层流病房造血干细胞移植阶段性分层全责护理工作模式的建立  

Hierarchical full-responsibility nursing system in the laminar air flow units for hematopoietic stem cell transplantation

作　　者：郭彩利[1] 孙春红[1] 刘芳[1] 姚建娜[1] 

机构地区：[1]西安交通大学医学院第一附属医院血液内科,710061

出　　处：《中华现代护理杂志》2012年第28期3387-3391,共5页Chinese Journal of Modern Nursing

摘　　要：目的建立层流病房干细胞移植各阶段分层全责护理工作模式，使患者得到安全、专业、无缝隙的优质护理服务。方法建立组织架构与职责，员工的培训考核，制定与实施移植前期、预处理期、移植期、移植后期各阶段护理工作方式，并将护士的分层使用与阶段性责任护理相结合，为患者提供综合、全新的护理工作模式。收集采用该模式后的40例干细胞移植患者临床资料，与未实施该模式的37例患者的临床资料进行对比，比较两组患者并发症发生情况及患者的满意度。结果干细胞移植阶段性分层全责护理工作模式建立以后，40例移植患者体温升高、口腔溃疡、肛周感染、出血性膀胱炎、中心静脉导管感染、移植物抗宿主病（GVHD）等并发症的发生率分别为75．00％，52．50％，5．00％，7．50％，0．00％，42．50％；未实施该模式的37例患者上述并发症的发生率分别为83．78％，78．38％，24．32％，29．73％，10．81％，45．95％；实施前后比较差异有统计学意义（）（2值分别为4．299，4．299，5．862，6．385，7．469，3．862；P均〈0．05）。干细胞移植阶段性分层全责护理工作模式实施后提高了层流病房护士的理论与操作成绩[（90．25±5．25）分比（71．20±5．15）分，（92．55±5．33）分比（80．24±4。20）分]，差异有统计学意义（t值分别为-45．876，-22．437；P均〈0．01），患者和医生对护士的满意度也明显提高（97．29％比83．78％，95．00％比80．00％），差异有统计学意义（X2值分别为3．944，4．114，；P均〈0．01）。结论干细胞移植阶段性分层全责护理工作模式建立以后，护士的服务意识、移植专科知识和操作水平得到了明显的提高，使患者在移植期得到了规范、科学的护理，减少了并发症的发生，缩短了住院时间。Objective To establish hierarchical full-responsibility nursing system in the laminar air flow units for various stages of hematopoietic stem cell transplantation, in order to guarantee that patients receive safe, professional and seamless quality nursing service. Methods Organizational structure and responsibility as well as staff training and assessment were established. Nursing methods in various stages of transplantation were developed and carried out. Meanwhile, primary nursing and hierarchical system were combined together to provide patients with the comprehensive and brand-new nursing mode. Clinical data of 40 cases with HSCT using the mode, and 37 cases without using the mode were both gathered, and complications as well as patients＇ satisfaction were compared between two groups. Results After the establishment of the hierarchical full- responsibility nursing system, the incidence rates of complications including temperature rise, oral ulcer, perianal infection, hemorrhagic cystitis, central venous catheter-related infection and GVHD of the 40 cases were respectively 75.00% ,52.50% ,5.00% ,7.50% ,0.00% ,42.50% , while those of the 37 cases without the system were 83.78%, 78.38%, 24. 32%, 29.73%, 10.81% ,45.95%. The differences were statistically significant （ ~2 = 4. 299,4. 299,5. 862,6. 385,7. 469,3. 862, respectively ; P 〈 0.05 ）. The hierarchical full- responsibility nursing system improved nurses＇ theory and operation achievements （90.25 ~ 5.25 vs 71.20 ＋ 5.15, and 92.55 ＋5.33 vs 80.24 ＋4.20）, and the differences were statistically significant （t = -45. 876, -22.437, respectively;P 〈 0.01 ）. Both patients＇ and doctors＇ satisfaction with nurses were also obviously improved （97.29% vs 83.78% and 95.00% vs 80.00% ）, and the differences were statistically significant （~2 = 3. 944 6,4. 114 3, respectively; P 〈 0. 05 ）. Conclusions After the hierarchical full-responsibility nursing system is established, nurses＇ service consciousness, special knowledge and operati

关 键 词：造血干细胞移植 层流室 阶段护理 优质护理 分层全责护理 

分 类 号：R47[医药卫生—护理学]