Effect of lean management based on time-action in patients undergoing off-pump coronary artery bypass grafting
10.3760/cma.j.cn115682-20211025-04795
- VernacularTitle:基于时间-动作法的精益管理模式在非体外循环冠脉旁路移植术患者术中的应用
- Author:
Liyan CAI
1
;
Xuezhi LIU
;
Haiyan REN
;
Jianwei YAN
;
Hui LIU
Author Information
1. 临汾市中心医院手术室，临汾 041000
- Keywords:
Operating Room nursing;
Coronary artery bypass grafting;
Off-pump;
Process optimization;
Lean management
- From:
Chinese Journal of Modern Nursing
2022;28(27):3769-3773
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of the lean management based on time-action in the nursing management of patients undergoing off-pump coronary artery bypass grafting (OPCABG) .Methods:From January 2019 to December 2020, convenience sampling was used to select 248 patients undergoing OPCABG who were admitted to the Cardiovascular Surgery of Linfen Central Hospital as the research object. The patients admitted from January to December 2019 were set as the control group ( n=120) , and the patients admitted from January to December 2020 were set as the observation group ( n=128) . The control group was given routine Operating Room nursing management, while the observation group was given time-action based lean management on the basis of the control group. The Operating Room nursing quality, operation-associated indicators, nursing risk events, transfer to cardiopulmonary bypass and early postoperative complications were compared between the two groups. Results:In the observation group, the score of equipment and instrument management was (27.65±1.73) , the score of nurse cooperation was (27.41±1.88) , the score of equipment preparation was (18.37±1.29) , and the total score of nursing quality was (92.08±3.92) , and the scores were higher than those of the control group [ (24.48±1.89) , (25.35±1.64) , (16.45±1.82) , and (84.86±4.79) ], with statistical differences ( P<0.01) . In the observation group, the preoperative preparation time was (27.08±6.64) min, the operation time was (174.12±42.55) min, and the pick-up time was (21.68±5.35) min, which were shorter than those of the control group [ (35.62±7.81) min and (192.55±43.06) min, (26.44±6.57) min], and the differences were statistically significant ( P<0.01) . The lowest intraoperative nasopharyngeal temperature in the observation group was (34.79±0.84) ℃, and the lowest hematocrit was (33.66±2.74) %, which were higher than those in the control group, and the differences were statistically significant ( P<0.01) . In the observation group, the total incidence of nursing risk events was 2.34% (3/128) , the rate of transfer to cardiopulmonary bypass was 1.56% (2/128) , and the total incidence of postoperative complications was 18.75% (24/128) , which were lower than those of the control group [8.33% (10/120) , 6.67% (8/120) , 31.67% (38/120) ], and the differences were statistically significant ( P<0.05) . Conclusions:The application of the lean management based on time-action in the nursing management of OPCABG patients in the Operating Room can improve the quality of nursing, efficiency and safety of surgery, and help reduce the incidence of cardiopulmonary bypass, nursing risk events and postoperative complications.
