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Objective:To investigate the effect of different cleaning methods on the cleaning effect of Da Vinci robotic electrosurgical instruments and the feasibility of adenosine triphosphate(ATP) fluorescence detection technology for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.Methods:A total of 180 electrosurgical instruments were divided into control group and test group by random digits table method from June 2018 to June 2019 after robotic surgery. For the control group, 90 cases were manually cleaned to complete the device cleaning process, and for the test group, 90 cases were mechanically cleaned to complete the device cleaning process. Through visual observation, magnifying glass examination and ATP fluorescence detection technology, the cleaning effect of the two methods and the correlation between the evaluation results obtained by ATP fluorescence detection technique and traditional inspection method were compared.Results:The qualified rate of visual observation, magnifying lens examination and ATP fluorescence detection in the control group were 95.56%(85/90), 86.67% (78/90) and 84.44% (76/90), respectively, and that in the test group were 100.00% (90/90), 97.78% (88/90) and 98.89% (89/90), respectively. The test group was higher than the control group. The difference between the two groups was statistically significant ( χ2 values were 4.310, 7.745, 12.291, P<0.05 or 0.01). In the control group, there was a positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.374, P < 0.01), and a significant positive correlation between the qualified rate of magnifying lens examination ( r value was 0.538, P < 0.01). In the test group, There was also a significant positive correlation between the qualified rate of ATP fluorescence detection and visual observation ( r value was 0.754, P < 0.01), and between the qualified rate of magnifying lens examination( r value was 0.556, P < 0.01). Conclusions:Mechanical cleaning is used to clean Da Vinci robotic electrosurgical instruments, which is superior to traditional manual cleaning. ATP fluorescence detection technology is feasible for evaluating the cleaning effect of Da Vinci robotic electrosurgical instruments.
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Objective@#To analyze the effect of variables on both " effective operative time" and " operative turnaround rate" .@*Methods@#Based on the time node data of operation rooms (OR) of a hospital in 2017, SPSS 19.0 statistical software was used to analyze the " effective operative time" and " operative turnover rate" under different condition variables. The methods include mean value, standard deviation and independent sample t test.@*Results@#The mean values of " effective operative time" varied with months (with the highest month of 9.18±2.49 h/d, and the lowest month of 7.93±2.60 h/d), and with workdays as well (the highest on Monday: 8.72±2.57 h/d, and the lowest on Friday: 7.77±2.67 h/d). Meanwhile it also varied with ORs (the highest of 9.92±2.50, and the lowest of 4.84±1.98). In surgeries which started before 8: 30 am, the effective operative time of OR was significantly higher than others. On Mondays, the effective operative time of ORs was the highest, but the operative turnover rate was poor (as low as 13.20%). There was significant difference in the operative turnover rate between specialized ORs and those not for general purpose.@*Conclusions@#In order to optimize the comprehensive utilization of operation rooms, it is necessary to coordinate the operations, reduce the proportion of non-planned operations on " Mondays" , raise the turnover rate, and strengthen the coordination between working posts.
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Objective To study the application effectiveness of standard operating procedure (SOP) video in management of minimally invasive device cleaning.Methods Standard management began to be implemented in a hospital since January 2015, training was mainly conducted with video-based SOP lecture, defect rate of devices, qualified rate of sterilization package, and satisfaction of surgical staff before (in 2014) and after (in 2015) implementing SOP were compared, management efficacy was evaluated.Results After the implementation of SOP, device defect rate reduced from 6.19％ before the implementation to 0.99％, qualified rate of sterilization package increased from 90.03％ to 98.34％, satisfaction of surgical staff increased from 80.00％ to 97.78％, differences were all statistically significant(all P<0.05).Conclusion The implementation of SOP management can effectively improve the cleaning quality of surgical devices, reduce defect rate of devices, and improve the learning effect of staff, which is worth to be popularized and applied in clinical practice.
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Objective To analyze the application effect of disposable surgery retractor which made of high polymer medical plastic.Methods From January 2016 to October 2016,80 patients of HCC who were treated with hepatectomy under general anesthesia in our hospital were randomly divided into the control group and the observation group according to different retractor during surgery.The control group used the traditional abdominal retractor during the sugery.Meanwhile,the observation group used disposable surgery retractor.The application effect between the two groups were compared.Results The satisfaction rate of surgical exposure and effect in surgeon of the observation group were higher than those of the control group.The wound pain time of patients in perioperative period and 1 month after surgery and chronic pain incidence in postoperative 6 months between the two groups were evaluated.It turned out that the difference in average pain score was statistically significant (P<0.05).Conclusion The disposable surgical retractor can improve the satisfaction rate of surgeons with better surgical exposure,and it can significantly reduce the damage of wound tissue,which effectively relieves the postoperative pain,shortens the time of postoperative pain,and reduces the incidence of chronic pain.
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Objective To investigate APP mobile information technology innovation methods in preoperative visits to patients in the clinical application effect. Methods A total of 840 patients undergoing elective surgery were divided into control group and experimental group by random digits table method with 420 cases each and control group by adopting the method of the nurse oral interpretation of the preoperative visit list and health education leaflets oral interpretation information, experimental group using mobile medical technology innovation preoperative visit method, combining with specialized subject characteristic in APP software design way of cartoon animation and video surgery in patients with preoperative visit. The comparison of two groups of patients with the patients know about the operation, cooperate with surgery, perioperative anxiety levels, hospitalized experience satisfaction four dimensions of experience were performed. Results The patients know about the operation was (7.6 ± 2.3) points in control group and(8.5 ± 2.5)points in experimental group, and there was significant difference between two groups (t=5.430,P<0.01). The cooperate with surgery was 92.62%(389/420) in experimental group and 75.71%(318/420) in control group, and there was significant difference between two groups(χ2=45.032, P<0.01). The perioperative anxiety levels was (38.27 ± 2.50) points in experimental group and (47.21 ± 3.84) points in control group, and there was significant difference between two groups (t=8.420, P<0.01). The hospitalized experience satisfaction was (96.41±2.30) points in experimental group and (93.70±1.51)points in control group, and there was significant difference between two groups (t=3.297, P <0.01). Conclusions Using APP for clinical preoperative visit mobile information technology, which can effectively improve the patients know about the operation and the matching degree, reduce the perioperative patients with anxiety, improve surgical patients during hospitalization medical treatment satisfaction.
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This paper summarized nursing points for caring 23 cases undergoing pediatric heart transplantation,including:characteristics of accessing and protection of hearts,collaboration in pediatric heart transplantation,nursing of capacity management,temperature controlling,extracorporeal membrane oxygenation and delayed sternal closure during surgeries.The average length of hospitalization for 23 cases was 24.5±8.3 days,1 case died from primary graft failure after 19 months,the rest of 22 cases survived,and cardiac function recovered to NYHA class Ⅰ-Ⅱ.