为在眼科日间手术模式下既能满足玻璃体视网膜术后体位需求,又能合理利用有限空间,本研究团队在原有的眼科日间病房座椅的基础上,增加玻璃体手术后体位护理等功能,发明了一种护理座椅[专利号:国家实用新型专利(ZL 2017 2 0942404. 1)]。该座椅采用钢喷塑(或不锈钢)、木板、海绵和人造革皮等材料,其结构主要包括座椅的主体部分、俯卧台、杂物篮、收纳架、输液杆套筒等部分。其制作材料简单,操作方便,安全使用,既能保证临床体位护理需求,又能节省空间,便于病房环境管理。
To meet the needs of the postoperative position nursing after pars plana vitrectomy in the day surgery mode,this research team has designed a nursing chair [patent number: National Uutility Model Patent (ZL 201720942404. 1)] based on the original chair of ophthalmic day ward, adding the functions of postvitreous nursing and so on. The seat is made from steel spray plastic (or stainless steel), wood, sponge and artificial leather, and the structure mainly consists of the main body, the countertop for prone position, the junk basket, the storage rack, and the infusion rod sleeve. The seat can be made by simple materials. The seat is easy to operate and safe to use, which can not only meet the needs of clinical body position nursing care, but also save the ward’ space and facilitate the environmental management of the ward.
目的:探讨PDCA循环管理模式在优化白内障日间患者诊疗流程中的应用与成效。方法:选取中山大学中山眼科中心白内障病区2018年9月至2019年12月收治的白内障日间患者400例作为试验对象,选择2018年9月至2019年4月200例患者作为优化前组,选择实施PDCA循环管理模式后的2019年5月至2019年12月的200例患者作为优化后组。统计并比较两组患者实施前后的术前检查时长、住院时长、术后第1天复诊路径及患者满意度。结果:PDCA循环管理法实施了7个月后,患者术前检查时长由优化前的(2.94±2.12) h降至(2.09±0.93) h,住院时长由优化前的(22.73±1.14) h 降至(5.22±1.29) h,差异均具有统计学意义( P <0.001);患者满意度由优化前的92%上升至96%(P<0.05);术后第1天,患者复查所需行走的路径缩短,由以前的172 m降至129 m。结论:实施PDCA循环管理模式能有效地改善白内障日间患者的诊疗流程,缩短患者诊疗时间,提高患者的满意度,值得临床推广。
Objective: To explore the application and effect of Plan-Do-Check-Act (PDCA) cycle management mode in optimizing the diagnosis and treatment process of cataract patients with daytime surgery. Methods: A total of 400 cases of patients with daytime surgery admitted to Department of Cataract, Zhongshan Ophthalmic Center,Sun Yat-sen University from September 2018 to December 2019 were selected as the experimental subjects. 200 patients from September 2018 to April 2019 were selected as the pre-optimization group, and 200 patients from May 2019 to December 2019 after the implementation of the PDCA cycle management mode were selected as the post-optimization group. Time of preoperative examination, length of hospital stay, the follow-up path in the first day after surgery and patient satisfaction were statistically compared between the two groups before and after implementation. Results: Seven months after the implementation of PDCA cycle management mode, the preoperative examination time decreased from (2.94±2.12) h to (2.09±0.93) h, and the length of hospital stay decreased from (22.73±1.14) h to (5.22±1.29) h, and the differences were statistically significant (P<0.001); the patients’ satisfaction increased from 92% to 96% (P<0.05); the follow-up path in the first day after operation was changed from the 13th floor (172 m) to the 3rd floor (129 m). Conclusion: The implementation of PDCA cycle management mode can effectively improve the diagnosis and treatment process of cataract patients with daytime surgery, shorten the diagnosis and treatment time and improve the satisfaction of patients, so it is worthy of clinical promotion.
目的:探究角膜移植日间手术患者的延续护理需求现状及其影响因素。方法:采用便利抽样法抽取行角膜移植日间手术的173例患者,采用课题组自行设计的一般资料调查表、角膜移植日间手术患者延续护理需求调查问卷进行调查。采用独立样本t检验、单因素方差分析、多元线性回归进行统计分析。结果:角膜移植日间术后患者延续护理需求得分为88.13±15.55,其中,对疾病相关知识的需求得分最高,为4.39±0.66,对心理护理的需求得分最低,为2.72±1.18;在延续护理实施方式方面,74.6%患者倾向于电话随访,只有5.8%倾向于上门服务;在影响因素方面,婚姻状况、视力、家庭月收入、文化程度是延续护理需求的影响因素。结论:角膜移植日间术后患者的延续护理需求较高,应根据患者延续护理需求及影响因素进行个性化指导,以提高角膜移植手术的成功率和减少并发症的发生。
Objective: To explore transition care needs among patients with keratoplasty in day ward and analyze the influencing factors. Methods: Using convenience sampling method, 173 patients undergoing keratoplasty in day ward were selected, and they were investigated by using a self-designed general information questionnaire and a questionnaire of transitional care needs of patients with keratoplasty in day ward. T-test, one-way analysis of variance (ANOVA), multiple linear regression were used to analyze the data. Results: The total score of transitional care needs among patients with keratoplasty in day ward was 88.13±15.55. The demand for disease related knowledge was the highest (4.39±0.66), the demand for mental nursing was the lowest (2.72±1.18). In terms of the way of implementation, 74.6% patients preferred telephone follow-up and only 5.8% preferred door-to-door service. Single-factor analysis showed that marital status, vision, monthly income, educational level were the factors influencing the demand for transitional care (P<0.05). Conclusion: Patients with keratoplasty in day ward have a high demand for transitional care. In order to improve the success rate of keratoplasty and reduce the incidence of complications, personalized guidance should be given according to patients’ transitional care needs and influencing factors.
目的:探讨多元化宣教在提高眼科日间手术患者眼部用药正确率及满意度的应用效果。方法:采用便利抽样的方法,选取中山大学中山眼科中心2020年10至12月收治的200例眼科日间手术患者眼部用药的执行者为对象,将10至11月收治的100例日间手术患者眼部用药的执行者纳入对照组,将12月收治的100例日间手术患者眼部用药的执行者纳入试验组。对照组采取传统宣教方式,试验组应用多元化宣教模式进行健康教育。采用自制的健康教育需求调查表调查眼部用药执行者的健康教育需求,采用眼部用药执行评价表、健康宣教满意度调查表评价干预效果。结果:采用多元化宣教方式干预后,试验组患者眼部用药正确率(94%)高于对照组(35%),差异具有统计学意义(P<0.05)。试验组对多元化宣教满意度得分明显高于对照组,差异具有统计学意义(P<0.05)。结论:多元化宣教模式可提高眼科日间手术患者眼部用药正确率,提高患者及家属的满意度,值得临床推广应用。
Objective: To explore the effect of diversified education on improving the accuracy and satisfaction of eye medication in patients undergoing ophthalmic ambulatory surgery. Methods: A total of 200 practitioners of administering eye medication after undergoing ambulatory surgery in Zhongshan Ophthalmic Center, Sun Yat-sen University from October to December 2020 were investigated by convenience sampling, 100 practitioners admitted from October to November were included in the control group, and 100 practitioners were included in the experimental group. The control group adopted the traditional method of education, while the experimental group applied diversified education mode to carry out health education. The health education needs of the patients were investigated by the self-made health education needs questionnaire, and the effect of intervention wasevaluated by the eye medication implementation evaluation form and health education satisfaction questionnaire. Results: After the intervention, the correct rate of eye medication in experimental group (94%) was higher than the control group (35%) with a statistical difference (P<0.05). The satisfaction score about diversified education in experimental group was significantly higher than the control group with a statistical difference (P<0.05).Conclusion: Diversified education model can improve the accuracy of administering eye medication in patientsundergoing ophthalmic ambulatory surgery, and the satisfaction in patients and their families is significantly improved. It is worthy of clinical application.
目的:构建、实施并评价眼科日间手术健康教育模式的有效性。方法:依托信息化手段和Teach-back法,构建眼科日间手术健康教育模式。选取2020年1月至2021年5月中山大学中山眼科中心日间手术患者177例为研究对象,采用历史对照研究法,对照组97例,观察组80例。对照组予常规健康宣教,观察组予基于信息化和Teach-back法的健康教育模式,比较2组患者健康教育知识掌握情况和围手术期护理满意度。结果:观察组健康教育知识自评得分和实际掌握程度得分均显著高于对照组(P<0.05);2组患者体位护理知识得分和护理工作满意度得分之间的差异无统计学意义(P>0.05)。结论:构建基于信息化和Teach-back法的健康教育模式可以提高眼科日间手术患者健康教育知识掌握度,但对于患者体位护理知识掌握程度和护理工作满意度方面的影响还需要进一步研究。
Objective: To construct, implement and evaluate the effectiveness of the health education model for ophthalmic day surgery. Methods: The health education model for ophthalmic day surgery was constructed relying on information-oriented means and Teach-back method. A total of 177 patients with day surgery in Zhongshan Ophthalmic Center from January 2020 to May 2021 were selected as the research subjects and divided into a control group (n=97) and an intervention group (n=80) by historical comparative study. The intervention group was carried out with the health education model based on information-oriented means and Teach-back method, while the control group received the routine health education. The health education knowledge and perioperative nursing satisfaction were compared between the 2 groups. Results: The scores of self-evaluation and nurse evaluation for health education knowledge in the intervention group were significantly higher than those in the control group (P<0.05). There was no significant difference in body position nursing knowledge score and nursing satisfaction score between the 2 groups (P>0.05). Conclusion: The health education model based on information oriented means and Teach-back method can improve the health education knowledge level of patients with ophthalmic day care surgery. In the meanwhile, further studies will be needed to explore the effects on patients in body position nursing knowledge and nursing satisfaction.