Application of the Care Bundle in Perioperative Nursing Care of the Type A Aortic Dissection

Abstract

Li Li,1– 3 Jiangqi Zhou,3 Likun Luo,3 Xiaoqing Chen,3 Yinglan Li2,4 1Xinjiang Medical University,Urumqi, 830000,Xinjiang, People’s Republic of China; 2Nursing School, Xinjiang Medical University,Urumqi, 830000, Xinjiang, People’s Republic of China; 3Operating Room,The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, Xinjiang, People’s Republic of China; 4Xiangya Nursing School, Central South University, Changsha, 410000, Hunan Province, People’s Republic of ChinaCorrespondence: Yinglan Li School of Nursing, Xinjiang Medical University, Xuelianshan Campus of Xinjiang Medical University, No. 567 North Shangde Road, Hemaquan New District, Shuimogou District, Urumqi, 830000, Xinjiang, People’s Republic of ChinaEmail [email protected]: To investigate the effect of the care bundle in the nursing care of the type A aortic dissection (TAAD).Methods: A total of 161 patients with TAAD were included in the study. They were divided into control group (n=79) and care bundle group (n=82). The patients in the control group received routine nursing, while the patients in the care bundle group received routine nursing and care bundle. IL-2, IL-6 and IL-10 levels in the three periods of T0 (before anesthesia), T1 (before anesthesia to 6 h after surgery) and T2 (6– 24 h after surgery), intraoperative blood loss, postoperative recovery, ICU stay time, intraoperative pressure ulcer rate, postoperative delirium rate, bloodstream infection rate and doctor satisfaction.Results: The postoperative T and pH levels in two groups were all in the normal range. The levels of IL-2, IL-6 and IL-10 in the care bundle group at different periods were also significantly different. The levels of IL-2 and IL-10 showed an increased trend, while that of IL-6 showed a downward trend. The intraoperative blood loss, postoperative recovery and ICU stay time, intraoperative pressure sore rate, postoperative delirium rate, and bloodstream infection rate were lower, whereas doctor satisfaction was all significantly higher in care bundle group.Conclusion: Care bundle increased the safety of the operation, and it was beneficial to the postoperative rehabilitation for TAAD patients.Relevance to Clinical Practice: Patients with TAAD who underwent operation need higher quality care during the entire operation. Cluster nursing is the kind of the nursing model that can better meet the requirements of the intraoperative nursing quality. The intervention methods in this study include 5 core nursing measures. These measures are implemented together in a synergistic manner to effectively improve the quality of nursing care in operating room and the health outcomes of patients with TAAD. Care bundle is worthy of clinical application.Keywords: care bundle, nursing care, type A aortic dissection

Keywords

• care bundle
• nursing care
• type a aortic dissection