早期预警评分-标准化沟通模型在食管癌住院患者病情观察中的应用研究

The application of MEWS scoring system in the observation of the condition of patients with cancer and esophageal cancer

目的应用早期预警评分(MEWS)-标准化沟通模型(SBAR)建立相应的监护方案及呼叫医生程序,对食管癌患者进行病情观察,预防术后并发症的发生,确保患者安全。方法选取肿瘤外科食管癌术后患者180例,采用随机表法分成对照组90例、实验组90例;对照组采用常规方法进行病情观察,实验组应用MEWS评分-SBAR沟通模型进行病情观察;比较2组患者ICU再入住率、平均住院日、患者满意度、护士病情观察能力和医生满意度。结果实验组患者住院期间ICU再入住率为3.4%,低于对照组的12.1%,差异有统计学意义(P<0.05);实验组患者平均住院日为(22.9±5.5)d,低于对照组的(30.3±7.3)d,差异有统计学意义(P<0.05);实验组患者满意度、护士病情观察能力、医生满意度分别为91.65%、93.3%、93.6%,均高于对照组的87.05%、80.2%、81.3%,差异有统计学意义(P<0.05)。结论 MEWS评分-SBAR沟通模型在肿瘤食管癌住院患者病情观察中的应用,为患者的病情评估提供了科学依据,提高了护士病情观察能力,降低了患者ICU再入住率,减少了食管癌患者平均住院日,提高了患者、医生满意度,保障了患者的安全。

Objective To apply MEWS scoring system to establish the corresponding monitoring program and call doctor pro- gram, and to ensure the patient safety. Methods t80 cases of postoperative esophageal cancer patients were selected, and randomly divid- ed into control and experiment group （n = 90）. The control group used routine method to observe the condition, MEWS scoring system was used to observe the condition of the experimental group. Compared the patients with ICU reentry rate ,average length of stay ,patient satisfac- tion,nurseb condition observation and active communication ability in two groups. Results Patients in the experiment group during hospi- talization ICU reentry rate was 3.4%, lower than that in control group of 12.1% （P 〈 0. 05 ）. The average length of stay in the experimen- tal group was 22.9 ±5.5 days,lower than that in control group of 30.3 ±7.3 days, the difference was statistically significant （P 〈0.05）.The patients＇ satisfaction, disease observation ability, nurses＇ initiative communication ability in experimental group was 91.65 % ,93.3 % and 96. 6% respectively, which were higher than those of the control group of 87. 05% , 80. 2% and 82. 4% （ P 〈 0. 05 ）. Conclusion Application of MEWS scoring system in the observation of the condition of patients with cancer and esophageal cancer can provide a scientific basis for the assessment of the patient~ condition ,reduce ICU reentry rate,improve patient satisfaction and the ability of observation and communication of the nurse~ condition and ensure the patient safety.