玻璃体内注射改进术前流程的初步应用效果  

Preliminary efficacy of preoperative process improvement on intravitreal drug injection

作　　者：王蕾[1] 刘淑贤[1] 宋薇[1] Wang Lei;Liu Shuxian;Song Wei(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2022年第6期463-466,共4页Ophthalmology in China

基　　金：首都医科大学附属北京同仁医院院内基金护理研究专项(2018-YJJ-HLL-007)。

摘　　要：目的研究玻璃体内注射改进术前流程的应用效果。设计前瞻性比较性病例系列。研究对象北京同仁医院眼科日间病房手术室玻璃体内注射患者500例。方法对玻璃体内注射术前流程进行改进(试验组260例),包括调整手术预约单申请项目顺序并增加色块来区分药品种类、将术眼标识改为带颜色和文字的贴纸、调整使用表面麻醉剂的次数和时间点。与传统术前流程(对照组240例)进行比较。主要指标核对手术单用时、手术医生及巡回护士对试验组手术单满意度、各种原因造成手术核对困难的比例以及患者术中疼痛评分。结果试验组核对手术单用时(2.00±0.49)min,明显低于对照组的(5.00±0.51)min(t=64.132,P<0.001)。医护对试验组手术单的满意度均为100%,对照组满意度均为20%。洗眼造成标识不清晰者对照组、试验组分别占41.7%、0.0%(χ^(2)=135.41,P<0.001):治疗巾包扎遮盖标识者对照组、试验组分别占100%(χ^(2)=192.4,P<0.001)。试验组疼痛评分(2.14±0.15)明显低于对照组的(2.82±0.54)(t=8.708,P<0.001)。结论优化玻璃体内注射术前流程有助于提高手术效率,增加医护满意度,降低患者术中疼痛感受。Objective To explore the preliminary efficacy of preoperative process improvement on intravitreal drug injection.Design Prospective comparative case series.Participants 500 patients undergoing intravitreal injection surgery in ophthalmic daytime operation room of Beijing Tongren Hospital.Method The preoperative process of intravitreal injection procedures was improved(study group,n=260 cases),including adjusting the order of application items in the surgical appointment form,adding color blocks to distinguish different injectable drugs,marking the surgical eye with multiple stickers with different color and fonts,and adjusting the frequency and timing of topical anesthetics.Traditional preoperative procedure(control group,n=240 cases)was compared with study group.Main Outcome Measures The time for checking surgical appointment form,the satisfaction of doctors and nurses on the improved surgical appointment form,the proportion of difficult surgical checking due to various reasons,and the intraoperative pain score of patients.Result The time for checking surgical appointment form in control group and study group were 5.00±0.51 min and 2.00±0.49 min,respectively(t=64.132,P<0.001).The proportion of satisfied with the surgical appointment form in surgeons and itinerant nurses was 100%in the study group and 20%in the control group.The proportion of unclear eye-marker caused by eyewash was 41.7%in the control group and 0.0%in the study group,respectively(χ^(2)=135.41,P<0.001).The proportion of the huck towel covering the surgical eye-marker was 100%in the control group and 0%in the study group,respectively(χ^(2)=192.4,P<0.001).Intraoperative pain score in study group was 2.14±0.15,less than in control group(2.82±0.54)(t=8.708,P<0.001).Conclusion Preoperative process improvement on intravitreal drug injection can help to increase the efficiency of intravitreal injection surgery,and increase medical staff satisfaction,and decrease the intraoperative pain of intravitreal injection.

关 键 词：玻璃体内注射 护理学 

分 类 号：R779.6[医药卫生—眼科]