Feasibility study of wound/ostomy nurse intervention in postoperative batch dressing change Wound/ostomy nurse

Feasibility study of wound/stoma nurse intervention in new model of postoperative wound batch dressing change treatment

Xuemei Luo

(Mianzhu People's Hospital, Sichuan Province, China, 618200)

In the traditional wound treatment model, dressing change of wounds is done by the doctor alone, but clinical surgery is often due to the number of surgeries and wounds, so dressing change of the incision in the postoperative period takes up a large amount of the doctor's time, resulting in the doctor not having more time for the patient, checking the work, and even not being able to perform the postoperative dressing for the patient in time due to busy work. In order to develop specialized nurses, expand the scope of nursing practice, liberate doctors, affordable patients, and improve the efficiency of medical quality, the general surgery department of our hospital from July 2012 to April 2013 used wound/wound dressing change on ? cases of hospitalized wound patients respectively using wound/ostomy specialist nurses batch dressing change and traditional physician dressing change to conduct a comparative study, reported as follows.

In China's traditional wound treatment model, wound dressing change is completed by the doctor alone, but the clinical busyness of the doctor's work leads to the patient's postoperative dressing change can not be carried out in a timely manner, which triggers disputes between doctors and patients and reduces patient satisfaction. With the increasing attention of the importance of wound/ostomy specialist nurses in the domestic medical community, in order to develop specialist nurses, expand the scope of nursing practice, strengthen the cooperation between doctors and nurses, and at the same time liberate the doctors, affordable to patients, and improve the quality of medical care, the general surgery department of our hospital has been combining the clinical characteristics and the needs of doctors and patients since 2012, and has started to implement the ? Wound/ostomy nurse intervention in postoperative incision dressing change? new project, to carry out the feasibility study and application of the new model of wound/ostomy specialist nurses intervening in postoperative wound bulk dressing change treatment, which is now reported as follows.

1 Data and Methods

1.1 Clinical data

2040 cases of surgical patients hospitalized in the Department of General Surgery of our hospital from July 2012 to September 2014, of which 1140 cases were male and 900 cases were female, with the age ranging from 3 to 90 years old, with an average age of 31.26 years. Among them, there were 1658 cases of acute wounds and 382 cases of chronic wounds, with a maximum wound area of 40cm ?27cm ?12cm , and a minimum wound area of 1.5cm ?1cm ?1cm . The study subjects were randomly divided into the observation group and the control group of 570 cases each, and there was no significant difference between the general information and wound conditions of the two groups (P < 0.01).

1.2 Methods

1.2.1 Setting the operation mode Drawing on the management operation mode of Linda Medical Center in the United States, in the daily operation, ordinary wounds are treated by specialist nurses; chronic wounds are managed by specialist nurses and junior doctors*** under the guidance of the supervising doctor; difficult and complex wounds are treated by specialist nurses and the supervising doctors*** after researching treatment plans. Difficult and complex wounds are treated by nurse specialists and doctors in charge after studying the treatment plan, thus forming a wound/stoma nurse specialist. Specialized nurses and junior doctors? The three-step working model is carried out by the specialized nurse and the doctor in charge*** together.

1.2.2 Operational methods

1.2.2.1 Observation group Wound/ostomy specialist nurses intervene in the first stage of suture incision dressing change immediately after surgery, and the batch dressing change work is concentrated in the morning, and the specialist nurses follow the supervising physician to check the room in the morning, assess the patient's wound condition, listen to and record the physician's requirements for dressing change of the special

wounds, and prepare the batch dressing change for the observation group. All items: 。。。。。。。 , in accordance with the clean-incision? Clean-contaminated incision? Contaminated incision? ** incision in the order of dressing change for the patient.

1.2.2.2 Control group The physician in charge decides the time of dressing change for the patient under his control according to his surgery, outpatient clinic and other work on the same day, prepares the necessary items for dressing change, and disposes of the items of dressing change after each of them is finished.

1.3 Evaluation indexes

Observe and compare the ** rate (%), wound healing rate (%), average wound healing time (d ), bed turnover rate (%), and patient satisfaction rate (%) of dressing change wounds in the two groups.

1.4 Statistical processing

A database was established and statistically analyzed using SPSS11.0 statistical software. The data were analyzed by mean + standard error (X+S), t-test was used to compare the means, and P ﹤ 0.05 was regarded as the difference of statistical significance.

2 Results

Comparing the wound ** rate, wound healing rate, average wound healing time, average hospitalization day and patient satisfaction rate between the two groups, the results showed that there was no significant difference in the wound ** rate between the two groups (P ＞0.05), which was not statistically significant; the difference in the wound healing rate, average healing time, bed turnover and patient satisfaction rate between the two groups was significant (P ﹤0.05), which was not statistically significant; the difference in the wound healing rate, average healing time, bed turnover and patient satisfaction rate was significant (P ﹤0.05). P ﹤0.05), statistically significant, see Table 1.

Table 1 Comparison of the average ** rate, healing time, bed turnover rate and patient satisfaction rate of wounds in the two groups of patients after dressing change Groups No. of cases ** rate

(%) Healing rate (%) Healing time (d)

34.11?2.10

29.17?0.31

P <0.05 Bed turnover rate Patient satisfaction rate (%) (%) 2.73?0.61 96.88?1.26 4.26?0.47 99.71?0.91 P <0.01 P <0.01 P <0.01 Observational group 570 2.01?0.02 82.38?0.91 Control group 570 1.98?0.01 90.79?1.00 P value

3 Discussion 570 P ＞0.05 P ＜0.01

3.1 Analysis of the results of the study The results of this study show that the operation of the new model of postoperative wound batch dressing change treatment by wound/ostomy nurses is effective and feasible, as evidenced by the fact that there is no significant difference between the wound ** rate of the patients with wound/ostomy nurses' batch dressing change and that of the clinician's dressing change and the rate of wound healing is gradually improved and the time of wound healing is shortened. There is no significant difference between the wound** rate of patients with wound/ostomy specialist nurses changing wounds in bulk and that of clinicians changing wounds. In the traditional model, wound treatment is completed by the physician alone, nurses are generally not involved, and the physician dealing with the wound is mostly a low seniority resident or trainee, the quality and efficiency varies, the time and method of dressing change is not uniform easy to cause wound pain, bleeding and mucous membrane damage, the cost of treatment is high, the healing process is slow, and the cycle is long.