基于链式管理理论构建妊娠合并脑出血病人剖宫产围术期多学科护理路径OA

Objective:To construct a multidisciplinary perioperative nursing pathway for cesarean section in pregnant women with intracerebral hemorrhage based on chain management theory.Methods:The preliminary pathway was developed with chain management theory as the framework,combined with literature analysis and case review,and structured around hospitalization days.Two rounds of expert consultation were conducted using the Delphi method among 15 experts.Expert opinions were analyzed and integrated to form the final clinical nursing pathway.Results:The effective response rates of the two rounds of expert consultation were both 100%.The authority coefficients of experts were 0.852 and 0.920.The Kendall's coefficients of concordance were 0.11 and 0.21(both P<0.05),respectively.The final clinical nursing pathway was organized into five phases:the first day of hospitalization,day 2 to preoperative day,day of cesarean section,postoperative days 1-3,and postoperative day 4 to discharge.Under this framework,there were 48 primary indicators and 196 secondary indicators.Conclusions:The multidisciplinary perioperative nursing pathway for cesarean section in pregnant women with intracerebral hemorrhage constructed in this study based on chain management theory clarifies the core contents and collaborative processes of maternal and neonatal care during each perioperative stage,standardizes the multidisciplinary management of high-risk pregnant women,and has good scientific rigor and clinical application value.It could provide reference for relevant nursing practice.