目的:评价疾病诊断相关分组(Diagnosis Related Groups,DRG)支付方式下手术室标准化护理流程的应用效果,为保障DRG支付模式的顺利实施提供参考.方法:采用方便抽样法,选取2023年3月至2024年3月DRG编码为GD25、IC35、EB15、BB35的4个组中均不伴并发症与合并症的120例手术患者为研究对象,其中2023年3月-9月的60例为对照组,2023年10月至2024年3月的60例患者为观察组,两组手术例数、手术操作及编码相同,观察组患者围手术期实施标准化护理流程,比较两组时间消耗、不可计价成本消耗、护理质量.结果:观察组套管针穿刺时间、外科洗手前物品准备时间、麻醉后至手术开始时间、术后器械清洗消毒时间均低于对照组,差异有统计学意义(P＜0.05);观察组无菌纱布使用量、手术器械空消数、消毒液使用量、手术铺单使用量均低于对照组,差异有统计学意义(P＜0.05);观察组器械准备不充分、耗材准备不充分、仪器设备故障、套管针穿刺未一次成功的发生率均低于对照组,差异有统计学意义(P＜0.05).结论:手术室标准化护理流程的应用可提高工作效率和质量,通过合理利用资源和准确计算手术操作项目成本,可确保医院DRG支付模式的顺利实施.
Application of standardized nursing process in operating room under DRG payment method
Objective:To explore the application effect of standardized nursing process in operating room under Diagnosis Related Groups(DRG)payment,and to provide reference for ensuring the implementation of DRG payment mode.Methods:A total of 120 surgical patients without complications or comorbidities were selected from 4 subgroups with DRG code GD25,IC35,EB15 and BB35,and the 60 patients from March to September 2023 were selected as the control group,and the 60 patients from October 2023 to March 2024 were selected as the observation group.There was no differnece in the number of surgical cases,surgical procedures and coding between the two groups.Standardized nursing process was implemented in the observation group during perioperative period,the time,the material cost cannot be priced and quality of nursing were compared between the two groups.Results:The trocar puncture time,item preparation time before surgical hand washing,time from anesthesia to the beginning of operation,and postoperative instrument cleaning and disinfection time in observation group were shorter than those in control group(P＜0.05).The amount of sterile gauze,the number of empty surgical instruments,the amount of disinfectant and the amount of surgical sheet in the observation group were less than those in the control group(P＜0.05).The incidence of inadequate equipment preparation,inadequate consumables preparation,equipment failure and trocar puncture failure in observation group were lower than those in control group(P＜0.05).Conclusion:The standardized nursing process in operation room is benefit to improve the work efficiency and quality,and ensure the implementation of the DRG payment mode in the hospital through rational utilization of resources and accurate calculation of operation project cost.
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