| Objective:To evaluate the postoperative effect、perioperative nursing measures and application effect of the clinical nursing pathway on obese patients who undertook the laparoscopic sleeve gastrectomy.Methods:63 obese patients undertook laparoscopic sleeve gastrectomy from September 2013-August 2014 in jilin central hospital are collected by random sampling, who are randomly divided into two groups:31 cases in the experiment group and 32 cases in the control group. The experimental group adopts the "line style" nursing pathway reported in 《Clinical nursing pathway of laparoscopic sleeve gastrectomy》. While the patients in control group recieve holistic nursing care. The evaluation index includesindicators of annual(ALOSandexoenditure), quality (postoperative complications andpain level), clinical outcomes(lower the ALOS and expenditure),satisfaction of patients(mastery of related knowledge of the patients and the family,satisfaction of nursing). We statisticaly analyse the data with SPSS18.0.Results:The perioperative and postoperative nursing indicators of the two groups are as follows:(1) The annual assessment index in both groups:the average hospitalization days in the experimental group is (6.12±0.12)days, while(9.48±0.36)days in the control group. The average hospitalization cost of the experimental group is(8798.5±753.5) yuan, while (12058.5 ±628.5) yuan in the control group. The index of the experimental group was better than the control group, the comparation between the two groups was statistically significant (P< 0.05);(2)Quality evaluation index in both groups:We found operative complications in(2±1)cases in the experimental group, while(3±1) cases in the control group. The postoperative pain is classified as follows: class Ⅰ 23 cases, Ⅱ 8 cases, Ⅲ 0 cases, control group:I 11 cases. The postoperative pain is classified:levels II 18 cases, III 3 cases. The index of the experimental group was better than control group, the comparation between the two groups was statistically significant (P< 0.05);(3) the evaluation index of clinical results in both groups:The the average hospitalization day in experimental group reduces 3.36 days compared with the control group, and 3260 yuan reduction per person in terms of the hospitalization costs;(4) The evaluation index of patients’satisfaction in both groups:The master degree of the relevant knowledge of the patients and family members in the experimental group is 92.98%,while 75.12% in the control group. The very satisfaction rate is 87% in the experimental group, and the overall satisfaction rate is 93.5%, while in the control group is 59.4% and 81.2% separately. The index of the experimental group was better than control group, the comparation between the two groups was statistically significant (P<0.05);Conclusion:1. Clinical nursing pathway can reduce the hospitalization days and hospitalization expenses of obese patients undertook laparoscopic sleeve gastrectomy2. The implementation of clinical nursing pathway can improve the quality of care, the patients’satisfaction, achieve the win-win hospital and society effect.3. The clinical nursing pathway can provide the basis for evidence-based nursing. |
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