腰椎后路减压融合内固定术加速康复外科对骨科护士护理的知识、信念和行为的效果分析

Analysis of Effect of Knowledge,Belief and Behavior of Orthopaedic Nurses on Nursing Care of Patients Undergoing Posterior Lumbar Decompression Fusion and Internal Fixation in Enhanced Recovery After Surgery

目的探讨腰椎后路减压融合内固定术加速康复外科(enhanced recovery after surgery,ERAS)对骨科护士护理的知识、信念和行为(知信行)以及围术期安全性的影响。方法2019年8月我科开展腰椎后路减压融合内固定术ERAS,使用《外科医护人员ERAS知信行现状的调查问卷》对开展常规护理模式和ERAS模式的98名骨科护士知信行状况进行调查,分析开展EARS对患者围术期质量安全的影响。结果开展腰椎后路融合减压内固定术ERAS后,骨科护士知识得分优秀率由40.8%(40/98)提高到55.1%(54/98)(χ^2=4.007,P=0.045),患者住院时间由(7.6±3.5)d缩短到(7.3±2.4)d(t=2.444,P=0.015),并发症发生率由3.3%(32/958)降至1.4%(12/883)(χ^2=7.732,P=0.005)。结论开展腰椎后路融合减压内固定术ERAS有助于提高患者围术期质量安全及护士知信行状况。

Objective To investigate the effect of knowledge,belief and behavior of orthopedic nurses on nursing care of patients undergoing posterior lumbar decompression fusion and internal fixation in enhanced recovery after surgery(ERAS),and to evaluate the safety of ERAS management,formulation and implementation in perioperative period of spinal surgery.Methods In August 2019,the ERAS was implemented in our department in patients receiving posterior lumbar fusion decompression and internal fixation.The Questionnaire on the Status of ERAS on the Knowledge,Belief and Behavior of Surgical Staff were used to investigate the orthopaedic medical staff before and after the implementation of ERAS,so as to compare the effect of ERAS on the perioperative quality and safety of patients.Results After performing ERAS for lumbar posterior fusion and decompression and internal fixation,the excellent knowledge score of orthopaedic nurses increased from 40.8%(40/98)to 55.1%(54/98)(χ^2=4.007,P=0.045),the average length of stay of patients decreased from(7.6±3.5)days to(7.3±2.4)days(t=2.444,P=0.015),and the complication rate decreased from 3.3%(32/958)to 1.4%(12/883)(χ^2=7.732,P=0.005).Conclusion ERAS for posterior lumbar fusion decompression and internal fixation is helpful to improve the perioperative quality and safety of patients and the knowledge,belief and behavior of nurses.