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Objective To evaluate the application effect of standardized communication mode, which was based on the situation, background, assessment and recommendation (SBAR communication mode), in interventional ward. Methods SBAR communication mode was implemented in interventional ward. Through the discussion of doctors and nurses, the SBAR communication template of common symptoms of specialized diseases was revised. The training, examination, utilization and evaluation of the SBAR communication template were conducted for all nurses. The medical adverse events caused by poor medical and nursing communication, the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction with nurses were recorded before and after the implement of SBAR communication mode, and the results were compared. Results After the implementation of SBAR communication mode, both the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction degree with nurses were significantly improved, the differences were statistically significant (P<0.05); and the incidence of medical adverse events caused by poor medical and nursing communication was remarkably decreased, the difference was statistically significant (P<0.05) . Conclusion The implementation of SBAR communication mode in the intervention ward can significantly improve the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction degree with nurses, and decrease the incidence of medical adverse events caused by poor medical and nursing communication, thus, the safety of patients can be guaranteed, meanwhile, the establishment of a harmonious medical and nursing team is promoted.
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Objective To make a further recognition of the real quality of life of post-discharge patients who carry a percutaneous transhepatic biliary drainage (PTBD) tube due to malignant obstructive jaundice in order to formulate the corresponding scheme of health education and continued nursing. Methods By using qualitative research with phenomenological method, the interventional specialized nurse made a indepth interview with the post-discharge patients who carried a PTBD tube due to malignant obstructive jaundice. Colaizzi seven-step analysis method was adopted to collate and analyze the clinical data. Results A total of 10 patients were finally enrolled in this study. The main considerations of patients carrying a PTBD tube in daily life included the changes of self-care ability in daily life, intensification or absence of a patient's role; worrying about prolapse and infection of the tube; disordered self-image and social phobia; different degrees of physical discomfort and negative emotion with psychological pressure; hoping improvement of the drainage bag and fixed materials and way; hoping more convenient way of dressing, etc. Conclusion The post-discharge patients carrying a PTBD tube live in different levels of stress. The medical staff should carry out targeted health education and extension care to help them and make research to improve equipment, so as to improve self-care ability, reduce complications as well as psychological pressure, thus, to improve the quality of life.
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Objective To investigate the clinical value of continuity nursing model in caring patients with malignant obstructive jaundice treated with percutaneous transhepatic biliary drainage (PTBD).Methods A total of 120 patients with malignant obstructive jaundice treated by PTCD were enrolled in this study.The patients were divided into the control group (n=60) and the observation group (n=60).Routine discharge guidance and health education was conducted for the patients of control group,while for the patients of observation group,in addition to conventional discharge education,the continuity nursing was executed by the responsible nurse.Continuity nursing was meant to continue the service,to guide the observation of the wound and dressing change,the observation of the quantity and quality of drainage solution,to teach the knowledge of the management of PTCD catheter as well as its complications,to guide patient's diet and rest,and to establish the continuity nursing records.Results The patients of both groups were followed up for 3 months.The patients' awareness rate of the knowledge related to PTCD tube in the observation group was significantly higher than that in the control group.The wound infection rate,the rate of PTCD tube prolapse or blockage,and the tube-related re-hospitalization rate in the observation group were strikingly lower than those in the control group (P＜0.05).Conclusion The continuity nursing model can significantly improve patients' awareness rate about the knowledge related to PTCD tube,reduce the incidences of biliary tract infection,PTCD tube prolapse or blockage,wound infection,and tube-related re-hospitalization,therefore,the quality of life can be surely improved.
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Objective To discuss the clinical application of the nursing management mode of doctornurse same group responsibility system in treating patieuts who are receiving transjugular intrahepatic portosystemic shunt (TIPS).Methods A total of 70 TIPS patieots,who were admitted to a certain level Ⅲ hospital during the period from January 2016 to December 2016,were enrolled in this study.Using the table of random number,the patients were equally divided into the control group and the study group with 35 patients in each group.Traditional nursing group management mode was adopted in the control group,while doctor-nurse same group responsibility system was carried out in the study group (including the hospitalization period and the follow-up visit after discharge).Complications during hospitalization,postdischarge incidence of hepatic encephalopathy,readmission rate,and patient's satisfaction with medical staff were calculated,and the results were compared between the two groups.Results After the implementation of doctor-nurse same group responsibility system,the post-TIPS complications,the post-discharge incidence of hepatic encephalopathy and the readmission rate were significantly decreased and the patient's satisfaction with medical staff was remarkably improved,the differences were statistically significant (P＜0.05).Conclusion The implementation of doctor-nurse same group responsibility management mode for TIPS patients in the interventional ward can effectively reduce postoperative complications,post-discharge incidence of hepatic encephalopathy and the readmission rate,meanwhile,the patient's satisfaction with medical staff are obviously improved.Therefore,the implementation of doctor-nurse same group responsibility management mode for TIPS patients is of great value in clinical practice.