ObjectiveTo investigate the effect of video-based educational intervention combined with maternal presence on perioperative adverse outcomes in preschool children undergoing general anesthesia， including cooperation in anesthesia induction， perioperative anxiety， pain and agitation during recovery. MethodsA total of 300 preschool children scheduled for general anesthesia in our hospital from June to December 2023 were randomly assigned to control group （n=150） and intervention group （n=150）. The control group received routine recovery care. For the intervention group， in addition to routine recovery care， a preoperative visit was scheduled one day before surgery. During this visit， mothers were guided to watch anesthesia videos with their children. During the waiting period in the operating room and 30 minutes after awakening， the mothers were guided to accompany the children for more than 30 minutes. Recovery conditions were recorded using the surgical anesthesia information system， and the children’s anesthetic induction compliance， perioperative anxiety， pain， and agitation were evaluated and recorded using the modified Yale Preoperative Anxiety Scale （m-YPAS）， the Induction Compliance Scale （ICC）， the Children’s Pain Behavior Scale （FLACC）， and the Pediatric Agitation and Emergence Delirium Scale （PAED）. ResultsOn the preoperative visit day， there were no statistically significant differences in baseline data between the two groups （P > 0.05）. For perioperative anxiety， the m-YPAS scores of the intervention group were significantly lower than those of the control group， both when entering the operating room waiting area （35.27±6.48 vs. 41.79±6.68， P < 0.05） and 30 minutes after postoperative recovery （20.13±7.05 vs. 35.75±9.51， P < 0.05）. In terms of anesthesia induction cooperation， the ICC scores of the intervention group were significantly lower than those of the control group （1.84±0.95 vs. 3.17±0.62， P < 0.05）， and the proportion of good induction cooperation was significantly higher than that of the control group （24.00% vs. 12.67%， P < 0.05）. There was no significant difference in awakening duration between the two groups， but the intervention group had a significantly shorter length of stay in the post-anesthesia care unit than the control group （0.90±0.29 hours vs. 1.29±0.42 hours， P < 0.001）. For perioperative agitation， the PAED scores of the intervention group were significantly lower than those of the control group （entering in the operating room waiting area： 8.5 vs. 9.2， P < 0.05； 30 minutes after postoperative recovery： 4.2 vs. 7.8， P < 0.05）. In terms of pain scores， the FLACC scores of the intervention group were also significantly lower than those of the control group， both when entering the operating room waiting area （ 5.3 vs. 6.7， P < 0.05； 30 minutes after postoperative recovery： 2.1 vs. 4.9， P < 0.05）. ConclusionsVideo-based educational intervention combined with maternal presence reduces the perioperative anxiety， pain and agitation of preschool children undergoing general anesthesia， and improved the compliance of anesthesia induction. It is recommended to promote this intervention measure in clinical practice.

Objective To develop the Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre and provide a scientific and practical guidance for improving the quality of nursing in operating theatre.Methods The writing team established by the Operating Room Nursing Professional Committee of Guangdong Nursing Association conducted systematic literature retrieval and screening,and used the updated clinical Guidelines for Research and Evaluation Ⅱ in UK 2017.AGREE Ⅱ and the evidence evaluation system of the Australian JBI(Joanna Briggs Institute,JBI)Evidence-Based Health Care Center evidence level system(2016 Edition)comprehensively analyzed the evidence related to the sensitive indicators for evaluating the quality of operating room nursing and the suggestions of the writing group members.The first draft was formed based on the three-dimensional quality evaluation theoretical framework of"structure-process-result".Through the Delphi method,after two rounds of expert consultations and members'votes,the first draft was deeply revised and improved.Results Based on the three-dimensional quality evaluation theoretical framework of"structure-process-outcome"proposed by American scholar Donabedian,the expert consensus finally included five primary indicators:basic nursing quality,quality indicators of patient safety,quality indicators of hospital infection control,quality indicators of medication and safety management,and quality indicators of specialised nursing in operating theatre.The secondary indicators consisted of one structural indicator(management of commonly used instrument and equipment in operating theatre)and 17 process indicators(e.g.,infusion and blood transfusion management,body temperature management,etc.).The tertiary indicators included 26 process indicators and 11 outcome indicators(e.g.,incidence of adverse reactions of infusion during surgery,incidence of intra-operative hypothermia,etc.).Conclusion The evidence-and guideline-based Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre based on eviclence and guidelines was established through rigorous evidence-based methods.It is operational and practical,and offers theoretical support and practical guidance for the managers of operating theatre to improve the quality of nursing.

Objective To develop the Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre and provide a scientific and practical guidance for improving the quality of nursing in operating theatre.Methods The writing team established by the Operating Room Nursing Professional Committee of Guangdong Nursing Association conducted systematic literature retrieval and screening,and used the updated clinical Guidelines for Research and Evaluation Ⅱ in UK 2017.AGREE Ⅱ and the evidence evaluation system of the Australian JBI(Joanna Briggs Institute,JBI)Evidence-Based Health Care Center evidence level system(2016 Edition)comprehensively analyzed the evidence related to the sensitive indicators for evaluating the quality of operating room nursing and the suggestions of the writing group members.The first draft was formed based on the three-dimensional quality evaluation theoretical framework of"structure-process-result".Through the Delphi method,after two rounds of expert consultations and members'votes,the first draft was deeply revised and improved.Results Based on the three-dimensional quality evaluation theoretical framework of"structure-process-outcome"proposed by American scholar Donabedian,the expert consensus finally included five primary indicators:basic nursing quality,quality indicators of patient safety,quality indicators of hospital infection control,quality indicators of medication and safety management,and quality indicators of specialised nursing in operating theatre.The secondary indicators consisted of one structural indicator(management of commonly used instrument and equipment in operating theatre)and 17 process indicators(e.g.,infusion and blood transfusion management,body temperature management,etc.).The tertiary indicators included 26 process indicators and 11 outcome indicators(e.g.,incidence of adverse reactions of infusion during surgery,incidence of intra-operative hypothermia,etc.).Conclusion The evidence-and guideline-based Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre based on eviclence and guidelines was established through rigorous evidence-based methods.It is operational and practical,and offers theoretical support and practical guidance for the managers of operating theatre to improve the quality of nursing.

Objective To investigate the application and effectiveness of the 90°oblique lateral decubitus position in retroperi-toneal laparoscopic urological surgery,providing a clinical approach to effectively reduce the incidence of pressure injuries on the skin.Methods A retrospective study was conducted on 60 urology patients who were admitted to the Department of Urology in our hospital from September to December 2023 for retroperitoneal laparoscopic surgery.The patients were divided into a traditional group and a trial group based on the surgical position,with 30 patients per group.A conventional 90°lateral decubitus position during surgery was applied to the patients in control group,while a 90°oblique lateral decubitus position was offered to the patients in trial group.The two groups were compared in terms of the incidence rate of skin pressure injury,lumbar back pain on the healthy side within 24 hours after surgery and the score of satisfaction from the surgical team.After controlling for demographic variables using logistic regression analysis,the risk of intraoperative pressure injury occurrence in the two groups of patients was found to be related to the group type.The risk of occurrence in the control group was 6.22 times that of the trial group.Results The observation group demonstrated a significantly lower incidence rate of postoperative skin pressure injury,a significantly lower postoperative lumbar back pain on the healthy side within 24 hours,and a significantly higher score in the surgical team satisfaction compared with those of the control group(all P<0.05).Conclusion In retroperitoneal laparoscopic urological surgery,the 90° oblique lateral decubitus position shows a superiority to the conventional lateral decubitus position in reducing the incidence rate of postoperative pressure injury and decreasing the lumbar back pain on the healthy side.

Objective To investigate the effectiveness of team-based learning(TBL)combined with research-based learning(RBL)in enhancing evidence-based nursing practice skills of undergraduate nursing interns.Methods A total of 114 undergraduate nursing students who interned in the operating room of a ⅢA hospital in Guangzhou from July 2021 to April 2022 were selected as study subjects.A randomized cluster sampling method based on a random number table was used to divide the students into a control group and a trial group.The control group received traditional teaching methods,while the trial group was taught using a combination of TBL and RBL.The two groups were compared in terms of evidence-based practice skills,critical thinking abilities,and their evaluations on the teaching methods.Results The differences in evidence-based practice skills and critical thinking abilities before and after the internship were significantly higher in the observation group compared to the control group(t=35.108,35.897;both P<0.05).Additionally,post-internship evaluation scores for the teaching methods in the trial group were significantly higher than those in the control group(t=-17.580,P<0.05).Conclusion TBL combined with RBL effectively enhances the evidence-based nursing practice skills and critical thinking abilities of undergraduate nursing interns.This approach also improves students'evaluations on the teaching methods and fosters the cultivation of excellent clinical evidence-based nursing professionals.

This paper summarises the experience in an emergency care of a patient who had a "silent lung" during ventilator-assisted ventilation while in the post-anaesthesia care unit (PACU) after a surgery of cavernous sinus fistula of internal carotid artery. By reviewing nursing records,the emergency nursing interventions were summed up,incluing immediate elimination of mechanical blockage,rapid identification and diagnosis of "silent lung",urgent application of manual balloon pressurisation ventilation to resolve ventilation difficulties and symptomatic medication to relieve airway spasm. A ventilator-assisted ventilation was reinitiated to ensure unobstructed breathing after the condition of patient had been stablised. Lungs were inflated when the condition of patient allowed together without a risk of airway spasm. Then the endotracheal catheter was removed under a deep anaesthesis. After 3 hours of emergency resuscitation,the patient became stable and safely returned to the ward. The patient was discharged 11 days later and was found in good condtion over the 3 months postoperative follow-up.

This paper summarises the experience in an emergency care of a patient who had a "silent lung" during ventilator-assisted ventilation while in the post-anaesthesia care unit (PACU) after a surgery of cavernous sinus fistula of internal carotid artery. By reviewing nursing records,the emergency nursing interventions were summed up,incluing immediate elimination of mechanical blockage,rapid identification and diagnosis of "silent lung",urgent application of manual balloon pressurisation ventilation to resolve ventilation difficulties and symptomatic medication to relieve airway spasm. A ventilator-assisted ventilation was reinitiated to ensure unobstructed breathing after the condition of patient had been stablised. Lungs were inflated when the condition of patient allowed together without a risk of airway spasm. Then the endotracheal catheter was removed under a deep anaesthesis. After 3 hours of emergency resuscitation,the patient became stable and safely returned to the ward. The patient was discharged 11 days later and was found in good condtion over the 3 months postoperative follow-up.

Objective:To explore the preventive effect of disposable incision protector on incision infection in patients with hepatolithiasis after open hepatectomy.Methods:A retrospective collection of patients with hepatolithiasis who underwent open hepatectomy with a disposable incision protector from January 2015 to December 2018 in the First Affiliated Hospital of Sun Yat-sen University was used as the intervention group. At the same time, patients with hepatolithiasis who did not use the incision protector to undergo partial hepatectomy from January 2012 and December 2014 were collected as the control group. Propensity matching analysis was used to reduce case selection bias and incidences of postoperative incision infection between the two groups were compared before and after matching.Results:In the primary cohort, there were 245 patients in the intervention group and 201 patients in the control group. Patients in the intervention group were younger than those of the control group ( P<0.05) . The proportion of patients with a history of biliary tract surgery in the intervention group was lower than that of the control group, and the operation time was shorter than that of the control group (all P<0.05) . The incidence of incision infection in the intervention group before matching was 5.7% (14/245) , lower than 15.9% in the control group (32/201) , and the difference was statistically significant (χ 2=4.436, P=0.035) . After propensity matching, 165 pairs of patients were generated, there were 165 patients in each group. There was no statistically significant difference in clinical baseline variables between the two groups ( P>0.05) . In the matching cohort, the incidence of incision infection in the intervention group was 7.9% (13/165) , which was lower than 15.2% (25/165) in the control group, and the difference was statistically significant (χ 2=4.283, P=0.039) . Conclusions:The disposable incision protector can effectively prevent postoperative incision infection in patients undergoing open hepatectomy for hepatolithiasis.

Objective To explore the application effect of postural animation video instruction mode in elderly patients undergoing epidural anesthesia. Methods A total of 300 patients with epidural anesthesia were registered from January 2015 to February 2016. The patients were divided into trial group and control group with 150 cases each. The trial group was preoperatively interviewed by the postural anatomy video instruction mode, and the control group was only preoperatively interviewed by oral interpretation. The epidural anesthesia effect and anxiety between the two groups were compared. Results The difference of anesthesia posture and anatomical position, the average time of epidural puncture, the success rate of one puncture and the degree of anxiety before and after mission were 90.67% (136/150), (14.50 ± 10.20) s, (425.60 ± 78.30) s, 97.33% (146/150) and (21.65 ± 6.62) points respectively. The control group was 22.00%(33/150), (112.60 ± 60.80) s, (589.40 ± 90.70)s, 82.67%(124/150) and (6.65 ± 5.40) points respectively. There were significant differences between the two groups (χ2=8.79, t=13.54-19.88, all P < 0.01). Conclusions The postural anatomical video teaching mode can relieve anxiety, improve the degree of fit of epidural anesthesia and the success rate of puncture, shorten the time of posture, thus shorten the average time of epidural puncture, improve the quality of nursing in the operating room, work efficiency.

Objective To investigate the risk factors and preventive measures of liver transplantation in patients with liver cirrhosis complicated with portal hypertension. Methods About 63 patients with cirrhosis and portal hypertension were treated with liver transplantation in our hospital from June 2014 to June 2016. The risk factors were investigated and the corresponding care measures were taken. Results All the 63 patients underwent the operation successfully. The total operation time ranged from 276 to 750 min, averaged (450.52 ± 25.43) minutes. The intraoperative blood loss was 300~5,600 mL, averaged (1693.06 ± 193.24) mL. Intraoperative blood transfusion ranged from 0 to 3,000mL, with an average (1400.50 ± 400.61) mL. Three patients contracted gastrointestinal bleeding after liver implants, which was cured after timely treatment and 5 patients with sacral pressure red tail, improved after treatment. Conclusion Due to the long operation time, bleeding, low temperature, risks of infection and other factors, pre-assessment of the intraoperative risks and relative coping measures are of great significance for the complete of operations.