输尿管镜取石术患者的临床护理路径对比研究  

The Challenge of Clinical Nursing Care Pathway

作　　者：邱玲[1] 李芳[1] 梁秋兰[1] 徐海岸[1] 

机构地区：[1]广州医学院第一附属医院微创外科中心,广东广州510230

出　　处：《中国医药指南》2013年第18期26-28,共3页Guide of China Medicine

摘　　要：目的探讨输尿管镜取石术患者实施临床护理路径之后的效果及挑战。方法对比同期进入临床路径与未进入临床路径接受输尿管镜取石术患者的临床资料以及护士工作量、医护患三方满意度等资料。结果实施CP及CNP之后,实验组的住院时间固定在3d,较对照组的4.8d明显减少(P=0.000);住院费用由11147元减少至9114元,有统计学差异(P=0.000)。患者住院期间,护士巡视的次数为24次,较对照组12次明显增加(P=0.023);潜在的医护差错由对照组的9%下降至1%,差异有统计学意义(P=0.005)。患者健康知识评分,实验组94.2明显高于对照组的73.5,差异有统计学意义(P=0.000)。患者满意度评分,实验组96.1高于对照组的78.3,差异有统计学意义(P=0.000);医护满意度评分,实验组94.3高于对照组的72.4,差异有统计学意义(P=0.001)。结论患者住院时间及费用减少,患者满意度提升;同时,对临床护理工作提出了更高的要求,工作强度增加,但只要遵循一定的规范,积极配合,医护质量及满意度也得到了有效的提升。Objective To explore the result of clinical nursing pathway for patients received ureteroscopic lithotripsy, and investigate the challenge. Methods When patientes planed to receive ureteroscopic lithotripsy in the the same period, and half patients was enrolled in clinical nursing care pathway group, the clinical data and satisfatory score for patientas, nurse and doctor was evaluated and compared. Results Aider the implementation of CP and CNP, the hospital stay in experimental group was 3 days, compared with 4.8 days in the control group, it decreased significantly （P=0.000）,hospitalization expense decreased from 11147 yuan to 9114 yuan, with statistical difference （P=-0.000）.The nurse patrol time was 24 times,much more than control group of 12 times （P=0.023）. Potential medical errors was noted in 1% in experimental group, less than 9% in the control group, the difference was statistically significant（P=0.005）. Patients＇s health knowledge grading in experimental group was significantly higher than in control group （94.2vs.94.2,p =0.000）. Patient satisfaction scores in experimental group is higher than in the control group（96.1 vs.78.3,P=0.000）.Care satisfaction score in the experimental group was higher than in the control group （94.3 vs.72.4,P=0.001）. Conclusion Patients benefited form the CNP regarding to the shorter hospital stay and fewer fee, thus, a high satisfaction score.At the same time, it put forward higher request for clinical nursing work, and much more work existed,but as long as they follow certain standard and actively cooperate with each other, the medical quality and satisfaction score could be effectively promoted.

关 键 词：输尿管镜取石术 临床路径 临床护理路径 对比研究 

分 类 号：R473.6[医药卫生—护理学]