摘要
目的探讨基于多学科协作的创伤性老年髋部骨折诊疗与护理模式的应用效果,分析其对患者住院期间手术相关指标、术后并发症发生率及护理满意度的影响。方法回顾性分析2022年9月—2023年4月在上海交通大学医学院附属第六人民医院接受髋关节手术的228例患者。根据救治和护理流程分为观察组(105例)和对照组(123例)。对照组采用常规流程,观察组在急诊科设置创伤性老年髋部骨折一站式病房,通过开通绿色通道和多学科综合会诊,优化诊疗和护理流程。比较2组患者手术相关指标、术后并发症发生率及患者满意度。结果与对照组比较,观察组术前等待时间[(1.62±0.35)vs.(2.70±0.52)d]、术后下床时间[(1.68±0.36)vs.(2.37±0.52)d]、住院时间[(5.62±1.76)vs.(8.27±2.52)d]明显缩短,术后入住ICU比例(2.86%vs.9.76%)及30 d再入院率(2.86%vs.9.76%)明显降低(均P<0.05)。与对照组比较,观察组术后肺部感染(2.86%vs.9.76%)、切口感染(4.76%vs.13.01%)、下肢深静脉血栓发生率(8.57%vs.17.89%)均显著降低(均P<0.05)。观察组总护理满意度为99.05%,明显高于对照组的91.87%(P<0.05)。结论基于多学科协作的创伤性老年髋骨折诊疗与护理模式可使患者尽早实施手术治疗,缩短住院时间,减少围手术期并发症,改善患者护理满意度。
Objective To investigate the impact of a multi-disciplinary team-based model on managing and caring for elderly patients with traumatic hip fractures,and analyze of surgical-related indicators,postoperative complications rate,and nursing satisfaction during the patient's hospitalization.Methods A retrospective analysis was conducted on 228 patients who underwent hip joint surgery at the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2022 to April 2023.The patients were divided into two groups:an observation group(105 cases)and a control group(123 cases),based on their treatment and care processes.The control group followed the routine procedure,while the observation group received acre in a dedicated one-stop ward designed specifically for elderly patients with traumatic hip fractures in the emergency department.The treatment and nursing process in the observation group were optimized through the implementation of a streamlined pathway and multidisciplinary comprehensive consultation.The study compared operation-related indicators,postoperative complication rates,and nursing satisfaction between the two groups.Results Compared with the control group,the observation group demonstrated significant improvements in various aspects.The preoperative waiting time[(1.62±0.35)d vs.(2.70±0.52)d],postoperative mobilization time[(1.68±0.36)d vs.(2.37±0.52)d],and length of hospital stay[(5.62±1.76)d vs.(8.27±2.52)d]were significantly shortened in the observation group(all P<0.05).Additionally,the observation group exhibited a significant decrease in the proportion of postoperative ICU admission(2.86%vs.9.76%)and 30-day readmission rate(2.86%vs.9.76%),all P<0.05.Moreover,compared with the control group,the incidence of postoperative pulmonary infection(2.86%vs.9.76%),incision infection(4.76%vs.13.01%),and lower extremity deep vein thrombosis(8.57%vs.17.89%)in the observation group were significantly reduced(all P<0.05).The overall nursing satisfaction rate in the observation group was 99.05%,which was significantly higher than in the control group(91.87%,P<0.05).Conclusion The implementation of a multidisciplinary team-based model for managing and caring for elderly patients with traumatic hip fractures has demonstrated several positive outcomes.This model facilitates early surgical treatment,leading to shorter hospital stays,decreased perioperative complications,and improved nursing satisfaction.
作者
熊飞
邵小平
芮碧宇
XIONG Fei;SHAO Xiaoping;RUI Biyu(Department of Emergency Medicine,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)
出处
《中华全科医学》
2023年第12期2156-2159,共4页
Chinese Journal of General Practice
基金
上海市卫生健康委员会科研项目(202240142)。
关键词
创伤性髋部骨折
老年
多学科协作
护理流程
绿色通道
效果评价
Traumatic hip fracture
Elderly
Multidisciplinary team
Nursing process
Green channel
Effect evaluation
