基于老年综合评估的护理在心脏外科高龄手术患者护理不良事件预防中的应用  

Application of nursing based on comprehensive geriatric assessment in the prevention of nursing adverse events in elderly patients undergoing cardiac surgery

作　　者：杜莹[1] 何媛[1] 陈秀梅[1] 彭辉[1] 刘媛[1] 李雪梅[1] Du Ying;He Yuan;Chen Xiumei;Peng Hui;Liu Yuan;Li Xuemei(Department of Cardiac Surgery,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科,100029

出　　处：《中华现代护理杂志》2020年第14期1845-1850,共6页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金(81370436)。

摘　　要：目的探讨基于老年综合评估制订的护理措施在预防心脏外科高龄手术患者护理不良事件中的应用效果。方法选择2018年6月-2019年5月在首都医科大学附属北京安贞医院行心脏外科手术的高龄患者56例作为观察组,按对等原则回顾性选择2017年6月-2018年5月行心脏外科手术的高龄患者51例作为对照组。对照组实施常规护理,观察组在常规护理基础上开展老年综合评估,基于评估结果制订护理计划和措施。比较两组患者住院期间护理不良事件的发生情况和住院时间。结果观察组患者非计划性拔管率、误吸率、跌倒率分别为1.79%(1/56)、1.79%(1/56)、0(0/56),低于对照组的13.73%(7/51)、15.69%(8/51)、9.80%(5/51),差异有统计学意义(P<0.05);观察组患者压力性损伤发生率为0(0/56),对照组为1.96%(1/51),差异无统计学意义(P>0.05);观察组患者置管切口感染率为0(0/56),低于对照组的9.80%(5/51),差异有统计学意义(P<0.05)。观察组患者住院时间少于对照组,差异有统计学意义(Z=8.068,P<0.01)。结论将老年综合评估运用于心脏外科高龄手术患者,可降低非计划性拔管、误吸、跌倒等护理不良事件的发生率,降低切口感染率,缩短住院时间。Objective To explore the application effect of nursing measures based on comprehensive geriatric assessment in the prevention of nursing adverse events in elderly patients undergoing cardiac surgery.Methods 56 elderly patients who underwent cardiac surgery in Beijing Anzhen Hospital Affiliated to Capital Medical University from June 2018 to May 2019 were selected as the observation group.According to the principle of reciprocity,51 elderly patients who underwent cardiac surgery from June 2017 to May 2018 were selected as the control group.The control group was given routine nursing while the observation group carried out comprehensive geriatric assessment based on routine nursing and formulated nursing plans and measures based on assessment results.The incidence of adverse nursing events during hospitalization and length of hospital stay were compared between the two groups.Results The unplanned extubation rate,aspiration rate and fall rate in the observation group were respectively 1.79%(1/56),1.79%(1/56)and 0(0/56),which were lower than 13.73%(7/51),15.69%(8/51)and 9.80%(5/51)in the control group,and the differences were statistically significant(P<0.05).The incidence of stress injury was 0(0/56)in the observation group and 1.96%(1/51)in the control group,and the difference was not statistically significant(P>0.05).The infection rate of tube incision in the observation group was 0(0/56),which was lower than 9.80%(5/51)in the control group,and the difference was statistically significant(P<0.05).The length of hospital stay in the observation group was shorter than that in the control group,and the difference was statistically significant(Z=8.068,P<0.01).Conclusions Application of comprehensive geriatric assessment in elderly patients undergoing cardiac surgery can reduce the incidence of unplanned extubation,aspiration,falls and other nursing adverse events,reduce the infection rate of incision and shorten the length of hospital stay.

关 键 词：老年人 心脏外科 老年综合评估 高龄 护理计划 

分 类 号：R473.6[医药卫生—护理学]