Perioperative multidisciplinary nursing model for endoscopic gastric submucosal dissection development and effect evaluation

Table 1 Comparison of general information between the two groups, n (%)

Group		Control group (n = 99)	Observation group (n = 99)	t	P value
Gender	Male	53 (53.54)	51 (51.53)	0.081	0.775
	Female	46 (46.46)	48 (48.48)
Age (mean ± SD, years)		61.75 ± 9.82	61.10 ± 9.16	0.451	0.63
Place of residence	Countryside	52 (52.53)	51 (51.52)	0.02	0.887
	Town	47 (47.47)	48 (48.48)
Educational level	Primary school and below	55 (55.56)	53 (53.54)	0.233	0.972
	Junior high school	22 (22.22)	24 (24.24)
	High school	15 (15.15)	16 (16.16)
	College degree or above	7 (7.07)	6 (6.06)
Coronary heart disease or diabetes	Yes	36 (36.36)	33 (33.33)	0.2	0.654
	None	63 (63.64)	66 (66.67)
Pathological staging of the disease	I	33 (33.33)	31 (31.31)	1.173	0.756
	II	18 (18.18)	21 (21.21)
	III	33 (33.33)	28 (28.28)
	IV	15 (15.15)	19 (19.19)
BMI (mean ± SD, kg/m2)		20.57 ± 1.23	20.34 ± 1.89	1.014	0.311
PG-SGA score (mean ± SD, points)		10.45 ± 3.67	10.78 ± 3.12	0.681	0.496

BMI: Body mass index; PG-SGA: The Scored Patient Generated Subjective Global Assessment.

Table 2 Expert authority level table

Round	Cs	Ca	Cr
Round one	0.803	0.712	0.758
The second round	0.903	0.753	0.828

Table 3 Inquiry results of the multidisciplinary team nursing quality index system for early gastric cancer patients during the perioperative period

Indicator	Importance (mean ± SD, points)	Coefficient of variation	Weight
1 Structural indicators	4.50 ± 0.55	0.12	0.1200
1.1 Human resource allocation	4.70 ± 0.45	0.10	0.0900
1.1.1 Nurse-to-patient ratio	4.60 ± 0.40	0.08	0.0080
1.1.2 Nurse skill level composition ratio	4.75 ± 0.30	0.06	0.0070
1.1.3 Presence of a multidisciplinary enhanced recovery after surgery (ERAS) team	4.90 ± 0.25	0.05	0.0120
1.1.4 Average nursing hours per 24 hours per hospitalized patient	4.70 ± 0.50	0.10	0.0030
1.2 Skill level and concept	4.75 ± 0.35	0.07	0.1100
1.2.1 Pass rate of nurse specialist skill training and assessment	4.85 ± 0.25	0.05	0.0230
1.2.2 Implementation rate of nurse training on ERAS concepts	4.80 ± 0.30	0.06	0.0230
1.3 Nursing protocols and procedures	4.70 ± 0.35	0.07	0.1200
1.3.1 Pass rate of training on perioperative gastric cancer nursing protocols	4.85 ± 0.25	0.05	0.0230
1.3.2 Pass rate of training on nasoenteric tube care protocols	4.80 ± 0.30	0.06	0.0070
1.3.3 Pass rate of training on abdominal drainage tube care protocols	4.75 ± 0.25	0.05	0.0070
1.3.4 Pass Rate of training on venous catheter maintenance procedures	4.70 ± 0.30	0.06	0.0070
1.4 Equipment	4.41 ± 0.25	0.13	0.0894
1.4.1 Ratio of monitors, mobile IV stands, walkers to beds	4.63 ± 0.25	0.14	0.0157
2 Process indicators	6.00	0.00	0.7332
2.1 Health education	4.65 ± 0.40	0.09	0.0690
2.1.1 Implementation rate of perioperative education on significance and methods of early postoperative ambulation	4.70 ± 0.40	0.09	0.0070
2.1.2 Mastery rate of postoperative oral nutritional solution preparation methods	4.60 ± 0.50	0.11	0.0030
2.1.3 Mastery rate of preoperative lung function exercise methods (for patients with underlying pulmonary diseases)	4.75 ± 0.35	0.07	0.0160
2.1.4 Implementation rate of discharge guidance	4.70 ± 0.40	0.09	0.0150
2.2 Psychological care	4.20 ± 0.60	0.14	0.0290
2.2.1 Screening rate for perioperative anxiety and depression	4.65 ± 0.650	0.11	0.0090
2.2.2 Intervention rate for perioperative anxiety and depression	4.60 ± 0.55	0.12	0.0060
2.3 Intraoperative temperature managemen	4.75 ± 0.35	0.07	0.1003
2.3.1 Implementation rate of intraoperative temperature management measures	4.85 ± 0.25	0.05	0.0402
2.3.2 Intraoperative normothermia achievement rate	4.80 ± 0.30	0.06	0.0402
2.4 Cooperation in tumor-free protective isolation techniques	6.00	0.00	0.3958
2.4.1 Implementation rate of supervision and cooperation in tumor-free protective isolation techniques	6.00	0.00	0.3958
2.5 Venous thromboembolism (VTE) management	4.65 ± 0.50	0.11	0.0440
2.5.1 VTE assessment rate	4.70 ± 0.40	0.09	0.0130
2.5.2 Implementation rate of VTE preventive measures	4.65 ± 0.45	0.10	0.0130
2.6 Pain management	4.55 ± 0.60	0.13	0.0320
2.6.1 Postoperative pain assessment rate	4.75 ± 0.35	0.07	0.0082
2.6.2 Mastery rate of patient- or family-controlled intravenous analgesia pump knowledge	4.60 ± 0.40	0.09	0.0020
2.6.3 Implementation rate of multimodal analgesia	4.70 ± 0.35	0.07	0.0082
2.7 Nutrition management	4.85 ± 0.25	0.05	0.2060
2.7.1 Preoperative nutrition assessment rate	4.80 ± 0.35	0.06	0.0252
2.7.2 Preoperative nutrition intervention rate	4.87 ± 0.35	0.07	0.0252
2.7.3 Implementation rate of postoperative early ONS1	4.93 ± 0.26	0.05	0.0772
2.8 Tube management	4.82 ± 0.35	0.07	0.1057
2.8.1 Venous catheter care compliance rate	4.82 ± 0.35	0.07	0.0182
2.8.2 Nasoenteric tube care compliance rate	4.75 ± 0.35	0.07	0.0200
2.8.3 Abdominal drainage tube care compliance rate	4.75 ± 0.35	0.07	0.0200
2.8.4 Implementation rate of urinary catheter removal on postoperative day 1 (for clinically stable patients)	4.55 ± 0.50	0.11	0.0070
2.9 Early ambulation	4.65 ± 0.59	0.09	0.0692
2.9.1 Completion rate of bedside activities on the day of surgery	4.75 ± 0.52	0.09	0.0216
2.9.2 Completion rate of ambulation on postoperative day 1	4.75 ± 0.35	0.09	0.0216
3 Outcome indicators	4.73 ± 0.46	0.07	0.2395
3.1 Adverse events	4.75 ± 0.35	0.09	0.2825
3.1.1 Incidence of stage 2 or above pressure injuries in hospitalized patients	4.80 ± 0.41	0.09	0.0117
3.1.2 Incidence of central venous catheter (CVC)-related bloodstream infections	4.87 ± 0.35	0.07	0.0187
3.1.3 Incidence of falls in hospitalized patients	4.73 ± 0.59	0.13	0.0041
3.1.4 Proportion of fall-related injuries in hospitalized patients	4.80 ± 0.56	0.12	0.0104
3.1.5 Incidence of deep vein thrombosis	4.84 ± 0.35	0.07	0.0166
3.1.6 Unplanned extubation rate	4.83 ± 0.56	0.12	0.0060
3.2 Complications	4.87 ± 0.35	0.07	0.4732
3.2.1 Incidence of aspiration during anesthesia recovery	4.84 ± 0.35	0.07	0.0852
3.2.2 Unplanned tube occlusion rate	4.83 ± 0.56	0.12	0.0281
3.3 Bowel function recovery	4.70 ± 0.45	0.10	0.1223
3.3.1 Bowel sound recovery rate within 12-24 hours postoperatively	4.87 ± 0.25	0.05	0.0291
3.4 Length of stay	4.70 ± 0.45	0.10	0.1223
3.4.1 Average length of stay for discharged patients	4.87 ± 0.26	0.05	0.0291

¹Oral nutritional supplements refer to the supplementation of deficiencies in the daily diet through the oral intake of special medical use (formula) foods in addition to the normal diet.

ERAS: Enhanced recovery after surgery; VTE: Venous thromboembolism; ONS: Oral nutritional supplements; CVC: Central venous catheter.

Table 4 Comparison of observation indicators between the two groups (%)

Indicator	Observation group (n = 99)	Control group (n = 99)	t/χ²	P value
Time to bowel sound recovery (hours, mean ± SD)	12.53 ± 1.21	17.16 ± 1.07	28.521	0.000
First time out-of-bed activity (hours, mean ± SD)	23.53 ± 2.34	29.06 ± 1.89	18.293	0.000
Length of hospital stay (days, mean ± SD)	6.63 ± 0.46	9.26 ± 0.37	44.327	0.000
Patient satisfaction	100.0	80.81	21.017	0.000
Postoperative bleeding rate	1.01	5.05	1.547	0.214
Perforation incidence rate	0.00	6.06	4.297	0.038
Postoperative infection rate	2.02	7.07	1.862	0.172
Overall complication rate	3.03	18.18	11.986	0.001