Application of surgery clinical nursing pathway in total laryngectomy patients

Abstract

Objective To explore the effects of clinical nursing pathway on patients with total laryngectomy.Methods Totals of 67 cases with total laryngectomy were divided into intensive group(34cases)and control group(33 cases) according to the random number table.Control group received nursing of routine interview before operation and cooperation during operation,while intervention group received clinical nursing pathway,including preoperative interview pathway,operation day support pathway,and postoperative interview Pathway.Many items of two groups were observed such as anxiety situation which measured by Self rating Anxiety Scale(SAS),operation starting time,bleeding during operation,anesthesia recovery time,complication during anesthesia recovery and patients' satisfaction degree.Results The SAS score of intervention group in one day before operation and before anesthesia was (46.37 ±4.78),(49.85 ±5.60),respectively,lower than that of control group ( 50.75 ± 5.82),( 53.96 ± 6.95 ),and the difference was statistically significant ( t =3.371,2.669,respectively; P ＜ 0.01 ).In intervention group,amount of bleeding during operation was (299.63 ±46.71 ) ml,anesthesia recovery time was (26.10 ± 5.08 ) min,hospital stays was ( 15.02 ± 2.74 ) d and patients'satisfaction score was(4.53 ±0.46),lower than that of control group,which in order was( 340.65 ± 59.68 ) ml,(34.50 ± 6.75)min,(19.76 ± 3.62)d,and differences between two groups were statistically significant (t =3.138,3.021,6.055,11.800,respectively;P ＜0.01).Conclusions Implementing surgery clinical nursing pathway for total laryngectomy patients can relive their anxiety,reduce operation staring time and anesthesia recovery time and reduce bleeding amount during operation and the incidence of complication during anesthesia recovery,which had improved therapeutic effect and patients' satisfaction. Key words: Clinical pathway; Laryngectomy; Intraoperative period; Nursing intervention