责任制整体护理在全程护理模式中的应用

Application of responsibility system holistic nursing care in the whole-course nursing mode

目的探讨责任制整体护理模式在肝胆外科围手术期患者中的应用效果。方法在肝胆外科病区实施责任制整体护理，包括改进照护模式、落实分级护理、优化工作流程、科学人力配置及完善护理质量监督体系，比较实施前后患者对专科疾病知识的了解情况、患者满意度、对责任护士知晓率、院内护理质量评分结果、护士直接护理时间及护理文件书写时间。结果实施后患者对各专科疾病知识的了解情况均高于实施前，差异有统计学意义（P〈0．05）；实施后患者满意度及对责任护士知晓率分别为98．22％，93．96％，均高于实施前的96．22％，89．67％，差异均有统计学意义（x2分别为7．16，11．84；P〈0．05）；实施后危重患者护理、急救技术、基础护理及消毒隔离的护理质量评分分别为（98．00±1．22），（96．56±1．22），（99．10±0．22），（99．30±0．22）分，均高于实施前的（91．58±1．22），（90．70±1．22），（91．84±1．22），（83．72±1．22）分，差异均有统计学意义（F分别为4．74，5．01，4．34，6．24；P〈0．05）；实施后护士直接护理时间为（368±12）min，高于实施前的（329±21）min，而护理文件书写时间为（20±4）min，低于实施前的（49±11）min，差异均有统计学意义（F分别为3．35，3．02；P〈0．05）。结论责任制整体护理的实施，有利于为患者提供全面、全程、专业、无缝隙的护理，促进了住院患者围手术期的专令与舒活．提高了患者及家属的满意席。

Objective To study the effect of responsibility system holistic nursing care on the perioperative patients in hepatobiliary surgery department. Methods Responsibility system holistic nursing care was performed in hepatobiliary surgery ward such as reformed the care mode, improved the working process, implemented grading nursing, scientific human configuration and perfected care quality supervision system and so on. Patients＇ specialist knowledge and understanding of the disease, patients＇ satisfaction, patients＇ awareness of primary nurses, score of nursing quality, direct nursing hour, nursing documents writing time were observed and compared before and after the nursing care was implemented. Results After the responsibility system holistic nursing care implemented, patients＇ specialist knowledge and understanding of the disease were significantly improved than that of before it implemented （ P 〈 0.05 ）. Patients＇ satisfaction and their awareness of primary nurses was 98.22% and 93.96% , respectively, and significantly higher than 96.22% and 89.67% of before （ P 〈 0.05 ）. The score of nursing quality including the nursing of critically ill patients （ 98.00 ± 1.22 ）, the technique of first aid （96.56 ± 1.22 ） , basic nursing （99.10 ± 0.22）, disinfection and isolation （99.30 ± 0.22 ） was significantly higher than （91.58 ± 1.22）, （90.70 ± 1.22 ）, （91.84 ±1.22 ）, （83.72 ± 1.22 ） that of before（P 〈 0.05 ）. After the care was implemented, direct nursing hour and nursing documents writing time was （ 368 ± 12 ） min and （ 20 ± 4 ） min, respectively, and that of before was （ 329 ±21 ） min and （49± 11 ） min, and the difference was statistically significant （ P 〈 0.05 ）. Conclusions The implementation of responsibility system holistic nursing care can provide comprehensive, full, professional, seamless care for patients and promote their perioperative safety and comfort, improve the satisfaction of patients and families.