膀胱全切术后尿路造口患者出院准备服务方案的制订与实施  

Development and practice of discharge planning service for patients with urostomy after total cystectomy

作　　者：李玲[1] 夏汝琴 郑红[1] Li Ling;Xia Ruqin;Zheng Hong(Second Division,Department of Urology,People′s Hospital of Wuhan University,Wuhan 430061,China)

机构地区：[1]武汉大学人民医院泌尿外二科,湖北武汉430061

出　　处：《护理学杂志》2022年第4期37-40,共4页Journal of Nursing Science

摘　　要：目的制订膀胱全切术后尿路造口患者出院准备服务方案,并探讨其临床应用效果。方法通过文献检索、回顾分析、质性访谈、德尔菲法、临床实证研究等环节,制订膀胱全切术后尿路造口患者出院准备服务方案。选取膀胱全切术后尿路造口患者140例进行非同期对照研究,对照组64例,采用常规出院方案;干预组76例,成立多学科协作管理团队,实施出院准备服务方案。结果干预组出院准备度、出院指导质量、尿路造口自护能力得分显著高于对照组,干预组出院30 d内再入院率显著低于对照组(P<0.05,P<0.01)。与对照组相比,干预组出院30 d内并发症总发生的相对危险度(RR)为0.361。结论实施膀胱全切术后尿路造口患者出院准备服务方案可提高患者出院准备水平、改善出院结局。Objective To develop a discharge planning service plan for patients with urostomy after radical cystectomy, and to investigate its clinical effect. Methods Through literature retrieval, retrospective analysis, qualitative interviews, Delphi based expert consultation, and clinical empirical study, the discharge planning service plan for urostomy patients after radical cystectomy was formulated. A non-concurrent controlled study involving 140 cases was conducted. Sixty-four patients in the control group received routine discharge care, while 76 patients in the intervention group was subjected to the discharge planning service plan carried out by a multidisciplinary cooperative management team. Results The scores of discharge readiness, quality of discharge instructions, urostomy self-care ability and satisfaction in the intervention group were significantly higher than those in the control group, while the readmission rate within 30 days after discharge were significantly lower in the former group(P<0.05,P<0.01). The risk ratio for the incidence rate of complications was 0.361, favoring the intervention group. Conclusion The rollout of discharge planning service for patients with urostomy after radical cystectomy can improve the level of discharge readiness, and make discharge outcomes better.

关 键 词：膀胱全切术 尿路造口 出院准备服务 出院计划 出院指导质量 自护能力 

分 类 号：R473.6[医药卫生—护理学]