蝮蛇咬伤患者临床护理路径的构建

Construction of the Clinical Nursing Pathway of Agkistrodon Halys Bite

目的构建适用于蝮蛇咬伤患者的临床护理路径(clinical nursing pathway,CNP)。方法 2011年12月至2012年4月,采用目的抽样法选择16名医疗及护理专家为咨询对象,在查阅文献、质性访谈、病历回顾的基础上,构建CNP初步框架,形成专家咨询问卷,应用德尔菲法对专家进行两轮咨询。结果两轮咨询问卷的回收率分别为100.0%和93.8%,权威系数均为0.86;一、二级条目的协调系数分别为0.336、0.304(P<0.01);重点护理方案中2个一级条目合并、出路径标准中增加1个二级条目、评估及观察记录单中增加2个二级条目,最终确立的蝮蛇咬伤CNP。主要包括路径出入标准、CNP表单、重点环节的护理方案、评估与观察记录单、健康教育记录单。结论 2轮咨询结果具有可靠性,所构建的蝮蛇咬伤CNP能为专病护理干预方案的选择提供参考。

Objective To construct the Clinical Nursing Pathway（CNP） adapt for Agkistrodon Halys Bite. Methods Based on literature review, qualitative interview and medical records review, the preliminary framework of CNP was created, and the questionnaire was further formed for experts to carry out a two- round consultation with 16 experts in the related field by using Delphi Method. Results The positive coef- ficients of the two-round consultation were 100.0% and 93.8% respectively;the authoritative coefficients were both 0.86; the coordinate coefficients of the first and second level entry were 0. 336 and 0. 304 respec- tively（P〈0.01）;the two fist level entries were combined in key steps, one second level entry added on the path out standard, and two second level entries added on the assessment record sheet, the final establish- ment of the CNP of Agkistrodon Halys Bite includes path in and out standard, forms of CNP, the care scheme of the key steps, observations and assessment record sheet and health education record sheet. Con- Clusion The two-round consulting results are reliable. The constructed CNP of Agkistrodon Halys Bite can provide reference to choose nursing intervention program for special disease.