肝癌电子杂志 ›› 2025, Vol. 12 ›› Issue (1): 46-52.

• 护理园地 • 上一篇    下一篇

达标理论导向的清单管理路径构建及其在经皮肝穿刺胆道引流术患者出院准备服务中的应用研究

丁志颖, 赵晓芸*, 戴琦琦, 蔡超红   

  1. 苏州大学附属第二医院介入科,江苏苏州 215026
  • 收稿日期:2024-12-19 出版日期:2025-03-31 发布日期:2025-05-08
  • 通讯作者: *赵晓芸,E-mail:zhaoxiaoyun177@126.com

Development of a checklist management pathway based on goal achievement theory and its application in discharge preparation for percutaneous transhepatic biliary drainage patients

Ding Zhiying, Zhao Xiaoyun*, Dai Qiqi, Cai Chaohong   

  1. Department of Intervention, the Second Affiliated Hospital of Soochow University, Suzhou 215026, Jiangsu, China
  • Received:2024-12-19 Online:2025-03-31 Published:2025-05-08
  • Contact: *Zhao Xiaoyun, E-mail: zhaoxiaoyun177@126.com

摘要: 目的: 评估基于达标理论的清单管理路径对经皮肝穿刺胆道引流术(PTBD)患者出院准备度的影响。
方法: 本研究采用便利抽样法,选取2023年2月至2024年2月苏州大学附属第二医院介入科60例恶性梗阻性黄疸且初次接受PTBD需要长期带管的患者,按入院顺序分为对照组和研究组。对照组34例患者接受常规PTBD围手术期护理;研究组26例患者接受基于达标理论的清单管理路径护理。比较两组患者出院准备度评分、满意度、出院后30 d内PTBD并发症发生率及非计划性再入院率。
结果: 研究组患者出院准备度评分、满意度均高于对照组患者,且差异均有统计学意义(P均<0.05)。在出院后30 d内,研究组患者出现导管滑脱、堵塞、感染及相关皮肤损伤等并发症的发生率低于对照组患者,且差异有统计学意义(P<0.05)。两组患者非计划性再入院率差异无统计学意义(P>0.05)。
结论: 基于达标理论的清单管理路径能够提升患者的管路管理能力和自我照顾能力,增强患者参与疾病管理的依从性与积极性。同时,该模式拓宽了护患沟通的深度,促进了患者与护理人员的互动,提高了出院准备度和患者满意度,减少了相关并发症发生率和非计划再入院率。

关键词: 经皮肝穿刺胆管引流, 达标理论, 出院准备度, 清单管理

Abstract: Objective: To evaluate the impact of a goal achievement theory (GAT)-based checklist management model on discharge preparedness in patients undergoing percutaneous transhepatic biliary drainage (PTBD).
Method: Sixty patients from the interventional department of a tertiary hospital in Suzhou, undergoing PTBD for the first time and requiring long-term catheter maintenance, were enrolled using convenience sampling. Patients were divided into a control group (n=34), receiving conventional perioperative PTBD care, and an experimental group (n=26), receiving care based on the GAT-based checklist management model. Key outcomes included discharge preparedness scores, patient satisfaction, catheter-related complication rates within 30 days post-discharge, and unplanned readmission rates.
Result: The experimental group had significantly higher discharge readiness scores and satisfaction compared to the control group (P<0.05). Within 30 days post-discharge, the experimental group had a lower incidence of complications such as catheter slippage, blockage, infection, and related skin damage compared to the control group (P<0.05). No significant difference in the unplanned readmission rate was found between the two groups (P>0.05).
Conclusion: The GAT-based checklist management model can enhance patients' catheter management and self-care abilities, as well as improve their compliance and engagement in disease management. Additionally, this model deepens the communication between patients and healthcare providers, fostering interaction and improving discharge readiness and patient satisfaction. It also reduces the incidence of related complications and the rate of unplanned readmissions.

Key words: Percutaneous transhepatic biliary drainage, Goal achievement theory, Discharge preparedness, Checklist management