The Application Of Continuity Of Nursing Care Framed By Omaha System In Patients With Permanent Colostomy Patients

Objective:Appling Omaha System to implement continuity of nursing care on patients with permanent colostomy,In order to summarize the nursing problem and interventions in patients after extended discharge,providing a scientific theory and practice guidance to improve the self-care intention,self-care knowledge,stoma self-care ability and reduce stoma complications.Methods:A total of 90 patients with permanent colostomy were enrolled in the three hospitals of Bengbu City from January to September in 2016.From January to April as the control group,from May to September for the experimental group,each group of 45 cases.The control group was given routine discharge guidance and follow-up,the experimental group was on the basis of the control group to implement the Omaha system as the framework of the continuity of nursing care.Through the review of literature,expert group discussion,establishing evaluation of intervention records for patients with permanent colostomy by using Omaha system as a framework and guided by holistic nursing theory and on Maslow 's Needs of Demand and Self-efficacy theory,combined with the characteristics of permanent colostomy patients rehabilitation and?Chinese intestinal stomatal care guidance(2013 version)?.The nursing problems of the experimental group after the discharge were evaluated,the the individualized and systematic follow-up nursing intervention was carried out,and the effect of the continuity of nursing care problem was dynamically evaluated from the three aspects of cognition,behavior and condition.Self-care questionnaires,self-care knowledge questionnaires,and self-care self-care ability scale were used to evaluate the self-will,self-care knowledge and self-care ability scores of the two groups at discharge,1 monthof discharge and 3 months of discharge.Analysis of the two groups of patients in the discharge day,discharge 1 month and discharge 3 months of stoma care and stoma complications.Result:(1)In the experimental group,the existing continuity of nursing care problem were mainly distributed in the psychological field(35.05%)and the health-related behavior field,followed by physiological field(23.25%)and environmental field(7.01%).Among them,the incidence of more than 50% of the nursing problem were personal care,role change,mental health,digestion-hydration,sleep and rest type,social,nutrition.(2)The experimental group of permanent colostomy patients discharged from the main potential care problems were 2,respectively,stoma complications and Skin complications around stoma.Among them,Skin complications around stoma were44(100%),and stoma complications were 42(95.5%).(3)We analyze the 7 existing nursing problems occurred more than 30% of patients from the experimental group on the day of discharge.There were significant differences in the score of knowledge,behavior,status about mental health,social,role changes,personal care,sleep and rest patterns,nutrition and digestion-hydration continued care at different stages(p <0.05).(4)There was no statistically significant difference between the two groups about Complications occur on the day of discharge and a month after discharge(p>0.05),the two groups of patients were statistically significant differences in the discharge of three months(p <0.05).(5)There was no statistically significant difference between the two groups about self-care knowledge scores on the day of discharge and three months after discharge(p>0.05),the two groups of patients were statistically significant differences in the discharge of a month(p <0.05).(6)There was no statistically significant difference between the two groups about Self-will scores on the day of discharge(p>0.05),the two groups of patients were statistically significant differences in the discharge of a month and three months(p<0.05).Conclusion:(1)The Omaha system provides a comprehensive assessment of continuity of nursing care problem in patients with permanent colostomy.(2)The Omaha system provides a comprehensive guidelines for intervention of continuity of nursing care problem in patients with permanent colostomy.(3)Continuity of nursing care with the Omaha system as a framework can improve the primary care problem in permanent colostomy patients in terms of cognition,behavior,and status.Continuity of nursing care with the Omaha system as a framework can improve the score of self-care will,self-care knowledge,self-care ability score of permanent colostomy patients,and reduce the occurrence of stoma complications.