背景:在2019年,有机会在放射引导手术(RGS)团队中增加一名护士。参照护士模式适应于,前哨淋巴结(SN)术前入路。
目的:为了描述定义前哨淋巴结参考护士(SNRN)配置文件的过程,验证其实际应用并建立其临床实施。
方法:过程管理的分析和持续改进方法(PDCA循环):乳腺癌方案中SNRN功能的定义和计划,对20名患者进行试点测试并分析数据,以验证电路并建立其最终临床实施。
结果:详细阐述了新的程序流程图,添加SNRN的图形,其作用及过程中的护理干预。在试点测试中,主观焦虑减少了58.3%,总体焦虑水平下降了75%,在放射性示踪剂给药期间,获得了100%的测试知识和患者对疼痛水平的可接受感知。关于技术质量,评估的8/10项目达到了RGS小组先前确定的水平。
结论:SN活检技术日益复杂,为在术前SN定位过程中实施护理提供了机会。SNRN的配置文件是执行它的理想选择,并导致护理诊断和评估项目的改进。
BACKGROUND: In 2019 the opportunity to add a nurse within the radioguided surgery (RGS) team was generated. The referent nurse model was adapted to, the sentinel node (SN) preoperative approaches.
OBJECTIVE: To describe the process performed to define the sentinel node referent nurse (SNRN) profile, to validate its practical application and to establish its clinical implementation.
METHODS: Methodology of analysis and continuous improvement in the management of processes (cycle PDCA): definition and planning of the SNRN functions in the breast cancer protocol, performance of a pilot test with 20 patients and analysis of the data in order to validate the circuit and establish its final clinical implementation.
RESULTS: New procedure flows-charts were elaborated, adding the figure of the SNRN, its function and nursing interventions during the process. In the pilot test a 58.3% reduction in subjective anxiety, a 75% decrease of the overall anxiety level, a 100% knowledge of the test and an acceptable patient perception of pain\'s level during the radiotracer administration were obtained. Regarding technical quality, 8/10 items assessed reached the level previously established by the RGS team.
CONCLUSIONS: The increasing complexity of the SN biopsy technique has created the opportunity to implement nursing care in the presurgical SN localization process. The profile of the SNRN is ideal for carrying it out and has led to improvements in the nursing diagnoses and assessed items.