腹腔镜连台手术护理风险管理影响因素的 质性研究

A Qualitative Study on Influencing Factors of Nursing Risk Management in Consecutive Laparoscopic Surgeries

摘要: 目的：深入了解腹腔镜连台手术护理风险管理的影响因素，为制订适配腹腔镜连台手术的护理风险管理策略，提升护理风险管理能力提供实践指导意见。方法：采用目的抽样法，选取某医院手术室2024年9月~12月配合腹腔镜连台的手术室护士及手术患者，进行质性访谈，通过定向内容分析法进行资料分析。结果：最终纳入访谈对象20名，其中手术室护士15名、手术患者5名。对资料分析后提炼出腹腔镜连台手术护理风险管理影响因素归纳为5个主题(人员、流程、设备与护理中断、制度、患者)及11个亚主题。结论：基于在某医院手术室的背景下，本研究发现腹腔镜连台手术护理风险的多维特征与核心影响因素，导致护理人员普遍存在连台手术专项知识技能不足、高风险环节风险认知分层差异显著等问题。护理管理者应关注强化分层培训体系建设，重点加强中断事件应对、多任务并行处理等专项能力训练，以提高腹腔镜连台手术的特殊操作规范与风险防控策略能力。

Abstract: Objective: To gain an in-depth understanding of the influencing factors in perioperative nursing risk management for laparoscopic consecutive surgeries, providing practical guidance for developing tailored nursing risk management strategies and enhancing risk management capabilities. Methods: Using purposive sampling, operating room nurses and patients undergoing laparoscopic consecutive surgeries at a hospital from September to December 2024 were selected for qualitative interviews, with data analyzed through directed content analysis. Results: A total of 20 interviewees were included, comprising 15 operating room nurses and 5 patients. Thematic analysis of the data identified five main themes (personnel, processes, equipment and nursing interruptions, systems, and patients) and 11 sub-themes influencing nursing risk management in laparoscopic consecutive surgeries. Conclusion: Based on the context of an operating room in a certain hospital, this study found the multidimensional characteristics and key influencing factors of nursing risks in consecutive laparoscopic surgeries. It showed that nurses generally lack specialized knowledge and skills for consecutive surgeries, and there are significant differences in risk perception of high-risk steps. Nursing managers should focus on strengthening the hierarchical training system, emphasizing training in handling interruption events and multitasking, so as to improve nurses’ ability to follow special operational standards and risk prevention strategies for consecutive laparoscopic surgeries.