摘要
目的:探讨护理多学科协作模式(multidisciplinary team,MDT)联合信息化血糖管理在虚拟病区围术期患者血糖管理中的应用效果。方法:采用便利抽样法选取西安交通大学第一附属医院9个病区的132名责任护士进行专业化培训,建立护理MDT血糖管理团队,利用血糖信息化联网平台联合医院信息管理系统构建虚拟病区,对围术期高血糖患者开展远程治疗,实现围术期血糖规范化管理。选取2018年1—8月在我院住院的416例围术期高血糖患者,按照入院时间分为对照组和试验组。对照组209例患者,采用传统血糖管理,试验组207例患者,采用护理MDT联合信息化血糖管理。比较目标科室责任护士培训前后的理论成绩,观察两组患者入院第1天、术前1 d、出院前1 d的空腹及三餐后2 h血糖。比较两组患者高血糖上报数、高血糖及时处理数、围术期高血糖患者入院-下达内分泌会诊医嘱时间及内分泌科会诊实施时间。结果:培训后,目标科室责任护士考核理论成绩较培训前提升,差异有统计学意义(P<0.01)。两组患者入院第1天血糖水平差异无统计学意义(P>0.05)。试验组患者术前1 d、出院前1 d的空腹、早餐后、午餐后及晚餐后2 h血糖均低于对照组,差异有统计学意义(P<0.01);试验组高血糖上报数、高血糖及时处理数高于对照组,围术期高血糖患者入院-下达内分泌会诊医嘱时间及内分泌科会诊实施时间短于对照组,差异均有统计学意义(P<0.01)。结论:本研究通过建立护理MDT血糖管理团队,搭建信息化血糖管理联网平台,开设虚拟病区并规范管理,提升了目标科室护士的围术期血糖管理知识水平及目标科室医护人员的血糖管理意识,提高了围术期高血糖患者的血糖管理效果,具有一定临床推广价值。
Objective To explore the effect of nursing multidisciplinary team(MDT)combined with informational blood glucose management in blood glucose management of perioperative patients in virtual ward.Methods We selected 132 responsible nurses in 9 wards of the First Affiliated Hospital of Xi'an Jiaotong University for professional training by convenience sampling,and established a nursing MDT of blood glucose management.Remote treatment for perioperative hyperglycemic patients was carried out to achieve standardized management of perioperative glucose by using the blood glucose information networking platform and the hospital information management system to build a virtual ward.A total of 416 perioperative hyperglycemic patients hospitalized in our hospital from January to August 2018 were selected and divided into control group and experimental group according to the admission time.A total of 209 patients of control group were treated with traditional blood glucose management,and 207 patients of experimental group were treated with nursing MDT combined with informational blood glucose management.We compared the theoretical performance of the responsible nurses in the target department before and after training,the blood glucose one day after admission,one day before surgery,one day before discharge,fasting blood glucose,2-hour blood glucose after three meals of patients between two groups.We also observed number of hyperglycemia reports,the number of timely treatments for hyperglycemia,the time from admission of perioperative hyperglycemic patients to issuing medical orders for endocrine consultation and the time for the endocrine consultation implementation in patients between two groups.Results After training,the theoretical performance of the responsible nurses in the target department was improved compared with that before training,and the difference was statistically significant(P<0.01).There was no statistical difference in the blood glucose one day after admission between two groups(P>0.05).The blood glucose of patients in experimental group was lower than that in control group one day before surgery,one day before discharge,fasting blood glucose,and blood glucose of 2-hour blood glucose after breakfast,lunch and dinner with statistical differences(P<0.01).The number of hyperglycemia reports,the number of timely treatments for hyperglycemia of patients in experimental group was more than that in control group;the time from admission of perioperative hyperglycemic patients to issuing medical orders for endocrine consultation and the time for the endocrine consultation implementation of experimental group was shorter than that of control group also with statistical differences(P<0.01).Conclusions This study builds the informational blood glucose management networking platform and develops virtual ward management through establishing nursing MDT of blood glucose management.It enhances the target department nurses'perioperative blood glucose management knowledge level,and raises the target department's medical and nursing staff's blood glucose management awareness,and improves the blood glucose effects of perioperative hyperglycemic patients,which has certain clinical promotion value.
作者
李蒙
梁茜
郭辉
辛霞
马洁
王娜
李婷
姚倩倩
赵梦
施秉银
Li Meng;Liang Qian;Guo Hui;Xin Xia;Ma Jie;Wang Na;Li Ting;Yao Qianqian;Zhao Meng;Shi Bingyin(Department of Endocrinology and Metabolism,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Plastic and Maxillofacial Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《中华现代护理杂志》
2020年第23期3210-3217,共8页
Chinese Journal of Modern Nursing
基金
国家重点研发计划(2018YFC1311500)。
关键词
糖尿病
围术期
高血糖
护理多学科协作模式
信息化血糖管理
虚拟病区
Diabetes mellitus
Perioperative period
Hyperglycemia
Nursing multidisciplinary team
Informational blood glucose management
Virtual ward
