| Objectives:Based on the consensus of experts in Enhanced recovery after surgery,constructing an Enhanced recovery after surgery in nursing clinical path table suitable for lung cancer patients to meet the needs of clinical work is to standardize and process nursing work,and formulate a comprehensive care plan through evidence-based medicine,thereby improving the quality of nursing service and improving patients.Methods:1.Through literature review and medical history review,determine the clinical nursing path table,medical advice items and nursing items,construct the preliminary clinical nursing path table,optimize it through expert consultation,and determine the feasibility of the clinical nursing path through pre-experiment,forming the final rapid rehabilitation clinical nursing path.2.Through random sampling,110 lung cancer surgery patients who were treated in the Second Department of Thoracic Surgery of Yunnan Cancer Hospital from February 2020 to November 2020 were selected as the research objects.There were 55 cases in the experimental group and 55 cases in the control group.Carry out a new type of rapid rehabilitation clinical nursing intervention method with the consent of patients and their families.The general demographic data of the two groups of patients were collected.The control group adopted conventional lung cancer perioperative nursing model,and the experimental group adopted rapid rehabilitation clinical nursing path measures on this basis.Comparison of postoperative catheter removal time,chest drainage tube removal time between the two groups of patients,comparison of preoperative and postoperative pulmonary function between the two groups,pain scores from the first postoperative day to discharge day,hospitalization time,hospitalization expenses,and postoperative care Quality assessment,comparison and analysis of the differences between the two groups and effect evaluation,summarizing nursing experience.3.Using SPSS 24.0 software for statistical analysis,the inspection level α=0.05,when P<0.05,the difference is statistically significant.The measurement data such as benefit indicators and laboratory indicators of the two groups of patients are expressed by x±s,using t test;the evaluation of the six-minute distance and pain scores of the two groups of patients at different time points uses repeated measures analysis of variance.Results:1.Through reading the medical record review system,collect the medical records of 63 patients who underwent elective radical resection of lung cancer from April 2019 to September 2019 and implemented ERAS measures during the perioperative period.Among them,4 patients had mutations and 59 had no complications..Analyze the selected medical records.Determine the average hospital stay 14.01±2.19;preoperative hospital stay 3.76±1.04;postoperative hospital stay 10.19±1.55;average hospitalization cost 42101.55±6826.73.Construct a clinical nursing path table for rapid rehabilitation of lung cancer patients.The nursing section uses time as the horizontal axis.Nursing The diagnosis and treatment items are on the vertical axis,forming a path table for changing patients’ admission to discharge.The patient section uses the time of the nursing section as a reference to formulate the corresponding nursing plan form,and the responsible nurse strictly implements the route table and records it in time and accurately.2.General demographic data:The control group and the experimental group were statistically processed in terms of gender,age,education level,marriage,smoking status,religious belief,occupation,family monthly income,medical payment form,and surgical site,and there was no statistical difference Academic significance(P>0.05),indicating that the two groups of patients are comparable under the same baseline.3.Analysis of rehabilitation indicators of the two groups of patients:the time of removal of the urinary catheter in the experimental group was shortened by 1.76 hours on average compared with the control group,the difference was statisticallysignificant(P<0.01);the analysis of the time of removal of the chest tube showed that the experimental group was relatively The time in the control group was shortened by 1.1 days(P<0.01).4.Benefit indicators:Table Result 8 shows that comparing the total length of hospitalization and hospitalization expenses of the two groups of patients,the total length of hospitalization of the experimental group was reduced by 2.08 days compared with the control group,and the difference was statistically significant(P<0.01);Compared with the control group,the hospitalization expenses of the group were reduced by an average of 7484.95 yuan,and the difference was statistically significant(P<0.01).5.Pain assessment analysis:Repeated measurement analysis of variance was performed on the pain scores of the two groups of patients.According to the multivariate test results,the pain scores of the patients decreased significantly over time,and the difference was statistically significant(F=153.84,P<0.01);There is a significant difference between the experimental group and the control group in pain scores,and it is statistically significant(F=105.50,P<0.01);the interaction analysis of time and group,the results show that between group and time There is an interaction between them,and it is statistically significant(F=5.63,P<0.01).Analysis of 6.6min walking experiment:According to the results of multivariate test,the 6min walking distance of patients has changed over time.The walking distance of patients after surgery is significantly less than that of patients before surgery,and the difference is statistically significant(F=13.51,P<0.05);The 6min walking distance between the experimental group and the control group was compared between the experimental group and the control group.The experimental group was significantly better than the control group,and it was statistically significant(F=3297.03,P<0.05);time and group interaction Effect analysis,the results show that there is an interaction between group and time,and it is statistically significant(F=4.30,P<0.01).7.Investigation and analysis of the quality of care of cancer patients:The investigation and analysis of the quality of cancer care of patients in the experimental group and the control group showed that the five dimensions of support and confirmation,spiritual care,sense of belonging,attention and respect for the patients in the ERAS nursing group were all higher than those in the five dimensions Control group,and the difference was statistically significant(P<0.01).8.Analysis of pulmonary function results:The pulmonary function indexes of the two groups of patients were analyzed.The results showed that there was no significant difference between the control group and the experimental group in Fev1 and Fvc before operation(P>0.01);the two groups of patients after Fevl and Fvc The difference is statistically significant(P<0.01)Conclusions:The construction and implementation of the clinical nursing path table for rapid rehabilitation of lung cancer patients can effectively improve the physical and psychological recovery of patients,can effectively reduce the occurrence and development of patient complications,reduce postoperative stress response,shorten the patient’s hospital stay,and improve economic benefits.Effectively improve the patient’s prognosis and outcome,which is conducive to the improvement of the quality of care,thereby promoting the development of rapid rehabilitation care. |
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