CAJ | 학술논문

　　目的探讨输尿管镜取石术患者实施临床护理路径之后的效果及挑战。方法对比同期进入临床路径与未进入临床路径接受输尿管镜取石术患者的临床资料以及护士工作量、医护患三方满意度等资料。结果实施 CP 及 CNP 之后，实验组的住院时间固定在3d，较对照组的4.8d 明显减少（P=0.000）；住院费用由11147元减少至9114元，有统计学差异（P=0.000）。患者住院期间，护士巡视的次数为24次，较对照组12次明显增加（P=0.023）；潜在的医护差错由对照组的9%下降至1%，差异有统计学意义（P=0.005)。患者健康知识评分，实验组94.2明显高于对照组的73.5，差异有统计学意义（P=0.000)。患者满意度评分，实验组96.1高于对照组的78.3，差异有统计学意义（P=0.000)；医护满意度评分，实验组94.3高于对照组的72.4，差异有统计学意义（P=0.001)。结论患者住院时间及费用减少，患者满意度提升；同时，对临床护理工作提出了更高的要求，工作强度增加，但只要遵循一定的规范，积极配合，医护质量及满意度也得到了有效的提升。
　　목적탐토수뇨관경취석술환자실시림상호리로경지후적효과급도전。방법대비동기진입림상로경여미진입림상로경접수수뇨관경취석술환자적림상자료이급호사공작량、의호환삼방만의도등자료。결과실시 CP 급 CNP 지후，실험조적주원시간고정재3d，교대조조적4.8d 명현감소（P=0.000）；주원비용유11147원감소지9114원，유통계학차이（P=0.000）。환자주원기간，호사순시적차수위24차，교대조조12차명현증가（P=0.023）；잠재적의호차착유대조조적9%하강지1%，차이유통계학의의（P=0.005)。환자건강지식평분，실험조94.2명현고우대조조적73.5，차이유통계학의의（P=0.000)。환자만의도평분，실험조96.1고우대조조적78.3，차이유통계학의의（P=0.000)；의호만의도평분，실험조94.3고우대조조적72.4，차이유통계학의의（P=0.001)。결론환자주원시간급비용감소，환자만의도제승；동시，대림상호리공작제출료경고적요구，공작강도증가，단지요준순일정적규범，적겁배합，의호질량급만의도야득도료유효적제승。
Objective To explore the result of clinical nursing pathway for patients received ureteroscopic lithotripsy, and investigate the challenge. Methods When patientes planed to receive ureteroscopic lithotripsy in the the same period, and half patients was enrolled in clinical nursing care pathway group, the clinical data and satisfatory score for patientas, nurse and doctor was evaluated and compared. Results After the implementation of CP and CNP,the hospital stay in experimental group was 3 days, compared with 4.8 days in the control group, it decreased significantly (P=0.000),hospitalization expense decreased from 11147 yuan to 9114 yuan, with statistical difference (P=0.000).The nurse patrol time was 24 times,much more than control group of 12 times (P=0.023). Potential medical errors was noted in 1% in experimental group, less than 9% in the control group, the difference was statistically significant(P=0.005). Patients’s health knowledge grading in experimental group was significantly higher than in control group (94.2vs.94.2,p =0.000). Patient satisfaction scores in experimental group is higher than in the control group(96.1 vs.78.3,P=0.000).Care satisfaction score in the experimental group was higher than in the control group (94.3 vs.72.4,P=0.001). Conclusion Patients benefited form the CNP regarding to the shorter hospital stay and fewer fee, thus, a high satisfaction score.At the same time, it put forward higher request for clinical nursing work, and much more work existed,but as long as they follow certain standard and actively cooperate with each other, the medical quality and satisfaction score could be effectively promoted.