择期剖腹探查胆囊切除术患者手术部位感染的预防

Q4 Nursing Frontiers of Nursing Pub Date : 2023-09-01 DOI:10.2478/fon-2023-0037
Erika Leslie R Magat, Josephine M De Leon
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引用次数: 0

摘要

摘要目的外科手术给患者带来巨大的风险。医疗保健专业人员认为对患者健康构成威胁的不良事件之一是称为手术部位感染(SSI)的并发症的发展。尽管正在进行一些努力以确定减少此类并发症的适当方法,但世界范围内SSI的发生率仍然很高。手术需要感染控制知识和保持手术部位清洁的高精度。本研究检验了手术室(OR)一揽子护理在选择性剖腹探查胆囊切除术患者中预防SSI的有效性。方法采用准实验的前测和后测设计来确定其有效性。该研究由60名参与者组成,分为两组:选择30名受试者接受OR一揽子护理,而其他30名受试者接受常规护理。分组是通过系统随机抽样技术确定的。手术室护理包有三个干预措施,即:(1)维持围手术期正常体温,(2)术前不切除手术部位毛发,(3)关闭腹壁前更换手套。这些患者使用标准仪器Bates-Jensen伤口评估工具(BWAT)在伤口愈合过程的干预后阶段进行评估,包括:止血、炎症和增殖阶段。为了描述在干预后各阶段实施OR一揽子护理后患者伤口状况的差异,我们使用了Friedman检验。为了描述两组患者在实施OR一揽子护理后伤口状况的差异,使用Mann-Whitney U检验。结果患者创面状况较好,愈合时间较长。术后第3天观察对照组与实验组创面情况的差异。这表明,根据BWAT评分严重程度评分,实验组的伤口状态愈合速度明显快于对照组。我们观察到患者在止血期和增生期的伤口状况有显著差异。结论在选定的医院,如果有统一和一致的实施上述干预措施,OR一揽子护理已被证明可有效预防剖腹探查胆囊切除术患者的SSI。
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Preventing surgical site infection using operating room bundle of care in patients undergoing elective exploratory laparotomy cholecystectomy surgery
Abstract Objective Surgical procedures manifest immense risks to patients. One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection (SSI). Although several efforts are being undertaken to determine the proper means to reduce such complications, there is still a high incidence of SSI worldwide. Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site. This study tested the effectiveness of an operating room (OR) bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery. Methods A quasi-experimental pretest and posttest design was utilized to determine its effectiveness. The study was composed of 60 participants divided into two groups: 30 subjects were selected to receive the OR bundle of care, while the other 30 subjects received the usual care. The groupings were determined through a systematic random sampling technique. The OR bundle of care had three interventions, namely: (1) maintaining perioperative normothermia, (2) no pre-operative surgical site hair removal, and (3) changing gloves before abdominal wall closure. These patients were evaluated using the standard instrument, Bates–Jensen Wound Assessment Tool (BWAT) in the post-intervention phases of the wound healing process, which are as follows: hemostasis, inflammatory, and proliferative phases. To describe the difference in the patients’ wound status after implementation of the OR bundle of care in each post-intervention phase, Friedman’s test was used. To describe the difference in the patients’ wound status in both groups after implementation of the OR bundle of care, the Mann–Whitney U test was used. Results The patient’s wound status was lower, indicating a more healing process. Differences between the wound status of the control and the experimental group were observed on the third postoperative day. This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring. A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed. Conclusions The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital, if there is uniform and consistent implementation of the said intervention.
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来源期刊
Frontiers of Nursing
Frontiers of Nursing Nursing-Nursing (all)
CiteScore
0.70
自引率
0.00%
发文量
38
审稿时长
16 weeks
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