A Study On The Construction Of Disease Management Training And Evaluation System Of Heart Failure For Community Medical Personnel

Objective To investigate the knowledge and current situation of heart failure disease management among community medical staff.To set up the management training and evaluation system of heart failure in the community.This system is used to train community medical staff in order to improve the management ability of heart failure and improve the current situation of heart failure.Method1.Status Survey: Using random sampling method,123 medical and nursing staff from six community health service centers in Nanjing were selected to carry out the related survey using the "knowledge and status of disease management of heart failure among community medical personnel".To analyze the knowledge and current situation of disease management in the community.2.Construction system: A total of 40 experts from five different fields,namely,community clinical medicine,community clinical nursing,nursing management,nursing education,and medical education,were selected from the community health service centers,hospitals and institutions of higher learning.The two rounds of expert consultation used the "questionnaire star" electronic questionnaire method,distributed and collected the questionnaire,collected and collated the questionnaire data,expert opinion,two rounds of expert opinion tends to agree,the questionnaire end.3.Empirical application: 45 medical staff from the research community,including 25 medical staff from the Model West Road Community Health Service Centre and 20 medical staff from the Changjiang Community Health Service Centre,were selected to design the Community Health Personnel Management Training Programme on Heart Failure for a period of three months based on the training and evaluation system established.Using the self-made "Community medical personnel heart failure disease management assessment questionnaire" and the expert assessment team to carry out the investigation,the field assessment,collected the comparative training before and after the theoretical knowledge,the operation skills,the management situation and the medical care satisfaction.Result1.Current Situation Survey: The content validity of the questionnaire on knowledge and status of disease management of heart failure among community medical personnel is 0.82,and the reliability of retesting is 0.86.The score of nurses and doctors majored in internal secretion grasping the knowledge of heart failure disease management was(11.33±4.27),Analysis of variance,The average accuracy of each item was 40.48%,there was a significant difference in the score among age,occupation and job title(P<0.05).The current situation of heart failure disease management has its disadvantages and difficulties in patients' medication,organization of patients' activities,follow-up,medical communication and disease management information system.2.System construction: The recovery rate of two rounds of consultation effective questionnaire is 100 %;The expert authority coefficient is 0.84 and 0.87 respectively.The variation coefficient of the first,second and third indexes of the management and evaluation system of heart failure of community medical personnel was 0.104-0.113,0.08-0.214,0.089-0.212 respectively.The Kendall coordination coefficient for the first,second and third levels of indicators is 0.098,0.182 and 0.178(P<0.01).The final definition includes the establishment of a system of indicators for the management and evaluation of heart failure among community medical personnel,consisting of 4 primary indicators,17 secondary indicators and 68 tertiary indicators.3.Empirical Application: The content validity of the questionnaire for the assessment of the management of heart failure among community medical personnel is 0.83 and the reliability of retesting is 0.85.Before and after the practical application,the scores of theoretical knowledge were(9.76±3.85)and(21.80±1.85),respectively.The average accuracy rate of each topic was 36.13 % and 80.74 % respectively.The difference is statistically significant(P<0.001).In terms of management,the number of quarterly patient activities organized and the number of quarterly family visits conducted was higher than before the demonstration(71.11% VS 93.33%,P<0.006);Significant improvement in the pass rate of skills(49.21 % VS 84.76 %,P<0.003).Conclusion1.The knowledge and development of the disease management of heart failure among community health care workers is not encouraging.Especially,young and low-grade health care workers are in urgent need of targeted training in the management of heart failure to improve their knowledge and ability to carry it out.2.The system of training and evaluation indicators for the management of heart failure among medical and nursing personnel in the community includes 4 primary indicators of training content,training methods,evaluation criteria and evaluation methods,17 secondary indicators and 68 tertiary indicators.3.Training medical personnel in heart failure disease management can improve their theoretical knowledge and operational skills;Improve the satisfaction of medical communication;At the same time,in practice,we will increase the number of patient activities and family visits and improve the disease management ability of medical care personnel.