Refined Nursing in Rehabilitation Training

NCT ID: NCT06329934

Last Updated: 2024-03-26

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 96 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-05-01
• Study Completion Date: 2024-01-01

Brief Summary

This study is to explore the clinical effect of refined nursing in rehabilitation training for patients with brain injury during the recovery period. Patients in the control group were provided with routine nursing intervention, while patients in the study group adopted a nursing mode based on the concept of refinement treatment. Comparison was made in terms of the Glasgow Coma Scale (GCS) score, cognitive function score, functional independence score, nursing satisfaction, and incidence of complications.

Detailed Description

This study is to explore the clinical effect of refined nursing in rehabilitation training for patients with brain injury during the recovery period. The subjects of the study were 96 patients with severe traumatic brain injury (TBI). According to the order of visits, there were 48 patients in the study group and the control group, respectively.Patients in the control group were provided with routine nursing intervention, while patients in the study group adopted a nursing mode based on the concept of refinement treatment. Comparison was made in terms of the Glasgow Coma Scale (GCS) score, cognitive function score, functional independence score, nursing satisfaction, and incidence of complications.

Conditions

Brain Injuries

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: SINGLE

Study Groups

the intervention group

Establishment of a hierarchical monitoring and management team, Assessment of pressure injury, Communication, Intervention for pressure ulcer, Rehabilitation training

Group Type: EXPERIMENTAL

Establishment of a hierarchical monitoring and management team

Intervention Type: BEHAVIORAL

To be specific, the head nurse served as the team leader to conduct comprehensive macro supervision; moreover, there were 3 responsible team leaders and 6 responsible nurses, all of whom had rich clinical nursing experience and solid theoretical knowledge of pressure injury. Consequently, a joint-action mechanism of the head nurse - responsible team leader - responsible nurses was developed to facilitate the unification of the training of nursing content, precautions, etc.

Assessment of pressure injury

Intervention Type: BEHAVIORAL

Based on the postoperative coma of patients, the Braden assessment scale was applied to effectively evaluate patients from six dimensions of sensory perception, moisture, activity mode, mobility, nutrition, friction, and shear. The total score was 23 points. Patients scoring 13\~14 points were evaluated by Braden once per week; and those scoring ≤12 points were evaluated at a frequency of 3d/ time.

Communication

Intervention Type: BEHAVIORAL

Through intensive face-to-face communication with family members, timely information on the surgical effect, mechanism of pressure injury, preventive measures, and clinical manifestations through intuitive methods such as PPT and video, family members were taught with basic knowledge of pressure injury, and guided to inform medical staff in a timely manner when patients had symptoms of pressure ulcer. Simultaneously, by case sharing and positive suggestions, family members were supported to alleviate their concerns and improve their coordination with treatment

Intervention for pressure ulcer

Intervention Type: BEHAVIORAL

For patients with a Braden score of \>14 points, attention should be paid to keeping skin dry and clean, regularly changing bed sheets and bedding (once per day). Patients with Braden score of 13-14 points should be provided with sponge mattresses, increased times of turning over once per 2 hours, and soft pillows or foam dressings at the site of occipital protuberance to relieve pressure and prevent pressure injury. For patients with Braden score ≤12 points, medical staff should repeatedly emphasize to their families the harm of pressure injury to postoperative recovery.

Rehabilitation training

Intervention Type: BEHAVIORAL

After regaining consciousness with stable vital signs, patients received rehabilitation training following the principle of association of activity and inertia in a regular order. Patients were guided to perform upper limb movements, joint flexion, lower limb flexion and extension, as well as daily training such as washing face, rinsing mouth, and dressing at a frequency of 3\~4 times/d. Moreover, patients were advised to minimize violent behaviors such as laughing and talking loudly

the control group

timely introduction of the current patient's condition to family members to alleviate their concerns, maintaining appropriate temperature (20 ℃\~22 ℃) and humidity (60.0%\~70.0%) in the ward, careful observation of vital signs such as heart rate, blood oxygen saturation, and blood pressure in patients, rehabilitation training

Group Type: ACTIVE_COMPARATOR

Rehabilitation training

Intervention Type: BEHAVIORAL

After regaining consciousness with stable vital signs, patients received rehabilitation training following the principle of association of activity and inertia in a regular order. Patients were guided to perform upper limb movements, joint flexion, lower limb flexion and extension, as well as daily training such as washing face, rinsing mouth, and dressing at a frequency of 3\~4 times/d. Moreover, patients were advised to minimize violent behaviors such as laughing and talking loudly

introduction of the current patient's condition to family members

Intervention Type: BEHAVIORAL

timely introduction of the current patient's condition to family members to alleviate their concerns

maintaining appropriate temperature and humidity in the ward

Intervention Type: BEHAVIORAL

maintaining appropriate temperature (20 ℃\~22 ℃) and humidity (60.0%\~70.0%) in the ward

careful observation of vital signs in patients

Intervention Type: BEHAVIORAL

careful observation of vital signs such as heart rate, blood oxygen saturation, and blood pressure in patients

Interventions

Establishment of a hierarchical monitoring and management team

To be specific, the head nurse served as the team leader to conduct comprehensive macro supervision; moreover, there were 3 responsible team leaders and 6 responsible nurses, all of whom had rich clinical nursing experience and solid theoretical knowledge of pressure injury. Consequently, a joint-action mechanism of the head nurse - responsible team leader - responsible nurses was developed to facilitate the unification of the training of nursing content, precautions, etc.

Intervention Type: BEHAVIORAL

Assessment of pressure injury

Based on the postoperative coma of patients, the Braden assessment scale was applied to effectively evaluate patients from six dimensions of sensory perception, moisture, activity mode, mobility, nutrition, friction, and shear. The total score was 23 points. Patients scoring 13\~14 points were evaluated by Braden once per week; and those scoring ≤12 points were evaluated at a frequency of 3d/ time.

Intervention Type: BEHAVIORAL

Communication

Through intensive face-to-face communication with family members, timely information on the surgical effect, mechanism of pressure injury, preventive measures, and clinical manifestations through intuitive methods such as PPT and video, family members were taught with basic knowledge of pressure injury, and guided to inform medical staff in a timely manner when patients had symptoms of pressure ulcer. Simultaneously, by case sharing and positive suggestions, family members were supported to alleviate their concerns and improve their coordination with treatment

Intervention Type: BEHAVIORAL

Intervention for pressure ulcer

For patients with a Braden score of \>14 points, attention should be paid to keeping skin dry and clean, regularly changing bed sheets and bedding (once per day). Patients with Braden score of 13-14 points should be provided with sponge mattresses, increased times of turning over once per 2 hours, and soft pillows or foam dressings at the site of occipital protuberance to relieve pressure and prevent pressure injury. For patients with Braden score ≤12 points, medical staff should repeatedly emphasize to their families the harm of pressure injury to postoperative recovery.

Intervention Type: BEHAVIORAL

Rehabilitation training

After regaining consciousness with stable vital signs, patients received rehabilitation training following the principle of association of activity and inertia in a regular order. Patients were guided to perform upper limb movements, joint flexion, lower limb flexion and extension, as well as daily training such as washing face, rinsing mouth, and dressing at a frequency of 3\~4 times/d. Moreover, patients were advised to minimize violent behaviors such as laughing and talking loudly

Intervention Type: BEHAVIORAL

introduction of the current patient's condition to family members

timely introduction of the current patient's condition to family members to alleviate their concerns

Intervention Type: BEHAVIORAL

maintaining appropriate temperature and humidity in the ward

maintaining appropriate temperature (20 ℃\~22 ℃) and humidity (60.0%\~70.0%) in the ward

Intervention Type: BEHAVIORAL

careful observation of vital signs in patients

careful observation of vital signs such as heart rate, blood oxygen saturation, and blood pressure in patients

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• patients diagnosed with severe TBI through imaging examinations such as head CT and magnetic resonance imaging
• patients with surgical indications
• patients with Glasgow Coma Scale (GCS) ≤8 points
• patients with complete clinical data
• patients with written informed consent provided by family members

Exclusion Criteria

• patients with organic lesions of major organs such as liver and kidney
• patients with contraindications for surgery
• patients with primary diseases such as cerebral hemorrhage and cerebral infarction
• patients with combined or multiple injuries
• patients with respiratory failure
• patients whose family members had cognitive impairment or abnormal mental behaviors

• Minimum Eligible Age: 33 Years
• Maximum Eligible Age: 43 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Xinxiang Central Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Jie Yang

Role: PRINCIPAL_INVESTIGATOR

Xinxiang Central Hospital

Locations

Effect of Refined Nursing in Rehabilitation Training for Patients with Brain Injury During the Recovery Period: An Observational Study

Xinxiang, Henan, China

Countries

China

Other Identifiers

XXZY-003

Identifier Type: -

Identifier Source: org_study_id