加速康复外科护理执行单在食管癌围手术期的应用

Clinical application of accelerated rehabilitation surgical nursing execution sheet in perioperative period of esophageal cancer

目的基于加速康复外科(Enhanced Recovery After Surgery,ERAS)理念,设计食管癌围手术期护理执行单,嵌入护理信息系统后进行临床应用。方法成立研究小组,设计食管癌ERAS护理执行单,并进行信息化构建。执行单上线使用3个月后,采用便利抽样法调查92名胸外科护士的使用接受度,以及执行单对护士ERAS知信行的影响;调取367份护理执行单数据,分析ERAS护理项目执行情况。结果执行单信息上线使用后,护士对表单的使用接受度为91.21%(82.41%~96.55%),ERAS知信行水平为(4.36±1.07)分,较使用前的(3.27±1.00)分有提高,差异有统计学意义(t=7.139,P<0.001);食管癌围手术期执行单各项目执行率为19.4%~95.4%,平均执行率为80.24%,各项目执行情况差异较大。结论本研究设计的护理执行单上线使用后,使用护士接受度高,有助于改善使用护士的ERAS认知和行为,并了解临床ERAS执行情况。

Objective Based on the concept of enhanced recovery after surgery(ERAS),a perioperative nursing execution sheet for esophageal cancer was designed and embedded in the nursing information system for clinical application.Methods A research group was established to design an ERAS nursing execution sheet for esophageal cancer and carry out information construction.Three months after the implementation of the execution sheet was put online,the convenience sampling method was used to investigate the acceptance of the use of 92 thoracic surgery nurses,and the effect of the execution sheet on the nurses’ERAS knowledge-attitude-practice(KAP).Data from 367 nursing execution sheets were collected to analyze the implementation of ERAS nursing programs.Results After the implementation of the execution sheet was put online,the acceptance rate of nurses in the use of the form was 91.21%(82.41%-96.55%),and the level of ERAS KAP was(4.361.07),which was higher than that before the use(3.271.00),and the difference was statistically significant(t=7.139,P<0.001).The implementation rate of each project in the perioperative execution sheet for esophageal cancer was 19.4%-95.4%,the average implementation rate was 80.24%,and the implementation rate of each project varied greatly.Conclusion After the nursing execution sheet designed in this study is used online,the acceptance of nurses is high,which is helpful to improve the awareness and behavior of users in ERAS and facilitate the understanding of clinical ERAS implementation.