老年髋关节置换患者出院护理计划制定与应用  

Formulation and application of discharge nursing plan for elderly patients with hip replacement

作　　者：真启云[1] 李真 崔莉莉 谢军[1] ZHEN Qiyun;LI Zhen;CUI Lili;XIE Jun(The Affiliated People's Hospital of Jiangsu University,Zhenjiang,212001,China)

机构地区：[1]江苏大学附属人民医院骨科,江苏省镇江市212001

出　　处：《护理实践与研究》2022年第19期2991-2996,共6页Nursing Practice and Research

基　　金：江苏省“六个一工程”拔尖人才科研项目(编号:LGY2020064)。

摘　　要：目的探索老年髋关节置换术患者出院高需求护理的问题,制订专科性护理出院计划,提高生存质量。方法成立出院准备度管理小组,运用出院准备度量表筛查出高需求患者。实施六项关键任务护理干预策略:针对高需求护理问题,开展“居家护理训练营”;实施居家环境改造计划;规范髋关节防脱位行为;进行深静脉血栓形成(DVT)自护预防、抗凝与出血管理;骨质疏松预防干预;使用互联网+护理科普平台。结果50例患者髋关节屈曲、外展等主动活动范围较术前明显提高,术后3个月,髋关节功能评分(Harris)由术前43.46±4.97分提高到88.32±6.68分,髋关节疼痛评分由术前4.44±0.91分,分别降低为出院时2.46±0.79分,术后1个月1.38±0.53分,42例患者术后3个月能独立行走1 km以上。结论老年髋关节置换术患者出院准备度干预策略具有明显的专科特性,应针对性的对护理需求采取专科性护理策略,有效提高患者髋关节功能康复效果。Objective To explore the problem of high demand nursing in elderly patients with hip replacement after discharge,and to develop specialized nursing discharge plan,so as to improve survival quality.Methods To form the discharge preparation level management group,and patients with high needs were screened by hospital discharge readiness scale.Six key missions nursing intervention strategies were implemented:"home care training camp"for high-demand nursing issues;Implement home environment renovation plan;To regulate the behavior of preventing hip dislocation;Deep vein thrombosis(DVT)self-care prevention,anticoagulation and bleeding management;Osteoporosis prevention intervention;Use the Internet+nursing science popularization platform.Results The active range of motion of 50 patients was significantly improved compared with that before operation.At 3 months after operation,the hip function score(Harris)increased from 43.46±4.97 points to 88.32±6.68 points,and the hip pain score increased from 4.44±0.91 points.They were reduced to 2.46±0.79 points at discharge and 1.38±0.53 points at 1 month after operation respectively.42 patients could walk more than 1 km independently 3 months after operation.Conclusion The intervention strategy of discharge readiness of elderly patients with hip replacement had obvious specialty characteristics,specialized nursing strategy was required to be applied on the nursing needs targeted,eff ectively improve the eff ect of hip joint function rehabilitation.

关 键 词：髋关节置换 出院准备度 高需求 护理计划 

分 类 号：R473.6[医药卫生—护理学]