International Journal of Orthopaedic and Trauma Nursing最新文献_第4页

Unintended consequences of using collars with occipital extensions in neck support – Snapshot assessment at the largest tertiary spinal referral centre in the UK 在颈部支撑中使用带枕骨延伸的颈圈的意外后果--英国最大的三级脊柱转诊中心的快照评估。

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-02-05 DOI: 10.1016/j.ijotn.2024.101083

N. Patel , A. Rajabian , J. George

Introduction

Upper cervical spine fractures are commonplace in the elderly following low energy trauma. These injuries carry high mortality rates, similar to patients sustaining hip fractures. A key aspect affecting clinical outcome is effective management in the first 12 weeks following injury. This study aims to assess the understanding of healthcare staff that may be required to care for such patients.

Materials and methods

A survey was carried out over a single day at the UK's largest Spine Specialist referral centre (Salford Royal Foundation Trust, SRFT) assessing the understanding of healthcare staff of the term, ‘Collar with occipital extension’, by asking staff to identify the safe position of the neck when looking at clinical images of a model in a collar in various different neck positions. The participants demographics were then taken, including profession, grade, spinal/post graduate experience, if English is their first language and their understanding of the term ‘Collar with occipital extension’.

Results

102 participants were interviewed and the results showed almost half (45.1%) of participants selecting an incorrect hyperextended neck to be a safe position for conservative treatment and only 37.3% selecting the neutral position as satisfactory. The only positive predictors identified for those selective the neutral safe cervical spine alignment was if participants had >5 years of previous spinal experience (p = 0.0006) or if they understood the term ‘Collar with occipital extension’ to be describing the collar component (p = 0.000013) and not neck position.

Conclusion

Management of spinal injuries are classically poorly managed in non-spinal centres, possibly due to the lack of training and understanding within the spinal speciality. This study shows the importance of clearly communicating with referring hospitals exactly how to conservatively manage patients with high cervical injuries to best improve clinical outcome.

介绍：上颈椎骨折是老年人常见的低能量外伤。这些损伤的死亡率很高，与髋部骨折患者类似。影响临床治疗效果的一个关键因素是伤后 12 周内的有效治疗。本研究旨在评估医护人员对护理此类患者的理解程度：在英国最大的脊柱专科转诊中心（索尔福德皇家基金会信托，SRFT）进行了为期一天的调查，评估医护人员对 "带枕骨伸展项圈 "这一术语的理解，方法是要求医护人员在观看戴有项圈的模型在各种不同颈部位置的临床图片时识别颈部的安全位置。然后对参与者进行人口统计学调查，包括职业、级别、脊柱/研究生经历、英语是否为母语以及他们对 "枕骨伸展项圈 "一词的理解：102 名参与者接受了访谈，结果显示近一半（45.1%）的参与者认为颈部过度伸展是保守治疗的安全姿势，只有 37.3% 的参与者认为中性姿势是令人满意的。对于那些选择中性安全颈椎对位的人来说，唯一的积极预测因素是参与者是否有5年以上的脊柱治疗经验（p = 0.0006），或者他们是否理解 "项圈与枕骨伸展 "一词是指项圈部分（p = 0.000013）而非颈部位置：可能由于脊柱专科缺乏培训和理解，非脊柱中心对脊柱损伤的处理通常很糟糕。这项研究表明，与转诊医院明确沟通如何对高颈椎损伤患者进行保守治疗对改善临床疗效非常重要。

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引用次数: 0

Nursing care after hand replantation based on Roy's adaptation model: A case report 基于罗伊适应模型的手再植术后护理：一例报告。

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-02-01 DOI: 10.1016/j.ijotn.2023.101039

Kamile Akarsu

Background

Hand injuries are very complex and worrying in terms of hindering activities of daily living, functionality and self-care skills. Hand injuries are caused by traumatic events, resulting in a partial or complete loss. The focus of acute treatment is surgical replantation.

Aim

In this study, nursing care and nursing experiences of a patient who was replanted as a result of hand trauma were discussed in the light of the Roy Adaptation Model.

Case

The male patient admitted to the emergency room due to traumatic amputation was a 49-year-old farmer. He lost his hand to an agricultural tool while working the land and was taken to the hospital within 4 h. He was taken up for emergency surgery for replantation. He has a history of diabetes mellitus. Nursing follow-up and interventions were applied by evaluating the data according to four adaptation modes (physiological needs, self-concept, role function and interdependence) within the scope of the Roy Adaptation Model.

Conclusion

and Suggestions: Patients experience difficulties (loss of function, financial problems, loss of role, psychological traumas) due to disability after injury. Therefore, nurses should know the underlying physiological risks, complications, and interventions to recognize and respond to situations that cause the loss of the reattached limb. Nursing models can identify patients' needs and problems, prevent complications, provide quality care, and manage the process. This study discussed the postoperative nursing care of a patient based on Roy's Adaptation Model.

背景：手部损伤在妨碍日常生活活动、功能和自我护理技能方面非常复杂和令人担忧。手部损伤是由创伤性事件引起的，导致部分或完全丧失。急性治疗的重点是手术再植。目的：本研究采用罗伊适应模型对一例因手外伤而再植的患者的护理和护理经验进行探讨。病例：因外伤性截肢而进入急诊室的男性患者是一名49岁的农民。他在耕地时被农具弄丢了一只手，4小时内被送往医院。他接受了紧急再植手术。他有糖尿病病史。在罗伊适应模型的范围内，根据四种适应模式（生理需求、自我概念、角色功能和相互依赖）对数据进行评估，采用护理随访和干预措施。结论：和建议：患者在受伤后因残疾而经历困难（功能丧失、经济问题、角色丧失、心理创伤）。因此，护士应该了解潜在的生理风险、并发症和干预措施，以识别和应对导致重接肢体丢失的情况。护理模式可以识别患者的需求和问题，预防并发症，提供优质护理，并管理整个过程。本研究以罗伊适应模型为基础，探讨一位病人的术后护理。

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引用次数: 0

Pain management education needs for nurses caring for older adults undergoing total knee replacement 护理接受全膝关节置换术老年人的护士对疼痛管理教育的需求

IF 1.4 Q2 Nursing

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-02-01 DOI: 10.1016/j.ijotn.2023.101037

Chayada Piyakhachornrot , Phichpraorn Youngcharoen

Introduction

Effective postoperative pain management is necessary to improve the outcomes of older adults undergoing total knee replacement (TKR). Discovering what registered nurses (RNs) need to know about pain management may be beneficial to improving the quality of care.

Aim

The study aimed to identify the information needed to develop pain management education for RNs caring for older adults undergoing TKR.

Methods

A qualitative descriptive design was used in this study. Three focus groups were conducted with 22 staff RNs with experience caring for older adults undergoing TKR at a supra-tertiary care hospital in Bangkok, Thailand; one focus group was conducted with five members of the hospital's nursing pain management committee. Data were analyzed using content analysis.