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The rapidly aging society gives rise to sizable demands for chronic disease nursing care. With IT development as backup, the hospital has developed a platform for regional collaborative nursing informationization within a medical alliance and a health management platform for home care of the elderlies. This practice can build an extended nursing care model, featuring the three main service lines of " hospital-family, hospital-medical alliance and hospital-community hospital-family". The model provides diversified, personalized, disease specific, informationization and multi-disciplinary coverage for nursing care, providing the primary level with high quality nursing resources.Medical alliances and corresponding communities share information, for a full-range, full region and full timeframe coverage of nursing health supervision and scientific guidance, thus effectively minimizing the rate of revisit to upper-level hospitals by patients and implementing the hierarchical medical system.
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Objective@#To evaluate the effects of extended nursing mode on the asthmatic children with allergic rhinitis (AR).@*Methods@#Totally116 children aged 6-14 years old with asthma and AR were enrolled to this study from November 2015 to October 2016 in our hospital. They were divided into the regular nursing group and the extended nursing group according to the voluntary principle. The patients in regular nursing group were received routine nursing care in or out of hospital, while the patients in extended nursing group received extended care besides routine nursing. The children were required to record diary about asthma and AR And participate in asthma action projects. Before and after intervention we observed the quantitative score of symptoms and signs, the times of acute attack, the times of oblivion medication, the average days of stay in hospital, the days of fail to School or kindergarten, the lung function and the fractional exhaled nitric oxide (FeNO) in children with asthma and AR within 1 year. These above marks were assessed five times respectively at starting (baseline) , 3 months, 6 months, 9 months and 12 months (1 year) The differences between two groups were compared with appropriate statistical methods.@*Results@#1 year later, out of 58 cases in extended nursing group, 40 patients (68.97%)were in good control and 18 cases (31.03%) in partial control. Out of 58 cases in regular nursing group, 22 cases (37.93%) were in good control and 36 patients (62.07%) in partial control. There were significant differences between two groups in the effect of disease (χ2=11.23, all P<0.01), the experimental group was significantly better than the control group. The symptoms and signs of allergic rhinitis average scores in regular nursing group were 1.88 ± 0.72, extended nursing group were 0.79 ± 0.71, the difference was statistically significant (t=8.080, P<0.01) with the extended nursing group much better that the regular nursing group. The symptoms and signs of asthma average scores in regular nursing group were1.83 ± 0.75, extended nursing group were 0.88 ± 0.67, the difference was also statistically significant (t=7.133, P<0.01) with the extended nursing group much better that the regular nursing group. In extended nursing groups within 1 year the numbers of acute attack (0.60±0.59), the times of oblivion medication (11.05±7.40), the average days of stay in hospital (8.83±2.79) days,the average days of failing to school or kindergarten (8.69±5.46) days, while in regular nursing group within 1 year the numbers of acute attack(2.94±1.52), the times of oblivion medication (35.28±8.84), the average days of stay in hospital(20.95±5.46 days), the average days of fail to school or kindergarten(24.72±5.92) days, the differences were also statistically significant (t=10.50-15.87, P<0.01). The lung function in extended nursing group (PEF: 82.02±6.04, FEVI: 88.19±5.10, FEV25: 80.67±4.88, FEV50: 80.07±3.73, FEV75: 81.52±3.85) and in regular nursing group (PEF: 79.02±6.12,, FEV1: 80.52±4.72, FEV25: 75.05±7.79, FEV50: 77.59±4.60, FEV75: 78.41±4.19) . The differences were also statistically significant (t=2.90-6.15, P<0.01).The FeNO(13.66±2.87) ppb in extended nursing group and (14.95±3.12) ppb in regular nursing group. There were statistical significant differences between the two groups (t=2.30, P<0.05) with extended nursing group much better than regular nursing group.@*Conclusion@#The effect of extended care group is better than that of regular nursing group, and extended care is much more benefit to control asthma and allergic rhinitis in children.
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Objective To evaluate the effect of individualized rehabilitation extended nursing on activities of daily living (ADL) in children with cerebral palsy. Methods A total of 156 cases of non-operative children with severe disorder of cerebral palsy from January to December 2017 in Sichuan 81 Rehabilitation Center, of 101 males and 55 females, aged 2-7 years with weighting 9 to 21 kg, were divided into 2 groups according to the time sequence, of which 70 cases of January to June 2017 before extension nursing as control group and 86 cases of July to December 2017 after extension nursing as observation group. The control group was received routine nursing according to the ADL rating scale, and the observation group was adopted the extended nursing method, according to the ADL rating scale to evaluate and judge the barrier grade, and chosen the suitable measures for rehabilitation nursing according to the individualized principle.The rehabilitation assessment was carried out before extended nursing (W0), the second week after extended nursing (W2), fourth week (W4), sixth week (W6), eighth week (W8), tenth week (W10), and twelfth week (W12) respectively. Results There was no significant difference in gender, age, weight and ADL scores at the time point of W0between the two groups (P>0.05). The ADL scores of the two groups were increased with the treatment time, and the increase of the observation group was greater than that of the control group. Compared with the control group, the ADL scores of the observation group were increased significantly at the time of W4to W12(P<0.01).After 12 weeks of treatment, there were 25 cases of mild disorders (29% ), 46 cases of moderate disorder (53.5% ) and 15 cases of severe disorder (17.5% ) in the observation group, and 3 cases of mild disorders (4.3% ), 38 cases of moderate disorder (54.3% ) and 29 cases of severe disorder (41.4% ) in the control group, and the observation group was obviously better than that of the control group (χ2＝21.083,P＜0.01). Conclusion Individualized rehabilitation extended nursing can improve ADL in children with cerebral palsy.
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Objective To establish an extended nursing service model for intravenous treatment in outpatient,so that patients with venous catheters nearby can receive catheter maintenance,which can reduce the medical cost and the incidence of complications during the maintenance of the catheters.Methods A three-level network of catheter maintenance was established in the area to evaluate the rate of return maintenance and the incidence of complications [catheter-related infection,medical adhesive-related skin injuries (MARSI) and catheter blockage] during catheterization.Results The rate of patient return maintenance as statistically signif-icant between the first half of 2015 and the second half of 2016 (60.0％ vs.29.7％,P=0.000).Compared with the first half of 2015,the incidence of catheter-related infections decreased in the second half of 2016 from 8.6％ to 3.3％,the incidence of MARSI decreased from 29.7％ to 10.1％,and the incidence of catheter blockage decreased from 8.5％ to 0.6％.(All P =0.000).Conclusion The comprehensive extended service mode for outpatient with venous catheters can reduce the incidence of complications during catheter maintenance,which can reduce the workload of outpatient intravenous treatment and also provide patients the convenience of catheter maintenance,and is worthy of clinical promotion.
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Objective To investigate the effects of extended nursing based on relationship, information and management on the self-care behaviors of patients with heart valve replacement. Methods According to admission time, 37 patients with heart valve replacement were set as the control group, which was given routine nursing intervention and another 42 patients as the study group, which received extended nursing based on the trinity of relationship, information and management 2~8 weeks after discharge. Before and after intervention, patients were evaluated by using the improved version of self-care behavior evaluation scale of heart disease (SNBAOHD). Result There were significant differences between the two groups in other items of SNBAOHD, except two items of low salt diet and medication (P<0.05). Conclusions Extended nursing after discharge based on the trinity of relationship, information and management can help the patients to be continuously cared. In this case, it is effective for the enhancement of off-hospital self-care ability and prevention of disease relapses.
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Objective To explore the effect of extended nursing mainly by stoma therapists on the self-care ability of permanent colostomy patients group.Methods Seventy-eight patients with permanent colostomy were equally randomized by random digits table into control group and observation group.The former received routine discharge education by duty nurses and the latter the extended nursing mainly by stoma therapists. Three months after discharge,the exercise of self-care agency scale (ESCA) was used to conduct the assessments for comparisons of two groups.Result The score on ESCA in the observation group was significantly higher than that of the control group (P<0.01).Conclusion The extended nursing mainly by stoma therapists can improve colostomy patients’quality of life effectively and help them more knowledgeable about the stoma knowledge and skills to enhance self-care ability.
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ObjectiveTo explore the effects of extended nursing intervention (ENI) in nursing ability of discharged patients with intubation of T-tubes.Methods Eighty-two patients with biliary diseases discharged with intubation of T-tubes were equally divided into two groups.The patients in the experiment group were treated with ENI and those in the control group were treated with conventional nursing.Each group received routine nursing and health education before discharge.All patients were followed up by a self-designed written questionnaire.Data regarding patients’ compliance behavior,knowledge of the diseases and satisfaction were collected and analyzed.Result Significant differences were observed between the two groups,the patients in the experiment group exhibiting better compliance behavior,their knowledge of their diseases improved and the rate of satisfaction higher (P<0.05). Conclusion ENI may be effective for the discharged patients with intubation of T-tubes to improve their compliance behavior, enhance their knowledge of their diseases and raise the rate of satisfaction.
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Objective To study the effect of extended nursing on puerperal melancholia incidence.Methods Two hundred perpetrates received interventions of extended nursing after delivery,including education about puerperal state,turning on hot line and creation of QQ group,follow-ups and supporting from family members.Result The incidence rate of puerperal melancholia since performance of extended nursing was significantly lower than what is after its performance(P<0.01).Conclusions The extended nursing can help perpetrates to receive nursing knowledge,alleviate their anxiety,strengthen the confidence to take care of baby.As the result,it can reduce the incidence of puerperal melancholia.