The Establishment And Application Of Extended Care Mode For Surgical Patients After Discharging From Hospitals

Objectives:1) In order to further implement the comprehensive, throughout, professional, humane care requirements of the twelfth Five-Year Plan, the purpose of the study was to explore the establishment of extended care for surgical patients after discharge from hospital.2) To evaluate and verify the extended care of our hospital, using the methods of questionnaires, telephone follow-up, interviews and so on.Methods:We designed and formed the "questionnaire of demand for the extended care services for surgical patients after discharge", which referred to the "Family Health Nurse Service Survey" of Zang Yu-li. After excluding the pediatric patients, obstetrics and gynecology patients and local anesthesia surgical patients,128surgical patients after discharge from our hospital were surveyed by the questionnaire and formed the extended care service files. When discharging, the primary nurse of the patient seek the patient’s agreement to establish extended care services file of this patient. And after two weeks, the doctor of this patient implemented the extended care services. Discharged after1month,3months and6months, the primary nurse of this patient implemented the extended care services.After the questionnaire survey for patients, we interviewed the related people who had participated the extended care services, including60nurses and30doctors. And phoned follow up40surgical patients after discharge, to survey their satisfaction, acceptance and comments about the services. And then we formed the questionnaire of nurse on the implementation of extended care services.All the data was analyzed by SPSS17.0statistical software.Results:1. After the survey for patients,47.7%-68.8%of the patients expressed needs for the basic health and disease knowledge.72.7%-83.6%of the patients showed they do not need the knowledge on the care operation of interventional treatment and each sub-entry of specialist care operations. Among seven kinds of extended care services mentioned in the questionnaire, outpatient reexamination and telephone follow-up had the highest percentage, which were30.8%and36.0%. And55.6%of the patients expressed that they want doctors to do the continuation of services, and35.1%of patients expressed their hope for the nurses.2. The survey for nurses showed that50%of the nurses indicated they can qualify their work completely, and46.7%of the nurses said they can qualify the work partly. The results also showed that61.7%of the nurses wanted to receive training on telephone and etiquette.71.7%of the nurses expressed the need for training of the expertise knowledge on disease.76.7%of the nurses said the extended care services can improve their personal capacity.93.3%of the nurses considered that the files of extended care services were suitable or basically suitable for the service objects.85%of the nurses believed that the extended care serviees were meaningful. And68.3%of the nurses thought the services can meet demands of patients.3. From the interview on30surgical doctors, we found that all these doctors considered the services can increase the popularity of the hospital, improve service processes and service quality. All doctors indicated there is no relatively fixed time for the implementation of extended care. However, they all expressed that they can give nurses guideline in time.28doctors believed that nurses can meet patients’demands basically.4. The telephone survey for patients showed that35patients were satisfied for the extended care services and they also felt the services make the distance between nurses and patients more close.30patients expressed the services can completely meet their demands.4patients felt the services were too frequent and the service time was too long.39patients affirmed the services.Conclusions:1. Surgical patients had strong demands for the services, especially for the illness-related knowledge and basic health knowledge. And they wanted nurses and doctors of the hospital, where the patients had lived, to do the services. So we can see that the extended care services get some approbate from the majority of patients.2. Most of the nurses can qualify the service work. And they thought it was meaningful. They felt it can enhance their personal capacity. However, they also need some training on the expertise knowledge and the service etiquette.3. Doctors approve on the implementation of extended care services. And they are willing to collaborate with the nursing staff.4. The extended care service model had been recognized by patients, nurses and doctors in a certain sense. It can be used as an effective nursing model to be promoted.