Objective To investigate the status of the knowledge, attitudes and intervention behaviors in medical professionals in the prevention and treatment of deep vein thrombosis (DVT), and explore the weak links in knowledge-attitude-practice of DVT. Methods From December 2017 to February 2018, a convenient sampling method was used to extract 158 medical professionals out of 204 medical professionals from Department of Orthopedics, West China Hospital of Sichuan University. The questionnaire included the general information and basic situation of DVT learning, the knowledge of DVT, intervention attitude and implementation of preventive measures. The survey involved orthopedic doctors, nurses, rehabilitation therapists and nutrition managers. Results A total of 158 questionnaires were distributed and 150 valid questionnaires were completed. The effective questionnaire recovery rate was 94.9%. The mean score of basic knowledge of DVT was 6.45±1.83, the mean score of risk factors was 13.29±3.38, the mean score of intervention attitudes was 9.57±0.78, and the mean score of prevention implementation was 23.33±5.85. Conclusions The knowledge-practice of DVT intervention in orthopedic medical staff is moderate, and the attitude of DVT intervention is better among medical staff. There are various characteristics and weaknesses in knowledge-practice. It is necessary to regularly carry out knowledge about DVT among medical staff to improve the professional level of medical staff to prevent and treat DVT.
In the context of the rapid development of contemporary medical industry and the unbalanced development of various subspecialties, expert consensus plays an extremely important role in guiding clinical practice and improving the quality of medical care. However, there are some deficiencies and limitations in the formation process and final report of the expert consensus. Therefore, this paper summarizes and reviews the definition, applications, and functions of expert consensus and the new progress of expert consensus formation methods by fully reviewing the literature, and puts forward the prospect. The purpose is to provide a reference for the production and application of expert consensus related to medical care, improve the outcomes of medical care, and upgrade the quality and level of medical services.
In addition to implementing a series of measures in the hospital, enhanced recovery after surgery also needs to balance pre-hospital rehabilitation and post-hospital continuation management for patients. In order to optimize the patient management process of hip and knee arthroplasty, the orthopedic team of West China Hospital of Sichuan University has developed a comprehensive management plan for patients undergoing artificial hip and knee arthroplasty based on the latest domestic and foreign literature and previous practice. This article introduces the program from the definition of whole process management, as well as the pre-hospital, in-hospital, and post-hospital management of patients undergoing hip and knee arthroplasty, and aims to provide experience and reference for future clinical practice.
Objective To explore the nursing quality standards of joint surgery based on “structure-process-outcome” three-dimensional quality evaluation model, and provide a reference for improving the quality of joint surgery nursing. Methods From March to July 2023, based on the “structure-process-outcome” three-dimensional quality structure model as the theoretical framework, combined with systematic literature review and semi-structured interviews, the quality standards of joint surgery specialist nursing were preliminarily formulated. The Delphi method was used for screening, demonstration, and correction, then the analytic hierarchy process was used to determine the weights. Results The recovery rates of the two rounds of expert letter consultation were 93.75% and 100.00%, respectively. The expert authority coefficients of both rounds were 0.95. The positive coefficients of experts in the two rounds were 0.93 and 1.00, respectively. The coefficients of variation after the second round of correspondence were 0-0.20. In the second round of correspondence inquiry, the Kendall harmony coefficients of primary standards, secondary standards and tertiary standards were 0.156, 0.115 and 0.285, respectively, with statistical significance (P<0.05). Finally, the quality standards of joint specialty nursing included 3 primary standards, 23 secondary standards and 99 tertiary standards. Conclusion The construction process of nursing quality standards of joint surgery specialty based on “structure-process-outcome” three-dimensional quality structure model is scientific and reliable, the index evaluation results are less volatile, and the opinions are concentrated, which can provide a basis for comprehensively, accurately and pertinently improving the quality of joint surgery specialty nursing.
Doctor-patient shared decision making is an expansion and extension of the patient-centered concept, which emphasizes communication and collaboration between doctors and patients in making decisions, focuses on patients, needs, enhances communication and exchange between doctors and patients, and improves the status of patients in medical decision making. This paper reviews the concept, domestic and international research overview, advantages, and application of doctor-patient shared decision making in hip and knee arthroplasty, and discusses the future research directions, in order to provide a reference for the application of shared decision making between doctors and patients in hip and knee arthroplasty in China.