钟迎梅 汤甜 李群辉 刘星华 陈洁 屈娟娟

[摘要] 目的 探討现况-背景-评估-建议（SBAR）沟通模式联合改良早期预警评分（MEWS）系统在心胸外科临床护理中的应用效果。 方法 2018年7月至2019年6月选取本院心胸外科收治的100例患者为研究对象，并通过随机数字表法将患者分为对照组与观察组，每组各50例。对照组实施常规护理管理，观察组在对照组的基础上实施SBAR沟通模式联合MEWS评分系统，比较两组患者与医生满意度、护理交接班评价情况及患者非预期监护室入住率。 结果 实施后，观察组的患者满意度为94.00%、医生满意度为96.00%，高于对照组的78.00%、82.00%，两组比较，差异有统计学意义（P<0.05）;观察组的交接班时间为（26.45±3.78）min，短于对照组的（35.37±4.12）min，其交接班信息评分为（94.37±4.75）分，高于对照组的（66.29±4.33）分，两组比较，差异有统计学意义（P<0.05）;且观察组的患者非预期监护室入住率为6.00%，低于对照组的24.00%，两组比较，差异有统计学意义（P<0.05）。 结论 在心胸外科临床护理中应用SBAR沟通模式联合MEWS评分系统，能进一步提升患者与医生的满意度，并缩短护理交接班时间，降低患者的非预期监护室入住率。

[关键词] 心胸外科;临床护理;SBAR沟通模式;MEWS评分系统

[中图分类号] R471          [文献标识码] B          [文章编号] 1673-9701（2021）31-0169-04

[Abstract] Objective To explore the application effect of SBAR （Situation， Background， Assessment， and Recommendation） communication model combined with MEWS （Modified Early Warning Score） scoring system in clinical nursing of cardiothoracic surgery. Methods One hundred patients treated in the department of cardiothoracic surgery in our hospital from July 2018 to June 2019 were selected as research subjects， and were divided into the control group（n=50） and the observation group（n=50） by the random number table method. Routine nursing management was given to the control group， and SBAR communication model combined with MEWS scoring system was applied in the observation group on the basis of the control group. The satisfaction of patients and doctors， the evaluation of nursing shift， and the unexpected ICU occupancy rates of patients were compared in the two groups. Results After implementation， the satisfaction of patients and the satisfaction of doctors in the observation group （94.00%， 96.00%） were higher than those in the control group （78.00%，82.00%）， with statistically significant differences （P<0.05）. The time of shift change in the observation group [（26.45±3.78） min] was less than that in the control group（35.37±4.12） min， and the information score of shift change in the observation group （94.37±4.75） points was higher than that in the control group （66.29±4.33）points， with statistically significant differences（P<0.05）. The unexpected ICU occupancy rate of patients in the observation group （6.00%） was lower than that in the control group （24.00%）， with statistically significant difference （P<0.05）. Conclusion The application of SBAR communication model combined with MEWS scoring system in clinical nursing of cardiothoracic surgery can further improve the satisfaction of patients and doctors，shorten the time of nursing shift change， and reduce the unexpected ICU occupancy rate of patients.

[Key words] Cardiothoracic surgery; Clinical nursing; SBAR communication model; MEWS scoring system

心胸外科是医院重要科室的组成部分之一，该科室患者均有着病情发展急剧凶险、主观诉求不强烈等特点，若患者的病情发展到“潜在危重病”阶段，则会对其生命构成极大威胁，因此，在临床中准确评估患者的病情情况对护理方案的制定、患者预后具有重要的意义[1-2]。……