门诊手术室超声引导下神经阻滞麻醉的护理

摘要

目的：介绍我院门诊手术室设立麻醉护士对麻醉护理质量的提高，以及带动超声引导神经阻滞新技术开展的前期经验。方法：回顾性研究门诊手术室手术麻醉的基本情况，按照时间段分为两组：麻醉组为2013年由麻醉护士按照研究中所确立的工作模式护理，对照组为2012年门诊手术室护士按照传统方法进行手术期护理。统计指标：①两年来门诊手术量，麻醉量，接受神经阻滞及超声引导下的麻醉病例数，超声引导下神经阻滞的类型，手术间周转率及开台及时率。②对患者，麻醉医师和手术医师的满意度调查，采用百分制。结果：2013年的手术量，麻醉病例数，神经阻滞病例数，超声引导下神经阻滞病例数均2012年明显增长，其中后三项指标相应的相对比在两年间的差异具有统计学意义（P ＜0.05）。骨科手术间周转率与开台及时率在2013年由2012年的36.4％与64.9％分别提高到55.6％与77.3％。患者与麻醉医生的评分两年间差异具有统计学意义（P ＜0.05）。结论：麻醉专科化护理可提高门诊手术室的工作效率，带来麻醉护理质量以及患者满意度的提高，并有可能促进超声引导神经阻滞新技术的开展，但是需要进一步规范化的发展。%Objective To introduce the early experience of improving the quality of anesthesia care and driving new technologies of ultra-sound - guided nerve block(USNB)after nurse anesthesia was founded in out - patient operating room(OOR)in our hospital. Method The retrospective study of the basic situation of surgery and anesthesia in OOR outpatient operating room. According to the time period,all subjects were divided into two groups:the anesthesia group in 2013 was the implementation mode of the nurse anesthesia in accordance with the study, the control group was in 2012 OOR nurses implemented operative care according to traditional methods. Statistical indicators:①the numbers of outpatient surgery,the cases of anesthesia,the numbers of patients receiving anesthesia and USNB,the type of USNB,the turnover rate among OR,and the rate of on time of surgery during two years. ②satisfaction surveys using percentile were distributed to patients,anesthesiologists and surgeons. Results In 2013,the numbers of outpatient surgery,the cases of anesthesia,the numbers of patients receiving anesthesia and US-NB,were significantly increased than in 2012,in which appropriate ratio relative of the later three indicators had a statistically significant difference between the two years(P <0. 05),the turnover rate among OR,and the rate of on time of surgery raised from 36. 4% and 64. 9%in 2012 to 55. 6% and 77. 3% in 2013 respectively. The satisfaction of patients and anesthesiologists had a statistically significant difference between the two years(P <0. 05). Conclusion The specialist care of anesthesia can improve the efficiency of OOR,improve patient satisfac-tion and quality of anesthesia care,and is likely to promote the new USNB technique,but it still requires further standardization of develop-ment.