Construction And Application Of Clinical Nursing Pathway For Patients With Critical Hematoma Drainage By Borehole

Research Purpose:Through nursing assessment,illness observation and clinical nursing,rehabilitation nursing,health education and other steps,we developed a specialist enquiry for the questionnaire.After two rounds of Delphi expert correspondence,we got clinical nursing pathway form for patients with critical hematoma drainage by borehole.Then,we used the designed pathway form to explore the advantages of clinical nursing pathway in patients with critical hematoma drainage by borehole.For example,the advantages of reducing complications,promoting recovery,reducing the length of hospital stay and the cost,improving the satisfaction and so on.The designed clinical nursing pathway form could be reasonably and simply applied to the nursing work of patients with critical hematoma drainage by borehole in the neurosurgery department,which can promote the clinical nursing pathway to more diseases.Research Methods:First of all,we set up a clinical nursing pathway team,and we extracted the nursing measures suitable for patients with critical hematoma drainage by borehole by reading the literature.We put these items into the questionnaire for expert consultation.Then through two rounds of Delphi expert correspondence method,we determined to design the appropriate clinical nursing pathway form for patients with critical hematoma drainage by borehole.We selected 82 patients with first cerebral hemorrhage admitted to the Department of Neurosurgery in a Third-class hospital of Xuzhou from December 2019 to December 2020.Then,We divided these patients into an intervention group and a control group by using a random number table,with 41 patients in each group.The control group adopted the routine perioperative nursing of cerebral hemorrhage in neurosurgery,and the intervention group adopted the clinical nursing pathway form designed by us.Research Results:Through the nursing intervention during our hospitalization,we found that in terms of the incidence of complications,the number of patients with brain edema in the intervention group was1,and the number of patients with brain edema in the control group was 6,P<0.05,the difference was statistically significant(χ~2=3.945,P=0.047).There were 2 cases of pulmonary infection in the intervention group and 9 cases in the conventional group(P<0.05),and the difference was statistically significant(χ~2=5.232,P=0.022).In terms of promoting rehabilitation,Barthel index of the intervention group was higher than that of the control group 14 days after surgery and at discharge,P<0.05,the difference was statistically significant.Besides,GCS score in the intervention group was higher than that in the control group at 7 and 14 days after surgery,P<0.05,with statistical significance.In terms of length of stay and the cost,the average length of stay in the intervention group was 26.57±4.27 days,and that in the control group was 29.59±5.06days,P<0.05,the difference was statistically significant(t=2.781,P=0.007).The average hospitalization cost of patients in the intervention group was 9.80±1.52 wan yuan,while the average hospitalization cost of patients in the control group was 10.71±1.77 wan yuan,P<0.05,the difference was statistically significant(t=2.424,P=0.018).In terms of the satisfaction survey,the results of the satisfaction survey of patients in the intervention group showed that the satisfaction ratio was 91.89%and 5.41%,while the satisfaction ratio of the conventional nursing group was 81.08%and 13.51%.The satisfaction ratio of the intervention group was higher than that of the control group,P<0.05,the difference was statistically significant(χ~2=9.345,P=0.009).Research Conclusion:Application of clinical nursing pathway in patients with critical hematoma drainage by borehole:clinical nursing pathway can reduce the occurrence of cerebral edema and pulmonary infection after critical hematoma drainage by borehole;It can promote the scores of Activity ofDaily Living Scale,and improve GCS and GOS score of patients,which could contribute to promoting the recovery of with critical hematoma drainage by borehole.Clinical nursing pathway can shorten the hospitalization time and reduce the hospitalization cost of with critical hematoma drainage by borehole.Clinical nursing pathway can improve the satisfaction of patients and their families to hospital service.