Application of Clinical Nursing Path Improvement for Day Surgery of Laparoscopic Cholecystectomy_West China Medical Journal

Authors：

 LiuLing ¹ ,  DaiYan ²

1. Day Surgery Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DaiYan, Email: 1846703501@qq.com

Keywords：

Clinical pathway; Nursing; Day surgery; Laparoscopic cholecystectomy

DOI：

10.7507/1002-0179.201600164

Video：

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Objective To investigate the efficacy of improved clinical nursing path for day surgery of laparoscopic cholecystectomy (LC). Methods The clinical data of 3 274 patients who underwent day surgery of LC following the clinical pathway between January 2011 and December 2015 were collected. The rate of adverse events including pain, postoperative nausea and vomiting (PONV), retention of urine and staxis before and after the improvement of clinical nursing path was analyzed and compared. Results For adverse event rate before and after the improvement of clinical nursing path, the difference in the incidence of pain and PONV was statistically significant (P < 0.05), while the difference in retention of urine and staxis was not statistically significant (P > 0.05). Conclusions Through the improvement of clinical nursing path for LC during day time, the procedure of nursing becomes more standardized. It is more feasible for clinical work and postoperative adverse reactio n rate becomes lower. It can also help shorten postoperative rehabilitation time and ensure perioperative medical quality and safety.

Citation： LiuLing, DaiYan. Application of Clinical Nursing Path Improvement for Day Surgery of Laparoscopic Cholecystectomy. West China Medical Journal, 2016, 31(4): 603-606. doi: 10.7507/1002-0179.201600164 Copy

1.	赵亮, 张颖, 胡牧, 等. 临床路径实施与应用效果探讨[J]. 中华医院管理杂志, 2010, 26(7): 497-500.
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11.	Apfel CC, Norbert R. Risk assessment of postoperative nausea and vomiting[J]. Int Anesthesiol Clin, 2003, 41(4): 13-32.
12.	李志超, 王煜, 王小成, 等. 基于快速康复外科理念的疼痛管理模式在日间腹腔镜胆囊切除术的应用[J]. 华西医学, 2015, 30(5): 804-807.
13.	Britainireland AG. Day case and short stay surgery: 2[J]. Anaesthesia, 2011, 66(5): 417-434.
14.	刘素珍, 李继平, 郭晶, 等. 日间手术患者延伸服务模式构建与实践[J]. 中国护理管理, 2012, 12(9): 5-7.
15.	马洪升, 余伟萍, 马庆鑫, 等. 日间手术医疗安全和病人感知调查与分析[J]. 中国医院管理, 2013, 33(2): 38-39.
16.	蒋群, 谷翔, 盛传玲. 临床护理路径表的制定与应用[J]. 当代护士: 学术版, 2012, (12): 174-176.
17.	戴燕. 优质护理服务在日间手术病房实践效果[J]. 华西医学, 2012, 27(11): 1707-1708.
18.	杨炯, 李劲松, 徐卫国. 临床路径评价指标体系的设计与构建[J]. 中国医院管理, 2010, 30(11): 23-25.
19.	马洪升, 戴燕. 解除日间手术后顾之忧[J]. 中国医院院长, 2013(6): 76-77.

1. 赵亮, 张颖, 胡牧, 等. 临床路径实施与应用效果探讨[J]. 中华医院管理杂志, 2010, 26(7): 497-500.
2. 马洪升, 戴燕. 日间手术治疗模式国内外发展简述[J]. 中国医院管理, 2012, 32(1): 47-48.
3. Philip BK. Day care surgery: the United States model of health care[J]. Ambul Surg, 2012, 17(4): 81-82.
4. Kjeld MP. The Nordic Health Care Model[C]// The 9th International Congress on Ambulatory Surgery. Copenhagen: IAAS, 2011.
5. Lombari P, Carlomagno N, Ricci G, et al. Laparoscopic cholecystectomy in day surgery[M]//Agresta F, Campanile FC, Vettoretto N. Laparoscopic cholecystectomy. Switzerland: Springer International Publishing, 2014: 131-139.
6. 鲍杨, 贺广宝, 张丽峰, 等. 日间手术麻醉安全性探讨[J]. 医学与哲学, 2014, (8): 86-87.
7. 徐海英, 沈伟. 择期手术患者缩短术前禁食禁饮时间的研究[J]. 护士进修杂志, 2010, 25(2): 109-111.
8. 秦薇. 择期手术患者术前禁食禁饮时间的研究进展[J]. 中华护理杂志, 2014, 49(1): 76-79.
9. Younis J, Salerno G, Fanto D, et al. Focused preoperative patient stoma education, prior to ileostomy formation after anterior resection, contributes to a reduction in delayed discharge within the enhanced recovery programme[J]. Int J Colorectal Dis, 2012, 27(1): 43-47.
10. Gustafsson UO, Scott MJ, Schwenk W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS (®)) Society recommendations[J]. World J Surg, 2013, 37(2): 259-284.
11. Apfel CC, Norbert R. Risk assessment of postoperative nausea and vomiting[J]. Int Anesthesiol Clin, 2003, 41(4): 13-32.
12. 李志超, 王煜, 王小成, 等. 基于快速康复外科理念的疼痛管理模式在日间腹腔镜胆囊切除术的应用[J]. 华西医学, 2015, 30(5): 804-807.
13. Britainireland AG. Day case and short stay surgery: 2[J]. Anaesthesia, 2011, 66(5): 417-434.
14. 刘素珍, 李继平, 郭晶, 等. 日间手术患者延伸服务模式构建与实践[J]. 中国护理管理, 2012, 12(9): 5-7.
15. 马洪升, 余伟萍, 马庆鑫, 等. 日间手术医疗安全和病人感知调查与分析[J]. 中国医院管理, 2013, 33(2): 38-39.
16. 蒋群, 谷翔, 盛传玲. 临床护理路径表的制定与应用[J]. 当代护士: 学术版, 2012, (12): 174-176.
17. 戴燕. 优质护理服务在日间手术病房实践效果[J]. 华西医学, 2012, 27(11): 1707-1708.
18. 杨炯, 李劲松, 徐卫国. 临床路径评价指标体系的设计与构建[J]. 中国医院管理, 2010, 30(11): 23-25.
19. 马洪升, 戴燕. 解除日间手术后顾之忧[J]. 中国医院院长, 2013(6): 76-77.

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