Objective To explore the effect of intensive care led by specialist nurses on medical adhesive-related skin injury (MARSI) in postoperative orthopedic patients.
Methods Patients admitted to the Orthopedic Department of the Medical Center Hospital of Qionglai City from June 2022 to December 2023 for scheduled or elective surgery were recruited and randomly divided into control group and intervention group. The control group received conventional care, while the intervention group received intensive care led by specialist nurse. The MARSI incidence of wound dressing and intravenous infusion channel dressing, rehabilitation outcomes (MARSI rehabilitation time, mobilization time, and hospitalization time), and nursing satisfaction between the two groups were compared.
Results A total of 400 postoperative orthopedic patients were included, of which 200 in the control group and 200 in the intervention group. The MARSI incidences of postoperative wound dressing (9.50% vs. 20.00%, P<0.05) and intravenous infusion channel dressing (3.00% vs. 13.50%, P<0.05) in the intervention group were significantly lower than those in the control group. The MARSI rehabilitation time [(10.27±0.08) d vs. (15.42±1.21)d,P<0.05], mobilization time [(1.40±0.26) d vs. (3.72±0.38)d, P<0.05], and hospitalization time [(8.41±0.21) d vs. (12.18±1.48)d, P<0.05] in the intervention group were significantly shorter than those in the control group. The nursing satisfaction rate of the intervention group (98.00% vs. 82.50%, P<0.05) was significantly higher than that of the control group.
Conclusion Compared with routine nursing, the intensive care led by specialist nurses can considerably reduce the incidence of MARSI, promote the rehabilitation effect, and improve nursing satisfaction in postoperative orthopedic patients, which has certain clinical application value.
Please download the PDF version to read the full text:
download
1.陈慈爱, 郭晶, 张玲芝. 我国医用粘胶相关性皮肤损伤的文献计量学分析[J]. 护理与康复, 2021, 20(4): 20-24, 29. [Chen CA, Guo J, Zhang LZ. Bibliometric analysis on domestic medical adhesive-related skin injury[J]. Nursing and Rehabilitation Journal, 2021, 20(4): 20-24, 29.] DOI: 10.3969/j.issn.1671-9875.2021.04.005.
2.Zhao HH, He Y, Wei Q, et al. Medical adhesive-related skin injury prevalence at the peripherally inserted central catheter insertion site: a cross-sectional, multiple-center study[J]. J Wound Ostomy Continence Nurs, 2018, 45(1): 22-25. DOI: 10.1097/WON.0000000000000394.
3.黄少泳, 赖海燕, 秦丽平, 等. 神经外科医用粘胶剂相关性皮肤损伤的危险因素研究[J]. 蛇志, 2020, 32(3): 317-319. [Huang SY, Lai HY, Qin LP, et al. Study on the risk factors of medical adhesive-related skin damage in neurosurgery[J]. Journal of Snake, 2020, 32(3): 317-319.] DOI: 10.3969/j. issn.1001-5639.2020.03.015.
4.Hall JC, Tarala RA, Tapper J, et al. Prevention of respiratory complications after abdominal surgery: a randomised clinical trial[J]. BMJ, 1996, 312(7024): 148-152. DOI: 10.1136/bmj.312.7024.148.
5.赵芳, 袁丽, 张明霞, 等. 我国糖尿病专科护士培养现状调查[J]. 中华护理杂志, 2020, 55(4): 590-594. [Zhao F, Yuan L, Zhang MX, et al. Investigation on the training status of diabetes specialist nurses in China[J]. Chinese Journal of Nursing, 2020, 55(4): 590-594.] DOI: 10.3761/j.issn.0254-1769.2020.04.021.
6.谢丽, 游倩, 朱丹, 等. 以造口专科护士为主导的链式管理对肠造口患儿的影响[J]. 护理学杂志, 2024, 39(6): 46-49. [Xie L, You Q, Zhu D, et al. Impact of chain management led by specialized stoma nurses on pediatric patients with enterostomy[J]. Journal of Nursing Science, 2024, 39(6): 46-49.] DOI: 10.3870/j.issn.1001-4152. 2024.06.046.
7.范丹丹, 邹丽芳, 林莺. 以专科护士为主导多学科团队协作的延续护理在急诊心肌梗死患者中的应用及效果评价[J].心血管病防治知识, 2024, 14(3): 62-64. [Fan DD, Zou LF, Lin Y. Application and effect evaluation of continuation nursing with specialized nurses in patients with emergency myocardial infarction[J]. Prevention and Treatment of Cardiovascular Disease, 2024, 14(3): 62-64.] DOI: 10.3969/j.issn.1672-3015(x).2024.03.019.
8.朱婷, 郭盛丽, 陈晓容, 等. 集束化护理在围术期护理中的应用进展[J]. 当代护士(中旬刊), 2023, 30(8): 12-15. [Zhu T, Guo SL, Chen XR, et al. Progress in the application of clustered nursing in perioperative nursing[J]. Modern Nurse, 2023, 30(8): 12-15.] DOI: 10.19792/j.cnki.1006-6411.2023.08.004.
9.沈艳芬, 侯晓婷, 杨红, 等. 集束化管理对中心静脉导管留置期间医用粘胶相关性皮肤损伤的影响[J]. 中国临床医生杂志, 2019, 47(5): 622-625. [Shen YF, Hou XT, Yang H, et al. The effect of cluster management on medical viscose-related skin injury during central venous catheter indwelling[J]. Chinese Journal for Clinicians, 2019, 47(5): 622-625.] DOI: 10.3969/j.issn.20958552. 2019.05.040.
10.张颖惠, 张加玲. 集束化护理对重症监护病房医用粘胶相关皮肤损伤发生率的影响[J]. 中国药物与临床, 2018, 18(1): 143-145. [Zhang YH, Zhang JL. The impact of cluster nursing on the incidence of medical viscose-related skin injury in intensive care units[J]. Chinese Remedies & Clinics, 2018, 18(1): 143-145.] DOI: 10.11655/zgywylc2018.01.065.
11.别逢桂, 常后婵, 罗彩霞, 等. 手术患者医用黏胶相关性皮肤损伤的集束化干预效果研究[J]. 循证医学, 2019, 19(2): 109-111. [Bie FG, Chang HC, Luo CX, et al. A study on intervention effects of reducing medical adhesive-related skin injury in surgical patients by bundles of care[J]. The Journal of Evidence-Based Medicine, 2019, 19(2): 109-111.] DOI: 10.12019/j. issn.1671-5144.2019.02.012.
12.Fumarola S, Allaway R, Callaghan R, et al. Overlooked and underestimated: medical adhesive-related skin injuries[J]. J Wound Care, 2020, 29(Sup3c): S1-S24. DOI: 10.12968/jowc.2020.29. Sup3c. S1.
13.陈永兰, 秦绮珑, 沈小星. 护理风险因素评估预防手术室不良事件的效果[J]. 国际护理学杂志, 2023, 42(8): 1356-1359. [Chen YL, Qin QL, Shen XX. Evaluation of nursing risk factors and effectiveness in preventing adverse events in the operating room[J]. International Journal of Nursing , 2023, 42(8): 1356-1359.] DOI: 10.3760/cma.j.cn221370-20220325-00336.
14.骆云霞. 粘胶去除剂预防CVC置入部位医用粘胶相关性皮肤损伤的应用效果分析[J]. 临床医药文献电子杂志, 2019, 6(17): 141,143. [Luo YX. Analysis of the application effect of adhesive remover in preventing medical adhesive related skin damage at the placement site of CVC[J]. Electronic Journal of Clinical Medical Literature, 2019, 6(17): 141,143.] DOI: 10.16281/j.cnki. jocml.2019.17.097.
15.Fumarola S, Allaway R, Callaghan R, et al. Overlooked and underestimated: medical adhesive-related skin injuries[J]. J Wound Care, 2020, 29(Sup3c): S1-S24. DOI: 10.12968/jowc.2020.29.Sup3c.S1.
16.卫雯诗, 杨益群. 成年病人中心静脉通路装置相关皮肤损伤干预研究进展[J]. 护理研究, 2021, 35(21): 3873-3877. [Wei WS, Yang YQ. Progress in central venous access device in adult patients[J]. Chinese Nursing Research, 2021, 35(21): 3873-3877.]DOI: 10.12102/j.issn.1009-6493. 2021.21.021.
17.Thayer D. Skin damage associated with vascular access: understanding common mechanisms of injury and strategies for prevention[J]. Journal of Radiology Nursing, 2021, 40(1): 61-68. DOI: 10.1016/j.jradnu.2020.05.011.