| 医护一体化模式在肺结核围术期患者护理中的实施效果分析 |
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| 引用本文： | 芦永赞,荣宁宁,韩星芬,师吉艳,韩英,曹文婷,赵常征,郝蓉美. 医护一体化模式在肺结核围术期患者护理中的实施效果分析[J]. 中国防痨杂志, 2018, 40(12): 1302-1305. DOI: 10.3969/j.issn.1000-6621.2018.12.012 |
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| 作者姓名： | 芦永赞 荣宁宁 韩星芬 师吉艳 韩英 曹文婷 赵常征 郝蓉美 |
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| 作者单位： | 250013.济南,山东大学附属山东省胸科医院外科重症监护病房(芦永赞、荣宁宁、赵常征、师吉艳、韩英、曹文婷),医疗保险办公室(韩星芬),肺功能室(郝蓉美); |
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| 摘 要： | 目的 探究医护一体化模式在肺结核围术期护理中的应用效果。方法 将2017年6月实施医护一体化模式前后的患者根据护理模式分为2组,分别为实施前组、实施后组,采用数字表法各随机选取100例患者。实施前组为传统模式:平行线式管理模式,医生下医嘱,护士被动执行,互不交叉。实施后组采用医护一体化模式,医生和护士在平等自主、互相尊重和信任且具有一定专业知识与能力的前提下,通过开放的沟通和协调,共同决策,分担责任,为患者提供医疗护理服务。分别比较两组患者的肺功能指标[第1秒用力呼气容积(FVE1)、用力肺活量(FVC)、第1秒用力呼气容积百分比(FVE1%)]、平均住院时间、并发症发生率、患者满意度情况。结果 术后7d肺功能检测:医护一体化实施前组FVE1、FVC、FVE1%分别为(1.79±0.30)L、 (2.49±0.55)L、(45.79±3.13)%;实施后组分别为(2.05±0.38)L、 (3.05±0.61)L、(49.05±5.38)%;两组比较,t值分别为5.371、6.824、5.243,P值分别为0.016、0.010、0.017,差异均有统计学意义。实施前组平均住院日为(14.23±2.88)d,实施后组为(10.45±2.15)d;两组比较,t=-10.523,P=0.004。实施前组拔管时间为(4.08±1.85)d,实施后组为(2.54±0.97)d;两组比较,t=-7.371,P=0.008;实施前组并发症发生率为19.00%(19/100),实施后组并发症发生率为3.00%(3/100);两组比较,χ 2=11.494,P=0.003。两组满意度比较,实施前组“很满意”者为61例,实施后组为 82例(χ 2=3.891,P=0.048);实施前组“一般满意”者为27例,实施后组为12例(χ 2=7.172,P=0.007);实施前组“不满意”者12例,实施后组为6例(χ 2=1.532,P=0.220)。医护一体化实施后组较实施前组平均住院日、拔管时间、并发症均下降,同时患者满意度增加。 结论 医护一体化模式能够促进肺结核患者围术期肺功能恢复,缩短住院时间,减少并发症,同时可提高患者的医疗满意度。
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| 关 键 词： | 结核 肺 围手术期医护 护理实践模式 对比研究 数据说明 统计 |
| 收稿时间： | 2018-10-18 |
The analysis of the effect of doctor-nurse integration mode during the perioperative period after pulmonary tuberculosis surgery |
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| LU Yong-zan,RONG Ning-ning,HAN Xing-fen,SHI Ji-yan,HAN Ying,CAO Wen-ting,ZHAO Chang-zheng,HAO Rong-mei.. The analysis of the effect of doctor-nurse integration mode during the perioperative period after pulmonary tuberculosis surgery[J]. The Journal of The Chinese Antituberculosis Association, 2018, 40(12): 1302-1305. DOI: 10.3969/j.issn.1000-6621.2018.12.012 |
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| Authors: | LU Yong-zan RONG Ning-ning HAN Xing-fen SHI Ji-yan HAN Ying CAO Wen-ting ZHAO Chang-zheng HAO Rong-mei. |
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| Affiliation: | Surgical Intensive Care Unit, Shandong Provincial Chest Hospital, Affiliated to Shandong University, Jinan 250013, China |
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| Abstract: | Objective To explore the application effect of integrated medical care mode in perioperative nursing of tuberculosis patients.Methods The pulmonary TB patients, undergoing surgery on June 2017, were divided into two groups randomly using random number tables, according to the application of doctor-nurse integration mode:(1) control group 100 cases were treated with the routine mode, which includes: parallel line management mode, doctor’s advice, and nurses’ passive implementation without crossover. (2) experimental group 100 cases were treated with the integration mode which includes through open communication and coordination and with shared responsibility, and mutual respect and trust and have a certain degree of professional knowledge and ability between doctors and nurses to provide patients with medical care. The pulmonary function indexes (FVE1, FVC, FVE1%), average hospitalization time, complication rate and patient satisfaction were compared between the two groups.Results Ventilatory function was tested at seven days after surgery. Compared with the control group with routine mode, the application of the new mode improved the ventilatory function significantly (FEV1: (1.79±0.30)L vs (2.05±0.38)L, t=5.371, P=0.016; FVC: (2.49±0.55)L vs (3.05±0.61)L, t=6.824, P=0.010; FVE1%: (45.79±3.13)% vs (49.05±5.38)%, t=5.243, P=0.017). There was also a significant improvement in hospitalization time((14.23±2.88 vs 10.45±2.15)days, t=-10.523,P=0.004), and a significant improvement in extubation time ((4.08±1.85 vs 2.54±0.97)days,t=-7.371,P=0.008). Moreover, there was also a higher complication rate detected in the control group (19 cases vs 3 cases, χ 2=11.494, P=0.003). Patient satisfaction has been found to be higher in the experimental group: strong satisfaction (61 cases vs 82 cases, χ 2=3.891, P=0.048), weak satisfaction (27 cases vs 12 cases, χ 2=7.172, P=0.007) and dissatisfaction (12 cases vs 6 cases, χ 2=1.532, P=0.220). The average hospitalization days, extubation time and complications in the integrated medical care group were lower than those in the previous group, and patients’ satisfaction was increased. Conclusion The integrated medical care model can promote the recovery of pulmonary function, shorten hospitalization time, reduce complications, and improve patients’ medical satisfaction. |
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| Keywords: | Tuberculosis,pulmonary,Perioperative care,Nurse’s practice patterns ,Comparative study,Data interpretation,statistical, |
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