误吸风险筛查闭环路径管理在神经外科患者护理中的应用效果

Application effect of close-loop path management of aspiration risk screening in patients in Department of Neurosurgery

目的构建神经外科患者误吸风险筛查闭环路径管理模式,并验证其在神经外科住院患者护理中的应用效果。方法通过文献检索与专家咨询,构建误吸风险筛查闭环路径管理模式。采用便利抽样法选取2019年1-12月广东省江门市某三甲医院神经外科住院患者,将2019年1-6月的患者设为对照组,接受常规的误吸评估与管理;将2019年7-12月的患者设为观察组,接受误吸风险筛查闭环路径管理。比较两组患者的误吸发生率和吸入性肺炎发生率。结果对照组共有506例患者,其中92例(18.18%)发生了误吸;观察组共有543例患者,其中74例(13.63%)发生了误吸,两组患者的误吸发生率比较,差异有统计学意义(χ^2=4.078,P=0.043)。对照组吸入性肺炎发生率为8.10%(41/506),观察组吸入性肺炎发生率为5.52%(30/543),两组比较差异无统计学意义(χ^2=2.758,P=0.097)。结论误吸风险筛查闭环路径管理规范了误吸风险筛查工作的流程,保障了动态评估的实施,有效降低了患者误吸的发生率,能够为提高患者误吸防治管理水平提供参考。

Objective To construct a close-loop path management model for aspiration risk screening of patients in Department of Neurosurgery,and verify its application effect in the nursing of inpatients in department of neurosurgery.Methods Through literature retrieval and expert consultation,the close-loop path management model of aspiration risk screening was constructed.The convenient sampling method was adopted to select inpatients in the Neurosurgery Department of a ClassⅢGrade A hospital in Jiangmen of Guangdong Province from January to December 2019.The patients admitted from January to June 2019 were set as the control group and received routine aspiration assessment and management while the patients admitted from July to December 2019 were set as the observation group and received close-loop management of aspiration risk screening.The incidences of aspiration and aspiration pneumonia were compared between the two groups.Results In the control group,there were 506 patients,of whom 92(18.18%)had aspiration.In the observation group,there were 543 patients,of whom 74(13.63%)had aspiration.There was a statistically significant difference in the incidence of aspiration between the two groups(χ^2=4.078,P=0.043).The incidence of aspiration pneumonia was 8.10%(41/506)in the control group and 5.52%(30/543)in the observation group.There was no statistically significant difference between the two groups(χ^2=2.758,P=0.097).Conclusions The close-loop management of aspiration risk screening standardizes the process of aspiration risk screening,guarantees the implementation of dynamic assessment and effectively reduces the incidence of aspiration,which can provide a reference for improving the management level of prevention and treatment of aspiration.