医护患一体化管理模式在神经外科躁动患者管理中的应用价值

Effectiveness of doctor-nursing-patient integration model in the management of agitated patients in neurosurgery

目的探讨神经外科躁动患者管理中应用医护患一体化管理模式的临床效果。方法选取2020年10月至2021年10月收治的86例神经外科重症颅脑损伤躁动患者纳入研究。按随机数字表法分为对照组和观察组,每组43例。对照组采用常规护理,观察组采用医护患一体化管理模式,比较2组的Riker镇静和躁动评分量表(RSAS)评分、医用管道的意外拔管情况、不良事件发生率、一般自我效能感量表(GSES)评分和护理满意度。结果观察组和对照组干预后的RSAS评分分别为(1.15±0.11)分和(1.49±0.23)分,2组的RSAS评分低于干预前,且观察组的RSAS评分低于对照组(P<0.05)。观察组医用管道的意外拔管率低于对照组,差异有统计学意义(P<0.05)。观察组不良事件发生率为2.33%,低于对照组的18.60%,差异有统计学意义(P<0.05)。观察组和对照组干预后的GSES评分分别为(36.86±3.17)分和(30.75±3.13)分,2组的GSES评分高于干预前,且观察组的GSES评分高于对照组,差异有统计学意义(P<0.05)。观察组和对照组护患沟通评分分别为(3.61±0.22)分和(2.89±0.16)分,护理服务态度评分分别为(3.57±0.22)分和(2.76±0.17)分,心理干预评分分别为(3.47±0.12)分和(2.89±0.15)分,健康宣教评分分别为(3.56±0.11)分和(2.51±0.06)分,护理操作技能评分分别为(3.55±0.13)分和(2.76±0.05)分,护理满意度总评分分别为(18.12±0.15)分和(16.47±0.22)分,观察组的护理满意度评分高于对照组,差异有统计学意义(P<0.05)。结论神经外科躁动患者管理中应用医护患一体化管理模式,能有效缓解患者躁动症状,降低医用管道意外拔管和不良事件发生率,提高患者自我效能感和护理满意度。

Objective To investigate the clinical effect of doctor-nursing-patient integration model in the management of agitated patients in neurosurgery.Methods A total of 86 patients with severe craniocerebral injury and agitation admitted to the Neurosurgery Department from October 2020 to October 2021 were enrolled.They were randomly assigned into the control group(n=43)and observation group(n=43).Routine nursing and doctor-nursing-patient integration model were performed in the control group and observation group,respectively.The Riker Sedation-Agitation Scale(RSAS)scores,accidental extubation of medical tubing,incidence of adverse events,General Self-Efficacy Scale(GSES)score and nursing satisfaction in both groups were compared.Results The RSAS scores of the observation group and the control group after intervention were 1.15±0.11 points and 1.49±0.23 points,respectively.The RSAS scores of the two groups were significantly lower than those before intervention,which were significantly lower in the observation group than those of the control group(P<0.05).The accidental extubation rate of medical tubing in the observation group was significantly lower than that of the control group(P<0.05).The incidence of adverse events in the observation group was significantly lower than that of the control group(2.33%vs 18.60%,P<0.05).The GSES scores of the observation group and the control group after the intervention were 36.86±3.17 points and 30.75±3.13 points,respectively.The GSES scores of the two groups were significantly higher than those before the intervention,which were significantly higher in the observation group than those of the control group(P<0.05).Nursing satisfaction was significantly higher in the observation group than that of control group,presenting as higher nurse-patient communication scores(3.61±0.22 points vs 2.89±0.16 points),nursing service attitude scores(3.57±0.22 points vs 2.76±0.17 points),psychological intervention scores(3.47±0.12 points vs 2.89±0.15 points),health education scores(3.56±0.11 points vs 2.51±0.06 points),nursing procedure skill scores(3.55±0.13 points vs 2.76±0.05 points)and total nursing satisfaction scores(18.12±0.15 points vs.16.47±0.22 points)(P<0.05).Conclusion The application of doctor-nursing-patient integration mode in the management of agitated patients in neurosurgery can effectively alleviate agitation symptoms,reduce the incidence of accidental extubation of medical tubing and adverse events,and improve the self-efficacy and nursing satisfaction.