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导航护理模式在胃癌患者连续性全程管理中的初步探讨与实践

The initial practice of nurse navigation in the continuous management of patients with gastric cancer

  • 摘要:
    目的 探讨“导航护士”角色在胃癌患者连续性全程管理中的应用效果。
    方法 以患者需求为导向,针对胃癌患者就医过程中诊疗不连续的主要环节,界定胃癌专病导航护士的角色功能和岗位职责,建立癌症患者连续性全程管理模式,并从患者满意度、医护人员认可度、围手术期并发症等方面评估该管理模式的应用效果。
    结果 成功建立胃癌专病导航护士介导的“门诊-住院-出院”全程管理模式。该模式下,患者治疗依从性明显提高,导航护理满意度较高,对各项工作满意率大于97%。医护人员对导航护士认可度较高(> 97%)。干预组术后Clavien-Dindo 2级肺部并发症发生率低于对照组(4.2% vs 15.5%,P=0.019)。
    结论 导航护士角色的引入和应用能推动胃癌全程管理模式的建立与发展,提高患者满意度及治疗依从性,值得推广应用与加强创新。

     

    Abstract:
    Objective To explore the application effect of the nurse navigation in the continuous whole-process management of patients with gastric cancer.
    Methods Under the guidance of patients' needs, the roles, functions and job responsibilities of nurse navigators for patients with gastric cancer were defined, and a continuous whole-process management model was established. The application effect of the management model was evaluated from the aspects of patient satisfaction, recognition of medical staff, perioperative complications and so on.
    Results An "outpatient-inpatient-discharge" management model mediated by a nurse navigator for gastric cancer was successfully established. In this mode, patients' satisfaction with medical guidance was significantly improved (satisfaction rate > 97%), patients' treatment compliance was also significantly improved. Nurse navigator had a high degree of recognition from medical staff (> 97%). The incidence of postoperative respiratory complications of Clavien-Dindo 2 level was lower in the intervention group than that in the control group (4.2% vs 15.5%, P=0.019).
    Conclusions The establishment of nurse navigation and beginning of relevant work could significantly improve patients' satisfaction and compliance and promote the progress of whole-process management of gastric cancer, and is worth of promoting application and strengthening innovation.

     

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