机器人辅助手术的护士培训方案构建及应用

Construction and application of a training program for nurses in robotic-assisted surgery

目的构建机器人辅助手术(robotic-assisted surgery,RAS)的护士培训方案并探讨其应用效果。方法基于文献回顾法和半结构式访谈法构建RAS的护士培训方案初稿。于2022年2月—4月,运用专家函询法对26名专家进行2轮函询,形成RAS的护士培训方案。采用便利抽样法,将2022年4月—7月在某三级甲等医院接受RAS配合培训的32名手术室护士作为对照组,将2022年8月—11月在该院接受同类培训的32名手术室护士作为试验组。对照组接受常规培训,试验组接受基于RAS的护士培训方案打造的培训,比较两组培训效果。结果2轮专家函询的问卷有效回收率均为100%;专家权威系数为0.933;肯德尔协调系数分别为0.261、0.312(P<0.001)。最终构建的RAS的护士培训方案由6个模块及其下设的85个条目构成。培训后,试验组理论考核得分、RAS系统无菌罩安装时间、RAS系统内镜校准操作时间、RAS系统入位操作时间、RAS系统入位一次成功率、RAS术前截石位摆放操作考核得分优于对照组(均P<0.05)。结论RAS的护士培训方案较为科学、可靠,其运用有助于提升护士配合RAS的知识与技能水平,提高培训效果。

Objective To develop a training program for nurses to assist in robotic-assisted surgery and explore its application effect.Methods The initial draft of the training program for nurses assisting in robotic-assisted surgery was constructed based on literature review and semi-structured interviews.From February to April 2022,a total of 26 experts were consulted through two rounds of expert consultation to finalize the training program.In application,32 operating room nurses who received training in robotic-assisted surgery cooperation in a tertiary hospital from April to July 2022 were assigned to the control group,while another 32 operating room nurses who received similar training in the same hospital from August to November 2022 were assigned to the experimental group.The control group received routine training,while the experimental group received training based on the training program for nurses assisting in robotic-assisted surgery.The training effects of the two groups were compared afterward.Results The effective recovery rate of the questionnaires for the two rounds of expert consultation was 100%.The expert authority coefficient was 0.933,and the Kendall's coordination coefficient was 0.261 and 0.312(P<0.001),respectively.The final training program for nurses assisting in robotic-assisted surgery consisted of six modules and 85 sub-items.After the training,the experimental group performed better than the control group in terms of theoretical assessment scores,installation time of the robotic-assisted surgery system's sterile hood,calibration time for endoscopic operations using the robotic-assisted surgery system,operation time for robotic-assisted surgery system positioning,first-attempt success rate for robotic-assisted surgery system positioning,and assessment scores for preoperative lithotomy position placement using the robotic-assisted surgery system(all P<0.05).Conclusion The development of the training program for nurses assisting in robotic-assisted surgery is scientific and reliable.In application it is helpful to improve nurses'knowledge and skills in assisting robotic-assisted surgery and enhance the training effect.