Management modes of integrated operating rooms

Objective To evaluate the efficiency of applying nurse-doctor integration management mode in operation room. Methods A historical control study was used to analyze the advantages of the nurse-doctor integration management mode in operation room, improving operation punctuality rate, increasing operative quantity, reducing the nurses ' over working time and surgical convergence time. The traditional management mode was adopted before January, 2016. The control group took management mode during the second half of 2015, and the observation group the second half of 2016. Results There were 12 592 operations in the control group; the operation punctuality rate was 79.7%; the surgical convergence time was (57.2±36.5) min; and the average over working time was (12.3±1.1) h. There were 14 262 operations in the operation group; the operation punctuality rate was 96.0%; thee surgical convergence time was (48.0±23.7) min; and the average over working time was (10.3±1.7) h. There were statistical differences in those three indicators between the two groups (P <0.05). Conclusions Compared with traditional operation room management mode, nurse-doctor integration operation room management mode can improve the first operation punctuality rate, shorten operation convergence time, reduc the work time of nurses, and increase the efficiency of operating room, so it is deserve to be popularized. Key words: Operating room; Nurse-doctor integration; Efficiency

Objective To discuss the application of computerized management of pathological specimens in operating room to put emphasis on the improved solution and optimized management process. Methods Through analysis of the features and shortcomings of the basic management process, we reformed the workflow with the help of information technology. Results In the operating room, we applied the computerized management policy in the whole course management of pathological specimens, including application for examination, collecting, verifying and receiving specimens. Conclusions Computerized management system standardizes the management of pathological specimens, enhances the accuracy and efficiency of workflow and improves the instantaneity and convenience of the supervision. Key words: Operating room; Pathological specimen; Computerized management

Objective To explore the clinical application of 5S methodology in the operation room of nursing management, and to provide reference for daily management. Methods A total of 2 459 patients were chosen from October 2012 to May 2014. 1 147 Patients from October 2012 to June 2013 were in the control group that given regular nursing management, while 1 312 patients from July 2013 to May 2015 were as experimental group and underwent 5S methodology. Quality of operation nursing management were compared before and after using 5S methodology, and managerial experience was summarized. Results The items readiness rate, equipment readiness rate, use of intact rate and emergency items readiness rate were 96.95%, 98.70%, 99.77% and 97.79%, respectively, and there were statistically significance between the two groups (χ2=10.52, 12.33, 8.76, 9.28, respectively; P<0.05). In the experimental group, the air bacteria detection index, time of fetching items and time of supplementing items were (29.71±5.94)cfu/m3, (18.34±6.42)and (17.85±5.89)s, which were better than those in the control group (t=132.48, 21.27, 26.18, respectively; P<0.05). For the satisfaction of medical staffs and patients, the experimental group (89.42% and 92.38%) were better than control group, the differences were statistically significant (χ2=8.56, 9.41; P<0.05). Conclusions The implement of 5S methodology can help to improve the efficiency of nursing management in operation room, and promote the operation room overall work efficiency and quality. Key words: Operation room nursing; 5Smethodology; Quality of management

Objective To investigate the application effect of point-factor method in constructing nursing performance management mode in Operating Room, so as to provide reference for improving quality of operating room nursing. Methods Relative indexes were collected and compared before (December 2014) and after (December 2015) implementation of nursing performance management mode in Operating Room basing on point-factor method, including performance assessment of nurses, professional standard test of nurses and satisfaction of nursing. Results The nursing performance management mode constructed by point-factor method included 4 first-level indexes and 20 second-level indexes, after implementation of which, Operating Room nurses′ scores of theoretical level, duty work quality, equipment operating quality, round going quality and total scores were all improved (P<0.05); scores of their three basis theory, three basis operation and professional achievements were also improved (P<0.05); satisfaction of patients, doctors and Operating Room nurses to the nursing work were improved (P<0.05). Conclusions The nursing performance management mode constructed by point-factor method can promote management efficiency in the Operating Room and improve quality of nursing. Key words: Operating Room; Personnel management; Performance management; Point-factor method

Objective To explore the method and effects of construction of operating room information management system based on Healthcare Information and Management Systems Society 7 (HIMSS 7) standards. Methods There were problems in traditional operating room information management system analyzed by department of anesthesiology and operating, Xuanwu Hospital, Capital Medical University. The operating room information management system was reconstructed and applied based on HIMSS 7. The process included nursing recording electronically, completing tripartite check and confirmation by using USB key or digital authentication software, viewing electronic medical record in nurse operator interface, realizing drug closed-loop management by importing intelligent medicine cabinet, informationalized pathology management, landing integration platform by single-point and so on. Results Reconstruction of system met the demands of HIMSS 7 hospital level judgment, reduced the workload of medical staff and improved work efficiency. Conclusions Reconstruction of operating room information management system based on HIMSS 7 standards can improve the work efficiency of staff in operating room and enhance perioperative safety factor of patients. Key words: Operating rooms; Information management systems; Healthcare Information and Management Systems Society 7 standards; Perioperative safety

Objective To explore the effects of WeChat group in teaching of standardized training among Operating Room nurses. Methods A total of 28 nurses accepting standardized training in Operating Room were selected as control group (standardized training) from July 2011 to December 2012. A total of 28 nurses accepting standardized training in Operating Room were selected as intervention group (standardized training & WeChat group teaching ) from January 2013 to July 2014. What was compared after intervention among nurses between two groups included theoretical knowledge, the score of operation skill, nurses′ satisfaction with training, the satisfaction degree of patients and family members and surgeons′ satisfaction with nurses. Results After the intervention with WeChat group teaching, scores of theoretical knowledge and technical knowledge were (96.3±3.6) and (94.5±4.6) in intervention group which were higher than those in control group with significant differences (t=-8.652, -7.254; P 0.05). Scores of suture needle, aseptic technique, transferring equipment in operation, arranging surgical position, surgery cooperation were (92.1±6.2), (91.6±5.2), (95.6±3.3), (96.2±3.6), (97.1±2.6) in intervention group which were higher than those in control group with significant differences (t=-4.125, -4.526, -3.856, -5.846, -9.032; P<0.01). Satisfaction degrees of nurses with training, surgeons with nurses, patients′ family members with treatment in intervention group were obviously better than those in control group with significant differences (P<0.01). Conclusions Training with WeChat group in nurses can visibly improve nurses′ study enthusiasm, theoretical knowledge, operation skill, satisfaction degrees of nurses with training, surgeons with nurses, patients and their family members with treatment and improve the quality of care in operating room at the same time. Key words: Operating Room; Standardized training; WeChat group

Objective To explore the methods of the standardized management used in humanistic nursing care and to assess its effects. Methods Measures of the standardized management began to be used in such care at the hospital since January 2013.Questionnaires of patient satisfaction with nursing care for inpatients and those discharged were used to assess the effects of the standardized management measures periodically and synthetically. Results The patient satisfaction with humanistic nursing care keeps increasing year by year from 2013 to 2015.The differences among three sets of data are statistically significant(P<0.05). Conclusions Humanistic nursing care calls for promotion of standardized management.It is high time to build such a standardized management system at the hospitals. Key words: Humanistic care; Nursing; Standardized management

Objecltive To intensify the coordination and nursing in the operation room in order to prevent surgical site infection after gastrointestinal operation. Methods 337 medical history of patients received gastrointestinal operation and third rate healing from 1999 to 2006 were collected. A series of intensified measures were applied to surgical site infection from 2003 gradually, including invocation of new surgical handwashing method, modified skin disinfection manner, adoption of degreasing with ethanol first before disinfection with iodophor, placement of incision protector and clean bag for incision protection after entering abdomen, changing to use new gastrointestinal anastomofic thimerosal,standardization of operation order and clean manage-ment in operation room. The incidence rate of surgical site infection after gastrointestinal operation of patients from 1999 to 2002 and from 2003 to 2006 underwent χ2 test. Results The incidence rate of surgical site in-fection after gastrointestinal operation greatly decreased after adoption of intensified nursing intervention, Signifi-cant difference existed in rate of patients with third rate healing between the year 1999 to 2002 and 2003 to 2006. Conclusions Modified nursing intervention for surgical incision after gastrointestinal operation can de-crease incision infection rate evidently. Key words: Gastrointestinal operation; Surgical site infection; Nursing

Objective To discuss the effects of time node control method on the utilization rate of operating room. Methods In 2017, the time node management and control method was implemented by using information management system. The existing problems before improvement were analyzed, the management system was formulated and the management and control measures were implemented. From the 1st to the 8th of December 2017, the operation data after intervention were compared with those of the same period in 2016, including the entering time and punctual rate of the first operation , the punctual admission rate of receptive operation. Results The time of receiving the first operation was 8: 23 in 2016, while in 2017 it improved to 7: 52. From 2016 to 2017, the punctual rate of the first operation increased from 64.71% to 78.54%, the difference was statistically significant (χ2=11.391, P 0.05) . Conclusions The application of time node can improve the utilization rate of operation room and work efficiency. Key words: Operation room; Nursing management; Time node; Utilization

Objective To investigate the current status of nursing management of patient with cancer pain in tertiary comprehensive hospitals of China, and cognitive status of nurses in pain management, to provide guidance for clinical nursing management. Methods A self-designed questionnaire was used to investigate 80 tertiary comprehensive hospitals from 20 provinces who participated in Chinese Nursing Association oncology nurse training in 2015. Results The results indicated that nursing pain management has been proceed in 64 comprehensive hospitals (80.0%), among which 44 hospitals (55.0%) have specialized nursing team; 41(51.25%) hospitals have specified nurses; 34 hospitals (42.5%) have pain nursing assessment record; and 51 hospitals (63.75%) have follow-up after patients discharge from hospital. Nurses thought that the adverse factors that affect the pain nursing management contain 9 aspects, in which the top three factors were: patients worry about the analgesic drug addiction (93.75%); no systemic and standardized pain nursing management process (91.25%) and nurses worry about the adverse effect of analgesic drug (85.50%). Conclusions At present, most of tertiary comprehensive hospitals in China have carried out nursing pain management in different extent, which lead to the slow development of nursing pain management. Sustained efforts should be pay to establish standardized management procedure, promote specified nurses education, and improve management of patients with cancer pain, and this will provide guidance for nursing pain management in the future. Key words: Pain; Nursing management; Situation analysis

Objective To explore the 5S quality management for analyzing the hidden danger of nursing safety at operation room and the results. Methods 10 nurses from the operation room of our hospital were selected to form a 5S quality management group. The operating room patients from January to April, 2008 were selected before 5S quality management as a control group; and the patients from May to July 2018 after 5S quality management were selected as a study group. The item management situations before and after 5S quality management and the patients’ satisfaction to the nurses were compared between these two groups. Results After 5S quality management, the occurrence of expired items decreased obviously, and the working environment finishing time and the time of taking and putting items were shortened obviously [ (2.85±0.87) per month vs. (0.34±0.14) per month, (26.38±4.40) min vs. (15.34±2.91) min, and (33.25±12.54) min vs. (24.37±5.34) min, all P<0.05]. The patient’ satisfaction to the nurses was significantly higher in the study group than in the control group [(90.24±5.14) vs. (81.24±3.27)], with a statistical difference (P<0.05). Conclusion Application of 5S quality management in operation room nursing care can reduce the occurrence of expired articles, create a clean working environment, and improve patients' satisfaction. Key words: 5S management; Operation room; Nursing care; Results

Objective To explore and analyze the correlation between nurses' willingness to stay in the operating room and job stressor, job burnout and work-family conflict. Methods A total of 128 nurses from Mianyang Central Hospital, Third People′s Hospital of Mianyang, Mianyang People′s Hospital were selected as the research objects. The questionnaire of nurses' retention intention, the scale of nurses' job stressor, the scale of nurses' occupational fatigue and the scale of work stress conflict were used to investigate and analyze the correlation between nurses' retention intention and work stressor, occupational fatigue and family conflict. Results The average retention intention of the nurses surveyed in this study was (3.16±0.71), and the retention intention of the nurses was in the middle level. Operating room nurses' total score of work stress was (95.27±15.28). Among them, the scores of time allocation and workload, nursing specialty and work were the highest (2.86 ± 0.73) and (2.75 ± 0.64), respectively. The highest score of personal achievement was (33.26 ± 8.39). The total score of work family conflict of nurses in operating room was (58.32 ± 11.29), and the total score was (3.09 ± 0.58). The average score of work family conflict based on time was the highest, which was (3.91 ± 0.64), which was the main source of work family conflict of nurses. Pearson correlation analysis showed that nurses' intention to stay was negatively correlated with work pressure, job burnout and work family conflict (r value was-0.374,-0.400,-0.327, P < 0.05). Conclusions Nurses' willingness to stay in the operating room is at a medium level. Nursing managers can reduce the pressure of occupational fatigue by reducing work stress and improve the willingness of nursing staff to stay. Key words: Operating room; Nursing staff; Retention intention; Source of work stress; Sense of occupational fatigue; Work-family conflict; Correlation

This paper introduced the background and application method of healthcare failure mode and effect analysis (HFMEA) to understand the application of HFMEA mode in the operation room nursing management at home and abroad, and explored its application value in nursing management of operating room. It can provide experience for the application of HFMEA in nursing process of operating room, so as to better reduce the incidence of nursing risk in operating room, protect patients' life safety and improve the quality of nursing. Key words: Review; Operating room; Healthcare failure mode and effect analysis; Nursing management; Nursing safety

Objective To explore the influence of dialect - based communication obstacle on the safety of ophthalmic operation room and to provide the basis for improving the safety of ophthalmic operation room. Methods An in-depth interview was taken on 10 medical staff by qualitative research. The information was arranged and analyzed by phenomenology method. Results The interview with the surgical doctors on the communication barriers were extracted to three themes, including lower surgical efficiency, decreased patient satisfaction, increased risk of surgical complications, the interview with the surgical nurses on the dialects leading to communication barriers were extracted three themes, including surgical verification difficult to carry out, affect the perioperative care, hinder the postoperative mission to carry out, the extracted themes about the impact on patients include increased stress and anxiety affect the surgical outcome, poor intraoperative experience reduced satisfaction, the extracted themes about solution include the organization of medical staff to learn the dialect of the common language, recruit staff diversification, to provide professional translation, standardized body language to instruct the patient. Conclusions In this study, the experience of communication disorder caused by doctors and nurses in the ophthalmic operating room reflects the shortcomings of the safety management of the ophthalmic operating room. These deficiencies can be reduced by the independent study of the medical staff. Key words: Dialect; Communication disability; Ophthalmic surgery; Qualitative research

Objective To explore the effects of diagnosis related groups (DRGs) related indexes in nursing human resource allocation of internal medicine system so as to provide a basis for reasonably allocating nursing human resource. Methods This study retrospectively consulted the medical record information of inpatients in internal medicine system of Linyi People's Hospital from 1st January 2017 to 31st December 2017, analyzed the production capacity of internal medicine system in 2017. Based on the capacity, this study allocated 2018 nursing human resource allocation of internal medicine, and compared the production capacity scores of internal medicine capacity, the medical service efficiency, medical service safety, nursing quality, satisfaction of nurses with nursing human resource allocation and patients' satisfaction with nursing care before and after implementation. SPSS18.0 software was used in data processing and analysis. Results After allocating nursing human resource based on DRGs capacity score, the production capacity scores were higher than those before implentation; the time efficiency of medical service efficiency reduced compared with that before implementation; ward management quality, nursing safety management quality, clinical nursing service quality, nursing documentation writing quality, health education quality, critical patients management quality, disinfection isolation quality, patients' satisfaction with nursing care and satisfaction of nurses with nursing human resource allocation in 2018 internal medicine system improved compared with those before implementation with statistical differences (t=-3.636、3.367、-13.090、-14.665、-11.630、-10.005、-11.572、-13.941、-8.906; P<0.05) . Conclusions Nursing human resource allocation based on DRGs capacity score could cover the demand of clinical nursing work, improve the work efficiency and nursing quality, and increase satisfaction of patients and nurses under the condition of limited nursing human resource. Key words: Nursing staff; Nursing human resource allocation; Diagnosis related groups; Capacity; Internal medicine