| Objective Based on evidence based nursing theory and Delphi method,ERAS nursing plan of patients undergoing lumbar short segment fusion was constructed.To explore the advantages,feasibility and safety of the program in the perioperative period of lumbar short segment fusion.Method Part one: evidence based resource retrieval The research team,through clarifying the research problems,selecting the appropriate literature retrieval database,determining the retrieval scheme,searching the relevant documents at home and abroad according to the retrieval steps,through strict literature screening and evaluation,including high-quality literature,collecting the best evidence-based evidence,clinical situation and the willingness of patients,preliminarily formulated the era care for patients undergoing lumbar short-term fusion surgery Management plan.Part two: Delphi method to construct ERAS nursing plan for patients undergoing lumbar short segment fusion The first part of the paper demonstrates the ERAS nursing plan of the patients who have been operated on lumbar short segment fusion by Delphi method.The research group selects 12 experts to conduct two rounds of inquiry by making expert correspondence questionnaire.Spss24.0 software is used to analyze data,and the indicators are deleted,modified or added according to the boundary value method and the feedback from each round of expert correspondence.Then,ERAS nursing care for patients with lumbar short segment fusion surgery applied in clinical is formed through the integration and induction of the research group plan.Part three: the clinical application of ERAS nursing plan for patients undergoing lumbar short segment fusion The sample size was calculated by the method of similar experimental research,and the sample size was calculated by repeated measurement variance analysis of measurement data.According to the standard of nanogram,62 patients were selected as the research object by convenient sampling method.The subjects were randomly divided into experimental group and control group by random digital table grouping method The experimental group was nursing with ERAS nursing plan of the patients with lumbar short segment fusion.During the study,the main evaluation indexes of the two groups were recorded: "ODI" evaluation score and hads The data of vas,total hospitalization days,first time to bed,exhaust time,time of pulling out tube,incidence of postoperative complications and satisfaction of patients with nursing work were analyzed statistically by spss24.0 software.The differences of main and secondary evaluation indexes were compared between the two groups under different nursing intervention methods,and the differences of lumbar spine were discussed The advantages,feasibility and safety of the clinical application of ERAS nursing plan for patients undergoing short segment fusion surgery.Result Part one: evidence-based resource retrieval The research group,through searching the relevant evidence based literature,through strict literature quality evaluation,finally included 20 evidence documents.According to the JBI evidence classification standard,the paper transforms the content of the collected documents into evidence grade,and the research team gives the recommendation level of evidence.Finally,3 level I indexes,16 level II indexes and32 leve III indexes were integrated to form the preliminary design of ERAS nursing program center for patients undergoing lumbar short segment fusion.Part two: Delphi method to construct ERAS nursing plan for patients undergoing lumbar short segment fusion In this study,two rounds of expert correspondence were conducted.The recovery rate of the two rounds of expert correspondence questionnaire was 100% and 100%,the effective rate was 100% and 100% respectively,and the positive coefficients of the two rounds of expert correspondence were 100% and 100% respectively.The expert authority coefficients of the two rounds of inquiry letters are 0.81 and 0.79 respectively.The range of coordination coefficient of the two rounds of inquiry experts was 0.26~0.33 and 0.37~0.44,respectively.The difference was statistically significant(P < 0.05).After the selection of the index by the boundary method and the two rounds of expert consultation,the ERAS nursing plan for the patients with lumbar short segment fusion surgery was formed,which includes 3 level I indexes,14 level II indexes and 29 leve III indexes.Part three: the clinical application of ERAS nursing plan for patients undergoing lumbar short segment fusion There was no significant difference between the two groups in the data comparison of age,sex and other general data before operation(P > 0.05),which was comparable.The difference between the two groups in the data of "ODI" score and "hads" score was statistically significant(P < 0.05).The difference between the two groups was statistically significant(P < 0.05).Conclusion Based on evidence-based nursing theory and Delphi method,the study of the ERAS nursing plan for patients with lumbar short segment fusion surgery is scientific in improving and standardizing the traditional nursing measures from three stages,namely,preoperative,intraoperative and postoperative.In the clinical application,the program not only reduces the incidence of postoperative complications,reduces the anxiety and depression of patients,shortens the number of hospitalization days,reduces the cost of hospitalization,improves the satisfaction of patients with nursing work,but also accelerates the recovery speed,improves the lumbar function and life status of patients after operation,and improves the quality of nursing service.This proves that the patients can improve the quality of nursing service The clinical application of this scheme in thoracolumbar spine surgery has advantages,feasibility and safety. |
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