Objective To illustrate the situation of delayed discharge of patients after total knee arthroplasty (TKA) under fast-track (FT) recovery model, and analyze the reasons. Methods We retrospectively analyzed the clinical data of 152 patients who accepted perioperative management under fast-track model from January to December 2014. The reasons for discharging over 72 hours after hospitalization were analyzed. Results Among the 152 patients, 119 were discharged over 72 hours after surgery, and the rate was 78.2%. The main reasons for delayed discharge were pain (32.8%), limited range of motion (31.9%) and unwillingness to be discharged (27.7%), respectively. Conclusion For patients who have undergone TKA, FT model can shorten hospital stay, save expenses, and accelerate postoperative rehabilitation, but there is still much room for improvement.
ObjectiveTo explore the effect of level management model in the application of nursing for pressure ulcers after spinal surgery. MethodA total of 3 558 patients underwent spinal surgeries between January 2014 and September 2015 were selected. We established a level management model, confirmed the personnel responsibilities, strengthened the pressure ulcers risk assessment of new inpatients, and standardized the processes of reporting pressure sores. We carried out the level management model between January and June 2014, summarized experience and formed a system file between July and December 2014, applied to the clinical work after continuous improvement between January and September 2015. High risk of pressure ulcers reporting rate, incidence of high-risk pressure ulcers, and healing rate of pressure ulcers were compared at the various stages. ResultsThe reporting rate of pressure ulcers raised, the incidence of pressure ulcers increased and the curing rate decreased after continuous improvement (P<0.05). ConclusionsLevel management model may effectively improve the quality of the nursing for spinal pressure ulcers.