无尿管病房护理工作模式的建立及应用

Establishment effects of nursing work model and clinical application in anuria ward

目的探讨无尿管病房护理工作模式的建立及临床应用效果。方法建立无尿管病房护理工作模式,具体方法包括:成立神经源性膀胱功能康复护理专科小组,明确组织架构、人员分工与职责、进行持续人员培训、教育和考核,制订标准化神经源性膀胱功能康复护理程序,落实膀胱功能评估、膀胱功能训练、健康教育、进行阶段性总结及持续质量改进。结果无尿管病房护理工作模式实施前护士理论考核成绩、技能考核成绩、护士自身满意度、医生对护士满意度、患者对护士满意度得分分别为(79.6±2.1)、(78.5±3.5)、(91.3±2.3)、(93.2±1.8)、(92.5±2.4)分,模式实施后分别为(89.2±1.8)、(87.6±2.7)、(96.3±3.6)、(97.4±1.6)、(98.6±1.3)分,模式实施前、后比较差异均有统计学意义(t=-8.755^-7.685,P<0.05)。模式实施前患者留置导尿管天数、膀胱残余尿量、泌尿系感染例数、住院天数分别为(31.63±8.47)d、(263.38±18.62)ml、(15.03±3.10)例、(21.27±1.64)d,模式实施后分别为(8.78±4.32)d、(79.39±17.36)ml、(5.36±1.35)例、(12.45±1.78)d,模式实施前、后比较差异均有统计学意义(t=-23.643^-5.874,P<0.05)。结论无尿管病房护理工作模式的建立,提高了护士对神经源性膀胱相关理论及护理技能水平,有效促进了神经源性膀胱功能障碍患者的功能康复,减少了并发症的发生,缩短住院天数,同时提升了护士的职业价值,使护士自身满意度,医生及患者对护士的满意度均得到提升。

Objective To explore the establishment of nursing work model and clinical application in anuria ward.Methods Established the nursing model of anuria ward in rehabilitation department,including the establishment of neurogenic bladder functional rehabilitation nursing specialist group.Define organizational structure,division of labor and responsibilities,conduct continuous personnel training,education and assessment,formulate standardized procedures for rehabilitation and nursing of neurogenic bladder function,implement bladder function assessment,bladder function training,health education,etc.Stage summary and continuous quality improvement.Results The scores of nurses/ theoretical examination,skill assessment,nurses’own satisfaction and doctors/satisfaction were 79.6±2.1 and 78.5±3.5,91.3±2.3,93.2±1.8,92.5±2.4,respectively.After the implementation of the model,the scores were 89.2±1.8,87.6±2.7,96.3±3.6and 97.4±1.6,98.6±1.3,respectively.Before and after the implementation of the model,the differences were statistically significant (t =-8.755--7.685,P <0.05). The number of days of indwelling urinary catheier,residual urinary volume of bladder,and urinary system infection cases before the implementation of the.model were (31.63±8.47)days and (263.38±18.62)ml, (15.03±3.10)cases,(21.27±1.64)days,respectively;and (8.78±4.32)days,(79.39±17.36)ml,(5.36± 1.35)cases,(12.45±1.78)days,respectively after the implementation.There was significant difference between the two groups (t =-23.643--5.874,P <0.05).Conclusions The establishment of nursing work model without urinary tube ward it can obviously improve the nurses ~theory and skill operation level of bladder function rehabilitation nursing,nurses themselves and doctors,patients satisfaction to nurses, and significantly reduce the number of days of indwelling catheter,urinary bladder residual urine,urinary tract feeling and hospitalization days.The nursing work mode of no urinary tube ward is normative and operable,and it is worth popularizing in clinic.