4R危机管理理论在达芬奇系统心脏不停跳房间隔修补术中的应用  

Application of 4R crisis management theory in repair of atrial septal defects in beating heart by using da Vinci robotic system

作　　者：杜祥飞 李珍宇 史卓颖 葛经武[1] DU Xiangfei;LI Zhenyu;SHI Zhuoying;GE Jingwu(Department of Anesthesiology and Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029)

机构地区：[1]南京医科大学第一附属医院麻醉手术科,江苏南京210029

出　　处：《实用临床医药杂志》2022年第2期128-131,141,共5页Journal of Clinical Medicine in Practice

基　　金：南京医科大学第一附属医院“临床能力提升工程”护理青年项目(JSPH-NC-2020-3)。

摘　　要：目的探讨4R危机管理法在达芬奇系统不停跳房间隔修补术中的应用效果。方法选取行达芬奇系统心脏不停跳房间隔缺损修补手术的98例患者为研究对象,随机分为对照组(常规管理)和实验组(4R危机管理理论),每组49例。比较2组的整理无菌台时间、手术时间、器械设备故障次数、识别风险率、巡回离室次数、术中护理风险事件发生次数和护理质量评分、护理应对能力评分以及医生及护理人员自身对护理的满意度。结果实验组整理无菌台时间及手术时间短于对照组,器械设备故障次数、巡回离室次数及术中护理风险事件发生次数少于对照组,识别风险率、护理质量评分、护理应对能力评分和医生及护理人员自身对护理总满意率高于对照组,差异有统计学意义(P<0.05)。结论 4R危机管理法在达芬奇系统不停跳房间隔修补术中的应用效果较好,有助于提高护理人员的护理能力,应用价值较高。Objective To investigate the application effect of 4 R crisis management theory in repair of atrial septal defects in beating heart by using da Vinci robotic system. Methods Ninety-eight patients underwent repair of atrial septal defects in beating heart by using da Vinci robotic system were randomly divided into control group(routine management) and experimental group(4 R crisis management theory), with 49 cases in each group. Time of cleaning aseptic table, operation time, number of equipment failure, rate of identify risks, number of rounds out of the room, number of intraoperative nursing risk events, nursing quality score, nursing coping ability score and satisfaction of doctors and nurses for nursing were compared between the two groups. Results The time of aseptic table cleaning and operation in the experimental group was significantly shorter, the number of equipment failure, the number of rounds out of the room and the number of intraoperative nursing risk events were significantly less, and rate of identify risks, the nursing quality score, nursing coping ability score and the total satisfaction rate of doctors and nurses for nursing were significantly higher than those in the control group(P<0.05). Conclusion 4 R crisis management method has a good effect in repair of atrial septal defects in beating heart by using da Vinci robotic system, which is helpful to improve the nursing ability of nurses and has high application value.

关 键 词：4R危机管理法 达芬奇不停跳房间隔修补术 护理质量 护理能力 护理满意度 

分 类 号：R472[医药卫生—护理学] R61[医药卫生—临床医学]