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Objective:To build a comprehensive clinical management of outpatient with orthotopic neobladder based on doctor-nurse cooperation to provide overall service to patients.Methods:The comprehensive clinical management was established in October 2018, 32 patients were collected retrospectively from January 2009 to before the establishment of the clinic, and 14 patients were collected from the establishment of the clinic to January 2020. After the establishment of the clinic, the comprehensive management mode was adopted, including the medical team implementing management from the aspects of implementing doctor-patient joint decision-making, guiding patients to carry out pelvic floor muscle rehabilitation training, teaching family members to carry out new bladder irrigation, and establishing patients′ records. Before the establishment of the clinic, there was no specialized personnel for unified management, and the doctor for new bladder irrigation and so on.Results:The rate of complete urinary control in the 46 patients with orthotopic neobladder was 82.6%(38/46) in the day and 71.7%(33/46) in the night. The rates of complete urine control of patients in the day and night were 12/14 and 9/14 after the establishment of the clinic. The length of stay which was (13.36 ± 9.44) d, and feeding time which was (5.00 ± 2.11) d of the patients after the establishment of the clinic were both less than those of the patients before the establishment of the clinic, which were (17.28 ± 9.98) d and (5.78 ± 2.90) d, but the differences were not statistically significant ( t values were -1.247 and -0.905 respectively, both P>0.05). However, for diurnal and night-time urine control, the proportion of people with more than one diaper was better after the establishment of outpatient clinic than before. Conclusions:The establishment of the comprehensive clinical management meets the needs of patients with orthotopic neobladder, enables patients to get the function of continence and urination sooner, and contributes to improve the clinical outcome of patients.
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The harmonious medical cooperation based on mutual respect and mutual trust is an important part of modern ICU medical care activities,throughout the whole process of ICU medical and nursing work.Whether the relationship between doctors and nurses is harmonious or not directly affects the prognosis of ICU patients.With the change of medical model,the relationship between doctors and nurses is changing. This paper analyzed the influencing factors of doctor nurse cooperative relationship and the significance of good doctor nurse communication and cooperation,summarized the methods and strategies to promote cooperation between doctors and nurses at home and abroad,which would provide reference for clinical cooperation between doctors and nurses in theory and practice.
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Objective To investigate the efficacy of acupuncture combined with doctor-nurse cooperation mode on stroke-associated pneumonia in patients with acute stroke. Methods 67 patients of acute stroke within 1 week in our hospital from March, 2013 to January, 2015 were randomly divided into control group (n=35) and treatment group (n=32). Both groups received neurological routine treatment and systematic rehabilitation training by professional physiotherapists under general nursing mode. The treatment group received acupuncture treatment under doctor-nurse cooperation mode additionally. Incidence of stroke-associated pneumonia, swallow function and aspiration rate were recorded. Results Compared with the control group, the incidence of stroke-associated pneumonia significantly decreased in the treat-ment group after treatment (χ2=4.615, P=0.032). The retention volume of epiglottic vallecula and pyriform sinus (tdilute barium=21.01, tthick barium=19.85), the duration of pharynx period (tdilute barium=17.03, tthick barium=13.68), and the start time of pharynx period (tdilute barium=19.63, tthick barium=17.86) were less in the treatment group than in the control group (P0.05). Conclusion Acupuncture combined doctor-nurse cooperation mode may decrease the rates of aspiration and stroke-associated pneumonia in acute stroke patients through improving their swallow function.
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Objective To explore the feeling and experience of the nursing undergraduate students in the simulation training for the doctor-nurse cooperation emergency before their internship,in order to provide reference for making excellent teaching and practical plan of emergency nursing.Methods Using phenomenology method,the experience records of thirty-six nursing students were collected.The experience was recorded by Colaizzi method.Results Five themes were summarized by Colaizzi method:preliminary acquaintance of doctor-nurse cooperation; reflection on division of labor cooperation; scan self-ability; focus on interpersonal communication;comprehension of emergency characteristics.Conclusions Simulation training for doctor-nurse cooperation emergency can give nursing students' opportunity of cooperative learning; Simulation training for doctor-nurse cooperation emergency can arouse nursing students' interest of active learning; Simulation training for doctor-nurse cooperation emergency can develop nursing students'habit of reflective learning;Simulation training for doctor-nurse cooperation emergency can improve nursing students' ability of integrative learnng.