基于格林模式的手术烟雾干预策略在手术室医护人员中的应用效果

邱小丹; 王乐洁; 张敏; 颜林志

doi:10.16766/j.cnki.issn.1674-4152.002746

基于格林模式的手术烟雾干预策略在手术室医护人员中的应用效果

doi: 10.16766/j.cnki.issn.1674-4152.002746

温州医科大学附属第二医院手术室，浙江温州 325000

基金项目:

浙江省医药卫生科技计划项目 2020KY643

详细信息

通讯作者:
邱小丹, E-mail: qxdqxd2005@163.com

中图分类号: R192 R472.3
计量
- 文章访问数: 154
- HTML全文浏览量: 32
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2022-03-14
- 网络出版日期: 2022-12-30

Effect of surgical smoke intervention strategy based on Green model on medical staff in operating room

Operating Room of the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的以格林模式为理论基础，调查评估手术室医护人员对手术烟雾的防护现状，针对评估结果制定、实施干预策略，并探讨其应用效果，为手术烟雾干预策略在手术室医护人员中的应用提供指导依据。方法依据纳入、排除标准，选取78名温州医科大学附属第二医院手术室医护人员为研究对象，将2021年2—5月采用常规模式管理阶段作为干预前；将2021年6—9月以格林模式为理论基础，制定并实施干预策略管理的阶段作为干预后，比较干预前后手术室医护人员手术烟雾防护知识、态度、行为及手术烟雾影响自评得分情况。结果干预后，手术室医护人员手术烟雾防护知识[(14.17±4.36)分]、态度[(72.89±6.11)分]及行为[(68.34±7.35)分]得分均明显优于干预前[(9.16±3.62)分、(64.78±7.24)分及(52.73±6.48)分]；手术烟雾影响自评得分[(4.89±1.76)分]明显低于干预前[(6.47±2.53)分]，差异有统计学意义(P < 0.05)。结论以格林模式为理论基础的干预策略应用于手术室医护人员，能够提高手术室医护人员手术烟雾防护知识的认知程度，有效改善其防护态度，规范防护行为，降低手术烟雾影响自评得分。
- 格林模式 /
- 手术室医护人员 /
- 手术烟雾 /
- 干预策略
Abstract: Objective To investigate and evaluate the protection status of operating room medical staff against surgical smoke using Green mode as theoretical basis, develop and implement intervention strategy according to assessment result, discuss application effect of the strategy, and provide guidance gist to the application of surgical smoke intervention strategy in operating room staff. Methods A total of 78 operating room medical staff from the Second Affiliated Hospital of Wenzhou Medical University were selected as research object according to including and excluding standard. The conventional mode management stage will be adopted from February to May 2021 as the before intervention stage, and the stage of formulating and implementing intervention strategy management based on Greens model from June to September 2021 will be taken as the after intervention stage. The knowledge, attitude and behavior of operating smoke prevention, and self-assessment scores impacted by operating smoke among operating room medical staff before and after intervention were compared. Results After intervention, the scores of surgical smoke prevention knowledge [(14.17±4.36) points], attitude [(72.89±6.11) points] and behavior [(68.34±7.35) points] of medical staff in the operating room were significantly higher than those before intervention [(9.16±3.62) points, (64.78±7.24) points and (52.73±6.48) points]. The self- assessment score of surgical smoke influence [(4.89±1.76) points] was significantly lower than that before intervention [(6.47±2.53) points], the difference was statistically significant (P < 0.05). Conclusion The application of intervention strategy using Green mode as theoretical basis in operating room medical staff can enhance the cognition degree to surgical smoke prevention knowledge, effectively improve their protective attitude, regulate their protective behavior, and decrease their self-assessment score of surgical smoke influence.
- Green mode /
- Operating room medical staff /
- Surgical smoke /
- Intervention strategy

HTML全文

表 1 手术室医护人员一般特征

Table 1. General characteristics of medical staff in operating room

项目	类别	人数	构成比(%)
性别	男性	11	14.10
	女性	67	85.90
年龄(岁)	20~30	28	35.90
	31~40	29	37.18
	41~50	18	23.08
	>50	3	3.84
工作年限(年)	≤5	18	23.08
	6~10	25	32.05
	＞10	35	44.87
学历	大专	2	2.57
	本科	70	89.74
	研究生	6	7.69
职称	初级	32	41.03
	中级	39	50.00
	高级	7	8.97

下载: 导出CSV

表 2 手术室医护人员手术烟雾防护培训及继续教育需求情况

Table 2. Operation smoke protection training and continuing education needs of medical staff in operating room

项目	类别	人数	构成比(%)
参加正规培训(次)	0	7	8.97
	1	13	16.67
	2	45	57.69
	≥3	13	16.67
继续教育需求	有	76	97.44
	没有	2	2.56

下载: 导出CSV

表 3 干预前后手术室医护人员手术烟雾防护知识、态度及行为评分比较(x±s，分)

Table 3. Comparison of scores of knowledge, attitude and behavior of operation smoke protection of medical staff in operating room before and after intervention (x±s, points)

时间	人数	知识	态度	行为
干预前	78	9.16±3.62	64.78±7.24	52.73±6.48
干预后	78	14.17±4.36	72.89±6.11	68.34±7.35
t值		59.793	63.385	158.464
P值		< 0.001	< 0.001	< 0.001

下载: 导出CSV

参考文献(17)

[1]	苏娜. 格林模式促进手术室护士防护电外科烟雾的效果研究[D]. 太原: 山西医科大学, 2019. SU N. Effect study on model promotes or nurses to protect electrical surgery smoke[D]. Taiyuan: Shanxi Medical University, 2019.
[2]	杨洋, 马燕兰. 手术烟雾对医护人员的健康危害及其防护措施的研究进展[J]. 中华现代护理杂志, 2018, 24(27): 3345-3348. doi: 10.3760/cma.j.issn.1674-2907.2018.27.031 YANG Y, MA Y L. Research progress on health hazards and protective measures of surgical smog to medical staff[J]. Chinese Journal of Modern Nursing, 2018, 24(27): 3345-3348. doi: 10.3760/cma.j.issn.1674-2907.2018.27.031
[3]	唐韧冰, 杜美华, 陆叶. 手术烟雾的危害及其防护的研究进展[J]. 中华护理杂志, 2017, 52(9): 1065-1067. doi: 10.3761/j.issn.0254-1769.2017.09.010 TANG R B, DU M H, LU Y. Resarch progress on the harm and protection of surgical smoke[J]. Chinese Journal of Nursing, 2017, 52(9): 1065-1067. doi: 10.3761/j.issn.0254-1769.2017.09.010
[4]	彭红, 廖思兰, 莫恋. 手术室医护人员外科手术烟雾认知与防护的调查研究[J]. 临床医学工程, 2018, 25(5): 687-688. doi: 10.3969/j.issn.1674-4659.2018.05.0687 PENG H, LIAO S L, MO L. Investigation on cognition and protection of surgical smoke for medical staff in operation room[J]. Clinical Medical Engineering, 2018, 25(5): 687-688. doi: 10.3969/j.issn.1674-4659.2018.05.0687
[5]	刁晓丽, 李晓红, 迟俊涛. 格林健康教育模式的适用性综述[J]. 中华现代护理杂志, 2021, 27(17): 2368-2371. doi: 10.3760/cma.j.cn115682-20201011-05683 DIAO X L, LI X H, CHI J T. Applicability review of PRECEDE-PROCEED health education model[J]. Chinese Journal of Modern Nursing, 2021, 27(17): 2368-2371. doi: 10.3760/cma.j.cn115682-20201011-05683
[6]	王筱筱, 段宏为, 林航, 等. 格林模式在健康教育中的应用进展[J]. 中国护理管理, 2018, 18(4): 570-574. doi: 10.3969/j.issn.1672-1756.2018.04.030 WANG X X, DUAN H W, LIN H, et al. Application of the PRECEDE-PROCEED model in health education[J]. Chinese Nursing Management, 2018, 18(4): 570-574. doi: 10.3969/j.issn.1672-1756.2018.04.030
[7]	李育红, 秦德华, 孙静, 等. 格林模式在手术室护士预防血源性职业暴露中的应用[J]. 中华现代护理杂志, 2018, 24(5): 506-509. doi: 10.3760/cma.j.issn.1674-2907.2018.05.003 LI Y H, QIN D H, SUN J. Effects of Green model on preventing blood-induced occupational exposure in operating room nurses[J]. Chinese Journal of Modern Nursing, 2018, 24(5): 506-509. doi: 10.3760/cma.j.issn.1674-2907.2018.05.003
[8]	田红梅, 李婷, 刘畅. 格林模式在实习护生标准预防中的研究进展[J]. 护理研究, 2016, 30(27): 3335-3337. doi: 10.3969/j.issn.1009-6493.2016.27.003 TIAN H M, LI T, LIU C. Research progress on the precede proceed in the standard of prevention of student nurses[J]. Chinese Nursing Research, 2016, 30(27): 3335-3337. doi: 10.3969/j.issn.1009-6493.2016.27.003
[9]	苏娜, 付秀荣, 张伟, 等. 格林模式在手术烟雾防护中的应用研究[J]. 护理研究, 2019, 33(8): 1440-1442. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201908044.htm SU N, FU X R, ZHANG W, et al. Application of Green's model in the protection of surgical smog[J]. Chinese Nursing Research, 2019, 33(8): 1440-1442. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201908044.htm
[10]	谭文君, 朱皓阳, 马涛, 等. 局部负压吸引对手术室烟雾PM2.5浓度的影响[J]. 护理研究, 2019, 33(8): 1325-1329. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201908010.htm TAN W J, ZHU H Y, MA T, et al. Influence of local negative pressure suction on concentration of PM2.5 of operating room smoke[J]. Chinese Nursing Research, 2019, 33(8): 1325-1329. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201908010.htm
[11]	杜海霞, 苏凤龙, 赵巧棉. 快速康复护理对宫腔镜子宫手术患者术后疼痛及康复的影响[J]. 河北医学, 2018, 24(03): 514-517. doi: 10.3969/j.issn.1006-6233.2018.03.045 DU H X, SU F L, ZHAO Q M. Effect of rapid rehabilitation nursing on postoperative pain and rehabilitation in patients undergoing hysteroscopic uterine surgery[J]. Hebei Medicine, 2018, 24(3): 514-517. doi: 10.3969/j.issn.1006-6233.2018.03.045
[12]	穆莉, 王琤, 黄丽文, 等. 外科手术烟雾中可吸入颗粒物(PM10)浓度变化的原因分析[J]. 中华现代护理杂志, 2019, 25(4): 444-447. doi: 10.3760/cma.j.issn.1674-2907.2019.04.014 MU L, WANG C, HUANG L W, et al. Analysis of the reasons for the change of inhalable particulate matter (PM10) concentration in surgical smoke[J]. Chinese Journal of Modern Nursing, 2019, 25(4): 444-447. doi: 10.3760/cma.j.issn.1674-2907.2019.04.014
[13]	何庆娟, 罗小平, 梁爱群. 格林模式教育对手术室护士电外科烟雾防护效果的影响[J]. 齐鲁护理杂志, 2020, 26(8): 133-135. doi: 10.3969/j.issn.1006-7256.2020.08.049 HE Q J, LUO X P, LIANG A Q. Effect of green model education on the effect of electrosurgical smoke protection of nurses in operating room[J]. Qilu Journal of Nursing, 2020, 26(8): 133-135. doi: 10.3969/j.issn.1006-7256.2020.08.049
[14]	李文娟, 张晓丽, 王义会, 等. 基于格林模式的健康教育在预防上尿路结石患者复发中的应用[J]. 中华现代护理杂志, 2019, 25(15): 1888-1892. doi: 10.3760/cma.j.issn.1674-2907.2019.15.010 LI W J, ZHANG X L, WANG Y H, et al. Application of health education based on green model in preventing recurrence of patients with upper urinary tract calculi[J]. Chinese Journal of Modern Nursing, 2019, 25(15): 1888-1892. doi: 10.3760/cma.j.issn.1674-2907.2019.15.010
[15]	苏云萍, 王雅玲. 格林模式在手术室护士防护教育过程中的应用[J]. 中国当代医药, 2021, 28(15): 210-213. doi: 10.3969/j.issn.1674-4721.2021.15.059 SU Y P, WANG Y L. Application of Green model in the process of nurses' protection education in operating room[J]. China Modern Medicine, 2021, 28(15): 210-213. doi: 10.3969/j.issn.1674-4721.2021.15.059
[16]	先会, 谢飞, 杨晓莹. 电外科烟雾对手术环境及其暴露人群健康影响的研究进展[J]. 西南医科大学学报, 2018, 41(6): 571-573. XIAN H, XIE F. Research advances in the effect of electrosurgical smoke on surgical environment and the health of exposed population[J]. Journal of Southwest Medical University, 2018, 41(6): 571-573.
[17]	陈秋竹, 杜津, 贾小蓉, 等. 前处理模式健康教育在热性惊厥患儿家属中的应用观察[J]. 中华全科医学, 2021, 19(4): 632-635. doi: 10.16766/j.cnki.issn.1674-4152.001880 CHEN Q Z, DU J, JIA X R, et al. Application of PRECEDE-PROCEED mode health education in the family of children with febrile seizures[J]. Chinese Journal of General Practice, 2021, 19(4): 632-635. doi: 10.16766/j.cnki.issn.1674-4152.001880