Perioperative Nursing Intervention On Patients With Parastomal Hernia By Specialist Nurses In The Operating Room

ObjectiveExploring the effects of perioperative nursing intervention on patients with parastomal hernia by nurses in the operating room, to provide theoretical basis for effective perioperative nursing intervening by nurses in the operating room, and to improve the prognosis of patients.MethodsForty-two cases undergoing parastomal hernia repair surgery inaprovincial hospitalbetween August2011and June2014were randomly divided into Intervention Group(n=21)and Control Group(n=21). The proceed tissue isolation type mesh (Johnson&Johnson) proceed were utilized to repair the parastomal hernia under endotracheal intubation general anesthesia in both groups. Besides traditional nursing, patients in Intervention Group received perioperative nursing intervention-including the effective preoperatively psychological nursing, cooperating visits with anesthesiologist before surgery, operation details of nursing and humanistic care, postoperative visit, and prevention and treatment of complications-by specialist nurses in the operating room according to their psychological and physiological characteristics. Traditional preoperative nursing were given to other patients in the control group, including psychological nurse caring and preopreative examination, ward nursing like drainage tube nursing, stoma care and complication prevention, and the roles of nurse in the operating room. Recording the patients’ BP and HR:the morning in the second day in hospital, the moment before going into the operating room, the moment before anesthesia induction in the operating room, the moment at the beginning of the operation,1h after the surgery began, the end of operation and the moment when pulling out the endotracheal tube in the recovery room. Anxiety were investigated with the Self-Rating Anxiety Scale (SAS) the day before surgery, at the moment before surgery in the operation room, the moment before anesthesia induction in the operating room and three days after operation respectively. Using the visual analogue scale to investigate the pain after the patients revival. Satisfaction with nurses in the operating room was investigated when they were paid a postoperative visit and days of patients’ staying in hospital were compared between two groups.Results1.There were significant differences in systolic blood pressure (SBP) in three time points-the moment before going into the operating room, the moment before anesthesia induction in the operating room, and the moment when pulling out the endotracheal tube in the recovery room--between two group (P<0.05). However, there were no statistical significance in the other three time points-the morning in the second day in hospital, the moment at the beginning of the operation,1h after the surgery began, and the end of operation (P>0.05).2.Significant differences of HR were found in two time points-the moment before anesthesia induction in the operating room, and the moment when pulling out the endotracheal tube-were shown (P<0.05). However, there were no statistical significance in the other five time points-the morning in the second day in hospital, the moment before going into the operating room, the moment at the beginning of the operation,1h after the surgery began, and the end of operation (P>0.05).3.Significant differences of anxiety levels were found at the moment before anesthesia induction in the operating room between two groups (P<0.05). However, no statistical significance seen the day before surgery,and three days after operation respectively(P>0.05).4.Satisfaction of patients with nurses in the operating room in the intervention group (100%) was significantly higher than that in control group (81%)(P<0.05). 5. The visual analogue scale grade of intervention group was significantly lower than the control group(P<0.05).6.Patients in intervention group stay significantly longer in hospital than patients in control group(P<0.05).ConclusionsPerioperative nursing intervention executed by specialist nurses in the operating room decreased the levels of SBP and HR after the patient going into the operating room and extubation, also decreased anxiety levels at the moment before anesthesia induction in the operating roomand hospital stay,improved the satisfaction degree of patients when suffering less pain,which helped the perioperative patients to recover quickly.