Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics

Nurse-Assisted Rehabilitation Protocols Following Anterior Cruciate Ligament Reconstruction

Despite significant advancements in surgical instruments and operation skills, short- and long-term outcomes following anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, as many patients fail to return to their pre-injury level of sports. Inadequate ACL rehabilitation is the primary cause of poor outcomes. Nurses have become a crucial element in the rehabilitation process. Although there is no consensus regarding the optimal post-operative rehabilitation protocols, restoring muscle strength and neuromuscular control are consistently the primary goals. This literature review presents nurse-assisted rehabilitation protocols aiming at improving muscle strength and neuromuscular control. The review discusses postoperative rehabilitation, including home-based and supervised rehabilitation, open and closed kinetic chain exercises, eccentric and concentric training, blood flow restriction training, and plyometric training. Each training protocol has its benefits and drawbacks, and should be used cautiously in specific stages of rehabilitation. Neuromuscular training, such as neuromuscular electrical stimulation, neuromuscular control exercises, and vibration therapy, is considered crucial in rehabilitation.

Effect of application of short-form video health education on the health knowledge and satisfaction with nursing care of patients with lower extremity fractures

BACKGROUND

Video health education has been increasingly adopted in the clinic to expand patient guidance and improve perioperative outcomes. To date, however, it is unclear whether the use of short-form videos and web-based clinician-created forums actually improve the perioperative experience of patients.

OBJECTIVE

To evaluate the effect of application of short-form video health education on the health knowledge and satisfaction with nursing care of patients with lower extremity fractures.

METHODS

This study is a quasi experimental study, using convenient sampling method and grouping according to historical control., one hundred and twenty-two patients admitted with lower limb fractures to the orthopedic ward of a tertiary first-class general hospital in Fujian, China were enrolled in this study. Based on their admission order, patients admitted from September 2021 to November 2021 were enrolled into the control group (n = 61) and patients admitted from December 2021 to March 2022 were enrolled in the intervention group (n = 61). Both groups received identical admission-based patient education, perioperative care, and discharge rehabilitation instructions. The control group received the traditional education method while the intervention group received a short-form educational video in addition to the traditional education method. Patient perioperative health knowledge and patient satisfaction with nursing care during treatment of lower limb fractures were compared across the two groups.

RESULTS

Preoperative health knowledge in the intervention group was 95.1%, compared to 82.0% in the control group (χ2 = 3.954, P<0.05). The Newcastle satisfaction with nursing scales score in the intervention group was (80.902 ± 7.016) points, compared to (78.131 ± 8.213) points in the control group. These group differences were statistically significant (P < 0.05).

CONCLUSION

The application of a short-form educational video during the perioperative care of patients with lower limb fractures may improve patients' understanding of perioperative health and increase satisfaction with nursing care.

Analysis of the impact of ERAS-based respiratory function training on older patients’ ability to prevent pulmonary complications after abdominal surgery

BACKGROUND

In China, as the population grows older, the number of elderly people who have died from respiratory problems has increased.

AIM

To investigate whether enhanced recovery after surgery (ERAS)-based respiratory function training may help older patients who had abdominal surgery suffer fewer pulmonary problems, shorter hospital stays, and improved lung function.

METHODS

The data of 231 elderly individuals having abdominal surgery was retrospectively analyzed. Based on whether ERAS-based respiratory function training was provided, patients were divided into ERAS group (n = 112) and control group (n = 119). Deep vein thrombosis (DVT), pulmonary embolism (PE), and respiratory tract infection (RTI) were the primary outcome variables. Secondary outcome variables included the Borg score Scale, FEV1/FVC and postoperative hospital stay.

RESULTS

The percentage of 18.75% of ERAS group participants and 34.45% of control group participants, respectively, had respiratory infections (P = 0.007). None of the individuals experienced PE or DVT. The ERAS group’s median postoperative hospital stay was 9.5 d (3-21 d) whereas the control groups was 11 d (4-18 d) (P = 0.028). The Borg score decreased on the 4^th d following surgery in the ERAS group compared to the 2^nd d prior (P = 0.003). The incidence of RTIs was greater in the control group than in the ERAS group among patients who spent more than 2 d in the hospital before surgery (P = 0.029).

CONCLUSION

ERAS-based respiratory function training may reduce the risk of pulmonary complications in older individuals undergoing abdominal surgery.

Clinical Effect of Application of Interventional Treatment Models for Improvement of Quality of Postoperative Recovery in Elderly Patients with Total Hip Arthroplasty

OBJECTIVE

To investigate the application value of the interventional treatment model for improving the recovery of elderly patients after total hip arthroplasty (THA).

METHODS

A total of 50 patients who received THA were randomly divided into the control group (25 cases) undergoing traditional treatment and the experimental group (25 cases) undergoing intervention of cognition, emotion, environment, education, nutrition, and sleep. The mini-mental state examination (MMSE) score, the incidence and duration of postoperative cognitive dysfunction (POCD), the out-of-bed activity time, hospital stays, and the satisfaction degree of patients were compared between the two groups.

RESULTS

There was no statistically significant difference in basic information between the two groups. On days 7 and 14 after surgery, the MMSE score of the control group was significantly lower than that of the experimental group (P <0.05). The incidence of POCD in the experimental group was lower and its duration was shorter than in the control group but without statistical significance. Besides, the significantly decreased out-of-bed activity time, the reduced length of hospital stay, and the higher satisfaction degree were observed in the experimental group (P <0.05).

CONCLUSION

Interventional treatment model could significantly increase the MMSE score, accelerate the recovery of elderly patients after THA, and increase their satisfaction degree.

Effect of Transdermal Fentanyl Patch Combined with Enhanced Recovery after Surgery on the Curative Effect and Analgesic Effect of Liver Cancer

Its goal was to see how a transdermal fentanyl patch combined with accelerated recovery after surgery (ERAS) affected the treatment efficacy and analgesic effect of liver cancer, as well as to help patients with liver cancer choose the right analgesic treatment and nursing mode. 150 patients with liver cancer were divided into group A (transdermal fentanyl patch), group B (ERAS), and group C (transdermal fentanyl patch combined with ERAS). Patients in the three groups were compared in terms of pain, survival, psychological status, adverse responses, postoperative recovery, and patient satisfaction. The results showed that under different treatment and nursing methods, the number of patients with mild cancer pain in the three groups was increased, especially the number of patients with mild cancer pain in group C (P < 0.05). Besides, the quality of life score of patients in each group was decreased. Patients who received the combination analgesia had a significantly higher quality of life than those who received simply a transdermal fentanyl patch or ERAS (P < 0.05). The scores of both the Hamilton anxiety scale (HAMA) and Hamilton depression rating scale (HAMD) of patients with the combined analgesia were decreased signally (P < 0.05). There were few patients with combined analgesia who had adverse reactions (P < 0.05). After surgery, the time of the first anal exhaust, first defecation, and first ambulation in group C were shorter than those in the other two groups (P < 0.05). To summarize, combining the two techniques aided in the recovery of gastrointestinal function as well as the physical recovery of patients following surgery. Furthermore, combining the two approaches produced a clear analgesic impact, which could improve patients' quality of life while also having a favorable clinical adoption effect.

Effect of WeChat-Based Health Preaching Combined with an Enhanced Recovery after Surgery Model on Perioperative Limb Motor Function and Complications in Orthopaedic Patients

Objective

To evaluate the effect of WeChat-based health preaching combined with an enhanced recovery after surgery (ERAS) model on perioperative limb motor function and complications in orthopaedic patients.

Methods

By means of retrospective analysis, the medical data of 68 orthopaedic patients who received surgical treatment in our hospital (from 01, 2020–12, 2021) were collected, and the patients were equally divided into the study group (SG) and control group (CG) according to their admission order, with 34 cases each. From 7 d before surgery to the time of hospital discharge, WeChat-based health preaching combined with ERAS perioperative nursing was performed to patients in the SG, and routine orthopaedic perioperative nursing was performed to those in the CG. Before and after nursing, patients' Visual Analog Scale for Fatigue (VAS-F) scores, Houston Pain Outcome Instrument (HPOI) scores, and brief Fu-gI-Meyer (FMA) motor scores were investigated and the incidence rates of postoperative complications and nursing satisfaction of patients in the two groups were recorded.

Results

After nursing, SG obtained a significantly better VAS-F score and HPOI score (P < 0.001), significantly higher postoperative 7 d and predischarge lower limb FMA scores (20.06 ± 2.13 vs 18.38 ± 2.36, 27.50 ± 1.90 vs 24.09 ± 2.25, P < 0.05), and significantly lower annual incidence rate of complications compared with those of the CG (P < 0.05); and the nursing satisfaction scores of the SG and CG were 9.18 ± 0.82 points and 6.76 ± 0.91 points, respectively, indicating significantly higher nursing satisfaction in the SG than in the CG (P < 0.001).

Conclusion

The nursing model of WeChat-based health preaching combined with ERAS can effectively improve the knowledge level of orthopaedic patients, thereby improving their abilities of pain management and self-management, accelerating the recovery of their limb function, and reducing the incidence rate of postoperative complications. The patients are more satisfied with such nursing model, indicating its better promotion value.