脊柱围手术期临床护理实践和管理:协和经验

Practice and management of clinical perioperative nursing of spinal surgery based on the experience of Peking Union Medical College Hospital

脊柱手术范围广,手术方式多,患者年龄跨度大,造成了脊柱手术的围手术期护理工作十分繁杂且护理重点多变。提高脊柱手术患者围手术期护理管理质量始终是临床关注的焦点,也是研究的热点。本文重点围绕入院评估、"3W1H"法健康宣教、术前准备、术后生命体征监测、神经功能观察、疼痛、体位、胃肠道不适、早期离床活动、并发症防治和3C结构化病情交接管理等内容,结合近年来研究进展和临床实践经验提炼出协和经验,以期为脊柱手术围手术期护理临床工作提供思路。

Spinal surgery has the characteristics of wide involved range,varied surgical methods and large age span of patients,which makes perioperative nursing be very complicated and changeable.Therefore,improving the quality of perioperative care management of patients undergoing spinal surgery has been the focus of clinical attention and a hot spot of research.This paper will focus on admission assessment,health education,preoperative preparation,postoperative monitoring of vital signs,neurological observation,pain,posture,gastrointestinal discomfort,early out-of-bed,prevention and treatment of complications,and handover management,in combination with advances in recent years to introduce the research progress and clinical practice comprehensively in our hospital,in order to provide ideas for clinical perioperative nursing of spinal surgery.