A Research Of Continuous Nursing Based On Omaha System In Patients With Total Knee Arthroplasty

Objective Applying for Omaha system to evaluating health problems who operated total knee arthroplasty.Establishing quantitative and continuity Nursing-plan thus provide quantitative functional exercises for total knee arthroplasty and professional,personalized,accurate nursing plan,finally achieving rapid recovery.Methods Selected 55 patients with total knee arthroplasty in July 2016 to July 2017 at Sports Medical Department,using the random number table method 27 cases of 28 cases were randomly divided into trial group and control group,experimental group adopted based on the Omaha system formulated by quantitative protection of told single and continuity care scheme,the control group using conventional knee arthroplasty after the nursing care methods.The postoperative daily knee functional exercise and the change of cognition,behavior and status of patients after the implementation of the program were monitored(Likert five-point scoring method was adopted).At the same time,compare two groups of patients with postoperative 1 day,1 week after operation,1 month,3 months,6 months of pain score(RVAS,DVAS)change,joint mobility,AKS score and postoperative complications.Adopt the Delphi expert consultation method to establish the health assessment form.All data were typed in Excel and analyzed by SPSS20.0 software,measurement data using mean + /-standard deviation,count data using t-test and chi-square test,evaluation of intervention effect in different periods by repeated measurement variance analysis,P < 0.05 difference is statistically significant.Results(1)One week after operation,the recovery evaluation sheet,statistics out physical field problems most(50.90%),then followed by health related behaviors(34.55%),psychosocial areas(10.91%),environment(3.64%).(2)One day after surgery,the problem was focused on pain,urinary,defecation,neuron-muscle-skeletal function;1month-3months after surgery,the problem was focused on intramuscular-skeletal function,physical activity,sleep,and pain.3 months to 6 months after surgery,the problem focused on intramuscular-skeletal function,physical activity,sleep,and income.(3)Examination in patients at different times(after 1 day,1 week,1 month,3 months,6 months)in pain and function of nerve,muscle,bone,physical activity,sleep health problems in four aspects of KBS score comparison difference had statistical significance(P < 0.05).(4)Two groups of patients with resting VAS in postoperative 1 day,1 week after operation,postoperative 1 month,3 months after operation all have significant difference(P < 0.05),dynamic VAS in the first postoperative day no statistical difference(P > 0.05),the first week after operation,postoperative 1 month,3 months after statistically significance(P < 0.05).(5)Two groups of patients of motion on the first day after comparing differences of statistical significance(P > 0.05),postoperative 1 week,1 month,3 months,6 months was statistically significance(P < 0.05).(6)Two groups of patients with postoperative 1week,postoperative 1 month AKS joint score difference was statistically significant(P < 0.05),postoperative 1 week,1 month,3 months,6 months AKS functional score difference had statistical significance(P < 0.05).(7)There were statistically significant differences between the two groups of patients with intramuscular thrombosis(P < 0.05).Conclusion(1)Evaluation system based on Omaha can help nurse after TKA surgery of rapid and exact health problems,avoid each nurse,evaluation results are different each time,so as to improve the compliance of clinical nurses to evaluate consistency and correctly.(2)The care plan based on Omaha intervention system,improve the health problems in different periods in patients with KBS score,make the patients have acertain health care knowledge related to the operation,in the absence of professional nurses independently under the guidance of rehabilitation exercise,as soon as possible to restore the knee joint function.(3)Based on the continuity nursing program of Omaha system,it is helpful to help patients to reduce postoperative pain,improve joint activity and joint functional status,reduce complications,it deserve to be promoted clinically.