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Objective:To study the clinical value of the ISBAR communication model based on nursing priorities in nursing ward rounds.Methods:Using a quasi-experiment method, 104 patients who received secondary and tertiary care from April to June 2020 were set as the control group, and 122 patients who received secondary and tertiary care from July to September 2020 were set up as the experimental group, with non-randomized method. The experimental group used the ISBAR communication model based on nursing priorities for nursing ward rounds, and the control group used the traditional method for nursing ward rounds. The abilities of bedside nurses collecting the patients′condition, the bedside nurses′ condition observation and the nurses′ critical thinking were compared between the two groups, and the patients' nursing quality and satisfaction were also compared.Results:The scores of the bedside nurses′ knowledge of the patients′ condition were 81.14±3.09 in the test group and 75.90±2.84 in the control group, with statistically significant difference ( t value was -12.88, P<0.01). The scores of the bedside nurses′ ability in observing patients′ condition were 140.50 (137.00, 144.50) in the experimental group and 135.50 (128.75, 139.00) in the control group, with statistically significant difference ( Z value was -3.399, P<0.01). The scores of the Critical Thinking Disposition Inventory Chinese-version (CTDI-CV) were 309.82±36.33 in the experimental group and 286.86±33.54 in the control group, with statistically significant difference ( t value was -2.177, P<0.05). The scores of patient care quality evaluation were 62.50 (60.00, 64.00) in the experimental group and 59.00 (55.00, 61.50) in the control group, with statistically significant difference ( Z value was -6.47, P<0.01). The patient discharge satisfaction score of the experimental group was 53.00 (48.75, 55.00), and that of the control group was 51.00 (44.00, 54.00), with statistically significant difference ( Z value was -3.56, P<0.01). Conclusions:The application of ISBAR communication model based on nursing priorities in nursing ward rounds had a significant promotion effect on the improvement of nurses' abilities of collecting the patients′ condition, observing patients′ condition, and critical thinking, and can effectively improve nursing care quality and patients′ satisfaction.
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Objective:To explore the effect of continuing care based on the WeChat public platform questionnaire star on the fluid replacement operation of peritoneal dialysis patients.Methods:Convenience sampling method was used to select 210 patients undergoing peritoneal dialysis in the Panyu Central Hospital, Guangzhou from January to June 2019. They were divided into a experimental group and a control group by random number table method, each with 105 cases. The patients of the control group were given routine continuous care for peritoneal dialysis, such as outpatient follow-up, telephone follow-up, home visit, etc., and oral education. On this basis, in the experimental group, the patients first joined the WeChat public platform, implementing network-based health education and questionnaire stars for real-time testing, and multi-dimensional communication with patients. The knowledge of the peritoneal dialysis fluid replacement operation, the fluid replacement operation evaluation score, the catheter outlet replacement drug evaluation score, the fluid replacement operation self-management score and compliance were compared before and after intervention in the two groups. And the incidence of complications related to the peritoneal dialysis fluid exchange operation of the two groups were compared before and after intervention.Results:The experimental group′s knowledge of peritoneal dialysis fluid exchange operation, examination score of fluid exchange operation, and abnormal situation management score of fluid exchange operation management were 55.88±8.97, 92(89, 96), 12(11, 12) after three-month intervention, and higher than the control group [51.88±10.24, 91 (86, 94), 12 (9, 12)], with statistically significant difference ( t value was 3.00, Z value was -2.483, -2.308, P<0.05). After six-month intervention, the relevant knowledge of peritoneal dialysis fluid replacement operation, fluid replacement operation evaluation score, catheter outlet replacement drug evaluation score and fluid replacement operation management score (routine fluid replacement operation, abnormal situation handling) of the experimental group were 57.52±9.41, 93 (90,96), 90 (87,94), 18 (17,18), 12 (11,12), which were higher than the control group [53.61±10.29, 90 (86,94), 90 (87,92), 17 (15,17), 12 (9,12)], with statistically significant difference ( t value was 2.87, Z value was from -7.181 to -2.664, P<0.01). The difference between the groups was statistically significant ( χ2 value was 4.21-7.517, all P<0.05); and the difference between the intervention time points was statistically significant ( χ2 value was 11.805-164.95, all P<0.05). After six-month intervention, the complications of catheter infection, peritonitis, and poor drainage were 9 (8.91%), 5 (4.95%), and 5 (4.95%) in the experimental group, which were significantly lower than those in the control group [21 (20.39%), 14 (13.59%), 15 (14.56%)], with statistically significant differences ( χ2 value was 5.36, 4.51, 5.33, both P<0.05). Conclusions:The continuous care of the WeChat public platform questionnaire star has a significant promotion effect on the improvement of the knowledge, operation ability, compliance and self-management behavior of the peritoneal dialysis patients, and can effectively reduce the complications caused by the peritoneal dialysis operation.
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Objective To explore the application effect of the multidisciplinary collaborations in control of peritoneal dialysis patients with hypertension. Methods A total of 220 cases of peritoneal dialysis patients divided into experimental group and control group (each group had 110 cases) according to the random number table. In which, the control group received routine capacity control and health education with a total of 105 patients finished the study. The experimental group received of multidisciplinary collaborations on the basis of routine capacity control and health education with a total of 107 patients finished the study. Observe changes with knowledge of drugs, medication compliance, self-management behavior and blood pressure of patients before and after the intervention respectively. Results In experimental group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.93 ± 0.49), 0.00 (0.00, 0.25), (2.69 ± 0.25) points before the intervention, 6 months after the intervention were (1.17 ± 0.54), 0.25 (0.00, 0.50), (2.86 ± 0.15) points, the difference between the groups was statistically significant (t=38.60, Z=4.34, t= 2.45, P 0.05), there were statistically significant differences in self-management behavior (t=6.23, P 0.05); there was significant difference between the 2 groups after intervention (t=4.11, Z=4.03, t=4.34, P0.05);6 months after the intervention there was significant difference between the 2 groups (t=2.22, 2.72, P < 0.05 or 0.01). Conclusions Multidisciplinary collaborations have a significant role in patients with peritoneal dialysis, especially in blood pressure control, medication compliance and self-management behavior.
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Objective To investigate effect of the transtheoretical model and stages of change (TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis (MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group (65 of 70 cases completed with TTM) and the control group (63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of self-management behavior were higher in control group after 3 months intervention,the differences was statistically significant (P ＜ 0.05),in which the scores of problem solving (2.97 ± 0.28),self care activities (2.99±0.28),relationships (3.13±0.35) and emotional treatment (2.80 ± 0.32) in experimental group was apparently higher than control group at the same time,the scores were (2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level [(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus [(55.33±14.45) mg2/dl2 vs.(72.35±20.94) mg2/dl2],serum parathyroid hormone [238.00 (130.35,413.85) ng/L vs.297.75 (155.02,760.37) ng/L] (t=11.01,8.43,Z=-2.09,P＜0.05).Conclusions TTM is conducive to promote behavior change,improve self-management conduct,and also reduce serum phosphorus level in MHD patients.