探讨持续质量改进手术室护理流程在开放腹股沟疝修补术中的应用效果。

选取2020年1月至2022年12月，首都医科大学附属北京天坛医院采用"七步法"行开放腹股沟疝修补术的腹股沟疝患者共110例，构建持续质量改进手术室护理方案。将改进方案实施前（2020年1月至2021年6月）收治的55例患者作为对照组，实施后（2021年7月至2022年12月）收治的55例患者作为观察组。对比2组患者的手术时间、术后切口感染率，护理人员手术配合度，手术室护理人员操作规范性（无菌操作规范性、手术流程规范性、手卫生操作规范性）及手术室整体护理质量，患者满意度。

观察组较对照组手术时间更短[（80.84±3.58）min vs（82.59±4.21）min]，手术配合度更好[（9.12±0.14）分vs（8.25±0.68）分]，患者总满意度更高（90.91% vs 76.36%），差异均有统计学意义（P<0.05）。观察组较对照组切口感染率有下降趋势，但差异无统计学意义（P>0.05）。观察组手术室护理人员无菌操作、手术流程、手卫生规范性评分，手术室整体护理质量（环境管理、物品摆放、消毒隔离、护理文书登记）均较对照组有所提升（P<0.05）。

持续质量改进手术室护理流程可有效提高术中医护配合度，缩短手术时间，提高手术室整体护理质量及患者满意度。可能会降低切口感染率，但有待大样本研究进一步观察。

To explore the application effect of operating room nursing process based on continuous quality improvement in open inguinal hernia repair.

A total of 110 patients with inguinal hernia undergoing open herniorrhaphy with seven-step method in Beijing Tiantan Hospital Affiliated to Capital Medical University were enrolled between January 2020 and December 2022. According to the implementation of operating room nursing program based on continuous quality improvement, they were divided into control group (55 cases, before implementation, between January 2020 and June 2021) and observation group (55 cases, after implementation, between July 2021 and December 2022). The operation time, incidence of postoperative incision infection, surgical cooperation of nursing staffs, surgical cooperation of nursing staffs, standardization of operation by nursing staffs (aseptic operation, surgical procedure and hand hygiene operation), overall nursing quality of operating room, and patients satisfaction were compared between the two groups.

Compared with the control group, the operation time was shorter [(80.84±3.58) min vs (82.59±4.21) min], surgical cooperation was better [(9.12±0.14) scores vs (8.25±0.68) scores], and overall satisfaction was higher (90.91% vs 76.36%) in the observation group, with statistical significance (P<0.05). The incidence of incision infection in the observation group was lower than that in the control group, but the difference was not statistically significant (P>0.05). The standardization scores of aseptic operation, surgical procedure and hand hygiene operation by nursing staffs, and scores of overall nursing quality in operating room (environmental management, items placement, disinfection and isolation, registration of nursing documents) in the observation group were improved compared with those in the control group (P<0.05).

The operating room nursing process based on continuous quality improvement can effectively improve intraoperative doctor-nurse cooperation, shorten the operation time, improve overall nursing quality of operating room and patients satisfaction, which may reduce the incidence of incision infection. However, it needs to be further observed in a large sample study.