CAJ | 학술논문

目的：完善腰椎手术患者临床护理路径，为患者提供规范化、科学化的护理服务模式，培养护士发现问题、思考分析问题及解决问题的能力，建立护士临床护理思维。方法以病历和文献回顾为理论依据，以科室现使用的临床路径为基础，查阅患者在手术不同阶段产生的主要护理问题与干预措施，结合《护理结局分类》形成针对性的腰椎手术患者结局评价指标。经过专家咨询与修改，形成符合腰椎手术患者的临床护理路径。结果构建了以护理结局为导向的腰椎手术患者住院当天、术前日、手术日、术后1~3 d、术后4~10 d不同阶段的临床护理路径。结论以护理结局为导向的腰椎手术患者临床护理路径，集中了临床护理路径与护理程序的优势，实现了从个案管理到群体化护理，在使用过程中能充分反映不同层级护理人员的水平与资质，增加护士间的团队合作精神。
목적：완선요추수술환자림상호리로경，위환자제공규범화、과학화적호리복무모식，배양호사발현문제、사고분석문제급해결문제적능력，건립호사림상호리사유。방법이병력화문헌회고위이론의거，이과실현사용적림상로경위기출，사열환자재수술불동계단산생적주요호리문제여간예조시，결합《호리결국분류》형성침대성적요추수술환자결국평개지표。경과전가자순여수개，형성부합요추수술환자적림상호리로경。결과구건료이호리결국위도향적요추수술환자주원당천、술전일、수술일、술후1~3 d、술후4~10 d불동계단적림상호리로경。결론이호리결국위도향적요추수술환자림상호리로경，집중료림상호리로경여호리정서적우세，실현료종개안관리도군체화호리，재사용과정중능충분반영불동층급호리인원적수평여자질，증가호사간적단대합작정신。
Objective To find out main nursing problems and to provide standardized nursing service for patients with lumbar spine surgery in different stages and to develop clinical nursing thought among nurses. Methods Nursing outcome evaluation indexes were identified with literature review as theoretical basis, clinical pathway and nursing process at present as the framework. Clinical nursing pathway for patients with lumbar spine surgery was then developed through expert consultation and the modification of indexes. Results Nursing outcome oriented clinical nursing pathway was constructed in different stages of lumbar spine surgery. Conclusion With the advantage of both clinical nursing pathway and nursing process, nursing outcome oriented clinical nursing pathway is beneficial to improving cooperation among nurses and satisfaction from doctors and patients.