Measures for quality nursing services in operating rooms (2 articles)

Measures for high-quality nursing services in operating rooms (2 articles)

Part 1

"Quality nursing services" refers to taking the patient as the center, strengthening basic nursing care, and comprehensively implementing Nursing responsibility system, deepen the connotation of nursing profession, and improve the overall level of nursing services. "Patient-centered" means to consider patients at all times in terms of ideology and medical behavior, and put patients first in all activities; closely focus on patients. According to the needs of the Ministry of Health, we will improve service quality, control service costs, formulate convenient measures, simplify work processes, and provide patients with "high-quality, efficient, low-cost, satisfactory, and assured" medical services. The staff actively participated in changing the service concept so that the patient can be in the best physical and psychological state and spend the operation happily. Specific measures for high-quality nursing services are formulated as follows:

1. Preoperative visits are extended to patients Family members

1. The preoperative visit is usually conducted in the afternoon of the first day before the operation. The visitor is a circulating nurse who cooperates with the patient's surgery. The visit should be avoided as much as possible when the patient is eating or undergoing other treatments. The visit time should be controlled to 10 to 15 minutes, and a quiet and comfortable visit environment should be provided as much as possible to reduce noise.

2. Read the medical and nursing records carefully before the visit, and understand the surgery and anesthesia methods. Condition and various biochemical examination results. Understand the patient's general condition, mental and emotional conditions, sensory conditions, motor nerve conditions, excretion conditions, breathing, circulation, body temperature, skin, water and electrolyte balance, etc., and conduct preoperative assessment (including pressure ulcer assessment). and falling off the bed). Anticipate possible problems during the operation from a nursing perspective, be aware of the entire operation process, and take active and effective measures to prevent it.

3. Take the initiative to do yourself before entering the ward. Make an introduction to eliminate the unfamiliarity between the nurse and patient, and then explain the purpose of the visit. For patients such as infants and young children, communicate well with their families. Introduce the environment of the operating room, the medical facilities during the operation, and some of the sounds that will be made during the operation. Introduce anesthesia methods and anesthesia positions

4. Encourage patients to express their wishes and concerns, inform them of the position during the operation, possible discomfort and necessary cooperation, as well as precautions before entering the room: fasting and drinking. time; change into clean clothes on the day of surgery; leave any valuables, accessories, dentures, etc. to family members for safekeeping; female patients should not wear makeup, etc.

5. According to the patient’s different psychological state, acceptance ability, and living habits. and family background, use kind and warm words to comfort and encourage patients, provide targeted psychological care, and pay attention to protecting patient privacy to enhance patients' confidence in overcoming the disease

6. According to the visit record sheet. Record the contents carefully so that corresponding measures can be taken. After the preoperative visit, thank the patient for his cooperation and tell him that he will be with him during the surgery the next day to calm the patient's nervousness.

7. The visit should not only relieve the patient's nervousness, but also communicate more with the family members. The more the family members know about the surgery, the better they can help the patient reduce pre-operative anxiety. Some issues that are inconvenient to explain to the patient can be explained clearly to the family members. Gain the trust and cooperation of family members. Instruct family members to wait in the family lounge outside the operating room on the day of surgery so that they can communicate directly with family members when special circumstances arise during the operation and when viewing specimens after surgery, gaining valuable time to ensure the patient's life and the smooth progress of the operation. Extend humane, systematic and standardized preoperative visits to family members.

2. Intraoperative care

1. On the day of the operation, after the patient arrived at the operating room, the visiting nurse took the initiative to hand over the situation with the ward nurse yesterday and checked according to relevant requirements. After everything is correct, lead the patient into the operating room and prepare anesthesia supplies.

2. Before anesthesia, the circulating nurse will check the patient's information again with the surgeon and anesthesiologist, and at the same time cooperate with the anesthesiologist to provide anesthesia.

3. Assist the doctor to position the patient, guide the patient to position according to the positions mentioned in the preoperative visit, and make full use of the position cushions to make the surgical patient more comfortable and the surgical field more clearly exposed. Maintain thoracic motion and functional limb position.

4. Pay attention to psychological care, understand the needs of patients in a timely manner and meet their needs.

Special attention should be paid to several time periods: such as during anesthesia, at the beginning of surgery, when the patient feels unwell, and when vital signs change. It is emphasized that the circulating nurse must be beside the patient to comfort and encourage.

5. Carry out hand-in-hand services for the elderly, children and women. Communicate with the patient while operating and hold the patient's hand when necessary. For example, before anesthesia is administered, the circulating nurse will say to the patient: "Please hold my hand, I will accompany you through this special moment. If you have any discomfort, please tell me and we will help you solve it."

6. For conscious and nervous patients, not only provide psychological counseling, but also hold the patient's hand and ask them to do deep breathing exercises with you to relax the tension.

7. Strictly conduct a three-party verification before starting the operation and check the relevant information again.

8. When the operation begins, pay attention to adjusting the room temperature. Pay attention to keeping warm, put a scarf around the patient's neck and a warm sleeve on the outstretched arms, and remove the quilt from the patient until the doctor is ready to disinfect; after the operation, help the patient dress when sending the patient out of the operating room. Be tidy and pay attention to protecting the patient's privacy and keep warm. When the weather is cold, the infusion fluid and peritoneal lavage fluid should be warmed to prevent intraoperative hypothermia.

9. During the operation, closely observe changes in the patient’s vital signs, pay attention to ECG monitoring, and maintain smooth infusion. And carefully observe the patient's facial expressions and the use of various instruments to ensure the smooth progress of the operation and the safety of the patient.

10. After the operation and during recovery from anesthesia, the operating room nurse should guard the patient's bedside to prevent the patient from falling into the bed, ensure the smoothness of the drainage tube and intravenous indwelling needle, and prevent accidents such as tube detachment. .

11. Strictly implement various nursing operating procedures in the operating room. Keep various nursing records carefully. Requirements: All care must be stable, accurate, light and fast. During the operation, do not talk about topics unrelated to the operation, do not make loud noises, and show humane care.

12. Establish a patient pick-up and drop-off register and a rapid pathology register, and improve the shift handover process and the writing of the shift handover register. Carefully fill in the surgical care record sheet, and improve the filling and storage of antibiotic execution sheets. Strengthen the handover between circulating nurses and resuscitation room nurses, self-examine potential safety hazards, and ensure the safety of surgical patient care.

2. Postoperative follow-up visit

1. After the operation is completed, the anesthesiologist, surgeon and circulating nurse will send the patient back to the ward, place him in the correct position, and complete the handover with the ward nurse , conduct a detailed handover of the patient's intraoperative conditions, input fluids, skin conditions, and various pipelines. Explain to family members the required positions and requirements for anesthesia methods, as well as the management of various wound drainage tubes, to obtain cooperation. ,

2. The time for the postoperative follow-up visit is generally chosen on the second day after the operation. If the patient has a large scope of surgery and other special circumstances, the visit time can be appropriately delayed. When entering the ward, you should greet the patient first and communicate with the patient through The patient and his family members had a conversation to understand their attitude and psychological state towards the surgery, as well as their understanding and tolerance of the surgery. They introduced the general situation of the surgery and necessary postoperative precautions to the patient in an easy-to-understand way, and encouraged them to recover with peace of mind.

3. Deal with, comfort and explain the nursing problems raised by patients, and communicate with the head nurse to solve and rectify problems that cannot be handled in time.

4. Follow up the patients after surgery, patiently answer the patients’ questions, give words of encouragement, and send heartfelt blessings to the patients; understand the patients’ satisfaction with the work and services of the operating room nursing staff. Spend.

5. Provide feedback to surgeons to understand intraoperative cooperation and serve clinical aspects that need improvement so that medical and nursing cooperation can be more tacit.

6. Learn from the ward nurse about the items that need improvement in the transfer handover. Use this feedback to understand the shortcomings in the nursing work in the operating room, and carefully complete the records of the postoperative follow-up visit record sheet. Develop corrective actions to better serve patients.

Part 2

1.1 General information

60 patients who came to our hospital’s operating room for surgery from January 2017 to January 2018 were selected as the research subjects. , according to the random grouping method, they were randomly divided into a control group and an observation group, with 30 patients in each group. Among them, there were 17 males and 13 females in the control group; they were 22 to 71 years old, with an average age of (44.8±9.1) years; there were 16 males and 14 females in the observation group; they were 21 to 72 years old, with an average age of (44.7±8.8) years; Through comparison, it was found that there was no significant difference in the basic information of the two groups of patients (Pgt; 0.05), and clinical comparison can be made.

1.2 Nursing methods

Patients in the control group received routine nursing care in the operating room, while patients in the observation group received high-quality nursing intervention measures on the basis of the control group. The details are as follows.

1.2.1 Pre-operative visit

One day before the operation, the responsible nurse should understand the medical records in detail and understand the patient's basic situation. Including name, gender, age, examination results, diagnosis, anesthesia method, etc., and ask the doctor in charge about the equipment and surgical methods required for the operation. Then introduce the surgical precautions to the surgical patient in advance and patiently communicate with the patient.

1.2.2 Preoperative preparation

Before the operation, arrange the responsible nurse to do the preoperative preparation work, including greeting the patient, communicating with the patient, understanding the patient's preparation, encouraging the patient, and improving the patient's health. Surgery confidence. In the preparation area, provide patients with a comfortable environment, relieve patient stress, try to meet patients' needs, encourage patients, and establish a good nurse-patient relationship.

1.2.3 Strengthen the scientific management of nursing in the operating room

The nursing department established a management team to improve the nursing work system, establish a standardized nursing system, standardize the group management system, and establish a nursing assessment system. Conduct regular assessments of nursing staff to promote the enthusiasm of nursing staff and improve the quality of nursing care.

1.2.4 Strengthen nursing training

First, formulate a good nursing training plan, strengthen the training of theoretical knowledge and clinical skills, and improve the professional knowledge and technical level of nursing staff. Nursing staff should actively solve difficult problems existing in the nursing process through consultation and ward rounds before surgery, so as to improve work efficiency and nursing quality. Pay attention to cultivating the professionalism, communication skills and health education of nursing staff.

1.2.5 Improve operating room nursing services

Adopt targeted nursing methods according to the patient’s surgical content to provide patients with more professional, comprehensive and humane services [2] .One day before the operation, medical staff should communicate with the patient to eliminate the patient's bad emotions, encourage the patient's self-confidence, conduct a comprehensive assessment of the patient's specific situation, and provide a targeted care plan based on the patient's own situation.

1.2.6 Strengthen communication with patients

Medical staff should strengthen communication with patients, promote harmonious communication between nurses and patients, and create a good communication atmosphere between nurses and patients. It is beneficial to the patient's negative emotions and increases the patient's confidence in treatment.

1.2.7 Postoperative care

After the operation, the blood stains on the patient’s skin should be cleaned, and the patient’s bed should be replaced with new clothes and sheets to make the patient’s ward clean. The environment remains comfortable and dry. Pay close attention to changes in the patient's vital signs. If there are any abnormalities, notify the superior physician in time for treatment and treatment. Postoperative nursing staff should patiently answer patients' questions and family members' questions, provide patient guidance, and at the same time instruct patients to maintain a light daily diet and balanced nutritional intake [3].

1.3 Observation indicators

Comparative observations were made on nursing quality, patient satisfaction and nursing safety issues between the control group and the observation group.

1.4 Data processing

Use statistical software SPSS20.0 to conduct statistical research. Measurement data are expressed as mean ± standard deviation (?±s), t test is used, and Plt ; 0.05, means the difference is significant and statistically significant.