Objective:To explore the effects of perioperative clinical pathway of accelerated rehabilitation surgery strategy in patients undergoing cholangiopancreatography(ERCP).Methods:Randomly selected 40 patients undergoing ...Objective:To explore the effects of perioperative clinical pathway of accelerated rehabilitation surgery strategy in patients undergoing cholangiopancreatography(ERCP).Methods:Randomly selected 40 patients undergoing ERCP from our hospital which is People's Hospital,Jingjiang City,for research,and divided the patients into two groups.The 20 patients who were given conventional education methods were set as the reference group,and the 20 patients who were given perioperative clinical pathway care with accelerated rehabilitation surgery strategies were the research group,where the clinical nursing effect of the two groups was statistically compared.Results:According to clinical observation and statistics,the study group's postoperative time to eat for the first time,time to get out of bed,hospitalization time,and surgical blood loss were better than those of the reference group,P<0.05;the anxiety and depression scores of the study group were lower than those after nursing in the reference group,P<0.05;the incidence of complications in the study group was lower than that in the reference group,and patient satisfaction was higher than that in the reference group,where both P<0.05.Conclusion:The application of perioperative clinical pathway care based on the strategy of accelerated rehabilitation surgery can achieve significant results in ERCP patients,which can effectively improve the surgical indicators of patients and reduce the risk of complications.展开更多
China has been undertaking a profound reform on health care.Although more than 1.16 billion people have been covered by rural and urban medical insurance to date,the level of reimbursement from insurance is very limit...China has been undertaking a profound reform on health care.Although more than 1.16 billion people have been covered by rural and urban medical insurance to date,the level of reimbursement from insurance is very limited,especially for critical diseases such as leukemia.This places heavy economic burdens on patients.Under these circumstances,systems innovation is imperative for the efficient utilization of limited funding.In this respect,certain valuable experience from other countries may prove helpful.The prospective payment system of Diagnosis-related Groups(DRGs),Clinical Paths,and the Comparative Effectiveness Analysis adopted by the National Institute of Health and Clinical Excellence(NICE,UK),can befine tools to reduce medical costs and improve quality of services.Treatments of acute promyelocytic leukemia at Rui-Jin Hospital,and childhood acute lymphoblastic leukemia at Shanghai Children’s Medical Center,can be taken as suitable models to illustrate the crucial role of Clinical Paths in guaranteeing clinical and cost effectiveness of medical services for critical diseases,and to satisfactorily justify the feasibility of DRGs in China.展开更多
Objective: the experiment will improve the rehabilitation of patients with ischemic stroke and provide comprehensive support for its combination with clinical treatment model. Methods: during the experiment, the patie...Objective: the experiment will improve the rehabilitation of patients with ischemic stroke and provide comprehensive support for its combination with clinical treatment model. Methods: during the experiment, the patients suffering from coronary artery stroke insufficiency were selected as the purpose of this study. During the period from January to December 2020, the corresponding treatment methods were given to 70 patients who had expired in our hospital. This is divided into two groups using the random number method. Although the patient group uses the conventional rehabilitation method, this group is a clinical nursing model and the treatment results are compared. Results: from the point of view of medical quality, the MMSE indexes of the observed patients were higher than those of the control group, while the ADL index was (91.7±5.4) to evaluate the quality of life of the control group (84.3±4.9), with a statistical value (n < 0.05). At the same time, in the investigation of complications and residual consequences, the incidence rate of patients was 2.9% (1/35) and 14.3% (5/35), which was lower than 5.7% (2/35) and 22.9%(7/35) in the control group. The difference was statistical data. Conclusion: the use of clinical assistance model to restore patients with ischemic stroke not only improves their cognitive and sports functions, but also contributes to their survival, and is very important for clinical propaganda of complications and complications.展开更多
Objective: to explore the application value of fiberoptic bronchoscope and alveolar lavage in children with refractory pneumonia. Methods: the clinical study selected 80 cases of children, as a clinical analysis objec...Objective: to explore the application value of fiberoptic bronchoscope and alveolar lavage in children with refractory pneumonia. Methods: the clinical study selected 80 cases of children, as a clinical analysis object, the study starting time is in August 2021, the clinical analysis data collection, the research plan, until August 2022, the study selected case, as a group standard, the group to nursing path intervention, control group to basic intervention, the number of children in each group of 40 cases, fiber bronchoscope alveolar lavage, analysis of lung function, satisfaction, compliance, improvement time, nursing quality. Results: the group family satisfaction is higher, compliance, nursing quality is better than the control group, children with disease improvement time, lung function improvement effect is better than the control group, P <0.05. Conclusion: clinical intervention during refractory pneumonia symptoms fiber bronchoscope alveolar lavage nursing pathway comprehensive intervention, has high clinical application value, can significantly improve the treatment effect, increase the patient care service compliance, shorten the disease rehabilitation time, can use for primary medical institutions, worthy of widely recommended clinically.展开更多
Objective: The use of clinical care pathway for bronchopneumonia patients. Methods: 64 children admitted for bronchopneumonia from March 2022 to September 2022 were randomly selected, and the clinical care mode was us...Objective: The use of clinical care pathway for bronchopneumonia patients. Methods: 64 children admitted for bronchopneumonia from March 2022 to September 2022 were randomly selected, and the clinical care mode was used as the group basis, namely experiment and control, and the number of children in each group was 32. All the children in the control group received routine care, and all the children in the observation group implemented the clinical nursing path, comparing the effect. Results: The observation group improved better than the control group, P 0.05. The improvement of lung function in the observed group was better than that in the control group, with P 0.05. The odds of complications were significantly higher in the control group than in the observed group, with P 0.05. Finally, in the scores of basic operation, service attitude, risk handling ability and sense of responsibility in four aspects, the work scores of the caregivers in the observation group were better, with significant differences (p 0.05). Conclusion: The adoption of clinical nursing path is helpful to strengthen the lung function, reduce the complication rate of children, and promote the gradual improvement of patients condition, which is worth promoting.展开更多
Objective: to study the effect of clinical nursing path high quality nursing in the perioperative period of PCI treatment for acute myocardial infarction. Methods: 60 patients with acute myocardial infarction who rece...Objective: to study the effect of clinical nursing path high quality nursing in the perioperative period of PCI treatment for acute myocardial infarction. Methods: 60 patients with acute myocardial infarction who received percutaneous coronary intervention (PCI) were divided into conventional intervention group (28 cases) and combined intervention group (32 cases). The conventional intervention group received routine nursing intervention measures, and the combined intervention group received clinical pathway management quality nursing intervention. The postoperative treatment status (postoperative exhaust time, activity time out of bed, postoperative hospitalization time), the incidence of complications and psychological status of patients in the two groups after nursing intervention were compared. Results: there was no difference in clinical data between the two groups (P>0.05). The postoperative exhaust time, activity time out of bed and postoperative hospitalization time in the combined intervention group were shorter than those in the conventional intervention group, with statistical significance (P<0.05). The total incidence of complications in the combined intervention group was 39.29%, significantly lower than 12.5% in the conventional intervention group, and the difference between groups was statistically significant (P<0.05). The scores of mental state (SCL-90) of patients in the combined intervention group were lower than those in the conventional intervention group, and the difference between groups was statistically significant (P < 0.05). Conclusion: quality nursing based on clinical nursing path management should be applied in the perioperative period of PCI treatment for patients with AMI. It is helpful to speed up postoperative recovery (to achieve early exhaust and get out of bed), reduce psychological burden (to avoid adverse psychological state), reduce the incidence of complications, shorten the time of hospital stay, and achieve the purpose of promoting patients' recovery.展开更多
[Objective] To explore the effect of clinical care pathways in perioperative patients with autologous arteriovenous fistula balloon expansion. [Method] 202 patients undergoing autologous arteriovenous fistula from Jul...[Objective] To explore the effect of clinical care pathways in perioperative patients with autologous arteriovenous fistula balloon expansion. [Method] 202 patients undergoing autologous arteriovenous fistula from July 2021 to June 2022 were randomly divided into a control group (101 cases) and an observation group (101 cases) to compare the incidence rates of postoperative complications, hospitalization days, hospitalization expenses, knowledge of self-management of arteriovenous fistula and nursing satisfaction. [Results] In the observation group, the incidence of arteriovenous fistula was higher than that of the control group, and the hospitalization days and hospitalization costs were lower than that of the control group. The difference between the two groups was statistically significant (P < 0.05). [Conclusion] The application of the clinical nursing path to intervene in patients with autologous arteriovenous fistula balloon dilation can reduce the incidence of postoperative complications, shorten the hospital length of time, reduce hospitalization costs and improve patient satisfaction, which is clinical promotion significance.展开更多
Objective: to explore the role of standard clinical treatment of diabetes in the regulation of diabetes. Methods: from June 2020 to June 2021, 110 patients with type 2 diabetes were selected from the total number of d...Objective: to explore the role of standard clinical treatment of diabetes in the regulation of diabetes. Methods: from June 2020 to June 2021, 110 patients with type 2 diabetes were selected from the total number of diabetic patients in our hospital. The one-way method is applied twice. Set up a monitoring team to provide standard clinical care for 55 diabetes patients;Compared with 55 even cases, the standard nursing model was adopted. Quality of life indicators (social function, physiological function, role function, psychosomatic function, material life), comparative results, results obtained through research on the behaviors of doctors in the two groups (smoking ban, correct diet, physical exercise, blood pressure control, emotion regulation, regular medication, regular examination) (disease symptoms, pathogenesis, prevention and treatment knowledge, treatment principles, life behaviors, and psychological regulation). Results: the three blood sugar indexes provided by the monitoring group after nursing were all lower than those of the control group, the five quality of life indexes obtained by the monitoring group after nursing were all higher than those of the control group, and the six indexes were higher than those of the control group. The statistical data were of great significance to the seven cases. When the monitoring group after nursing was more frequent than the control group, (P<0.05). Conclusion: the clinical treatment approach of the normalized type 2 diabetes patients had higher blood sugar indexes, and the quality of life, knowledge, compliance with doctors advice and other aspects had more important significance to clinical application.展开更多
文摘Objective:To explore the effects of perioperative clinical pathway of accelerated rehabilitation surgery strategy in patients undergoing cholangiopancreatography(ERCP).Methods:Randomly selected 40 patients undergoing ERCP from our hospital which is People's Hospital,Jingjiang City,for research,and divided the patients into two groups.The 20 patients who were given conventional education methods were set as the reference group,and the 20 patients who were given perioperative clinical pathway care with accelerated rehabilitation surgery strategies were the research group,where the clinical nursing effect of the two groups was statistically compared.Results:According to clinical observation and statistics,the study group's postoperative time to eat for the first time,time to get out of bed,hospitalization time,and surgical blood loss were better than those of the reference group,P<0.05;the anxiety and depression scores of the study group were lower than those after nursing in the reference group,P<0.05;the incidence of complications in the study group was lower than that in the reference group,and patient satisfaction was higher than that in the reference group,where both P<0.05.Conclusion:The application of perioperative clinical pathway care based on the strategy of accelerated rehabilitation surgery can achieve significant results in ERCP patients,which can effectively improve the surgical indicators of patients and reduce the risk of complications.
基金supported in part by the Program of Improving Health Services in China’s Rural Areas supported by the World Bank Loans(Qinghai Province,QHWST-2009KT01).
文摘China has been undertaking a profound reform on health care.Although more than 1.16 billion people have been covered by rural and urban medical insurance to date,the level of reimbursement from insurance is very limited,especially for critical diseases such as leukemia.This places heavy economic burdens on patients.Under these circumstances,systems innovation is imperative for the efficient utilization of limited funding.In this respect,certain valuable experience from other countries may prove helpful.The prospective payment system of Diagnosis-related Groups(DRGs),Clinical Paths,and the Comparative Effectiveness Analysis adopted by the National Institute of Health and Clinical Excellence(NICE,UK),can befine tools to reduce medical costs and improve quality of services.Treatments of acute promyelocytic leukemia at Rui-Jin Hospital,and childhood acute lymphoblastic leukemia at Shanghai Children’s Medical Center,can be taken as suitable models to illustrate the crucial role of Clinical Paths in guaranteeing clinical and cost effectiveness of medical services for critical diseases,and to satisfactorily justify the feasibility of DRGs in China.
文摘Objective: the experiment will improve the rehabilitation of patients with ischemic stroke and provide comprehensive support for its combination with clinical treatment model. Methods: during the experiment, the patients suffering from coronary artery stroke insufficiency were selected as the purpose of this study. During the period from January to December 2020, the corresponding treatment methods were given to 70 patients who had expired in our hospital. This is divided into two groups using the random number method. Although the patient group uses the conventional rehabilitation method, this group is a clinical nursing model and the treatment results are compared. Results: from the point of view of medical quality, the MMSE indexes of the observed patients were higher than those of the control group, while the ADL index was (91.7±5.4) to evaluate the quality of life of the control group (84.3±4.9), with a statistical value (n < 0.05). At the same time, in the investigation of complications and residual consequences, the incidence rate of patients was 2.9% (1/35) and 14.3% (5/35), which was lower than 5.7% (2/35) and 22.9%(7/35) in the control group. The difference was statistical data. Conclusion: the use of clinical assistance model to restore patients with ischemic stroke not only improves their cognitive and sports functions, but also contributes to their survival, and is very important for clinical propaganda of complications and complications.
文摘Objective: to explore the application value of fiberoptic bronchoscope and alveolar lavage in children with refractory pneumonia. Methods: the clinical study selected 80 cases of children, as a clinical analysis object, the study starting time is in August 2021, the clinical analysis data collection, the research plan, until August 2022, the study selected case, as a group standard, the group to nursing path intervention, control group to basic intervention, the number of children in each group of 40 cases, fiber bronchoscope alveolar lavage, analysis of lung function, satisfaction, compliance, improvement time, nursing quality. Results: the group family satisfaction is higher, compliance, nursing quality is better than the control group, children with disease improvement time, lung function improvement effect is better than the control group, P <0.05. Conclusion: clinical intervention during refractory pneumonia symptoms fiber bronchoscope alveolar lavage nursing pathway comprehensive intervention, has high clinical application value, can significantly improve the treatment effect, increase the patient care service compliance, shorten the disease rehabilitation time, can use for primary medical institutions, worthy of widely recommended clinically.
文摘Objective: The use of clinical care pathway for bronchopneumonia patients. Methods: 64 children admitted for bronchopneumonia from March 2022 to September 2022 were randomly selected, and the clinical care mode was used as the group basis, namely experiment and control, and the number of children in each group was 32. All the children in the control group received routine care, and all the children in the observation group implemented the clinical nursing path, comparing the effect. Results: The observation group improved better than the control group, P 0.05. The improvement of lung function in the observed group was better than that in the control group, with P 0.05. The odds of complications were significantly higher in the control group than in the observed group, with P 0.05. Finally, in the scores of basic operation, service attitude, risk handling ability and sense of responsibility in four aspects, the work scores of the caregivers in the observation group were better, with significant differences (p 0.05). Conclusion: The adoption of clinical nursing path is helpful to strengthen the lung function, reduce the complication rate of children, and promote the gradual improvement of patients condition, which is worth promoting.
文摘Objective: to study the effect of clinical nursing path high quality nursing in the perioperative period of PCI treatment for acute myocardial infarction. Methods: 60 patients with acute myocardial infarction who received percutaneous coronary intervention (PCI) were divided into conventional intervention group (28 cases) and combined intervention group (32 cases). The conventional intervention group received routine nursing intervention measures, and the combined intervention group received clinical pathway management quality nursing intervention. The postoperative treatment status (postoperative exhaust time, activity time out of bed, postoperative hospitalization time), the incidence of complications and psychological status of patients in the two groups after nursing intervention were compared. Results: there was no difference in clinical data between the two groups (P>0.05). The postoperative exhaust time, activity time out of bed and postoperative hospitalization time in the combined intervention group were shorter than those in the conventional intervention group, with statistical significance (P<0.05). The total incidence of complications in the combined intervention group was 39.29%, significantly lower than 12.5% in the conventional intervention group, and the difference between groups was statistically significant (P<0.05). The scores of mental state (SCL-90) of patients in the combined intervention group were lower than those in the conventional intervention group, and the difference between groups was statistically significant (P < 0.05). Conclusion: quality nursing based on clinical nursing path management should be applied in the perioperative period of PCI treatment for patients with AMI. It is helpful to speed up postoperative recovery (to achieve early exhaust and get out of bed), reduce psychological burden (to avoid adverse psychological state), reduce the incidence of complications, shorten the time of hospital stay, and achieve the purpose of promoting patients' recovery.
文摘[Objective] To explore the effect of clinical care pathways in perioperative patients with autologous arteriovenous fistula balloon expansion. [Method] 202 patients undergoing autologous arteriovenous fistula from July 2021 to June 2022 were randomly divided into a control group (101 cases) and an observation group (101 cases) to compare the incidence rates of postoperative complications, hospitalization days, hospitalization expenses, knowledge of self-management of arteriovenous fistula and nursing satisfaction. [Results] In the observation group, the incidence of arteriovenous fistula was higher than that of the control group, and the hospitalization days and hospitalization costs were lower than that of the control group. The difference between the two groups was statistically significant (P < 0.05). [Conclusion] The application of the clinical nursing path to intervene in patients with autologous arteriovenous fistula balloon dilation can reduce the incidence of postoperative complications, shorten the hospital length of time, reduce hospitalization costs and improve patient satisfaction, which is clinical promotion significance.
文摘Objective: to explore the role of standard clinical treatment of diabetes in the regulation of diabetes. Methods: from June 2020 to June 2021, 110 patients with type 2 diabetes were selected from the total number of diabetic patients in our hospital. The one-way method is applied twice. Set up a monitoring team to provide standard clinical care for 55 diabetes patients;Compared with 55 even cases, the standard nursing model was adopted. Quality of life indicators (social function, physiological function, role function, psychosomatic function, material life), comparative results, results obtained through research on the behaviors of doctors in the two groups (smoking ban, correct diet, physical exercise, blood pressure control, emotion regulation, regular medication, regular examination) (disease symptoms, pathogenesis, prevention and treatment knowledge, treatment principles, life behaviors, and psychological regulation). Results: the three blood sugar indexes provided by the monitoring group after nursing were all lower than those of the control group, the five quality of life indexes obtained by the monitoring group after nursing were all higher than those of the control group, and the six indexes were higher than those of the control group. The statistical data were of great significance to the seven cases. When the monitoring group after nursing was more frequent than the control group, (P<0.05). Conclusion: the clinical treatment approach of the normalized type 2 diabetes patients had higher blood sugar indexes, and the quality of life, knowledge, compliance with doctors advice and other aspects had more important significance to clinical application.
