| Objective: Developed the "three-stage abbreviation " 3S " during the period of hospitalization,return home,and pronunciation training-TL patients' vocal function remodeling clinical nursing path schedule","3S-TL patients' vocal function remodeling clinical nursing path evaluation standard";The application and evaluation of the experiment,the preliminary construction of "3S-TL patient vocal function remodeling clinical nursing path schedule table" and "3S-TL patient vocal function remodeling clinical nursing path evaluation table standard" for the future development of TL patients vocal function rehabilitation Provide reference basis for nursing practice.Methods: Use the methods of literature analysis,evidence-based research and metrology: screening of the 3S-TL vocal function remodeling clinical nursing path and the relevant items of the evaluation standard;understanding the patient's postoperative nursing needs through qualitative interviews;using clinical case review method to select Doctor-order nursing project,designing3S-TL patients' vocal function to reshape clinical nursing path and evaluation standard items,applying Delphi method,consulting the items,content and importance of preliminary path development,after repeated discussion,modification and improvement by the research group,Preliminary construction of "3S-TL patients with vocal function remodeling clinical nursing path schedule table" and "3S-TL patients with vocal function reshaping clinical nursing path evaluation standard";using similar experimental research methods,during the hospitalization,regression The three-stage TL vocal function rehabilit ation during family and pronunciation training promotes the planned,complete,and continuous path application;the non-synchronized historical controlledunequal experiments were used to evaluate and compare the path effects of the two groups.Use Excel2017 and SPSS18.0 statistical software for data processing.Results:1.Constructed "3S-TL patients' vocal function remodeling clinical nursing path schedule plan" and "3S-TL patients' vocal function remodeling clinical nursing path evaluation standard",in which there are 3 schedule plans: schedule during hospitalization: The horizontal axis is based on the time period before and after the operation.The admission-1 day before surgery,the day of surgery,the first 1-3 days after surgery,4 days after surgery-1 day before discharge,5days after discharge,the vertical axis is evaluation,examination,8 aspects of treatment,medicine,activities,diet,nursing treatment,and health education;return to the family schedule plan table: the horizontal axis takes the discharge follow-up period as the node,week 1,week 2,week 3,week 4,month 2,6in the third month,the vertical axis is assessment,tracheostomy care,complication care,speech rehabilitation care,psychological care,diet care,6 as pects;the schedule table during pronunciation training: the horizontal axis is pronunciation training(Esophageal pronunciation training)The starting period is a node,there are 3 on the first day,26 th day,and 7th day,the vertical axis is evaluation,pre-esophageal pronunciation training,nursing guidance before esophageal pronunciation training,esophageal pronunciation training,evaluation5 The evaluation criteria include: the number of days of hospitalization,the total cost of hospitalization,the incidence of postoperative complications,the rate of re-hospitalization of patients,the effect of esophageal pronunciation training,the knowledge of esophageal pronunciation training,and the satisfaction of 7 indicators;The Delphi expert consultation method of the round,the expert authority coefficient is greater than 0.70,indicating that the expert authority is high;the recovery rate of the two rounds of the expert consultation path is 100% in both the first and second rounds;the expert'sopinion coordination coefficient: the first round is 0.312,0.423 in the second round,p<0.01 shows reliable results.2.Path application effect comparison between the two groups: average hospital stay(22.40±9.90 days in the test group,28.04±12.91 days in the control3.group,P?0.05),the test group was reduced by 6 days compared with the controlgroup;average total hospitalization cost(test group 4.46 ±15,500 yuan,controlgroup 54,100±22,900 yuan,P?0.05),the test group decreased by 10,000 yuancompared with the control group;the incidence of patient complications(test group 14.29%,control group 37.14%,P?0.05);patients Rehospitalization rate: 20.00% in the test group,42.90% in the control group,P?0.05;the diffe renceswere statistically significant;the vocal function score(60.50±18.21 point s in the test group,32.00±12.64 in the control group,P?0.05)was statistically different Significance;awareness rate of esophageal pronunciation tr aining related knowledge: 85% in the test group and 68% in the control group,P?0.01,thedifference was statistically significant.4.Satisfaction: 94.28% of patients,95% of family members,and 93.27% of staff.Conclusions:1.Build "3S-TL patient vocal function remodeling clinical nursing path schedule table" and "3S-TL patient vocal function remodeling clinical nursing path evaluation standard" with "time period as horizontal axis and path content as vertical axis";Through the implementation in a top three hospital,the validity,practicability and operability of the path form and evaluation criteria were initially verified.2.After the application of CNP,it can effectively reduce the average hospitalization days and hospitalization costs of TL patients,reduce the incidence of Complications and re-hospitalization rate of patients,improve the awareness rateof esophageal pronunciation training related knowledge of patients,and the pronunciation effect is good.Patients,family members andstaff are satisfied with the overall evaluation of the content,method and time of this route.3.Initially establish a 3S-TL patient vocal function remodeling clinical nursingpath implementation plan to form a new nursing model for TL patient vocal function reshaping clinical nursing path. |
PDF Full Text Request