导航护士主导的三级质控在胸腔镜肺癌切除术患者加速康复中的应用  

Application nurse-navigator-led 3-level quality control inspection in ERAS program for lung cancer patients undergoing thoracoscopic resection

作　　者：杨剑[1] 陈杰 黄培雯 安闯 贺学宇[1] Yang Jian;Chen Jie;Huang Peiwen;An Chuang;He Xueyu(Department of Thoracic Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院胸外科,湖北武汉430071 [2]美国马里兰大学护理学院

出　　处：《护理学杂志》2022年第16期12-15,共4页Journal of Nursing Science

基　　金：武汉大学中南医院科技创新培育基金项目(CXPY2022065);武汉大学中南医院临床护理研究项目(LCHLYJ202208)。

摘　　要：目的探讨导航护士主导的三级质控在胸腔镜肺癌切除术患者加速康复中的应用效果。方法将140例行胸腔镜肺癌切除术患者随机分成对照组和观察组各70例。对照组实施常规加速康复管理。观察组实施导航护士主导的三级质控,包括责任护士每班交接自评互评、责任护理组长核实反馈、导航护士协调同质化加速康复路径管理。结果实施后,观察组术后首次下床时间、胸腔引流管留置时间、住院时间显著短于对照组,疼痛评分及住院费用显著低于对照组,加速康复满意度评分显著高于对照组(均P<0.05)。结论以导航护士为主导的三级质控,可促进胸腔镜肺癌切除术患者加速康复实施质量的提升。Objective To investigate the effect of nurse-navigator-led 3-level quality control inspection in ERAS program for lung cancer patients undergoing thoracoscopic resection.Methods A total of 140 lung cancer patients undergoing thoracoscopic resection were randomly divided into 2 groups of 70 cases each.The control group was given routine ERAS management,while the intervention group was subjected to a three-level quality control ERAS program led by nurse navigators,with measures including SBAR based self-assessment and mutual evaluation of charge nurses,verification and feedback from the nursing team leaders,and coordination of homogeneous ERAS path management of patients by nurse navigators.Results After the intervention,the time to get out of bed after surgery,the indwelling time of the chest tube,length of hospital stay,pains scores and hospitalization expense in the intervention group were significantly shorter and lower than those of the control group,while scores of patient satisfaction with ERAS in the former group were significantly higher than the latter(all P<0.05).Conclusion Application of nurse-navigator-led 3-level quality control inspection in ERAS program can improve the quality of ERAS implementation for lung cancer patients undergoing thoracoscopic resection.

关 键 词：肺癌 胸腔镜手术 导航护士 加速康复外科 质量控制 持续质量改进 围术期护理 

分 类 号：R473.6[医药卫生—护理学]