摘要
目的分析心脏和血管外科术后感染的影响因素,并针对具体因素采用护理管理(Nursing management,M)、护理技能(Nursing skills,S)、护理服务(Nursing service,S)、护理安全(Nursing safety,S)[1M3S]管理模式进行干预,评估干预效果。方法选择2017年5月-2018年10月成都医学院第一附属医院收治的150例心脏和血管外科手术患者为研究对象,依据随机对照表法分对照组和研究组,各75例,其中对照组采用常规护理干预,研究组在1M3S管理模式的指导下接受护理干预,分析心脏和血管外科手术感染的影响因素,并探讨1M3S护理干预对感染、护理人员知识技能及患者满意度的影响。结果术后发生感染患者24例,感染率为16.00%(24/150)。单因素分析结果显示手术时长、手术失血量、护理类型对心脏和血管外科患者术后感染有一定影响。多因素分析结果显示护理类型(P=0.001,95%Cl=1.871~12.425)、手术时长(P=0.038,95%Cl=1.064~9.045)是心脏和血管外科患者术后感染的影响因素(P<0.05);研究组护理人员的理论知识、仪器设备使用、专科技术操作和急救技能评分分别为(38.21±1.46)分、(35.29±3.28)分、(37.73±2.61)分和(36.73±2.13)分高于对照组(P<0.05);呼吸机相关性肺炎、压疮、人工气道非计划性拔管的发生率分别为16.00%、10.67%和2.67%低于对照组(P<0.05)。结论护理方式对心脏和血管外科手术后感染有一定影响,其中1M3S管理模式干预可显著改善护理人员知识技能,从而显著降低患者感染率,有利于预后。
OBJECTIVE To analyze the influencing factors of postoperative infections in cardiovascular surgery and to implement the intervention under 1 M3 S management model including nursing management,nursing skills,nursing service,and nursing safety according to specific factors,and evaluate the effect of these interventions.METHODS A total of 150 patients undergoing cardiovascular surgery admitted in the First Affiliated Hospital of Chengdu Medical College from May 2017 to Oct.2018 were selected as the research subjects.They were randomly divided into a control group(n=75)and a research group according to the randomized control table method,with 75 cases in each.The control group were treated with routine nursing intervention,and the research group were received nursing intervention under the guidance of M3 S1 management mode.The influencing factors postoperative infection in cardiovascular surgery were analyzed and the effect of 1 M3 S nursing intervention on infection,knowledge and skills of nursing staff and patient satisfaction were investigated.RESULTS There were 24 patients with infection after operation,and the infection rate was 16.00%(24/150).The results of univariate analysis showed that the length of operation,the amount of blood loss and the types of nursing had certain effects on the postoperative infection in patients with cardiac and vascular surgery.Multivariate analysis showed that nursing types(P=0.001,95%Cl:1.871-12.425),operation time(P=0.038,95%Cl:1.064-9.045)were the influencing factors of postoperative infection in patients with cardiac and vascular surgery(P<0.05).The scores of theoretical knowledge,use of instruments and equipment,specialized technical operation and first-aid skills of nursing staff in the research group were(38.21±1.46),(35.29±3.28),(37.73±2.61)and(36.73±2.13),respectively significantly,higher than those in the control group(P<0.05).The incidence of ventilator-associated pneumonia,pressure ulcers and unplanned pullouts of artificial airway were 16.00%,10.67%and 2.67%,respectively significantly,lower than those of the control group(P<0.05).CONCLUSION Nursing mode has a certain impact on infections after cardiovascular surgery.Among them the intervention of 1 M3 S management mode can significantly improve the knowledge and skills of nursing staff’s,thus significantly reduce the infection rate of the patients,which is beneficial to the prognosis.
作者
王辉
刘莎莎
魏勇
袁希
WANG Hui;LIU Sha-sha;WEI Yong;YUAN Xi(First affiliated Hospital of Chengdu Medical College,Chengdu,Sichuari 610500,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第14期2226-2230,共5页
Chinese Journal of Nosocomiology
