Application And Effect Evaluation Of Case Management In Patients With Permanent Pacemaker

ObjectiveThe purpose of this paper is to discuss the Case Management in permanent placement of pacemaker patients,set up multidisciplinary team closely,develop Permanent Pacemaker personalized,standardization,continuous comprehensive nursing program,through case management enhancement in patients with active participation of disease management consciousness,establishing the correct concept of health behavior,to discuss the case management of permanent pacemaker in patients with different period demand,hospitalization expenses,postoperative complications,satisfaction and quality of life.MethodsThis study selected from January 2012 to September 2014 in a hospital in 114 cases of permanent pacemaker implantation in Jinzhou city of Liaoning province were randomly divided into two groups,including 59 cases in the control group,the group received the routine nursing care of patients;55 patients in the intervention group and routine nursing care based on case management intervention on patients with active participation by a multidisciplinary team of medical patients.According to the placement of a permanent pacemaker in patients with preoperative,intraoperative,needs assessment and case hospitalization time 24~48 hours a week during and after surgery in the postoperative management team from the physiological index,the degree of cognition,mental status,economic status,family support,nutritional status,evaluation of professional assessment,seven aspects of activities and behavior the plan the implementation,through the establishment of the We Chat platform in patients after discharge,the implementation of continuous,timely follow-up after permanent pacemaker in 1 months,two patients discharged from the patient satisfaction survey,3 months,6 Months of patients quality of life scores,finally summarize the intervention group with the needs of the various stages of assessment,case management team to assess the situation,compared two groups of patients hospitalized expense,satisfaction,pacemaker postoperative complications and quality of life.ResultsThe results of this study show: a total of 114 patients with pacemaker placement,mean age(68.05±11.49)years;male 55 cases,female 59 cases,19 cases of ?°AVB,third degree atrioventricular block 34 cases,31 cases of sick sinus syndrome,complete atrioventricular block in 5 cases,the other 25 patients,aged 25~90(68.05±11.49)years old.General information on two groups of gender,age,underlying disease,the difference was not statistically significant(P>0.05),comparable.Patients with single and double chamber pacemaker placement for case management intervention,P=0.454 and P= 0.417>0.05,the difference was not statistically significant.Case management of patients with single-chamber pacemaker surgery fee plus the cost of materials affect P=0.411 and P=0.933,P>0.05,the difference was not statistically significant.Case management model for the cost of treatment in patients with single-chamber pacemaker affect P=0.788,the difference was not statistically significant,case management models P=0.002 for the cost of treatment in patients with dual chamber pacemaker,P<0.01 was considered statistically significance.After the patient was discharged a month Satisfaction P=0.000(P<0.01)3 months after discharge satisfaction survey P=0.000(P <0.01),the difference was statistically significant.A total of seven people in the control group postoperative complications,in which four people pocket hematoma,infection 1,2 electrode displacement,the intervention group of 2 persons happened postoperative complications are capsular hematoma.Two groups P <0.05 was considered statistically significant.Quality of life scores in patients: control group 72.58 ± 11.3,the intervention group score 77.40 ± 8.84,P = 0.012(P<0.05)difference was statistically significant.ConclusionsAfter placement of a permanent pacemaker patient case management interventions for patients at different times of dynamic needs assessment,patients are encouraged to participate in the whole process of disease treatment,standardized permanent pacemaker patient care programs,enhanced medical knowledge and treatment programs active participation of the patient's disease management awareness,establish the correct concept of health behavior,reflects the individualized medical care,enhance the doctor-patient,retaining the trust between patients and promote patient transition from hospital to home continuity of self-management,both reduce the economic burden of the portion of pacemaker patients,reduce the incidence of postoperative complications,and improve patient satisfaction,we succeeded in improving the quality of life of patients after surgery.