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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 369 -372. doi: 10.3877/cma.j.issn.1674-392X.2019.04.022

所属专题： 文献；

护理园地

品管圈护理模式应用于成年男性腹股沟疝围手术期的效果
何晓兰1,†(), 蔡蕾1, 周雪玲1   
  1. 1. 510630　广州，中山大学附属第三医院胃肠外科
  • 收稿日期:2018-12-01 出版日期:2019-08-18
  • 通信作者: 何晓兰
  • 基金资助:
    广东省医学科学技术研究基金项目(201711794044915)

Effect of quality control circle nursing mode applying in perioperative period of adult male patients with inguinal hernia

Xiaolan He1,†(), Lei Cai1, Xueling Zhou1   

  1. 1. Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Zhongshan University, Guangzhou 510630, China
  • Received:2018-12-01 Published:2019-08-18
  • Corresponding author: Xiaolan He
  • About author:
    Corresponding author: He Xiaolan, Email:
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何晓兰, 蔡蕾, 周雪玲. 品管圈护理模式应用于成年男性腹股沟疝围手术期的效果[J]. 中华疝和腹壁外科杂志(电子版), 2019, 13(04): 369-372.

Xiaolan He, Lei Cai, Xueling Zhou. Effect of quality control circle nursing mode applying in perioperative period of adult male patients with inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(04): 369-372.

目的

探讨品管圈护理模式应用于成年男性腹股沟疝围手术期的临床效果。

方法

回顾性分析2017年2月至2018年6月，中山大学附属第三医院行疝修补术的61例男性腹股沟疝患者的临床资料。根据患者在围手术期接受的护理方式不同，分为2组。对照组患者28例，于围手术期采用常规护理；研究组患者33例，于围手术期应用品管圈护理。2组术后均随访2～12个月。比较2组住院时间、术后并发症发生率、患者对护理的满意度、患者对护理安全知识知晓率及护理差错率。

结果

研究组患者住院时间短于对照组，术后并发症总发生率及护理差错率显著低于对照组，差异有统计学意义（P<0.05）；研究组患者对护理的总满意度、患者对护理安全知识知晓率显著高于对照组，差异有统计学意义（P<0.05）。Cox回归模型分析发现，患者护理安全知识知晓率越高，采用品管圈护理模型的患者，发生并发症风险越低，是并发症的保护因素（P<0.05）。年龄越高，发生并发症风险越高，是并发症的危险因素（P<0.05）。

结论

在疝修补手术围手术期应用品管圈护理模式可显著缩短患者住院时间，减少术后并发症的发生，提升患者满意度及整体护理质量，值得推广应用。

关键词: 品管圈护理模式, 疝，腹股沟, 围手术期, 应用效果
Objective

To explore the application of quality control circle (QCC) nursing mode in perioperative period of adult male patients with inguinal hernia.

Methods

61 adult male patients with inguinal hernia undergoing hernia repair from February 2017 to June 2018 in the Third Affiliated Hospital of Zhongshan University were selected as the research objects. Their clinical data were retrospectively analyzed. The patients were divided into the two groups according to the nursing methods during the perioperative period. The control group (n=28) received routine nursing during the perioperative period, and the experiment group (n=33) received QCC nursing mode during the perioperative period. The two groups were followed up for 12 months. The hospital time, the incidence of postoperative complications, the satisfaction of patients to nursing, the awareness rate of patients' nursing safety knowledge and the rate of nursing errors were compared between the two groups.

Results

The hospital time in the experiment group was shorter than that in the control group, the incidence of postoperative complications and the rate of nursing errors in the experiment group were significantly lower than those in the control group (P<0.05). The total satisfaction of patients to nursing and the awareness rate of patients' nursing safety knowledge in the experiment group were significantly higher than those in the control group (P<0.05). Cox regression model analysis showed that the higher patients get the awareness rate of nursing safety knowledge, the lower the risk of complications occur in patients with QCC nursing mode, which was the protective factor of complications (P< 0.05). The higher the age of patients, the higher the risk of complications, which is a risk factor for complications (P<0.05).

Conclusion

During the perioperative period of hernia repair, the application of QCC nursing mode can significantly shorten the hospital time of patients, reduce the occurrence of postoperative complications, improve patients' satisfaction and overall nursing quality, and it is worth popularizing and applying in clinic.

Key words: Quality control circle nursing mode, Hernia, inguinal hernia, Perioperative period, Application effect
表1 2组临床指标比较
组别 研究组(33例) 对照组(28例) 检验值 P值
术后住院时间(d,±s) 5.31±1.43 9.11±1.64 9.668 <0.001
护理差错率[例(%)] 1(3.03) 7(23.33) 4.633a 0.031
患者对护理的总满意度[例(%)] 32(96.97) 18(64.29) 10.947 <0.001
患者护理安全知识知晓率[例(%)] 28(84.85) 13(46.43) 10.146 0.001
表2 2组并发症发生情况比较[例（%）]
组别 研究组(33例) 对照组(28例) χ2值 P值
尿潴留 2(6.06) 5(17.86) 1.076a 0.300
异物感硬结 1(3.03) 2(7.14) 0.021a 0.884
阴囊血清肿 1(3.03) 2(7.14) 0.021a 0.884
阴囊水肿 2(6.06) 2(7.14) 0.029a 0.865
切口愈合不良 0(0) 2(7.14) Fisher 0.459
慢性疼痛 1(3.03) 1(3.57) Fisher 1.00
总发生率 7(21.21) 14(50) 5.561 0.018
表3 并发症发生情况的Cox回归分析
变量 β SE waldχ2 P HR 95% CI
年龄 0.067 0.032 4.384 0.036 1.07 1.07(1.00~1.14)
住院时间 0.027 0.025 1.166 0.280 1.03 1.03(0.98~1.08)
护理差错率 0.631 0.345 3.345 0.067 1.88 1.88(0.96~3.70)
患者对护理的总满意度 -0.783 0.872 0.806 0.369 0.46 0.46(0.08~2.52)
患者护理安全知识知晓率 -0.164 0.055 8.891 0.003 0.85 0.85(0.76~0.95)
护理模式 -0.218 0.03 52.804 <0.001 0.80 0.80(0.76~0.85)
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