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Objective:The aim was to explore the needs of patients readmitted with chronic heart failure (CHF) for pre-discharge preparation services and to provide reliable evidence to support the development of a discharge preparation service plan.Methods:The research was based on the phenomenology research method. Using a purposive sampling method, 12 readmitted patients with CHF from the First Hospital of Heilongjiang University of Traditional Chinese Medicine were selected and interviewed in a semi-structured manner between February and April 2023, and the data were analyzed using the Colaizzi seven-step analysis.Results:Among 12 patients, 6 males, 6 females, aged 53 to 85 years old. The discharge preparation service needs of readmitted patients with CHF can be categorised into 3 major themes of physiological-psychological-social, containing 6 sub-themes: the need to improve self-management skills, the need for rehabilitation and exercise, the need for improvement of negative emotions, the need for improvement of health education, the need for improvement of home care, and the need for health resource services.Conclusions:Patients readmitted with CHF have greater needs for self-management knowledge and skills, family care needs, professional guidance needs, and information on referral services from primary health resources, and nursing staff should focus on assessing such needs of patients in order to develop individualized plans for discharge preparation services for patients with CHF.
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With the deepening of the reform of the medical and health system and the continuous optimization of the medical order,it is especially important to organize the development of admission and discharge standards and improve the service of preparing patients for discharge.In recent years,the research and application of machine learning technology in the medical field has been intensifying,and it has unique advantages in processing data and risk prediction research.Therefore,this paper reviews the development process,types of machine leaming,the content and effects of its application in patient discharge preparation services,and the current problems,in order to provide references for healthcare professionals to implement the best clinical decisions and further improve the patient discharge preparation service model.
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Objective To understand the discharge readiness of fathers of preterm infants in the Neonatal Intensive Care Unit(NICU),analyze its influencing factors,and provide a basis for formulating individualized discharge health education plans and continuous care plans.Methods A convenience sampling method was employed to select fathers of preterm infants admitted to the NICU in a tertiary A hospital in Zhejiang Province from March 2022 to June 2022 as the subjects of the study.A general information questionnaire and the Discharge Readiness-Parent Version scale were used for the survey.Multiple linear regression analysis was applied to analyze the factors influencing the discharge readiness of fathers of NICU preterm infants.Results A total of 186 fathers of NICU preterm infants were included in the study.The total score of the Discharge Readiness-Parent Version scale was(179.97±28.20)points;the standardized score was(7.82±1.16)points;33.3％of the fathers of preterm infants had a standardized score of＜7 points.Multiple linear regression analysis results showed that the factors influencing the discharge readiness of fathers of NICU preterm infants included the gestational age at birth,birth weight,length of hospital stay,distance to access healthcare service,as well as the fathers'age,annual family income,and number of children in the family.Conclusion The discharge readiness of fathers of NICU preterm infants is at a moderate level.Nursing staff need to pay attention to the discharge readiness of fathers of preterm infants who have lower gestational age at birth,lower birth weight,longer hospital stays,longer distance to healthcare service,and who are younger,have lower annual family income,and are having their first child.Individualized discharge health education plans and continuous care plans should be formulated for them to improve their caregiving knowledge and skills.
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Objective To gain an in-depth understanding of the real experiences,feelings and needs of fathers of premature infants in NICU regarding hospital discharge preparation,and to provide a basis for medical institutions on the development of personalized health education plans and continuous nursing care plans for discharged premature infants.Methods By the purposive sampling method,15 fathers of premature infants in NICU of a tertiary obstetrics and gynecology hospital in Zhejiang Province from April 2022 to July 2022 on the day of discharge and 6 weeks after discharge were selected for semi-structured interviews,and the interview data were analyzed using the Colazzi's phenomenological 7-step analysis.Results The experiences and needs of NICU premature fathers in discharge preparation are divided into 4 themes.1.The father's problems coexist with the growth of premature infants,such as expecting to see premature infants on the day of discharge and having confidence in discharge care,experiencing various negative emotions after discharge,and increasing empathy and sense of responsibility after discharge.2.Inadequate ability to care for oneself,including a lack of access to professional care knowledge,a need to improve nursing skills,and an overreliance on premature mothers.3.Social role conflict in the family.4.Longing for assistance,including professional medical advice and more family support.Conclusion Fathers of premature infants in the NICU coexist with negative emotions and growth experiences as they prepare for discharge,with various needs such as reducing role conflict,enhancing independent care ability,and obtaining psychological and multi-party support.To improve their discharge preparation level,nursing staff should develop a personalized health education plan as well as a continuous nursing plan.
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[Objective]:To explore the effect evaluation of discharge preparation service on elderly patients with hip fractures.Methods:Totally 80 elderly patients with hip fractures admitted to Shanghai Sixth People′s Hospital from April 2019 to October 2019 were selected as the research objects, and they were divided into intervention group and control group according to admission time, 40 patients in each group. The control group was given routine nursing care, and the intervention group was given readiness service for hospital discharge.The application effect of the scheme was evaluated by the degree of readiness for discharge and the quality of discharge guidance, Barthel index score, Harris score and incidence of complications.Results:In the intervention group,the total score of readiness for hospital discharge of patients was 83.43±8.10,the total score of the quality of discharge guidance was 151.30±16.61,while those in the control group were 77.13 ± 9.30, 141.58 ± 18.34, the differences between the two groups were statistically significant( t=3.23, 2.49, both P<0.05).In terms of the follow-up after patients were discharged for 3 months, the Harris hip score and Barthel index scores for patients with hip fracture were 82.53 ± 7.83 and 88.13 ± 3.34,while those were 76.03 ± 12.15, 86.13 ± 2.65 in the control group,the differences between the two groups were statistically significant ( t=2.84, 2.97, both P<0.05). Conclusions:The discharge preparation service can effectively improve the readiness for hospital discharge and the quality of discharge guidance. It improves the hip joint function, the quality of life of patients, and the clinical outcome of patients effectively.
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Objective:Under the guidance of evidence-based theory, the discharge preparation intervention plan for stroke patients was constructed, in order to provide a reference for improving the discharge preparation of stroke patients.Methods:To retrieve the relevant guidelines, consensus, literature and quality evaluation, summarize relevant evidence and evaluate the first draft of the intervention plan, implement two rounds of expert enquiry, according to the expert score and opinions, and improve the entries after the group discussion to form the final intervention plan.Results:In the two rounds of correspondence, the expert positive coefficient was 100%, the expert authority coefficient was 0.81 and 0.84 respectively, and the Kendall harmony coefficient of each entry was 0.165 and 0.453 respectively. The difference was statistical significant ( P<0.05). The ultimate in intervention plan included 6 primary entry, 23 secondary entries. Conclusions:The discharge preparation intervention plan for stroke patients constructed in this study is scientific, reliable and feasible, and is of great significance to improving the discharge preparation of stroke patients.
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Objective:To implement evidence-based practice of discharge preparation service in maternal and to explore the clinical effect.Methods:Based on the evidence-based continuous quality improvement framework, apply the evidence on the clinical through evidence acquisition, baseline evaluation, evidence introduction, and after-effect evaluation. Sixty women hospitalized in the obstetrics department of the Affiliated Hospital of Chengde Medical College from January to March 2021 were selected as the baseline group, and 60 women hospitalized in the obstetrics department of the hospital from April to July 2021 were selected as the evidence application group, to evaluate and compare the quality of discharge guidance for practitioners, discharge readiness level, maternal and newborn management knowledge level, incidence of maternal and newborn complications and the compliance of practitioners to evidence.Results:Finally, 10 pieces of evidence applied to clinical practice were included and 15 review indicators were translated. After the application of evidence, the quality of discharge guidance of practitioners increases from (141.83±24.66) to (166.13±10.30), the maternal discharge readiness increased from (127.12 ± 26.29) to (137.63 ± 22.59) , the score of maternal knowledge level increased from (164.58 ± 20.10) to (176.08 ± 24.25) , t values were -7.04, -2.39 and -2.83, all P<0.05. The incidence of postpartum women breast disease, postnatal constipation and newborn eczema, newborn red buttocks, newborn diarrhea, newborn jaundice decreased significantly, the difference were statistically significant, χ2 values were 5.21-7.50, all P<0.05. After the application of evidence, the implementation rate of the review indicators increased from ≤31.67% to ≥86.66%. Conclusions:The evidence-based practice of discharge preparation service in postpartum women improve the quality of discharge guidance for practitioners and compliance with evidence, promote clinical quality improvement, can be used for clinical reference.
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Objective:To evaluate the practicability and effectiveness of nursing plan for elderly patients with urinary incontinence after operation.Methods:The patients admitted to the Department of Urology and Gynecology in a Grade 3A general hospital from September to October 2019 were selected as the control group, and the patients admitted from December 2019 to January 2020 as the intervention group. In the quasi-experimental study, the control group was given routine discharge guidance, and the intervention group was given a nursing plan for elderly patients with urinary incontinence to observe the preliminary effect of the nursing program for a period of 2 months.Results:Two months after implementation, the total scores of discharge preparation, quality of life and satisfaction of urinary incontinence in the intervention group was (125.08 ±17.64), (58.79 ±5.52) and (96.09 ±2.53) respectively, which were significantly different from those in the control group ( P<0.05). Conclusion:The preliminary verification of the scheme has a certain feasibility, has a certain guiding significance for nurses, and is helpful to improve the discharge preparation of elderly surgical patients with urinary incontinence and improve their satisfaction and quality of life when they are discharged.
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The discharge preparation service is a complete process, which is of great significance for ensuring the patients′ discharge safety and the home sustainability of rehabilitation nursing. It has become a hot issue among international nursing scholars. This paper reviews the concept, implementation content, assessment tools, nursing practice of patient discharge preparation services, so as to provide theoretical basis for forming patient discharge preparation services system with medical environment in China.
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Devido à precocidade cada vez maior da alta hospitalar pós-cirúrgica, a orientação do paciente torna-se de grande valor para a melhoria do auto cuidado. A aferição dos resultados dessa orientação é uma das formas de garantir a efetividade da intervenção do enfermeiro. Acredita-se que a aplicação de um modelo educativo que atenda as necessidades específicas do aprendiz adulto possa auxiliar o desempenho competente do enfermeiro no cumprimento da sua tarefa como educador. Portanto, realizou-se uma investigação com os objetivos específicos de: 1) levantar o número de pacientes que tiveram problemas de seguimento relacionados às orientações sobre aspectos gerais, complicações e iniciativas, e 2) verificar a opinião dos pacientes sobre a estratégia utilizada para a realização da ação educativa. O método utilizado desenvolveu-se em duas etapas. Na primeira etapa (intra hospitalar) realizou-se uma ação educativa baseada no modelo Andragógico e na fase extra hospitalar utilizou-se a visita domiciliar como estratégia para observar o seguimento do paciente às orientações ministradas. As principais conclusões do presente estudo demonstram que: a) a metade dos pacientes apresentou problemas indicativos do não seguimento das recomendações técnicas; b) a taxa de 1,4 problemas por paciente parece pequena em relação ao número de problemas possíveis (36); c) o cuidado com a ferida operatória foi o aspecto geral que apresentou maior número de pacientes com problemas; d) a alimentação e a postura corporal foram outros aspectos gerais que apresentaram taxas mais expressivas de pacientes com problemas de adesão; e) no presente estudo chama a atenção o fato dos pacientes que receberam orientações específicas relacionadas aos aspectos gerais apresentarem maior número de problemas que aqueles que não receberam essa orientações; f) quanto ao seguimento das orientações relacionadas as complicações os resultados demonstram que os ) pacientes seguiram essas orientações; g) a forma como as orientações foram ministradas não ocasionou grandes dificuldades para a compreensão dos pacientes e parece ter sido suficiente e agradável; h) a visita domiciliar, neste estudo, parece ser de grande importância para sanar falhas e atender as necessidades não previstas. Finalmente, parece que os resultados obtidos demonstram que o Modelo de Educação de Adulto (Andragogia) adotado pode ser considerado efetivo e que é de extrema importância o planejamento da alta do paciente cirúrgico e o preparo para o seu auto cuidado.
As post-surgery patients are discharged earlier from hospitals, instruction is of great value in improving self-care. One of the ways of assuring the effectiveness of nurse intervention is to measure the results of the instruction. It is believed that the application of an educational model which addresses the specific needs of the adult learner can improve nurse performance in patient education. This way, the current research aims to: 1) investigate the number of patients who had problems following the instructions in terms of general aspects, complications and initiatives; 2) verify patient opinion vis-à-vis the strategy employed in the educational action. The method used consists of two parts. In the first phase (in hospital), the educational action taken was based on an andragogical model. And, in the extra hospital phase, home visits were used to observe how patients were dealing with the instructions presented to them. The main conclusions of this research point out that: a) half of the patients had problems which indicates that they did not follow the tecnical recommendations; b) the rate of 1,4 problem per patient seems low when one considers the number of possible problems (36); c) surgical wound care was the general aspect which caused most problems among patients; d) eating and body posture were the other general aspects which presented the highest rates of patients with compliance problems; e) the current research calls attention to the fact that patients who received specific instructions related to general aspects presented more problems than those who did not receive these instructions; f) in term of following the instructions related to the complications, results demonstrate that patients followed these instructions; g) the manner in which the instructions were presented to the patients did not cause understanding difficulties and were apparently enough and pleasant; h) home visits, in this research, seem to be of great importance to solve flaws and respond to unforeseen needs. Finally, the results demonstrate that the adopted Adult Education Model (Andragogy) might be considered effective and of extreme importance when planning the discharge of post-surgical patient and preparing for self-care.