骨科入院护理流程再造的学习曲线分析

Learning curve research on redesign of orthopedic admission nursing procedure

目的：探讨骨科入院护理流程再造的学习曲线规律，为全面推进骨科护理流程再造提供参考。方法回顾性分析实施入院护理流程再造后250例入院患者的临床资料，这些患者覆盖了学习阶段和成熟阶段，按入院时间顺序以50例作为一个阶段，共分为A、B、C、D、E 5组，比较5组患者在入院时间和满意度方面的差异，运用线性回归方法研究入院护理流程再造的学习曲线及入院时间对患者满意度的影响。结果各组平均入院时间为A组（27．47±3．64）min，B组（23．86±1．95）min，C组（21．84±2．09）min，D组（21．74±1．83）min，E组（21．85±1．79）min；各组患者平均满意度为A组（95．32±1．57）分，B组（97．44±0．95）分，C组（98．78±0．51）分，D组（99．00±0．35）分，E组（98．96±0．35）分；各组间入院时间、满意度差异均有统计学意义（F值分别为54．465，61．052；P＜0．01）。经后续比较，A组与B、C、D、E 4组在入院时间、满意度上差异具有统计学意义（P＜0．01），B组与A、C、D、E 4组在入院时间、满意度上差异具有统计学意义（ P＜0．01）；C、D、E 3组在入院时间、满意度上差异不具有统计学意义（ P＞0．05）。绘制骨科入院护理流程再造的学习曲线，学习曲线的对数形式（ R2＝0．747，F＝289．389，P＜0.05）以及患者满意度对入院时间（R2＝0．669，F＝500．532，P＜0．05）均具有线性回归关系。结论入院护理流程再造的实施具有显著的学习曲线特征，前100例为学习阶段，100例后进入成熟阶段。入院护理流程再造显著地减少了患者入院时间，有助于形成良好的“第一印象”，提高患者满意度。

Objective To explore the principles of learning curve on redesign of orthopedic admission nursing procedure in order to provide reference to promote the overall nursing procedure .Methods A total of 250 cases after redesign of orthopedic admission nursing procedure were analyzed .These cases covered the stage from the beginning to the matured stage .Every 50 cases were taken as a group and a phase of learning curve . The admission time and satisfaction score were compared among the five different phases （ groups ） .The linear regression technique was employed to research the learning curve and the effect of admission time on the patients ＇satisfaction.Results The mean admission time in each group was （27.47 ±3.64） min in Group A, （23.86 ± 1.95）min in Group B, （21.84 ±2.09）min in Group C, （21.74 ±1.83）min in Group D, and （21.85 ±1.79） min in Group E, respectively.The scores of patients＇satisfaction in each group were （95.32 ±1.57）min in Group A, （97.44 ±0.95）min in Group B, （98.78 ±0.51）min in Group C, （99.00 ±0.35）min in Group D, and （98.96 ±0.35） min in Group E, respectively.The differences were significant （P ＆lt;0.01）.Further analysis showed that , compared Group A with the other groups , the differences in the admission time and patients＇satisfaction were significantly different （P＆lt;0.01）.The differences of admission time and patients＇satisfaction among Group C, Group D and Group E had no difference （P＆gt;0.05）.The learning curve （R2 =0.747,F=289.389,P＆lt;0.05） of redesign of orthopedic admission nursing procedure showed that there was linear regression relationship between the admission time （R2 =0.669,F=500.532,P＆lt;0.05） and patients＇satisfaction.Conclusions The redesign of orthopedic admission nursing procedure is characterized by the learning curve , which the first 100 cases are in the learning stage and after 100 cases is the matured stage .The redesign of orthopedic admission nursing procedure can significantly decrease the admission time and is benefit to establish “the good first impression” and the improvement of the patients＇satisfaction.