临床护理路径在胰腺癌手术患者中的应用效果研究

发布时间：2018-06-21 20:21

本文选题：临床护理路径 + 胰腺癌手术患者　；参考：《华北理工大学》2017年硕士论文

【摘要】：目的在胰腺癌手术患者中应用临床护理路径,以进一步探讨临床护理路径对胰腺癌手术患者的平均住院天数、平均住院费用、健康知识水平、对护理人员的护理服务质量满意度、术后常见并发症、术后自理能力恢复情况的临床应用效果。为护理人员实施临床护理路径的有效干预提供依据。方法选取2015年7月1日～2016年12月30日期间在唐山市人民医院和唐山市开滦医院肝胆外科住院治疗的18~80岁的胰腺癌(Pancreatic Cancer,PC)患者为研究对象,且诊断均符合第14版《实用内科学》中的诊断标准,共60人,均经临床护理路径小组培训的医师确诊并进行评估可行手术治疗。将入选的手术患者按入院的先后顺序随机分为常规护理组和临床护理路径组,每组各30人。在基线调查的基础上,患者从入院到出院,常规护理组的手术患者采用一般常规护理,临床护理路径组的手术患者按照已制定的临床护理路径进行护理,包括:基础护理(Basic Nursing,BN)(级别护理、生命体征)、护理评估、医嘱执行(用药、治疗、检验、检查)、健康教育(Health Education,HE)等。患者出院时对手术患者平均住院费用,平均住院天数,手术患者的胰腺癌健康知识掌握情况,手术患者对护理人员的护理服务质量满意度,术后常见并发症,术后生活自理能力恢复情况进行调查和统计,以评价临床护理路径在实际临床工作中的应用效果。并使用SPSS18.0统计软件进行数据统计分析。结果干预前,两组手术患者的一般情况,本组研究对象共60例,常规护理组和临床护理路径组各30例。对其进行统计学分析,差异无统计学意义(P0.05),两组均衡可比。干预后,1)对两组手术患者的平均住院天数及住院费用进行比较:常规护理组手术患者平均住院天数为(24.78±4.48天),平均住院费用为(7.20±0.94万元),临床护理路径组手术患者平均住院天数为(19.35±3.45天),平均住院费用为(6.80±0.72万元),并进行统计学分析,差异有统计学意义(P0.05)。2)对两组手术患者的胰腺癌健康知识掌握情况,对护理人员的护理服务质量满意度,术后出现常见并发症,手术患者术后生活自理能力恢复情况进行比较,并进行统计学分析,差异均有统计学意义(P0.05)。结论临床护理路径在胰腺癌手术患者中的应用:1)减少了手术患者的平均住院天数及住院费用。2)提高了手术患者的胰腺癌健康知识水平及对护理人员的护理服务质量满意度。3)减少了手术患者术后常见并发症的出现,加快了患者术后自理能力的恢复。
[Abstract]:Objective to explore the average hospitalization days, average hospitalization cost and health knowledge of patients undergoing pancreatic cancer surgery by clinical nursing pathway. Effect of clinical application on nursing care quality satisfaction, postoperative complications and recovery of self-care ability of nursing staff. To provide the basis for the effective intervention of clinical nursing path. Methods from July 1, 2015 to December 30, 2016, 18 ~ 80 years old patients with pancreatic cancer, Pancreatic Cancerus, who were hospitalized in the Department of Hepatobiliary surgery, Tangshan people's Hospital and Kailuan Hospital, Tangshan City, were selected as the study subjects. All the diagnoses were in accordance with the diagnostic criteria in the 14th edition of practical Internal Medicine. 60 patients were confirmed by the doctors trained in the clinical nursing path group and evaluated the feasibility of surgical treatment. The patients were randomly divided into routine nursing group and clinical nursing path group with 30 patients in each group. On the basis of baseline investigation, the patients in the routine nursing group were treated with general routine nursing care, and the patients in the clinical nursing path group were nursing according to the established clinical nursing path from admission to discharge. These include: basic nursing, vital signs, nursing evaluation, medical advice (medication, treatment, testing, examination, health education), and so on. The average hospitalization cost, average hospitalization days, the health knowledge of the patients with pancreatic cancer, the satisfaction of the patients with nursing service, the common complications after operation, the average hospitalization cost, the average length of stay in hospital, the health knowledge of the patients, the quality of nursing care, the quality of nursing care, To evaluate the application of clinical nursing pathway in clinical work, the recovery of self-care ability after operation was investigated and counted. SPSS 18.0 statistical software was used for statistical analysis. Results before intervention, there were 60 cases in the study group, 30 cases in the routine nursing group and 30 cases in the clinical nursing path group. The statistical analysis showed that there was no significant difference between the two groups (P 0.05). After intervention, the average hospitalization days and hospitalization costs of the two groups were compared: the average hospitalization days were 24.78 卤4.48 days in the routine nursing group, the average hospitalization cost was 7.20 卤9400 yuan in the clinical nursing path group, and the average hospitalization cost was 7.20 卤9400 yuan in the clinical nursing path group. The average hospitalization days were 19.35 卤3.45 days and the average hospitalization expenses were 6.80 卤7200 yuan. The difference was statistically significant (P0.05. 2) the health knowledge of pancreatic cancer patients in the two groups were compared, and the satisfaction of nursing staff, the common complications after operation and the recovery of self-care ability of postoperative patients were compared between the two groups. The difference was statistically significant (P 0.05). Conclusion the application of clinical nursing pathway in patients with pancreatic cancer surgery: 1) can reduce the average hospitalization days and hospitalization costs of patients with pancreatic cancer, and improve the health knowledge level of pancreatic cancer patients and the nursing service quality of nursing staff. Volume satisfaction. 3) reduced the occurrence of common postoperative complications in patients undergoing surgery. The recovery of self-care ability after operation was accelerated.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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