Application Of Clustering Nursing In The Risk Management Of Severe Acute Stroke Patients

Objective:Study of predictive and prospective cluster intervention strategies in patients with severe stroke in emergency department,analysis of predictive risk factors and study of cluster intervention strategies,to form a scientific,practical clinical guide,which help nurses to accurately identify critical signs and give predictable measures to manage various advanced complications of stoke and reduce the occurrence of adverse prognosisMethods:A total of 118 patients with acute severe stroke admitted to the emergency department of the First Hospital of Jilin University from July 2016 to January 2017 were enrolled in the study.According to the visiting time,the patients were divided into control group(60 cases)providing routine nursing interventions and experimental group(58 cases)providing cluster interventions.The routine nursing measures were implemented.According to literature review,and experience review,we summarized the high-risk factors for severe stroke patients,including early deterioration of neurological function,weakened respiratory function,airway obstruction,respiratory failure,aspiration,increased intracranial pressure,cerebral palsy,skin lesions,seizures,and restlessness.For the above-mentioned high-risk factors,clustered nursing interventions,including early identification of critical signs and observations of specific conditions,early treatment of various risk factors leading to exacerbations,elimination of unpleasant stimuli,and reduction of nursing operations were adopted.The incidence of short-term adverse outcomes and the incidence of various high-risk complications were compared between the two groups.All data were analyzed by SPSS 19.0 software.The measurement data were analyzed by t-test.Count data were analyzed by ?2 test.P<0.05 for both sides stand for statistically significant.Results:1.The incidence of short-term poor prognosis was 31.0% in the experimental group with cluster intervention strategies,which was significantly lower than that in the control group(53.3%)(P=0.014).2.The incidence of various high-risk risk factors was 8.6% in the experimental group with cluster intervention strategies,which was significantly lower than the control group(23.3%)(P=0.03).3.The C—SAQ score of nurses in emergency department was significantly improved.(P<0.001)Conclusions:1.The development of cluster intervention strategies and the provision of predictive and prospective care to patients can effectively reduce the incidence of adverse prognosis.2.The cluster intervention strategies provide professional and effective response measures in sudden disease changes,which in turn reduces the incidence of high-risk risk factors for patients and improves quality of nursing.3.The cluster intervention strategies create positive security attitude and harmonious security atmosphere.