无缝隙护理配合模式应用于心脏瓣膜置换术中的作用评价

Evaluation on Effect of Seamless Nursing Cooperation Model in the Cardiac Valve Replacement

目的探讨在心脏瓣膜置换术中实施无缝隙护理配合模式的作用及效果。方法以甘肃省天水市第一人民医院手术室2013年2月—2017年7月收治的80例实施心脏瓣膜置换术患者作为受试者,借助随机数字表分为2组。参考组实施常规护理配合,无缝隙组实施无缝隙护理配合模式。以准时手术率和手术配合度、手术时间、术中不良事件发生率、医生对护理配合的满意度作为观察指标。结果无缝隙组准时手术率远高于参考组(100.00%vs 85.00%,χ~2=4.505,P=0.034),无缝隙组完全配合、部分配合和完全不配合者分别有38例、2例和0例,参考组分别为31例、6例和3例,完全配合率分别为95.00%和77.50%,手术配合度分布及完全配合率组间对比差异有统计学意义(χ~2=5.165,P=0.023);无缝隙组和参考组手术时间分别为(135.6±12.4)min和(152.4±11.9)min,差异有统计学意义(t=12.907,P=0.000);无缝隙组低血压、物品准备不全、物品管理不当发生率分别为5.00%、0.00%、0.00%,参考组分别为17.50%、12.50%、15.00%,对比差异有统计学意义(χ~2=3.286,P=0.047;χ~2=5.333,P=0.021;χ~2=6.486,P=0.011);无缝隙组医生对护理配合非常满意、尚可、不满意者分别有32例、6例、2例,参考组分别有23例、9例、8例,总满意率分别为95.00%、80.00%,对比差异有统计学意义(χ~2=4.114,P=0.043)。结论对心脏瓣膜置换术治疗的患者给予无缝隙护理配合模式能够保证准时手术,提高配合度,缩短手术时间并减少不良事件,还可提高医生对护理配合的满意度。

Objective To study the effect of seamless nursing cooperation model in the cardiac valve replacement.Methods 80 cases of patients with cardiac valve replacement admitted and treated in our hospital from February 2013 to July 2017 were selected and randomly divided into two groups, the control group used the routine nursing, while the seamless group used the seamless nursing, and the on-time operation rate, operation cooperation degree, operation time,incidence rate of intraoperative adverse events, and satisfactory degree of doctors to the nursing cooperation were observed. Results The on-time operation rate in the seamless group was much higher than that in the control group,（100.00% vs 85.00%,χ^2=4.505,P=0.034）, and the complete cooperation, partial cooperation and complete in-cooperation in the seamless group and in the control group were respectively（38 cases, 2 cases, 0 cases vs 31 cases, 6 cases and 3 cases）, and the complete cooperation rate was respectively 95.00% vs 77.50%, and the differences in the distribution of operation cooperation and complete cooperation rate were statistically significant（χ^2=5.165,P=0.023）, and the difference in the operation time between the seamless group and the control group was statistically significant [（135.6±12.4）min vs（152.4±11.9）min]（t=12.907,P=0.000）; and the differences in the incidence rates in the hypotension, incomplete material preparation and improper material management between the seamless group and the control group were statistically significant [5.00%,0.00%,0.00% vs 17.50%,12.50%,15.00%]（χ^2=3.286,P=0.047; χ^2=5.333,P=0.021; χ^2=6.486,P=0.011）; in the seamless group, 32 cases of doctors were very satisfied with the nursing cooperation, 6 cases were satisfied with the nursing cooperation ad 2 cases were unsatisfied with the nursing cooperation, in the control group, 23 cases were very satisfied with the nursing cooperation, 9 cases were satisfied with the nursing cooperation and 8 cases were unsatisfied with the nursing cooperation, and the total satisfied rate was respectively 95.00% vs 80.00%, and the difference was statistically significant（χ^2=4.114,P=0.043）. Conclusion The seamless nursing cooperation model in patients treated with cardiac valve replacement can ensure the one-time surgery, improve the cooperation degree, shorten the operation time,reduce the adverse events, and improve the satisfied degree of doctors to the nursing cooperation.