医护一体化护理模式在经阴道自然腔道内镜手术中的应用  

The application of doctor-nurse integrated health care management model in transvaginal natural ;orifice transluminal endoscopic surgery

作　　者：李莉莉[1] 蒙美英[1] 刘兰英[1] 朱桂香[1] 刘龙清[1] 陈珍[1] 陈凤[1] 凌七招 张国玺[1] 邹晓峰[1] 

机构地区：[1]赣南医学院第一附属医院泌尿外科,赣州341000

出　　处：《中国实用护理杂志》2017年第3期169-173,共5页Chinese Journal of Practical Nursing

基　　金：国家高技术研究发展计划（863计划）（2012AA021100）;江西省财政厅、科技厅科技支撑计划（20121BBG70032）;江西省卫生厅重大科技计划（20104008）;江西省卫生计生委科技计划（20155407）.

摘　　要：目的探讨医护一体化护理模式在经阴道自然腔道内镜手术（NOTES）围手术期护理管理中的应用效果。方法选择经阴道NOTES患者70例，按照随机数字表法分为对照组和研究组各35例。对照组采用传统的护理模式，研究组则实施医护一体化模式下的分层小组制来护理患者，即由三线（组长）、二线、一线医生、麻醉医生组成的医生系列和二级责任组长、一级责任护士、手术室腔镜组巡回护士组成的护士系列共同构成一个“医护一体化”的医疗护理小组。比较2组患者住院时间、术前等待时间、对疾病认识、术后早期活动及术后合理饮食情况、患者对护理工作的满意度、医生对护士术中配合满意度及医护工作总体满意度。结果研究组患者术前等待时间、住院时间、术中配合满意度、患者满意度及医护总体满意度分别为（3.95±0.51）d、（11.58±1.83）d、（95.48±3.82）%、（99.26±0.61）%、（96.33±0.29）%，对照组分别为（5.50±0.68）d、（15.79±2.14）d、（82.08±7.21）%、（92.18±3.54）%、（80.03±5.88）%，2组比较差异有统计学意义（t=-4.431～6.172，均P＜0.05）。研究组患者对疾病认识、术后早期活动、合理饮食方面（术后进食时间）分别为（92.77±0.59）%、（1.60±0.63）d、（2.20±0.54）d，对照组分别为（93.15±0.47）%、（1.90±0.42）d、（2.40±0.33）d，2组比较差异无统计学意义（t=-0.898、-0.771、-0.201，均P＞0.05）。结论医护一体化新模式的实行可优化医护搭配，提升护理质量，改善患者就医体验，提高患者及医生对护理工作的满意度。Objective To explore the doctor-nurse integrated health care management model in perioperative nursing management of transvaginal natural orifice transluminal endoscopic surgery （NOTES）. Methods A total of 70 female patients underwent transvaginal NOTES. All patients were randomly divided into the control and the study groups. The control group adopted the traditional model of care, and the study group implemented a layered panel system of integrated health care nursing mode, which consisted of three lines （leader）, second line, front-line doctors, anesthesiologists consisting of the doctor series and secondary responsibility leader, a responsibility of nurses, operating room nurses laparoscopy group traveling together constituted a series of nurses′ health care integration of the health care team. The average length of stay, preoperative waiting days, awareness of the disease, earlypostoperative activities and reasonable diet, patient satisfaction with care, doctors′ satisfaction with nurses′ operation and overall satisfaction with health care work were compared. Results The preoperative waiting days, average length of stay, surgical satisfaction, patients′ satisfaction, doctors-nurses′overall satisfaction in the study group were （3.95±0.51） d, （11.58±1.83） d, （95.48±3.82）%, （99.26± 0.61）%, （96.33±0.29）%, the control group were （5.50±0.68） d, （15.79±2.14） d, （82.08±7.21）%, （92.18± 3.54）%, （80.03 ± 5.88）%, the differences were statistically significant （t=-4.431-6.172, P 〈 0.05）. The patients awareness of the disease, early postoperative activities and reasonable diet （postoperative eating time） in the study group were （92.77 ± 0.59）%, （1.60 ± 0.63） d, （2.20 ± 0.54） d, the control group were （93.15 ± 0.47）%, （1.90 ± 0.42） d, （2.40 ± 0.33） d, the difference was not statistically significant （t=-0.898,-0.771,-0.201, P〉0.05）. Conclusions The implementation of＂doctor-nurse integrated health care＂new m

关 键 词：护理 经自然腔道内镜手术 经阴道途径 医护一体化 

分 类 号：R473.71[医药卫生—护理学]