摘要
目的 探讨以失效模式与效应分析(FMEA)模式为指导的呼唤式护理结合营养干预在重度颅脑损伤伴昏迷患者中的应用价值.方法 选取 2021 年 8月—2023年8 月哈尔滨医科大学第一附属医院收治的 84 例重度颅脑损伤伴昏迷患者为研究对象,按随机数字表法将其分为对照组和观察组,各 42 例.对照组采用常规护理干预,观察组采用以FMEA模式为指导的呼唤式护理结合营养干预.对比两组的苏醒情况、营养指标、家属满意度.结果 干预后,观察组中文版国际昏迷恢复量表中的视觉为(3.02±0.43)分、听觉为(2.77±0.26)分、运动为(4.34±0.51)分、觉醒状态为(2.14±0.27)分、血清白蛋白为(42.53±3.75)g/L、总蛋白为(72.14±5.58)g/L、前白蛋白为(219.42±15.77)mg/L、血红蛋白为(115.38±10.15)g/L,分别高于对照组的(2.62±0.37)分、(2.24±0.34)分、(3.76±0.44)分、(1.86±0.15)分、(37.86±3.35)g/L、(66.47±5.13)g/L、(203.46±11.38)mg/L、(101.28±9.19)g/L,组间差异有统计学意义(P<0.05);家属满意度量表中的服务态度为(44.38±2.02)分、操作技能为(46.36±1.43)分、环境管理为(45.66±1.05)分、护理质量为(46.05±1.18)分,分别高于对照组的(38.90±3.53)分、(40.56±2.85)分、(40.14±2.76)分、(41.27±3.55)分,组间差异有统计学意义(P<0.05).结论 以FMEA模式为指导的呼唤式护理结合营养干预可以加快重度颅脑损伤伴昏迷患者苏醒,改善营养状况,减少并发症的发生,提高家属满意度.
Abstract
Objective To explore the application value of call based nursing guided by failure mode and effect analysis(FMEA)model combined with nutritional intervention in patients with severe traumatic brain injury with coma.Methods 84 patients with severe traumatic brain injury and coma admitted to the First Aifffiliated Hospital of Harbin Medical University from August 2021 to August 2023 were selected as the research subjects,divide them into a control group and an observation group using a random number table method,with 42 cases in each group.The control group was given routine nursing,and the observation group was given call based nursing guided by FMEA model combined with nutritional intervention.Compare the awakening status,nutritional indicators,and family satisfaction between two groups.Results After the intervention,the Chinese version of the coma Recovery Scale-Revised for the observation group showed visual scores of(3.02±0.43),auditory scores of(2.77±0.26),motor scores of(4.34±0.51),arousal status scores of(2.14±0.27),serum albumin scores of(42.53±3.75)g/L,total protein scores of(72.14±5.58)g/L,prealbumin scores of(219.42±15.77)mg/L,and hemoglobin scores of(115.38±10.15)g/L,respectively,which were higher than(2.62±0.37)and(2.24±0.35)g/L,(3.76±0.44)points,(1.86±0.15)points,(37.86±3.35)g/L,(66.47±5.13)g/L,(203.46±11.38)mg/L,(101.28±9.19)g/L in the control group the differences between the groups were statistically significant(P<0.05);the service attitude score in the Family Satisfaction Scale was(44.38±2.02)points,operational skills score was(46.36±1.43)points,environmental management score was(45.66±1.05)points,and nursing quality score was(46.05±1.18)points,respectively which were higher than(38.90±3.53)points,(40.56±2.85)points,(40.14±2.76)points,and(41.27±3.55)points in the control group,the differences between the groups were statistically significant(P<0.05).Conclusion Call based nursing guided by FMEA model combined with nutritional intervention can speed up the awakening of patients with severe traumatic brain injury with coma,improve nutritional status,reduce complications and improve family members satisfaction.
万方数据