| Objective :to explore the clinical application value of establishing the integrated management mode of anesthesia and nursing combined with predictive nursing after anesthesia for the elderly,so as to provide a reference for the elderly patients with clinical elective surgery to reduce complications after anesthesia.Through clinical trials,the influence of anesthesia nursing integrated management mode combined with predictive nursing on the attitude of medical cooperation and the satisfaction of medical work were analyzed.Methods :a randomized controlled study was used in this study.115 elderly patients who met the inclusion criteria after general anesthesia from June 2019 to December 2019 were randomly divided into control group(50)and experimental group(65)according to the computer.1.Control group: traditional nursing mode was applied: the original anesthesiologist of the patient and the paramedics of PACU were transferred,PACU did not set up full-time anesthesiologist,the nursing group was composed of N3 chief nurse and a nurse,the patients were observed by the paramedics,and the patients were given routine nursing and predictive nursing according to the general nursing in the anesthesia recovery room.If the patient has any abnormality,report it to the original anesthesiologist of the patient immediately and handle it according to the doctor's order.Experimental group: anesthesia nursing integrated management mode combined with targeted predictive nursing.An integrated management group of anesthesia and nursing was established.The members of the integrated management group of anesthesia and nursing were composed of PACU full-time anesthesiologists and hierarchical nursing team members.In the process of diagnosis and treatment from entry to exit in the anesthesia recovery room,the original anesthesiologist and nurse of the patient hand over the patient to the full-time anesthesiologist and nurse of PACU.In PACU,the full-time anesthesiologist and N4 level nurse use scientific medical knowledge to makespecific analysis according to the patient's condition,quickly make predictive nursing plans and measures,which are implemented by N3 level nurse Improve the ability of risk prevention and treatment.To provide targeted predictive nursing for the possible complications,to ensure the safety of elderly patients in PACU,and to lay the foundation for the whole process nursing of patients' rehabilitation.To provide patients with combined medical and nursing services in the form of anesthesia and nursing integrated dual discipline team cooperation.Data collection: general data,Qor-40 anesthesia recovery evaluation scale,and preoperative evaluation and education by members of the integrated group were collected.After the operation,the patients were filled in by PACU specialist nurses,Aldrete scoring record form,visual simulation scoring method,complications,symptoms and patients' satisfaction.24 hours,three days after operation and seven days after operation,the patients filled in visual analogue scoring method and qor-40 anesthesia recovery evaluation scale.2.Statistical processing: spss22.0 software is used for statistical analysis,percentage is used for qualitative data,chi square or Fisher exact probability method is used for inter group comparison;when quantitative data do not conform to normal distribution,median and quartile spacing are used for statistical description,rank sum test is used for inter group comparison;when quantitative data obey normal distribution,mean ± standard is used for statistical description The difference between the two groups was statistically significant(P < 0.05).Result:1.The operation time between the control group and the experimental group was compared,P > 0.05,the difference was not statistically significant;the anesthesia recovery time between the two groups was compared,P < 0.05,the difference was statistically significant..2.Comparison of Aldrete group scores: there was no statistical significance in the comparison of T0,T1.5 and t out of the room between the t control group and the experimental group(P > 0.05);there was statistical significance in the comparison of T0.5 and T1 between the control group and the experimental group(P < 0.05).3.Comparison of scores in Aldrete group: there were significant differences between the two groups in the time of T0,T0.5,T1,T1.5 and T out of the room(P <0.05).Further comparison between t0 and T0.5,t0 and T1,t0 and T1.5,T0 and T out of the room,T0.5 and T1,T0.5 and T1.5,T0.5 and T out of the room,T1 and T1.5,T1 and T out of the room,T1.5 and T out of the room(P < 0.05).There were differences between T0,T0.5,T1,T1.5 and T out of the room Compared with the time of leaving the room,the difference was statistically significant(P < 0.05).4.Score comparison between vas groups: there was no significant difference between the two groups on the third day and the seventh day after operation(P > 0.05);there was no significant difference between the two groups on the first day after operation(P < 0.05).5.Comparison within vas group: the difference between the two groups was statistically significant(P < 0.05)on the first day after operation,the third day after operation and the seventh day after operation;further comparison between the two groups showed that: the first day after operation,the third day after operation,the seventh day after operation,the third day after operation,the first day after operation and the seventh day after operation The difference was statistically significant(P <0.05);6.Qor-40 score of the two groups: the physical comfort,emotional state,psychological support,self-care ability and pain of the two groups were statistically significant(P < 0.05)in the period of one day before operation,one day after operation,three days after operation and seven days after operation;further two comparisons:physical comfort,emotional state,psychological support,self-care ability and pain oneday before operation and one day after operation One day before and three days after operation,one day after operation and three days after operation,one day after operation and seven days after operation,three days after operation and seven days after operation are statistically significant.7.Qor-40 score between the two groups: the physical comfort,emotional state,psychological support,self-care ability and pain of the two groups on the day before operation,three days after operation and seven days after operation were compared between the control group and the experimental group(P > 0.05),the difference was not statistically significant;the physical comfort and pain of the one day after operation were compared between the two groups(P < 0.05),the difference was statistically significant.8.Average handover time of the two groups: in the experimental group,the handover time of the clinical nurses was(14.20±0.83)min,while that of the control group was(15.03±0.92)min,the difference was statistically significant.(P < 0.05)9.Comparison of complications between the two groups: the main complications of the two groups were hypoxemia,abnormal heart rate,nausea and vomiting,and consciousness disorder.3 patients in the nursing group had nausea and vomiting,1patient in the control group had hypoxemia,6 patients had abnormal heart rate,3patients had nausea and vomiting,3 patients had consciousness disorder,and the rate of complications was 20%.The data of the two groups were statistically significant.Conclusion: the integrated management mode of anesthesia and nursing combined with the application of predictive nursing is beneficial to shorten the recovery time,reduce the incidence of restlessness,reduce postoperative complications,improve the efficiency of nursing workers and improve clinical satisfaction. |
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