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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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Objective To compare predictive power for deep vein thrombosis among hip and knee joint replacement patients using Autar scale and Wells scale.Methods Convenience sampling method was used.Totally 331 patients from ten tertiary hospitals receiving hip and knee joint replacement were recruited.General information questionnaire,Autar scale and Wells scale were used to collect data.Telephone follow-up was performed at 2 weeks,1 month and 3 months after hospital discharge.The primary endpoint of follow-up was occurrence of DVT,and the secondary endpoint was no occurrence of DVT within 3 months after hospital discharge.Results The Cronbach's α coefficients of Autar scale ranged from 0.716 to 0.762 for scores 24h before operation,24h after operation and at the day of discharge,and those of Wells scale ranged from 0.580 to 0.603.The area under the ROC curve of Autar scale ranged from 0.726 to 0.798.The area under the ROC curve of Wells scale ranged from 0.568 to 0.628.Conclusion The predictive power of Autar scale was higher than that of Wells scale which enabled Autar scale to better predict deep vein thrombosis for patients receiving hip and knee joint replacement.
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BACKGROUND:Compliance of mechanical device reduced in the prevention of deep venous thrombosis. OBJECTIVE:To evaluate the compliance on mechanical prevention measures in the prevention of deep venous thrombosis, and to analyze the reason for compliance reduction. METHODS:We searched Cochrane Library, PubMed, Embase, and Medline for articles on compliance of inpatients on mechanical device for prevention of deep vein thrombosis published from inception to December 2015. At the same time, the“snowbal”method was used to screen the references. After the literatures were screened, using the Newcastle Ottawa Scale tools and Agency for Healthcare Research and Quality standard, two researchers evaluated the quality of the literatures independently and strictly. Data were extracted if meet the discharge standard. The software of Meta-analyst Beta3.13 was used for heterogeneity analysis and publication bias test in the extracted data. According to the heterogeneity analysis results and literature types, a reasonable statistical analysis method was selected to col ate, summarize and discuss. RESULTS AND CONCLUSION:Final y, 12 papers were included, 9 of which were cross-sectional studies, 2 cohort studies, and 1 case-control study. The odds ratio about compliance rate of inpatients with mechanical devices was 53.2%(95%CI:38.7-67.2). Subgroup analysis showed that the odds ratio about compliance rate of pneumatic compression devices was 54.9%(95%CI:34.9-73.4). The odds ratio about compliance rate on elastic stockings was 47.9%(95%CI:34.3-61.8). The detection of mechanical device of surgical patients showed that odds ratio about compliance rate was 66.8%(95%CI:47.4-81.7). Our results confirm that the compliance rate of the use of mechanical devices for the prevention of deep venous thrombosis in clinical inpatients requests to be improved. The reason for reduced compliance rate should be further investigated to improve the compliance rate.
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BACKGROUND:Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE: To investigate the efficacy and safety of intravenous drip combined with intra-articular injection of tranexamic acid on postoperative hidden blood loss in patients who received primary total hip arthroplasty. METHODS:Clinical data of 65 patients undergoing primary total hip arthroplasty were randomized to the test group and the control group. The patients in the test group received 0.5 g tranexamic acid through intravenous drip when the surgery starts and 0.5 g tranexamic acid inside hip joint through a drainage tube after capsule closure, and retaining for 6 hours. The patients in the control group intravenously received the same volume of physiological saline, and 50 mL physiological saline through a drainage tube after suture, and retaining for 6 hours. We compared with intraoperative blood loss, postoperative dominant blood loss and hidden blood loss, pain score, blood transfusion rate, deep vein thrombosis and day of hospitalization in both groups. RESULTS AND CONCLUSION:Hemoglobin and hematocrit were higher in the test group than in the control group after replacement (P 0.05). These results indicate that the intravenous drip combined intra-articular injection of tranexamic acid in patients receiving total hip arthroplasty could reduce the amounts of postoperative dominant and hidden blood loss and blood transfusion rate, and did not increase the incidence of deep vein thrombosis.
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Venous thromboembolism is a serious complication of the patients undergoing orthopaedic surgery.Effective diagno-sis and assessment are important methods to predict venous thromboembolismand decrease the incidence of venous thromboenbolism . This paper summaries the advantages and disadvantages of subjective and objective assessment tools to help doctors and nurses find the patients with high risk in the early stage,take individual prevention,and decrease the incidence of venous thromboembolism.