基于加速康复模式下伤口专科护士在普外科手术伤口管理中的推广效果

The Promotional Effect of Specialized Wound Nurses in Surgical Wound Management in General Surgery under the Enhanced Recovery after Surgery Model

摘要: 目的：探讨基于加速康复模式下伤口专科护士在普外科手术伤口管理工作中的推广效果。方法：将2023年6月~2023年8月在我科行胃肠手术的132例患者为对照组，2023年11月~2024年1月在我科行胃肠手术的143例患者为观察组。比较两组患者伤口感染发生率，术后住院天数，患者等待换药的时间，责任护士寻找告知医生换药的时间，医生在伤口管理上的时间，以及患者的满意度。结果：试验组和对照组的感染发生率分别为1.67%和2.27%，胃部手术患者术后住院时间分别为(9.00 ± 2.04) d和(9.64 ± 0.92) d，结直肠手术患者术后住院时间分别为(7.64 ± 1.86) d和(8.12 ± 1.05) d，患者等待换药时间分别为7.75 ± 4.57 min和20.40 ± 14.68 min，责任护士寻找告知医师换药的时间分别为2.55 ± 1.23 min/d和12.20 ± 5.54 min/d，医师用于伤口管理的时间分别为2.46 ± 1.30 min/d和9.56 ± 3.59 min/d，两组比较，除感染发生率外差异均有统计学意义(P < 0.05)。患者术后住院时间、责任护士寻找告知医师换药时间、患者等待换药的时间以及医师用于伤口管理时间均明显缩短，而且患者对伤口管理的满意度高于95%。结论：伤口专科护士为主导的医护一体化手术伤口管理模式能够缩短患者术后住院时间、患者等待换药时间，符合ERAS发展的需求，丰富了ERAS内涵。同时能够减少护士寻找告知医师换药时间，缩短医师在伤口管理中的时间，利于科室伤口管理资料数据的收集，提高了医护工作效率，增强了科室凝聚力，实现了医护患三满意，值得推广。

Abstract: Objective: To explore the promotion effect of specialized wound nurses in wound management of general surgery under accelerated rehabilitation mode. Methods: 132 patients who underwent gastrointestinal surgery in our department from June 2023 to August 2023 were taken as the control group, and 143 patients who underwent gastrointestinal surgery in our department from November 2023 to January 2024 were taken as the observation group. The incidence of wound infection, the number of days in hospital after surgery, the time for patients to wait for dressing change, the time for responsible nurses to find and inform doctors of dressing change, the time for doctors to manage wounds, and patient satisfaction were compared between the two groups. Results: The incidence of infection in the test group and the control group was 1.67% and 2.27%, respectively. The hospitalization time of patients with gastric surgery was (9.00 ± 2.04) days and (9.64 ± 0.92) days, respectively. The hospitalization time of patients with colorectal surgery was (7.64 ± 1.86) days and (8.12 ± 1.05) days, respectively. The waiting time for dressing change was 7.75 ± 4.57 min and 20.4 ± 14.68 min, respectively. The time for the responsible nurse to seek and inform the physician to change the dressing was 2.55 ± 1.23 min/d and 12.20 ± 5.54 min/d, respectively, and the time for the physician to use wound management was 2.46 ± 1.30 min/d and 9.56 ± 3.59 min/d, respectively. The difference between the two groups was statistically significant (P < 0.05), except for the incidence of infection. The patient’s length of stay after surgery, the time for the responsible nurse to seek and inform the doctor about dressing change, the time for the patient to wait for dressing change, and the time for the doctor to use wound management were significantly shortened, and the patient’s satisfaction with wound management was higher than 95%. Conclusion: The integrated medical and nursing wound management mode led by specialized wound nurses can shorten the hospital stay and waiting time of patients after surgery, meet the needs of ERAS development, and enrich the connotation of ERAS. At the same time, it can reduce the time for nurses to find and inform doctors about dressing changes, shorten doctors’ time in wound management, facilitate the collection of department wound management data, improve the efficiency of medical and nursing work, enhance the cohesion of departments, and achieve the three satisfaction of doctors, nurses and patients, which is worth promoting.