循证护理在颅骨修补术中的应用

Application of evidence-based nursing in the cranioplasty patients

目的探讨循证护理在颅骨修补术中的应用效果。方法选取2010年3月至2012年2月天坛普华医院收治的48例行颅骨修补术的患者为调查对象，采用随机数字法分为观察组26例和对照组22例。观察组采用循证护理方法，首先提出问题，由护士对相关护理证据进行查询，并以实证为依据进行临床循证护理实践；对照组采用传统的颅骨修补术护理。对两组患者平均住院天数、住院费用、术后并发症及患者对护理工作的满意度和护理工时进行比较。结果观察组患者对护理工作的满意度为96．2％，高于对照组的68．2％，两组比较，差异有统计学意义（χ2=2．34，P=0．04）；观察组护理工时、平均住院天数、住院费用分别为（9．15±1．89）h、（8．9±2．4）d、（5964±682）元，均低于对照组的（12．87±2．14）h、（12．6±3．1）d、（7026±855）元，两组比较差异有统计学意义（t分别为2．68，2．67，2．71；P=0，00）；对照组有3例（13．6％）发生术后并发症，观察组仅出现1例（4．5％）并发症，明显低于对照组，两组比较，差异有统计学意义（χ2=1．97，P=0．00）。结论采用循证护理模式对颅骨修补术的患者实施护理可提高患者满意度，缩短护理工时、平均住院天数，减少患者术后并发症及住院费用。

Objective To investigate the effect of evidence-based nursing on the cranioplasty patients. Methods Totals of 48 schizophrenia patients between March 2012 and February 2013 were randomly divided into observation group （ n = 26） which received evidence-based nursing and nursing implementation methods were found from the database according to the clinical questions, and control group （ n = 22 ） which received routine nursing care. Patients＇ satisfaction, nursing hours, average length of stay, hospitalization costs, and post-operation complications of the two groups were observed and compared. Results The patients＇ satisfaction in observation group was 96.2%, which significantly higher than 68.2% of control group （ χ2 = 2.34, P = 0.04）. The nursing hours, average length of stay, hospitalization costs of observation group respectively were （9.15 ± 1.89） h, （8.9 ± 2.4） d, （5 964 ± 682） yuan, and that of control group were （ 12.87 ± 2. 14） h, （ 12.6 ± 3.1 ） d, （ 7 026 ± 855 ） yuan, and the difference was statistically significant （ t = 2.68,2.67,2.71, respectively, P = 0. 00 ）. And 3 cases occurred postoperative complications in control group which was significantly higher than 1 eases in observation group （ χ2 = 1.97, P = 0. 00 ）. Conclusions Evidence-based care model can be used in the nursing of cranioplasty patients, for it can improve patients＇ satisfaction, shorten stay in hospital and nursing hours, and reduce the hospitalization costs.