摘要
目的探讨手术室护士急救能力评价指标体系的构建及“三定”急救模式在异位妊娠大出血患者中的应用分析。方法于2018年3月起截至2018年末,通过文献回顾形成手术室护士急救能力评价体系草案,编制咨询问卷,结合半结构访谈,德尔菲法及层次分析法完成构建手术室护士急救能力评价指标体系并确定各指标权重。前瞻性纳入2019年1月—2019年12月急诊实施“三定”急救护理模式前抢救的45例异位妊娠大出血患者设为对照组,将2020年1月—2020年12月急诊应用“三定”急救护理模式抢救的48例异位妊娠大出血患者设为研究组。比较新构建的手术护士急救能力评价指标体系指标干预前后急救医生满意度、护士压力评分及护理人员各方面技能评分变化。对比“三定”模式干预前后患者急救时效性指标差异及护理满意度情况。结果研究组患者抢救时间、急诊室停留时间及手术出血量均显著少于对照组(t=13.335,21.261,13.246,P<0.05)。两组抢救成功率均为100%。研究组患者急诊护理满意度为97.92%明显高于对照组84.44%,数据差异有统计学意义(χ^(2)=5.362,P<0.05)。干预后,护士压力评分较干预前显著降低,医生满意度明显提高,数据差异有统计学意义(t=6.898,5.431,P<0.05)。干预后,急救护理人员的个人基本能力、专业急救技能、一般急救技能、急救知识能力及环境管理能力评分均较干预前显著提升,有统计学意义(t=3.504,3.705,4.369,3.884,2.578,P<0.05)。结论在更为科学合理的手术室护理急救能力评价指标体系的指导下,对异位妊娠大出血患者实施“三定”急救模式进行干预,可显著改善患者急救时效性指标,提高患者护理满意度,且可有效降低护士急救身心压力评分,并提高急救医生满意度,值得推广。
Objective To construct an evaluation index system of emergency response ability for nurses in operation room and to evaluate the application of"three fixed"emergency mode in ectopic pregnancy patients with massive hemorrhage.Methods From March 2018 to the end of 2018,a draft evaluation system for emergency response ability of nurses in operation rooms was formed through literature review,and a consultation questionnaire was prepared.Combined with semi-structured interviews,Delphi method and analytic hierarchy process,the evaluation index system for emergency response ability of nurses in operation rooms was constructed and the weight of each index was determined.Forty-five patients who were prospectively included into the control group and were rescued before the emergency implementation of"three fixed"emergency care mode from January 2019 to December 2019 were selected as the research group.Forty-eight patients who were rescued after emergency application of"three fixed"emergency care mode from January 2020 to December 2020 were selected as the research group.The changes of indexes such as emergency doctor satisfaction,nurse pressure score and nursing staff skill score before and after the intervention were compared.The differences of timeliness indexes of first aid and nursing satisfaction of patients before and after the intervention with"three fixed"mode were compared.Results The rescue time,emergency room stay time and surgical bleeding volume of the research group were all significantly shorter/lower than those in the control group(t=13.335,21.261,13.246,P<0.05).The success rates of rescue in the two groups were both 100%.The satisfaction rate of patients in the research group for emergency care was 97.92%,significantly higher than that in the control group(84.44%,t=5.362,P<0.05).After the intervention,the nurses'stress scores were significantly reduced and the doctors'satisfaction was significantly improved compared with those before the intervention(t=6.898,5.431,P<0.05).After intervention,the scores of personal basic ability,professional first-aid skill,general first-aid skill,first-aid knowledge ability and environmental management ability of the emergency nursing staff were significantly increased compared with those before intervention(t=3.504,3.705,4.369,3.884,2.578,P<0.05).Conclusion Under the guidance of a more scientific and reasonable evaluation index system of emergency care ability in operating rooms,the implementation of the"three fixed"emergency mode of intervention for patients with massive hemorrhage from ectopic pregnancy can significantly improve the timeliness index of patients'emergency care and improve patients'satisfaction with care,effectively reduce the scores of physical and mental pressure of nurses in emergency care,and improve the satisfaction of emergency doctors,which is worthy of promotion.
作者
李敏
蔡懿
LI Min;CAI Yi(Operating Room,Bazhong Central Hospital,Bazhong Sichuan 636000,China)
出处
《中国急救复苏与灾害医学杂志》
2022年第11期1497-1501,1514,共6页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
四川省基层卫生研究项目(编号:SWFZ20-C-100)。
关键词
手术室护士
急救能力
评价指标
体系构建
“三定”急救模式
异位妊娠
Operating room nurses
First aid capabilities
Evaluation indicators
System construction
"Three fixed"emergency mode
Ectopic pregnancy
