The Construction And Preliminary Application Of A Health Education Program For Enterostomy Patients Based On The Best Clinical Practice Guidelines

Objectives:The best clinical practice guidelines for screening healthy education in patients with enterostomy were searched and the content of health education recommendation was analyzed.Using expert meeting combined with clinical actual to select clinically applicable enterostomy health education recommendations,and to convert the selected health education recommendation into health education measures,and build patient education program based on the best enterostomy clinicalguideline.The indigenous gastrostomy patient health education program.In addition,the preliminary clinical application process of healthy education program for patients with enterostomia was explored in order to optimize the healthy education process of patients with enterostoma and improve the nursing quality of healthy education for patients with enterostoma.Methods:In this study,the KTA model was used as a guide,and the health education knowledge and health care education of the patients with intestinal stoma were taken as the starting point,The previous study of our research group has retrieved the clinical practice guidelines related to or contained intestinal colostomy patients health education during 2006-2015 at home and abroad.Using AGREE II tools to evaluate the methodological quality of the included guidelines,and using the expert meeting method to evaluate the rationality of the integration of the health education recommendations of the final included Class A guideline On this basis,the expert meeting method was used to evaluate the clinical applicability of education recommendation on the health of integrated enterostomatopoietic patients.At the same time,combined with baseline surveys of health education for patients with enterostomies in pilot wards,using meeting methods/interviews and survey scales to identify major barriers to the application of health education recommendations,formulate the corresponding action strategies for them.In addition,the final recommendation of education for patients with enterostomatology was converted into education for patients with enterostomatology,and a healthy education scheme for patients with enterostomatology was constructed based on the best clinical practice guidelines.An expert demonstration meeting was held to evaluate the rationality and clinical significance of education scheme for patients with enterostoma.Using experimental research method,select a Beijing 3top hospital gastrointestinal surgery as a pilot unit,for a two-month health education after colostomy baseline clinical status survey,The clinical environment of health education for patients with intestinal stoma in the pilot ward was reconstructed.All the nurses in the trial wards were trained in the health education program for enterostomal patients,and the clinical practice of the application of the health education program for enterostomal patients was carried out,and the effect of health education was evaluated from the structure/process result levelResults:After 2015 a new guideline,ERAS was included.Using AGREE ? tool to evaluate the quality of its methodology,ERAS guide quality grade for class A,the overall quality is good.The four A grades intestinal stomaclinical practice guidelines evaluated by the previous study of the research group were added.We ultimately included 5 a-class colostomy clinical practice guidelines,A total of 70 recommendations,including 66 health education related recommendations.Based on the principle of summarizing and integrating,the researchers and the team integrated the relevant recommendation opinions of health education,and finally got 33 recommendation opinions of health education based on the expert opinions.The 33 health education recommendations were evaluated for for clinical applicability evaluation,finally selected article 9 currently applicable to pilot wards with the intestinal colostomy patients health education and clinical practice of health education recommendations.On this basis,the recommendations for health education were transformed into health education measures.The obstacle factors in the implementation of health education in pilot wards were analyzed,and corresponding strategies were formulated to construct a health education program for enterostomal patients based on the best clinical practice guidelines,including the intestines.Osteostomy patient health education implementation plan,enterostomal patient health education instruction manual and gutostomy patient health education process.Before the implementation of the health education program for enterostomal patients based on the best clinical practice guidelines,a baseline survey of health education in pilot wards showed that:The main obstacles to clinical practice arenurse(human resources,lack of related knowledge)environment(pilot wards,lack of health education for patients with intestinal colostomy related written materials)and patients(such as lack of knowledge).the implementation rate of the review criteria for the 9 selected intestinal stoma health education recommendations was 0%-37.0%most of the health education after colostomy in the pilot ward recommendations not fully carried out.Using experimental research method,intestinal colostomy patients health education program was applied to pilot wards,nurses and patients before and after the application of the project in general information on the difference has no statistical significance(p>0.05).Education knowledge level and satisfaction degree of enterostomatal health of nurses after the program was applied were higher than the baseline survey level,and the difference was statistically significant(p<0.05).After the application of the scheme,education knowledge acquisition and satisfaction of patients with intestinal stomatal health were both higher than the baseline survey level,and the difference was statistically significant(p<0.05).After the application of the scheme,the hospitalization time of the patients with enterostomy increased,and the hospitalization cost decreased compared with that before,and the difference was not statistically significant(p>0.05).After the implementation of the program,the implementation rate of the standard review was 22.2%to 100%,which was significantly higher than the baseline survey.The implementation rate of education recommendation on the health of patients with enterostomy was higher among nurses in the pilot ward.Conclusions:The clinical practice guidelines for enterostomal health education have not yet been retrieved,but the existing health education recommendations in the clinical practice guideline of enterostomal nursing can provide reference for the clinical practice of health education for enterostomal patientsDraw lessons from foreign guide,must combine their own national conditions,selection of suitable for clinical actual intestinal colostomy patients health education recommendations,build intestinal colostomy patients health education plan,guide the intestinal colostomy patients in clinical practice of health education.