Objective:To explore the application of the 4R problem analysis method combined with reverse teaching in nursing teaching in the pediatric operating room.Methods:In this study, 480 nursing students who were assigned to the operating room of Hunan Children's Hospital for internship from August 2020 to August 2022 were selected as research subjects. They were divided into control group and observation group in order of admission, with 240 students in each group. The control group received traditional teaching, while the observation group received the 4R problem analysis method combined with reverse teaching. At the end of the internship, the two groups were compared for comprehensive ability assessment scores, recognition of nursing teaching, and degree of satisfaction with the teaching. The t-test and χ2 test were performed using SPSS 22.0. Results:The scores of theoretical knowledge, basic nursing skills, specialized nursing skills in the operating room, and comprehensive nursing skill assessment of the observation group were significantly higher than those of the control group ( P<0.05). The recognition of nursing teaching among the nursing interns in the observation group was significantly higher than that in the control group ( P<0.001). There was a significant difference in the degree of satisfaction with the teaching between the two groups of nursing interns ( χ2=118.35, P<0.001). Conclusions:The 4R problem analysis method combined with reverse teaching can effectively improve the nursing teaching quality and the degree of satisfaction with the teaching among nursing interns in the pediatric operating room, enabling them to better grasp theoretical and practical skills.

Objective The aim of this study was to investigate the high risk factors of intraoperative stress injury in children with posterior spinal scoliosis and to construct a corresponding risk prediction model.Methods A total of 237 cases of orthopaedic surgery for posterior scoliosis performed in three first-class hospitals in Changsha City from October 2021 to February 2023.The patients were divided into injury group(31 cases)and uninjured group(206 cases)according to whether stress injury occurred.The risk factors were screened by single factor analysis and multiple Logistic regression analysis,and the corresponding risk prediction model was constructed.Results The results of single factor analysis showed that constitutional index,preoperative skin condition,preoperative hypoproteinemia,preoperative anemia,operative time,intraoperative body temperature and intraoperative bleeding were related to the occurrence of vascular crisis.BMI,preoperative skin condition,preoperative hypoproteinemia,operative time and intraoperative bleeding are high risk factors for the occurrence of intraoperative stress injury in children with posterior scoliosis.The area under ROC curve is 0.612,the sensitivity is 89.7％,and the specificity is 91.0％,indicating that this model has good risk prediction ability.Conclusion BMI,preoperative skin condition,preoperative hypoproteinemia,operative time and intraoperative bleeding are high risk factors for the occurrence of intraoperative stress injury in children with posterior scoliosis.

Objective:To investigate the occurrence of pressure injury in infants undergoing operation and analyze the risk factors of pressure injury.Methods:Using the retrospective analysis method, a total of 657 infants and young children who were admitted to Department of Anesthesia Surgery and underwent operation in Hunan Children's Hospital from July 2018 to June 2021 were selected as research objects. According to National Pressure Ulcer Advisory Panel (NPUAP) , infants and young children undergoing operation were evaluated. They were divided into the pressure injury group ( n=15) and the no pressure injury group ( n=643) according to the occurrence of pressure injury. The age of infants and young children, operation time, body temperature of 30 minutes after operation, fasting time, body mass index (BMI) , operation position, pressure injury time, pressure injury location, pressure injury classification and operation type were collected. The occurrence of postoperative pressure injury was investigated and the related factors were analyzed. Results:Among the 657 infants and young children undergoing operation, 21 cases had pressure injury. Logistic regression analysis showed that the operation duration was≥3 h ( OR=4.362, 95% CI: 3.322-5.728) , the body temperature of 30 minues after surgery was lower than 34.0℃ ( OR=1.066, 95% CI: 1.009-1.127) and BMI greater than 17.9 kg/m 2 ( OR=2.683, 95% CI: 1.133-6.356) were risk factors for pressure injury in infants undergoing surgery ( P<0.05) . Conclusions:The incidence of pressure injury in infants and young children undergoing operation is relatively high. Therefore, it is necessary to focus on evaluating the influencing factors of pressure injury in the perioperative period and implement effective preventive measures to reduce the incidence of pressure injury as much as possible.