本文選題：臨床護理路徑 + 胰腺癌手術患者��； 參考：《華北理工大學》2017年碩士論文

【摘要】：目的在胰腺癌手術患者中應用臨床護理路徑,以進一步探討臨床護理路徑對胰腺癌手術患者的平均住院天數、平均住院費用、健康知識水平、對護理人員的護理服務質量滿意度、術后常見并發(fā)癥、術后自理能力恢復情況的臨床應用效果。為護理人員實施臨床護理路徑的有效干預提供依據。方法選取2015年7月1日～2016年12月30日期間在唐山市人民醫(yī)院和唐山市開灤醫(yī)院肝膽外科住院治療的18~80歲的胰腺癌(Pancreatic Cancer,PC)患者為研究對象,且診斷均符合第14版《實用內科學》中的診斷標準,共60人,均經臨床護理路徑小組培訓的醫(yī)師確診并進行評估可行手術治療。將入選的手術患者按入院的先后順序隨機分為常規(guī)護理組和臨床護理路徑組,每組各30人。在基線調查的基礎上,患者從入院到出院,常規(guī)護理組的手術患者采用一般常規(guī)護理,臨床護理路徑組的手術患者按照已制定的臨床護理路徑進行護理,包括:基礎護理(Basic Nursing,BN)(級別護理、生命體征)、護理評估、醫(yī)囑執(zhí)行(用藥、治療、檢驗、檢查)、健康教育(Health Education,HE)等。患者出院時對手術患者平均住院費用,平均住院天數,手術患者的胰腺癌健康知識掌握情況,手術患者對護理人員的護理服務質量滿意度,術后常見并發(fā)癥,術后生活自理能力恢復情況進行調查和統計,以評價臨床護理路徑在實際臨床工作中的應用效果。并使用SPSS18.0統計軟件進行數據統計分析。結果干預前,兩組手術患者的一般情況,本組研究對象共60例,常規(guī)護理組和臨床護理路徑組各30例。對其進行統計學分析,差異無統計學意義(P0.05),兩組均衡可比。干預后,1)對兩組手術患者的平均住院天數及住院費用進行比較:常規(guī)護理組手術患者平均住院天數為(24.78±4.48天),平均住院費用為(7.20±0.94萬元),臨床護理路徑組手術患者平均住院天數為(19.35±3.45天),平均住院費用為(6.80±0.72萬元),并進行統計學分析,差異有統計學意義(P0.05)。2)對兩組手術患者的胰腺癌健康知識掌握情況,對護理人員的護理服務質量滿意度,術后出現常見并發(fā)癥,手術患者術后生活自理能力恢復情況進行比較,并進行統計學分析,差異均有統計學意義(P0.05)。結論臨床護理路徑在胰腺癌手術患者中的應用:1)減少了手術患者的平均住院天數及住院費用。2)提高了手術患者的胰腺癌健康知識水平及對護理人員的護理服務質量滿意度。3)減少了手術患者術后常見并發(fā)癥的出現,加快了患者術后自理能力的恢復。
[Abstract]:Objective to explore the average hospitalization days, average hospitalization cost and health knowledge of patients undergoing pancreatic cancer surgery by clinical nursing pathway. Effect of clinical application on nursing care quality satisfaction, postoperative complications and recovery of self-care ability of nursing staff. To provide the basis for the effective intervention of clinical nursing path. Methods from July 1, 2015 to December 30, 2016, 18 ~ 80 years old patients with pancreatic cancer, Pancreatic Cancerus, who were hospitalized in the Department of Hepatobiliary surgery, Tangshan people's Hospital and Kailuan Hospital, Tangshan City, were selected as the study subjects. All the diagnoses were in accordance with the diagnostic criteria in the 14th edition of practical Internal Medicine. 60 patients were confirmed by the doctors trained in the clinical nursing path group and evaluated the feasibility of surgical treatment. The patients were randomly divided into routine nursing group and clinical nursing path group with 30 patients in each group. On the basis of baseline investigation, the patients in the routine nursing group were treated with general routine nursing care, and the patients in the clinical nursing path group were nursing according to the established clinical nursing path from admission to discharge. These include: basic nursing, vital signs, nursing evaluation, medical advice (medication, treatment, testing, examination, health education), and so on. The average hospitalization cost, average hospitalization days, the health knowledge of the patients with pancreatic cancer, the satisfaction of the patients with nursing service, the common complications after operation, the average hospitalization cost, the average length of stay in hospital, the health knowledge of the patients, the quality of nursing care, the quality of nursing care, To evaluate the application of clinical nursing pathway in clinical work, the recovery of self-care ability after operation was investigated and counted. SPSS 18.0 statistical software was used for statistical analysis. Results before intervention, there were 60 cases in the study group, 30 cases in the routine nursing group and 30 cases in the clinical nursing path group. The statistical analysis showed that there was no significant difference between the two groups (P 0.05). After intervention, the average hospitalization days and hospitalization costs of the two groups were compared: the average hospitalization days were 24.78 鹵4.48 days in the routine nursing group, the average hospitalization cost was 7.20 鹵9400 yuan in the clinical nursing path group, and the average hospitalization cost was 7.20 鹵9400 yuan in the clinical nursing path group. The average hospitalization days were 19.35 鹵3.45 days and the average hospitalization expenses were 6.80 鹵7200 yuan. The difference was statistically significant (P0.05. 2) the health knowledge of pancreatic cancer patients in the two groups were compared, and the satisfaction of nursing staff, the common complications after operation and the recovery of self-care ability of postoperative patients were compared between the two groups. The difference was statistically significant (P 0.05). Conclusion the application of clinical nursing pathway in patients with pancreatic cancer surgery: 1) can reduce the average hospitalization days and hospitalization costs of patients with pancreatic cancer, and improve the health knowledge level of pancreatic cancer patients and the nursing service quality of nursing staff. Volume satisfaction. 3) reduced the occurrence of common postoperative complications in patients undergoing surgery. The recovery of self-care ability after operation was accelerated.
【學位授予單位】：華北理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.73

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