Objective To investigate the development of the digital wireless network billing system of oxygen flow in clinical application. Methods By random 220 cases of patients who need to absorb oxygen were divided into the observation group(108 cases)and the control group(112 cases), the observation group used the digital wireless network billing system of oxygen flow, and the control group adopted the traditional buoy type oxygen gauge instrument. The following items were compared between the two groups: dispute rates between nurses and patients for different amount of absorbed oxygen, the average time cost for nurses in measuring the duration of oxygen absorbing, total income per barrel for recycling oxygen. Results For the dispute rates between nurses and patients for different amount of absorbed oxygen were 0.93% in the observation group, and 75.89% in the control group. The average time cost for nurses in measuring the duration of oxygen absorbing was 2.03 minutes for the observation group, and 12.54 minutes for the control group; total income per barrel for recycling oxygen was 42.68 yuan per barrel of the observation group, and 28.23 yuan in the control group. The statistical analysis between the two groups was supported by 95% confidential level. Conclusions Using the digital wireless network billing system of oxygen flow in clinical can reduce the dispute rates between the nurses and patients, improve patients' satisfaction degree, reduce the total time cost for nurses in measuring the duration of oxygen absorbing, raise efficiency, build a clear scientific charge system of oxygen flow, and restore economic loss.

Objective To explore the effect of multimodal analgesia methods on postoperative pain in patients with calcaneal fracture. Methods Totally 96 cases of the patients with calcaneal fracture were divided into the control group and the observation group, there were 48 cases in each group. The control group was treated with conventional methods of postoperative analgesia, the observation group was given with the multimodal analgesia method. The VAS scores,functional exercises compliance and the incidence of adverse reaction for patients between the two group were observed and compared. Results The scores of pain at different time points in the observation group was 3.40 ± 0.41, 2.50 ± 0.75, 2.10 ± 0.84, 2.00 ± 0.52 respectively, while in the control group was 5.50 ± 0.35, 4.50 ± 0.55, 3.60 ± 0.62, 3.10 ± 0.45 respectively, the difference between the two groups was significant, t=6.85-11.62, P < 0.01. The good functional exercises compliance in the observation group was 87.5%(42/48), which was higher than the 68.8%(33/48) in the control group, the difference between the two groups was significant (χ2=7.571, P<0.05). The occurrence of nausea and vomiting was lower than the control group (χ2=4.800 and 4.360, P<0.05). Conclusion Multimodal analgesia method can improve analgesia effect obviously, improve functional exercises compliance, reduce the incidence of adverse reaction.

Objective To know the situation of postoperative pain and the satisfaction with pain management in patients who suffered osteonecrosis of the femoral head ( ONFH ) and accepted free vascularized fibular grafting ( FVFG ) , and analyze the influencing factors of satisfaction with pain management. Methods By convenience sampling method, 140 inpatients who underwent FVFG for 72 hours were recruited in this study. These patients were admitted in the orthopedic department of the Sixth People′s Hospital of Shanghai from January to October 2016, and were investigated by the general information questionnaire, the brief pain inventory, and the pain treatment satisfaction scale. The influencing factors of satisfaction with pain nursing were analyzed. Results The score of the most severe pain intensity of the 140 patients reached ( 4. 92 ± 1. 36 ) . The total score of patients′ satisfaction with pain management was (81. 81±9.09), among which, the dimension of professional skills earned the highest average score of (4.00± 0.61), followed by the dimension of trust, which was up to (3. 90±0.53). The dimension of the relation of education got the lowest score of (3.77±0.30). The analysis of single factor showed that the age and the education levels affected the satisfaction of pain management ( P<0. 05 ) . The stepwise multiple regression analysis reviewed that there were five factors having influences on the satisfaction of pain management, and they were: the most severe pain intensity after FVFG, the influences of pain on functional exercise, the degree of pain relief, the education level of patients, and the influences of pain on patients′sleeping. These can successfully explain 70.8% of the variation of the satisfaction ( R2=0.708) . Conclusions Patients are overall satisfied with postoperative pain treatment. Factors such as the most severe pain intensity after FVFG, the influences of pain on functional exercise, the degree of pain relief, the education level of patients, and the influences of pain on patients′sleeping will affect the degree of satisfaction.

Objective To introduce and Chinesize the self-efficacy for rehabilitation outcome scale (SER) from America, and to evaluate the reliability and validity of Chinese version SER in total knee arthroplasty patients .Methods The SER from America received the translation , back translation and cultural adjustment according to the standard step of Chinesization .One hundred and forty-six patients with total knee arthroplasty were surveyed by the Chinese version SER , and the items of scale were chosen by the method of extreme group , and the reliability and validity were assessed by the descriptive analysis , correlation analysis , factor analysis and maximum oblique rotation .Results Twelve items were contained in the Chinese version SER, and the coefficient of Cronbach ’s α was 0.942.The factor analysis showed that there were two factors , and the contribution rate of cumulative variance was 75.31%.Conclusions The Chinese version SER has good reliability and validity , and can be used for evaluation of the self-efficacy for rehabilitation exercise in total knee arthroplasty patients in our country .

[Objective]:To explore the effect evaluation of discharge preparation service on elderly patients with hip fractures.Methods:Totally 80 elderly patients with hip fractures admitted to Shanghai Sixth People′s Hospital from April 2019 to October 2019 were selected as the research objects, and they were divided into intervention group and control group according to admission time, 40 patients in each group. The control group was given routine nursing care, and the intervention group was given readiness service for hospital discharge.The application effect of the scheme was evaluated by the degree of readiness for discharge and the quality of discharge guidance, Barthel index score, Harris score and incidence of complications.Results:In the intervention group,the total score of readiness for hospital discharge of patients was 83.43±8.10,the total score of the quality of discharge guidance was 151.30±16.61,while those in the control group were 77.13 ± 9.30, 141.58 ± 18.34, the differences between the two groups were statistically significant( t=3.23, 2.49, both P<0.05).In terms of the follow-up after patients were discharged for 3 months, the Harris hip score and Barthel index scores for patients with hip fracture were 82.53 ± 7.83 and 88.13 ± 3.34,while those were 76.03 ± 12.15, 86.13 ± 2.65 in the control group,the differences between the two groups were statistically significant ( t=2.84, 2.97, both P<0.05). Conclusions:The discharge preparation service can effectively improve the readiness for hospital discharge and the quality of discharge guidance. It improves the hip joint function, the quality of life of patients, and the clinical outcome of patients effectively.

Objective To cultivate and improve specialty clinical nursing skills and level of orthopedic nurses by applying standardized patients in their examination, and to explore effective mode of professionalized and standardized training of orthopedic nurses so as to improve nursing quality of orthopedic departments. Methods 3 nurses were recruited as SP and were trained. Examination range was defined. 20 nurses working in department of joint surgery for more than 6 months were examined with SP as objects. Application effect of SP was evaluated.Results Authenticity scores of SP were (3.97±0.79) points. Examination results of nurses with application of SP:nursing diagnosis (2.38±0.66), problem-solving ability (2.37±0.71), communication skills (2.56±0.72) and clinical skills (2.34±0.61), remaining to be improved.Conclusions Application of SP in professional training of clinical nurses in orthopedic departments can improve practice operational ability of nurses, which shows a new direction in in-job training for clinical nurses.

Objective:To explore the continuous nursing needs at discharge among geriatric hip fracture patients with hip arthroplasty.Methods:From January to March 2019, this study selected 15 geriatric hip fracture patients with hip arthroplasty by purposive sampling. Semi-structured interview was carried out for those patients at discharge. Colaizzi 7-step analysis was used to data analysis to understand the needs.Results:By analyzing, marshaling and extracting, there were three themes concerned by postoperative patients. Those themes included the needs for health education, improving unhealthy psychology and health services.Conclusions:Hip fracture patients with hip arthroplasty have many burdens and needs for physiology, psychology and society. Nurses should pay more attention to those patients, and provide targeted intervention as well as thorough health education for discharged patients to improve their self-care abilities.

Objective:To investigate knowledge, attitude and practice status of transitional care in orthopedic nurses in Shanghai and their advice on transitional care for hip fractures.Methods:From January to March 2019, the questionnaire star was used to send "nurse transitional care knowledge attitude practice scale" and "self-made opinion questionnaire on postoperative transitional care for patients with hip fractures" to orthopedic nurses in 18 public secondary and tertiary hospitals in Shanghai by link through WeChat platform to conduct a questionnaire survey. A total of 423 valid questionnaires were collected.Results:The total scores of knowledge, attitude and practice dimensions of transitional care in orthopedic nurses were respectively (39.60±8.72) , (60.43±9.52) and (29.03±8.43) , which were at the medium level. Position and education background were the influencing factors of the total score of knowledge, attitude and practice of transitional care in orthopedic nurses ( P<0.05) . Hospital level, professional title, educational background and position were the influencing factors of knowledge score of transitional care in orthopedic nurses ( P<0.05) . Position, education background and hospital level were the influencing factors of the attitude score of transitional care in orthopedic nurses ( P<0.05) . Professional title was the influencing factor of the practice score of transitional care in orthopedic nurses ( P<0.05) . Orthopedic nurses believed that the best way to realize transitional care needs was WeChat official account, the most important dimension was rehabilitation exercise, the best practitioner was the rehabilitation therapist and the most appropriate frequency was once every two weeks. Conclusions:The level of knowledge, attitude and practice of transitional care in clinical nurses in Shanghai needs to be further improved. To carry out transitional care for hip fractures, it is necessary to strengthen information exchange between medical institutions, establish and improve the nurses' transitional care training system, establish a new transitional care service system based on information technology and centered on patients and promote the orderly development of transitional care work.

Objective To deeply know the psychological experience and coping style of patients with osteonecrosis of the femeral head (ONFH) in the process of free vascularized fibular graft transplantation, and provide basis for the development of targeted interventions.Methods Semi-structured in-depth interviews were used to investigate 10 cases of patients undergoing free vascularized fibular graft transplantation for femoral head necrosis by phenomenology method. Colaizzi data analysis principles were used to analyze and refine topic. Results Three themes were extracted: patients with insufficient understanding of disease and treatment; patients under high pressure; change of self-consciousness.Conclusions In the process of free vascularized fibular graft transplannation for ONFH, medical staff should have much more communication with patients, and provide more support and help for patients and their families. Through the psychological support, effective rehabilitation guidance and correction of bad habits the treatment effect and patients' coping capabilities would be improved.

Objective To discuss and analyze the effect of orthopedic specialist nurse training. Methods Twenty three orthopedic nurses were enrolled and they implemented a three-month full-time college study, including one-month theoretical study and two-month clinical practice. The theoretical examination, review report, nursing paper proposal, case study presentation and specialist skills test were used to evaluate the training effect comprehensively. Results More than 90% nurses thought the levels of specialty theory, specialty skills, professional self-value and self-management skills, personal ability, specialized comprehensive quality and ability of critical thinking were improved. 60% -70% nurses thought in the aspects of nursing research and paper writing ability had a great progress. Conclusions Orthopedic specialist nurse training had an important practical significance in improving the orthopedic nurse specialist business knowledge and skills, so it is worthy of of popularization.