Résumé
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.
Résumé
Objective To investigate the effect of rapid rehabilitation nursing mode on postoperative complications in elderly patients with appendicitis. Methods Forty-eight elderly patients with appendicitis underwent surgery from July 2013 to June 2014 were set as the control group, and another fifty-three elderly patients from July 2014 to June 2015 as observation group. The patients in the control group were treated with routine care while the patients in the observation group with rapid rehabilitation nursing. Operative complications, gastrointestinal tumor recovery and postoperative hospitalization time were compared within one week after the operations between two groups. Result The rates of constipation, abdominal distention, chills and dysuria in the observation group were significantly lower than those of the control and the time of anal first exhaust, defecation and postoperative hospitalization in the observation group were significantly lower or shorter than those in the control group (all P<0.05). Conclusion The rapid rehabilitation nursing mode based on evidence can reduce surgery complications in elderly patients, promoter recovery and shorten hospitalization time.