【术后多专业综合治疗】。

4区 医学 Q3 Medicine Orthopade Pub Date : 2022-02-01 Epub Date: 2022-01-14 DOI:10.1007/s00132-021-04208-3
Rainer Kretschmer, Jens Trögner, Maximilian Schindlbeck, Paul Schmitz
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引用次数: 1

摘要

背景:在骨科中心,术后多专业综合治疗已被证明是老年患者康复的有效组成部分。治疗的目的是尽量减少围手术期的风险,并在急性住院期间安全地实现个人康复目标。为了满足老年患者的需求,除了改变空间划分和设计外,主要需要调整团队组成和程序流程。治疗策略:一个跨学科和多专业的团队(骨科/创伤学、老年病学、护理学、物理治疗、职业治疗、社会服务、心理学、语言治疗等)在定期的团队会议上使用老年病学评估来收集和分析患者当前的康复状况;制定了基于icf的目标,并根据个人需要调整治疗方法。在这方面,重点也是记录个人风险(合并症、精神状态、多种药物、营养不良、脆弱性)和避免可预防的并发症。避免或治疗术后谵妄的多专业策略尤为重要。此外,保持患者的自主权是重中之重,以便他们可以从急性住院出院,加强后续治疗或家庭环境。在急性住院设施中建立骨科管理是流程链中的重要组成部分,许多老年患者从中受益于术后恢复。
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[Postoperative multiprofessional comprehensive treatment].

Background: In orthogeriatric centers, postoperative, multiprofessional comprehensive treatment has proven to be an effective component in the convalescence of geriatric patients. The aim of the treatment is to minimize the perioperative risk and safely achieve individual rehabilitation goals in the acute inpatient stay. To meet the needs of geriatric patients, in addition to changes in the spatial division and design, primarily adjustments to the team composition and the procedural processes are required.

Therapeutic strategies: An interdisciplinary and multiprofessional team (orthopedics/traumatology, geriatrics, nursing, physiotherapy, occupational therapy, social services, psychology, speech therapy, …) uses geriatric assessments in regular team meetings to collect and analyze the current rehabilitation status of patients; ICF-based goals are formulated and the therapy is adapted to individual needs. Here, too, the focus is on recording the individual risk (comorbidities, mental status, polypharmacy, malnutrition, fragility) and avoiding preventable complications. Multiprofessional strategies for avoiding or treating postoperative delirium are particularly important. In addition, maintaining patients' autonomy is the top priority, so that they can be released from the acute inpatient stay strengthened for follow-up treatment or their home environment. The establishment of orthogeriatric comanagement in acute inpatient facilities is an important component in the process chain, from which many geriatric patients benefit in the context of postoperative recovery.

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来源期刊
Orthopade
Orthopade 医学-整形外科
CiteScore
1.40
自引率
0.00%
发文量
62
审稿时长
6-12 weeks
期刊介绍: Der Orthopäde is an internationally recognized journal dealing with all aspects of orthopaedics and its neighboring areas. The journal serves both the scientific exchange and the continuing education of orthopaedists. Freely submitted original papers allow the presentation of important clinical studies and serve scientific exchange. Comprehensive reviews on a specific topical issue focus on providing evidenced based information on diagnostics and therapy. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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