医护患加速康复临床护理路径在肺癌胸腔镜切除患者中的应用

Doctor-nurse-patient accelerated rehabilitation clinical nursing pathway in patients with thoracoscopic resection of lung cancer

目的构建并评价以导航护士为主导的医护患加速康复临床护理路径在肺癌胸腔镜切除患者围手术期管理中的作用。方法采用方便抽样法选取2022年7月—2023年7月在某三级甲等医院行胸腔镜切除术的肺癌患者128例为研究对象,按照患者入院的先后顺序,其中2022年7月—2023年1月入院的患者为对照组,2023年2-7月入院的患者为观察组,每组64例。对照组根据科室制定的常规护理措施实施护理,观察组梳理“医-护-患”三个角色需要完成的内容,构建导航护士主导实施的加速康复临床护理路径并开展培训与实施,比较2组的干预效果。结果2组患者术后首次下床时间、尿管拔除时间、胸管留置时间、术后中度及以上疼痛发生率、住院费用、住院时间、加速康复外科(enhanced recovery after surgery,ERAS)满意度比较均有统计学意义(P<0.05)。结论实施医护患加速康复临床护理路径保障了患者围手术期加速康复护理措施的有效实施,有利于患者的康复进程,缩短住院时间,减少住院费用,提高患者满意度。

Objective To construct and evaluate the effect of doctor-nurse-patient accelerated rehabilitation clinical nursing pathway for patients led by navigation nurses in the perioperative management of patients with thoracoscopic resection of lung cancer.Methods Using a convenience sampling method,128 lung cancer patients who underwent thoracoscopic resection at a tertiary hospital from July 2022 to July 2023 were selected as the study subjects.According to the order of admission,patients admitted from July 2022 to January 2023 were assigned to the control group,and patients admitted from February 2023 to July 2023 were assigned to the observation group,with 64 patients in each group.The control group implemented nursing according to routine nursing measures formulated by the department,while the observation group doctor-nurse-patient accelerated rehabilitation clinical nursing pathway guided by navigation nurses.The intervention effects of the two groups were compared.Results There were statistical significance in the first time of out of bed,urinary catheter removal time,chest tube retention time,incidence of moderate or severe postoperative pain,hospitalization expense,hospitalization duration and satisfaction with enhanced recovery after surgery(ERAS)between the two groups(P<0.05).Conclusion Doctor-nurse-patient accelerated rehabilitation clinical nursing pathway for patients guarantees the effective implementation of accelerated rehabilitation nursing measures in perioperative period,and it is conducive to the rehabilitation of patients,and is worthy of clinical promotion.