目的 探讨医护标准化沟通下缺血性脑卒中介入术后患者镇痛镇静评估流程的应用效果。方法 采用便利抽样法,选取广州市某三级甲等医院神经内科重症监护病房的缺血性脑卒中患者72例,采用历史对照方法,按照入院日期先后顺序,将2024年6—10月入院的37例作为观察组,2024年2—5月入院的35例作为对照组,观察组采用医护标准化沟通下缺血性脑卒中介入术后镇痛镇静评估流程,对照组采用本科室常规方法进行镇痛镇静评估。比较2组在患者镇痛镇静药物使用率、医护人员的医护合作评分的组间差异。结果 观察组37例、对照组35例完成干预。观察组镇痛镇静药物使用率低于对照组,差异有统计学意义（57% VS 80%,χ2=4.470,P<0.05）,实施镇痛镇静评估流程前后,医护人员合作情况得到改善,在信息交流、共同决策和医护关系3个维度的得分分值,差异均具有统计学意义（t=4.549~9.339,P<0.05）。结论 应用本流程有利于优化临床镇痛镇静药物的使用,提高医护团队协作水平。
Abstract
Objective To investigate the effectiveness of analgesia and sedation assessment process following endovascular treatment for ischemic stroke under structured healthcare professional communication. Methods Using convenience sampling, 72 patients with ischemic stroke from the neurological intensive care unit of a tertiary grade-A hospital in Guangzhou were selected. Thirty-seven patients admitted between June and October, 2024 were assigned to the observation group, while thirty-five patients admitted from February to May, 2024 to the control group. Standardized communication-based analgesia and sedation assessment process was implemented in the observation group, while routine procedure in the control group. Analgesic/sedative medication usage rate and healthcare team collaboration score before and after the implementation of the process were compared. Results All the patients complete the intervention. There was significantly lower analgesic/sedative medication usage rate in the observation group, indicating statistical significance (57% VS 80%, χ2=4.470, P<0.05). After implementing the analgesia and sedation assessment process, collaboration among healthcare professionals improved significantly. The scores in all three dimensions—information exchange, shared decision-making, and nurse-doctor relationship—showed statistically significant differences(t=4.549~9.339, P<0.05). Conclusion The implemented process effectively optimizes clinical utilization of analgesic/sedative medication and enhances interdisciplinary collaboration among healthcare professionals.
关键词
缺血性脑卒中 /
介入术 /
镇痛镇静评估 /
医护标准化沟通 /
评估流程 /
SBAR模式
Key words
ischemic stroke /
endovascular treatment /
analgesia and sedation assessment /
standardized medical-nursing communication /
assessment process /
SBAR mode
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基金
南方医科大学南方医院临床研究专项（2023CR026）
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