The Intervention Study Of Patients Care Bundles Applied In The Prevention Of Venous Thrombosis After Undergoing Total Hip Replacement

Objective:Depend on the Evidence-Based Medicine methods to construct the care bundles prevention strategy of lower deep vein thrombosis for the patients of undertaking total hip replacement,improve the quality of clinical nursing.Discuss the feasibility and effectiveness of patient care bundles in the prevention of lower deep venous thrombosis after total hip replacement,provide certain scientific information for the clinical nursing practice.Methods:Depend on the Evidence-Based Medicine methods to construct the care bundles prevention strategy of lower deep vein thrombosis for the patients of undertaking total hip replacement,which is revised and perfected by the expert consultation method.The evidence-based nursing practice group was set up under the guidance of the tutor group,which was by the charge of the head nurse to regularly train the nurses in the Department of orthopedics for evidence-based nursing and deep vein thrombosis and supervise the implementation of the cluster nursing intervention program.Undertake Color Droppler ultrasound examination of both lower limbs to 60 patients undertaking total hip replacement in department of orthopedics ward of Yanan Hospital of Kunming city,60 patients have no lower deep venous thrombosis,according to the random number table,60 patients was divided into the control group and the observation group of 30 cases,and use sequential and numbered sealed opaque envelopes to save random packets,routine nursing prevention in control group,patient care bundles in observation group includes early functional exercise,use of air pressure pump,hypodermic injection of low molecular weight heparin or oral Lev Shaaban,Knowledge-Attitude-Practice interventions.The two groups were observed and recorded before and after the intervention of lower extremity vascular color Doppler ultrasound examination results,four items of blood coagulation,clinicalsymptoms,Well’s thrombosis risk score,Harris hip score,deep venous thrombosis before and after the letter score and training of nurses in the Department of orthopedics KAP score,compared two patients with lower extremity deep after the group of venous thrombosis.Results:1.After screening,the final inclusion articles included 3 evidence summaries,2evidence-based guidelines,1 evidence abstract,and 2 best practice information;main evidence of Patient Care Bundles strategies was extracted.2.Undertake preoperative Color Droppler ultrasound examination of both lower limbs to 60 patients undertaking total hip replacement in department of orthopedics ward of Yanan Hospital of Kunming city,60 patients have no lower deep venous thrombosis,two groups of patients undertake Color Droppler ultrasound examination on the tenth day after surgery,the observation group have no blood flow block and venous thrombosis,whereas the control group have blood flow block of 5 cases and venous thrombosis of 1 cases,the difference between the two groups of Color Droppler ultrasound examination results has statistical significance(P<0.05).3.The difference between the two groups of in preoperative has no statistical significance(P>0.05),after the end of the course,the difference between the two groups of four items of blood coagulation still has no statistical significance(P<0.05).4.Two groups were examined before operation,and no clinical symptoms related to deep venous thrombosis of limb superficial varicose,limb tibial tuberosity 10 cm swelling,limb deep vein along to tenderness,limb Hoaman syndrome and limb Pratt’s syndrome were found,end of therapy,two groups of patients were compared with the occurrence of limb tibial tuberosity 10 cm swelling,limb deep vein along to tenderness,limb Hoaman syndrome and limb Pratt ’s syndrome,the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).But two groups of patients were compared with limb superficial varicose,the difference was no statistically significant5.There was no significant difference in the Well ’s score between the two groupsbefore intervention(P>0.05).After the end of the treatment,the Well’ s score in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).6.There was no significant difference in the Harris score between the two groups before intervention(P > 0.05).After the end of treatment,the Harris score in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).7.There was no significant difference in knowledge,attitude and behavior between two groups before intervention(P > 0.05).After treatment,the score of knowledge and belief in deep venous thrombosis of observation group was higher than that of control group,the difference was statistically significant(P<0.05).8.The score of evidence-based nursing and deep venous thrombosis after training in Department of orthopedics was higher than that before training,and the difference was statistically significant(P<0.05).Conclusion:1.The construction of the care bundles prevention strategy of lower deep vein thrombosis for the patients of undertaking total hip replacement is feasible,which can provide certain scientific information for the clinical nursing practice.2.Patient care bundles is beneficial to reduce the occurrence risk of lower deep venous thrombosis after total hip replacement,relieve the symptoms of lower deep vein thrombosis for the patients of undertaking total hip replacement and promote the recovery of postoperative hip joint function in patients,which deserves to popularize and apply in clinical practice.3.Well’s Scale is beneficial to early warning the occurrence risk of lower deep venous thrombosis after total hip replacement,which deserves to popularize and apply in clinical practice.4.Knowledge-Attitude-Practice interventions beneficial to improve the business level and evidence-based quality of orthopedic nurses and the patients of undertaking total hip replacement in the cognitive degree of deep venous thrombosis.It helps to improve the compliance of cluster intervention program,improve thequality of clinical nursing and clinical nursing management,reduce the occurrence risk of lower deep venous thrombosis after total hip replacement and improve the clinical outcomes of patients.