术后静脉血栓塞栓症 预防非关节塑造膝盖手术:一个闭环临床审计
Hassan Imtiaz1, Emmanuel Anaga2, Georgios Kouklidis3
1Trauma and Orthopaedics, University Hospitals Dorset, Poole, GBR.
Cureus
|September 8, 2025
概括
针对性教育后,对于非关节造形膝关节手术,静脉血栓栓塞 (VTE) 预防的遵从性显著改善. 该审计强调需要持续努力,以确保遵守国家卫生和护理卓越研究所 (NICE) 的指导方针.
科学领域:
- 整形外科手术 整形外科手术
- 血管外科 血管外科
- 公共卫生 公共卫生
背景情况:
- 静脉血栓栓塞 (VTE) 是骨科手术后的一个显著的,可预防的风险.
- 在非关节整形膝关节手术中,VTE预防的指导方针是不一致的,导致临床实践变化.
- 遵守国家卫生和护理卓越研究所 (NICE) 在非关节整形膝关节手术中对VTE预防的指导方针需要评估.
研究的目的:
- 评估在非关节塑造膝关节手术中遵守NICE关于VTE预防的指导方针.
- 评估教育干预措施对VTE预防遵守的影响.
- 在第三级骨科中心确定VTE预防实践需要改进的领域.
主要方法:
- 采用了闭环审计设计,在两个六个月的时间内回顾患者数据.
- 纳入标准侧重于接受非关节塑造膝关节手术的18岁以上患者.
- 在干预前和后测量了符合NICE VTE预防标准的符合性,这包括了一次手术团队教学会.
主要成果:
- 最初的VTE预防遵守率为50%,对于关节镜和36%,对于其他非关节塑性膝关节手术.
- 干预后,合规性增加到55% (关节镜) 和68% (其他非关节塑性手术).
- 在非关节镜手术中观察到统计学上显著的改善 (p=0.02),而关节镜手术的增加并不显著 (p=1.0).
结论:
- 在非关节置换手术的膝关节手术中,在VTE预防指南的遵守中发现了显著的差距.
- 有针对性的教育有效地提高了合规性,特别是在非关节镜病例中.
- 持续的干预措施,包括标准化的文档和持续的培训,对于维持和增强VTE预防至关重要.
相关概念视频
Venous Thrombosis III: Interprofessional Care
280
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
280
Peripheral Artery Disease V: Postoperative Nursing Management
379
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
379
Venous Thrombosis IV: Nursing Management
202
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
202
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
294
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
294
Venous Thrombosis I: Introduction
379
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
379
Pulmonary Embolism III: Nursing Management
369
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
369


