王淑娟
陕西省人民医院,重症医学科 陕西西安 710000
摘要:目的:探讨静脉治疗护理MDT对预防静脉炎的临床应用效果。方法:选取2019年1月—2020年1月在本院接受静脉治疗的80例患者作为研究对象,将其分为对照组(40例)和观察组(40例),对照组采用常规护理模式,观察组采用静脉治疗MDT护理模式。结果:观察组不论是护理效果还是患者满意度均优于对照组(P<0.05)。结论:对于接受静脉治疗的患者来说,静脉治疗MDT护理模式具有较强的针对性和有效性,与常规护理模式相比,静脉治疗MDT护理模式在护理效果上更为显著,不仅降低了静脉炎的发生率,而且还提高了患者的满意度,其临床应用价值相对较高。
关键词:静脉治疗;护理MDT;静脉炎
MDT即多学科会诊,指的是多学科资深专家以共同讨论的方式为患者制定诊疗方案,主要对象为复杂疾病患者。我院重症医学科作为发展专科,主要承担着重症患者的诊疗工作,对于大多数重症患者来说,长期的化疗、放疗很容易影响其身体机能,严重时会直接影响其血管状态,因此静脉炎的发生风险也相对较高。[1]随着科学技术的不断发展,MDT模式得到了广泛的关注,特别是在一些大型医院中,静脉治疗护理MDT得到了有效的运用,该护理模式不仅极大地降低了静脉炎的发生率,而且还改善了患者的负面情绪,这对提高患者的满意度和依从性是十分重要的。本文通过探讨静脉治疗护理MDT对预防静脉炎的临床应用效果,并获得了相关的研究数据,现报道如下。
1、资料与方法
1.1一般资料
选取2019年1月—2020年1月在本院接受静脉治疗的80例患者作为研究对象,将其分为对照组(40例)和观察组(40例)。对照组:男18例,女22例,患者年龄20—66岁,平均(45.7±3.2)岁。观察组:男20例,女20例,患者年龄21—68岁,平均(47.1±3.3)岁。两组患者均是在知情自愿的情况下参与本次调查研究的,且他们的一般资料具有可比性(P>0.05)。
1.2方法
对照组采用常规护理,观察组在此基础上采用静脉治疗MDT护理模式,具体内容如下:①成立MDT护理小组。通过对MDT模式的了解我们能够知晓,该护理模式最大的优点就是具有较强的综合性与专业性,因此在开展实际工作之前,我们首先要结合患者的实际病情成立MDT护理小组。通常来说,小组成员主要包括静脉治疗小组、麻醉科、重症医学科、肿瘤科、护理科等重要科室的负责人,每个成员在小组内都承担着不同的职责,旨在最大限度的发挥自身的专业优势。为了强化小组成员的内部沟通,静脉治疗小组负责人应联合护理科室的负责人建立多样性的网络交流平台,比如微信群、QQ群等,以此方便小组成员共同探讨诊疗方案,从而提高互动效率。[2]②确定静脉治疗护理MDT模式。首先,MDT护理小组需要确定会诊对象,主要选择对象为常规护理效果不佳的患者,由静脉治疗小组提供患者病资料,以便为会诊工作的顺利开展提供可靠的依据。待上述工作完成后,MDT护理小组便可以安排会诊流程,具体来说,主要包括以下几点内容:第一,由收治科室确定会诊时间;第二,MDT护理小组在三个工作日之内进行多学科研究;第三,收治科室向MDT护理小组介绍病例信息;第四,MDT护理小组进行临床观察和讨论;第五,结合患者情况制定针对性的静脉护理计划,并与患者及家属做好沟通工作;第六,根据会诊记录进行检测和评估,针对不足之处进行改正和完善;第七,密切追踪患者的治疗和康复情况,可根据追踪信息做出适当调整。[3]除此之外,为了优化MDT护理小组结构,不同科室的专家还需要轮流参与研讨会,争取在互相交流和学习的过程中增长见识,在提高自身专业素养的同时,也能强化团队意识和服务意识,这对提高MDT护理工作的整体质量是极为有利的。
2、结果
2.1观察组的患者满意度明显高于对照组(P<0.05),具体数据见表1。
表1 两组患者满意度的对比情况[n(%)]
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1L05vue9VAUL0YfGngSwNffnCl0fiYaiJl0ReVlkzDtpsZAADgCE22VKNb/bRet+OhUxhmfx5jplv8qU1XvJUaAk97KvjSwJcGvvzgSqOx7t/PBVca+NLAlwa+/OBKg6BaCVxp4EsDXxr48oMrjcbGVAEAAD4TWqoFwZUGvjTwpYEvP7jSoPu3ErjSwJcGvjTw5QdXGgTVSuBKA18a+NLAlx9caTCmCgAAUAFaqgXBlQa+NPClgS8/uNJItlS/vr5Cano8Hsv/NIGJiYmJiekPT4/Hw4yZu7p/v76+dkd4AACAu6DGO4IqAACAAUEVAACgEGq8+x+ZfxDLmwH27gAAAABJRU5ErkJggg==)
2.2护理后,观察组的焦虑自评分数和抑郁自评分数下降程度明显高于对照组,说明观察组的护理效果也优于对照组(P<0.05),具体数据见表2。
表2 两组焦虑自评分数、抑郁自评分数的对比情况(分)
![](data:image/png;base64,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)
3、讨论
MDT作为一种全新的护理模式,具有较强的专业性和综合性,该模式不仅在很大程度上降低了误诊率,而且还为患者提供了更多有效的治疗方案,极大地减轻了患者的生理和心理痛苦。对于接受静脉治疗的患者来说,他们大多是重症患者,传统的护理模式虽然具有一定的治疗功效,但是很难从全方面满足患者的实际需求。而静脉治疗MDT护理模式恰好弥补了传统护理模式的不足,不论是在诊疗方式上还是在专业领域上都有所突破,极大地改善了护理效果,同时也降低了静脉炎的发生率。本次研究表明,观察组的满意率高达100%,而对照组仅为77.50%,与此同时,观察组的焦虑自评分数、抑郁自评分数在护理后有了显著的下降,而对照组虽然也有所下降,但是下降幅度却不及观察组。
综上所述,静脉治疗MDT护理模式作为一种综合性的护理模式,对于改善重症患者的血管状态具有积极的作用,该护理模式对于预防静脉炎有着显著的优势,同时还在很大程度上提高了患者的满意度和依从性,有助于构建良好的医患关系,值得在临床上大力推广。
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