Donabedian结构-过程-结果模式在提高ICU患者深静脉血栓预防效果中的初探

摘要

目的 探讨 Donabedian结构-过程-结果模式应用于 ICU患者深静脉血栓的预防效果,以提高护理人员对深静脉血栓患者的有效干预及患者的满意度.方法 选取 2014 年 1－12 月入住新疆维吾尔自治区人民医院重症医学二科的 205 例术后患者作为实施前的资料,2015 年 1－12 月入住新疆维吾尔自治区人民医院重症医学二科的 252 例术后患者作为实施后的资料,以Donabedian的结构-过程-结果模式为理论框架,构建 ICU患者深静脉血栓预防的方案;评价深静脉血栓预防护理措施项目的结构、过程及结果并对其开展结构-过程-结果模式.结果 实施干预前后,深静脉血栓的预防措施落实率由干预措施实施前的 52.20％提高到实施后的 88.10％,DVT发病率由实施前的 5.36％降低到实施后0.79％,实施后 Autar评分表上报率(90.22％)较实施前(72.49％)有显著的提高,实施后护理人员深静脉血栓预防相关知识分值较实施前均有明显的提高,实施后患者有效健康宣教达标率(93.65％)和患者满意度(94.84％)均高于实施前,差异均有统计学意义(P＜0.05).结论 Donabedian 的结构-过程-结果模式是提高 ICU深静脉血栓预防效果的有效干预手段,便于护理人员实施深静脉血栓预防的相关干预措施,并大大提高了患者的满意度.%Objective To explore the preventive effect of Donabedian structure-process-result model on ICU patients with deep venous thrombosis,and improve the nursing staff effective intervention to patients with deep venous thrombosis and patients′satisfaction.Methods From January to December 2014,205 patients who were admitted to the second Department of critical Medicine in the Region People′s Hospital were se-lected as the data before implementation.From January to December 2015,252 postoperative patients ad-mitted to the second Department of intensive Medicine in the Region People′s Hospital were used as the data after implementation.Donabedian structure-process-result model was taken as the theoretical frame-work,the scheme of prevention of deep venous thrombosis in ICU patients was constructed,and the struc-ture,process and results of the preventive nursing measures for deep venous thrombosis were evaluated,and the structure-process-outcome model was developed.Results The prevention rate of DVT increased from 52.20％(before the intervention)to 88.10％(after the intervention).The incidence rate of DVT de-creased from 5.36％(before the implementation)to 0.79％(after the implementation).The reported rate of Autar score was 90.22％after implementation,which was significantly higher than that before imple-mentation(72.49％).The scores of related knowledge of deep venous thrombosis prevention in nursing staff were significantly higher than those before implementation.The rate of effective health education reached the standard(93.65％)and patient satisfaction(94.84％)were significantly higher than those be-fore implementation(P ＜0.05).Conclusion Donabedian structure-process-result model is an effective in-tervention to increase the rate of deep venous thrombosis.The intervention measures and patient satisfac-tion of deep venous thrombosis prevention were improved significantly.