急性心肌梗死静脉溶栓程序化管理

Procedural nursing management of intravenous thrombolytic therapy in acute myocardial infarction

目的 探讨急性心肌梗死 (AMI)静脉溶栓程序化护理管理模式的应用价值。方法 根据AMI诊疗过程各时期对护理工作的不同要求 ,制定一套程序化护理管理模式。将连续的护理过程划分为接诊准备及接诊 -溶栓前准备及溶栓 -溶栓后观察相对独立的三个阶段 ,针对每一阶段特点制定内容详尽而又重点突出的护理计划 ;建立管理程序评价制度 ,对护理工作及时进行考评和监督。结果 此项护理管理程序的应用明显缩短了接诊到开始溶栓的时间 (doortoneedletime) ;能指导护士及时发现各种并发症 ,提高了护理工作的预见性 ;管理程序评价制度的实施 ,保证了各阶段护理程序的落实。结论 该模式实用性强 。

Objective To explore the clinical value of procedural nursing management during intravenous thrombolytic therapy of acute myocardial infarction (AMI).Method A suit of procedural nursing pattern was programmed according to the different demands on nursing in proceeding of intravenous thrombolysis.The continuous course of intravenous thrombolytic treatment was divided into three relative independent stages,that is,preparation before admission to CCU,preparation before thrombolysis and observations of thrombolytic therapy,and detailed nursing plans worked out according to the character of each stage,and the effects of nursing evaluated immediately after carried out each procedure.Result The procedural nursing pattern shortens the door to needle time and directs nurses to find all kinds of complication immediately and improve the calculation of nursing.Implement the procedural management evaluation to ensure the fulfillment of nursing process in different level.Conclusion Our clinical experience demonstrates that this pattern is feasible and can ensure the proceeding of intravenous thrombolytic therapy rapidly and safely in patients with AMI.