Application of clinical nursing pathway in pneumonia and nursing application

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  【Abstract】 Objective: To explore the clinical nursing path in pneumonia and nursing application. Methods: from October May to20122010 in our hospital32 cases of pneumonia patients were randomly divided into two groups, the control group used the traditional way of nursing care, observation group using clinical nursing pathway in nursing. Results: the observation group on nursing job satisfaction was significantly higher than that of control group ( P<0.01), patients and their families on disease related knowledge was significantly higher than that of control group ( P<0.01). Conclusion: the application of clinical nursing path in patients with pneumonia in nursing, can significantly increase the work of the initiative, plan, normative, is worth popularizing.
  【Key words】 clinical nursing pathway; pneumonia; standardization
  Clinical nursing path ( clinical nursing pathway ) is a new clinical service mode, mainly from patient-centred concept, based on the patient''s disease, psychological, social, environmental, cultural background and other aspects of the actual situation, by health care personnel to establish medical care program. The program for the specific operation developed sequentially, time and the most appropriate clinical service program, in order to accelerate patient recovery, reduce the waste of resources, to achieve the best medical care effect.
  1  clinical data
  1.1 average data selected from October to2012May in our hospital in 2010patients with pneumonia in 32 patients, male 18 cases, female 14 cases; the age ranged from 36 to65 years, mean 42.8± 6.5 years. The bacterial pneumonia in 16 cases, viral pneumonia in 7 cases,6 cases with mycoplasma pneumonia, chlamydia pneumonia in 3 cases. The patients were clinically diagnosed, without any complications, according to the sequence of admission were divided into observation group and control group with 16 cases in each group, the two groups of patients age, sex, severity, chest, no significant difference ( P > 0.05).
  1.2methods after admission were recorded body temperature, breathing sound, routine blood test, X-ray recovery time, hospitalization costs, length of stay; using a self-designed questionnaire, for families of patients satisfaction assessment.
  2 clinical nursing path
  Clinical nursing path is patients during hospitalization care model, is the needle before specific patient groups, with time for the axis, to hospital admissions guide, at the time of diagnosis, examination, treatment, medication, nursing care, diet guidance, activities, education, discharge planning, ideal nursing means for the vertical axis, made a schedule when to do, on which inspection, treatment and nursing, disease extent, where to be discharged and detailed description and record of the plan, standardized, convenient management, to enhance nursing quality good nursing work mode. The doctor give acetanilide, and closely observe the efficacy, prevent the temperature dips to patients. To keep the mouth clean, encourage patients to multiple mouthwash, patients drink plenty of water, dry lips lip can be coated with oil, prescribed antibiotics. Observation of family members of patients with febrile convulsion and guide the recognition of the early symptoms, such as irritability or glazed expressions, small limbs tic, should be reported promptly, so as to timely handle.   Sweat a lot when the timely replacement of underwear, and pay attention to keep warm. Hyperthermia may give physical cooling,30 min after cardioversion of measuring temperature and make records. 1guide and demonstration so that patients can effective cough;2 ground change posture, to assist in turning back percussion sputum;3patients maintained adequate intake of water, in order to reduce the secretion of consistency;4 on weak cough, sputum more patients, should actively adopt aspirator sputum suction;5compliance with antitussive and expectorant agent. The doctor give oxygen inhalation.
  Normal diet, observed in 2~ 3 D had no positive sign after health education; clinical pathway evaluation; health rating scale score; periodic inspection, inform the outpatient reexamination time, discharge procedures.
  3 Results
  Two groups of patients of the parameters, the observation group on nursing job satisfaction was significantly higher than that of control group ( P<0.01), patients and their families on disease related knowledge was significantly higher than that of control group ( P<0.01).
  4  discuss
  4.1clinical nursing pathway of clinical nursing path is a professional nurses to conduct health education timetable and schedule, and in the form of time, to provide effective care and treatment. At the same time, clinical nursing path as a new nursing management pattern, with the concept of performance management, will recover as soon as possible and try to reduce health care costs for the nursing of patients with serious content, reduce the hospitalization time, reduce medical costs, improve patients'' satisfaction to nursing care.
  4.2clinical nursing path of standardization of implementation and effect of clinical pathway design and implementation is normative and binding, once made, should carry out strictly. Clinical pathway is critical to the success of professional work together in collaboration. The patient was hospitalized after the various links are assigned, medical personnel in the completion of various tasks at the same time to evaluation of treatment and nursing target, active treatment, nursing and rehabilitation program to inform the patient, so the patient will take the initiative to match the treatment and nursing care, but also improves the patient of the illness cognition level and on the medical staff ''s trust a sense of.
  4.3the implementation of clinical nursing path can improve satisfaction with nursing care, the nursing work specific, timely understanding of patients thought trends, the correct analysis of patients with a variety of symptoms, increased the nurse-patient communication opportunity, improving the patients on disease related knowledge rate, to meet the patients and their families to the related disease knowledge demand, alleviate the tension, anxiety. Promote the exchange and communication between nurses and patients, close relationship between nurses and patients, improve the patient degree of satisfaction to the nursing work, so that continuously improve the quality of nursing. In the whole process of nurses to assume management, design, coordination of family members of patients with involvement of the mission and to promote the implementation of clinical nursing path, evaluation, correction, from time to time, content, methods are put forward strict requirements. Each shift nurses must click on the path to the content is implemented, a detailed account of family members of patients should master the health knowledge and skills. Patients and their families from passive to active participation in treatment and nursing care of patients with. From table 1that the patients in the observation group were significantly better than the control group the recovery ( P<0.05).
  Reference
  [1] chief editor Xu Ping. Lung transplantation nursing [M]. Southeast University press,2007.11:98-100.
  [2] Ji Ying, Zhou Yong, Li Tianya, et al. Clinical pathway implementation significance of [J]. Shanghai nursing,2005,4:12-13.
  [3] Lu Zhangyun. Clinical pathway in single disease medical nursing management application [J]. Chinese Journal of practical nursing,2006,22(3) :66.
  [4] Hu Yamei, Jiang diseases. The Futang Practical Pediatrics [M]. 7edition, Beijing: People''s Medical Publishing House,2002:1174 1215
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