The Application Effect Of Medical Integration Model In The Perioperative Period Of Bronchial Foreign Body Removal In Children With Fiber Bronchoscope

Objectives To evaluate the application effect of integrated medical care cooperation model in the perioperative period of bronchial foreign body removal in children with fiber bronchoscope.Methods 1.Using the method of convenient sampling,according to the inclusion and exclusion criteria,the children admitted for bronchial foreign body in Pediatric Intensive Care Unit,a grade a hospital in zhengzhoufrom January 2017 to August2018 were collected as subjects of the study.Random number table method was used to divide them into control group and observation group,each group of 39 cases,two groups of children with statutory guardians were informed of the study and signed informed consent,each child selected a family member to participate in the study at the same time.In the control group,clinical treatment and nursing were performed according to the traditional model,which mainly included preoperative preparation,psychological counseling,intraoperative coordination,postoperative observation and nursing,etc.The intervention group conducted the medical integration model,which mainly including:(1)Setting up a medical integration team;(2)Integrated hospital admission assessment;(3)Carrying out integrated medical care ward rounds and formulating perioperative care record sheet for medical staff which is conducive to the exchange and discussion of patients' conditions between doctors and nurses;(4)Carrying out the integrated perioperative nursing,which consist of hospitalization,preoperative preparation,intraoperative cooperation and postoperative nursing;(5)The implementation of medical care integration hospital health education,including admission,perioperative period and discharge education;(6)Standardized communication among doctors,nurses and patients.2.The families of the two groups filled out the State Anxiety Inventory(S-AI)on the day of admission,the period of surgery and the day of discharge to evaluate the psychological status of the families of the two groups.On the day of discharge,the critical care family satisfaction survey(CCF-SS)was filled out by the family members of the two groups to evaluate the satisfaction of hospitalization.The Jefferson medical cooperative attitude scale was filled out on the day of discharge by doctors and nurses who were in charge of the children of the two groups and evaluating the medical cooperative attitude of the medical staff of the two groups.3.Collecting the data and using the spss 17.0 software to record and analyze the data.The following statistical methods were mainly used: analysis Chi-square test,descriptive statistics analysis,t test of two independent sample,variance analysis and independent t test of two samples,P<0.05 was set as statistically significant difference.Results 1.A total of 78 subjects were actually included in this study,and 39 subjects were actually included in both groups.There were no statistically significant differences between the two groups in age,sex,type of foreign body,location and other general data(P>0.05),and the data were comparable.The families of the two groups were all married without divorce.There were no statistically significant differences between the families of the two groups in gender,marital status,education level and work status(P>0.05).The data were comparable.There was no significant difference in the course of disease and foreign body diameter between the two groups(P>0.05),and the data were comparable.There was no significant difference in age and working years between the two groups(P>0.05),and the data were comparable.The composition of professional title and educational background of nurses in the two groups was not statistically significant(P>0.05),and the data were comparable.2.Preoperative waiting time refers to the time from admission to the beginning of surgery,including the time of preoperative anesthesia.The results of this study showed that there was significant difference between the two groups in the preoperative waiting time(t=8.381,P<0.05).The waiting time of the control group was longer than that of the observation group.There was significant difference between the two groups in the operation time(t=5.758,P<0.05),and the operation time was longer in the control group.3.Common complications after surgery were fever,pharyngeal pain,aggravated cough,bloody sputum,and laryngeal edema.This study results show that the overall incidence of postoperative complications between the two groups has significant statistically difference(c 2=4.622,P<0.05).There was no significant difference between the two groups in the incidence of pharyngeal pain,fever,aggravating cough and blood in phlegm(P>0.05).4.The results of this study showed that there was significant difference between the two groups in the length of hospitalization between the two groups(t=2.985,P<0.05),and the length of hospitalization was longer in the control group.There was significant difference between the two groups in the hospitalization expenses(t=6.132,P<0.05),and the hospitalization expenses in the control group were higher than those in the observation group.5.The results of this study showed that there was significant difference between the two groups in the doctors' attitudes towards medical cooperation(t=10.90,P<0.05),and the scores of the observation group were higher than those of the control group.There was significant difference between the two groups in the scores of the two groups of children's nurses' attitudes toward medical cooperation(t=17.786,P<0.05)and the scores of the observation group were higher than those of the control group.6.The results of this study showed that there was no significant difference in state anxiety scores between the two groups on the day of admission(t=1.221,P>0.05),and there were significant differences between the two groups on the day of waiting(t=15.271,P<0.05),in which the anxiety score of the observation group was lower than that of the control group,there were significant differences between the two groups on the day of discharge(t=3.239,P<0.05),in which the anxiety score of the observation group was lower than that of the control group.7.The results of this study showed that the satisfaction scores of the patients' family members in the observation group on the day of discharge were 94-100(97.44± 1.80),and the satisfaction scores of the patients' family members in the control group on the day of discharge were 89-96(92.59±2.35).there were significant differences between the two groups on the satisfaction scores of the patients' family members on the day of discharge(t=10.223,P<0.05),and the satisfaction scores of the observation group were higher than those of the control group.Conclusions Study confirmed that the cooperation of medical integration mode by bronchoscopy bronchial foreign bodies can shorten the patient's preoperative waiting time,operation time and hospitalization time,reduce the cost of hospitalization and the postoperative complications incidence,can boost the enthusiasm of the medical cooperation,improve families of children with anxiety,raise families of children with satisfaction.