胸外科护士眼中的加速康复外科——基于会议问卷调查结果分析

The opinion of nurse on enhanced recovery after surgery in thoracic surgery:A questionnaire survey

目的分析胸外科护士对加速康复外科(enhanced recovery after surgery,ERAS)的理解及看法,以利于促进ERAS的临床应用。方法对参加2016年11月25~26日第一届胸科ERAS华西论坛的护士进行问卷调查,收到有效问卷259份,并对问卷结果进行分析。结果 (1)ERAS临床应用现状:13.5%的护士所在医院只关注并未使用,86.5%所在医院有不同程度开展,85.7%认为外科都该应用ERAS,58.7%认为ERAS现状是理念大于实践,40.2%认为所有患者都适合应用ERAS理念;(2)81.9%的护士认为ERAS评价标准应该是平均住院时间,患者感受及社会满意度三者的综合;(3)70.7%的护士认为学科整合,外科为主和医护一体是ERAS最佳实现模式分析,44.8%认为医院行政推动是推动ERAS应用的最佳途径;(4)69.1%的护士认为是方案不成熟、无共识和规范及医患安全无保障是ERAS运用中依从性差的原因,79.5%认为ERAS会议内容应包括宣传规范与共识、分析研究项目与实施和宣讲现状与进展。结论 ERAS理念已得到大家认可,多学科协作和医院推动是临床应用的最佳实现途径。

Objective To analyze the nurses＇ current view and perceptions of enhanced recovery after surgery （ERAS） by a questionnaire and to promote the clinical application of ERAS. Methods We conducted a questionnaire study for nurses who attended the First West China Forum on Chest ERAS in Chengdu during September 26-27, 2016 and 259 questionnaires were collected for descriptive analysis. Results （1） The application status of ERAS： There were 13.5% responders whose hospital took a wait-an-see attitude, while the others＇ hospital took different actions for ERAS; 85.7% of nurses believed that ERAS in all surgeries should be used; 58.7% of nurses believed that the concept of ERAS was more in theory than in the practice; 40.2% of nurses thought that all patients were suitable for the application of ERAS; （2） 81.9% of nurses believed that the evaluation criteria of ERAS should be a combination of the average hospital stay, patients’ comprehensive feelings and social satisfaction; （3） 70.7% of nurses thought that the combination of subjects integration, surgery orientation and surgeon-nurse teamwork was the best model of ERAS; 44.8% of nurses thought the hospital administration was the best way to promote ERAS applications; （4） 69.1% of responders believed that immature plan, no consensus and norms and insecurity for doctors were the reasons for poor compliance of ERAS; 79.5% of nurses thought that the ERAS meeting should include the publicity of norms and consensus, analysis and implementation of projects and the status and progress of ERAS. Conclusion ERAS concept has been recognized by most nurses. Multidisciplinary collaboration and hospital promotion is the best way to achieve clinical applications.