| Objective:To construct a whole-course specific case management program for patients after skin soft tissue expansion and evaluate its application effect.Methods:1.Systematic retrieval of literature on whole-course disease management and case management of tissue dilation complications in the soft tissue group was carried out.Comprehensive analysis was made on the basis of the evidence recommendation level and evidence classification method of JBI 2016 edition,and the draft of whole-course disease case-management plan for patients undergoing skin soft tissue expansion was developed.Apply expert discussion method to revise the first draft and form the final version of the plan.2.In this study,a quasi-experimental study design was used to select114 patients with skin and soft tissue expansion from the plastic and aesthetic surgery department of burn surgery in a third-level first-class hospital in Changsha city.According to the length of hospitalization,57 patients were divided into control group(June 2019-May 2020)and intervention group(June 2020-May 2021).There was no significant difference in general data between the two groups(P<0.05).The control group received conventional management plan.On the basis of the control group,the intervention group implemented the whole course of disease specific case management program.The incidence of complications,prevention and nursing knowledge of complications,patient satisfaction,waiting time for bed,length of stay and hospitalization cost of patients undergoing skin and soft tissue expansion were analyzed.Results:1.In this study,the constructed whole-course specific case man agement program for skin soft tissue expansion included 4 intervention stages:pre-hospital,in-hospital,post-hospital,and post-hospital,wi th a total of 15 interventions.2.In this study,the comparison of complications between the two groups was statistically significant(P<0.05),the complication rate in the control group was 15/57(26.32%),and that in the intervention group was 7/57(12.28%).In the control group,the incidence of complications in the face,neck,head and chest area was relatively high,10.5%,8.8%,5.3% and 5.3%,respectively.3.Comparison of knowledge score of prevention and nursing of complications of skin and soft tissue dilation between two groups: The control group was(11.88±0.87)points,and the intervention group was(14.14±0.77)points,the difference between the two groups was statistically significant(P < 0.05).4.Comparison of patient satisfaction scores between the two groups:the control group was(41.79±2.76)points,and the intervention group was(43.49±1.77)points,the difference between the two groups was statistically significant(P < 0.05).5.Comparison of waiting time,length of stay and hospitalization cost between the two groups:The time of waiting for bed in the control group was(4.16±1.23)days,the length of stay was(20.61±7.67)days,and the hospitalization cost was(3.57±0.53)yuan in the group.The time of waiting for bed in the intervention group was zero,the length of stay was(16.79±5.92)days,and the hospitalization cost was(3.26±0.71)yuan.The difference between the two groups was statistically significant(P < 0.05).Conclusion1.Based on evidence-based and expert discussion,this study constructed a whole-course disease-specific case management intervention program for patients undergoing skin and soft tissue expansion,which has good clinical value.2.The application of whole-course disease-specific case management intervention program can reduce the incidence of postoperative complications,improve patients’ awareness of complication prevention and nursing knowledge,improve patient satisfaction,shorten waiting time for bed and length of stay,and reduce hospitalization costs,which is worth promoting in clinical practice.There are 5 figures,17 tables and 105 references... |
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