoperatively. Assess for intrinsic/extrinsic risk factors. Undertake a reassessment if there is any significant change in the individual′s condition. Include a comprehensive skin assessment as part of every risk assessment to evaluate any alterations to intact skin. Undertake a comprehensive skin assessment that includes skin temperature, color, edema, change in tissue consistency in relation to surrounding tissue, skin moisture, and skin integrity. Inspect the skin under and around medical devices at least twice daily for the signs of pressure related injury on the surrounding tissue. Assess and document physical characteristics including: location, category/stage, size, tissue types, color, periwound condition, wound edges, sinus tracts, undermining, tunneling, exudate, and odor. Staff education should be a core component of any quality improvement project aimed to improve the accuracy of pressure injury classification and quality of documentation. Health professionals should receive education regarding the prevention, assessment and management of pressure injury. The use of multi-component strategies or a computerized clinical decision support can be considered in quality improvement initiatives for improving pressure injury classification and documentation.@*Conclusions@#Medical institutions should strengthen training of nursing staff, especially pressure ulcer assessment and standardization of nursing records. It is also needed to raise awareness of relevant risks. Nursing staff should perform risk assessment dynamically and professionally, in order to timely identify the occurrence of pressure injuries to and ensure patients′ safety. Since best evidence would be updated along with research project, researchers should selectively apply evidence based on clinical settings and hospital conditions.
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Burns , Disasters , Electrocoagulation , Fires , Hot Temperature , Operating Rooms , Oxygen , SkinABSTRACT
Under the bio-psycho-social medical mode, operation room nurses should not only continuously improve their own professional level, but also improve their ethical quality. This paper expounded the connotation, importance, and current situation of ethical quality of nurses in the operation room, and mainly analyzed the strategies to enhance the ethical literacy of nurses in the operation room from the aspects of the clinical ethics standard in operation room, Quality Control Circle management, narrative medicine, reading party and watching party, and the medical humanities lecture.
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Objective To investigate the value of intraoperative X-ray guided and CT guided percutaneous biopsy in the diagnosis of thoracic and lumbar space occupying lesions.Methods A total of 97 patients with thoracic and lumbar space occupying lesions who were not diagnosed clinically in our hospital from May 2011 to July 2016 were retrospectively analyzed.All patients underwent percutaneous vertebral biopsy under the guidance of Artis-Zeego robot in the Artis-Zeego complex operating room of our hospital.Thoracic vertebral body biopsy in patients with a total of 46 cases were divided into T group,in which X-ray guided percutaneous biopsy in 25 cases were divided into T-x group,CT guided percutaneous biopsy in 21 cases were divided into T-ct group.Lumbar puncture biopsy in patients with a total of 51 cases were divided into L group,in which X-ray guided percutaneous live review of 24 cases were divided into L-x group,CT guided percutaneous biopsy in 27 cases were divided into L-ct group.According to the packet respectively in X-ray or CT monitoring,the use of bone biopsy needle under local anesthesia,transpedicular approach for spinal lesions of bone amount,by changing the working path or direction bone biopsy needle of different diameter to save drilling samples which were immediately placed in 10％ formalin,specimens were sent for pathological examination and corresponding pathological and cytological examination.The success rate,diagnostic accuracy and complications of percutaneous biopsy were compared between the two groups in X-ray and CT guided percutaneous vertebral biopsy.Results T-x group of 25 patients,5 patients with puncture failure for intraoperative X-ray monitoring difficulties were transferred to puncture under the guidance of CT,the success rate of puncture was 80％ (20/25).Of the patients with success puncture,6 cases were unidentified by pathological examination,the total diagnostic accuracy rate of biopsy in T-x group was 70％ (14/20).The success rate of puncture in T-ct group was 100％,significantly higher than that of T-x group(P ＜ 0.05).In T-ct group,3 cases were unidentified by pathological examination,the total diagnostic accuracy rate of biopsy was 88.5 ％ (23/26),which was significantly higher than that of T-x group (P ＜ 0.05).In the L-x group,1 case with puncture failure for pain during the operation,the success rate of puncture was 95.8％ (23/24),patients of L-ct group were successfully punctured,the success rate was 100％,the difference between the two groups was not significant(P ＞ 0.05).In the L-x group,2 patients failed to confirm the diagnosis,the diagnostic total accuracy rate of L-x group was 87.5％ (21/23);of the L-ct group,1 cases failed to confirm the diagnosis,the diagnosis total accuracy rate of L-ct group was 96.3％ (26/27),the difference between two groups was not significant (P ＞ 0.05).Complications:In the T-x group,1 cases received additional local anesthetic after puncture for pain;1 patients had transient lower extremity paresthesia,and the symptoms were improved 1 weeks later;1 case with intraoperation puncture site paining was not alleviated and had to stop the puncture.All patients with CT guided biopsy had no complications.Conclusion CT and X-ray guided percutaneous biopsy has important significance in diagnosis and treatment of spinal lesions,and CT guided percutaneous biopsy is safer for thoracic lesions with higher diagnostic rate,while for lumbar lesions fluoroscopy,X-ray or CT guided percutaneous biopsy has the same security and diagnostic rate.
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Objective To explore the influence of the comprehensive and continuous management on the quality improvement of medical equipment in the operation room.Methods The"Five in One"mode,which consisted of organization scheme, regulations implementation, operation training, utilization supervision and maintenance, was applied in an observation group,and a control group was established with conventional management mode.The two groups were compared in the times per week of medical equipment utilization, maintenance and hidden risks elimination, the incidence rates of failures and adverse events as well as the medical staffs'satisfaction.Results The observation group had the times per week of medical equipment utilization and hidden risks elimination significantly more than those of the control group, while the times in a week of medical equipment maintenance,failures and adverse events less statistically(P<0.05).The medical staffs' satisfaction in the observation group was enhanced obviously when compared with that in the control group (P<0.05). Conclusion The new"Five in One"mode is effective in solving the problems that occur when the old decentralized mode is adopted for medical equipment management in the operation room. [Chinese Medical Equipment Journal,2018,39(5):84-86]
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Objective To estimate the effect of diversified training model in training nurses in operation room. Methods A total of 36 nurses during 2014-2016 were chosen by using diversified training model. The effect and degree of doctors′satisfaction were evaluated. Results After diversified joint training, the average specialist theoretical scores of orthopedic surgery specialist nurses in 2014, 2015, 2016 were 78.444±6.243,84.072±4.754,90.565±2.597; the operational skill scores were 79.444± 4.623, 84.472±2.922,90.118±2.713, the differences were statistically significant (F=58.156, 82.619,P＜0.05). Preoperative operating specification rates were 72.2% (26/36), 86.1% (31/36), 100.0% (36/36);intraoperative operating specification rates were 75.0% (27/36), 83.3% (30/36), 100.0% (36/36); surgical instrument operating specification rates were: 66.7% (24/36), 83.3% (30/36), 97.2% (35/36); surgical fit:72.2% (26/36), 88.9% (32/36), 97.2% (36/36), the differences were statistically significant(χ2=9.755-11.624, P＜0.05). Conclusions The diversified training model is a valuable method in training nurses in operation room.
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A fines del 2017 el Depto.de Anestesiología del Hospital de Clínicas realizó la presentación del MANUAL: MANEJO de CRISIS en SALA de OPERACIONES. A continuación hacemos una síntesis de los fundamentos que llevaron a la elaboración-adaptación de dicho manual para nuestro país (basado en ''OR Crisis Checklists '' disponible en www.proyectcheck.org/crisis).
At late 2017`s the Anesthesiology Department of "Hospital de Clinicas" presented the manual named: Crisis Management in operation room. Following, we make a summary of the bases that lead to the making-adaptation of such manual for our country (based on "OR Crisis Checklists" available atwww.proyectcheck.org/crisis).
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Humans , Operating Rooms/methods , Checklist , Intraoperative Complications/prevention & controlABSTRACT
Objective To design a thermal alarm sensing controller to avoid burns by the high-frequency electric knife in the operating room. Methods The system development of the controller was executed under Visual DSP, and a thermal alarm sensing control method based on multi-thread temperature feedback regulation was proposed for eliminating the risk of the burns by the high-frequency electric knife in the operating room. The functional and technical indexes of the controller were analyzed to construct its overall framework model, the control law was designed for the temperature feedback control of the controller, and proportion-integral-derivative (PID) control algorithm was applied to the improvement of the controller. Modular design was involved in the controller hardware which was composed of the temperature sensing AD module, baseline drift suppression module, high voltage adjust module, interrupt module and alarm communication circuit. Software process was designed, and then simulation experiment was carried out to test the performances of the controller. Results The controller gained advantages in high loading performance and high-frequency baseline at zero level to realize compensation, and was gifted with high anti-interference ability and precision when fulfilling the safety control of the high-frequency electric knife by multi-thread temperature regulation and overheating interrupt. Conclusion The controller behaves well in the alarm against the burns by the high-frequency electric knife in the operating room.
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Objective To explore the management of non-responsible articles checking inveracity in operation room. Methods From January 2016 to January 2017,22 cases of non-responsible articles checking inveracity events were analyzed and the countermeasures were put forward. Results Twenty-two cases of non-responsible operation articles checking were the minor defects of surgical instrument. 7 cases related to incorrect operation of the surgeon and the indifference of the goods inventory consciousness. 9 cases were from the department of orthopedics, 5 cases were from the department of gynaecology,3 cases were from the department of hepatobiliary surgery,and another 5 cases were from other department. In the style of surgery, 12 cases of 22 cases were from minimally invasive surgery,10 cases were from open surgery.In the style of articles,10 cases were from one-off consumptive material,8 cases were from conventional instruments of surgery,and the rest of 4 cases were from rent instruments. Conclusions We should strengthen the occupation safety education for surgeons, enhance the orthopedics specialized surgical cooperation and management of external instruments,formulate checking rules of articles, summarize and revised the requirements of minimally invasive surgery.We should work on standards for new consumptive material and surgical instrument. Wen should work on the emergency plans of non-responsible operation articles checking inveracity events,timely write the report of accident events.
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Objective To study and analyze the application of Humanistic Psychological Intervention in the operation of laparoscopic bladder tumor resection and ileal neobladder. Methods 100 cases of laparoscopic bladder tumor resection and ileal neobladder were selected from February 2015 to December 2016 in our hospital as the study subjects, and randomly divided into the control group and the experimental group, with 50 patients in each group. The patients in control group received routine nursing care, while the experimental group received Humanistic Psychological Intervention Nursing in operation room. The nursing satisfaction and related clinical indicators were compared in the two groups. Results After the corresponding nursing, the total satisfaction in the experimental group was 47 cases (94%), the total satisfaction in the control group was 36(72%). The satisfaction degree of the patients in the experimental group was significantly higher than that in the control group, the difference was statistically significant (P<0.05). The hospitalization time and operation time of the experimental group were significantly shorter than those of the control group, and the amount of bleeding in the control group was significantly higher than that in the experimental group, the difference was statistically significant (P<0.05). Conclusion The application of operation room humanized psychological intervention after resection of ileal neobladder surgery in laparoscopic bladder tumor can improve nursing satisfaction to a large extent, improve the treatment effect of the patients, help patients recover, with further clinical promotion and application significance.
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<b>Objective: </b>From September 2009, the Department of Pharmacy of Kitasato University Kitasato Institute Hospital started operation room services, and the pharmacist in charge also responds to the inquiries from the operation room staff (doctors and nurses) concerning pharmaceutical compounds. In the present study, we collected the inquiries and analyzed their contents in order to understand the information of pharmaceutical compounds required by the operation room staff.<br><b>Methods: </b>The inquiries from operation room staff received between October 2009 and March 2012 were collected and the contents were analyzed.<br><b>Results: </b>A total of 625 inquiries (mean, 20.8 inquiries per month) were received. Regarding the contents of inquiry, the most frequent inquiry was on “the presence or absence of the stock” (70.7%), followed by “drug information” (17.0%), “handling of controlled substances” (5.9%), and “handling of non-controlled substances” (4.2%). For “the presence or absence of the stock,” the most common pharmaceutical compounds inquired were antibacterial agents, anesthetics, and infusion fluids. For “drug information,” the contents were diverse, ranging from drug efficacy to operation method, whether compounds are included in hospital drug list, in-hospital preparations, and drug selection. For “handling of non-controlled substances,” the most frequent inquiries were associated with the expiration date after unsealing.<br><b>Conclusion: </b>The most frequent inquiry from the operation room staff was on “the presence or absence of the stock,” and the common subject of inquiry was presumably pharmaceutical compounds frequently used at the time of surgery. The analysis showed that the operation room requires a wide range of information.
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Objective:To discuss PDA-based operation room management model and optimize the management procedure of operation room.Methods: Ninety six cases of patients were selected and evaluated the satisfaction by using traditional operation and PDA operation, compared with the experimental results.Results: The nursing efficiency has been improved by 27.5%, the nursing error has been decreased to zero and the patient satisfaction has been maintained more than 96% after PDA large screen call system used.Conclusion: The large screen call system based on PDA has optimized the nursing workflow, improved the nursing efficiency and quality, promoted the innovation of nursing mode and advanced the management level.
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Objective To explore the effects ofDoctor-nurse Integratingmode on the operation room nursing quality improvement. Methods From July 2014 to Dec. 2014,11 423 operations in our hospital were chosen as control group,while 10 897 operations from Jan. 2015 to June 2015 as intervention group.An administrating group of Doctor-nurse Integrating mode was formed, with both doctors and nurses acting as quality controllers. A144 Regular Meetings System was also formed. The author retrospected and analyzed 11 423 negative accidents which occurred during operation. Management details and responsibilities were specified, and training was enhanced. All these were monitored, controlled, implemented and improved by operation doctors, anaesthesia doctors and operation room nurses. Results The rate of negative accidents dropped from 1.226%(140/11 423) to 0.340%(37/10 897) since the implementation of Doctor-nurse Integrating mode of operation quality control. Conclusions Doctor-nurse Integrating mode of operation quality control has positive effects on the improvement of operation nursing quality.