Research On Admission And Discharge Criteria Of Intermediate Care And Intermediate Care Mode For Fracture Patients

Objective To investigate the general situation, the cognition of intermediate care and the demand situation of fracture surgery patients. Through the establishment of admission and discharge carteria of intermediate care of fracture patients and the investigation results to form the intermediate care model of fracture patients, so as to improve patients’health better. To evaluate the effectiveness of the intermediate care model to reduce the complications, improve self-care ability of daily living, reduce readmission rate, improve the satisfaction of patients,so as to provide quality basis for the expanded of intermediate care model.Methods The methods of this study included literature reviewing, questionnaire investigation and Delphi method. Using self-designed questionnaire, we conducted one survey to 504 fracture surgery patients from one hospital in Beijing. Another questionnaire survey was conducted to 25 specialists from 7 hospitals in Beijing and hebei, Sichuan, Jiangsu province. Based on the analysis of care needs and recognition of intermediate care model of orthopeadic surgery patients, combining BI instrument, we established the admission and discharge criteria of intermediate care and intermediate care mode for fracture patients. After collecting and analyzing the valid questionnaires of three rounds of Delphi method, we tentatively set the intermediate care model of fracture surgery patients.100 hip fracture patients were involved in the intervention program with a random sample. The prevalence of orthopeadic related complications and the satisfaction of patients were made comparison before and after three months.Results1. Majority of the fracture patients didn’t know about intermediate care. The orthopeadic patients had heavy degree of disability, more than 80% of patients result of mild disability.2. Different stage of age, sex, martal status, cultural level had different nursing needs, the difference were statistically significant(P<0.05).3. Logistic single factor analysis showed, the factors that influence discharge of patients were degree of self-care ability and degree of the risk of DVT and PTE.4. Through the three rounds of Delphi methods, we initially identified the admission and discharge criteria for orthopeadic patients. It includes 11 first level indicators and 31 second level indicators.5. The model of intermediate care improved self-care ability of patients(P<0.05) and reduce the prevalence of complication (P<0.05). In terms of patients’/their family members’obedience and satisfaction,the difference were no statistically significant(P> 0.05).Conclusions1. Through the study of the present situation of orthopaedic patients, we knew the cognition and nursing needs of fracture patients. These can build the foundation for the establishment of admission and discharge criteria of intermediate care and intermediate care mode.2. The establishment of admission and discharge criteria of intermediate care and intermediate care model for fracture patients, can provide reference for the construction of acute illness intermediate care mode.