应用目标策略性干预的婴幼儿消化道出血患儿护理质量评价指标的建立与应用

    Establishment and application of the nursing quality evaluation indexes for infants with gastrointestinal bleeding using target strategic intervention

    • 摘要:
      目的 观察应用目标策略性干预的婴幼儿消化道出血患儿护理质量评价指标的建立与应用效果。
      方法 前瞻性选择2019—2021年儿科诊治的消化道出血婴幼儿166例作为研究对象。依据随机数列表法将所有病人分为对照组(常规护理干预)和观察组(行护理质量评价指标下的目标策略性干预),各83例。比较2组总有效率、出血停止时间、输血量、再出血率、住院时间及护理前后血红蛋白水平(Hb)、血细胞比容(Hct)水平、患儿家长不良情绪和护理满意度。
      结果 观察组总有效率高于对照组(P<0.05)。观察组出血停止时间、输血量、再出血率、住院时间均小于对照组(P<0.05)。护理3 d后,2组Hb、Hct水平均高于护理前(P<0.05),观察组Hb、Hct水平均明显高于对照组(P<0.01)。护理3 d后,2组患儿家长SDS评分与SAS评分均高于护理前(P<0.05),观察组SDS评分与SAS评分均明显低于对照组(P<0.01);观察组基础护理、护理安全、病房管理、护理文书在内的护理质量评分均明显低于对照组(P<0.01)。观察组护理总满意度高于对照组(P<0.05)。ROC曲线结果显示,护理总有效率+不良情绪+护理质量+护理满意度,四者联合用于评价目标策略性干预对婴幼儿消化道出血患儿护理质量的ROC为0.671,Cut-off值为2.003,灵敏度1.000,特异度0.275,阳性预测值0.525,阴性预测值1.000,约登指数0.275(P<0.05)。
      结论 目标策略性干预护理模式可提高婴幼儿消化道出血整体治疗有效率,促进患儿早期出血停止,降低二次出血率,改善贫血状态,缓解患儿家长的不良情绪,极高整理护理满意度。目标策略性干预护理模式临床应用优势明显。

       

      Abstract:
      Objective To investigate the establishment and application effects of the nursing quality evaluation indexes for infants with gastrointestinal bleeding using target strategic intervention.
      Methods A total of 166 infants with gastrointestinal bleeding in department of pediatrics from 2019 to 2021 were prospectively selected as the study subjects. According to the random number table method, the patients were divided into the control group(routine nursing intervention) and observation group(targeted strategic intervention under nursing quality evaluation index) (83 cases in each group). The total effective rate, bleeding stop time, blood transfusion volume, rebleeding rate, hospital stay, levels of hemoglobin(Hb) and hemocytometer(Hct) before and after nursing, parents' bad mood and nursing satisfaction were compared between two groups.
      Results The total effective rate of the observation group was higher than that of control group(P<0.05). The bleeding stop time, blood transfusion volume, rebleeding rate and hospital stay in the observation group were lower than those in control group(P<0.05). After 3 days of nursing, the Hb and Hct levels in two groups were higher than those before nursing(P<0.05), and the Hb and Hct levels in the observation group were significantly higher than those in control group(P<0.01). After 3 days of nursing, the SDS and SAS scores in two groups were higher than those before nursing(P<0.05), the SDS and SAS scores in the observation group were significantly lower than those in control group(P<0.01). The nursing quality scores of basic nursing, nursing safety, ward management and nursing document in the observation group were significantly lower than those in control group(P<0.01). The total satisfaction of nursing in the observation group was higher than that in control group(P<0.05). The ROC curve results showed that the ROC, Cut-off value, sensitivity, specificity, positive predictive value, negative predictive value and Jorden index of the four targeted strategic intervention combination of total effective rate of nursing, negative emotion, nursing quality and nursing satisfaction for evaluating the nursing quality of infants with gostrointestinal bleeding were 0.671, 2.003, 1.000, 0.275, 0.525, 1.000 and 0.275, respectively(P<0.05).
      Conclusions The target strategic intervention nursing mode can improve the overall treatment efficiency of infant gastrointestinal bleeding, promote the cessation of early bleeding, reduce the rate of secondary bleeding, improve the anemia status, alleviate the bad mood of the parents of children, and improve the satisfaction of nursing care. Therefore, the target strategic intervention nursing mode has obvious advantages in clinical application.

       

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