笃铭丽,周意,方芳,陈兰,王秋莉.CCU心肌梗死患者护理流程再造的实证研究[J].上海护理,2017,17(8):
CCU心肌梗死患者护理流程再造的实证研究
DOI:
中文关键词:  CCU  心肌梗死  护理  流程再造
英文关键词:CCU  myocardial infarction  nursing  process reengineer
基金项目:上海交通大学医学院科技,jyh1410
作者单位E-mail
笃铭丽* 上海交通大学附属第一人民医院 200080 shikareely@163.com 
周意 上海交通大学附属第一人民医院 200080  
方芳 上海交通大学附属第一人民医院 200080  
陈兰 上海交通大学附属第一人民医院 200080  
王秋莉 上海交通大学附属第一人民医院 200080  
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中文摘要:
      目的 对CCU心肌梗死患者护理流程进行再造,以提高心肌梗死患者救治效率,改进CCU医护人员的自我效能感。方法 通过成立流程再造团队、分析现有流程缺陷、文献分析、头脑风暴、医护大讨论等措施对CCU心肌梗死患者护理流程进行再造,形成流程图,并对CCU医护人员进行相关培训。实施流程再造前,选取2015年1月~3月由于急性心肌梗死入住我院CCU的患者作为对照组,实施流程再造措施后选取2016年1月~3月由于急性心肌梗死入住我院CCU的患者作为观察组,观察两组患者救治效率,CCU护士的自我效能感。结果 对CCU心肌梗死患者护理流程实施再造后,在心电图操作、建立静脉通路及采血、药物应用、询问病史完成各项记录、医嘱审核、医患术前沟通等6个项目的操作时间达标率方面比较差异有统计学意义,p<0.05。实施流程再造后CCU护士自我效能感有所提高,p<0.05,差异有统计学意义。结论 对CCU心肌梗死患者实行急救流程再造,可以提高心肌梗死患者救治效率,改进CCU护士的自我效能感。
英文摘要:
      Objective: To improve the therapeutic efficiency in patients with myocardial infarction (MI), and enhance the self-efficacy of coronary care units (CCUs) nursing staff by reengineering the nursing process for MI patients in CCUs. Methods: The nursing process for MI patients in the CCUs was reengineered by setting up an reengineering team analyzing the current process, reviewing literature, etc, in order to form workflow charts and train CCU nursing staff accordingly. The therapeutic efficiency and self-efficacy was compared between the patients with acute myocardial infarction (AMI) admitted in the CCU of Shanghai General Hospital from January to March, 2016 under the reengineered nursing process and those from January to March, 2015 as the controlled group. Results:The significant improvements (p<0.05) were observed in the qualified rates of finished time of performing electrocardiogram exams, establishing venous access, collecting blood samples, administering medications, recording medical history, and reviewing physician’s orders, and communicating with patients preoperatively. Conclusion: The reengineered emergency nursing process for MI patients in the CCUs may improve the therapeutic efficiency of MI patients and enhance the self-efficacy of CCU nursing staff.
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