通过对1999年1月至2007年8月,肝移植病人术后门诊复查的情况做一总结,通过护理干预,使病人复查得到极大方便,并拓展了护理工作领域,提高了门诊护理工作的质量,并提升了医院的形象。
The annual incidence of diabetic foot ulcers in China is as high as 8.1%, which ranks first among the causes of chronic wounds in China. Although through the efforts of several generations of podiatrists and the building of multidisciplinary collaboration team, the major amputation rate in patients with diabetic foot ulcers in China has been decreased significantly, it is still far higher than the level of developed countries in Europe and the United States. Therefore, in order to cope with the increasing occurrence and recurrence of refractory diabetic foot ulcers, in addition to further optimizing the construction of multidisciplinary collaboration team, it is an urgent topic for us to explore the construction of a multidisciplinary integrated team to seamlessly connect the diagnosis and treatment of different aspects of foot disease. This article describes the importance and necessity of building a wound repair center with Chinese characteristics, which is a model of multidisciplinary integrated team, aiming at provide a theoretical basis for establishing a multidisciplinary integrated management model and realizing seamless connection between diagnosis and treatment, so as to further improve the cure rate of diabetic foot ulcers.
Ambulatory surgery ward is a fast and effective way of treating, nursing and patients’ education. We report the practice of ambulatory surgery ward in West China Hospital of Sichuan University about patients’ reception, treatment and nursing, medical safety, health education and post-operative follow-up. Results show that ambulatory surgery ward would guarantee patients’ safety, shorten hospitalization days and decrease medical cost, with more than 98% of patients’ satisfaction.
Objective To understand the incidence and severity of postoperative acute pain in patients undergoing day surgery, and to explore the influencing factors of moderate to severe pain after surgery, so as to provide a reference for pain management in day surgery. Methods Convenience sampling method was used to select patients undergoing day surgery under multi-modal pain management in West China Hospital of Sichuan University between April and August 2020, and the general conditions, surgical conditions, and postoperative pain of the patients were investigated. According to the degree of postoperative pain, patients were divided into mild pain group and moderate to severe pain group. Logistic regression analysis was used to explore the influencing factors of postoperative pain in the two groups. Results A total of 509 patients were finally included, of which 69 patients presented with moderate to severe pain. Logistic regression analysis showed that patient age [odds ratio (OR)=0.970, 95% confidence interval (CI) (0.946, 0.993), P=0.012], pain threshold [OR=1.348, 95%CI (1.048, 1.734), P=0.020] and postoperative drainage tube [OR=2.752, 95%CI (1.090, 6.938), P=0.017] were the influencing factors of moderate to severe pain after surgery. Conclusion Under multimodal pain management, the incidence of moderate to severe pain in day surgery patients is low, and medical staff should further strengthen pain management from the factors affecting pain to reduce the incidence of moderate to severe pain after surgery.
Objective To explore the application effects of innovative health education on patients undergoing ambulatory laparoscopic cholecystectomy (LC). Methods A total of 139 patients undergoing ambulatory LC from November to December 2016 were selected as the control group, receiving the traditional health education; and other 141 patients undergoing ambulatory LC from February to March 2017 were selected as the observation group, receiving the innovative health education. The two groups were followed up and observed 1 day, 2, and 28 days after the discharge, and the incidence rates of adverse reactions such as postoperative pain, bleeding and incision infection were measured, and the disease knowledge mastery, self-care skills, medication compliance and satisfaction to nursing and hospital were evaluated. Results The total incidence rate of adverse reactions was 7.8% in the observation group and 25.2% in the control group (P<0.001). Medication compliance from high to low was 90, 46 and 5 cases in the observation group and 59, 64 and 16 cases in the control group (P<0.001). In the observation group, the scores of disease knowledge mastery, self-care cognition, nursing satisfaction and hospital satisfaction were 93.4±5.5, 91.4±4.5, 96.4±3.7 and 98.1±3.7, respectively, which were higher than those in the control group (83.8±8.7, 83.2±9.1, 91.5±9.2 and 94.8±7.3, respectively) with statistical significance (P<0.001). Conclusion Innovative health education has certain application effects on ambulatory LC, and it can significantly improve disease knowledge mastery and self-care cognition, and help to ensure the medical quality and safety during perioperative period, and improve the patients’ satisfaction.
ObjectiveTo establish a systematic, scientific, and sensitive index system to provide a scientific basis for quality evaluation and comprehensive quality management of day surgery nursing.MethodsThe databases of Wanfang, China National Knowledge Infrastructure, CQVIP, PubMed, and Web of Science were searched. The retrieval time was from the establishment of the databases to 15th July, 2019. Based on the “structure-process-outcome” management model, Delphi method was used to conduct two rounds of expert consultation for nursing experts related to day surgery in five tertiary hospitals. The results of the consultation were sorted out and the consensus of experts was obtained, so as to determine the quality-sensitive indicators of day surgery nursing.ResultsA total of 20 nursing experts participated in the questionnaire survey. The final evaluation indicators determined by expert correspondence included 1 structural indicator, 9 process indicators, and 4 outcome indicators.ConclusionsThe construction of quality evaluation standard of day surgery nursing not only embodies the connotation of nursing management of day surgery, but also puts forward clear requirements and quality standards for specialized nursing management. It has high reliability, scientificity, and strong operability, which can effectively improve the quality of nursing management and service level of day surgery.
The Wound Care Center of West China Hospital of Sichuan University is motivated by professional and high-quality solutions to patients’ wound problems. It has explored and carried out a variety of wound treatment modes, such as wound care specialist clinic, wound nursing expert clinic, integrated wound multiple disciplinary team clinic and complex and difficult wound consultation. Under the multi-mode management of wound treatment, patients with all levels and all types of wounds are treated in an orderly manner, which has effectively promoted the development of wound care to a deeper level, a wider range and a higher level. This paper introduces the experience of multi-mode wound treatment in Wound Care Center from the aspects of organizational structure and treatment process, wound outpatient management, wound treatment competence matching and multi-mode operation. The purpose is to provide a reference for the management of related departments in similar hospitals.
To retrospectively summarize the medical rescue organization and strategy of West China Hospital medical team during the Wenchuan earthquake so as to provide reference for rescue practice in the future. We emphasize that the key point to improve the efficiency of rescue is scientifically assigning and util izing medical resource according to the demand at the actual locale of the earthquake and the characters of various stages of the earthquake .
By learning the nearly ten years’ experience and summaries in day surgery, West China Hospital of Sichuan University drafts a series of standards for day surgery management. This article mainly introduces the pre-administration management standards of West China Hospital of Sichuan University, involving: standards for the management of surgeons, nurses, patients, and the type of operation; standards for pre-administration work procedure; standards for pre-administration health education; standards for appointment, scheduling, and coordination for day surgery; and standards for surgery notification. This paper aims to share experience with peer professionals, and provide theoretical basis and practical guidance for the standardization and development of day surgery, as well as the establishment of a safe day surgery management system.
Objective To discuss the running effect of the modified hospital-community integrated two-way-referral service mode in day surgery. Methods The hospital-community integrated two-way-referral service mode in day surgery was built in May 2014 by our center, and applied in the communities’ health service network in Chenghua District, Wuhou District, and Jinjiang District. From March 2017 some improvements of the mode were made, such as assigning specific person for the management of two-way-referral, conducting lectures in communities to train the community medical staff, and carrying out gratuitous treatment. The community acceptance rate and patients satisfaction were retrospectively analyzed between March of 2016 and March of 2017, and the number of upward referral (from community to hospital) was retrospectively analyzed between March to June of 2016 and March to June of 2017. Results The community acceptance rate was elevated from 81.3% to 99.1% and the patients satisfaction was improved from 95.4% to 100.0%, and the differences between the two periods were statistically significant (P<0.05). The number of upward referral increased from 0 to 23. Conclusions The modified hospital-community integrated service mode could optimize the course of surgery appointment, and make it convenient for patients. Furthermore, it also adjusts the reasonable allocation of medical resource effectively and promotes the implementation of national hierarchical medical system.