“图文式护理准备清单”在腹腔镜活体供肝获取术中的应用

Clinical application of"picture-type nursing preparation checklist"in laparoscopic living donor hepatectomy

目的:探讨手术室护理人员使用"图文式护理准备清单"在提升腹腔镜活体供肝获取术(LLDH)手术配合能力,进而提高手术医师满意度的效果分析。方法:选取首都医科大学附属北京友谊医院2020年1月至2022年2月由同一医护团队完成的100例LLDH供者作为研究对象。将2020年1月至2021年1月期间进行手术的50例供者作为对照组,术前、术中使用"文字式护理准备清单";将2021年2月至2022年2月期间进行手术的50例供者作为观察组,术前、术中使用"图文式护理准备清单"。记录两组供者术前准备时间、术中暂停时间和有效手术时间。术毕向手术医师发放手术室护理工作满意度调查问卷。正态分布计量资使用成组t检验进行比较,计数资料采用χ^(2)检验进行比较。P<0.05为差异有统计学意义。结果:对照组供者术前准备时间平均为(63.2±11.2)min,手术床准备不当以及手术相关设备和器械台车摆放位置不合理占时较长,分别为(3.2±0.7)、(11.6±1.5)和(7.4±0.8)min。术中暂停时间平均为(5.2±2.2)min,腔镜用超声吸引刀连接不熟练导致检测通过率较低及腔镜用Hem-o-lok取夹钳忘记准备遗忘占时较长,分别为(1.9±0.4)和(1.2±0.2)min。有效手术时间平均为(182.8±20.6)min。观察组采用"图文式护理准备清单"管理后,LLDH术前准备时间、术中暂停时间均较对照组显著降低,分别为(48.4±8.4)与(63.2±11.2)min、(3.1±1.7)与(5.2±2.2)min,差异均有统计学意义(t=7.475和5.341,P均<0.05)。两组有效手术时间差异无统计学意义(t=1.584,P>0.05)。观察组与对照组手术医师反馈率均为100%,对于手术室护理工作满意度评分分别为(93.4±4.1)和(85.6±5.2)分,差异有统计学意义(t=8.330,P<0.05)。结论:"图文式护理准备清单"可有效减少LLDH术前、术中准备时间,提升手术医师对手术室护理工作满意度,保障手术患者安全。

Objective:To explore the effect of"picture-type nursing preparation checklist"used by operating room nurses in improving surgical cooperation ability and satisfaction of surgeons in laparoscopic living donor hepatectomy(LLDH).Methods:One hundred LLDH donors admitted by the same medical team from January 2020 to February 2022 at Beijing Friendship Hospital were selected as the research subjects.Fifty donors who underwent surgery from January 2020 to January 2021 were selected as the control group,and a"literal nursing preparation list"was used before and during the surgery;fifty donors who underwent surgery from February 2021 to February 2022 were selected as the observation group,and a"picture-type nursing preparation checklist"was used before and during the surgery.The preoperative preparation time,intraoperative pause time,and effective surgical time of the above two groups were recorded.A satisfaction survey questionnaire on operating room nursing work was distributed to surgeons after surgery.The measurement data of normal distribution was compared with group t test,and the counting data were compared with chi-square test.P<0.05 was considered as statistically significant.Results:The average preoperative preparation time in the control group was(63.2±11.2)min.Improper preparation of the operating table,improper placement of operation-related equipment and instrument trolley took up a longer time,which were(3.2±0.7),(11.6±1.5),and(7.4±0.8)min,respectively.The average intraoperative pause time was(5.2±2.2)min.The inexperience in connecting the endoscope with an ultrasound suction knife resulted in a low detection pass rate and a longer time for forgetting to prepare the Hem-o-lok clamps for the endoscope,which were(1.9±0.4)and(1.2±0.2)min,respectively.The average effective surgical time was(182.8±20.6)min.After the observation group was managed with a"picture-type nursing preparation checklist",the preoperative preparation time and intraoperative pause time of LLDH were significantly reduced compared to the control group,which were(48.4±8.4)and(63.2±11.2)min,(3.1±1.7)and(5.2±2.2)min,respectively,the differences were statistically significant(t=7.475 and 5.341,P all<0.05).There was no statistically significant difference in effective surgical time between the two groups(t=1.584,P>0.05).The feedback rates of surgeons in the observation group and the control group were both 100%,and the satisfaction scores for operating room nursing work of the observation group and the control group were(93.4±4.1)and(85.6±5.2)scores,respectively,with a statistically significant difference(t=8.330,P<0.05).Conclusions:The"picture-type nursing preparation checklist"can effectively reduce the preparation time before and during LLDH,improve the satisfaction of surgeons on the nursing work in the operating room,and ensure the safety of surgical patients.