麻醉重症监护室护理标准作业流程的构建与应用 [中文引用][英文引用]

目的  构建麻醉重症监护室（anesthesia intensive care unit，AICU）护理标准作业流程（standard operating procedure，SOP），为麻醉护理标准化、规范化与同质化发展提供依据，并验证其应用效果。方法  在文献研究、半结构化访谈及小组讨论的基础上，形成 AICU 护理 SOP 初稿；采用德尔菲专家函询法对 16 名专家进行 2 轮函询，最终确定 AICU 护理 SOP。在此基础上开展类实验研究，将 100 例 AICU 患者分为对照组与试验组各 50 例，分别实施常规护理与 SOP 护理，比较两组患者转入和转出用时、术后恢复质量、满意度及使用 SOP 前后护士交接班质量。结果  2 轮专家咨询问卷回收率均为 100.00%，专家权威系数分别为 0.912 和 0.925，肯德尔协调系数 W 分别为 0.120 和 0.134（均 P<0.001）。最终形成的 AICU 护理 SOP 包含 4 个一级条目、16 个二级条目、67 个三级条目。应用结果显示，试验组患者转入与转出用时短于对照组（均 P<0.05），术后恢复质量、满意度高于对照组（均 P<0.001），护士交接班质量高于使用护理 SOP 前（P<0.001）。结论  本研究构建的 AICU 护理 SOP 具有良好的科学性与可靠性，临床应用效果良好，可提升护理工作效率、改善患者恢复质量与满意度，具有较强的实用价值与推广意义。

Objective To develop a standard operating procedure（SOP）for nursing care in the anaesthesia intensive care unit （AICU）suitable to the Chinese healthcare context and to evaluate its preliminary application effects，thereby providing a scientific basis for the standardisation，normalisation，and homogenisation of anaesthetic nursing. Methods A draft of AICU nursing SOP system was formulated based on a literature review，semi-structured interviews，and expert group discussions. Delphi method was then used to conduct two rounds of expert consultation with 16 experts，and the SOP was finalised. The analytic hierarchy process（AHP）was applied to calculate the weights of indicators at all levels. Subsequently，a quasi-experimental study was conducted，in which 100 AICU patients were assigned to a control group and an experimental group（with 50 cases in each）with routine nursing care and SOP-based nursing care，respectively. Work efficiency，postoperative recovery quality，handover quality，and patient satisfaction were compared between the two groups. Results The response rates for both rounds of expert consultation were 100.00% with the expert authority coefficients of 0.912 and 0.925，respectively，and Kendall's W coefficients of 0.120 and 0.134，respectively（both P<0.001）. The finalised SOP comprised 4 first-tier indicators，16 second-tier indicators and 67 third-tier indicators. The application results showed that the experimental group exhibited significantly shorter admission and transfer times than the control group（P<0.05），significantly better postoperative rehabilitation quality and with a higher patient satisfaction（P<0.001），Nurses’handover quality is higher than before the implementation of nursing SOP（P<0.001）. Conclusion The AICU nursing SOP developed in this study demonstrates good scientific rigor and reliability，as well as favourable clinical application effects with improved nursing work efficacy，patient recovery quality and patient satisfaction. It therefore holds a considerable practical value for clinical application.