ObjectiveTo explore the continuous care demands in liver transplant recipients and the influencing factors. MethodFrom October to December 2013, 235 liver transplant recipients were investigated with self-designed questionnaire to learn their continuous care demands. Factors affecting demands for continuous care were analyzed with single factor Chi square analysis and binary logistic regression analysis. ResultsA total of 130 recipients (55.3%) needed continuous care. Single factor chi-square analysis showed that three factors including complications, re-hospitalization and time to get to the nearest medical organization were significant for continuous care demands (P<0.05). Binary logistic regression analysis showed that the longer the time spent by liver transplant recipients to reach the nearest medical organization was, the more they hoped for continuous care[OR=3.040, 95%CI (1.585, 5.829), P=0.001]; the patients with readmisson within one year after surgery hoped less continuous care[OR=0.515, 95%CI (0.292, 0.907), P=0.022]. ConclusionsAt present, acceptance degree for continuous care in the liver transplant recipients is quite high. In the continuous care research and practice, we should develop new models and tools to shorten the time and distance between nurses and patients so as to meet the individualized care demands of the patients and improve their quality of life.
Objective To explore the application of fast track surgery (FTS) mode through multidisciplinary cooperation for the perioperative period of liver cancer. Methods A total of 188 patients with liver cancer treated between April and December 2014 were randomly divided into two groups: FTS group (n=94) and control group (n=94). The FTS group was treated with multidisciplinary cooperative FTS mode, while the control group was treated with traditional perioperative treatment. The self-care ability of daily life, pain, ambulation time and frequency, anal exhaust time, defecation time, hospital stay, hospitalization expenses and readmission rate were compared between the two groups. Results Compared with the control group, patients in the FTS group had a better ability of self-care one to three days after surgery, more reduced pain 8, 24 and 48 hours after surgery, more frequent ambulation and longer ambulation time three days after surgery, shorter time of defecation and exhaust, shorter hospital stay and lower hospitalization expenses. All the above differences were statistically significant (P<0.05). The readmission rate, self-care ability four to seven days after surgery, pain scores 72 and 96 hours after surgery were not significantly different (P>0.05). Conclusion Multidisciplinary cooperative FTS mode for liver cancer perioperative rehabilitation can improve patients’ self-care ability, promote a speedy recovery, reduce hospitalization costs, save medical resources and improve disciplinary teamwork ability.
Objective To investigate the risk factors and prevention methods of the venous thromboembolism (VTE) after hepatectomy. Methods The literatures about VTE after hepatectomy in recent years at home and abroad were reviewed and summarized. Results The risk factors for postoperative VTE include tumor, male, old age, massive hepatectomy, hypercoagulability, etc. The incidence of VTE in patients with massive hepatectomy is significantly higher, which is closely related to the hypercoagulability caused by postoperative liver dysfunction. Effective prophylaxis include mechanical methods and anticoagulant drugs, the latter of which can markedly reduce the incidence of VTE. For patients who develop postoperative liver insufficiency, including those with cirrhosis and high risk of bleeding, anticoagulant VTE prophylaxis dosing decisions should be made with caution. In addition, it is rationale for extended thromboprophylaxis in high risk patients. Conclusions VTE is a common complication after hepatectomy, resulting in prolonged postoperative hospital stay and increased postoperative mortality. Therefore, it is important to determine the risk of VTE after surgery to improve the prognosis of patients after hepatectomy.
目的 调查临床护士对静脉输液治疗相关知识的知晓度，分析存在的问题，以便有针对性地进行专业指导和培训。 方法 2011年8月，自制静脉输液治疗相关知识知晓度的调查问卷，利用护士参加医院集体培训的机会对158名临床护士进行问卷调查。 结果 ① 70.3%的护士静脉输液治疗知识主要来源于医院培训，护士对静脉输液治疗知识的内涵认识欠全面。② 44.2%护士对留置针的规范化固定及冲、封管方法了解不充分，仅约1/3的护士了解留置针A-C-L维护法，规范维护管理知识掌握不充分。③ 护士对静脉输液常见并发症认识欠深入，认为常见并发症发生的主要原因与患者的血管有关（静脉炎占78.5%，渗出占83.5%，导管堵塞占81.0%）。④ 9%的护士发生针刺伤后不能正确处理，护士对针刺伤原因认识清晰，处理方法还需加强培训。 结论 临床护士对静脉输液治疗相关知识的掌握欠全面性、系统性和专业性，需要对护士采取多种形式、多种途径的专业指导和培训，才能使临床护士全面掌握静脉输液治疗相关知识，促进静脉输液治疗规范化和专业化，有效保障护理质量和安全。
ObjectiveTo explore the application effect of itinerant strengthening post in ophthalmic day operating room.MethodsIn June 2019 (before the establishment of the itinerant strengthening post) and January 2020 (after the establishment of the itinerant strengthening post), satisfaction of 21 ophthalmic surgeons in the ophthalmic day operation room of the West China Hospital of Sichuan University on intraoperative nursing cooperation, and coping ability scores of operation in key links, satisfaction with scheduling and workload, as well as complaints and accusations received by surgeons of 15 ophthalmological nurses in the ophthalmic day operation room of the West China Hospital of Sichuan University were collected. The total volume of eye day surgeries and the length of the day operating room open in the second half of 2018 and 2019 were retrospectively collected.ResultsAfter the establishment of the itinerant strengthening post, the coping ability score of operation in key links of ophthalmological nurses was improved [(3.28±0.72) vs. (4.67±0.72), P<0.01]. In terms of surgeons’ satisfaction with intraoperative nursing cooperation, with the exception of aseptic operation, the other items were improved (P<0.05). The surgical nurses’ satisfaction with scheduling and workload [(3.30±0.77) vs. (4.47±0.67), P<0.01]; nurses’ complaints and accusations received by surgeons [(3.60±1.18) vs. (2.33±0.82), P<0.01] were improved. The volume of eye day surgery from July to December 2019 increased by 6.58% over the same period in 2018, and the average open time of the operating room increased by 1.88%.ConclusionThe setting up of itinerant strengthening posts in the ophthalmology day operation room is conducive to strengthening the strength and business guidance of the nurses’ key links in the operation room in a timely and effective manner. It can optimize the allocation of human resources in the operating room as much as possible when the existing nursing staff is in short supply, and improve the quality and efficiency of ophthalmic surgery nursing, which is worthy of promotion and application.
Objective To explore the feasibility and the security of one-day stay ward in stripping surgery of saphenous vein varicosity. Methods Two hundred and eighty two patients treated in our hospital in 2011 were enrolled in this study， according to the operation mode， these patients were divided into 2 groups， ninety patients in one-day stay ward group and one hundred and ninety two patients in in-patient group. Their clinical features and medical operation indexs（included preoperative waiting time， duration of hospital stay， and medical cost）were retrospectively analyzed. Results There was no statistical differences on clinical features between the two groups. But compared with in-patient group， the preoperative waiting time， duration of hospital stay， and medical cost were shorter or lower in one-day stay ward group （P＜0.05）. Conclusions The one-day stay ward operation mode can decrease preoperative waiting time， duration of hospital stay and medical cost significantly， and it also can ensure the safety of clinical treatment. So it’s worthy in the clinical promotion.
Objective To investigate the status quo of implementation ofIntravenous Practice Standard in a tertiary A hospital in Sichuan. Methods At 09:00-11:30 am, on March 16th, 2016, a questionnaire designed by intravenous team (IV Team) was used to conduct the investigation in all the inpatiets according to inclusion and exclusion criteria. The SPSS 17.0 software was used to perform all statistical analysis. Results The intravenous infusion rate in the hospital was 76.87%, while the rate in Emergency Department peaked up to 96.11%. Indwelling needle was the most common used device for intravenous therapy in clinical practice, which was used in 77.91% of the inpatients, and steel needle, peripherally inserted central catheter (PICC), central venous catheter, and implantable venous access port were also widely used. Peripheral intravenous catheter was used in 2 990 inpatients, and 78.12% of the puncture sites met the standard; PICC was used in 397 inpatients, and 90.17% of the puncture sites met the standard. The incidence of intravenous infusion related-complications was 15.08%, the incidence of drug exosmosis / exudation was 10.06%, and the incidence of catheter-related blood stream infection (CRBSI) was 2.89%. Conclusions On the whole, the intravenous infusion rate in this hospital accords with the national average level, but the rate in some departments should be controlled. The selection of device for intravenous therapy is reasonable, but the selection of intravenous site should be more standardized. The incidence of intravenous infusion related-complications is low, but the prevention and control of drug exosmosis / exudation and CRBSI should be reinforced. Health care organizations should pay more attention to enforce the Intravenous Practice Standard into practice to promote clinical medical service.