以专科护士为主导的集束化护理预防骨科术后医用粘胶相关性皮肤损伤的效果  

Application of intensive care led by specialist nurse to prevent medical adhesive-related skin injury after orthopedic surgery

作　　者：李小群 任燕梅 杨勇[1] 徐雅琴 曾议 夏琪[3] LI Xiaoqun;REN Yanmei;YANG Yong;XU Yaqin;ZENG Yi;XIA Qi(Second Department of Orthopedics,Sichuan Provincial People's Hospital Qionglai Hospital,Medical Center Hospital of Qionglai City,Qionglai 611530,Sichuan Province,China;Respiratory and Critical Care Medicine,Sichuan Provincial People's Hospital Qionglai Hospital,Medical Center Hospital of Qionglai City,Qionglai 611530,Sichuan Province,China;Day Chemotherapy Center and PICC Center,Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省人民医院邛崃医院/邛崃市医疗中心医院骨二科,四川邛崃611530 [2]四川省人民医院邛崃医院/邛崃市医疗中心医院呼吸与危重医学科,四川邛崃611530 [3]四川省人民医院日间化疗中心和PICC中心,成都610072

出　　处：《医学新知》2024年第9期970-977,共8页New Medicine

基　　金：四川省医学会骨科(尚安通)专项科研课题项目(2021SAT21)。

摘　　要：目的探讨以专科护士为主导的集束化护理对骨科术后患者医用粘胶相关性皮肤损伤(medical adhesive-related skin injury,MARSI)的预防效果。方法招募2022年6月至2023年12月邛崃市医疗中心医院骨科收治的限期或择期手术患者,随机分为对照组和研究组。对照组患者采用常规护理,研究组患者采用以专科护士为主导的集束化护理。观察比较两组的伤口敷料和静脉输液通道敷料MARSI发生率、康复效果(MARSI康复时间、下床活动时间和住院时间)和护理满意度。结果共纳入骨科术后患者400例,其中对照组和研究组各200例。研究组术后伤口敷料MARSI发生率(9.50%vs.20.00%,P<0.05)和静脉输液通道MARSI发生率(3.00%vs.13.50%,P<0.05)分别显著低于对照组。研究组MARSI康复时间[(10.27±0.08)d vs.(15.42±1.21)d,P<0.05]、下床活动时间([1.40±0.26)d vs.(3.72±0.38)d,P<0.05]和住院时间([8.41±0.21)d vs.(12.18±1.48)d,P<0.05]均显著短于对照组。研究组护理满意度(98.00%vs.82.50%,P<0.05)显著高于对照组。结论与常规护理比较,以专科护士为主导的集束化护理干预可显著降低骨科术后患者MARSI的发生率,促进康复效果,提升患者护理满意度,具有一定临床应用价值。Objective To explore the effect of intensive care led by specialist nurses on medical adhesive-related skin injury(MARSI)in postoperative orthopedic patients.Methods Patients admitted to the Orthopedic Department of the Medical Center Hospital of Qionglai City from June 2022 to December 2023 for scheduled or elective surgery were recruited and randomly divided into control group and intervention group.The control group received conventional care,while the intervention group received intensive care led by specialist nurse.The MARSI incidence of wound dressing and intravenous infusion channel dressing,rehabilitation outcomes(MARSI rehabilitation time,mobilization time,and hospitalization time),and nursing satisfaction between the two groups were compared.Results A total of 400 postoperative orthopedic patients were included,of which 200 in the control group and 200 in the intervention group.The MARSI incidences of postoperative wound dressing(9.50%vs.20.00%,P<0.05)and intravenous infusion channel dressing(3.00%vs.13.50%,P<0.05)in the intervention group were significantly lower than those in the control group.The MARSI rehabilitation time[(10.27±0.08)d vs.(15.42±1.21)d,P<0.05],mobilization time[(1.40±0.26)d vs.(3.72±0.38)d,P<0.05],and hospitalization time[(8.41±0.21)d vs.(12.18±1.48)d,P<0.05]in the intervention group were significantly shorter than those in the control group.The nursing satisfaction rate of the intervention group(98.00%vs.82.50%,P<0.05)was significantly higher than that of the control group.Conclusion Compared with routine nursing,the intensive care led by specialist nurses can considerably reduce the incidence of MARSI,promote the rehabilitation effect,and improve nursing satisfaction in postoperative orthopedic patients,which has certain clinical application value.

关 键 词：医用粘胶相关性皮肤损伤 骨科手术 集束化护理 专科护士 发生率 康复 护理满意度 

分 类 号：R684.1[医药卫生—骨科学]