摘要
目的:设计全麻俯卧位手术护理风险核查表并评价其使用效果。方法:根据WHO模型要求,采用循证学的方法,组成多学科研制团队,设计全麻俯卧位手术护理风险核查表。全面检索相关指南并评价其质量,对纳入指南的证据等级进行评价整理后制成核查表草稿,采取德尔菲(Delphi)专家咨询法邀请多学科专家进行两次函询确定初稿,随后开展小范围实验确定终稿,最后开展前后对照实验以评价其应用效果。结果:设计了一份需要在4个暂停点核查22项条目的风险核查表,使用该表后,22项条目的总体执行率增长了22.73%,且10项措施的执行率均增长,差异有统计学意义(P<0.05)。结论:全麻俯卧位手术护理风险核查表能有效协助护士落实全麻手术俯卧位的各项护理措施,保证患者安全,且该表操作简单、接受度高,是转化循证证据的有效工具,值得推广使用。
Objectives: To develop a General Anesthesia Prone Position Surgical Checklist (GAPPSC) for circulating nurses and evaluate its effectiveness. Methods: The GAPPSC were established according to the WHO model using evidencebased methods. Through analysis of literature reviews and evidence evaluation, the draft checklist was designed. Then 10 experts of relative areas to operating room care were consulted by mails for two rounds using Delphi method about the second edition of GAPPSC. The final edition of GAPPSC was developed after a field test. Later a pilot test was launched to test its effectiveness. The formal study was conducted between May and October 2017 to finally compare the data collected before and after the application of the checklist. Results: A checklist with 22 necessary items to be checked at 4 pause points was developed .The study showed a significant 22.73% of increase in the total implementation rate of the 22 items on the checklist after its implementation. Besides, the implementation rates of 10 items of the checklist also increased significantly (P<0.05). Conclusion: The GAPPSC transferred from 10 clinical practice guidelines is a useful tool for increasing the delivery of essential nursing practices for patients after general anesthesia in the prone position. Meanwhile, it can also help circulating nurses to provide safe, standardized and evidence-based nursing practices and consequently improve patient safety, which indicates that GAPPSC is a practical tool to help facilitate basic nursing practices.
作者
蔡建树
项伟岚
陈渊航
祁海鸥
张立秀
CAI Jianshu;XIANG Weilan;CHEN Yuanhang;QI Haiou;ZHANG Lixiu(Operation Room, Sir Run Run Shaw Hospital Affliated to MedicalCollege of Zhejiang University, Zhejiang province, 310016, China)
出处
《中国护理管理》
CSCD
北大核心
2019年第4期612-617,共6页
Chinese Nursing Management
关键词
核查表
俯卧位
全麻手术
患者安全
手术体位
checklist
prone position
general anesthesia surgery
patient safety
surgical position
