改进护理查对记录表在腹部外科手术患者医源性感染预防中的应用

Improved nursing checkup record table in prevention of nosocomial infection in patients undertaking abdominal surgery

目的探讨改进护理查对记录表在腹部外科手术患者的应用。方法2016年1月至2016年12月对本院原有的护理查对记录表进行简化及改进，并将改进的护理查对记录表应用在腹部外科手术患者中，改进前后对腹部外科患者护理质量及满意度的影响比较。结果改进后腹部外科手术患者医源性感染、护理纠纷、护理风险事件发生率分别为2．50％、0．83％、1．67％明显低于改进前10．00％、8．33％、10．83％，差异有统计学意义（P〈0．05）；而患者满意率为95．83％高于改进前85．00％，差异有统计学意义（P〈0．05）。改进后外科护士在病房管理、基础护理、病历书写、护理记录、意外风险处理及总护理质量等方面评分分别为（17．22±3．96汾、（18．36±4．55）分、（17．55±4．22汾、（16．23±4．56）分、（13．92±3．26）分、（76．25±10．96）分明显高于改进前（12．69±2．25）分、（10．45±1．78）分、（11．85±2．56）分、（10．69±3．12）分、（9．69±4．36）分、（53．48±5．23）分，差异有统计学意义（P〈0．05）。结论护理查对记录表的应用可提高腹部外科手术患者护理质量，降低患者术后医院性感染的发生，提高患者满意度。

Objective To investigate the application improved nursing checkup record table in patients undertaking abdominal surgery. Methods From January to December, 2016, the original nursing checkup record table were simplified and improved and was applied in patients undertaking abdominal surgery. The nursing quality and satisfaction were compared between before and after the improvement. Results The incidences of nosocomial infection, nursing dispute, and nursing risk event were 2.50%, 0.83%, and 1.67% after the improvement, which were lower than those before the improvement （10.00%, 8.33%, and 10.83%）, with statistical differences （all P 〈 0.05）. The satisfaction was higher after than before the improvement （95.83% vs. 85.00%）, with a statistical difference （P 〈 0.05）. The scores of ward management, basic nursing, medical record writing, nursing record, accidental risk management, and total nursing quality of the surgical nurses were （ 17.22±3.96 ） , （ 18.36±4.55 ） , （ 17.55±4.22 ） , （ 16.23±4.56 ） , （ 13.92±3.26 ） , and （ 76.25±10.96 ） after the improvement and were （ 12.69±2.25 ） , （ 10.45±1.78 ） , （ 11.85±2.56 ） , （ 10.69±3.12 ） , （ 9.69±4.36 ） , and （ 53.48±5.23 ） before the improvement, with statistical differences （ all P 〈 0.05 ） . Conclusion The application of improved nursing checkup record table can improve the nursing quality, decrease the incidence of nosocomial infection, and increase the patients＇ satisfaction.