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Objective:To explore the application effect of clinical nursing pathway based on enhanced recovery after surgery (ERAS) concept in perioperative nursing of gastric cancer in the elderly, so as to provide basis for the selection of clinical nursing plan.Methods:A total of 92 patients with gastric cancer who underwent surgical treatment in Hefei Second People′s Hospital from January 2018 to July 2020 were enrolled. They were divided into the observation group and the control group by random number table method, 46 cases in each group. The control group was given routine nursing intervention, while the observation group was given clinical nursing pathway based on ERAS concept for intervention. The postoperative recovery, improvement of nutritional indexes, postoperative complications were compared between the two groups.Results:The first bowel sound time, first exhaust time, first defecation time, leaving bed time, indwelling time of urinary catheter, and postoperative hospitalization time were (18.43 ± 1.80) h, (43.67 ± 8.79) h, (53.06 ± 5.18) h, (22.65 ± 4.95) h, (29.08 ± 2.69) h, (13.93 ± 2.19) d in the observation group, while (22.96 ± 2.24) h, (47.98 ± 8.46) h, (57.97 ± 5.65) h, (31.30 ± 5.73) h, (35.40 ± 3.66) h, (15.48 ± 2.40) d in the control group, there were significant differences between the two groups ( t values were 2.40-10.69, all P<0.05). There was no significant difference in the nutritional indexes before intervention between the two groups( P>0.05). After intervention, the levels of serum total protein, serum albumin and hemoglobin were (64.43 ± 6.22), (35.43 ± 3.07), (125.88 ± 4.75) g/L in the observation group, while (55.97 ± 5.25), (29.96 ± 2.64), (120.05 ± 5.07) g/L in the control group, there were significant differences between the two groups ( t=7.05, 9.16, 5.69, all P<0.05). The incidence of postoperative complications was 4.35%(2/46) in the observation group, 19.57%(9/46) in the control group, there was significant difference between the two groups ( χ2=5.06, P<0.05). Conclusions:The clinical nursing pathway based on ERAS concept can effectively ensure the nutrition needed by patients with gastric cancer during postoperative rehabilitation, accelerate rehabilitation process, and reduce the incidence of postoperative complications.
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OBJECTIVE: To evaluate the effect of clinical nursing pathway(CNP) on clinical nursing of patients with pneumoconiosis. METHODS: A total of 120 patients with pneumoconiosis were selected as the subjects by the judgment sampling method. The patients were divided into control group and observation group by random number table method, with 60 cases in each group. The patients in the control group were given routine treatment and nursing after admission, while the patients in the observation group were treated similarly to that of the control group plus CNP. The treatment of patients in both groups were carried out until they were discharged from hospital. General Self-Efficacy Scale, Medical Coping Style Questionnaire and Quality of Life Scale were used to measure the self-efficacy, coping style and of quality of life of these two groups before and after the implementation of CNP. RESULTS: Before the implementation of CNP, there was no significant difference in the scores of self-efficacy, three dimensions of coping style and four dimensions quality of life between the two groups(P>0.05). After the implementation of CNP, the scores of self-efficacy, face dimension and quality of life in the observation group were higher than those in the control group(P<0.01). The scores of surrender and avoidance dimensions decreased(P<0.01). CONCLUSION: The implementation of CNP can improve the self-efficacy, coping style and quality of life of pneumoconiosis patients.
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Objective To explore the effect of nutritional support based on clinical nursing pathway on nutritional status and quality of life among elderly inpatients with Alzheimer disease (AD). Methods A total of 101 elderly inpatients with AD who met the criteria of the protocol were consecutively enrolled and randomly divided to study group receiving nutritional support based on clinical nursing pathway for two months (n = 51) and control group receiving routine nutritional management for 2 months (n =50). Nutritional risk and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and Quality of Life-Alzheimer's Disease Scale (QOL-AD) respectively before and after nutritional support. Results Baseline data were comparable between the two groups (all P>0. 05). After 2-month nutritional support, compared to the control, the incidence of nutritional risk (36. 0％ vs 17. 6％, P = 0. 037) and undernutrition (26. 0％ vs 9. 8％, P = 0. 033) decreased significantly in study group. The score of quality of life in study group were significant higher than that of control group (35. 73±5. 85 vs 30. 76±6. 14, P = 0. 023). Conclusion The nutritional support based on clinical nursing pathway is helpful to improve the nutritional status and quality of life in elderly hospitalized patients with AD.
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Objective@#To explore the effect of nutritional support based on clinical nursing pathway on nutritional status and quality of life among elderly inpatients with Alzheimer disease (AD).@*Methods@#A total of 101 elderly inpatients with AD who met the criteria of the protocol were consecutively enrolled and randomly divided to study group receiving nutritional support based on clinical nursing pathway for two months (n=51) and control group receiving routine nutritional management for 2 months (n=50). Nutritional risk and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and Quality of Life-Alzheimer's Disease Scale (QOL-AD) respectively before and after nutritional support.@*Results@#Baseline data were comparable between the two groups (all P>0.05). After 2-month nutritional support, compared to the control, the incidence of nutritional risk (36.0% vs 17.6%, P=0.037) and undernutrition (26.0% vs 9.8%, P=0.033) decreased significantly in study group. The score of quality of life in study group were significant higher than that of control group (35.73±5.85 vs 30.76±6.14, P=0.023).@*Conclusion@#The nutritional support based on clinical nursing pathway is helpful to improve the nutritional status and quality of life in elderly hospitalized patients with AD.
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OBJECTIVE: To explore the application effect of clinical nursing pathway( CNP) in nursing care on patients with occupational noise-induced deafness( ONID) under medical observation.METHODS: The patients with ONID under medical observation in hospital were randomly selected and divided into CNP group( 50 cases) and control group( 50 cases) by random number table method.The control group was given routine nursing care,and the CNP group was given CNP care according to the nursing path table.Self-Rating Anxiety Scale,Self-rating Depression Scale and SF-36 Scale were used to observe the anxiety, depression and quality of life of these two groups.The time and expenses of hospitalization,and degree of nursing satisfaction were also observed.RESULTS: Before nursing care implementation,the scores of anxiety,depression and 8 dimension of quality of life did not show statistical significance between these two groups( P > 0.05).After nursing care implementation,the improvement of anxiety,depression and quality of life in the CNP group were significantly better than that of the control group( P < 0.01).The patients in the CNP group had shorter duration of hospitalization( P < 0.01),decreased hospitalization expenses( P < 0.05),and increased nursing satisfaction( P < 0.01) compared with the control group.CONCLUSION: CNP implementation can effectively reduce the anxiety and depression symptoms of patient with ONID under medical observation during the diagnostic process of occupational diseases.It can reduce the time and costs of hospitalization,improve their quality of life and satisfaction of nursing care.CNP can be widely used in clinical practice.
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Objective To evaluate the clinical nursing pathway in the treatment of stroke patients in combination with traditional Chinese medicine and western medicine. Methods A hundred patients were randomly divided into observation group and control group, 50 cases of each, which selected in Zhoushan Hospital of Traditional Chinese Medicine from January to December in 2015. The normal nursing methods were used in the control group and the clinical nursing paths were used in the observation group. Results The average value of Barthel score of the observation group was significantly better than that of the control group (55.93±9.12 vs. 46.51±9.29, P<0.05) . The recovery efficiency of the observation group was significantly higher than that of the control group (90.00％ vs. 62.00％, P<0.05) . The score of satisfaction of nursing work in the observation group was higher than that of the control group (9.13±0.49 vs.7.08±0.72, P<0.05), and the average length of stay was shortened (43.62±3.79 vs. 65.13±3.11, P<0.05) respectively compared with the control group, and the curative effect of topsis was evaluated by topsis method, and the Ci value of the observation group (Ci=0.781) was better than that of the control group (Ci =0.219) . Conclusion The clinical nursing pathway could significantly improve stroke patients Barthel score, muscle strength and nursing job satisfaction, and overall reduce the duration of hospital stays.
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Objective To establish a clinical nursing pathway for elderly parturients. Methods The clinical nursing pathway draft for elderly parturients were designed though the method of case analysis and literature review. Delphi method was used by 10 experts engaged in clinical medical or nursing with 2 rounds. Results The recovery rates of the two Delphi method were 100%, the experts who put forward the proposal on the 2 rounds of expert conclusion were 60.00% (6/10) and 20.00% (2/10) respectively. The expert's familiarity with the correspondence is 0.90, the coefficient of judgment is 0.80 and the coefficient of authority is 0.85.The mean value and standard deviation of the 2 rounds of correspondence were 3.60～5.05 (standard deviation 0.34～0.94) and 3.91～4.13 (standard deviation 0.26～0.60)respectively. The coordination coefficients of the 2 rounds of experts consultation were 0.441 and 0.592 (all P＜0.001). The clinical nursing pathway for elderly parturients with pregnancy management were three stages: confirmed pregnancy to 13+6weeks, 14 weeks to 27+6days pregnant and 28 weeks pregnant to childbirth, including a total of 74 projects for 4 modules such as medical history collection, physical examination, clinical laboratory and other examination and nursing measures. Conclusions The practicable clinical nursing pathway for elderly parturients was constructed because its high degree of familiarity,authority,coordination and concentration. The statistical analysis results are reliable,it is beneficial to standardize the pregnancy management for elderly parturients and improve the quality of clinical nursing.
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Objective To construct clinical nursing pathway for patients with laparoscopic cholecystectomy surgery in acute cholecystitis stage, and to provide standardized nursing service. Methods With case record and literature review as theoretical basis, Omaha System as frame, clinical nursing pathway with patient centered was developed through analysis of main nursing problem and intervention. Results Omaha System oriented clinical nursing pathway was constructed in different stages of Laparoscopic cholecystectomy surgery with acute calculous cholecystitis. Conclusions Combined standardized nursing language and nursing process, clinical nursing pathway based on Omaha system provide practicability nursing plan in different stage regarding time as the coordinate axle. It contains assessment, problem, intervention and outcome evaluation indexed, which is beneficial to improve nursing quality.
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@#Objective To develop a nursing pathway outlined the reasonable timing for care of paraplegia patients at rehabilitation stage. Methods Literature and patient records were reviewed to draw up a clinical nursing pathway. It was modified and finalized after 2 rounds of Delphi's expert-consultation. Results and Conclusion The draft was responded by 100% of the experts, with a specialist authoritative coefficient of 0.87. The text for the clinical nursing pathway was then completed.
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Objective To develop a nursing pathway outlined the reasonable timing for care of paraplegia patients at rehabilitation stage. Methods Literature and patient records were reviewed to draw up a clinical nursing pathway. It was modified and finalized after 2 rounds of Delphi's expert-consultation. Results and Conclusion The draft was responded by 100%of the experts, with a specialist authoritative coeffi-cient of 0.87. The text for the clinical nursing pathway was then completed.
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Objective:To study the effect of learning plan guidance based on clinical nursing pathway applied in the teaching of surgical nursing.Methods: The nursing specialty students from two classes of grade 2010 were divided into experiment group and control group for the research randomly. Learning plan guidance based on clinical nursing pathway was performed in experiment group, while traditional teaching method was performed in control group. Students were evaluated by teacher during the course; Theoretical examination was carried out after the course. The students in the experiment group were required to fill in questionnaire.Results: Attitude of students in the experiment group is positive. Experimental group was excelled control group obviously in theoretical examination, and the difference was statistically significant (P<0.01).Students in the experiment group made a positive evaluation for teaching effect.Conclusion: Learning plan guidance based on clinical nursing pathway is suit for the reform in teaching of surgical nursing. It can improve the student nurses' comprehensive abilities.
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Objective To study the role of clinical nursing pathway (CNP)in health education for patients undergoing percutaneous nephrolithotomy (PCNL).Methods Ninety patients with PCNL were randomized into the observation group and the control group in equal number: the former received CNP health education and the latter routine health education while hospitalization. The two groups were compared in terms of scores on health education,satisfaction with nursing,incidence of postoperative extubation and hospital stay.Result The scores on health education,satisfaction with nursing and incidence of postoperative extubation in the observation group were all significantly higher than those of the control group (allP<0.05) and the hospital stay in the former was significantly shorter than that of the latter (P<0.05).Conclusions PCNL in use of CNP health education can promote patients’ health education quality,reduce their incidence of extubation,shorten their hospital stays and improve their satisfaction of nursing. It is worthy of clinical promotion and application.
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Objective To observe the effect of clinical nursing pathway used in double-C treatment of elderly patients with type 2 diabetes.Methods 140 elderly type 2 diabetic patients were randomly divided into the control group and the experimental group with 70 cases in each group,both groups adopted double C treatment.The control group received routine care,on the basis of routine nursing care,the experimental group implemented CNP mode.After treatment,type 2 diabetes knowledge mastering levels,the number of days of blood glucose reaching standard level,insulin dosage,incidence of hypoglycemia,satisfaction degree with quality of care,compliance rate and passing rate of health education were compared.Results After treatment,for patients with good compliance rate,the control group accounted for 50.00％,the experimental group accounted for 68.57％,the compliance rate of the experimental group was better than the control group.The incidence of hypoglycemia in the control group was 10.00％,and 1.43％ in the experimental group.The kn owledge mastering levels and satisfying rate with nursing care were 67.14％ and 82.86％ in the control group,and 95.71％ and 98.57％ in the experimental group.The number of days of blood glucose reaching standard level,insulin dosage,passing score of health education were (8.35 ± 1.41) d,(60.36±9.23) U/d,(65.20±3.42) points in the control group,and (4.68±1.32) d,(42.34±7.74) U/d,(90.15±2.15) points in the experimental group.The results of the experimental group were better than those of the control group.Conclusions The clinical nursing pathway in double C treatment of elderly patients with type 2 diabetes demonstrates the advantages of advance,orderly and efficiency,which is worthy of further research and extension.
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Objective To research the significance of application of clinical nursing pathway in patients undertaking glossectomy and forearm flap reconstruction.Methods Sixty patients with tongue cancer who undertook glossectomy and forearm flap reconstruction were enrolled.The patients were randomly divided into the experimental group and the control group (30 cases in each group).The patients of the experimental group received nursing following clinical nursing pathway,and the patients in the control group received routine nursing service.The patients and doctors satisfaction evaluation were compared between the two groups with a self-designed nursing quality evaluation form.The qualities of care achieved in 2 groups were compared.Results It took less in-ward time and expenditure in the experimental group compared with the control group.The quality of care,the satisfactory degree of patients and doctors in the exipermental group were significantly higher than those of the control group.Conclusions The establishment and application of the clinical nursing pathway in patients undertaking glossectomy and forearm flap reconstrucition contributes to improve the satisfaction of patients and doctors and the quality of nursing service.
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Objective To explore the effect of nursing clinical pathway in percutaneous coronary intervention(PCI)for patients with acute myocardial infarction(AMI).Methods Sixty AMI patients were randomly divided into nursing clinical pathway(NCP) group and control group equally by their registration sequence.Patients in the control group received routine nursing care,while patients in NCP group received nursing according to the nursing clinical pathway.Results Compared with the conventional group, the time of preoperative preparation,bed rest and hospitalization was obviously shortened.The incidence of complications and hospital costs were both declined,and meanwhile the quality of care and patient satisfaction improved significantly(P<0.05). Conclusions The application of nursing clinical pathway in patients with AMI can be timely and effective in the treatment of PCI, lower the mortality and complications and moreover improve nurses' working enthusiasm.
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Objective To evaluate the application effect of clinical nursing pathways in acute myocardial infarction patients by using the Meta-analysis.Methods Published randomized controlled trials (RCT) in acute myocardial infarction patients were searched and screened in CNKI,VIP,Wanfang database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.0 software was taken for analysis.Results Totally 18 studies including 1877 cases were eligible to the criteria (894 in the experimental group and 983 in the control group) altogether.The Meta-analysis showed there was significant difference between the experimental group and the control group in hospitalization days,patients' satisfaction degree and rate of mastering knowledge.Significant difference existed between the experimental group and the control group in bedridden time,complication rate and the recurrence rate of myocardial infarction.Conclusions Application of clinical nursing pathway in acute myocardial infarction patients can shorten hospitalization days,increase patients' satisfaction degree and rate of mastering knowledge,decrease bedridden time,complication rate and the recurrence rate of myocardial infarction.
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Objective To explore the application effect of clinical nursing pathway on maintenance hemodialysis patients.Methods Totally 120 patients with maintenance hemodialysis between January 1 and December 31 2009 were randomly assigned to the control group and the observation group with 60 patients in each group.The clinical pathway was established and applied to the observation group.The treatment effect was compared between two groups.Results The incidence of complications and nursing errors declined with the application of clinical nursing pathway,and the doctor's orders compliance and the satisfaction and quality of care were improved significantly.Conelusions The application of clinical nursing pathway in maintenance hemodialysis patients is an effective method for improving overall care quality and the satisfaction degree of the patients with nursing,so as to improve their survival rate.
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Objective To study the effect of clinical nursing pathway on oral and maxillofacial trauma.Methods One hundred inpatients were assigned according to the odd or even number of registration into the experiment group and the control group equally.The experiment group received clinical nursing pathway while the control one routine nursing.Results The rates of awareness of health education and satisfaction in the experiment group were significantly higher than the control group and the average stay was significantly shorter than that of the control group(both P<0.05).Conclusion The clinical nursing pathway used in the care of oral and maxillofacial trauma may standardize the manipulations of nursing care,enhance the nursing staff's sense of responsibility, and promote the patients' satisfaction,as well as the quality of care.
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Objective To investigate the preventive effect of clinical nursing pathway of health education on partum urinary retention.Methods Two hundred and forty primiparas hospitalized in our hospital from September 2012 to February 2013 were randomized equally into the observation group and the control group.The former received health education by clinical nursing pathway and the control group conventional health education.The two groups were compared in terms of incidence of postpartum urinary retention.Results The incidences of postpartum urinary retention in the observation group and the control one were 3.33% and 11.67%,respectively.The difference in the incidence between the groups were statistically significant(P<0.05).Conclusion The clinical nursing pathway of health education may effectively prevent the occurrence of postpartum urinary retention.
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Objective To investigate the effect of clinical nursing pathway on patients with cerebral infarction. Methods Two hundred patients with cerebral infarction were randomized by random digit table into the clinical pathway group and the conventional nursing group.The former was managed with the clinical nursing pathway and the latter received conventional nursing. The neurologic impairment and the activities of daily life were assessed respectively by national institute of health stroke scale(NIHSS) and Barthel index(BI).The two groups were compared in terms of hospital stay,medical expense,patient’s satisfaction and curative effect. Results Compared to the conventional nursing group,the clinical pathway group was shorter at hospital stay,lower at lower hospitalization cost,higher at patient’s satisfaction and higher in the score by Barthel index,compared to the conventional nursing group(all P<0.05). Conclusion The application of clinical nursing pathway in patients with cerebral infarction can improve the activities of daily living and the quality of care,shorten length of stay,reduce medical cost and increase patients’satisfaction drgree.