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find Keyword "日间手术" 205 results
  • Application effect of refined management in day surgery based on diagnosis-related groups

    Objective To evaluate the refined management effect of diagnosis related groups (DRG), summarize the experience of refined management, and put forward corrective measures for existing problems. Methods Patients who underwent day surgery services at Shantou Central Hospital between April 2021 and March 2023 were selected. According to the management mode, patients will be divided into a conventional management group (April 2021 to March 2022) and a refined management group (April 2022 to March 2023). The general condition, medical quality, and patient satisfaction indicators of two groups of patients were compared. And according to the DRG group stratification, the differences in medical indexes such as length of hospital stay, total hospitalization expenses, and postoperative complications between the two groups were analyzed. Results A total of 4 584 patients were included, including 1 686 in the conventional management group and 2 898 in the refined management group. There were statistically significant differences between the two groups in terms of patient source, surgical grade, and provincial weight coefficient (P<0.05). However, there was no statistically significant difference in gender, age, and discharge method (P>0.05). The satisfaction of the refined management group with surgical procedures, preoperative guidance, service attitude, and nursing skills was higher than that of the conventional management group (P<0.05). A total of 4 DRG groups (≥ 100 patients) were included, with 2 215 patients in the refined management group and 1 460 patients in the conventional management group. Among them, there were 1496 cases in the group CB39 (cataract surgery), 336 cases in the group GE10 (inguinal and abdominal hernia surgery, age<17 years old), 1412 cases in the group JB29 (partial mastectomy for non-malignant breast tumors), and 431 cases in the group NE19 (vulvar, vaginal, and cervical surgeries). Among them, in the group CB39 (cataract surgery), group GE10 (inguinal and abdominal hernia surgery, age<17 years old), group JB29 (partial mastectomy for non-malignant breast tumors), and group NE19 (vulvar, vaginal, and cervical surgeries), the total hospitalization cost and length of stay in the refined management group were lower than those in the conventional management group (P<0.05). In the group CB39 (cataract surgery) and group NE19 (vulvar, vaginal, and cervical surgeries), the incidence of postoperative complications in the refined management group was lower than that in the conventional management group (P<0.05). In the group GE10 (inguinal and abdominal hernia surgery, age<17 years), the incidence of pain and incision bleeding in the refined management group was lower than that in the conventional management group (P<0.05); In the group JB29 (partial mastectomy for non-malignant breast tumors), the incidence of incision infection in the refined management group was lower than that in the conventional management group (P<0.05). There was no statistically significant difference in other indicators between the two groups (P>0.05). Conclusion Carrying out refined management for day surgery can reduce medical expenses, shorten the length of hospital stay, improve medical quality, and promote the high-quality development of hospitals while ensuring medical safety.

    Release date:2024-12-27 02:33 Export PDF Favorites Scan
  • Application of quality control management based on clinical pathway in orthopaedic day surgery

    ObjectiveTo explore the application of clinical pathway in patients undergoing orthopedic day surgery.MethodsPatients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2020 were selected as the clinical pathway group, and all of them were managed by clinical pathway. Patients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2019 were selected as the routine group, and all of them were managed by conventional clinical methods. The general conditions of patients, physicians’ work efficiency, medical costs and medical quality were compared between the two groups.ResultsThe clinical pathway group included 246 patients, and the routine group included 391 patients. There was no significant difference in gender, age or disease distribution between the two groups (P>0.05). Compared with the routine group, the clinical pathway group had obvious advantages in terms of average time spent by a physician in issuing a medical order each time [(5.64±3.29) vs. (2.12±1.05) min], average number of revisions per physician’s order (1.40±0.24 vs. 0.38±0.19), rate of filing medical records within 3 days (90.28% vs. 97.97%), hospital costs [(7462.10±1035.01) vs. (6252.52±1189.05) yuan], drug costs [(652.21±88.53) vs. (437.17±108.20) yuan], length of stay [(1.23±1.04) vs. (1.02±0.18) d] and delayed discharge rate (7.93% vs. 2.03%), with statistically significant differences (P<0.05). There was no significant difference between the two groups in terms of unplanned reoperation rate, unplanned rehospitalization rate, or patient satisfaction (P>0.05).ConclusionCompared with routine clinical management, clinical pathway management can improve work efficiency, reduce medical cost and improve medical quality more effectively in the implementation of orthopedic day surgery, which has very positive effects and is worthy of promotion and application.

    Release date:2021-03-19 01:22 Export PDF Favorites Scan
  • 膝关节镜日间手术卫生经济学效果分析

    目的 通过回顾性比较膝关节镜日间手术与非日间手术模式的卫生经济学相关指标,评价膝关节镜日间手术运行模式的卫生经济学效果。 方法 选择2014年8月-2015年6月行膝关节镜手术治疗的232例患者,将采用膝关节镜日间手术的138例患者作为日间组,同期在普通病房行膝关节镜手术治疗的94例患者作为非日间组,比较两组患者的平均住院费用、药费、材料费、治疗费、等候手术时间、平均住院时间、满意度和并发症发生率等指标。 结果 非日间组患者的平均满意度为94.89%,日间组患者的平均满意度为96.27%。日间组患者的平均总费用、药费、材料费和治疗费明显低于非日间组,两组差异有统计学意义(P<0.05)。非日间组患者的平均等候手术时间为(2.37±1.77)d,平均住院时间为(5.22±2.49)d;日间组患者当日住院当日手术,平均等候手术时间为0 d,平均住院时间为1 d。两组患者的等候手术时间和平均住院时间比较差异有统计学意义(P<0.05)。两组患者的并发症发生率比较差异无统计学意义(P>0.05)。 结论 膝关节镜日间手术与非日间手术相比,日间手术在提高床位周转率、医疗资源的利用率及大幅度降低住院费用方面具有明显的优势。

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  • Management experience of day surgery in children’s hospital

    ObjectiveTo explore the management experience of day surgery in children specialized hospitals.MethodsWuhan Children’s Hospital began one-day pediatric surgery in 1981. In 2001, one-day surgery center was formally established to centralize treatment and management. In the past three years, the mixed management of centralized and decentralized treatment was increased. At the same time, the one-day surgery management process was optimized, the relevant access and evaluation system was strictly implemented, to ensure the medical quality and medical safety.ResultsSince 2001, more than 120 000 cases of day surgery had been performed in the hospital, without death or other serious complications. The incidence of common postoperative complications was less than 0.8%, and the time of occurrence of complications was mainly within 12 hours after surgery. By 2018, the number of day surgeries in the hospital accounted for 29.57% of the annual elective surgeries, and the overall incidence of complications was lower than the traditional hospitalization mode of the same disease.ConclusionsThe concept of patient-centered service is truly embodied in day surgery. Specialized hospitals, especially children’s hospitals, have a large number of single diseases, a large demand for patients’ surgeries, a high degree of homogeneity of surgeries, good surgical results, and urgent needs and advantages to carry out day surgery. Day surgery is suitable to start in developed departments, and be promoted in other specialties of the hospital when experience has been accumulated, so as to increase the proportion of day surgery in elective surgery gradually.

    Release date:2019-02-21 03:19 Export PDF Favorites Scan
  • Application of Personalized Health Education in Patients Undergoing Day Surgery

    ObjectiveTo carry out health education to day surgery patients, assist the smoothness of their operation, promote early recovery of patients and improve the quality of nursing and patients' degree of satisfaction. MethodsA total of 1 888 operations from January to May, 2013 were chosen to be the control group; and 2 136 operations from January to May, 2014 were regarded as the trail group. Patients in the control group accepted routine nursing and health education, while patients in the trail group accepted health education before and after surgery, and through telephone during the follow-up period. ResultsThe rate of failure to keep the appointment, the readmission rates, and the satisfaction rate to the nursing work were 0.28%, 0.94% and 94.71% respectively in the trial group, while were 3.50%, 3.07%, and 90.20%, respectively in the control group. the differeces between the two groups were significant (P<0.05). ConclusionPersonalized health education can ensure the smooth operation of day surgery, advance wound healing of the patients, and improve the day surgery ward care quality and patient satisfaction.

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  • Experience sharing of building functional modules of day surgery information management

    With the rapid development of day surgery mode in China, day surgery management has shifted from extensive to refined, but there are still many problems in the information system of day surgery in Chinese hospitals. The Second Affiliated Hospital Zhejiang University School of Medicine has developed a day surgery information management system since 2018, established a pre-hospital and in-hospital day surgery ecological management, and integrated daily management concepts and management rules into the system through the whole-process information management. It realized the whole process, full data, closed-loop and path-based information management of day surgery. This paper introduces the day surgery information management system of the Second Affiliated Hospital Zhejiang University School of Medicine, and aims to share the experience of building the day surgery information management function module.

    Release date:2022-03-25 02:32 Export PDF Favorites Scan
  • 两种床位预约模式对眼科日间手术患者到达医院后取消手术的影响分析

    目的 探讨病房护士轮班的床位预约模式和专人专岗床位预约模式对眼科日间手术患者到达医院后取消手术的影响因素,以提高日间手术患者的入住率。 方法 将2014年5月-8月实施病房护士轮班的床位预约模式预约了日间手术,到达医院后取消了手术的患者作为对照组;2015年5月-8月实施专人专岗床位预约模式预约了日间手术,到达医院后取消了手术的患者作为观察组。对两组患者临床资料进行统计分析。 结果 2014年5月-8月实施病房护士轮班的床位预约模式预约日间手术患者2 581例,手术1 679例,取消手术902例,其中到达医院后取消手术(对照组)患者297例,占预约总数的11.51%。2015年5月-8月实施专人专岗床位预约模式预约日间手术患者1 813例,手术1 705例,取消手术108例,其中到达医院后取消手术(观察组)58例,占预约总数的3.20%。两组患者到达医院后取消手术占预约总数的百分比比较,差异有统计学意义(P<0.05)。眼科日间床位预约患者到达医院后取消手术的主要原因是血糖未控制在正常范围,其他原因为术前未按医嘱使用抗生素眼药、术前检查不完善、未按医嘱禁食禁饮。观察组患者因血糖未控制在正常范围、术前未按照医嘱使用抗生素眼药、术前检查不完善、未按医嘱禁食禁饮而取消手术的比例与对照组比较差异有统计学意义(P<0.05)。眼科日间手术患者到达医院后取消手术的病种主要集中在白内障和眼底病,观察组患者取消手术的病种与对照组比较均有差异(P<0.05)。 结论 专人专岗床位预约模式优于病房护士轮班床位预约模式。设置专人专岗位完成床位预约,能有效减少手术的取消,提高病床使用率,为患者提供同质化的院前指导,提高患者及家属完成术前准备的依从性,改善患者住院体验。

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  • Application of quality control circle in reducing temporarily stopping rate of day surgery

    ObjectiveTo investigate the effect of quality control circle (QCC) activity in reducing the temporarily stopping rate of day surgery.MethodsThe QCC activity was carried out from December 2018 to October 2019. By determining the theme of the activity and drawing up the plan, a retrospective analysis of pre-hospital day surgery stoppage status and reasons was performed based on 2 696 patients who had reserved surgery in the day surgery center from December 2018 to February 2019. Based on the data, the goal was determined, and measures were developed and confirmed from May to August 2019. Then the measures were standardized and implemented continuously from September to October 2019. The rate of surgical cessation before the implementation of the measures (from December 2018 to February 2019) was compared with that after the implementation of the measures (from September to October 2019).ResultsAfter the QCC activity, the temporarily stopping rate decreased from 2.89% to 1.34%, and the difference was statistically significant (P<0.001).ConclusionThe QCC activity can effectively reduce the temporarily stopping rate of day surgery, and lay the foundation for continuously promoting the optimization of day surgery resources and quality improvement.

    Release date:2020-03-25 09:12 Export PDF Favorites Scan
  • Expert consensus on the management model of integrating emergency and routine medical care in day surgery wards

    Day surgery wards have advantages such as the ability to quickly free up beds and possessing necessary medical resources, making them a focal department for the integration of emergency and routine medical care within healthcare institutions. The Day Surgery Nursing Committee of Sichuan Tianfu New Area Medical Association gathered experts from relevant fields, took into account the actual situation and previous practices of integrating emergency and routine medical care in day surgery wards, and developed this expert consensus. It covers the aspects of emergency plans, process mechanisms, spatial preparations, personnel preparations and deployment, material preparations, and information sharing and coordination of the management model of integrating emergency and routine medical care in day surgery wards, so as to provide professional guidance and references for the management model of integrating emergency and routine medical care in day surgery wards, and offer new ideas and methods to maximize patient treatment during emergency situations.

    Release date:2024-02-29 12:03 Export PDF Favorites Scan
  • Perioperative analgesia management standard for day surgery in West China Hospital of Sichuan University

    In recent years, day surgery has developed rapidly in China, but there is still a certain gap between domestic and international fields. The whole-process perioperative analgesia management standard is one of the necessities to ensure the rapid recovery and timely discharge of patients undergoing day surgery, and it is also an effective driving force to narrow the gap between domestic and international day surgery management. Based on the clinical experience of perioperative analgesia management for day surgery patients in West China Hospital of Sichuan University, this paper summarizes the implementation strategies, quality control of perioperative analgesia management and the construction of painless day surgery ward, and formulates the perioperative analgesia management standard for day surgery, which will provide a reference for the perioperative analgesia management for day surgery in China.

    Release date:2023-02-14 05:33 Export PDF Favorites Scan
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