Construction Of Clinical Pathway And Effectiveness Evaluation Of Day Surgery

Objective: To clarify the current status of day surgery in clinical practice and show the problems,and deficiencies.Provide a more scientific management of the day surgery process by the combination of nursing pathways.Improve the success rate of surgery and patient satisfaction.Methods: Firstly,interviews were conducted for medical staff involved in day surgery using the interview method to analyze the current clinical problems in daytime surgery.Then,using the Delphi method,combined with the questions from the interview method,a questionnaire was developed based on the clinical path of the original day surgery,and two rounds of expert consultation were used to re-establish a new care path through the statistical method of chi-square test.form.Finally,a historical comparison method was used to randomly select 200 patients from January to June of 2017,and between August 2017 and January 2018,respectively,and used the day-to-day surgical nursing clinical pathway before and after the development.Evaluation,statistical analysis of variance analysis of the two groups of patients in the preoperative waiting time,the number of cases converted to non-day surgery,the number of complications,patient satisfaction statistical differences.Improve the current existing care path and re-implement it,collecting its feedback and comprehensive clinical results.Results: 1.Through the interview method,it is concluded that there are currently 6 aspects of clinical problems in day surgery;2.After two rounds of discussion by the Delphi expert consultation method,the average value of each item is above 4.00,and the coefficient of variation(CV)were less than 0.20,the coordination coefficient of consultation dimension was 0.354,2 = 85.037,significance level was p < 0.001,and 17 items of "day surgery clinical path table" were finalized;3.By using "day surgery" After the Clinical Pathology Table was administered,the patient's preoperative waiting time in the observation group was significantly shorter than that in the control group(p<0.05),and the number of observations in the observation group was significantly lower than that in the control group(p<0.05).Satisfaction of the treatment process and health education was significantly higher than that of the control group(p<0.05).Conclusion: 1.Summarizes the problems of lack of specialist nursing staff during day surgery,the need to simplify the charging model,the incomplete preoperative and postoperative health education,the need to improve the surgical procedures during the day,the need to improve the medical insurance system,and the need for extended nursing care.2.The expert opinion of the "Clinical Procedures Table for Day Surgery Care" formulated has a better degree of concentration of opinions,authority factor and coordination coefficient.The results are credible and representative;3.The use of the watch in clinical practice increases the number of days.The utilization rate of surgery has improved the procedure of day surgery and patients are more satisfied with day surgery.