Study On The Application Of The Discharge Plan For Transjugular Intrahepatic Portosystemic Shunt

Objective According to the characteristics of patients after TIPS,the needs of patients and literature review and analysis,combined with the national conditions of China,a discharge plan based on hospital level,which can provide continuous care for TIPS patients,was worked out.According to the discharge plan,the patients with liver disease who underwent TIPS were followed up for 6 months from admission to discharge,and the self-nursing ability,quality of life,incidence and readmission rate of hepatic encephalopathy were evaluated,and the effect of discharge plan on the nursing effect of patients undergoing tips was explored.Methods This study is divided into two stages.The first stage is composed of three parts: one is to review the domestic and foreign discharge planning guidelines and related literature,summarize the conditions that an effective discharge plan must meet,and provide a theoretical basis for the formulation of an effective discharge plan;the other is to use the purpose sampling method to conduct a qualitative study on the current situation and needs of patients after tips,so as to understand the patients before and after discharge For the problems to be solved,the results of qualitative research should be taken as the basis for the intervention measures of discharge plan;thirdly,the discharge plan of patients after TIPS should be formulated according to the results of literature review and qualitative interview in the early stage,and the measures of discharge plan should be revised through group focus interview.In the second stage,120 patients with liver diseases who had tips in the digestive department of a third grade a hospital from July 2018 to June 2019 were randomly divided into two groups according to the random number table method.The control group received routine nursing and 1,3 after discharge,6-month follow-up call;the experimental group implemented the discharge plan,intervened the patients according to the discharge plan process,evaluated the improvement of self-care ability and quality of life of the patients in the two groups with ESCA and SF-36,and counted the readmission rate and the incidence of hepatic encephalopathy within 6 months.Results A total of 116 patients completed the collection of materials,including 57 patients in the discharge plan and 59 in the control group.The results showed that there was no significant difference in the four dimensions and total scores of self-care ability between the experimental group and the control group at admission(P > 0.05).After six months of intervention,the four dimensions and total scores of self-care ability in the experimental group were higher than those in the control group(P < 0.05);there was no significant difference in the eight dimensions of life quality between the experimental group and the control group at admission(P Over 0.05),after six months of intervention,the scores of 8dimensions of the quality of life in the experimental group were higher than those in the control group,with a statistically significant difference(P < 0.05);after six months,the total number of readmission in the experimental group was 7,accounting for 12.3%;the number of readmission in the control group was 16,accounting for 27.12% of the total number in the control group,with a statistically significant difference(P < 0.05);within six months,the readmission rate in the experimental group was lower than that in the control group,with a statistically significant difference(P < 0.05);and The number of cases of hepatic encephalopathy in the experimental group was 6 cases,accounting for 10.5% of the total number of experimental group,the incidence of hepatic encephalopathy in the control group was 15,accounting for 25.4% of the total number of control group,the incidence rate of hepatic encephalopathy in the experimental group was lower than that in the experimental group,the difference was statistically significant(P<0.05).Conclusion(1the implementation of TIPS discharge plan can significantly improve the le vel of self-care ability of patients.(2)the implementation of TIPS discharge plan can i mprove the quality of life of patients after TIPS(3)the implementation of TIPS discharge plan can reduce the incidence of hepatic encephalopathy after TIPS,(4)the implementation of discharge plan after TIPS can reduce the readmission rate of patients after TIPS,and help patients make a smooth transition from hospital to family.