| Objective This study was conducted to design the CABG-CNP under the direction of the PDCA cycle, and to evaluate its clinical effects.Methods This research was performed in two consecutive phases. In the first phase, by the method of analyzing data, searching evidences and consulting experts, the papers and clinical implementation process of the CABG-CNP were designed. In the second phase, 87 CABG patients were selected by convenience sampling. These patients were all conformed to the choose standards and agree to take part in the research. The patients hospitalized during September to December of 2007 were studied as the controlled group, the patients hospitalized during January to April of 2008 were as the experimental group. The members of two groups had no statistical difference in sex, age, preoperative heart function, EF value and grafts number in the operation (p>0.05) . In order to judge the effects of the CABG-CNP, the clinical nursing quality such as grading nursing and documents writing, the patients' Barthel Index(BI), the patients' satisfaction to the nursing, the cure rate, the complication accidental rate, the patients' hospitalization time and the cost were collected as the evaluation indexes.Results In the first phase, the papers and implementing process of CABG-CNP were designed. The papers were composed of 4 parts, which are the first page, the registeration of the patients, the CNP forms for each period in peri-operation and variance document. There are 5 CNP forms in the paper, which were pre-operational CNP form(in the ward), inter-operational CNP form(in the operation room), operation day of after-operational CNP form(in ICU), 1～2 days after operation of after-operational CNP form(in ICU) and 3～9 days after operation of after-operational CNP form(in the ward). According to "task-time" designation, each form listed all nursing measures in strict time of each period, and asked the nurse to mark " V " verifying the request been finished. In the second phase, the results of the study showed: the nursing quality of grading nursing and documents writing in CNP model was prior to the controlled group (p<0.01), the BI of the experimental group's patients were higher than the controlled group's patients(p<0.05). The patients of the experimental group showed more general satisfaction than the other teams(p<0.05), in 12 items of the questionnaire, except the two items which standed for the nurse took care of her image and the nurse did medication and treatments for me in time have no difference (p>0.05) , another 10 items showed that the experimental groups evaluations were higher than the controlled group distinctly (p<0.05～p<0.01) . The difference of the two groups' cure rate and complication accidental rate had no distinct statistical meaning(p>0.05) . The experimental group's total and each period hospitalizational time were less than the controlled group obviously(p<0.001 ) , the experimental group's paid less in the whole peri-operation period and peri- and 3～9 days after-operation period obviously (p<0.01, p<0.001, p<0.001), but the the costs of inter-and 1～2days after-operation had no distinct statistical meaning (p>0.05) .Conclusion With the application of the CABG-CNP by the direction of PDCA, the clinical nursing quality would be improved, the patients would get rehabilitation faster, the patients' satisfaction to the nursing would be improved, the patients would cost less time in the hospital and paid less, and the specialty nurse and the head nurse would get mature quickly. In present medical condition, to develop CNP is practical and helpful to the nursing specialty. To grasp the whole process of the study and emphasize the nursing characteristics were the key points of the research of CNP. |
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