摘要
目的探讨三级甲等医院腹部外科医护人员实施快速康复外科(ERAS)面临的阻碍因素,为卫生主管部门和医院管理者制定ERAS的推广策略提供参考依据。方法2017年7—10月采用目的抽样法选取4所三级甲等医院腹部外科的12名医生和护士为访谈对象,采用半结构式访谈提纲对其所在科室实施ERAS面临的阻碍因素进行深入访谈,采用Colaizzi方法分析访谈资料。结果阻碍ERAS实施的因素主要归纳为6个方面:多学科之间协作困难、医护人员传统观念难以改变、缺乏患者理解与配合、安全性有待全面验证、缺乏支持和保障措施、基层医院医疗资源不足。结论国内三级甲等医院实施ERAS面临团队协作困难、医护人员认知不足、缺乏患者理解与配合、安全性有待全面验证、政策支持和保障措施不到位、基层医院医疗资源匮乏等方面的障碍因素,管理部门应针对上述阻碍因素制订针对性的推广策略,从而促进ERAS的普及应用。
Objective To explore the implementation barriers of enhanced recovery after surgery(ERAS)among medical staff of Abdominal Surgery in ClassⅢGrade A hospitals so as to provide a reference for health authorities and hospital managers to develop the promotion strategy of ERAS.Methods From July to October 2017,this study selected totals of 12 doctors and nurses of Abdominal Surgery Department from 4 ClassⅢGrade A hospitals as interviewees by purposive sampling.In-depth interview on implementation barriers of ERAS in departments was carried out with the semi-structured interview outline.The Colaizzi method was used to interview data analysis.Results Implementation barriers of ERAS main included 6 aspects involving the difficulties in multidisciplinary collaboration,difficuties in changing traditional concept among medical staff,lack of patients'understanding and collaboration,safety remained to be tested,lack of support and safeguard measure and insufficient medical resource in primary hospitals.Conclusions ClassⅢGrade A hospitals of China are faced with barriers when implementing ERAS,including the difficulties in team collaboration,insufficient cognition of medical staff,lack of patients'understanding and collaboration,safety remained to be tested,lack of policy support and safeguard measure and insufficient medical resources in primary hospitals.Management departments should develop the targeted promotion strategy based on those barriers to promote the popularity and application of ERAS.
作者
罗先武
谭初花
Luo Xianwu;Tan Chuhua(Department of Health Management,Wuhan University School of Health Sciences,Wuhan 430071,China;Department of Nursing,Wuhan University School of Health Sciences,Wuhan 430071,China;Department of Nursing,Huizhou Health Sciences Polytechnic,Huizhou 516025,China)
出处
《中华现代护理杂志》
2020年第4期429-434,共6页
Chinese Journal of Modern Nursing
关键词
腹部
围手术期
快速康复外科
实施障碍
医护人员
质性研究
Abdomen
Perioperative period
Enhanced recovery after surgery
Implementation barriers
Medical staff
Qualitative research
