探索使用电子护理记录进行冠状动脉旁路移植手术的患者的护理服务
Yewon Lee1, Jungkyun Woo2, Sumi Sung2
1College of Nursing, Seoul National University, Seoul, Republic or Korea.
Studies in health technology and informatics
|May 17, 2025
概括
标准化的护理记录揭示了冠状动脉旁路移植 (CABG) 患者的关键护理实践. 对护理陈述的分析发现,疼痛管理,肺部护理和精神状态评估对于改善患者的治疗结果至关重要.
科学领域:
- 护理信息学 护理信息学
- 心血管外科 护理 血管外科
- 临床数据分析 临床数据分析
背景情况:
- 标准化的护理记录对于一致的患者护理至关重要.
- 冠状动脉旁路移植 (CABG) 手术需要专门的术后护理干预.
- 分析护理数据可以揭示护理提供模式.
研究的目的:
- 为了探索接受CABG手术的患者的护理护理.
- 用标准化的护理记录进行数据分析.
- 确定影响CABG患者结果的关键护理实践.
主要方法:
- 分析了来自122名CABG患者的184,029份护理陈述.
- 护理陈述的语义映射到SNOMED CT概念.
- 识别经常出现的护理陈述及其临床相关性.
主要成果:
- 437个独特的护理陈述代表了大多数数据.
- 确定了重要的护理类别:疼痛管理,术后肺部护理和精神状态评估.
- 语义映射促进了对护理干预措施的理解.
结论:
- 标准化的护理记录为CABG患者护理提供了宝贵的见解.
- 确定关键的护理实践可以改善患者的治疗结果.
- 护理信息学可以提高心血管外科手术的护理质量.
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