多学科合作加速康复外科工作模式下的护理管理实践及效果评价

doi:10.3969/j.issn.1672-1756.2018.04.025

多学科合作加速康复外科工作模式下的护理管理实践及效果评价

张继芝李秀娥徐玉芝彭玉兰吕守英高莉

聊城市第二人民医院护理部，252601 山东省聊城市临清市

出版日期:2018-04-25 发布日期:2018-04-25
基金资助:
聊城市科技攻关项目（聊卫医函〔2017〕9号）

Application of a multidisciplinary Enhanced Recovery After Surgery pathway to improve patient outcomes

Online:2018-04-25 Published:2018-04-25

摘要/Abstract

摘要： 目的：评价在全院外科系统推行多学科合作加速康复外科（ERAS)的工作模式在临床实践中的效果。方法：成立多学科合作ERAS项目推进团队，组织临床试点科室查找循证依据，经沟通讨论、参观培训、在试点科室推行后进行督导改进，运行成熟后通过一带一帮扶模式在全院外科系统开展；推行多学科合作ERAS前的11 007例患者为对照组，推行后的13 927例患者为观察组。比较ERAS推行前后两组患者术后并发症、外科系统相关运行数据及护士职业认同感。结果：观察组患者术后静脉血栓栓塞症、切口感染、肺部感染发生率均低于对照组，差异有统计学意义（P<0.05）；观察组患者平均住院日、平均住院费用、31天内非计划再住院率均低于对照组，差异有统计学意义（P<0.05）；推行多学科合作ERAS后，护士职业认同评定量表调查结果显示总平均分由（3.14±0.63)分升至（3.35±0.52)分，差异有统计学意义（P<0.05）。结论：在全院外科系统推行多学科合作下的ERAS是行之有效的工作方式，可加速患者康复，对护理团队产生积极正向的影响，促进医院的健康可持续发展。

Abstract: Objective: To evaluate the effect of a multidisciplinary Enhanced Recovery After Surgery (ERAS) pathway in surgical specialties. Methods: An ERAS expert panel was established to develop appropriate pathway, and generated it to all the surgical departments. The postoperative complication rates, surgical related data and nurses' professional identity were compared before and after the intervention. Results: The observation group had significantly lower postoperative complication rates than the control group (P<0.05). The observation group had shorter average hospitalization days, expenses and readmission rate were lower than the control group, the difference was statistically significant (P<0.05). The mean score of nurses' professional identity was improved from (3.14±0.63) to (3.35±0.52). Conclusion: The multidisciplinary ERAS pathway is effective for patients' rehabilitation, also improve nursing team's ability.

张继芝李秀娥徐玉芝彭玉兰吕守英高莉. 多学科合作加速康复外科工作模式下的护理管理实践及效果评价[J]. , 2018, 18(4): 546-552.