Application of hierarchical monitoring management and refined nursing in postoperative treatment of severe craniocerebral injury

Abstract

Objective To investigate the effect of graded surveillance management and refined nursing mode on the incidence of stress injury in patients with coma after operation for severe craniocerebral injury. Methods 62 patients with coma after operation for severe craniocerebral injury treated in our hospital from July, 2017 to July, 2019 were selected, and were divided into a routine group and a combination group according to the admission order, with 31 cases in each group. The routine group implemented routine nursing intervention; in addition, the combination group group implemented hierarchical monitoring management and refined nursing mode. The postoperative rehabilitation indicators [mechanical ventilation time, intensive care unit (ICU) treatment time, and hospitalization days], the incidences of stress injury, family members' satisfaction to nursing work, and blood flow velocities of the femoral and iliac veins before and after the intervention were compared between the two groups. Results The mechanical ventilation time, ICU treatment time, and hospitalization days were shorter in the combination group than in the control group (all P<0.05). The blood flow velocities of the femoral and iliac veins were faster in the combination group than in the control group (both P<0.05). The incidence of stress injury was lower in the combination group than in the control group [6.45% (2/31) vs. 25.81% (8/31) P<0.05]. The satisfaction of the family members to the nursing work was higher in the combination group than in the control group [93.55% (29/31) vs. 70.97% (22/31), P<0.05]. Conclusion Hierarchical monitoring management + refined nursing mode can be applied to patients with coma after surgery for severe craniocerebral injury, and can significantly accelerate their blood flow velocity, reduce the incidence of stress injury, shorten the postoperative recovery time, and improve the satisfaction of family members. Key words: Hierarchical monitoring management; Refined nursing mode; Severe craniocerebral injury; Coma; Stress injury