协同护理模式对膝关节置换手术患者感染率及满意度的研究

Collaborative management model in the study of early postoperative infection control for the total knee replacemen patients

目的探讨协同护理模式（Collaborative care model,CCM）对行膝关节置换手术患者术后感染率、二次翻修率及满意度的影响。方法选择2014年1月-2014年12月在新疆医科大学第六附属医院行单膝关节置换手术的患者160例,随机分为对照组（80例）和观察组（80例）,两组患者在手术室管理环节、供应室管理环节、病房管理环节、手术团队管理环节相同,术后2～3d护士对对照组患者进行回访,了解患者术后感染情况及满意度情况。观察组患者在对照组的基础上采用CCM,护士分别于患者术后2w、1个月、3个月、1a进行电话回访,对患者功能进行系统评分,了解患者术后感染情况及满意度情况。结果对照组患者术后感染8例,感染率为10%,观察组术后感染1例,感染率为1.3%,对照组患者术后翻修率为100%,观察组患者术后翻修率为0%。对照组患者术后满意度为86%,观察组患者术后满意度为96%。两组患者术后感染率、患者满意度差异有统计学意义（P〈0.05）。结论协同护理模式能有效降低膝关节置换患者术后早期感染率,早期发现术后感染,降低患者术后二次翻修率,提升患者满意度,对医院感染控制有指导意义。

Objectiive To explore the influence of collaborative care model（CCM）on infection rate,two revision rate and patients′satisfaction of patients undergoing knee replacement surgery.Methods 160 patients with single knee replacement surgery collected January 2014 to December 2014 in the Sixth Affiliated Hospital of Xinjiang Medical University,were randomly divided to control group（80cases）and observation group（80cases）,2groups of patients in the operating room management process,supply room management link,ward management links,surgical team management aspects of the same,the control group of patients after 2-3days nurses to pay a return visit,understand the patients infected and satisfaction.The observation group patients in the control group based on the CCM,nurses in patients after 2 weeks,1 month,3 months,1athe telephone visit 1times,scoring system on the function of patients,postoperative understanding after the infection and satisfaction.Results In the control group,8cases of postoperative infection,the infection rate was 10%,1cases of postoperative infection,the infection rate was 1.3%,the control group was 100%,the revision rate was,the observation group was 0%.The postoperative satisfaction was 86%in the control group and 96%in the observation group.2groups of patients with postoperative infection rate,patient satisfaction difference was statistically significant（P 0.05）.Conclusion Collaborative nursing model can effectively reduce the knee joint replacement patients early after infection rate,early detection of postoperative infection,reduce the patients after secondary revision rate,improve patient satisfaction and the hospital infection control is of guiding significance.