主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (4): 488-493.doi: 10.3969/j.issn.1672-1756.2025.04.002

• 特别策划·肿瘤专科护理发展 • 上一篇    下一篇

基于PEPPA模式肿瘤吞咽障碍护理门诊的设立和实践

赵艺媛 张颖 陆宇晗 张岩 张亚冰 张彬 王晶晶   

  1. 北京大学肿瘤医院暨北京市肿瘤防治研究所头颈外科,恶性肿瘤发病机制及转化研究教育部重点实验室,100142 北京市 (赵艺媛,张颖,张岩,张亚冰,张彬);护理部(陆宇晗);国家药物临床试验机构(王晶晶)
  • 出版日期:2025-04-15 发布日期:2025-04-15
  • 通讯作者: 陆宇晗,硕士,主任护师,护理部主任,E-mail:lu_yuhan@sina.com
  • 作者简介:赵艺媛,硕士,副主任护师,护士长
  • 基金资助:
    国家公立医院改革与高质量发展示范项目(北京市海淀区)(11010822T000001740154)

Establishment and practice of an oncology dysphagia nursing clinic based on the PEPPA model

ZHAO Yiyuan, ZHANG Ying, LU Yuhan, ZHANG Yan, ZHANG Yabing, ZHANG Bin, WANG Jingjing   

  1. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing, 100142, China
  • Online:2025-04-15 Published:2025-04-15
  • Contact: E-mail:lu_yuhan@sina.com

摘要: 目的:探索肿瘤吞咽障碍护理门诊的工作模式及管理策略,并评价其在肿瘤专科护理管理中的实践效果。方法:基于加拿大高级临床护理实践角色发展及评价模式,对肿瘤吞咽障碍患者及医务人员进行需求分析,设计以患者为中心的护理门诊。于2023年6月正式开通线上、线下双融合的肿瘤吞咽障碍护理门诊,通过有资质的出诊人员进行规范地筛查及评估、制定全面的康复治疗计划并跟踪实施效果,实现吞咽障碍筛查、评估、计划、实施、随访及转介的一体化专科护理;通过规范门诊制度、组建多学科团队、加强医院支持保障与宣传等多项策略保障护理门诊正常运行,并通过监测就诊患者经口进食能力恢复率、就诊患者误吸性肺炎发生率等指标评价门诊运行效果。结果:护理门诊实施后,41例(80.4%)患者经口进食能力基本恢复,吞咽功能较干预前显著改善(P<0.05),就诊患者居家康复期间的误吸性肺炎发生率为2.0%(1/51)。结论:本研究通过科学构建肿瘤吞咽障碍护理门诊,促进了肿瘤患者吞咽障碍的康复及肿瘤护理专科发展。

关键词: 吞咽障碍;护理门诊;高级临床护理实践角色发展及评价模式;肿瘤护理

Abstract: Objective: To explore the operational model and management strategies of an oncology dysphagia nursing clinic, and to evaluate its effects on patients' outcomes. Methods: Based on the model of Participatory, Evidence-based, Patient-centered Process for APN role development, implementation, and evaluation (PEPPA), a needs analysis was conducted among oncology dysphagia patients and healthcare providers. Guided by this framework, an online-offline integrated oncology dysphagia nursing clinic was launched in June 2023. Certified practitioners performed standardized screening, developed comprehensive rehabilitation plans, and tracked patients' outcomes, achieving integrated specialized care encompassing dysphagia screening, assessment, planning, implementation, follow-up, and referral. The quality improvement strategies included establishing clinic protocols, forming a multidisciplinary team, enhancing institutional support, and strengthening reporting. Key outcomes monitored were oral intake recovery rates and aspiration pneumonia incidence. Results: Post-implementation, 41 patients (80.4%) achieved oral intake functional recovery, with significant improvement in swallowing function compared to that of baseline (P<0.05). Aspiration pneumonia incidence during home care was 2.0% (1/51). Conclusion: The oncology dysphagia nursing clinic effectively promotes functional recovery in cancer patients with swallowing disorder and advanced specialized oncology nursing practices.

Key words: swallowing disorders; nursing clinic; PEPPA model; oncology nursing

中图分类号:  R47;R197