Impact of perioperative enhanced recovery after surgery on wound infection in patients undergoing orthopaedic surgery: A meta-analysis.

The aim of this study was to evaluate the effects of perioperative application of enhanced recovery after surgery (ERAS) concepts on wound infections and post-operative complications in patients receiving orthopaedic surgery, to provide a theoretical basis for post-operative care. Randomised controlled trials (RCTs) on the application of ERAS to patients receiving orthopaedic surgery, published up to October 2023, were identified in PubMed, Web of Science, Cochrane Library, Embase, Wanfang, China Biomedical Literature Database and China National Knowledge Infrastructure databases. Literature was screened and evaluated by two reviewers based on the inclusion and exclusion criteria, and data were extracted from the final included articles. Data were analysed using RevMan 5.4 software. A total of 20 RCTs were included in the analysis, which included 1875 patients undergoing orthopaedic surgery, of whom 938 and 937 were in the ERAS and control groups, respectively. The analysis revealed that in patients undergoing orthopaedic surgery, implementation of ERAS in the perioperative period was associated with a significantly reduced the rate of wound infections (1.6% vs. 6.19%, risk ratio [RR]: 0.30, 95% confidence interval [CI]: 0.18-0.50, p < 0.001) and complication (5.12% vs. 21.88%, RR: 0.23, 95% CI: 0.17-0.32, p < 0.001) and can effectively shorten the hospital length of stay (standardised mean difference [SMD]: -2.50 days, 95% CI: -3.17 to -1.83 days, p < 0.001) compared with that of conventional care. The available evidence suggests that the implementation of ERAS in the perioperative period of patients undergoing orthopaedic surgery could effectively reduce the rate of wound infections and complications, shorten the hospital length of stay and promote the early recovery of patients.

Effect of continuity of care on quality of life and medication compliance of patients with ST-segment elevation myocardial infarction.

OBJECTIVE: To investigate the effects of continuity of care (COC) on the quality of life and medication compliance of patients with ST-segment elevation myocardial infarction (STEMI). METHODS: A retrospective analysis was conducted in 98 patients with STEMI that were treated in our hospital from January 2017 to December 2018. The 98 cases were assigned to a control group given routine nursing and an experimental group given routine nursing combined with COC according to different nursing approaches. The quality of life and medication compliance in the two groups were compared. RESULTS: Higher role-emotional (RE) scores were observed in the control group after nursing (P<0.05). Compared to results before nursing as well as the control group, the experimental group obtained higher quality of life scores in the dimensions of physical functioning (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), RE, mental health (MH), and better medication compliance after the implementation of COC (P<0.05). Compared to the control group, the experimental group showed a markedly lower incidence of minor bleeding and arrhythmia, a higher nursing satisfaction, and a higher excellent and good rate of cardiac function (P<0.05). The experimental group outperformed the control group in left ventricular ejection fraction (LVEF) and 6-min walking distance (P<0.05). CONCLUSION: COC improves the quality of life, medication compliance, and nursing satisfaction of STEMI patients, and reduces adverse events.

Analysis of Rehabilitation Effect of Neurology Nursing on Stroke Patients with Diabetes Mellitus and Its Influence on Quality of Life and Negative Emotion Score.

Objective: To explore and analyze the rehabilitation effect of neurology nursing on stroke patients with diabetes mellitus (DM) and its influence on quality of life and negative emotion score. Methods: In this experiment, 110 stroke patients with DM diagnosed and treated in our hospital from 2018 to 2020 were randomly selected and assigned to the study group (SG) and the control group (CG) according to different nursing methods, with 55 cases in each group. In SG, they were given neurology nursing. In CG, they were given routine nursing. The rehabilitation efficacy, quality of life, and negative emotion scores were compared between the two groups. Results: Compared with the CG, the levels of fasting blood glucose, 2 h postprandial blood glucose, and urinary microalbumin in SG were obviously better after treatment. In SG, the proportion of patients with basic recovery and significant improvement after treatment was higher, and the proportion of patients without treatment effect was significantly lower. Overall, the nursing effect of the SG after treatment was better than that of the CG. There was no striking difference in the quality of life and Morisky scores between the two groups before nursing intervention (P > 0.05), but the quality of life and Morisky scores of patients in SG were obviously higher than those in CG after nursing intervention. After nursing intervention, SAS and SDS scores of patients in SG were obviously lower than those of patients in CG, and patients in SG were less affected by negative emotions. Questionnaires were used to investigate the satisfaction of patients in both groups, and the results showed that the satisfaction of patients in SG was higher (all P < 0.05). Conclusion: Neurology nursing has better clinical efficacy for stroke patients with DM and has obvious rehabilitation effect. The quality of life and negative emotion score of patients are better, which is worthy of extensive clinical promotion and application.

Application of evidence-based nursing in patients with acute myocardial infarction complicated with heart failure.

OBJECTIVE: To explore the application of evidence-based nursing (EBN) in patients with acute myocardial infarction (AMI) complicated with heart failure. METHODS: A total of 76 patients with acute myocardial infarction complicated with heart failure after Percutaneous Transluminal Coronary Intervention (PCI) were admitted to the Department of Cardiology of our hospital from April 2018 to October 2019 and randomly divided into the control group and the experimental group, with 38 patients in each group. The control group received routine nursing and the experimental group received EBN nursing. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) scores, quality of life, long-term treatment efficacy, and nursing satisfaction in the two groups before and after nursing were compared and analyzed. RESULTS: In terms of SAS and SDS, the experimental group after nursing had remarkably lower scores than the control group (t=6.468, 4.025, all P < 0.001). The quality-of-life scores of patients in both groups after nursing were better, and the increase in the experimental group was more evident (all P < 0.05). Left Ventricular Ejection Fraction (LVEF) in the experimental group was significantly higher compared with the control group (t=2.480, P < 0.05), while Left Ventricular Diastolic Diameter (LVDd) and Brain Natriuretic Peptide (BNP) were significantly lower (t=3.824, 12.241, all P < 0.001). Considering the total nursing satisfaction, the experimental group demonstrated a higher satisfaction rate (P < 0.05). CONCLUSION: EBN is beneficial for patients with AMI complicated with heart failure, and it is worth being popularized in clinical nursing.