Using Omaha System As A Framework To Establish The Transitional Care Plan And Exploring Its Effectiveness In The Discharged Patients With Indwelling T-shaped Tube

Objectives:1.To establish transitional care plan in the discharged patients with indwelling T-shaped Tube by using Omaha System;2.To explore the effect of transitional care plan in the discharged patients with indwelling T-shaped Tube.Methods:1.Through the literature review,using the Omaha System as a framework,combined with the physiological characteristics of patients with indwelling T-shaped Tube and disease symptoms/signs,establishing the transitional care plan in the discharged patients with indwelling T-shaped Tube by using Omaha System as a framework preliminary.Then,through experts consultation and preliminary experiments,it is gradually adjusted and improved.Finally,the transitional care plan in the discharged patients with indwelling T-shaped Tube by using Omaha System as a framework was established.2.After obtaining the approval from the hospital ethics committee and the permission of doctors in this field,according to the inclusion and exclusion criteria,90 patients with T-shaped Tube indwelling from biliary and pancreatic department of a top-three hospital in Wuhan were selected as study subjects.The subjects were randomly divided into the observation group(n=45)and the control group(n=45)by using a black box touch ball method.The control group adopt the nursing procedures to implement routine care and follow-up after discharge.Meanwhile,the observation group adopt the transitional care plan by using Omaha system as a framework.Observing 90 patients' scores of the Exercise of self-care agency scale(ESCA)at the time the three days after surgery,the day before discharge,one week after discharge and two weeks after discharge.The score of ESCA and the incidence of common complications of indwelling T-shaped Tube were taken as the evaluation index.Results:The study provides a systematic,comprehensive assessment,intervention and evaluation program for the implementation of the transitional care plan in the discharged patients with indwelling T-shaped Tube by using Omaha System.The data of self-care ability of the two groups were analyzed showed that after intervention(on the day of discharge,one weekend after discharge and two weeks after discharge)the scores of the self-care ability and scores of all dimensions in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).In addition,the incidence of common complications of indwelling T-shaped Tube,such as infection,fever,accidental detachment and diarrhea,was significantly lower in the observation group than in the control group.Conclusions:The research confirms that the transitional care plan in the discharged patients with indwelling T-shaped Tube which is established by using Omaha System as a framework:(1)which can comprehensively assess nursing problems related to the discharged patients with indwelling T-shaped Tube and improve the outcome of K-B-S score;(2)which can improve patients' self-care ability,lower the incidence of complications such as infection,fever,accidental removal of tubes,diarrhea.(3)Therefore,the program simplifies the application process of nursing procedures,normalizes the record language and implementation process of transitional nursing,quantifies the outcome of transitional nursing,effectively guides clinical nursing,improves work efficiency and the quality of care.