“图画式护理准备清单”在脊柱内镜日间手术中的应用

Application of"pictorial nursing preparation list"in spine endoscopic day surgery

目的:探讨“图画式护理准备清单”在脊柱内镜日间手术中的应用效果。方法:采用便利抽样法,选取2021年3-5月行日间脊柱内镜下腰椎间盘切除手术病人为对照组,2021年6-7月行日间脊柱内镜下腰椎间盘切除手术病人为观察组。对照组采用原有的“文字式护理准备清单”管理方案,观察组采用自制“图画式护理准备清单”管理方案,分别记录2组脊柱内镜日间手术从病人入室至手术开始的术前准备时间(T_(1)),术中因物品缺少手术停顿等待时间(T_(2)),有效手术时间(T_(3))和术毕手术医生对护理满意度评分,并进行统计分析。结果:对照组T_(1)为(14.70±5.26)min,占时最长的步骤为手术床摆放错误、C臂机摆放错误和找不到标记笔;T_(2)为(6.11±2.16)min,术中占时最长的为局麻药准备不足、手术贴膜准备错误及光源影像机连接不熟练;T_(3)为(56.51±8.98)min,手术医生对护理满意度评分为(85.12±4.78)分。采用“图画式护理准备清单”后,观察组T_(1)为(12.53±4.68)min,T_(2)为(4.96±2.04)min,较对照组明显缩短(P<0.05);手术医生对护理满意度评分为(92.41±4.29)分,较对照组升高(P<0.05)。结论:通过观察总结的“图画式护理准备清单”可显著降低脊柱内镜日间手术的“无效”时间,规范手术流程,提升日间手术接台效率,可推广至其他内镜类日间手术流程。

Objective:To explore the application effect of"pictorial nursing preparation list"in day surgery of spinal endoscopy.Methods:Using a convenience sampling method,patients who underwent day spinal endoscopic lumbar discectomy from March to May 2021 were selected as the control group,and patients who underwent day spinal endoscopic lumbar discectomy from June to July 2021 were selected as the observation group.The control group used the original"written nursing preparation list"management program,and the observation group used the"pictorial nursing preparation list"management program.The preoperative preparation time from patient admission to the start of surgery(T_(1)),intraoperative waiting time due to lack of items(T_(2)),effective operative time(T_(3))and postoperative surgeon′s satisfaction with care scores were recorded separately for the 2 groups of spinal endoscopic day surgery,and statistical analysis was performed.Results:In the control group,T_(1)was(14.70±5.26)min,and the longest steps accounted for were wrong placement of the operating bed,wrong placement of the C-arm machine,and inability to find the marker pen;T_(2)was(6.11±2.16)min,and the longest intraoperative steps accounted for were insufficient preparation of local anesthetics,wrong preparation of the surgical patch,and unskilled connection of the light source imaging machine;T_(3)was(56.51±8.98)min and postoperative surgeon satisfaction score with nursing was(85.12±4.78)points.After using the"pictorial nursing preparation list",T_(1)and T_(2)in the observation group[(12.53±4.68)min,(4.96±2.04)min]were significantly lower than those in the control group(P<0.05),and the surgeon′s satisfaction score was significantly increased compared with the control group[(92.41±4.29)points,P<0.05].Conclusions:The"pictorial nursing preparation list"can significantly reduce the"ineffective"time of spinal endoscopic day surgery,standardize the surgical process,improve the efficiency of day surgery table,and can be extended to other endoscopic day surgery processes.