| Purpose:To understand the needs of operating nurse who participating in gynecology surgery in the operation room involved in the discussion of preoperative care and having a talk about the content before the operation with surgeon.Delph method was used to develop the content framework for operating nurse and surgeon who participating in gynecology surgery in the operation room to discuss before operation.At last the discussion of preoperative care can be done according to the content framework.And the discussion will be applied to clinical gynecologic surgery.It can also evaluate the effect of operating nurses participating in preoperative discussion on the quality of surgical care.Method:It consists of 2 parts.The first one is the content framework of preoperative care discussion determined by Delph method,mainly using literature retrieval,group discussion and the method(that of investigation for the need of operating nurses involved in preoperative discussion)to make a preliminary framework of preoperative care discussion.Then through two rounds of expert consultation to optimize and develop the“Table of contents of preoperative medical care discussion”,determinning the content of the discussion.The second one is the evaluation of using the“Table of contents of preoperative medical care discussion”.We choose 208 operating nurse who participating in gynecology surgery in the operation room of four first-class three-grade hospitals in Hubei Province.They were divided into experimental group and observation group by convenient sampling.The experimental group go on the preoperative discussion accroding to the table and the observation group do it by convention.Then we observe and evaluate the preoperative preparation of surgical personnel,the situation of the nursing staff out of the room,the quality of operation care and the satisfaction degree of the operating doctor.All data are collected by EXCEL 2007 for input,summary and arrangement.And EXCEL 2007 and software SPSS 22 were used to calculate the related indexes.Descriptive statistics,such as constituent ratio,rate,frequency,etc.were used for data statistics.For statistical analysis of constituent data,SPSS 22 was used for Significant X2-Test.Results:1.Combining the literature search and the findings of the preoperative discussion of surgical nurses,we drawed up a preliminary draft of the“Table of contents of preoperative medical care discussion”,consisting of 50 entries in 7 dimensions.2.After two rounds of Delphi method consultation,the mean value of Importance judgment weight of 7 dimensions and 28 entries in the table were all greater than 4.00.And the coefficient of variation CV was less than 0.20.For the dimension and item,the expert coordination coefficients were 0.143(c~2=11.424,P=0.044,P<0.05)and0.138(c~2=59.818,P<0.001).Finally we determined the“Table of contents of preoperative medical care discussion”.3.Accroding to the table,after the preoperative discussion,the preoperative preparation level of the surgical nurses in the experimental group was significantly higher than that of the observation group(93.43%VS.62.50%)(P<0.05).4.Accroding to the table,after the preoperative discussion,the rate of outing of room of the experimental group nurses was lower than that of the observation group(7.30%VS.22.79%)(P<0.05).5.Accroding to the table,after the preoperative discussion,the operating completion degree and nursing quality of the operation nurses in the experimental group were significantly higher than those in the observation group(P<0.05).6.Accroding to the table,after the preoperative discussion,the satisfaction degree of the operating doctor to the experimental group nurses was higher than that of the observation group(92.70%VS.83.09%)(P<0.05).Conclusion:1.Combining the literature search and the findings of the preoperative discussion of surgical nurses,the preliminary draft of the“Table of contents of preoperative medical care discussion”shows better in the degree of concentration of expert opinions,the authority coefficient and the coordination coefficient.The results are credible and representative.2.Using the table,it is helpful for surgical nurses to avoid inadequate preparations for use caused by the unknown for special use or equipment or the difference of the same operation of the surgical equipment and equipment preparation in complex cases or the surgical nurses not able to estimated during the operation.It also reduce the number of out of room personnel during operation and improve the preoperative preparation level and the safety level of the patients.3.It is helpful for strengthenning the understanding of the special conditions,steps and professional information of the operation before operation,and improving the quality of the operation and the cooperation of doctors and nurses.4.Through the preoperative care discussion,there can be more systematic and planned communication between doctors and nurses.It is helpful to improve the communication ability of surgical nurses and to learn new surgical and clinical knowledge during communication.It can also improve the clinical nursing ability of nurses and the ability to cooperate with the team.5.The application of preoperative care discussion model increased the communication frequency between surgeons and operation room nurses to some extent,improving the communication ability,efficiency and mutual trust.It can improve the relationship between doctors and nurses and improve the surgeon’s satisfaction with the nurses in the operation room. |
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