摘要
目的探讨《基于节点控制的标准手术配合操作程序》的建立和在腹腔镜下袖状胃切除手术中的应用及效果评价.方法通过查阅文献并结合临床实际工作制定《基于节点控制的腹腔镜下袖状胃切除手术配合标准操作程序》后,并通过专家小组会议对研究方案及内容进行最终确认;采用随机对照实验,选取2022年07月-09月在南京医科大学附属常州第二人民医院三级甲等综合医院减重代谢外科行腹腔镜下袖状胃切除的患者40例,分为干预组(n=20)与对照组(n=20).对照组给予围术期常规护理程序进行配合,干预组按照标准操作程序进行围术期配合.结果干预组平均住院天数为5.0 d,对照组平均住院天数为6.4 d,干预组平均住院天数较对照组显著减少(P<0.001),干预组住院费用的中位数为47087.1(46204.1~48282.2)元,对照组住院费用的中位数51175.5(48668.2~53339.6)元,干预组较对照组住院费用显著下降(P<0.001).干预组手术患者及家属对手术室护士满意度的中位数为92.5(91.5~95.0)分,对照组手术患者及家属对手术室护士满意度的中位数为85.0(85.0~86.0)分,干预组较对照组手术患者及家属对手术室护士满意度显著升高(P<0.001).干预组手术医生对巡回护士满意度的中位数为92.0(91.0~93.0)分,对照组手术医生对巡回护士满意度的中位数85.0(84.0~86.0)分,干预组较对照组手术医生对巡回护士满意度显著升高(P<0.001).干预组手术医生对器械护士满意度的中位数为92.0(92.0~93.0)分,对照组手术医生对器械护士满意度的中位数为83.0(82.5~84.0)分,干预组较对照组住院费用显著降低(P<0.001).干预组发生护理中断事件涉及患者12例(60%),对照组发生护理中断事件涉及患者18例(90%),干预组术中护理中断事件发生率显著低于对照组(P<0.05).结论《基于节点控制的手术配合标准操作程序》的应用能够显著缩短腹腔镜袖状胃切患者的住院天数,降低住院费用,提高患者及家属和手术医生对手术室护士的满意度;能提升手术配合效果,规范手术配合流程,减少护理中断事件的发生.
Objective To explore the establishment of nodal control based standard operating procedures for surgical coordination and its application and effect evaluation in laparoscopic sleeve gastrectomy.Methods The Standard Operating Procedure for Coordination of Laparoscopic Sleeve Gastrectomy based on Nodal Control was formulated through literature review and clinical practice,and the research plan and content were finally confirmed through expert group meeting.A randomized controlled experiment was conducted to select 40 patients who underwent laparoscopic sleeve gastrectomy in the Bariatric and Metabolic Department of a Grade-III general hospital from July to September 2022.They were divided into intervention group(n=20)and control group(n=20).The control group was provided with perioperative routine nursing procedures,and the intervention group was provided with perioperative coordination according to the Standard Operating Procedure.Results The average length of hospitalization in the intervention group was 5.0 days,and the average length of hospitalization in the control group was 6.4 days.The average length of hospitalization in the intervention group was significantly reduced compared with the control group(P<0.001).The median cost of hospitalization in the intervention group was 47087.1(46204.1~48282.2)Yuan.The median hospitalization cost in the control group was 51175.5(48668.2~53339.6)Yuan,and the hospitalization cost in the intervention group was significantly decreased compared with the control group(P<0.001).The median satisfaction of patients and their families to operating room nurses in the intervention group was 92.5(91.5~95.0)points,and that of patients and their families in the control group was 85.0(85.0~86.0)points.The satisfaction of patients and their families in the intervention group was significantly higher than that in the control group(P<0.001).The median satisfaction of surgeons to itinerant nurses in the intervention group was 92.0(91.0~93.0)points,and that of surgeons in the control group was 85.0(84.0~86.0)points.The median satisfaction of surgeons in the intervention group was significantly higher than that in the control group(P<0.001).The median satisfaction of surgeons to instrument nurses in the intervention group was 92.0(92.0~93.0)points,and that of surgeons in the control group was 83.0(82.5~84.0)points.The hospitalization cost in the intervention group was significantly lower than that in the control group(P<0.001).Nursing interruption events occurred in 12 patients(60%)in the intervention group and in 18 patients(90%)in the control group.The incidence of intraoperative nursing interruption events in the intervention group was significantly lower than that in the control group(P<0.05).Conclusion The application of“Nodal Control based Standard Operating Procedure for Surgical Coordination”can significantly shorten the length of hospital stay in patients with laparoscopic sleeve gastrectomy,reduce the hospitalization cost,and improve the satisfaction of patients,their families and surgeons to nurses in the operating room.It can improve the effect of surgical cooperation,standardize the procedure of surgical cooperation and reduce the occurrence of nursing interruption.
作者
陈志强
郭道遐
钱峻
段枫
肖立
CHEN Zhiqiang;GUO Daoxia;QIAN Jun;DUAN Feng;XIAO Li(Department of Surgery,The Second People's Hospital of Changzhou,Nanjing Medical University,Changzhou,Jiangsu 213000,China;School of Nursing,Soochow University Health Science Center,Suzhou,Jiangsu 215021,China;Department of Bariatric and Metabolic Surgery,The Second People's Hospital of Changzhou,NanjingMedical University,Changzhou,Jiangsu 213000,China)
出处
《手术电子杂志》
2023年第1期57-63,共7页
Electronic Journal of Medical Operations
基金
南京医科大学附属常州第二人民医院护理科研项目(2021HZD002)
关键词
节点控制
腹腔镜下袖状胃切除术
标准化操作程序
手术配合
nodal control
laparoscopic sleeve gastrectomy
standardized operating procedures
operative coordination
