With the continuous development of medical technology, the division of labor between doctors and nurses has become more and more refined. The coordination between the two promotes better services and meets the nursing needs of patients. The nursing needs of orthopedic patients are Very complex. Below are the orthopedic papers I compiled for your reference. Orthopedic Dissertation Sample 1: Orthopedic Pain Nursing Medical Dissertation
Abstract: Patients often have fear due to lack of understanding of the disease and treatment effects, which intensifies the feeling of pain. Therefore, nurses provide necessary care and guidance. The patient is depressed.
Keywords: Orthopedics; Nursing Medicine
1. Materials and Methods
290 orthopedic patients hospitalized in a certain hospital from April 2009 to October 2009 Selected cases: 210 males, the oldest is 69 years old, the youngest is 4 years old, 80 are females, the oldest is 78 years old, the youngest is 2 years old. In the care of these 290 orthopedic pain patients, intervention was carried out from four aspects: general nursing, specialist nursing, medication nursing, and psychological nursing, and good results were achieved.
2. Symptomatic treatment
1. Drug analgesia For patients with severe pain or whose pain cannot be relieved by other nursing methods, analgesics are used to relieve pain. Mild pain: non-opioid drugs, antipyretic analgesics, anti-inflammatory drugs, such as aspirin, ibuprofen; moderate pain: weak opioids, such as codeine, codeine, and buprofen , severe pain: choose strong opioids, such as morphine and pethidine.
2. Technical analgesic physiotherapy, cold therapy, heat therapy, ice compress, hot spring bath, microwave, infrared, etc.
3. Nursing
1. General nursing The causes of pain in orthopedic injuries can be divided into three categories: (1) Acute pain, which is seen after trauma or illness, such as fractures, Pain after surgery; (2) Chronic malignant pain, which occurs in malignant tumors or other progressive diseases, such as osteosarcoma, rheumatoid arthritis, etc.; (3) Chronic non-malignant pain, which occurs when non-progressive tissue damage or injuries have already occurred. Cured patients, such as shoulder and back pain, proliferative arthritis, etc. Before care, the cause of the patient's pain should be accurately understood and its degree correctly assessed, and physical therapy measures such as heat and ice packs, hot spring baths, Huibo waves, and infrared rays should be used in a targeted manner. During the nursing process, attention should be paid to observing the patient's reaction, especially for young children and the elderly, and their performance should be carefully observed, such as the patient's posture and posture, facial expression, emotional state, sweating, muscle tension, etc., to understand the degree of pain and care. Soothing effect on its pain.
2. Specialist care
Pain is the most common symptom of most orthopedic diseases, especially for orthopedic patients after surgery. The pain is even more obvious and severe. They have surgery. Most of them damage receptors such as muscles, muscle cavities, joints, and periosteum. The nature of the pain is deep pain, which is a kind of soreness and relatively diffuse pain. In specialist care, the patient should be helped to keep the affected limb in a suitable position, and the principle of traction should be used to help the patient move the affected limb, reduce pain, and allow the patient to cooperate with treatment. For patients who are fixed with bandages or plasters after surgery, they should first pay attention to observe the blood supply of the affected limbs, whether there is swelling of the extremities, whether there is pressure sore formation in the plaster and other special circumstances. During window examination, painkillers should not be easily applied, otherwise it will cause skin ulcers and even necrosis. For pain caused by improper posture and overexertion, the patient can be helped to change positions to relieve pressure and relieve pain. One day after the operation, the pain can gradually reduce under normal circumstances. If it does not reduce or worsen, and the body temperature does not drop or rise, you should consider wound infection, check the wound healing status, and report it in time.
3. Medication nursing
In medication nursing, the method of stepped administration is generally used. According to the patient's pain level and specific conditions, the stepped administration is performed from weak to strong. Mainly used Tramadol hydrochloride sustained-release tablets and Mexicontin controlled-release tablets are mainly taken orally. For those with severe pain that affects their sleep, intramuscular injections of diazepam, diazepam, and pethidine can be given. And provide preventive medication according to the situation. In addition, patients should be frequently visited, comforted and encouraged, and efforts should be made to reduce the patient's psychological pressure and improve the pain threshold; when using opioids such as Guadi, one should observe whether there is respiratory depression; non-opioid drugs such as Suomi If there is pain, you should mainly observe whether there is any tendency of gastrointestinal bleeding.
In addition to the above aspects, nursing staff should pay attention to being warm, friendly, confident, and generous in their manners when interacting with patients. They should operate conscientiously and skillfully, carefully observe the patient's reaction, the location, nature, rhythm and degree of pain, and make themselves Put yourself in the patient's position and experience his or her pain, making the patient feel understood and cared for, thus effectively alleviating his or her pain psychologically.
4. Psychological nursing
Patients often have fear due to lack of understanding of the disease and treatment effects, which intensifies the feeling of pain. Therefore, nurses provide necessary care and guide patients. The heart is filled with stagnation. Patients should be supported with sympathy, comfort and encouragement, try to reduce the patient's psychological pressure, distract attention, keep the patient happy, emotionally stable, relaxed, and increase tolerance to pain. When treating and caring for patients, move accurately and gently, avoid roughness, and minimize painful stimulation. For example, when performing debridement, catheterization, changing sheets, turning over and other nursing operations, when the patient must be moved, attention should be paid to maintaining a comfortable position to avoid causing pain to the patient. At the same time, the cooperation of the patient's family members should be sought. When the patient is in pain, the accompanying family members will also be affected and show anxiety. This emotion will in turn affect the patient, causing the patient's pain to worsen. Do a good job in the ideological work of patients and their families so that patients have good psychological factors and a positive and rational state, which can also play a role in relieving pain and helping recovery.
References
1. Investigation into the causes of constipation and nursing care in bedridden orthopedic patients Shi Min, Zhang Xiuqiong, Zhou Yongxia, Jiang Muyao PLA Nursing Journal 2004-05-25110
2. Analysis of factors related to sterile surgical incision infection in orthopedics and nursing intervention in operating room Gong Xixue; Lu Meifang; China Medical Herald 2011-01-2586 Orthopedic paper sample 2: Orthopedic patient nursing safety management paper
Abstract: Accompanying With the current acceleration of population aging, the number of elderly people in our country is also increasing, and the number of aging orthopedic patients is also in the process of gradually increasing. Most elderly orthopedic patients have varying degrees of limb limitation. In addition, elderly orthopedic patients belong to a high-risk patient group and are usually associated with other cerebrovascular and heart diseases. Therefore, hospital orthopedics departments have higher requirements for clinical nursing quality.
Keywords: orthopedics; safety management
1. Materials and methods
1. Methods
Before the implementation of enhanced safety management, Patients in the control group were only given routine orthopedic safety care, including health education, psychological care, safety management, etc. The observation group received enhanced safety management on the basis of routine orthopedic care. Before care, first analyze the orthopedic unsafe factors, determine the orthopedic risk factors in the form of a questionnaire, and formulate targeted safety management strategies. Secondly, a professional nursing safety management team was established to form a three-level nursing safety management network to eliminate unsafe factors in orthopedics, correct potential safety hazards, and conduct safety education and training for orthopedic nursing staff on a regular basis to enhance the nursing staff's sense of responsibility and strengthen their awareness of prevention. Nursing staff then formulate individualized health education and safety care plans based on each patient's general information, and conduct intensive safety education for the patient's family members. Distribute written materials, explanations, and emergency handling demonstrations on safety hazards to patients and their families, inform patients of simple self-rescue methods, and encourage patients and their families to actively participate in safety management and build a good nurse-patient relationship. At the same time, we should do a good job in ward safety management, appropriately increase bed rails for patient beds in the ward, place sharp instruments, hot water bottles and other dangerous items away from patients, and place anti-slip pads in the corridors and washrooms of the ward to maintain the safety inside the ward. Clean, tidy, and regularly ventilated. For orthopedic patients who have been bedridden for a long time, help them turn over and help their family members clean the patient's skin to reduce the incidence of pressure ulcers.
2. Evaluation indicators
Record the incidence of accidents during the care of the two groups of patients, count the number of complaints during the care, and use a self-made satisfaction questionnaire to evaluate the two groups of patients. satisfaction rate.
3. Statistical analysis
SPSS19.0 statistical software was used to process the research data of this group. Count data were subjected to ?2 test. When P<0.05, the difference was considered to be statistically significant. significance.
II. Results
1. Comparison of the incidence of unsafe events during the nursing period of the two groups of patients
During the nursing period, there was 1 case of fall and 2 cases of pressure ulcer in the observation group. , the overall adverse event incidence rate was 6.6%; in the control group, there were 2 cases of burns, 2 cases of self-injury, 4 cases of falls, and 5 cases of pressure ulcers, with a total incidence rate of 28.9%. There was a significant difference between the observation group and the control group (P<0.05).
2. Comparison of the complaint rate and satisfaction rate between the two groups of patients during the nursing period
One patient in the observation group complained, and 44 patients were satisfied. The satisfaction rate was 97.8%, which was significantly higher than the 80.0 in the control group. %, the difference between groups is significant (P<0.05).
3. Discussion
With the current acceleration of population aging, the number of elderly people in my country is also increasing. The number of aging orthopedic patients is also gradually increasing. Most elderly orthopedic patients have varying degrees of limb limitation. In addition, elderly orthopedic patients belong to a high-risk patient group and are usually associated with other cerebrovascular and heart diseases. Therefore, hospital orthopedics departments have higher requirements for clinical nursing quality. As an important component of nursing work, safety management has become increasingly important in clinical nursing work. A large number of research reports have suggested that the implementation of effective safety management can significantly reduce the incidence of risk events and improve the overall quality of hospital care. . In the clinical care of orthopedic patients, unsafe factors generally include four parts, namely the professional level of the nursing staff, the patient's own factors, and the risk assessment ability and responsibility of the nursing staff. Generally, elderly orthopedic patients usually have multiple injuries, their condition progresses rapidly, and their physical functions are in a stage of continuous degradation. If nursing staff only follow routine operations and mechanically carry out medical instructions, they lack the ability to handle risk events and emergencies. It is more likely to lead to accidents, and it is impossible to build a harmonious nurse-patient relationship, and cannot better gain the trust of patients and their families [7-8]. Nursing safety is the prerequisite for determining the quality of nursing care. It is also the basis for hospitals to provide safe, satisfactory and high-quality services to patients. It is an important link in reducing medical disputes and medical accidents. In view of the safety hazards existing in orthopedic nursing work, carrying out orthopedic nursing safety management and strengthening safety education are the keys to improving the quality of orthopedic nursing. In this group of studies, patients in the observation group were given enhanced safety education on the basis of routine care, and nursing staff were regularly organized to conduct safety knowledge education and training to strengthen the nursing staff's sense of responsibility and require nursing staff to provide health education and training to the patients during the nursing process. Safety management ensures that patients have the full right to know, informs patients and their families of any unexpected situations that may arise during treatment and examination, and builds a good nurse-patient relationship so that patients and their families can fully trust the nursing staff to reduce the occurrence of medical disputes Rate. At the same time, the nursing staff are urged to master the general information of the patients, carry out targeted nursing intervention, provide patients with humanized nursing services, give appropriate verbal comfort to seriously ill patients, correct their negative psychological emotions, and at the same time popularize necessary health information to each patient. knowledge to improve compliance with their treatment. In addition, we should strengthen preventive care in the ward and provide good care for the ward environment to avoid accidents caused by objective factors and reduce the incidence of risk events. The results of this study suggest that the accident rate of patients in the observation group who implemented enhanced safety management was significantly lower than that of the control group, and the patient satisfaction rate was significantly higher than that of the control group. It also further confirmed that in the safety management of orthopedic patients, the implementation of enhanced safety management Safety education programs can not only reduce the incidence of medical disputes and accidents, but also optimize the quality of care and improve patient satisfaction with care, which is worthy of promotion.
References
1. Investigation into the causes of constipation and nursing care in bedridden orthopedic patients Shi Min, Zhang Xiuqiong, Zhou Yongxia, Jiang Muyao PLA Nursing Journal 2004-05-25110