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

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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. 基于快速康復外科理念的疼痛管理模式在日間腹腔鏡膽囊切除術的應用[J]. 華西醫學, 2015, 30(5): 804-807.
13.	Britainireland AG. Day case and short stay surgery: 2[J]. Anaesthesia, 2011, 66(5): 417-434.
14.	劉素珍, 李繼平, 郭晶, 等. 日間手術患者延伸服務模式構建與實踐[J]. 中國護理管理, 2012, 12(9): 5-7.
15.	馬洪升, 余偉萍, 馬慶鑫, 等. 日間手術醫療安全和病人感知調查與分析[J]. 中國醫院管理, 2013, 33(2): 38-39.
16.	蔣群, 谷翔, 盛傳玲. 臨床護理路徑表的制定與應用[J]. 當代護士: 學術版, 2012, (12): 174-176.
17.	戴燕. 優質護理服務在日間手術病房實踐效果[J]. 華西醫學, 2012, 27(11): 1707-1708.
18.	楊炯, 李勁松, 徐衛國. 臨床路徑評價指標體系的設計與構建[J]. 中國醫院管理, 2010, 30(11): 23-25.
19.	馬洪升, 戴燕. 解除日間手術后顧之憂[J]. 中國醫院院長, 2013(6): 76-77.

1. ?趙亮, 張穎, 胡牧, 等. 臨床路徑實施與應用效果探討[J]. 中華醫院管理雜志, 2010, 26(7): 497-500.
2. 馬洪升, 戴燕. 日間手術治療模式國內外發展簡述[J]. 中國醫院管理, 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. 鮑楊, 賀廣寶, 張麗峰, 等. 日間手術麻醉安全性探討[J]. 醫學與哲學, 2014, (8): 86-87.
7. 徐海英, 沈偉. 擇期手術患者縮短術前禁食禁飲時間的研究[J]. 護士進修雜志, 2010, 25(2): 109-111.
8. 秦薇. 擇期手術患者術前禁食禁飲時間的研究進展[J]. 中華護理雜志, 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. 基于快速康復外科理念的疼痛管理模式在日間腹腔鏡膽囊切除術的應用[J]. 華西醫學, 2015, 30(5): 804-807.
13. Britainireland AG. Day case and short stay surgery: 2[J]. Anaesthesia, 2011, 66(5): 417-434.
14. 劉素珍, 李繼平, 郭晶, 等. 日間手術患者延伸服務模式構建與實踐[J]. 中國護理管理, 2012, 12(9): 5-7.
15. 馬洪升, 余偉萍, 馬慶鑫, 等. 日間手術醫療安全和病人感知調查與分析[J]. 中國醫院管理, 2013, 33(2): 38-39.
16. 蔣群, 谷翔, 盛傳玲. 臨床護理路徑表的制定與應用[J]. 當代護士: 學術版, 2012, (12): 174-176.
17. 戴燕. 優質護理服務在日間手術病房實踐效果[J]. 華西醫學, 2012, 27(11): 1707-1708.
18. 楊炯, 李勁松, 徐衛國. 臨床路徑評價指標體系的設計與構建[J]. 中國醫院管理, 2010, 30(11): 23-25.
19. 馬洪升, 戴燕. 解除日間手術后顧之憂[J]. 中國醫院院長, 2013(6): 76-77.

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West China Medical Journal

Application of Clinical Nursing Path Improvement for Day Surgery of Laparoscopic Cholecystectomy

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