摘要
背景:早期离床活动是脊柱手术患者术后早期康复的核心,了解脊柱手术患者术后首次下床活动的现状有助于不断优化下床活动流程,保障医疗护理质量和患者安全。目的:了解国内医院脊柱手术患者术后首次下床活动现状,为医疗护理工作提供指导。方法:采用自行设计的问卷,通过问卷星,对全国华东地区、华南地区、华北地区、西北地区、西南地区、东北地区各城市采用目的抽样选取骨科综合能力较强的三级甲等医院进行调查。结果:国内医院已经开始重视脊柱手术患者术后首次下床活动风险,并通过评估以期降低风险。多数医院由主管医师根据自身专业认知水平结合患者情况决定患者术后首次下床活动时机,但是首次下床活动流程的实施主要由护士完成,评估和实施的主体不一,存在一定的风险。为了提高术后首次下床活动成功率,在下床活动流程中已增加训练动作,但是多依据医护人员经验进行。使用规范化流程,脊柱手术患者术后首次下床活动面临的风险更少。结论:目前已对脊柱手术患者术后首次下床活动风险有了一定的重视,并采取措施降低风险,但很多环节仍需进一步规范。应充分发挥医护一体化及康复师参与的多学科团队形成《脊柱手术患者术后首次下床活动标准化实践方案》,通过全面、细化的评估内容及量化、标准化的下床活动流程,保障医疗护理质量和患者安全。
Background:Early mobilization is the core of early postoperative rehabilitation of spinal surgery patients.It may be helpful to optimize the management of early mobilization after surgery and ensure the quality of medical care and patient safety by investigating the status of the early mobilization.Objective:To investigate the early mobilization after spinal surgery.Methods:Early mobilization after spinal surgery was investigated by a self-designed questionnaire and purposive sampling in Class 3A hospitals in 31 provinces in the whole country.Results:Domestic hospitals have begun to pay attention to the risk of early mobilization in spinal surgery patients,and reduce the risk through assessment.In most hospitals,the time of early mobilization is decided by the doctors according to their own professional cognition and the patient’s condition.Nurses are mainly responsible for implementing the process of ambulation,and there are certain risks between doctors’assessment and nurses’implementation.In order to improve the success rate of early mobilization,training movements have been added in the process of ambulation,but they are mostly carried out according to the experience of medical staff.With standardized ambulation process,spinal surgery patients are less at risk for early mobilization.Conclusions:The risk of early mobilization after spinal surgery has been paid more attention,but many measures need to be further standardized.It should be given full play to the medical integration and multidisciplinary team involved in rehabilitation to form the standardized practice plan for early mobilization of spinal surgery patients,and ensure the quality of medical care and patient safety through the comprehensive and detailed assessment content and the quantified and standardized ambulation process.
作者
佟冰渡
李高洋
王薇
杨莹
田雪
仉建国
王升儒
陈亚萍
TONG Bingdu;LI Gaoyang;WANG Wei;YANG Ying;TIAN Xue;ZHANG Jianguo;WANG Shengru;CHEN Yaping(Department of Orthopaedics,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China)
出处
《中华骨与关节外科杂志》
2021年第7期626-631,共6页
Chinese Journal of Bone and Joint Surgery
基金
北京协和医学院中央高校基本科研业务费项目(3332020012)
关键词
脊柱手术患者
首次下床活动
问卷调查
Spinal Surgery Patients
Early Mobilization
Questionnaires
作者简介
通信作者:陈亚萍,E-mail:18612672357@139.com
