摘要
目的分析4R危机管理模式在老年髋部骨折患者静脉血栓栓塞症(Venous Thromboembolism,VTE)防控管理中的应用效果,旨在为临床老年髋部骨折患者静脉血栓栓塞症的防控提供新的思路。方法选取2021年11月—2023年6月医院创伤显微手外科收治的老年髋部骨折患者100例作为研究对象,将2021年11月—2022年8月收治的50例纳入对照组,实施常规护理干预,将2022年9月—2023年6月收治的50例纳入观察组,在常规护理干预的基础上实施4R危机管理模式护理。分别采用多普勒超声检查两组患者VTE发生情况,记录两组患者首次下床时间及住院时间;使用Harris髋关节功能评分量表(Harris Hip Score,HHS)对两组患者出院前髋关节功能进行评估,用修订版骨科患者下肢深静脉血栓知信行调查量表对患者VTE知识、信念、行为情况进行调查。结果观察组患者的VTE发生率低于对照组,差异有统计学意义(P<0.05);观察组患者的首次下床时间及住院时间短于对照组,差异有统计学意义(P<0.05);观察组患者出院前的髋关节功能评分高于对照组,差异有统计学意义(P<0.05);观察组患者的VTE知识、信念、行为得分均高于对照组,差异有统计学意义(P<0.05)。结论4R危机管理模式在老年髋部骨折患者VTE防控管理中应用效果较好,能提高患者VTE的知信行水平,有效预防VTE的发生,促进患者早日下床,缩短患者住院时间,加快患者髋关节功能的恢复。
Objective To analyze the application effect of the 4R crisis management model in the prevention and control of venous thromboembolism(VTE)in elderly patients with hip fractures,with the goal of providing new insights into the clinical prevention and control of VTE in this patient population.Methods A total of 100 elderly patients with hip fractures admitted to the hospital's Trauma and Microsurgery Hand Surgery Department from November 2021 to June 2023 were selected as the study subjects.Among them,50 patients admitted between November 2021 and August 2022 were assigned to the control group and received routine nursing care,while the other 50 patients admitted between September 2022 and June 2023 were assigned to the observation group and received 4R crisis management model nursing in addition to routine care.Doppler ultrasound was used to assess the occurrence of VTE in both groups of patients,and the time to fi rst ambulation and length of hospital stay were recorded.The Harris Hip Score(HHS)was used to evaluate hip joint function in both groups before discharge,and the Revised Knowledge,Attitudes,and Practices Questionnaire for Lower Limb Deep Vein Thrombosis in Orthopedic Patients was used to investigate the patients'knowledge,attitudes,and practices regarding VTE.Results The incidence of VTE in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The time to fi rst ambulation and length of hospital stay in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).The hip joint function score before discharge was higher in the observation group compared to the control group,the difference was statistically significant(P<0.05).The VTE knowledge,attitudes,and practices scores in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion The application of the 4R crisis management model in VTE prevention and control for elderly patients with hip fractures has shown positive results.It improves patients'knowledge,attitudes,and practices regarding VTE,effectively prevents its occurrence,promotes early ambulation,shortens hospital stay,and accelerates the recovery of hip joint function.
作者
梁小凤
梁剑敏
唐四桂
林琦
钟玲琳
LIANG Xiaofeng;LIANG Jianmin;TANG Sigui;LIN Qi;ZHONG Linglin(People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)
出处
《护理实践与研究》
2025年第5期747-752,共6页
Nursing Practice and Research
基金
广西壮族自治区卫健委科研课题基金(编号:Z20210603)。
关键词
4R危机管理
髋部骨折
静脉血栓栓塞症
预防
老年人
4R crisis management
Hip fractures
Venous thromboembolism
Prevention
Elderly people
