急性脑梗死患者临床路径管理的优化与效果观察  

Optimization and effect observation of clinical pathway management in patients with acute cerebral infarction

作　　者：郭剑虹[1] 洪建文[1] 唐小荣[1] 林剑雄[1] 蓝书祥 GUO Jian-hong;HONG Jian-wen;TANG Xiao-rong;LIN Jian-xiong;LAN Shu-xiang(Department of Quality Control,Chaozhou Central Hospital,Guangdong Province,Chaozhou521000,China)

机构地区：[1]广东省潮州市中心医院质控科

出　　处：《中国当代医药》2019年第36期196-200,共5页China Modern Medicine

基　　金：广东省潮州市科技专项课题（2017GY17）

摘　　要：目的探讨急性脑梗死患者临床路径管理的优化与效果。方法随机选取2016年3月~2017年6月我院收治的采用传统临床路径流程进行诊治和管理的180例急性脑梗死患者作为优化前组,将2017年7月~2018年12月使用优化后临床路径管理的180例急性脑梗死患者作为优化后组。优化后组是对常规的急性脑梗死临床路径流程进行优化,并将脑梗死单病种质量控制指标内容纳入流程管理。评价并比较两组患者从急诊接诊到入院接受治疗的时间、主要质控指标完成情况、诊疗效果、继发并发症总发生率及患者对医疗护理工作的总满意率。结果优化后组患者从急诊接诊到入院接受治疗的时间短于优化前组,差异有统计学意义(P<0.05)。优化后组患者的神经功能缺失评估、吞咽困难评价、深静脉血栓预防、血管功能评价、降脂药物使用指标完成率均高于优化前组,差异有统计学意义(P<0.05);两组患者入院后和出院后抗栓药物使用指标完成率比较,差异无统计学意义(P>0.05)。两组患者的诊疗效果比较,差异无统计学意义(P>0.05)。优化后组患者的继发并发症总发生率低于优化前组,差异有统计学意义(P<0.05)。优化后组患者对医疗护理工作的总满意率高于优化前组,差异有统计学意义(P<0.05)。结论优化后的急性脑梗死临床路径管理,能缩短患者从急诊接诊到入院接受治疗的时间,明显提高主要质控指标完成率和患者对医疗护理工作的总满意度,降低患者继发并发症总发生率。优化后的临床路径管理流程更合理、诊疗更规范,能更好地提高患者救治质量和患者服务满意率。Objective To explore the optimization and effect of clinical pathway management in patients with acute cerebral infarction.Methods A total of 180 patients with acute cerebral infarction using traditional clinical pathway in our hospital from March 2016 to June 2017 were randomly selected as the pre-optimization group,and another 180 patients with acute cerebral infarction using the optimized clinical pathway management from July 2017 to December 2018 were selected as the post-optimization group.The acute cerebral infarction clinical pathway of traditional process optimization and quality control indexes of single diseases and cerebral infarction were set into process management in the post-optimization group.The time from emergency to admission for treatment,the completion of the main quality control indicators,the diagnosis and treatment effect,the total incidence of secondary complications,and the total satisfaction rate of patients to medical nursing were evaluated and compared in the two groups.Results The time from emergency to admission for treatment in the post-optimization group was shorter than that in the pre-optimization group,and the difference was statistically significant(P<0.05).The index completion rates of neurological deficit evaluation,dysphagia evaluation,deep vein thrombosis prevention,vascular function evaluation,and lipid-lowering drug use in the post-optimization group were higher those in the pre-optimization group,and the differences were statistically significant(P<0.05).There were no significant differences in the completion rates of antithrombotic drugs between the two groups after admission and after discharge(P>0.05).There was no significant difference in diagnosis and treatment effect between the two groups of patients(P>0.05).The total incidence of secondary complications in patients in the post-optimization group was lower than that in the pre-optimization group,and the difference was statistically significant(P<0.05).The total satisfaction rate of patients to medical nursing in

关 键 词：临床路径 急性脑梗死 医疗质量 

分 类 号：R197.323[医药卫生—卫生事业管理]