提早开胸患者术后下床活动时间

Moving up Postoperative Off-Bed Ambulation among Patients with Thoracotomy

针对开胸患者术后下床活动延迟现状,收集数据,明确疼痛与患者不愿下床活动为主要症结。召开头脑风暴会议,通过原因分析、要因选定、真因验证,确定了制度、流程、宣教等7条真因。多方拟定对策,从5方面改进:疼痛评估、完善制度、修订流程、制定作业指导书、设计宣教手册等。使胸外科开胸患者术后下床活动时间从3.16天提前至1.24天,降低了患者开胸术后并发症发生率,促进了患者快速康复。

According to the delayed postoperative off-bed ambulation in patients with thoracotomy, data were collected to clarify the main problems of pain and the patient＇s reluctance to get out of bed. A brainstorming session was held. Through the analysis of causes, selection of major causes, and verification of true causes, seven real reasons such as systems, processes, and missions were identified. The countermeasures were developed by many ways with five aspects of improvement： pain assessment; system improvement; revision of the process; the formulation of work instructions; and design of education booklet. The postoperative off-bed ambulation among patients with thoracotomy was advanced from 3.16 days to 1.24 days, which reduced the postoperative complications of thoracotomy and promoted the patient＇s rapid recovery.