摘要
目的 探讨消化道中毒护理亚专科建设及实践效果.方法 根据消化道中毒护理专科特点和院内救治原则,2022年1月科室创建消化道中毒亚专科护理组,制订组织结构、质控方法、工作内容、标准流程、培训方案,比较消化道中毒亚专科护理组创建前后护士临床综合实践能力、专科理论及专科技能、护理措施实施的时间节点参数、患者主要结局指标的变化.结果 创建消化道中毒亚专科护理组后护士的临床综合实践能力、专科理论及专科技能显著提高(P＜0.001).急性消化道中毒患者护理措施落实时间节点指标:心电监护开始时间缩短约2 min(P=0.005)、血标本采集时间缩短约5 min(P＜0.001)、血液灌流开始时间缩短约30 min(P=0.029)、灌流器使用间隔时间缩短约17 min(P=0.001)、静脉用药开始时间缩短约2 min(P=0.005)、解毒剂开始使用时间缩短约36.50 min(P＜0.001);尿标本采集时间、洗胃开始时间、导泻开始时间均有缩短趋势,但差异无统计学意义(P＞0.05).患者主要结局指标:7 d存活率提高约8％(P=0.024)、28 d存活率提高约8％(P=0.045).次要结局指标:普通病房住院时间缩短约1 d(P=0.008)、ICU住院时间缩短约3 d(P=0.029);抢救室滞留时间有缩短趋势,但差异无统计学意义(P＞0.05).结论 消化道中毒护理亚专科建设可有效提高护士专科护理实践能力,提高消化道中毒患者的护理质量.
Abstract
Objective To explore the construction and application effects of sub-specialty nursing for gastrointestinal poisoning.Methods According to the specialty characteristics of gastrointestinal poisoning nursing and the principles of hospital treatment,a sub-specialty nursing group of gastrointestinal poisoning was established in January 2022,and the organizational structure,quality control methods,work contents,standard procedures and training programs were formulated.The changes of nurses'clinical comprehensive practice ability,specialty theory and specialty skills,time node parameters of nursing measures implementation and main outcome indicators of patients were compared before and after the establishment of subspecialty nursing group of gastrointestinal poisoning.Results The clinical comprehensive practice ability,specialty theory and specialty skills of nurses were significantly improved after the establishment of subspecialty nursing group of gastrointestinal poisoning(P＜0.001).For time node indicators of implementation of nursing measures for patients with acute gastrointestinal poisoning,the start time of ECG monitoring was shortened by about 2 min(P=0.005),the blood sample collection time was shortened by about 5 min(P＜0.001),the start time of hemoperfusion was shortened by about 30 min(P=0.029),the interval of perfusion was shortened by about 17 min(P=0.001),and the start time of intravenous medication was shortened by about 2 min(P=0.005),the beginning time of antidote use was shortened by about 36.5 min(P＜0.001).The collection time of urine sample,the start time of gastric lavage and the start time of catharsis all showed a shortening trend,but the differences were not statistically significant(P＞0.05).For the main outcome indicators of patients,the survival rate at 7 days was increased by about 8％(P=0.024),and the survival rate at 28 days was increased by about 8％(P=0.045).For secondary outcome measures,the length of stay in general ward was shortened by about 1 days(P=0.008),and the length of stay in ICU was shortened by about 3 days(P=0.029).There was a trend of shortening of the stay time in emergency room,but the difference was not statistically significant(P＞0.05).Conclusion The construction of sub-specialty nursing of gastrointestinal poisoning can effectively improve nurses'ability of specialized nursing practice and improve nursing quality of patients with gastrointestinal poisoning.
维普
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