Objective To explore the analgesic effect of dicaine combined with penetration en-hancer applied to venipuncture with venous indwelling needle. Methods 60 patients treated with selec-five operation under epidural anesthesia were divided into the control group and the experimental group with 30 patients in each group. The control group was treated with conventional method of venipuncture. The experimental group was externally applied with dicaine combined with penetration enhancer 50 min-utes before the venipuneture in basilic or cephalic vein. Local reactions were observed after venipuncture and the analgesic effects were evaluated with visual analogue scale(VAS 0～100 mm). Results The analgesic ef-fect in the experimental group was obviously better than that of the control group with a significantly lower VAS. The maintaince of analgesic time in the experimental group lasted above 90 minutes. Condusious The analgesic effect of dieaine combined with penetration enhancer can be approved with a very high analgesia rate, its onset time is much shorter than conventional method and maintenance time is much longer.

Objective:To develop dynamic management strategies for intraoperative acquired pressure injuries (IAPI) in neurosurgery patients and evaluate their implementation effects, so as to provide constructive suggestions for the management of IAPI.Methods:This study was conducted by a non-synchronous before and after control study. From January 2021 to December 2022, 220 patients undergoing neurosurgery in the Second Affiliated Hospital of Guilin Medical College were conveniently selected as the study objects, and divided into the control group and the observation group with 110 patients in each group according to the time of operation. The control group was given routine nursing measures to prevent IAPI, and the observation group was given dynamic management program based on timing theory on bisis of routine nursing. The score of preoperative stress injury,incidence of IAPI and the self-efficacy scores of nurses in the management of stress injury in operating room were compared between the two groups.Results:Before intervention, the scores of preoperative stress injury in control group and observation group were (14.69 ± 2.93) points and (14.78 ± 2.89) points, respectively, with no statistical significance ( t=-0.23, P>0.05).After the intervention, the incidence of IAPI was 3.64%(4/110) in the control group and 0 in the observation group, and the difference was statistically significant ( χ2=4.07, P<0.05). The self-efficacy scores of nurses in the management of stress injury before and after intervention were (29.13 ± 4.87) and (36.41 ± 5.83), respectively, and the difference was statistically significant ( t=-6.21, P<0.05). Conclusions:The implementation of dynamic management strategy of IAPI can effectively reduce the incidence of IAPI in neurosurgery patients and improve the self-efficacy of nurses in operating room.

" Day surgery hospital-community joint follow-up model " results newly from the deepening implementation of the hierarchical medical system policy. It is designed to follow up the patients discharged from hospital but not fully recovered in time to ensure the prevention of adverse events after surgery. It can also improve the quality and efficiency of follow-up, and ensure the safety and integrity of the whole day operation management. In this context, through a comparative study of 720 patients discharged from daytime surgery in the region, patients in the combined follow-up group were followed up by telephone on the 3rd day after the operation by nurses from the day surgery ward. On the 10th and 20th days after the operation, the family doctor from the community health service center will visit the patient at home and follow up the patient by telephone. One month later, the patient returned to the hospital for follow-up consultation. Follow-up results show day surgery hospital-community joint mode as a helpful aid in keeping track of the patients postoperative rehabilitation, reducing complications and handling in time, while improving the ambulatory surgery perioperative safety.

Objective:To understand the potential categories of self-efficacy in stress injury management of nurses in operating room and analyze the characteristics of different categories of nurses.Methods:A cross-sectional survey was conducted from June to August 2022. A total of 469 operating room nurses from 12 Grade A hospitals in Guangxi, Sichuan, Guizhou, Yunnan, Shanxi, Xinjiang and Chongqing were selected by convenient sampling method as subjects. General data questionnaire, proactive personality Inventory, Caring behavior Inventory, transformational leadership inventory, nursing clinical Decision scale and nurses stress injury management self-efficacy scale were used to investigate. Potential profile was used to analyze nurses' self-efficacy in stress injury management, and multiple Logistic regression was used to analyze different potential factors.Results:The self-efficacy of nurses in the management of stress injury in operating room could be divided into three potential profiles: poor self-efficacy group (23.9%, 112/469), medium self-efficacy group (33.0%, 155/469) and good self-efficacy group (43.1%, 202/469). Proactive personality, caring behavior, transformational leadership, nursing clinical decision-making and educational background were the factors influencing self-efficacy of operating room nurses in stress injury management (all P<0.05). Conclusions:There are three potential profiles of self-efficacy in the management of stress injury in operating room nurses. Nursing managers can give targeted intervention strategies according to different characteristics of nurses to improve their self-efficacy.