组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2024, Vol. 20 ›› Issue (5): 551-.

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基于SWITCH专科护理交接核查表在口腔颌面显微皮瓣重建手术中的应用

  

  • 出版日期:2024-10-08 发布日期:2024-11-28

plication of nursing handover checklist based on SWITCH in oral and maxillofacial microvascular reconstructive surgery

  • Online:2024-10-08 Published:2024-11-28

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摘要：

目的　基于SWITCH设计专科护理交接核查表，并探讨其在口腔颌面显微皮瓣重建手术中的应用效果。方法　根据SWITCH内容，设计口腔颌面显微皮瓣重建手术的专科护理交接核查表。将2021年1月至12月期间在口腔颌面外科进行的150例显微皮瓣重建手术随机分为实验组和对照组。实验组采用专科护理交接核查表，实施术中护理交接；对照组采用常规口头交接方式，按物品清点方法交接。比较两组的交接时长、交接过程评价、交接质量，以及医护人员的满意度评分。结果　两组的交接时长无统计学差异，分层分析中，实验组腓骨肌皮瓣病例的巡回护士交接时长显著短于对照组（P=0.014 6）。实验组器械护士的总体交接能力评分为6.95±0.76，显著高于对照组的6.25±0.85（P=0.008 4）。其中，在组织效能和沟通技巧部分，器械护士和巡回护士的实验组评分均高于对照组，差异有统计学差异（P<0.05）；在临床判断部分，器械护士的实验组评分显著高于对照组（P=0.030 5）。实验组器械护士和巡回护士的交接错漏次数分
别为（1.25±1.02）次和（1.05±1.10）次，明显低于对照组的（3.10±2.29）次和（2.65±2.30）次（P=0.002 1，P=0.007 9）。实验组手术医师、器械护士和巡回护士的总体满意度明显高于对照组（P<0.000 1，P=0.026 1，P=0.031 6）。结论　对于复杂且耗时长的口腔颌面显微皮瓣重建手术而言，基于SWITCH的专科护理交接核查表规范了口腔颌面显微皮瓣重建手术护理交接的流程和内容，提高交接班质量，降低错漏发生率，改善了医护人员的工作体验。

关键词: 护理核查表, 　术中交接, 　显微皮瓣重建手术

Abstract: Objective　To design the intraoperative nursing handover checklist based on SWICTH checklist and investigate its application in oral and maxillofacial microsurgical flap reconstruction. Methods　The intraoperative nursing handover checklist of oral and maxillofacial microvascular flap reconstruction was established according to SWICTH checklist. A total of 150 cases of microsurgical flap reconstruction performed in the department of oral and maxillofacial surgery from January to December 2021 were randomly divided into experimental and control groups. The handover checklist was used in experimental group， in comparison with oral handover method in control group. The quality and the duration of intraoperative nursing handover as well as the satisfaction scores from surgical team were compared between the two groups. Results　There was no statistical difference in handover duration between the two groups. In stratified analysis， the duration of circular nursing handover for fibular myocutaneous flap cases in experimental group was significantly shorter than that of control group （P=0.014 6）. The score of overall competence from scrub curses in experimental group was 6.95±0.76， significantly higher than 6.25±0.85 in control group （P=0.008 4）. In fields of organization and communication skills， the scores of scrub and circular nurses in experimental group were statistical higher than those in control group （P<0.05）. In the clinical judgment section， the score of scrub nurses in experimental group was significantly higher than that in control group（ P=0.030 5）. The nursing handover errors and omissions of scrub and circular nurses in experimental group were（ 1.25±1.02） times and（ 1.05±1.10） times， respectively， which were significantly lower than（ 3.10±2.29） times and（ 2.65±2.30） times in control group （P=0.002 1， P=0.007 9）. The score of satisfaction of surgeons and handover nurses in experiment group was significantly higher than that in control group （P<0.000 1， P=0.026 1， P=0.031 6）. Conclusion　In terms of complicated oral and maxillofacial microvascular flap reconstruction， the intraoperative nursing handover checklist based on SWITCH standardizes the procedure and content of shifting， enhances handover quality， reduces the incidence of shifting errors and omissions， and improves the satisfaction of medical and nursing staff.

Key words: Nursing checklist, 　Intraoperative handover, 　Microvascular flap reconstruction