基于专家共识围手术期预防术中低体温护理措施实施现状

Status quo of implementing perioperative nursing measures to prevent intraoperative hypothermia based on expert consensus

目的了解熟悉手术室患者围手术期术中保暖措施的应用情况,寻找目前护理实践工作与专家共识之间的差距和造成差距的原因。方法2021年3—11月,采用田野研究方法对石家庄市某三级甲等医院手术室护理工作进行为期8个月的参与式观察与访谈,对田野笔记与访谈内容应用质性研究三级编码的方法进行分析。结果通过对368例围手术期患者低体温预防的观察,了解目前围手术期预防低体温的相关措施,析出风险评估类、环境准备类、个性化设置类保温措施与专家共识和手术室护理实践指南基本一致,但有些方面(如输注液体加温、被物覆盖等)仍有较大发展空间。结论手术室护士在低体温防治中发挥着主力军的作用,只有不断加强手术室护士预防围手术期低体温意识,使预防保温措施恰当应用,才能从根本上解决围手术期低体温问题。

Objective To understand the application of intraoperative warming measures for patients in the operating room during perioperative period,and find out the gap between current nursing practice and expert consensus and the reasons for the gap.Methods From March to November 2021,adopted the field research method to conduct an 8-month participant observation and interview on the nursing work in the operating room of a third-grade class-A hospital in Shijiazhuang City,and analyzed the field notes and interview contents with the three-phase coding method in qualitative research.Results Through the observation on 368 patients undergoing perioperative hypothermia prevention,we learned about the current measures related to perioperative hypothermia prevention.It was found that the risk assessment,environmental preparation,and personalized thermal insulation measures were basically consistent with those included in the expert consensus and the operating room nursing practice guide,but there was still a large potential for development in some aspects(such as infusion fluid heating,quilt covering,etc.).Conclusion The nurses in the operating room play a major role in the prevention and treatment of hypothermia.Only by continuously strengthening the awareness of the nurses in the operating room to prevent perioperative hypothermia and making proper use of preventive measures can the problem of perioperative hypothermia be fundamentally solved.