基于有限时间理论的日间手术全流程护理清单的构建与应用

doi:10.3761/j.issn.0254-1769.2024.10.011

摘要/Abstract

摘要：

目的基于有限时间理论，以扁桃体切除日间手术为例，构建日间手术全流程护理清单，并评价其应用效果。方法基于文献检索、现场观察法及专家函询法构建扁桃体切除日间手术全流程护理清单。便利选取浙江省杭州市某三级甲等综合医院日间病房行扁桃体切除手术的患者197例，其中2023年4月—6月入组的98例患者作为试验组，采用该研究构建的扁桃体切除日间手术全流程护理清单进行护理，2023年1月—3月入组的99例患者作为对照组，采用常规护理。比较两组围手术期焦虑程度、术后疼痛程度、术后并发症发生率及患者对护理服务的满意度。结果试验组手术前、出院时的焦虑程度，术后6、12、24 h疼痛程度，术后14 d内切口感染、胃肠道反应等并发症发生率均低于对照组，差异均具有统计学意义（P<0.05）；试验组对护理服务的满意度得分（99.40±0.69）分高于对照组（90.36±1.04）分，差异具有统计学意义（P<0.001）。结论采用扁桃体切除日间手术全流程护理清单能够改善患者围手术期焦虑情绪，减轻术后疼痛，降低术后并发症的发生率，同时提高患者的满意度。

关键词: 有限时间理论, 扁桃体切除术, 日间手术, 全流程管理, 护理清单

Abstract:

Objective Based on the limited time theory，taking tonsillectomy day operation as an example，the whole process nursing list of day operation was constructed，and its application effect was evaluated. Methods The nursing service list of tonsillectomy was constructed based on literature research，field observation and expert correspondence. A total of 197 patients who underwent tonsillectomy in the day ward of a tertiary A general hospital in Hangzhou，Zhejiang Province were selected. Among them，98 patients from April to June 2023 were taken as an experimental group and treated with the whole-process nursing list of daytime tonsillectomy constructed in this study，and 99 patients from January to March 2023 were taken as a control group and routine nursing was adopted. The anxiety degree，postoperative pain score，postoperative complication rate and patients’ satisfaction with nursing service were compared between the 2 groups. Results Anxiety scores before operation and at discharge，pain scores at 6 h，12 h and 24 h after operation，and incidence of complications such as infection and gastrointestinal reaction within 14 days after operation in the experimental group were lower than those in the control group，with statistical significance（P<0.05）. The satisfaction of nursing service in the experimental group（99.40±0.69） score was significantly higher than that in the control group（90.36±1.04） score，and the difference was statistically significant（P<0.001）. Conclusion The use of tonsillectomy day whole-process nursing list can improve perioperative anxiety，relieve postoperative pain and reduce the incidence of postoperative complications，and improve patient satisfaction.

Key words: Finite Time Theory, Tonsillectomy, Day Surgery, Whole Process Management, Nursing List

袁芳, 冯勤, 钱援芳, 吴婉, 刘中慧, 胡霜霜. 基于有限时间理论的日间手术全流程护理清单的构建与应用[J]. 中华护理杂志, 2024, 59(10): 1226-1232.

YUAN Fang, FENG Qin, QIAN Yuanfang, WU Wan, LIU Zhonghui, HU Shuangshuang. Construction and application of a nursing list for whole process of day surgery based on the theory of limited time[J]. Chinese Journal of Nursing, 2024, 59(10): 1226-1232.

图/表 4

表1 扁桃体切除日间手术全流程护理清单

Table 1 The whole process nursing list of tonsillectomy day surgery

表2 两组一般资料的比较

Table 2 Comparison of general data between the 2 groups

表3 两组焦虑评分比较（分，$\bar{x}±s$）

Table 3 Comparison of anxiety scores between the 2 groups（score，$\bar{x}±s$）

表4 两组患者术后疼痛评分比较（分，$\bar{x}±s$）

Table 4 Comparison of postoperative pain scores between the 2 groups （score，$\bar{x}±s$）

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