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Objective:To explore the effects of risk grading nursing on the prevention of postoperative deep vein thrombosis (DVT) and quality of life in patients undergoing knee arthroscopic surgery.Methods:A total of 1 140 patients undergoing knee arthroscopic surgery in Beijing Jishuitan Hospital were selected. The 529 cases with routine nursing from January to December 2018 were selected as the control group, while another 611 cases with risk grading nursing from January to December 2019 were selected as the observation group. The incidence of DVT, limbs swelling, quality of life and nursing satisfaction were compared between the two groups.Results:The incidence of DVT and the positive rates of Homan sign and Neuhof sign were 2.78% (17/611), 3.93% (24/611), 4.91% (30/611) in the observation group, and 5.10% (27/529), 10.02% (53/529), 11.72% (62/529) in the control group, the differences were statistically significant ( χ2=4.12, 16.70, 17.72, all P<0.05). The peripheral diameter and body surface temperature at 5 cm above the ankle, 10 cm below the patella and 15 cm above the patella were (21.30 ± 1.72) cm, (34.89 ± 2.75) cm, (46.69 ± 4.58) cm, (33.14 ± 1.40) ℃, (34.45 ± 1.52) ℃, (35.22 ± 1.36) ℃ in the observation group, and (22.88 ± 1.43) cm, (35.91 ± 1.81) cm, (49.18 ± 4.23) cm, (34.39 ± 1.22) ℃ (35.88 ± 1.49) ℃, (35.97 ± 1.31) ℃ in the control group, the differences were statistically significant ( t values were -16.74--7.25, all P<0.05). The scores of general health, physiological function, physiological function, mental health, social function, emotional function, body pain and body vitality were (75.84 ± 5.33), (79.78 ± 5.71), (76.71 ± 4.14), (84.91 ± 4.15), (75.53 ± 4.19), (78.80 ± 6.76), (74.85 ± 3.49), (78.61 ± 3.52) points in the observation group, and (71.39 ± 4.28), (75.44 ± 6.26), (73.05 ± 4.09), (80.15 ± 6.87), (71.66 ± 4.18), (74.89 ± 6.23), (71.14 ± 5.20), (74.66 ± 5.14) points in the control group, the differences were statistically significant ( t values were 10.10-15.57, all P<0.05). The satisfaction scores of nursing communication, safety, nursing technology, nursing, guidance and physical environment were (4.54 ± 0.42), (4.75 ± 0.46), (4.54 ± 0.52), (4.60 ± 0.48), (4.60 ± 0.53), (4.30 ± 0.64) points in the observation group, and (3.93 ± 0.34), (3.98 ± 0.37), (3.96 ± 0.41), (3.93 ± 0.38), (3.85 ± 0.36) (3.74 ± 0.38) points in the control group, the differences were statistically significant ( t values were 17.62-30.82, all P<0.05). Conclusions:Risk grading nursing is beneficial to alleviate postoperative limb swelling in patients after knee arthroscopic surgery, reduce incidence of DVT, improve quality of life and nursing satisfaction.
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Objective Skin tears are one of the skin adverse events in hospitalized patients which increased the length of stay and cost.How to intervene effectively is one of the global research priorities.The article aimed to study effective treatment for skin laceration by analyzing the characteristic and classification and applying grading nursing care for skin laceration.Methods From the first visit of 26 patients,the wound care center assessed the site,cause,severity classification and duration of skin laceration and managed wounds with individualized grading nursing care and overall intervention.Measurement was done on the area reduction once a week with dynamic adjusting interventions until healing.Results 26 patients with skin laceration were mainly grade 3,accounting for 76.92％ (20/26).Extremities were the main injured sites,accounting for 84.62％ (22/26).All wounds healed within 60 days and the average healing time was (22.38-±13.56)days.Median healing time was 20 days.No significance was found in the reduction rate of wounding site in 3 weeks and healing time for different severity grades,different durations and different sites of skin laceration (P＞0.05).Conclusion Individualized grading nursing care can efficiently treat skin tears with different severity,durations and sites.
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Objective To construct a grading nursing care system at public hospitals based on the severity of illness and activities of daily living ( ADL). Methods Multi-center stratified random sampling was used to investigate the general adult patients hospitalized in 12 wards of six tertiary-level hospitals in the eastern, central and western parts of China from January to December of 2016. The Barthel index and simple clinical score ( SCS) were used to evaluate their ADL and severity of illness, while a customized direct nursing hour scale was applied to record the direct nursing time needed by patients in 24 hours. Nursing grades were defined according to different conditions and ADL and to the difference of patient needs of 24 h direct nursing hours. Results 7 200 patients were investigated in total, and 7 073 effective questionnaires were collected (98. 24% ). Seven new grades of nursing care were defined based on patients′ severity of illness, ADL and different 24 h direct nursing time. These grades match the existing four grading nursing care levels to become refined sub-levels. Conclusions Patients can be graded according to their conditions, ADL and the 24 h direct nursing time needed. Such a new method is more objective, specific and quantitative than before, conducive to upgrading fine management level of nursing.
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This paper analyzed the current situation of grading nursing and discussed the ethical problems generated in the implementation of grading nursing.Based on the ethical significance of grading nursing in practice,to achieve better quality and efficient nursing,this paper put forward some countermeasures,including establishing ethics training mechanism and enhancing the nurses' ability of ethical decision-making,paying attention to collaborator coordination and demonstrating team spirit,striving to establish and maintain harmonious environment and improving the working enthusiasm of nurses so as to promote the harmonious relationship between patients and nurses.
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Objective To discuss the influence of grading nursing care by physician-nurse cooperation decision-making on the quality of patient care and disease outcomes,and evaluate the application feasibility of nursing core system in this nursing mode.Methods 379 patients were admitted to departments of orthopedics and endocrinology from two hospital areas of our hospital from January 2011 to January 2012.Patients were divided into two groups according to nursing process.Patients who were given conventional grading nursing were set as the routine group,and patients receiving physician-nurse collaboration grading nursing were set as the collaboration group.The nursing quality and nursing efficiency,and the disease outcome of patients were compared between the two groups.Results The quality of care,the qualified rate of care plan implementation,the coverage rate of health education of patients and the patient satisfaction rate were higher in the collaboration group than those in the routine group.The performing rate of doctor's orders,the awareness rate of patient disease,the average length of hospital stay,compliance of medical orders and re-admission rate of patients with the same or a related disease within three months were significantly different between two groups.The collaboration group improved the matching degree of nursing grade with disease condition,understanding of professional knowledge,recording of nursing records,deficient nursing process,and communication ability of life knowledge,compared with those of the routine group.Conchusions Nursing grading mode by physician-nurse collaboration decision-making can obviously improve the defmition of grading nursing and the general treatment effect of patients,it significantly improved the quality of grading nursing.
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Objective To explore the influencing factors of the implementation of general hospital guiding principles of nursing classification (trial) in clinical nursing work.Methods 152 nurses and 143 doctors were selected from three 3A-level hospitals in Changchun and were investigated with self-designed questionnaires,and the data were statistically analyzed.Results The first three influencing factors were the responsibility,quantity and basic qualities of nurses.Grading nursing standards,leadership value degree and the differences of disease had lower influencing degree.There were cognitive differences between nurses and doctors on the influencing factors on implementation of the principle.Conclusions To improve execution of the principles,the cognition of doctors and nurses on the principles must be unified.Increasing nurses' basic quality and responsibility and carrying out effective human resources management are very useful.
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ObjectiveTo discuss the quantitative criteria of grading nursing of three common psychiatric diseases in psychiatric department. MethodsUsing SI、N-BPRS,BRMS and HAMD scales to evaluate180 patients with schizophrenia,mania and depression upon admission and after admission.The quantitative evaluation of grading nursing of these three diseases was compared. ResultsFor the three common mental diseases N- BPRS scale scores were as follows.Superfine nursing:schizophrenia (80.66+11.22)points; mania (80.05± 15.44)points; depression (76.88±9.82)points.Primary care:schizophrenia (67.47± 10.18)points; mania ( 62.91 ± 10.19 )points; depression ( 56.63±9.52 )points; Secondary nursing:schizophrenia ( 44.04 ±8.67 )points;mania( 39.57±9.47 )points ;depression( 37.73±7.75 )points.The three- level nursing:schizophrenia( 27.97±2.19 )points;mania(27.89±2.28)points;depression(27.45±1.31 )points. ConclusionsUsing evaluating scores of NBPRS scale to determine the quantitative criteria of grading nursing of three common psychiatric diseases is a feasible choice,after training,nurses of high qualification can grasp skillfully the operation process.
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Objective To calculate and analyze the grading nursing costs in a grade Ⅲ-A general hospital, and give suggestions to the government for rational pricing. Methods 6 wards were selected as the subjects, we calculated the total expenses by the ratio of income method, meanwhile, by sharing the cost we calculated the actual costs of grading nursing and let them underwent variance analysis. Results The actual cost of grade 1 nursing was (64.06±14.58) yuan, the actual cost of grade 2 nursing was (40.06±13.49) yuan, and the actual coat of grade 3 nursing was (31.11±5.81) yuan, by statistic analysis, the actual grad-ing nursing costs were significantly different from the current pricing system. Conclusions The grouping of nursing expense ia a difficult point in nursing cost study, and by calculating the actual grading nursing cost, we could develop measures to control the cost effectively. And the grading nursing total coat calculat-ing is the foundation of rational prices setting of grading nursing.