| BackgroundHip fractures mainly include femoral neck and intertrochanteric fractures.They are one of the most common fractures in elderly patients,accounting for about 30% of hospitalized elderly patients with fractures.With the intensification of aging,its incidence is increasing year by year.Elderly patients with hip fractures have a high incidence of complications due to long-term bed rest,leading to poor quality of life and even life-threatening.In order to reduce the time spent in bed,surgical treatment as soon as possible is currently used to promote recovery.However,the quality of life of patients after surgery is still at a low-to-medium level.It can be seen that postoperative rehabilitation and care are also essential.Accelerated rehabilitation surgery can promote rapid and excellent recovery of surgical patients.Therefore,this research is based on the concept of Enhanced Recovery After Surgery(ERAS)and rapid surgical treatment as the background to build a systematic and scientific postoperative care for elderly hip fractures.The plan is implemented in order to reduce the postoperative traumatic stress response,reduce complications,and improve hip joint function.ObjectivesThe post-operative nursing program for elderly hip fractures under the ERAS concept is constructed and clinically applied,in order to reduce postoperative traumatic stress response,reduce postoperative complications,shorten hospital stay,and improve hip joint function.Methods1.The research subjects Sixty-five elderly hip fracture patients who were treated by rapid surgery in the Department of Traumatology and Orthopedics of an Orthopedic Hospital in Henan Province from October 2019 to June 2020 were selected as the research objects,and were divided into the control group using a random number table method 34 cases in the test and 31 cases group.2.Construction plan Based on literature research and combined with the actual postoperative needs of elderly hip fracture patients,a postoperative nursing plan for elderly hip fractures based on the concept of ERAS was formulated.After 2 rounds of expert letter inquiries and modifications based on expert opinions and suggestions,a systematic and scientific postoperative ERAS nursing program for elderly hip fractures containing 8first-level indicators and 21 second-level indicators was finally formed.3.Program implementation The control group implemented routine postoperative care program,and the experimental group adopted the ERAS care program for elderly hip fractures based on routine care.4.Evaluation index The two groups of patients were evaluated for pain and nutritional risk scores on the 1st,3rd,and 7th days after the operation;the hip function scores of the patients were evaluated at the time of discharge and 3 months after discharge;the hospitalization time,complications,hospitalization expenses,Patient satisfaction with nursing work.Statistical analysis was performed on the data using SPSS17.0.Results1.Pain and nutritional risk score On the first day after surgery,the pain score(t=-0.796,p>0.05)and nutritional risk score(t=-0.867,p>0.05)of the experimental group were compared with those of the control group.There was no significant difference;On the third day after surgery,the pain score of the experimental group was compared with that of the control group(t=-2.521,p<0.05),the difference was statistically significant;the nutritional risk score of the experimental group was compared with that of the controlgroup(t=-0.892,p>0.05),the difference was not statistically significant;on the 7th day after operation,the pain score(t=-5.906,p<0.05)and nutritional risk score(t=-4.187,p<0.05)of the experimental group were compared with those of the control group.The differences are statistically significant.2.Hip function scores At discharge,the hip function scores of the experimental group were compared with those of the control group(t=1.418,p>0.05),and the difference was not statistically significant;3 months after discharge,the hip function scores of the experimental group were compared with the control group(t=4.433,p<0.05),the difference is statistically significant.3.Other indicators Compared with the control group(t=-4.160,p<0.05),the difference in hospitalization time between the experimental group and the control group was statistically significant.The complication rate was compared with the control group(χ2=4.27,p<0.05),the difference was statistically significant,Satisfaction during hospitalization was compared with that of the control group(t=10.08,p<0.05),the difference was statistically significant;the hospitalization expenses of the two groups were compared(t=-0.801,p>0.05),the difference was not statistically significant.ConclusionsA scientific and practical nursing plan based on the concept of ERAS was constructed after the operation of the elderly hip fracture.This program can reduce postoperative pain,improve nutrition,reduce postoperative complications,improve hip joint function,and shorten hospital stay. |
PDF Full Text Request