跨学科团队合作处理复杂伤口的实践与效果

Pilot study on the model and effects of managing complex wounds with interdisciplinary team cooperation

目的:分析跨学科团队合作处理复杂伤口的方法和效果。方法:根据复杂伤口治疗需要建立跨学科合作团队,包括造口治疗师、外科医生、病理科医生等。所有纳入患者先由伤口护理中心造口治疗师进行评估和检查,分析判断患者的健康问题,采用互助式或菜单式合作模式,按需联系相关专家会诊,制定专科治疗方案和伤口护理方案。由伤口护理中心护士负责执行方案并评价效果,统计并分析合作模式实施3年中不同类型复杂伤口的治愈率和平均愈合时间,回顾性分析实施前3年同类伤口的结果作对照。结果:合作模式实施后3年与实施前3年分别处理628例和563例复杂伤口,总体治愈率提高13.63%(P<0.05),平均愈合时间缩短25.67 d(P<0.05)。结论:跨学科团队合作模式有助于提高复杂伤口治愈率、缩短愈合时间,是提高伤口护理效果的可行方法。

Objective： To explore the model and effects of managing complex wounds with interdisciplinary team cooperation. Methods： According to characteristic of complex wounds, an interdisciplinary team, including senior enterostomal therapist （ET）, surgeons and pathological physicians, was built. ET assessed and checked every patient at first, and then analyzed and recognized healthy problems, using “help each other or menu list mode” to contact with related surgeons or physicians to consult and make treatment protocols and wound care plan. Wound care nurses charged for carring out wound care plan, and evaluated wounds healing rate and healing time after interdisciplinary team cooperation. Retrospective analysis about different complex wounds healing rate and healing time was conducted with data before the interdisciplinary team setting up three years ago. Results： Before interdisciplinary team cooperation model, 563 patients with complex wounds were managed ,while with interdisciplinary team cooperation model, 628 complex wounds were managed. Total healing rate was by raised 13.63% （P〈0.05） and mean healing time was shortened 25.67 days （P〈0.05）. Conclusion： Interdisciplinary team cooperation model is beneficial to enhance wound healing rate and decrease healing time. It may be a good method to improve wound care results.