Abstract:

Objective To establish a homogenized nursing linkage mode for wound care in the region to promote the homogenization of wound knowledge and skills in the region,and provide homogenized wound care for patients.Methods We developed a management software system for diagnosis and treatment collaboration for wound care in the region,and investigated the level of wound nursing care of nurses in Yangpu district,Shanghai,using self-designed survey questionnaire. From November to December,2016,seven international stoma therapists in Yangpu district were selected to form the team of teachers. From January to June,2017,30 nurses from six community health service centers engaged in wound care were selected as the experimental group,and received homogenized training. Thirty-two nurses from specialist team of a tertiary hospital were selected as the control group,and received routine specialist training. The differences in specialist theory,operation,and clinical practical nursing ability between two groups were compared.Results The results of baseline survey showed that the score of wound stoma team members was higher than that of community nurses, and the difference was statistically significant（t=-672.27,P<0.01）.There were no significant differences in scores of specialist theoretical knowledge and operational skills between community nurses receiving homogenized training and specialist team in tertiary hospital（P>0.05）. There was no significant difference in the clinical practical nursing ability between community nurses and specialist team in tertiary hospital（P>0.05）,the special nursing capacity in the two groups tend to be homogeneous.Conclusion The homogenized nursing linkage mode for wound care in the region is conducive to promoting the homogenization of specialized nursing capacity among different medical institutions.

Key words: Community Health Nursing, Wound Care, Homogenized Nursing, Progressive Patient Care, Referral and Consultation

摘要：

目的 构建伤口护理区域同质化联动模式,促进伤口知识和技能在区域内的同质化传递,为患者提供同质化伤口护理。方法 开发区域伤口协作诊疗管理软件系统,采用自制的伤口护理现状调查表,调查上海市杨浦区社区护士的伤口护理水平。于2016年11月—12月选取杨浦区内的7名国际造口治疗师,成立师资队伍;于2017年1月— 6月选择6所社区卫生服务中心从事伤口护理的30名护士作为试验组,给予同质化培训,并应用区域伤口协作诊疗管理软件系统进行伤口的同质化护理;从1所三级医院专科团队中抽取32名护士作为对照组,接受常规的专科培训;比较两组护士在专科理论、操作及临床实际护理能力方面的差异。结果 基线调查结果显示,伤口造口团队成员的考核成绩比社区护士的考核成绩高,差异有统计学意义（t=-672.27,P<0.01）。接受同质化培训后社区护士在专科理论知识和操作技能方面的得分及临床实际护理能力与三级医院护士比较,差异均无统计学意义（P>0.05）,两组专科护理能力和水平趋于同质化。结论 伤口护理区域同质化联动模式有利于促进不同医疗机构间专科护理能力和水平的同质化。

关键词: 社区保健护理, 伤口护理, 同质化护理, 患者分级医疗, 转诊和会诊