临床护理路径在肩关节镜手术患者围手术期的应用

Application of clinical nursing pathway in patients with shoulder arthroscopic surgery in intraoperative period

目的：探讨肩关节镜围术期患者应用临床护理路径的效果，并逐步改进建立适合肩关节镜患者的标准化护理模式。方法收集2012年1-12月住院行肩关节镜手术未应用临床护理路径的45例患者作为对照组，2013年1-12月住院行肩关节镜手术应用临床护理路径的44例患者作为研究组。分析两组患者的住院时间、住院费用及患者满意度等情况。结果对照组与研究组患者的总住院时间分别为（7．89±3．95），（6．50±3．26）d，两组比较差异有统计学意义（t＝2．238，P＜0．05）。对照组患者术前住院时间为（3．02±2．13）d，研究组为（3．08±1．36）d，两组比较差异无统计学意义（t＝0．549， P＞0．05）。对照组患者术后住院时间为（3．16±2．03）d，研究组为（2．96±1．35）d，两组比较差异有统计学意义（ t＝2．511， P ＜0．05）。对照组患者平均住院费用为（48464．31±14813．99）元，研究组为（41899．65±12292．36）元，两组比较差异有统计学意义（t＝2．272，P＜0．05）。两组患者对护理质量的满意度比较，差异有统计学意义（χ2＝6．621，P＜0．01）。结论肩关节镜患者应用临床护理路径能减少患者住院时间、住院费用，提高患者的满意度，是一种切实、可行、有效的护理模式。

Objective To investigate the application of clinical nursing pathway in perioperative care of shoulder arthroscopic surgery , in order to improve and establish the standard nursing model .Methods Totals of 45 patients admitted from January 2012 to December 2012 were served as the control group , without clinical nursing pathway.Totals of 44 patients from January 2013 to December 2013 were served as the study group with clinical nursing pathway .The hospital stay , medical expenses and patients＆#39;satisfaction were compared between the two groups .Results After appling the clinical nursing pathway , the hospital stay of the control group and the study group were （7.89 ±3.95） and （6.50 ±3.26） days.There was a significant difference between the two groups （t =2.238, P 〈0.05）.The hospital stay of the control group and the study group before the operation were （3.02 ±2.13） and （3.08 ±1.36） days, with no significant difference （t=0.549, P〉0.05）. The hospital stay of the control group and the study group after the operation were （3.16 ±2.03） and （2.96 ± 1.35） days, with a statistically significant difference （ t=2.511, P〈0.05）.The medical expenses of the control group and the study group were （48 464.31 ±14 813.99） and （41 899.65 ±12 292.36） yuan.There was a significant difference between the two groups （t=2.272, P〈0.05）.The satisfaction between the two groups had a significant difference （χ2 =6.621, P〈0.01）.Conclusions The application of clinical nursing pathway can effectively reduce hospital duration , medical cost and improve satisfaction of patients with shoulder arthroscopic surgery , and it is a practical , feasible and effective nursing model .