麻醉恢复室患者《转运前护理观察指标》的制定及应用

Formulation and Application of A Predetermined Discharge Criteria Using by Nurses in the Postanesthesia Care Unit

目的探讨参考《患者离室标准》制定的《转运前护理观察指标》应用于全麻手术患者的效果。方法便利抽样选择2013年5-8月南方医院300例成年择期行全身麻醉的手术患者,按手术时间分成两组,对照组(control group)患者由麻醉恢复室(post-anesthesia care unit,PACU)医生在患者离室标准的基础上,根据个人经验观察后,进行Steward评分,之后通知护士转运;观察组(observation group)患者由PACU护士按照《转运前护理观察指标》的要求进行判断,满足条件后通知PACU医生进行Steward评分,之后遵医嘱转送。比较两组患者满足转送条件时间、实际转送时间、转送至病房后术后基本情况的差异。结果观察组患者PACU的满足转运条件时间和实际转运时间均明显短于对照组(均P<0.05);两组患者转送至病房后不良事件发生率差异无统计学意义(均P>0.05)。结论麻醉护士执行预先制定的《转运前护理观察指标》,主动进行患者转运前病情观察,可明显缩短患者留置PACU时间,提高医疗和护理工作效率。

Objective To investigate the effects of a predetermined discharge criteria using by nurses on the patients during the awaken period of general anesthesia in the post-anesthesia care unit （PACU ）. Methods By convenience sampling,300 adult patients were divided into two groups.In control group,all patients were evaluated by an anesthetist according to the discharge criteria.After assessing the patient and giving Steward score based on personal experience,then the anesthetist informs the nurse to discharge the patient.The patients in the observation group were evaluated by a PACU nurse using predetermined discharge criteria.While get a satisfied result,the nurse will report it to the anesthetist for Steward score assessing.The patients then were discharged according to the doctor’s advice.The time that discharge criteria were met,the actual discharge time,and the occurrence of general events after operation were recorded and evaluated.Results The length of PACU stay was significantly shorter for patients in the observation group than that in the control group （all P〈0.05）.There was no significant difference in the occurrence of general events after operation between the two groups （all P〉0.05）.Conclusion Predeter-mined discharge criteria used by nurse can significantly decrease in PACU stay time and improve the medical and nursing efficiency.