Objective To summarize the role and implementation effect of risk management in Ophthalmic Day Surgery Center. Methods Since the establishment of Ophthalmic Day Surgery Center on October 8th, 2012, risk management was implemented in the aspects of hardware management, post setting, file management, operating process, service, etc., and the adverse events occurred in the period were analyzed to find out the defectiveness and hidden dangers in the working process, and then refined intervention measures were put forward and carried out. The surgical amount, occurrence of nosocomial infections and nursing adverse events, and patients satisfaction from October 8th, 2012 to June 30th, 2015 were analyzed. Results During this period, 52 073 ambulatory operations were completed, with no nosocomial infection and 2 cases of nursing adverse events. The patients satisfaction in 2013, 2014, and 2015 was 98.09%, 98.22%, and 99.85%, respectively. Conclusion The implementation of risk management in Ophthalmic Day Surgery Center can effectively reduce the occurrence of adverse events in nursing work, improve work efficiency, help to establish and improve the nursing security environment, improve the nurse-patient relationship, and improve patients satisfaction.
Objective To explore the effect of the feed-forward control on safety nursing of ophthalmologic day surgery patients under general anesthesia. Methods A total of 623 ophthalmologic day surgery patients under general anesthesia were retrospectively selected into the control group, who adapted the routine nursing in the Ophthalmic Day Surgery Center from January to December 2015; a total of 1 210 ophthalmologic day surgery patients under general anesthesia were retrospectively selected into the observation group, who received the feed-forward control of nursing safety management on the basis of routine nursing care from January to December 2016. The incidence rate of the adverse events and potential safety hazards and satisfaction rate were compared between the two groups. Results The incidence rate of the adverse events and potential safety hazards in the observation group (0.83%, 10/1 210) was lower than that in the control group (3.37%, 21/623), the satisfaction rate in the observation group (98.67%) was higher than that in the control group (97.11%), and the differences were statistically significant (P<0.05). Conclusion The application of feed-forward control in the safety care of patients during the ophthalmologic day surgery under general anesthesia can effectively reduce the incidence of adverse events and potential safety hazards, and ensure the safety of medical care.
ObjectiveTo investigate the preoperative cognition of the patients undergoing daytime ophthalmic fundus surgery and understand their needs of health education, so as to provide an evidence for efficient and accurate preoperative health education services within the limited time of the ophthalmic day fundus surgery.MethodsThe convenient sampling method was used to select the patients who met the inclusion criteria in the ambulatory operating room of Beijing Tongren Hospital, Capital Medical University from December 2017 to May 2018. The study included three parts: the general information of the patients, the preoperative cognition of the patients, and the needs for health education service of the patients. Questionnaires were designed according to the research purpose and method, which were distributed and recovered by professionals.ResultsA total of 112 patients were included. Among them, the cognitive scores of operation process (2.57±0.56), preoperative diet (2.58±0.59), preoperative medication (2.60±0.64), and psychological status (2.58±0.65) were relatively low. More health education services were needed in three aspects: the cognition of operation details [operation duration (85.71%), surgeons (79.46%), operation start time (76.79%)], intraoperative cooperation (90.18%), and intervention for preoperative anxiety (78.57%).ConclusionNurses should formulate the contents of preoperative health education according to the preoperative cognition and nursing needs of patients, so as to provide efficient and accurate health education services for patients.
Objective To explore the effect of extended nursing intervention on patients with enucleation day surgery. Methods Patients who underwent monocular enucleation in the day ward of the Ophthalmology Center, Beijing Tongren Hospital, Capital Medical University between July 2020 and June 2021 were selected. They were randomly divided into control group and trial group by random number table method. The control group was given routine day-to-day nursing care, while the trial group added the extended nursing intervention measures of “forward and extended” on the basis of routine day-to-day overall nursing. The preoperative and postoperative anxiety levels, health knowledge awareness, operation shutdown rate, and nursing satisfaction were compared between the two groups of patients, and the application effect of extended nursing interventions in such patients was evaluated. Results Finally, 106 patients were included, 106 questionnaires were distributed, 106 were recovered, and the recovery rate was 100.0%. There were 53 cases in both the control group and the trial group. There was no significant difference in gender, age and education level between the two groups (P>0.05). The operation shutdown rate in the trial group was lower than that in the control group (0.0% vs. 11.3%). The preoperative and postoperative anxiety scores of the trial group were lower than those of the control group (preoperative: 50.06±5.27 vs. 58.25±5.21, postoperatively: 49.43±5.45 vs. 58.53±5.55). The score of the health knowledge awareness questionnaire in the trial group was higher than that in the control group (89.96±2.88 vs. 75.00±3.16). The degree of satisfaction in the trial group was better than that in the control group. In the trial group, 38 cases were very satisfied, 14 cases were satisfied, and 1 case was dissatisfied. In the control group, 19 cases were very satisfied, 27 cases were satisfied, and 7 cases were dissatisfied. The above differences were statistically significant (P<0.05). Conclusions Nursing intervention of “forward and extended” for patients with enucleation day surgery can effectively relieve patients’ anxiety before and after surgery, improve health knowledge awareness and nursing satisfaction, and reduce the operation shutdown rate.
Objective To evaluate the effect of optimizing the management measures of cataract ambulatory surgery. Methods The patients who underwent cataract phacoemulsification combined with intraocular lens implantation in the Ambulatory Surgery Center of East District of Beijing Tongren Hospital affiliated to Capital Medical University were selected. Patients between January and December 2021 (after the optimization of ambulatory surgery process) were included, and patients between January and December 2020 (before the optimization of ambulatory surgery process) were included as control. The three factors of age, gender and surgical eye type were used as predictive variables for propensity score matching. The proportion of patients who completed the surgery according to the scheduled time, the proportion of eye drops used according to the doctor’s instructions and the number of hospital visits before and after the optimization of the ambulatory surgery process were compared with the patients who successfully matched. Results A total of 28306 patients were included, including 13284 before and 15022 after process optimization. There were 13467 males and 14839 females, with a median age of 70 (60, 78) years. There was no statistically significant difference in the age of patients before the process optimization (P>0.05), but there was statistically significant difference in gender and surgical eye (P<0.05). After the propensity score matching, a total of 12932 pairs of patients were matched successfully. After the propensity score matching, there was no statistically significant difference between the two groups in age, gender and surgical eye (P>0.05). After the process optimization, the proportion of patients who completed surgery on schedule (98.8% vs. 93.3%) and used eyedrops according to the doctor’s instructions (97.4% vs. 93.0%) were higher than that before the process optimization, and the proportion of patients who came to hospital more than 3 times (0.7% vs. 1.9%) was lower than that before the process optimization (P<0.05). Conclusion The optimized ambulatory surgery process can help patients complete the surgery according to the scheduled time and use eye medication according to the doctor’s instructions, and can reduce the number of patients coming to the hospital.
This article discusses the concret implementation of day surgery in Ophthalmology Center, Beijing Tongren Hospital, Capital Medical University during the coronavirus disease 2019 epidemic and under the regular prevention and control, so as to provide a basis for ensuring the safety and effectiveness of clinical work in the special period. According to the requirements of health administration departments and the hospital for the prevention and control of epidemic, combining with the characteristics of concret work, the Ophthalmology Center carried out and accurately implemented a series of prevention and control management measures, and obtained good results in the clinical work on the basis of comprehensive security protection. From February to October, 2020, there were a total of 16 507 cases who underwent the day surgery in the Ophthalmology Center, with no surgical infection or suspected case of coronavirus disease 2019. The safety and quality management of epidemic prevention and control has played an active and effective role in the active development of day surgery in this center. The safe and optimized diagnosis and treatment process has reassured the patients and their families, and the strict implementation of protective measures by medical staff has ensured the safety of surgery and the work being proceed with smooth progress and high efficacy.