| Objective（1）On the basis of evidence-based medicine,a clinical nursing pathway suitable for 18F-FDG PET/CT myocardial metabolic imaging was constructed,and the implementation effect of this pathway in improving patient compliance,relieving anxiety,shortening examination time,improving image quality,reducing hypoglycemia,postural hypotension and other adverse reactions was evaluated.（2）The construction of this clinical pathway will provide an evidence-based basis and a positive reference value for the improvement and continuous improvement of the standardized process of 18F-FDG PET/CT myocardial metabolic imaging nursing in nuclear medicine specialty.Methods（1）By searching CNKI,wanfang medicine,Pubmed,Embase,Web of science and other databases,reading a large number of literatures,based on evidence-based medicine,listening to and screening the needs of clinical senior medical workers for the construction and application of clinical nursing path module for 18F-FDG PET/CT myocardial metabolic imaging.（2）Establish a letter consultation expert group with a reasonable structure based on years of work,educational background,professional research direction and other major aspects.Based on the support of relevant theories and evidence-based evidence,Delphi expert letter consultation method（Delphi）is adopted to solicit expert opinions,obtain consistent opinions on the access path standard,variation,clinical nursing path implementation evaluation index,and nursing path implementation,and finally determine the clinical nursing path of 18F-FDG PET/CT myocardial metabolic imaging.（3）According to include and exclude the standard choice in February 2019 to December 2019 in Beijing a third rate of cardiovascular specialist hospitals in 18F-FDG PET/CT myocardial metabolic imaging of the client as the research object,the control group subjects traditional nursing,the experimental group subjects of clinical nursing path,the two groups of subjects baseline information,image quality,client total duration,knowledge awareness,compliance,incidence of adverse reaction,nursing service satisfaction and state trait anxiety（STAI）score comparison with SPSS 23.0statistical software to analyze the results and processing,Descriptive analysis of client baseline data;The two independent sample t test was used for the comparison between the two groups,and the paired t test was used for the comparison before and after the intervention.The ratio of ratio and composition was tested by X2.The significance test values of this study were all 0.05.Results（1）Through reading a large number of literature,this study refer to the related database,supported by evidence-based medical evidence preliminary build 18F-FDG PET/CT myocardial metabolic imaging subjects tested period clinical nursing path,establish project team,on line 18F-FDG PET/CT myocardial metabolic imaging subjects construction of clinical nursing path content published constructive Suggestions to this path involved in nursing contents carefully screening,judgment,finally forms the preliminary clinical nursing path for 18F-FDG PET/CT myocardial metabolic imaging.Using Delphi method to write two rounds of experts,4 hospital experts,10 outside specialist hospital,2 eliminate invalid experts enquiry table,final enquiry for 12 experts,our nursing path for screening,judgment,and to further improve the content,expert enquiry for results:（1）the active coefficient of experts: two rounds of expert enquiry for recovery are 85.71% and 100% respectively;（2）the degree of authority of expert opinions: Cr=0.877;（3）degree of coordination of expert opinions: 61 items in the third level of nursing project in the first round of the questionnaire,and the Kendall coefficient of synergy of necessity and feasibility was 0.458 and 0.491respectively;17 items in the third level of propaganda and education content,and the Kendall coefficient of synergy of necessity was 0.467.In the second round of the questionnaire,there were 63 third-level nursing items,and the Kendall synergism coefficient of necessity and feasibility was 0.554 and 0.586,respectively.There were18 third-level propaganda items,and the Kendall synergism coefficient of necessity was0.510,P<0.05.（2）Clinical application results:（1）there was no statistical significance in the comparison of general data of the two groups of subjects,which was comparable.（2）The rate of good image quality was 93.4% in the experimental group and 76.5% in the control group,with statistically significant differences（P<0.05）.（3）The awareness rate of examination-related knowledge was 74.7% in the experimental group and 20.0%in the control group,with statistically significant differences（P<0.05）.（4）There was a statistically significant difference between the two groups in the compliance with the high-fat and low-carb water dinner on the previous day and the degree of cooperation on the inspection day（P<0.05）.There was no statistically significant difference in the comparison of fasting compliance on the day of examination（P>0.05）.（5）The total inspection time of the subjects in the experimental group was 195.22±25.026 minutes,and that of the subjects in the control group was 218.62±28.279 minutes,with statistically significant differences（P<0.05）.（6）There was a statistical difference in the satisfaction of the two groups of patients with nursing services（P<0.05）.（7）During the test period,the number of cases of adverse reactions in the experimental group was significantly lower than that in the control group（P<0.05）.（8）STAI score: the two groups of subjects were compared before and after the examination,there was no statistical significance before the examination（P>0.05）,comparable;There was no statistical significance before and after the test in the control group（P>0.05）,and the clinical nursing time of the patients in the experimental group significantly decreased compared with that before the test.（3）A detailed analysis was carried out on the variation factors in the clinical pathway: the variation factors were mainly affected by the individual,family and social environment factors,image quality,adverse reactions and other factors,and the patients failed to follow the normal nursing process.Conclusions（1）The implementation of the clinical nursing pathway of 18F-FDG PET/CT myocardial metabolic imaging can reduce the negative emotions during the examination.（2）The implementation of the clinical nursing path of 18F-FDG PET/CT myocardial metabolic imaging can improve the awareness rate of relevant knowledge of the subjects,increase the degree of understanding of the examination,and enhance the confidence of the subjects. （3）The implementation of the clinical nursing path of 18F-FDG PET/CT myocardial metabolic imaging can greatly improve the patient’s compliance during the examination and shorten the examination time.（4）The implementation of the clinical nursing path of 18F-FDG PET/CT myocardial metabolic imaging can effectively improve the image quality and improve the diagnostic accuracy of doctors.（5）The implementation of the clinical nursing path of 18F-FDG PET/CT myocardial metabolic imaging can reduce the incidence of patients with hypoglycemia,postural hypotension,palpitations and other adverse reactions,which is conducive to improving the comfort level during the examination.（6）The implementation of clinical nursing path of 18F-FDG PET/CT myocardial metabolic imaging provides beneficial reference value and evidence-based basis for the standardization and standardization of nursing work.Clinical nursing path has strong operability and practicability,which is helpful to fully reflect the characteristics of nursing profession in the current medical situation. |
