护理研究

SBAR沟通模式交接班联合护理质量指标管理对胆管结石患者护理质量、不良事件及并发症影响

Effect of SBAR communication mode combined nursing quality index management on nursing quality,adverse events and complications of patients with bile duct stones

:1210-1214
 
目的 探讨标准化沟通(SBAR)模式交接班联合护理质量指标管理在胆管结石患者中的应用效果及护理质量、不良事件及并发症影响。方法 选取天津市人民医院2021年1月—2022年12月收治的80例胆管结石患者,应用抽签法分为观察组与对照组,每组各40例。所有患者均采取手术治疗,其中对照组患者实施常规护理,观察组患者在对照组基础上增加SBAR沟通模式交接班联合护理质量指标管理。对比两组患者的护理质量、护理不良事件发生率、护理满意度及术后并发症发生率。结果 观察组基础护理、护理态度、护理责任心、风险识别能力、风险防范能力护理质量评分高于对照组(P<0.05);两组注射、口服给药差错、换药、抽血差错、病例书写错误以及执行医嘱不及时等护理不良事件发生率对比差异无统计学意义(P>0.05),观察组患者护理满意度高于对照组(P<0.05);观察组患者压疮、感染、静脉血栓等并发症发生率均低于对照组(P<0.05)。结论 SBAR沟通模式交接班联合护理质量指标管理针对胆管结石患者应用效果显著,可改善临床护理质量,同时患者护理满意度较高,进一步降低患者术后并发症发生率。
Objective To investigate the application effect of SBAR communication mode shift combined with the management of care quality indicators on patients with bile duct stones and their influence on postoperative complications. Methods Eighty patients with bile duct stones admitted to our hospital from January 2021 to December 2022 were selected,and divided into observation group and control group by drawing lots,40 cases each.All the patients were treated by surgery,and the control group patients received routine care,and the observation group patients added the SBAR communication mode.The quality of care,incidence of adverse events,satisfaction with care and incidence of postoperative complications of the two groups were compared. Results The quality of care values of basic care,nursing care,nursing responsibility,risk identification and risk prevention in the observation group were significantly higher than in the control group(P<0.05).There was no difference in the incidence of nursing side effects such as injection and oral administration errors,dressing changes,blood sampling errors,case clerk errors and delayed execution of medical orders between the two groups(P>0.05).Patient satisfaction in the observation group was significantly higher than that in the control group(P<0.05).The incidence of complications such as pressure ulcers,infections and venous thrombosis in the observation group was significantly lower than that in the control group(P<0.05). Conclusions SBAR communication mode and combined nursing quality index management for patients with bile duct stones,which can improve the quality of clinical nursing and patient nursing satisfaction,and further reduce the incidence of postoperative complications in patients.
临床诊疗

肩关节镜手术中臂丛神经阻滞与关节腔内注射局麻药对术后镇痛的效果研究

The effect of arm nerve block and intraarticular injection of local anesthetic on postoperative analgesia in shoulder arthroscopic surgery

:134-137
 
目的 探讨臂丛神经阻滞和关节腔内注射局麻药联合应用在肩关节镜手术中的应用价值。方法 对肩关节镜手术患者100例进行研究,2018年8月—2020年8月入组,根据随机数字表法分组处理,对照组和观察组各为50例,前者用臂丛神经阻滞,后者与关节腔内注射局麻药联合,比较2组麻醉效果、不同阶段疼痛程度、肩关节功能。另对比2组不良反应。结果 观察组麻醉起效时间、苏醒时间和拔管时间分别为(10.72±2.45)min、(8.21±1.32)min和(9.52±1.12)min,与对照组对应指标有差异(P<0.05);2组术前疼痛程度和肩关节功能对比无差异(P>0.05),观察组术后6 h、术后24 h和术后48 h疼痛评分依次为(1.31±0.27)分、(2.87±0.52)分和(3.44±0.42)分,术后6 h、术后12 h、术后24 h和术后48 h镇静评分分别为(2.92±0.32)分、(2.54±0.24)分、(2.38±0.12)分和(2.27±0.15)分,术后1周、1个月和3个月的肩关节功能评分分别为(50.12±4.54)分、(56.18±4.12)分和(73.16±4.78)分,较之于对照组有差异(P<0.05);对照组和观察组出现不良反应的概率分别为18.00%和4.00%(P<0.05)。 结论 在肩关节镜手术中联合应用臂丛神经阻滞联合关节腔内注射局麻药麻醉方式,可提高麻醉效果,术后镇痛和镇静效果明显,也可减少不良反应,对患者肩关节功能改善作用明显,存在广泛应用价值。
临床诊疗

游泳抚触操对新生儿神经行为及体格发育的影响

Influence of physical caress at swimming on newborns to neonatal behavioral and physical development

:95-96
 
目的 游泳抚触操对新生儿神经行为及体格发育影响的研究。方法 将76例正常新生儿随机分为观察组(游泳加抚触操)31例,对照组(常规沐浴)45例,两组新生儿分别于出生后第5天、14天、42天对两组新生儿进行新生儿行为神经评分(NBNA),新生儿生后睡眠情况比较,胎便初排,胎便转黄时间比较,新生儿体重,身长比较。结果 两组新生儿神经行为及体格发育各项指标与对照组相比,差异有统计学意义,(P<0.01)。结论 游泳抚触操对新生儿神经行为及体格发育有促进作用,临床值得推广应用。
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