首台手术准备流程再造在日间手术管理中的应用效果分析  

Analysis of the application effect of the first-surgery preparation process reengineering in day surgery management

作　　者：詹丽莉 李兰 张黎 肖珊 黄明君[1] ZHAN Lili;LI Lan;ZHANG Li;XIAO Shan;HUANG Mingjun(Day Surgery Center,General Practice Medical Center,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院全科医学中心日间手术中心/四川大学华西护理学院,成都610041

出　　处：《华西医学》2025年第2期250-255,共6页West China Medical Journal

基　　金：四川省科技计划项目(2022JDKP0015)。

摘　　要：目的探讨首台手术准备流程再造在日间手术管理中的短期应用效果。方法2019年7月四川大学华西医院开始通过流程再造理论重新构建日间手术首台手术准备标准流程。选取2019年2月—6月在日间手术中心行全身麻醉手术的首台手术患者(以下简称“首台患者”)为流程再造前组,2019年7月—11月的首台患者为流程再造后组,比较两组首台手术流程中各环节间隔时间、各环节晚点发生率等指标。结果共纳入633例患者,其中流程再造前组309例,流程再造后组324例。流程再造后组首台患者入院办理时间[(30.24±7.86)vs.(22.45±10.65)min,P<0.001]、医生下医嘱时间[(9.42±7.07)vs.(5.45±5.86)min,P<0.001]、护理准备完成后等候入室时间[(23.67±17.59)vs.(18.46±19.60)min,P=0.001]、首台患者入院到入室总等待时间[(73.42±18.46)vs.(65.27±21.00)min,P<0.001]均短于流程再造前组。流程再造后组患者入院时间晚于07:50(2.3%vs.0.3%,P=0.034)、护士准备完成时间晚于08:20(6.1%vs.2.5%,P=0.022)的发生率低于流程再造前组。结论首台手术准备流程再造后日间手术各环节管理效果显著,能缩短患者等待时间,避免患者入院时间晚、下医嘱时间晚、护理准备完成时间晚等因素对患者准时入室的影响。Objective To explore the short-term effects of reengineering for the first-surgery preparation process in day surgery management.Methods In July 2019,West China Hospital of Sichuan University began to reconstruct a standard process for the first-surgery preparation process in day surgery based on the theory of process reengineering.Patients who underwent the first general anesthesia operation on the day at the Day Surgery Center between February and June 2019 were selected as the pre-reengineering group,and those between July and November 2019 were selected as the post-reengineering group.The time intervals for each stage of the surgical process and the incidences of delays in each stage were compared between the two groups.Results A total of 633 patients were included,with 309 in the prereengineering group and 324 in the post-reengineering group.The time from arrival to admission for the first patient[(30.24±7.86)vs.(22.45±10.65)min,P<0.001],time from admission to doctor’s orders[(9.42±7.07)vs.(5.45±5.86)min,P<0.001],waiting time before entering the operating room after nursing preparation[(23.67±17.59)vs.(18.46±19.60)min,P=0.001],and total waiting time from admission to entering the operating room[(73.42±18.46)vs.(65.27±21.00)min,P<0.001]in the post-reengineering group were all shorter than those in the pre-reengineering group.The incidence of patients admitted after 07:50(2.3%vs.0.3%,P=0.034)and the incidence of nurses’preparation completion time extending beyond 08:20(6.1%vs.2.5%,P=0.022)in the post-reengineering group were lower than those in the pre-reengineering group.Conclusion The reengineering of the first-surgery preparation process significantly improves the management of day surgery across multiple stages of the process,reducing patient waiting times and minimizing delays in admission,order processing,and nursing preparations that may affect patients’punctual entry into the operating room.

关 键 词：日间手术 首台手术 流程再造 术前准备 

分 类 号：R473.6[医药卫生—护理学]