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术前管道模拟训练在老年外科病房整体护理中的应用

Application of preoperative pipeline simulation training on holistic nursing in Department of Surgical Geriatrics

摘要:

目的:探讨提前进行管道模拟训练方法,使老年患者提前适应术后带管环境,减少术后非计划拔管(UEX)的发生。方法2013年6月—2014年6月选择择期行全麻手术的老年患者216例,随机分为对照组(n =106)和观察组(n =110)。对照组使用常规方法宣教管道类型及术后注意事项;观察组使用术前管道模拟训练的方法,依据术后留置的各种管道,按照术后实际位置粘贴于患者皮肤上,由护士引导患者逐个触摸各个管道位置、质地、牵拉管道力度,熟悉各种管道走形位置,介绍各种管道作用、不良反应。比较两组患者对术后管道认知程度、UEX 发生率、管道并发症发生率以及护理服务满意度。结果观察组患者术后 UEX 发生率、管道并发症发生率均低于对照组,管道认知和预见性护理感受情况优于对照组,差异均有统计学意义(P <0.05)。通过管道模拟训练,观察组患者满意度评分和各管道知识知晓率高于对照组,差异有统计学意义(P <0.05)。结论应用手术前管道模拟训练方法,可提高老年患者对管道的认知,增强患者保护管道的意识,利于护士对患者开展管道宣教,此方法在老年病区的应用前景广泛。

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abstracts:

Objective To explore the training method early, in order to make elderly to adopt the pipeline and reduce the incidence of postoperative unplanned extubation ( UEX). Methods A total of 216 patients who would have general anesthesia operation during July 2013 to July 2014 were divided into control group (n =106) and experimental group (n = 110). The elderly underwent routine education method and postoperative key points in the control group while elderly received preoperative pipeline simulation training according to all postoperative pipeline, its position of skin by patients touching each pipeline position, texture, pull strength of pipeline guided by nurses and was familiar with pipeline′s running position, effects and adverse effects in the experimental group. We compared the recognition of postoperative pipeline, the incidence rate of UEX, complications and nursing satisfaction. Results The pipeline recognition of experimental group was higher than that of control group, and the incidence rate declined 8. 5% , complications dropped off 11. 28% and nursing satisfaction climbed 17. 81% in the control group. Conclusions The application of preoperative simulation training for pipeline greatly improves patient recognition of the pipe, the awareness of pipeline protection, which will help nurses educate patients targeted and carry out perioperative health education. This method has a broad prospects for elderly community.

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