| Objective To evaluate the clinical care path used in patients with first episode of cerebral infarction (CI), make clear and definite the feasibility and role of clinical care path for rehabilitation care of limb function in stroke patients, to explore the prevention and reduction of the deterioration of the limb function after cerebral infarction, to propose appropriate nursing intervention countermeasures, to develop relevant measures, to control the medical costs of ischemic stroke, to curb excessive medical or irrational consumption and to conserve the limited medical resources. All of these are wished to offer better service to these patients and eventually alleviate the burden of cerebral infarction patients and their families.Method A total of66cases of inpatients with first episode of cerebral infarction was selected, in accordance with single disease management treatment of cerebral infarction and meeting the exclusion criteria from October2010to September2011in the neurology department of our hospital.7patients withdrew from the study during treatment, of which4patients discharged themselves from the hospital or interrupted the treatment without completing the treatment or rehabilitation treatment, and the other3patients were in coma during the observation period. Thus59cases were eventually included in this study and were randomly divided into experimental and control groups. The experimental group (28cases) went through clinical care path management; the control group (31cases) adopted traditional models of care management. Barthel Index changes, muscle strength, hospital costs, the length of hospital stay, and the degree of knowledge about health education and the satisfaction with nursing work, were all compared in patients discharged. Data were coded and entered in SPSS16.0for descriptive statistical analysis.Results It was found that there were no significant differences between the two groups in gender, age, illness degree, concomitant disease points and past history points (P>0.05).Two groups were comparable. During comparative analysis in management before and after the clinical care path for patients with cerebral infarction, there were no significant differences in the Barthel Index score of patients on admission compared with the control group (t=0.3309, P>0.05). But with discharged patients, Barthel Index score increased in experimental group compared to the control group, indicating the significance in statistics (t=2.8913, P<0.01). Furthermore, the improvement in muscle strength of the experimental group was better than that of the control group, also having the significance in statistics(X2=4.023, P<0.05). The fact that the average days of hospitalization in experimental group was shorter than those of control group again showed the significance (t=2.293, P<0.05). Nevertheless, there was no obvious difference as far as the the average cost of hospital stay is concerned (t=1.2541, P>0.05).The patients and their family caregivers in the experiment group had a more thorough understanding of health education knowledge than those in the control group, showing a significant difference(t=4.7419, P<0.01). And the degree of satisfaction for nursing work in the experiment group was also higher than in the control group, which had a significant difference (t=3.8960, P<0.01) too.Conclusion The application of clinical care path to the patients with first episode of cerebral infarction,for their early clinical rehabilitation and care, can help them to improve the Barthel Index score and muscle strength, promote their limb function rehabilitation and daily activity, as well as raise the degree of knowledge about health education and the satisfaction with nursing work, without increasing the medical costs and the hospital stay time. It is also helpful in providing a reference for the department in charge of development of CI care path management. |
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