| Objective(s):1.The patients’ caprini self-rating scale was applied to the orthopedics department of a3 A hospital in Kunming,and patients were encouraged to self-rate.The differences between the scores of medical staff and patients’ self-rating were compared,so as to further verify whether the scale is effective in orthopedic patients.2.The purpose of this study is to use the theoretical framework of interactive patient participation in patient safety to prevent and care for deep venous thrombosis in patients undergoing hip replacement during perioperative period.The data of thrombosis cases,coagulation data,sub-item percentile hip score,LDVT knowledge,attitude and practice level,patient satisfaction and hospitalization time were collected.To explore the application effect of the theoretical framework of interactive patient participation in patient safety in the prevention of perioperative thrombosis in patients undergoing hip replacement,so as to improve the level of patients’ knowledge,attitude and practice,reduce the incidence of deep vein thrombosis,improve the function of patients’ hip joint,improve patients’ satisfaction and shorten the hospitalization time.Methods:1.According to the inclusion exclusion criteria,70 patients admitted to the orthopedic ward of a tertiary hospital in Kunming from November 2021 to December 2021 were selected,and the responsible nurse used the clinically common Caprini scale to score the thrombotic risk within 24 hours of the patient’s admission.The data of Caprini thrombosis score results were entered by Excel and statistically analyzed by SPSS26.0.2.This study belongs to quasi-experimental research,Eighty-eight inpatients who were admitted to the Department of Orthopaedics of a 3A hospital in Kunming from January,2022 to November,2022,and met the diagnostic criteria and discharge criteria,were selected as the research object.SPSS26.0 software was used to generate random numbers and randomly group them.The control group used routine perioperative thrombus prevention nursing,and the intervention group used interactive patient participation and patient safety theory framework to carry out thrombus prevention nursing on the basis of routine perioperative thrombus prevention in the control group.The contents of the intervention include establishing an interactive patient-participating patient safety nursing team,carrying out homogenization training for the team members,consulting relevant literature and the prevention plan of deep vein thrombosis in orthopedic surgery,and forming an interactive patient-participating patient safety thrombus prevention intervention measure after intervention measures extraction,feasibility analysis and two special discussions.From three aspects: caring participation,appealing participation and decision-making participation,the prevention and nursing measures of thrombus were detailed at five time points: within 24 hours after admission,from the second day of admission to the first day before operation,the day after operation,from the first day after operation to the third day after operation,and from the fourth day after operation to the day of discharge,and the implementation of preventive measures was supervised.The results of color Doppler ultrasound examination of both lower limbs,four coagulation items(thrombin time,prothrombin time,activated partial thromboplastin time,fibrinogen),D-dimer value,sub-item percentile hip score,LDVT knowledge,attitude and behavior level,patient satisfaction and average hospital stay of the two groups were compared,and the data were processed and statistically analyzed by SPSS26.0.Results:1.Among 70 patients,nurses and patients rated low risk,medium risk,high risk and extremely high risk as 7 cases,14 cases,30 cases and 13 cases respectively.Kappa consistency test(Kappa value =0.875,P < 0.001)was performed on the risk grade scores of these 70 patients,and Bland-Altman statistical analysis was performed on the scores of nurses and patients’ self-evaluation(t value = 2.984,P = 0.004).The test results were significant,which meant that the consistency level was strong.2.A total of 88 patients were screened into the study group after being included in the exclusion criteria.During the study,one patient in the control group voluntarily withdrew,and one patient in the intervention group died because of the deterioration of his condition and changed his major.Finally,43 cases in the control group and 42 cases in the intervention group completed this study.2.1General data,there is no statistical difference in demographic data and disease-related information between the two groups(P > 0.05),which is comparable.2.2 Main outcome indicators:(1)Incidence of deep venous thrombosis:After the intervention,there were 6 cases of deep vein thrombosis in the control group,the incidence rate was 13.95%;In the intervention group,there were 0 cases of deep vein thrombosis,the incidence rate was0%,and the difference was statistically significant(P<0.05).(2)D-dimer value(D-D): There was no statistical difference between the two groups on the day of admission and 3 days after operation(P > 0.05),but in the 7 days after operation,the intervention group was better than the control group,with statistical difference(P < 0.05).(3)Four coagulation items: prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and fibrinogen C(FIB),there was no significant difference between the two groups on the day of admission(P > 0.05).However,in the numerical comparison of 3 days and 7 days after operation,the intervention group was superior to the control group,and the differences were statistically significant(P< 0.05).(4)Sub-item percentile hip score: There was no statistical difference between the two groups on the day of admission and 24 hours after operation(P > 0.05),but there was statistical difference on the day of 3 days and 7 days after operation(P < 0.05).At the same time,in the comparison of the scores of each item,the pain and function of the two groups were better than those of the control group at 3 days and 7 days after operation,and the difference was statistically significant(P < 0.001).Conclusion(s):1.The results of nurses’ and patients’ Caprini self-assessment are consistent.The patients’ Caprini self-assessment scale is a suitable tool for VTE risk assessment of inpatients in China,which can guide VTE prevention strategies according to patients’ self-assessment scores before operation.2.In the perioperative nursing care of patients undergoing hip replacement,applying the theoretical framework of patient safety based on interactive patient participation can prevent the occurrence of clinical thrombosis and reduce the incidence of thrombosis to a certain extent.3.Applying the theoretical framework of patient safety based on interactive patient participation in perioperative prevention of thrombosis in patients undergoing hip replacement can improve the function of patients’ hip joint,improve the level of patients’ knowledge,attitude and practice,shorten hospitalization time,improve patients’ satisfaction,jointly safeguard patients’ safety and avoid certain medical accidents in clinic. |
PDF Full Text Request