Application of the five constant method management model based on chain theory in operating room nursing management
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摘要:
目的 本研究旨在探究基于链式理论的五常法管理模式在手术室护理中的应用价值，明确其对手术效率、安全指标、护理管理质量及满意度的影响，为优化手术室护理管理体系提供实践依据。 方法 选择2024年2—9月在山东省第二人民医院行手术治疗的200例患者为对照组，选择2025年1—6月在该院行手术治疗的200例患者为观察组。对照组患者实施常规手术室护理管理，观察组实施基于链式理论的五常法管理模式。对比2组手术效率、手术安全相关指标、护理管理质量及护理满意度。 结果 观察组患者术前等待时长及术后复苏时长分别为（0.74±0.18）h、（0.97±0.28）h，均短于对照组的（1.13±0.35）h、（1.26±0.54）h（P＜0.05），但2组间手术时长比较差异无统计学意义（P＞0.05）；观察组手术安全相关指标均优于对照组（P＜0.05）；观察组护理管理质量总分[（90.55±2.14）分]高于对照组[（81.75±4.92）分，P＜0.05]；观察组护理满意度为93.5%（187/200），高于对照组[84.0%（168/200）, P＜0.05]。 结论 基于链式理论的五常法管理模式能够有效提高手术效率及手术安全性，对提升手术室护理管理质量及护理满意度方面具有积极作用。 Abstract:Objective This study intends to explore the application value of the five constant method management model based on chain theory in operating room nursing, clarify its impact on surgical efficiency, safety indicators, nursing management quality and satisfaction, and provide practical basis for optimizing the operating room nursing management system. Methods A total of 200 patients who underwent surgical treatment at the Second People's Hospital of Shandong Province from February to September 2024 were selected as the control group, and 200 patients who underwent surgical treatment at the hospital from January to June 2025 were selected as the observation group. The control group patients received routine operating room nursing management, while the observation group received a five constant method management model based on the chain theory. Compare surgical efficiency, surgical safety related indicators, nursing management quality, and nursing satisfaction. Results The preoperative waiting time and postoperative recovery time for patients in the observation group were (0.74±0.18) h and (0.97±0.28) h, respectively, both shorter than those in the control group [(1.13±0.35) h and (1.26±0.54) h, P < 0.05], but there was no statistically significant difference in surgical time between the two groups (P>0.05). The safety related indicators of the observation group were better than those of the control group (P < 0.05). The total score of nursing management quality in the observation group (90.55± 2.14) was significantly higher than that in the control group (81.75±4.92). The nursing satisfaction rate of the observation group was 93.5%(187/200), which was higher than the control group (84.0%, 168/200, P < 0.05). Conclusion The five constant method management model based on the chain theory can effectively improve surgical efficiency and safety, and has a positive effect on enhancing the quality of nursing management and nursing satisfaction in the operating room. -
表 1 2组行手术治疗患者一般资料比较
Table 1. Comparison of general data of patients undergoing surgical treatment in the two groups
组别 例数 性别 年龄(x±s，岁) BMI (x±s) 疾病类型(例) 收缩压(x±s，mmHg) 舒张压(x±s，mmHg) 心率(x±s，次/min) 男性 女性 肝胆外科疾病 骨科疾病 耳鼻咽喉科疾病 泌尿外科疾病 对照组 200 91 109 47.82±7.35 23.50±2.83 65 58 32 45 128.68±12.44 82.91±8.42 76.48±10.11 观察组 200 84 116 48.12±8.55 23.41±2.71 60 61 28 51 129.41±13.05 82.13±8.11 77.05±9.42 统计量 0.498a 0.442b 0.325b 0.917a 0.573b 0.944b 0.583b P值 0.480 0.689 0.745 0.821 0.567 0.346 0.560 注：a为χ2值，b为t值；1 mmHg=0.133 kPa。 
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表 2 2组行手术治疗患者手术效率比较(x±s)
Table 2. Comparison of surgical efficiency between the two groups of patients undergoing surgical treatment(x±s)
组别 例数 术前等待时长(h) 手术时长(min) 术后复苏时长(h) 对照组 200 1.13±0.35 84.23±12.68 1.26±0.54 观察组 200 0.74±0.18 83.95±11.76 0.97±0.28 t值 14.014 0.229 6.742 P值 ＜0.001 0.819 ＜0.001
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表 3 2组行手术治疗患者手术安全相关指标比较[例(%)]
Table 3. Comparison of surgical safety-related indicators between the two groups of patients who underwent surgical treatment[cases(%)]
组别 例数 手术安全核查正确 手术部位标识核查正确 手术抗菌药物预防使用时机正确 术中低体温发生 手术室护士锐器伤发生 手术标本处理正确 对照组 200 185(92.5) 188(94.0) 182(91.0) 57(28.5) 10(5.0) 190(95.0) 观察组 200 194(97.0) 197(98.5) 193(96.5) 39(19.5) 3(1.5) 198(99.0) χ2值 4.071 5.610 5.163 4.441 3.896 5.498 P值 0.044 0.018 0.023 0.035 0.048 0.019
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表 4 2组行手术治疗患者护理管理质量比较(x±s，分)
Table 4. Comparison of nursing management quality for patients undergoing surgical treatment in two groups(x±s, points)
组别 例数 环境与物品管理 流程规范执行 应急能力 文书记录 总分 对照组 200 19.83±2.48 18.74±2.10 18.05±1.84 20.16±1.31 81.75±4.92 观察组 200 22.06±1.02 21.96±0.97 21.14±0.82 22.33±0.57 90.55±2.14 t值 11.761 19.686 21.693 21.481 23.196 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 ＜0.001
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表 5 2组行手术治疗患者护理满意度比较[例(%)]
Table 5. Comparison of nursing satisfaction among patients in the two groups who underwent surgical treatment[cases(%)]
组别 例数 非常满意 满意 一般 不满意 非常不满意 护理满意度 对照组 200 82(41.0) 86(43.0) 19(9.5) 11(5.5) 2(1.0) 168(84.0) 观察组 200 102(51.0) 85(42.5) 9(4.5) 4(2.0) 0 187(93.5) 注：2组护理满意度比较，χ2=9.039，P=0.003。
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