| Objective Based on the consensus of Delphi experts,the clinical nursing pathway in Post Anesthesia Care Unit(PACU)was preliminarily constructed,and on this basis,clinical verification and application were carried out to explore the application effect of clinical nursing pathway in anaesthesia recovery period of patients after general anesthesia.to provide reference for the implementation of nursing in the recovery period of anesthesia.Methods 1.On the basis of literature review,a preliminary draft of the clinical nursing pathway of PACU was developed by group discussion,and the clinical nursing path of PACU was constructed by Delphi method.The research team initially constructed the clinical nursing pathway list of PACU from May to June 2019,and solicit expert opinions from July to October 2019.Two rounds of Delphi method expert letter consultation were completed,and the final path list was further revised and improved according to the expert opinions.2.To evaluate the application effect of the clinical nursing pathway of PACU constructed.A total of 355 patients after general anesthesia who were admitted to PACU of a Class A hospital from December 2019 to September 2020 were selected and randomly divided into the intervention group and the control group.The control group was treated with routine nursing during anesthesia convalescence,and the intervention group was treated with clinical nursing path way.The general information and basic information of patients were collected,Length of Stay(LOS)in PACU、the incidence of complications 、Compliance during the recovery period of anesthesia were compared between the two groups,and the application effect of clinical nursing pathway was verified.ResultsResults of expert consultation:(1)The recovery rates of two rounds of expert consultation were 90.91% and 100.00%,respectively,and the expert positive coefficient > was 70%.(2)The coefficient of expert authority Cr= 0.89,the basis of judgment Ca= 0.87,and the degree of familiarity Cs= 0.92.(3)The coefficient of variation of path table was 0.06～ 0.21,the Kendall harmony coefficient was 0.25,and the significance level of the coordination coefficient was P < 0.05.(4)The average score of two rounds expert opinion concentration was 4.46,and the frequency of full marks was 0.61.According to the expert opinions,9 items were added,19 items were modified and 3 items were deleted.Finally,6 first-level items,31 second-level items and 121 third-level items were formed.and the patient version of the clinical nursing path was constructed.construct the classification management of patients in anesthesia recovery period based on the theoretical framework of fast and slow channels.2.Application effect of clinical nursing path in PACU: there was no statistical significance in general information between the two groups,which was comparable.LOS of PACU in the intervention group was 1.08(1.00,1.33)less than the control group(1.16,1.42),P < 0.05;The incidence of Emergency Agitation(EA)in the intervention group was 4.49% lower than the control group 10.16%(P < 0.05),and the compliance of the intervention group was 95.51% higher than the control group 89.27%(P <0.05).Conclusion1 Through the analysis of the results of expert consultation,the two rounds of Delphi consultation have a high degree of authority,high degree of enthusiasm,and a good degree of coordination,and the results of consultation are relatively reliable and scientific.Based on the fast and slow channels to assess the degree of risk of patients during the anesthesia recovery period,patients can be classified and managed in PACU to provide reference for clinical nursing practice.The patient version of the clinical nursing pathway has been constructed,and the clinical nursing pathway of PACU provides a theoretical basis for nursing during anesthesia recovery.2.Through the application of the clinical nursing pathway in PACU,the feasibility and operability of the pathway are preliminarily verified.After the application of the clinical nursing pathway,it can effectively reduce LOS of anesthesia recovery,improve the compliance of patients during the anesthesia recovery period,and reduce the incidence of EA during the anesthesia recovery period.However,the impact on complications still needs to be further explored,which verifies that the clinical nursing pathway is worthy of clinical reference Promote applications. |
PDF Full Text Request