Applied Research Of Cluster Nursing In Preventing Intraoperatively Acquired Pressure Injury In Brain Tumor

Objective:To explore the application effect of clustered nursing in the prevention of surgically acquired pressure injury in patients with brain tumors,and to provide effective nursing services for the prevention of surgically acquired pressure injuries in patients with brain tumors undergoing elective surgery.Combined with clinical nursing practice,the clinical application value of clustered nursing intervention in patients with brain tumors with surgically acquired pressure injury is analyzed through clinical experimental research.Provide a reference for reducing the incidence of surgically acquired pressure injuries in patients with brain tumors.Methods:This study adopted a randomized controlled method.From June 2020 to December 2020,154patients with brain tumors who met the admission criteria and received elective surgery in the neurosurgery department of a tertiary hospital were carried out according to the order of admission,using a random number table method.Sample grouping.Excluding 3 patients with missing information,they were finally designated as the control group and 76 cases in the control group.1.Control group:routinely visit patients one day before surgery:assess the general state of the patient,skin condition and patient activity,and check the Braden score of the patient’s ward.Before surgery,control blood sugar and blood pressure within the normal range.Explain the operation-related matters to patients and their families,so as to relieve the nervousness of the patients and better actively cooperate with the operation.Corresponding nursing measures are given to patients with high risk factors for pressure injury（Braden score≤12 points）.2.Experimental group:A clustered nursing research team was established,consisting of 2head nurses,1 graduate tutor,4 operating room nurses,1 operating room pressure ulcer expert group member,4 neurosurgery surgeons,4 nurses,and researchers.Before the start of the study,a unified training was conducted to learn the related knowledge of stress injury.Refer to the 2019 edition of"Prevention and Treatment of Stress Injuries:Clinical Practice Guidelines"and the evidence-based medical evidence of pressure ulcer evaluation and prevention in 2006,and formulate clustered care measures.Neurosurgery nurses used the NRS2002 Nutritional Assessment Scale to perform nutritional assessment within 48 hours of admission to the hospital,and provided nutritional support to patients with malnutrition.The operating room nurse visited the patients regularly one day before surgery and assessed by the observation sheet of pressure ulcer risk factors of surgical patients.For high-risk patients with scores≥12,inform the surgeon to pay attention to them and give corresponding clustered nursing measures during the operation for high-risk factors.Realizing medical-care cooperation makes medical-care communication and cooperation faster and more efficient,thereby improving the overall quality of medical services.3.Data collection:This study was conducted in the Department of Neurosurgery and Anesthesiology of a tertiary hospital in Inner Mongolia.Before the project was launched,the support and cooperation of the head nurse of the relevant department was first obtained.For this study,the investigator and the nurse in the ward filled out the patient’s one-on-one information and signed an informed consent form.In addition,the questionnaire was returned on the spot after the questionnaire was filled out,and individual items were supplemented and completed in time during and after the operation,and the quality of the filling was checked.4.Statistical analysis:the use of SPSS 25.0 software to statistically process the experimental data,general patient data,surgery-related risk factors,incidence of surgically acquired pressure injuries,univariate analysis of surgically acquired pressure injuries,and doctors’opinions on the operating room The percentage（%）of the nursing staff with the satisfaction score application is expressed,and the chi-square test is used for statistical inference;the mean±standard deviation（X±S）of the patient’s body temperature is expressed,and the t-test and repeated measures analysis of variance are used for statistical inference;the operating room nurses prevent stress The assessment results of sexual injury professional ability obey normal distribution,uniform variance,and use mean±standard deviation（X±S）to express,use t test for statistical inference;patient quality of life scores before and 1 week after surgery and average hospital stay after surgery The median（M）and interquartile range(P₂₅,P₇₅)were used to indicate,and non-parametric tests were used for statistical inference;the influencing factors of surgically acquired pressure injury were analyzed by logistic regression.All hypothesis tests P<0.05 indicate statistical significance.Result:1.Comparing the body temperature of the two groups of patients,the difference in body temperature at different time points is statistically significant.The difference in intervention factors between the experimental group and the control group is statistically significant,and there is an interaction between the intervention factors and the time factors.The results showed that the effects of time factors（ie body temperature before anesthesia,body temperature 2 hours during operation,and immediately after the operation）will vary with the intervention method.2.A univariate analysis of the influencing factors of surgically acquired pressure injury,including NRS2002 score,preoperative hemoglobin,albumin,surgical position,pressure injury high-risk score,surgical time,blood loss and other variables into logistic regression analysis.Logistic multivariate analysis of surgically acquired pressure injury.Hosmer test P>0.05;indicating that the binary logistic regression model fits the real data well.The results showed that the preoperative NRS2002 nutritional score and operation time in the model were P<0.05,and the difference was statistically significant.3.The five-day follow-up results of the two groups of patients showed that surgically-acquired pressure injuries occurred within three days after surgery,both of which were stage 1 and stage 2 pressure injuries.Five days after operation,the incidence of pressure injury between the two groups was compared,the baseline data of the control group and the experimental group were compared,P>0.05,the difference was not statistically significant,the data was comparable;the incidence of surgically acquired pressure injury was the control group It was 12.00%,the experimental group was 2.63%,P<0.05.4.At the beginning of the study and 6 months after the implementation of the study,the professional ability scores of cluster nursing members in preventing stress injuries were compared.The scores of theoretical knowledge and operational skills were both P<0.05,and the difference was statistically significant.5.At the beginning of the study and 6 months after the implementation of the study,the surgical doctors compared the satisfaction scores of the specialist nurses in the operating room,P<0.05,the difference was statistically significant.6.Comparison of the quality of life of the two groups of patients before operation,P>0.05,the difference was not statistically significant,the two groups were comparable;the comparison of the quality of life of the two groups of patients one week after the operation,P<0.05.7.Comparison of postoperative hospital stay between the two groups,P<0.05,the difference was statistically significant.Conclusion:The application of clustered nursing to prevent brain tumor surgery-acquired pressure injury can effectively reduce the incidence of surgical-acquired pressure injury,improve the professional ability of operating room nurses to prevent operating room-acquired pressure injury,and improve surgeons’The satisfaction of the nurses’cooperation can improve the quality of nursing in the operating room;improve the quality of life of patients after surgery,shorten the hospital stay,and reduce the cost of hospitalization.