RESUMEN
Context: Orthopedic internal fixation implantation (OIFI) is a frequently adopted surgery for fractures, but it can trigger various adverse reactions and increase patients' risks of postoperative complications. Reducing those risks is paramount for obtaining better therapeutic effects for OIFI. Objective: The study intended to analyze the value of predictive nursing, based on healthcare failure modes and effects analysis (HFMEA), and combined with multimodal analgesia for improving postoperative rehabilitation after orthopedic internal fixation (OIFI), with the aim of offering reliable, accurate, and novel ideas and directions for future clinical OIFI and prognosis improvement for patients. Design: The research team designed a retrospective analysis. Setting: The study took place in the Department of the Operating Room at Hefei First People's Hospital in Hefei, Anhui, China. Participants: Participants were150 patients who needed OIFI at the hospital between January and December 2020. Intervention: Participants were assigned to one of two groups, 87 to the intervention group, who received treatment with HFMEA-based predictive care combined with multimodal analgesia after OIFI, and 63 to a control group who received routine nursing combined with multimodal analgesia after OIFI. Outcome Measures: Postintervention, the study measured the effective treatment rate, risk priority number (RPN)-the severity, possibility, and detectable degree of the risk, analgesic effects, self-controlled delivery times, tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) levels, and incidence of adverse symptoms. Also postintervention, the participants completed a visual analogue scale (VAS) to indicate their satisfaction with the nursing as well as the Exercise of Self-care Agency (ESCA) scale and the Spielberger State-trait Anxiety Inventory (STAI). Results: The study found significant differences between the groups. The intervention group showed significantly lower RPN values, VAS scores for analgesia, TNF-α and IL-6 levels, and incidence of adverse symptoms and also indicated greater satisfaction with the nursing, a significantly higher ESCA score, and a significantly better psychological state. Conclusions: HFMEA-based predictive care combined with multimodal analgesia can substantially lower the risk and pain levels of patients undergoing OIFI and can improve their nursing experience and self-care ability, so it's worthy of clinical application, having great significance for patients' rehabilitation.