ObjectiveTo explore the application effect of itinerant strengthening post in ophthalmic day operating room.MethodsIn June 2019 (before the establishment of the itinerant strengthening post) and January 2020 (after the establishment of the itinerant strengthening post), satisfaction of 21 ophthalmic surgeons in the ophthalmic day operation room of the West China Hospital of Sichuan University on intraoperative nursing cooperation, and coping ability scores of operation in key links, satisfaction with scheduling and workload, as well as complaints and accusations received by surgeons of 15 ophthalmological nurses in the ophthalmic day operation room of the West China Hospital of Sichuan University were collected. The total volume of eye day surgeries and the length of the day operating room open in the second half of 2018 and 2019 were retrospectively collected.ResultsAfter the establishment of the itinerant strengthening post, the coping ability score of operation in key links of ophthalmological nurses was improved [(3.28±0.72) vs. (4.67±0.72), P<0.01]. In terms of surgeons’ satisfaction with intraoperative nursing cooperation, with the exception of aseptic operation, the other items were improved (P<0.05). The surgical nurses’ satisfaction with scheduling and workload [(3.30±0.77) vs. (4.47±0.67), P<0.01]; nurses’ complaints and accusations received by surgeons [(3.60±1.18) vs. (2.33±0.82), P<0.01] were improved. The volume of eye day surgery from July to December 2019 increased by 6.58% over the same period in 2018, and the average open time of the operating room increased by 1.88%.ConclusionThe setting up of itinerant strengthening posts in the ophthalmology day operation room is conducive to strengthening the strength and business guidance of the nurses’ key links in the operation room in a timely and effective manner. It can optimize the allocation of human resources in the operating room as much as possible when the existing nursing staff is in short supply, and improve the quality and efficiency of ophthalmic surgery nursing, which is worthy of promotion and application.
Objective To design nursing record sheet for day surgery in the Department of Ophthalmology and evaluate its effect through clinical application. Methods The nursing record sheet for day surgery in the Department of Ophthalmology was designed based on the theory of forms and record control, using the method of process analysis and process reengineering and taking into consideration the characteristics of nursing care during day surgery in the Department of Ophthalmology. The adverse event rate in nursing for ophthalmologic surgery and the satisfaction rate of operating room nurses were calculated before and after the application of this record sheet. Results From July to October 2015, the Department of Ophthalmology was involved in 9 cases (7.96%) of adverse events resulting from drawbacks of the nursing record design or mistakes in recording. From November 2015 to February 2016, the Department of Ophthalmology was involved in only 1 case (1.28%) of advense event resulting from defect caused by nuring record sheet; the difference was significant (P < 0.05). From July to October 2015, the satisfaction rate of oph thalmologic nurses before using the nursing record sheet was 54.33%, which was significantly improved to 98.71% from November 2015 to February 2016 after the utilization of the nursing record sheet. Conclusion The nursing record sheet for day surgery in the Department of Ophthalmology has been appropriately designed and is easy to use, which can improve the quality of surgery nursing as well as the satisfaction of operating room nurses.
Objective To evaluate the efficacy and safety of non-gas-dependent vitrectomy (PPV) assisted by mucoelastic agent (OVD) in ophthalmic surgery combined with internal limiting membrane flipping and covering in the treatment of idiopathic macular holes (IMH). MethodsA retrospective cohort study. From June 2023 to February 2024, 33 patients (33 eyes) diagnosed with IMH in Department of Ophthalmology of Changshu Second People’s Hospital were included in the study. Best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations were performed on all affected eyes before surgery. BCVA examination was conducted using the international standard visual acuity chart, and the results were converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity. The minimum diameter of the hole was measured using OCT. All affected eyes received standard 25G PPV treatment through the three channels of the flat part of the ciliary body. According to the surgical methods, they were divided into two groups: the OVD-assisted non-gas-dependent PPV combined with internal limiting membrane inversion and coverage treatment group (OVD group, 17 cases and 17 eyes) and the heavy water-assisted gas-dependent PPV combined with internal limiting membrane inversion and coverage treatment group (heavy water group, 16 cases and 16 eyes). Postoperatively, patients in the OVD group were not required to maintain a strict specific position, whereas those in the heavy water group needed to remain in a prone position for one week. The follow-up time points after the operation were 1 week, 1 month and 3 months. The main observation indicators included BCVA, intraocular pressure, hole closure rate and closure morphology of the two groups, as well as the occurrence of complications. The independent sample t test was used for comparison between groups. Pearson correlation analysis was used for the correlation between BCVA at 3 months after surgery and the minimum diameter of the surgical hole and BCVA before surgery. ResultsThree months after the operation, the rate of hole closure in the OVD group and the heavy water group was 17 (100.0%, 17/17) and 15 (93.8%, 15/16) eyes, respectively. There was no statistically significant difference in the hole closure rate (χ2=1.090) and closure type (Z=−0.780) between the two groups (P＞0.05). Compared with before the operation, the logMAR BCVA at each time point after the operation in the OVD group and the heavy water group was significantly improved (F=2.353, 1.375; P＜0.05). One week after the operation, the BCVA in the OVD group was significantly better than that in the heavy water group (t=-3.760, P＜0.01). In terms of intraocular pressure, compared with the baseline value before the surgery, there was a statistically significant difference in the OVD group one week after the surgery (Z=−3.454, P＜0.05). There were statistically significant differences in the heavy water group at 1 week, 1 month and 3 months after the operation (Z=−5.066, −3.423, −2.739; P＜0.05). After the operation, one eye in the heavy water group had high intraocular pressure, which returned to normal after combined treatment with intraocular pressure-lowering drugs. No ocular or systemic complications occurred in the OVD group. The results of the correlation analysis showed that postoperative BCVA was correlated with the minimum diameter of the surgical hole and BCVA before the surgery (r= 0.543, 0.658; P＜0.05). ConclusionsThe treatment of IMH with OVD-assisted non-gas-dependent PPV combined with internal limiting membrane flip coverage has a good effect. It helps promote the early recovery of macular morphology and visual function after surgery, and at the same time can avoid the maintenance of forced position and reduce perioperative risks.