基于ERAS理念的导航护士管理模式在成人腹股沟疝日间手术围手术期中的应用

赖丽雅; 范栩妃; 陈吉彩; 吴大洲

doi:10.16766/j.cnki.issn.1674-4152.003984

基于ERAS理念的导航护士管理模式在成人腹股沟疝日间手术围手术期中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003984

温州医科大学附属第一医院疝与腹壁外科，浙江温州 325000

基金项目:

浙江省自然科学基金项目 LY20H030003

温州市科技计划项目 Y20220112

详细信息

通讯作者:
赖丽雅，E-mail: 15888407518@163.com

中图分类号: R656.21 R473.6
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- 文章访问数: 1
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出版历程
- 收稿日期: 2024-04-16
- 网络出版日期: 2025-06-30

Application of the navigation nurse management model based on ERAS concept in the perioperative period of daytime surgery for adult inguinal hernia

Department of Hernia and Abdominal Wall Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的随着日间手术数量的增多，日间手术护理服务质量也备受关注。本研究基于ERAS理念，构建了成人腹股沟疝日间手术导航护士管理模式，为日间手术的规范化管理提供参考。方法采用随机数字表法将2023年1—12月在温州医科大学附属第一医院拟进行腹股沟疝日间手术的97例患者分为对照组(49例)和导航护士管理组(48例)。对照组给予日间手术常规管理，导航护士管理组给予基于ERAS理念的导航护士管理，均随访3个月，比较2组患者术前准备完成情况、手术临时取消率、术前等待时间、疾病和手术知识知晓度以及护理满意度。结果导航护士管理组术前准备缺陷率为29.17%(14/48)，低于对照组的59.18%(29/49，χ²=8.853，P=0.003);手术临时取消率为4.17%(2/48)，低于对照组的18.37%(9/49，χ²=4.863，P=0.027);术前等待时间为(65.22±10.23)min，短于对照组的(90.34±8.17)min(t=13.377，P＜0.001);疾病和手术知识知晓度评分高于对照组(P＜0.05);护理满意度评分高于对照组(P＜0.05)。结论基于ERAS理念的导航护士管理模式对提高成人腹股沟疝日间手术患者术前准备度、降低手术临时取消率、缩短术前等待时间以及提高患者相关知识知晓度和护理满意度均有积极意义。
- 成人腹股沟疝 /
- 日间手术 /
- 导航护士 /
- 围手术期管理 /
- 护理质量
Abstract: Objective With the increase of the number of day surgery, the quality of day surgery nursing service is also concerned. Based on the concept of ERAS, this study constructs a pilot nurse management model for adult inguinal hernia surgery during the day, providing reference for the standardized management of day surgery. Methods A total of 97 patients with inguinal hernia day surgery in the First Affiliated Hospital of Wenzhou Medical University from January to December 2023 were randomly divided into control group (49 cases) and navigation nurse management group (48 cases). The control group was given routine management of day surgery, and the navigation nurse management group gave navigation nurse management based on ERAS concept. All patients were followed up for 3 months to compare the preoperative preparation and completion, temporary surgical cancellation rate, preoperative waiting time, awareness of disease and surgical knowledge, and nursing satisfaction. Results The preoperative preparation defect rate in the navigation nurse management group was 29.17% (14/48), which was lower than the control group [59.18% (29/49), χ²=8.853, P=0.003]. The temporary surgical cancellation rate was 4.17% (2/48), which was lower than 18.37% (9/49) of the control group (χ²=4.863, P=0.027). Preoperative waiting time was (65.22±10.23) min, which was shorter than the control group [(90.34±8.17) min, t=13.377, P < 0.001]. Disease and surgical knowledge awareness score was higher than the control group (P < 0.05). The nursing satisfaction score was higher than the control group (P < 0.05). Conclusion The navigation nurse management mode based on ERAS concept is positive for improving preoperative preparation, reducing the temporary cancellation rate, shortening preoperative waiting time, and improving patient awareness and nursing satisfaction.
- Adult inguinal hernia /
- Daytime surgery /
- Navigation nurse /
- Perioperative management /
- Quality of care

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表 1 2组腹股沟疝患者一般资料比较

Table 1. Comparison of general information between two groups of inguinal hernia patients

组别	例数	性别(例)		年龄 (x±s，岁)	体重 (x±s，kg)	ASA分级(例)			疝类型(例)
组别	例数	男性	女性	年龄 (x±s，岁)	体重 (x±s，kg)	Ⅰ级	Ⅱ级	Ⅲ级	斜疝	直疝	复合疝
对照组	49	47	2	61.34±5.10	60.21±5.67	20	26	3	38	7	4
导航护士管理组	48	44	4	62.09±7.22	61.77±8.44	19	24	5	37	9	2
统计量		0.200^a		0.592^b	1.066^b	0.595^c			0.920^a
P值		0.654		0.555	0.286	0.743			0.631
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组腹股沟疝日间手术患者术前准备情况比较[例(%)]

Table 2. Comparison of preoperative preparation between two groups of inguinal hernia patients undergoing day surgery[cases (%)]

组别	例数	调整饮食不到位	禁食禁水不到位	必需的常规检查完成不到位	未备齐手术用物及药物	病历准备不齐全	局部皮肤清洁不到位	总计
对照组	49	5(10.20)	3(6.12)	6(12.24)	4(8.16)	3(6.12)	8(16.33)	29(59.18)
导航护士管理组	48	5(10.42)	1(2.08)	1(2.08)	2(4.17)	2(4.17)	3(6.25)	14(29.17)
χ²值		0.090	0.240	2.376	0.156	0.001	2.449	8.853
P值		0.765	0.624	0.123	0.693	0.981	0.118	0.003

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表 3 2组腹股沟疝日间手术患者手术开展情况和术前等待时间比较

Table 3. Comparison of surgical performance and preoperative waiting time between two groups of inguinal hernia patients undergoing day surgery

组别	例数	手术临时取消 [例(%)]	术前等待时间 (x±s，min)
对照组	49	9(18.37)	90.34±8.17
导航护士管理组	48	2(4.17)	65.22±10.23
统计量		4.863^a	13.377^b
P值		0.027	＜0.001
注：^a为χ²值，^b为t值。

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表 4 2组腹股沟疝日间手术患者对疾病和手术知识知晓度比较(x±s，分)

Table 4. Comparison of disease and surgical knowledge between two groups of inguinal hernia patients undergoing day surgery (x±s, points)

组别	例数	疾病基础知识	术前准备知识	术中配合方式	术后康复知识	总分
对照组	49	5.90±1.14	4.67±0.93	5.33±1.22	6.09±1.04	21.99±4.34
导航护士管理组	48	7.87±1.34	7.54±1.21	7.47±1.24	8.17±1.31	31.05±5.12
t值		7.804	13.114	8.568	8.670	9.408
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 5 2组腹股沟疝日间手术患者对护理工作满意度比较(x±s，分)

Table 5. Comparison of nursing satisfaction between two groups of inguinal hernia patients undergoing day surgery (x±s, points)

组别	例数	护理态度	护理技巧	护理水平	总分
对照组	49	15.23±3.40	14.67±2.49	15.89±3.10	45.79±6.12
导航护士管理组	48	17.31±3.09	16.70±3.10	16.90±3.82	50.91±5.10
t值		3.151	3.559	1.431	4.471
P值		0.002	0.001	0.156	＜0.001

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