Refined Nursing in Rehabilitation Training

Summary

This study is to explore the clinical effect of refined nursing in rehabilitation training for patients with brain injury during the recovery period. Patients in the control group were provided with routine nursing intervention, while patients in the study group adopted a nursing mode based on the concept of refinement treatment. Comparison was made in terms of the Glasgow Coma Scale (GCS) score, cognitive function score, functional independence score, nursing satisfaction, and incidence of complications.

Conditions

• Brain Injuries

Interventions

BEHAVIORAL

Establishment of a hierarchical monitoring and management team

To be specific, the head nurse served as the team leader to conduct comprehensive macro supervision; moreover, there were 3 responsible team leaders and 6 responsible nurses, all of whom had rich clinical nursing experience and solid theoretical knowledge of pressure injury. Consequently, a joint-action mechanism of the head nurse - responsible team leader - responsible nurses was developed to facilitate the unification of the training of nursing content, precautions, etc.

BEHAVIORAL

Assessment of pressure injury

Based on the postoperative coma of patients, the Braden assessment scale was applied to effectively evaluate patients from six dimensions of sensory perception, moisture, activity mode, mobility, nutrition, friction, and shear. The total score was 23 points. Patients scoring 13\~14 points were evaluated by Braden once per week; and those scoring ≤12 points were evaluated at a frequency of 3d/ time.

BEHAVIORAL

Communication

Through intensive face-to-face communication with family members, timely information on the surgical effect, mechanism of pressure injury, preventive measures, and clinical manifestations through intuitive methods such as PPT and video, family members were taught with basic knowledge of pressure injury, and guided to inform medical staff in a timely manner when patients had symptoms of pressure ulcer. Simultaneously, by case sharing and positive suggestions, family members were supported to alleviate their concerns and improve their coordination with treatment

BEHAVIORAL

Intervention for pressure ulcer

For patients with a Braden score of \>14 points, attention should be paid to keeping skin dry and clean, regularly changing bed sheets and bedding (once per day). Patients with Braden score of 13-14 points should be provided with sponge mattresses, increased times of turning over once per 2 hours, and soft pillows or foam dressings at the site of occipital protuberance to relieve pressure and prevent pressure injury. For patients with Braden score ≤12 points, medical staff should repeatedly emphasize to their families the harm of pressure injury to postoperative recovery.

BEHAVIORAL

Rehabilitation training

After regaining consciousness with stable vital signs, patients received rehabilitation training following the principle of association of activity and inertia in a regular order. Patients were guided to perform upper limb movements, joint flexion, lower limb flexion and extension, as well as daily training such as washing face, rinsing mouth, and dressing at a frequency of 3\~4 times/d. Moreover, patients were advised to minimize violent behaviors such as laughing and talking loudly

BEHAVIORAL

introduction of the current patient's condition to family members

timely introduction of the current patient's condition to family members to alleviate their concerns

BEHAVIORAL

maintaining appropriate temperature and humidity in the ward

maintaining appropriate temperature (20 ℃\~22 ℃) and humidity (60.0%\~70.0%) in the ward

BEHAVIORAL

careful observation of vital signs in patients

careful observation of vital signs such as heart rate, blood oxygen saturation, and blood pressure in patients

Sponsors & Collaborators

• Xinxiang Central Hospital

  lead OTHER

Principal Investigators

• Jie Yang · Xinxiang Central Hospital

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

33 Years

Max Age

43 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-05-01

Primary Completion

2023-05-31

Completion

2024-01-01

Countries

• China

Study Locations