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精准护理下加速康复外科理念在新疆推行现状调查与分析

Investigation and Analysis of the Implementation Status of Enhanced Recovery After Surgery in the Context of Precision Nursing in Xinjiang

  • 摘要:
      目的   调查与分析精准护理下新疆三甲医院外科护士推行加速康复外科(enhanced recovery after surgery, ERAS)理念的现状,为ERAS精准护理的发展提供依据。
      方法   2023年3−4月,采用便利抽样法,以在线问卷的形式收集新疆8所三甲医院外科护士实施ERAS现状的数据。
      结果  共收集有效问卷985份;8所医院中,已有7所医院在骨科推行了ERAS理念;外科护士ERAS知信行问卷平均得分(182.98±17.69)分,其中知识维度平均得分(13.08±1.51)分,态度维度平均得分(88.75±8.30)分,行为维度平均得分(81.15±11.96)分;61.02%外科护士开展ERAS路径的数量主要集中在4~6项,其中“预防术后肠梗阻”项目应用最普遍,达498人(占50.56%);78.48%的护士认为工作超负荷是精准护理下推行ERAS理念的最大阻碍因素,多学科协作差和护士推行意识不强位列第二、第三位,占74.92%和71.57%。
      结论   ERAS理念在新疆已得到外科护士的认可,但在所有外科领域的应用尚未普及,ERAS路径的实施数量和质量有待提高,精准护理下ERAS理念的发展依然任重道远。

     

    Abstract:
      Objective   To investigate the current status of surgical nurses' implementation of enhanced recovery after surgery (ERAS) concepts in the context of precision nursing in Xinjiang and to provide a basis for the development of precision nursing of ERAS.
      Methods   By way of convenience sampling, surgical nurses from 8 tertiary-care hospitals were involved in a survey on their ERAS implementation status in March and April 2023 and the results were collected by online questionnaire.
      Results   A total of 985 valid questionnaires were collected. Out of the 8 hospitals covered in the survey, the orthopedics departments of 7 hospitals have implemented ERAS concepts, accounting for 87.50%. The average score for the ERAS Knowledge, Attitude, and Practice Questionnaire among the surgical nurses was (182.98±17.69), of which, the average score for ERAS knowledge was (13.08±1.51), the average score for ERAS attitude was (88.75±8.30), and the average score for ERAS practice was (81.15±11.96). A total of 61.02% of the surgical nurses implemented ERAS pathways that concentrated on 4-6 pathways, with the prevention of postoperative ileus after surgery being the most commonly implemented pathway, accounting for 498 (50.56%) surgical nurses. A total of 78.48% of the nurses considered work overload to be the most important obstacle to implementing ERAS in the context of precision nursing. Poor multidisciplinary team collaboration and poor awareness of implementation among the nurses ranked the second and the third, accounting for 74.92% and 71.57%, respectively, of the surgical nurses.
      Conclusion   ERAS has won the approval of surgical nurses in Xinjiang, but it is still not widely implemented in all surgical fields. In addition, the quantity and quality of ERAS pathways implemented still need to be further improved. The development of ERAS in the context of precision nursing remains a long-term challenge.

     

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