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Objective To explore the application effect of "Disease-Characteristics Nursing Quality Improvement" Program (DNQIP) based on Kotter's change model in continuous improvement of patients' satisfaction and nursing quality. Methods Applicate Kotter's Change Model to implement DNQIP among 61 wards. The differences of patients' satisfaction and nursing quality among 2012 were compared (DNQIP had not been carried out by the whole hospital), 2014 (DNQIP had been carried out by the whole 61 wards) and 2016 (the 5-year-strategy had been realized). Results The 3-year-scores of patients' satisfaction were(95.94 ± 1.53), (98.18 ± 0.69), (99.43 ± 0.18) points and they were statistically significant (F=31 768.863,P=0.000).The 3-year-scores of nursing quality were (93.96 ± 0.56), (98.56 ± 0.43), (99.62 ± 0.23) points and they were statistically significant (F=3 004.598,P=0.000). The sores of 2014 were statistically improved compared with 2012 and the sores of 2016 were statistically improved compared with 2014 (P＜0.01). Conclusions DNQIP based on Kotter's change model is an effective method to improve the patients′satisfaction and nursing quality.
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Objective@#To explore the application effect of "Disease-Characteristics Nursing Quality Improvement" Program (DNQIP) based on Kotter's change model in continuous improvement of patients' satisfaction and nursing quality.@*Methods@#Applicate Kotter's Change Model to implement DNQIP among 61 wards. The differences of patients' satisfaction and nursing quality among 2012 were compared (DNQIP had not been carried out by the whole hospital), 2014 (DNQIP had been carried out by the whole 61 wards) and 2016 (the 5-year-strategy had been realized).@*Results@#The 3-year-scores of patients' satisfaction were(95.94±1.53), (98.18±0.69), (99.43±0.18) points and they were statistically significant (F=31 768.863, P=0.000).The 3-year-scores of nursing quality were (93.96±0.56), (98.56±0.43), (99.62±0.23) points and they were statistically significant (F=3 004.598, P=0.000). The sores of 2014 were statistically improved compared with 2012 and the sores of 2016 were statistically improved compared with 2014 (P<0.01).@*Conclusions@#DNQIP based on Kotter's change model is an effective method to improve the patients′ satisfaction and nursing quality.
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Objective To learn the efforts made by China′s medical institutions in furthering high-quality nursing services. Methods From June to October 2018, 582 cases were collected regarding" Furthering high-quality medical services" , which ranks one of the ten innovative medical services under China Healthcare Improvement Initiative ( 2018 -2010 ). By means of statistics on the frequency of the subject words in the cases, the authors identified hotspots of these hospitals in this regard, and used descriptive analysis to study the data.Results These keywords were categorized into six aspects, namely, strengthening the construction and management of nursing teams, creating special nursing service programs, creating innovative nursing models, innovating models of continuing care/home care/healthcare plus aging care, improving primary healthcare capabilities relying on medical alliances, and " internet plus nursing services". Conclusions Diversified measures should be taken to make up for the shortage of nursing manpower, strengthen the understanding of the connotation of quality nursing, and improve the nursing management mechanism.
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Objective@#To explore the effect of high quality nursing on the salivary fistula of the patients after parotid tumor operation.@*Methods@#August 2015-2017 June, 60 cases of parotid tumor were selected in our hospital for parotid tumor surgery. According to the nursing intervention methods, the observation group and the control group were divided into the observation group and the control group (n=30). The control group (n=30) was given the routine nursing. The nursing satisfaction of the two groups and the incidence of depression and anxiety before and after nursing. as well as the incidence of postoperative salivary fistula were observed.@*Results@#The total satisfaction degree of nursing in the observation group was 96.67% (29/30), the control group was 76.67% (23/30). The total satisfaction degree of nursing in the observation group was significantly higher than that of the control group, and the difference was statistically significant (χ2=17.311 4, P<0.01). After nursing, the Self-rating Depression Scale (SDS) score and the Self-rating Anxiety Scale (SAS) score of the observation group were 10.35±1.65, 13.56±1.44, which were significantly lower than 21.51±2.49, 30.42±3.58 in the control group, and the difference was statistically significant (t=20.463 5, 23.931 6, P<0.01). After nursing, physical function, cognitive function, emotional function, social function and role function score of observation group were 75.2±6.8, 70.2±7.0, 75.6±5.0, 76.8±7.3, 76.4±7.0, which were significantly higher than 60.7±6.7, 51.6±7.3, 60.8±6.2, 61.3±7.4, 61.1±7.4 of control group, the difference was statistically significant (t=8.167 3-10.177 5, P<0.0). The incidence of salivary fistula in the observation group was 10.00% (3/30) which was significantly lower than 43.33 (13/30) of the control group, and the difference was statistically significant (χ2=28.404 5, P<0.05).@*Conclusion@#The application of high quality nursing in postoperative salivary fistula of parotid tumor patients is significant. It can effectively improve the patients′ unhealthy psychological emotion, improve their quality of life and reduce the incidence of complications, which is worthy of clinical promotion.
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Objective To explore the influence of high quality nursing interventions in patients with pernicious placenta previa and the neonate's prognosis. Methods The clinical data about 28 patients with pernicious placenta previa treated from January 2016 to January 2017 were reviewed;the high quality nursing interventions were applied(study group). 30 patients with pernicious placenta previa treated from December 2014 to December 2015 were selected;the conventional nursing cares were applied (control group). After intervention, the clinical prognosis for the infants and mom was analyzed. Results At the time of admission, the research group of state anxiety and trait anxiety and depression scale scores were 58.42±3.61,55.57±2.69,55.06±2.67,before discharge,patients in the study group,state anxiety and trait anxiety and depression scale scores were 42.19 ±2.16,47.20±2.74 and 44.25± 4.36,the control group were respectively 58.96±3.35,55.27±2.75,55.23±3.12,before discharge respectively 44.35± 3.13, 49.35 ± 3.13, 48.67 ± 5.16, two groups were SAI, TAI and SDS score comparison no statistical significance (t=0.591, 0.420, 0.222, P > 0.05), the difference between the two groups before discharge compared with statistical significance (t=3.038, 2.775, 3.511, P<0.01);the time of termination of pregnancy, postpartum hemorrhage and neonatal postpartum 1min Apgar scores of the study group were 36.15± 0.77,1 000.19 ± 14.21,9.13± 0.10,the control group were 33.50±0.66,1 516.71 ±29.08,8.79± 0.50, and the difference was statistically significant (t=14.102, 32.490, 3.531, P<0.01);comparison of body mass in two groups showed no statistical significance (P>0.05);group of maternal and neonatal complications for a total of 7.14% (2/28), significantly lower than the control group 20.00%(6/30), the difference between significant(χ2=7.050,P<0.01);evaluation of nursing measures of maternal satisfaction in the study group(95.23+4.65)was higher than that of the control group(91.36±5.63),the difference was statistically significant correlation (t=2.842,P<0.05). Conclusions The high quality nursing interventions have an obvious effect in patients with pernicious placenta previa.It can relieve the negative emotions and improve the mom&infant's outcomes and the clinical satisfaction.
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Objective To study the influence of high quality nursing mode on the quality of life in endoscopic retrograde cholangiopancreatography (ERCP) patients. Methods A total of 292 patients with ERCP were randomly divided into control group and observation group with 146 cases in each group by the randomized block design method. The control group was given the conventional nursing care. The observation group was given the high quality nursing care based on the conventional nursing care. The score of Quality of Life of the World Health Organization (WHOQOL- 100), Quality of Life Index of Gastrointestinal Tract (GIQLI), Hamilton Anxiety Scale (HAMA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale(VAS) before and after nursing care were observed and compared. The difference impact of two kinds of nursing mode on nursing quality between two groups was evaluated. Results WHOQOL-100 score in the observation group after treatment, including physiology and psychology and environment and social relations state such as grading, was respectively (59.3 ± 6.0), (61.8 ± 7.2), (60.3 ± 6.2), (62.8 ± 7.3) points and GIQLI index included self-conscious symptom and body physiological status and daily and social activities,such as state of emotional and psychological and the overall score, was respectively (79.8±4.9), (19.8±1.8), (14.7±1.9), (19.2±2.8), (105.7±6.6) points, which was (50.9±6.3), (52.5±6.7), (51.4±5.6), (53.4±7.1), (67.2±4.8), (15.6±1.9), (10.2±1.8), (16.3±2.3), (94.4 ± 6.2) points in control group, the difference between two groups was statistically significantly(t=1.876-2.327, P<0.05). HAMA score and SAS scores and SDS score and VAS score in the observation group after nursing was respectively (24.28 ± 4.78), (29.48 ± 6.54), (30.55 ± 7.32), (4.55 ± 1.18) points and respectively (36.68 ± 5.39), (41.72 ± 6.03), (42.65 ± 7.21), (6.07 ± 1.17) points in the control group, the difference between two groups was statistically significantly(t=2.876-4.012, P<0.05). Conclusions High quality nursing mode of ERCP in patients with perioperative patients of psychological and physiological all have different degrees of improvement and is suitable for popularization and application in clinic.
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Objective To explore the effect of high quality nursing on the negative emotions and the complication in patients with acute leukemia, providing the basis for the clinical nursing work in acute leukemia disease. Methods A total of 94 cases with acute leukemia disease who were treated in the hospital from January 2014 to December 2015 were recruited as the study objects. The patients were divided into the observation group and the control group according to the random digit table method, with 46 cases in each group. The control group was given routine nursing, while the observation group was given high quality nursing. The nursing quality was compared between the two groups, mainly on the scores of the nursing quality, the incidence of postoperative complications, negative emotions and satisfaction of children and their families before and after nursing. Results The comprehensive quality score of nursing in nursing skills, nurses' attitude, ward management and health education in the observation group were significantly higher than that in the control group, and the difference were statistically significant (χ2=17.542- 38.002, P<0.01). The incidences of postoperative complications (infection, phlebitis, hemorrhage, fever) in the observation group were 4.25%(2/47), 2.13%(1/47), 4.25%(2/47), 0,which were significantly lower than those in the control group,17.14%(6/47), 10.64%(5/47), 17.14%(6/47), 6.38%(3/47),and the differences were statistically significant (χ2=3.683-4.021, P<0.05 or 0.01). The scores of negative sentiment in the process of treatment and after the treatment in the observation group were 27.82±7.04, 33.25±8.37,significantly lower than those in the control group, 36.02± 6.81, 45.74 ± 9.13,and the differences were statistically significant(t=3.992, 4.006, P<0.05). The satisfaction of patients and their families in the observation group was 95.74%(45/47),significantly higher than that in the control group, 72.34%(34/47), and the difference was statistically significant (χ2=4.336, P=0.001). Conclusions High quality nursing could reduce the negative emotions and complication of children with the acute leukemia disease effectively, improve the quality of nursing work, and enhance the satisfaction of the family, which had the characteristics of efficiency, scientificalness, rationality and convenience, and has important guiding significance for clinical management of acute leukemia diseases and related nursing work.
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Objective:To construct an integrated medical care service mode in hemodialysis and explore the application effect of the concept of integrated medical service in hemodialysis patients.Methods:In 2016,100 patients who had regular hemodialysis(lasting for more than 3 months) were selected from July to Septembe ras the control group,while another100 patients who had the regular hemo dialysis (lasting for more than 3 months) and received the concept of integrated medical care service were selected from October to December as the observation group.The treatment compliance,the incidence of hemodialysis complications,and patient satisfaction of twogroups were compared.Results:Both the treatment compliance and patient satisfaction of the participants in the observation group were significantly higher than those in the control group (P ＜ 0.05),while the incidence of hemodialysis complications in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion:The implementation of integrated medical careservice concept can fully deepen the service concept of people-oriented and patient-centered,carry out humanized services,improve the treatment compliance of hemodialysis patients,reduce the complications,promote the cooperation of doctors and nurses,enhance the effect of health education,and improve the patient satisfaction.
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Objective To explore the effect of high quality nursing care performing in the operating room and reasonable approach for assessment. Methods Stratified random sampling was used to select 93 nurses from two tertiary hospitals. The task performance and contextual performance was assessed before and after implementing a range of high quality nursing care program. Results The task performance scores and patient care, nursing information, nurse skills dimension scores respectively were 58.59 ±1.77, 19.27±1.16, 19.50±1.11, 19.80±0.70 after the operating room junior high quality nursing service project, which were 37.21 ± 1.92, 5.55 ± 0.86, 13.78 ± 1.12, 17.87 ± 0.98 before the implementation, the differences were statistically significant (t=-82.48--15.15, P<0.01). The performance scores and mutual support between colleagues, work out the extra burden, organizational support dimension scores were respectively 70.43 ± 2.94, 28.23 ± 1.21, 18.52 ± 1.29, 23.67 ± 1.86 after the operating room junior high quality nursing service project, which were 36.20 ± 1.79, 15.52 ± 1.94, 7.33 ± 1.11, 13.34 ± 0.87 before the implementation, the differences were statistically significant (t=-91.99--46.68, P<0.01). Conclusions The high quality nursing care program is a range of nursing service which can advance task performance and contextual performance of nurses in the operating room. Task performance and contextual performance are effective approaches by which high quality nursing care in operating room could be reasonably assessed.
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Objective:To explore the effect of continuous quality improvement theory on patients' satisfaction and nurses'perception of working environment.Methods:Quality nursing service satisfaction survey was conducted in 450 patients,at the same time,100 nurses were investigated for the situation of working environment.Patients' satisfaction and the status of nurses' perception of their own work environment were compared before and after the implementation of continuous quality improvement theory.Results:After the implementation of continuous quality improvement theory,both patients' satisfaction and nurses' perception of working environment were significantly improved (P ＜ 0.05).Gonclusions:Continuous quality improvement theory can improve the satisfaction of patients with high quality nursing service,and enhance the nurses' perception of their working environment.
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An introduction to the Basic service module featuring holistic,full flow and seamless connection built by the hospital.Authors described their experiences in achieving homogenous clinical nursing care,and pointed out that integrating medical humanistic care into the daily nursing process,can improve doctor-patient relationship and patients satisfaction,thus raising medical service quality and efficiency.
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Objective To observe the effect of high quality nursing care on the negative emotion and treatment compliance of patients with leukemia.Methods 116 patients with leukemia in our hospital from January 2010 to April 2014 were randomly divided into study group and control group,58 cases in each group.The control group was given routine nursing measures,and the research group was given high quality care measures based on the control group.Self rating Depression Scale (SDS) and self rating Anxiety Scale (SAS) was used to evaluate the adverse mood changes between the two groups before and after the intervention,and the treatment compliance,nursing satisfaction and the incidence of complications of the two groups were compared.Results After the intervention,SDS and SAS scores of the study group were significantly lower than those of the control group after the intervention,the difference was statistically significant (P＜0.05).The treatment compliance and satisfaction with nursing care of the study group were improved significantly than those of the control group (87.93％ vs 68.97％,96.55％ vs 81.03％),the difference was statistically significant (P＜0.05).The complication rate of the study group decreased significantly than that of the control group (15.52％ vs 31.03％),the difference was statistically significant (P＜0.05).Conclusion High quality nursing for patients with leukemia can significantly improve the psychological status of patients,improve the treatment compliance and nursing satisfaction,the incidence of complications decreased significantly.
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Objective To evaluate the clinical application of high quality for super-selective renal artery embolization (SRAE) in treating bleeding after percutaneous nephrolithotomy (PCNL).Methods 134 patients received percutaneous nephrolithotomy were divided into control group (67 patients) and observation group (67 patients).All of patients with serious bleeding after PCNL were given SRAE in the Second Affiliated Hospital of Kunming Medical College from June 2010 to June 2015.At the same time,we gave high quality nursing to observation group.The patients in control group received routine nursing.The effect of nursing was observed.Results The degree of hematuria disappear of the patients in observation group was higher than that in control group (P＜ 0.05).There were fewer complications in observation group.In the sixth month after discharge,none of them had obvious renal impairment.No recurrence of hematuria,pus kidney and urinary cyst was tested.All cases were satisfied with the treatment.Conclusion It's the key to prevent serious complications and cure successfully with effective and timely supervision and high quality nursing care during the perioperation of SRAE in treating bleeding after PCNL.
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Objective To explore the practical new type of patient information sign on the application effect of pediatric surgical ward. Methods Divided 200 cases of patients in our department into the control group and the observation group according to random number table, there were 100 cases in each group. The control group and the observation group in A and B ward respectively, A ward (control group) used the traditional end of the bed, B ward (observation group) used the new information sign. The incidence rate of adverse events, patients′ families health mission efficiently, satisfaction of patients or medical staff were compared between the groups. Results The incidence rate of adverse events in the observation group was significantly lower than that of in the control group [1%(1/100) vs 8%(8/100),χ2=5.701, P < 0.05]. The effectiveness of health education, satisfaction of patients or medical staff and patients′families to health mission satisfaction in the observation group were significantly higher than that of in the control group [91% (91/100) vs 79% (79/100), 97% (97/100)vs 84% (84/100), 98% (98/100)vs 86% (86/100),the value of χ2 was 5.647,9.828 and 9.783 respectively, P < 0.05)]. Conclusions This new utility model patient information sign by the clinical application effect is satisfied, the head of a bed, cue CARDS unification and standardization of management, and reduced the occurrence of nursing adverse events, which can effectively improve the continuity of care services, the effectiveness of health education and medical, nursing, and satisfaction. Should be used widely in clinical.
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Objective To apply high-quality nursing principles in the nursing education, allow nursing students to adapt to the modern nursing pattern more effectively in the oral and maxillofacial-head and neck oncology ward, and then to evaluate the effect of this application. Methods From June 2013 to March 2014, 60 nursing students had practiced in our department were randomly divided into the control group (30 cases, traditional teaching method) and the experimental group (30 cases, high-quality nursing teaching method). Nursing expertise, nursing procedures, teachers′ evaluation and patients′ satisfaction degree were evaluated. Results The nursing expertise, nursing procedures, teachers′ evaluation and patients′ satisfaction scores was (92.97 ± 5.65), (92.93 ± 4.38), (94.20 ± 2.95), (93.60 ± 3.97) in the experimental group respectively, while in the control group was(87.93 ± 4.62),(87.55 ± 7.54),(89.67 ± 6.21),(89.50 ± 5.80)respectively. All the four evaluation indexes of the experimental group were better than that of the control group(t=-3.78,-3.38,-3.61,-3.20), P﹤0.05. Conclusions Applying high quality nursing care principle in the nursing education allows students to adapt to the modern nursing pattern more quickly, and to establish foundations leading to their future professions.
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Objective To discuss the clinical value of high -quality nursing care in patients with diabetic ne-phropathy .Methods 160 patients with diabetic nephropathy were randomly divided into intervention group and control group, 80 cases in each group .The two groups were received the regular treatment and nursing care of diabetic ne-phropathy, while the intervention group further received high -quality nursing measures.The blood glucose, blood lip-id, renal function, oxidative stress index and SAS score were observed after 6 months.Results The blood glucose, blood lipid, renal function and SAS score index were significantly lower than the control group (p<0.05), and the oxi-dative stress index were improved significantly than that in the control group (p<0.05);Conclusion High-quality nursing intervention can obviously improve the psychological status and therapeutic effect of diabetic nephropathy .
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Objective We aimed to investigate the nurses' ethics cognition status and its influencing factors after carrying out the High quality nursing service demonstration project in Guangxi Zhuang Autonomous Region.Methods From May to June 2014,379 clinical nurses from 59 hospitals of different grades in Guangxi Zhuang Autonomous Region were investigated with the self-designed questionnaire.Results After carrying out the High quality nursing service demonstration project,the total score of the nurses' ethics cognition were (51.29±3.46),which was higher than those in 2010.There was no statistical difference in cognition of medical confidentiality between 2014 and 2010,but it showed significant statistical differences in dimensions of medical optimization,informed consent,the value of life,t value was 11.389,7.448 and 2.126,P ＜0.05.The multiple linear regression analysis showed that nurse-job seniority and hospital hierarchy of clinical nurses were influencing factors of nurses' ethics cognition; educational levels,professional title and nurse-job seniority of clinical nurses were influencing factors of medical optimization; nurses' professional title was influencing factor of informed consent; nurse-job seniority,department and hospital hierarchy of clinical nurses were influencing factors of medical confidentiality; nurses' educational level was influencing factor of life value.Conclusions The High quality nursing service demonstration project contributes to improve the level of nurses' ethics cognition.We should strengthen the nursing ethics continuing education system,in order to improve the nurses' comprehensive ethics cognition.
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Objective:To carry out the service in the oncology by medical volunteers, provide more comprehen-sive and intimate quality nursing services guidance with nursing staff together for cancer patients. Methods:Making the medical volunteers service application system, service process and service standards. According to the patients to nursing job satisfaction questionaire by a third party, through telephone follow-up forms, carry out the satisfac-tion survey. Combined with their own advantages of TCM medical volunteers, to carry out the diet instruction, psy-chological counseling, massage, warm room service, telephone return services such as ward, score of life quality of tumor patients on admission and after the volunteer service. Results:Ward accompanying rate dropping, increasing patient satisfaction with nursing service, improving the degree of identification of volunteer service, tumor patients and improving the quality of life, and is conducive to building a perfect medical students social practice platform. Conclusion:Volunteer services improve the quality of nursing service, cultivating a correct outlook on life, values and morality of medical volunteers, strengthening medical volunteer service consciousness, achieving win-win for patients, departments, volunteers.
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Objective To understand patients' needs of health education and explore the information nursing health education model through investigation of the inpatients' health education need.Methods Inpatients in department of neurology were investigated by a self-designed questionnaire that involved 21 items.171 copies of effective questionnaires were collected and went through analysis.Results 61.99 percent of patients pointed out that nurses didn't understand their need for health knowledge.47.95 percent of nurses had never asked patients how they felt about hospitalization before health education.Television was the main channel to get knowledge about health for patients,but the patients believed that the health knowledge from healthcare workers was the most reliable way.Conclusions To carry out targeted and information nursing health education integrated with psychological nursing can promote health education work.
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Since 2010,the activities of high quality nursing service demonstration project were carried out in the national health system,its main purpose is to strengthen the nursing foundation,and provide satisfactory service.By conducting these activities,significant achievements have been made,such as improved nursing quality,reduced nurse-patient disputes.However,in the process of implementation,there are stillsome problems for us to think about and solve.In this paper,there is a brief commentary about the results of high quality nursing implementation and related issues.