To explore the effects of the perioperative nursing pathway on physiological and mental status, and risk of infection in Tibetan patients with limb fractures.

A total of 86 Tibetan patients with limb fractures who were treated in Ganzi Tibetan Autonomous Prefecture People's Hospital in 2016 were collected in this study. The participants were divided into two groups according to the random number table, with 43 cases in each group. Based on the routine treatment, the control group received conventional perioperative nursing pathway. In contrast, the intervention group received modified nursing pathway tailored for Tibetan patients which included faith support, language assistance, and custom acceptance. Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate patients' anxiety and depression status at different time (i. e. before the admission, preoperative day, postoperative day, and on the day of discharge). The peripheral blood sample was collected to investigate patients' C-reactive protein level (CPR). The healthcare associated infection (HAI) was compared between two groups.

The HAMA scores were (21.3±2.1), (15.7±2.5), (13.1±2.4) and (11.8±1.8) for the intervention group, and (20.7±2.3), (18.1±2.0), (15.8±2.0) and (13.4±1.3) for the control group, which significantly decreased in both groups (F=131.511, 82.510; P<0.001). The intervention group had significantly lower HAMA scores at any evaluate time compared with the control group (t=4.916, 5.667, 4.725; P<0.001). The HAMD scores were (28.7±2.8), (23.6±2.4), (18.5±1.8) and (15.6±2.0) in the intervention group, and (28.4±2.3), (25.6±2.7), (22.6±2.2) and (19.4±2.3) in the control group. Both groups had significant reduction (F=153.582, 102.618; P<0.001) and the intervention group had significantly lower HAMD scores at any evaluate time compared with the control group (t=3.630, 9.458, 8.175; P<0.01). The serum CPR were (10.2±1.3), (7.8±1.5), (31.7±4.2), and (5.4±1.5) mg/L in the intervention group and (10.1±1.5), (9.8±1.2), (39.2±3.8) and (6.8±1.0) mg/L in the control group, which significantly decreased in both groups (F=139.315, 213.158; P<0.001). The intervention group had significantly lower serum CPR at any evaluate time compared with the control group (t=6.747, 8.582, 5.033; P<0.001). The intervention group had significantly lower incidence rate of HAI (18.6% vs. 39.5%; χ²=4.568, P<0.05) and less infection duration [(6.4±1.1) d vs. (11.5±2.0) d; t=6.701, P<0.001] compared with the control group.

The modified clinical perioperative nursing pathway can help patients' physiological and mental status, and reduce the risk of HAI in Tibetan patients with limb fractures.

Perioperative nursing; Tibetan nationality; Limbs fracture; Clinical nursing pathway