| Objective1.Establishing a doctor-nurse-integration nursing model of ischemic stroke in community hospital.2.Exploring working content and implementation plan of the doctor-nurse-integration team members in community hospital.3.Analyzing the doctor-nurse-integration nursing model of ischemic stroke in community hospital for medical cooperation attitude,feeling and job satisfaction.4.Analyzing the doctor-nurse-integration nursing model of ischemic stroke in community hospital's influence in daily life ability,neural function,motor function,negative mood,the quality of life,the influence of the secondary complications,and satisfaction in patients with ischemic stroke,Evaluating the model application effect in patients with ischemic stroke.5.Exploring the doctor-nurse-integration nursing model of ischemic stroke in community hospital's influence in the average length of hospital stay in patients with ischemic stroke and the influence of the hospitalization expenses.Methods1.This research adopts the historical comparison research method.In January 2016 to June 2016,receiving 52 patients with Ischemic stroke according to clinical diagnosis(control group)and the medical staff(9 doctor,14 nurse),treated with the traditional medical care work model.In July 2016 to December 2016,receiving 53 patients with stroke according to clinical diagnosis(medical integration)and the medical staff(9 doctor,14 nurse),treated with the doctor-nurse-integration nursing model of ischemic stroke in community hospital.Comparing the data between the control group and the doctor-nurse-integration group.Adopts self-contrast method to compare medical personnel data.2.Interventions:The control group nursing,medical treatment and rehabilitation separately.According to the ischemic stroke regular nursing care,nurse implement conventional treatment.The doctor-nurse-integration group were adopted the doctor-nurse-integration nursing model of ischemic stroke in community hospital.Establishing the community ischemic stroke care integration team,from community hospital to home care,medical integration team in the form of integrated multidisciplinary care team to provide patients with treatment,nursing,rehabilitation health care services.3.Statistical processing:Using the 19.0 statistical software for statistical analysis.Results1.Baseline data:The baseline difference between the two groups was not statistically significant(P>0.05),included gender,age,occupation,marital status,education level,accompanying disease,stroke site,and patient efficacy.The baseline data of the two groups were generally comparable(P>0.05),included age,sex,educational background,professional title and length of work.2.BI,FMA,SS-QOL:According to the analysis of variance of repeated measurement data,in patients admitted to hospital,1 month intervention,3 month intervention,the measurement of the BI index score,movement function score and quality of life score,the doctor-nurse-integration group's BI,FMA,SS-QOL scores rise trend better than the control group's.The difference was statistically significant(P<0.05).3.CSS,Negative emotion score:According to the analysis of variance of repeated measurement data,in patients admitted to hospital,1 month intervention,3 month intervention,the measurement of nerve function defect degree,degree of anxiety and depression,the medical group's CSS?SAS?SDS scores lower trend better than the control group's(P<0.05).4.Secondary complications:The doctor-nurse-integration group's secondary complications(except urinary tract infection)is less than the control group's(P<0.05).5.Patient satisfaction:The doctor-nurse-integration group's patients satisfaction total score and each dimension score were higher than the control group's(P<0.05).6.Length and cost of hospital stay:The doctor-nurse-integration group's hospitalization days and cost were both less than the control group's.The difference was statistically significant(P<0.05).7.The medical cooperation evaluation:The doctor-nurse-integration group's medical cooperation attitude score,doctor-nurse collaboration score were higher than the control group's.The difference was statistically significant(P<0.05).8.The medical job satisfaction evaluation:The doctor-nurse-integration group's the score of doctor evaluating nursing job satisfaction,the score of nurse evaluating their own job satisfaction were higher(P<0.05).Conclusion1.The model in community hospital is helpful to improve degree of nerve function defect,daily life activities ability,movement function,Negative emotions.2.The model in community hospital is helpful to reduce the length of hospitalization time and cost,Improve the beds turnover and the medical cost.3.The model in community hospital is helpful to improve medical cooperation attitude,medical cooperation feelings,doctors satisfaction of nursing work and nurses job satisfaction,promote the medical cooperation,improve the level of medical cooperation. |
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