發(fā)布時(shí)間：2018-06-21 20:21

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

【摘要】：目的在胰腺癌手術(shù)患者中應(yīng)用臨床護(hù)理路徑,以進(jìn)一步探討臨床護(hù)理路徑對胰腺癌手術(shù)患者的平均住院天數(shù)、平均住院費(fèi)用、健康知識(shí)水平、對護(hù)理人員的護(hù)理服務(wù)質(zhì)量滿意度、術(shù)后常見并發(fā)癥、術(shù)后自理能力恢復(fù)情況的臨床應(yīng)用效果。為護(hù)理人員實(shí)施臨床護(hù)理路徑的有效干預(yù)提供依據(jù)。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(shí)用內(nèi)科學(xué)》中的診斷標(biāo)準(zhǔn),共60人,均經(jīng)臨床護(hù)理路徑小組培訓(xùn)的醫(yī)師確診并進(jìn)行評估可行手術(shù)治療。將入選的手術(shù)患者按入院的先后順序隨機(jī)分為常規(guī)護(hù)理組和臨床護(hù)理路徑組,每組各30人。在基線調(diào)查的基礎(chǔ)上,患者從入院到出院,常規(guī)護(hù)理組的手術(shù)患者采用一般常規(guī)護(hù)理,臨床護(hù)理路徑組的手術(shù)患者按照已制定的臨床護(hù)理路徑進(jìn)行護(hù)理,包括:基礎(chǔ)護(hù)理(Basic Nursing,BN)(級別護(hù)理、生命體征)、護(hù)理評估、醫(yī)囑執(zhí)行(用藥、治療、檢驗(yàn)、檢查)、健康教育(Health Education,HE)等。患者出院時(shí)對手術(shù)患者平均住院費(fèi)用,平均住院天數(shù),手術(shù)患者的胰腺癌健康知識(shí)掌握情況,手術(shù)患者對護(hù)理人員的護(hù)理服務(wù)質(zhì)量滿意度,術(shù)后常見并發(fā)癥,術(shù)后生活自理能力恢復(fù)情況進(jìn)行調(diào)查和統(tǒng)計(jì),以評價(jià)臨床護(hù)理路徑在實(shí)際臨床工作中的應(yīng)用效果。并使用SPSS18.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)統(tǒng)計(jì)分析。結(jié)果干預(yù)前,兩組手術(shù)患者的一般情況,本組研究對象共60例,常規(guī)護(hù)理組和臨床護(hù)理路徑組各30例。對其進(jìn)行統(tǒng)計(jì)學(xué)分析,差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組均衡可比。干預(yù)后,1)對兩組手術(shù)患者的平均住院天數(shù)及住院費(fèi)用進(jìn)行比較:常規(guī)護(hù)理組手術(shù)患者平均住院天數(shù)為(24.78±4.48天),平均住院費(fèi)用為(7.20±0.94萬元),臨床護(hù)理路徑組手術(shù)患者平均住院天數(shù)為(19.35±3.45天),平均住院費(fèi)用為(6.80±0.72萬元),并進(jìn)行統(tǒng)計(jì)學(xué)分析,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2)對兩組手術(shù)患者的胰腺癌健康知識(shí)掌握情況,對護(hù)理人員的護(hù)理服務(wù)質(zhì)量滿意度,術(shù)后出現(xiàn)常見并發(fā)癥,手術(shù)患者術(shù)后生活自理能力恢復(fù)情況進(jìn)行比較,并進(jìn)行統(tǒng)計(jì)學(xué)分析,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論臨床護(hù)理路徑在胰腺癌手術(shù)患者中的應(yīng)用:1)減少了手術(shù)患者的平均住院天數(shù)及住院費(fèi)用。2)提高了手術(shù)患者的胰腺癌健康知識(shí)水平及對護(hù)理人員的護(hù)理服務(wù)質(zhì)量滿意度。3)減少了手術(shù)患者術(shù)后常見并發(fā)癥的出現(xiàn),加快了患者術(shù)后自理能力的恢復(fù)。
[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(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.73

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