基于 PDCA 和循证护理的耳鼻咽喉科手术室整体护理效果分析：基于回顾性病例对照研究。
Analysis of the Effect of Holistic Nursing in the Operating Room Based on PDCA and Evidence-Based Nursing in the Otorhinolaryngology Operating Room: Based on a Retrospective Case-Control Study.
机构信息
First People's Hospital Through the Operation Room, 222000 Lianyungang, China.
First People's Hospital Conduit Room, 222000 Lianyungang, China.
出版信息
Contrast Media Mol Imaging. 2022 May 21;2022:4514669. doi: 10.1155/2022/4514669. eCollection 2022.
OBJECTIVE
Based on a retrospective case-control study, this study aims to explore the effect of holistic nursing in operating room based on PDCA (plan, do, check, and action) process and evidence-based nursing (EBN) in a ear, nose, and throat operating room.
METHODS
About 200 patients who underwent otorhinolaryngology surgery in our hospital from January 2019 to September 2021 were enrolled. According to the difference of nursing mode, patients were assigned into a control group and study group; holistic nursing in operating room was included in control group, and holistic nursing in the operating room based on PDCA and EBN was included in study group. Nursing satisfaction, hypothermia, chills, restlessness, related indexes of operating room, nursing quality scores of operating room, and individual quality control scores were compared.
RESULTS
First of all, we compared the nursing satisfaction, the study group was very satisfied in 69 cases, satisfactory in 30 cases, general in 1 case, the satisfaction rate was 100.00%, while in the control group, 46 cases were very satisfied, 34 cases were satisfied, 13 cases were general, and 7 cases were dissatisfied, the satisfaction rate was 93.00%. The nursing satisfaction of the study group was higher compared to the control group ( < 0.05). Second, we compared the incidence of hypothermia, chills and restlessness. The incidence of hypothermia, chills, and restlessness in the study group was lower compared to the control group ( < 0.05). The time of tracheal tube extubation, PACU stay time, postoperative hospitalization time, hospitalization cost, and operation time in the study group was significantly lower compared to the control group ( < 0.05). In terms of the scores of nursing quality in the operating room, the instruments and equipment management, equipment preparation, nurses' cooperation skills, disinfection and isolation quality, and total score in the study group were higher compared to the control group ( < 0.05). Finally, we compared the scores of individual quality control examination. The scores of ward management, rescue, therapeutic articles, drug management, first-level nursing, nursing documents, and head nurse management in the study group were higher compared to the control group ( < 0.05).
CONCLUSION
Incorporating the concepts of PDCA and EBN into the overall care of the operating theatre is effective for patients in the ENT operating theatre. Our results show that this care can be effective in improving patients' surgical indicators, reducing the incidence of postoperative infections, shortening postoperative resuscitation and length of stay, reducing hospital costs, and promoting surgical patient satisfaction. While further multicenter studies are necessary, this series of nursing interventions remains worthy of replication in the clinical setting.
目的
本研究通过回顾性病例对照研究，探讨基于 PDCA（计划、执行、检查、行动）流程和循证护理（EBN）的手术室整体护理对耳鼻喉科手术室的影响。
方法
选取 2019 年 1 月至 2021 年 9 月在我院行耳鼻喉科手术的患者 200 例，根据护理模式的不同将其分为对照组和研究组，对照组采用手术室常规护理，研究组采用基于 PDCA 和 EBN 的手术室整体护理，比较两组护理满意度、低体温、寒战、躁动、手术室相关指标、手术室护理质量评分、个体质控评分。
结果
首先，我们比较了护理满意度，研究组非常满意 69 例，满意 30 例，一般 1 例，满意度为 100.00%，对照组非常满意 46 例，满意 34 例，一般 13 例，不满意 7 例，满意度为 93.00%。研究组的护理满意度高于对照组（<0.05）。其次，我们比较了低体温、寒战和躁动的发生率。研究组低体温、寒战和躁动的发生率低于对照组（<0.05）。研究组的气管导管拔管时间、PACU 停留时间、术后住院时间、住院费用和手术时间均显著低于对照组（<0.05）。在手术室护理质量评分方面，研究组的仪器设备管理、设备准备、护士配合技巧、消毒隔离质量和总分均高于对照组（<0.05）。最后，我们比较了个体质量控制检查评分。研究组的病房管理、抢救、治疗用品、药品管理、一级护理、护理文书、护士长管理评分均高于对照组（<0.05）。
结论
将 PDCA 和 EBN 理念融入耳鼻喉科手术室整体护理中，对患者有效。我们的研究结果表明，这种护理可以有效改善患者的手术指标，降低术后感染发生率，缩短术后复苏和住院时间，降低住院费用，提高手术患者满意度。虽然还需要进一步的多中心研究，但这一系列护理干预措施在临床实践中仍然值得复制。
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