Construction and implementation of ERAS ward management system based on 4S management model
10.3760/cma.j.cn115682-20210408-01561
- VernacularTitle:基于4S管理模型的加速康复病房管理体系构建与实施
- Author:
Jie WANG
1
;
Haofen XIE
;
Saisai PAN
;
Qinhong XU
;
Hong ZHU
;
Liang YANG
;
Yue HU
;
Libiao FANG
Author Information
1. 浙江省宁波市第一医院肝胆胰外科 315000
- Keywords:
Enhanced recovery after surgery;
Ward management;
Hepatobiliary Surgery;
4S management model
- From:
Chinese Journal of Modern Nursing
2021;27(33):4559-4562
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To build enhanced recovery after surgery (ERAS) ward management system based on the staff, stuff, structure space and systems (4S) management model, and explore the implementation effects of accelerated rehabilitation nursing management.Methods:A retrospective analysis was carried out on the implementation process of ERAS before 2020 in the Department of Hepatobiliary and Pancreatic Surgery, Ningbo First Hospital, Zhejiang Province. It was found that there were problems such as imperfect multidisciplinary team personnel, lack of systems, and lack of standardized process implementation rules. In April 2020, we created an ERAS ward based on the concept of 4S management model, improved the multi-disciplinary professional staff, equipment and venues, and formulated an ERAS ward system process. Patients undergoing ERAS in Hepatobiliary and Pancreatic Surgery Department from April to September 2019 were selected as the control group (383 cases of gallbladder surgery and 59 cases of liver surgery) , and patients admitted to the ERAS ward from April to September 2020 were selected as the experimental group (332 cases of gallbladder surgery and 72 cases of liver surgery) . The satisfaction, average length of hospitalization, hospitalization expenses and complication rate of the two groups of patients were compared, and doctors and nurses' specification implementation rate of the ERAS ward was counted.Results:The average length of hospitalization of patients with gallbladder surgery and liver surgery in the experimental group was shorter than that of the control group, and the hospitalization expenses were lower than those of the control group, and the differences were statistically significant ( P<0.01) . The complication rate (9.9%, 33/332) of patients undergoing gallbladder surgery in the experimental group was lower than that (16.7%, 64/383) in the control group, and the difference was statistically significant ( P<0.01) . The satisfaction of patients in the experimental group was higher than that in the control group, and the difference was statistically significant ( P<0.01) . The specification implementation rate of doctors and nurses was 96.7% (58/60) . Conclusions:The ERAS ward is based on the scientific supervision of staff, stuff, structure space and systems according to the concept of 4S management model, which is conducive to the comprehensive and standardized implementation of ERAS treatment and nursing, improves patient clinical outcomes and increases patient satisfaction.
