Effect of competence health cultivation on the prevention and control of inadvertent perioperative hypothermia

Wang, Ran; Ping, Fu-Min; Liu, Yue-Mei; He, Jing-Lan; Du, Shu-Fang; Shi, Pei-Zhao; Chen, Song; Shi, Ji-Yue

doi:10.1590/1806-9282.66.7.924

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Revista da Associação Médica Brasileira

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ORIGINAL ARTICLE • Rev. Assoc. Med. Bras. 66 (7) • July 2020 • https://doi.org/10.1590/1806-9282.66.7.924 copy

Effect of competence health cultivation on the prevention and control of inadvertent perioperative hypothermia

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE

To explore the feasibility of health competence cultivation on the prevention and control of Inadvertent Perioperative Hypothermia (IPH).

METHODS

Patients with expected spinal surgery were divided into group A and group B by the random number method. Group B followed routine IPH management, and health training measures for performance and ability were implemented in Group A. The scores of the health competence questionnaire, the temperature at different times, IPH complications, and hospitalization for the two groups were observed and compared.

RESULTS

The main evaluation indexes, such as the health competence questionnaire score, temperature fluctuations, and IPH complications, during the perioperative period in group A were significantly better than those in group B (p < 0.05). The indexes of anesthesia, total hospital expenses, and health service satisfaction in group A were also significantly better than those in group B, which shows the advantages of cultivating health capabilities in both doctors and patients.

CONCLUSION

Through health competence cultivation and feasible health management measures, the medical staff can improve the quality of IPH prevention and management.

Perioperative period; Hypothermia; Health management

Competence Health	Risk Elements	Patient Education and Evaluation	Medical Education and Evaluation	Expected Indicators
Physiological Competence Health	Diagnosis and treatment of physiological abnormalities	Preoperative evaluation of physiological function	Omnidirectional Risk Assessment Ability	Individual physiological health indicators can be based on
	Central hypothermia	Whole-course temperature monitoring and management	Regulations and Professional Insight	Scientific and Reasonable Equipment Technical Data
	Physiological function injury	Visceral Compensation and Prevention and Control	Risk Awareness and Recognition Preventive Ability	Precise Regulation and Timely Emergency Prevention and Control
Spirit Competence Health	Health cognitive impairment	Medical risk and coping Education	Health Humanities and Medical Effectiveness Evaluation	Health Cognition and IPH Knowledge Sharing
	Psychological adaptation disorder	Early Warning Guidance and Assistant Intervention Management	Occupational Behavior Habits and Care	Understanding Care and Joint Response under Expected Goals
	Abnormal moral behavior	Risk Communication and Moral Behavior Guidance	Professional Ethics and Patient Participation in Management	Behavior Regulation and Sharing under Security Expectation
Social Competence Health	Role Recognition Adaptation	Patient Role Adaptation and Family Care	Professional Role and Professional Behavior Standards	Role Orientation and Behavior Appropriateness
	Medical Expenditure Burden	Family Economic Burden and Medicare Model	Medical Benefit Welfare and Patient Health	Optimal Medical Benefit Based on Quality and Safety
	Communication, coordination and understanding	Active and Passive Communication and Cultural Understanding Ability	Health Education and Risk Sharing Awareness	Risk Consensus Awareness and Coordination Ability

Number	Core Measures	Standard Achievement	Score Assignment Standard
1	Risk Cognitive Education and Competence Guidance 48 hours before Operation	Familiar with the condition, know the operation method, confirm the risk early warning	2 points per item
2	High-energy diet and physical exercise guidance to ensure sleep quality	Energy reserve > 30%, physical stability, adequate sleep > 8 hours	2 points per item
3	Adaptive Education and Participatory Skills Guidance 24 hours before Operation	Familiar with operating room environment, clear hypothermia response and understanding of treatment cooperation requirements	2 points per item
4	Preoperative IPH Cognitive Education for Relatives and Patient Care Guidance	Actively provide health information, cooperate with patients to control diet and complete physical exercise	2 points per item
5	Education and preoperative preparation of patients within 4 hours before operation	Psychological comfort and intervention of patients, preoperative preparation and evaluation, nursing handover to meet the standard	2 points per item
6	Patient guidance, anesthesia induction preheating and environmental adaptation	Timely communication and cooperation, accurate feedback, preheating body temperature feeling up to standard	3 points per item
7	Position protection and accurate temperature monitoring and control equipment connection	Room temperature standard, effective coverage, accurate monitoring data, clear physical monitoring location	3 points per item
8	The alarm response and expectation are appropriate, and the fluctuation of monitoring indicators is up to the standard	Active physical monitoring, adapting to alarm response, early warning management up to standard, data fluctuation up to standard	3 points per item
9	Awakening Preheating Management and Comfort Feedback Reaching the Standard after Awakening	Pre-heating management before operation, temperature of awake precursor reaching standard and feedback reaching standard after awakening	3 points per item
10	Transfer body temperature up to standard, key handover and monitoring clear	Transfer temperature monitoring, ward handover, patients’feelings and relatives’ evaluation to reach the standard	2 points per item
11	Postoperative 24-hour temperature monitoring, doctor-patient cooperation with rehabilitation exercise	24-hour body temperature monitoring after operation, patient cooperation and rehabilitation, active prevention and control of relatives	2 points per item
12	No complications occurred 72 hours after operation, and the diet and physical fitness were up to standard.	Overall health assessment, post-operative infection, cardio-cerebral accident, and overall data evaluation	3 points per item

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[1] CORRESPONDING AUTHOR: Ji-Yue Shi Department of Pain, Affiliated Hospital of Hebei University of Engineering Congtai Road, n.81, Congtai District, Handan, Hebei, China – 056002 E-mail: jiyue_shi2@foxmail.com