Operating Room-Related Factors Analysis And Nursing Measures Of Postoperative Intracranial Infection

Objective:The purpose of this study is to investigate the related factors of intracranial infection after operation in a 3A hospital in Shanxi Province through cross-sectional investigation of the clinical data of patients,and to formulate specific preventive measures according to independent risk factors,so as to provide theoretical basis and technical guidance for preventing and reducing the occurrence of intracranial infection after operation in clinical work,and to strengthen the prevention of intracranial infection,and reduce the economic losses caused by internal infection to patients,hospitals and society.Methods:The first StageUsing the method of cross-sectional investigation and study,19 possible factors related to the occurrence of intracranial infection after operation were determined by consulting the relevant literature and consulting the medical staff of neurosurgery and operating room.The clinical data of 658 neurosurgical patients in a third-class A hospital in Shanxi Province were collected by self-designed information collection table.Through univariate and multivariate logistic regression analysis of 19 related factors collected in the study,the independent risk factors of intracranial infection after operation were obtained.The second stageFrom August to October 2018,220 patients with intracranial tumors undergoing elective neurosurgery in a 3A hospital in Shanxi Province were selected and divided into intervention group and control group according to the order of entering the operating room,110 cases in each group.To formulate targeted nursing measures for experimental research.By comparing the incidence of intracranial infection after operation between intervention group and control group,the clinical effect and implementation of targeted measures were analyzed.Intervention methods:(1)the control group received routine nursing in the operating room.(2)Nursing intervention measures were formulated in the intervention group:the number of operating rooms and the number of times of opening operation doors were controlled,and sterile gloves were replaced with sterile gloves for more than 4 hours.The others were the same as the control group.Results:1.From April to June 2018,658 neurosurgical patients were excluded from 47patients who did not meet the inclusion criteria.A total of 611 patients were enrolled.Among them,there were 50 cases in the intracranial infection group and 561 cases in the non-intracranial infection group.The intracranial infection rate after operation was 8.18%.Univariate analysis of 19 factors related to intracranial infection after operation showed that there were significant differences in 10 variables,including no space cap,emergency operation,implants,craniotomy,duration of sterile gloves more than 4h,diabetes mellitus,improper disposal of contaminants during operation,number of operation doors,number of operation rooms and duration of operation(p<0.05).Multivariate logistic regression analysis showed that emergency surgery,implants in operation,number of operation doors,the number of people operation rooms and the use time of sterile gloves more than 4h were independent risk factors for intracranial infection after operation.2.Among 220 patients undergoing neurosurgery from August 2018 to October 2018,there were 3 cases of intracranial infection in the intervention group(2.7%)and 10 cases of intracranial infection in the control group(9.1%),x~2=4.006,p=0.045),with significant difference(p<0.05).Conclusions:1.Postoperative intracranial infection is the result of a combination of hospital environment and patient’s own environment.Emergency surgery,implants,the time of opening doors,the number of people operating rooms,and the using time of sterile gloves more than 4h are independent risk factors for intracranial infection after operation.Through the analysis of OR value,the duration of sterile gloves use is continuous.The correlation between more than 4h and intracranial infection was the highest.The correlation degree of other factors was emergency operation>implants>the times of opening operation room>the number of people operation room.2.Through the analysis,the independent risk factors of intracranial infection after operation were obtained,and the scientific and targeted nursing countermeasures were formulated accordingly:using sterile gloves for more than 4 hours to replace sterile gloves,controlling the times of operating rooms and the number of people opening operations can reduce the incidence of intracranial infection after operation.