心内科住院患者陪护管理存在的问题及其整改措施

Difficulties and rectification measures in management of escort care of cardiology hospitalized patients

目的:分析心内科住院患者陪护人员管理难的原因,并探讨整改措施。方法:收集2016-03-01～2017-07-01我院心血管内科收治住院的220例患者的临床资料,其中男120例,女100例,年龄35.5～92.6岁,平均(63.5±3.3)岁;文化程度:初中以下24例,初高中116例,中专及以上80例;民族:汉族180例,少数民族40例;居住状况:与子女异地居住130例,与子女同城居住90例;疾病种类:高血压98例,急性心肌梗死23例,心力衰竭25例,心律失常74例。通过入院宣教、询问病情病史、检索病历及随访等整改措施的实施,分析评估陪护家属的外在需求,并对陪护人员管理方面存在的问题进行整改。结果:经过整改,患者心理健康、情绪稳定,能积极配合各项治疗;院内交叉感染率由整改前的(32.0±4.5)%下降至(18.0±2.5)%;患者住院天数由(6.0±1.2)d减少至(4.5±0.8)d;对医护人员的信任度由(88.0±2.2)%增加至(96.0±3.8)%;陪员人数由(4.0±2.0)人/d减至(2.0±1.0)人/d;探视次数由(3.0±2.5)次/d减至(1.0±0.5)次/d,差异均有统计学意义(均P<0.05)。患者住院期间的不良情绪中,孤独选项在患者和陪护人员中所占比例较高,分别为95.4%和80.3%;95.7%的患者和96.8%的陪护人员认为医患直接沟通是缓解不良情绪的最佳方法;75.4%的患者和72.8%的陪护人员表示能遵守现行的陪护制度;在希望解决的问题选择中,70.9%的患者和72.1%的陪护人员首选有效缓解患者不良情绪。结论:通过对陪护管理存在的问题进行分析和整改,陪护人员能积极配合医护人员工作,确保医疗工作正常开展,并且降低院内交叉感染发生率,确保患者安全、安心出院。

Objective:To analyze the difficulties and rectification measures in management of escort care for cardiology hospitalized patients.Methods:A total of 220 patients were admitted to the department of cardiology in our hospital from 2016-03-01 to 2017-07-01.Among them,there were 120 males and 100 females,(35.5-92.6)years old,with an average age of(63.5±3.3)years,24 below junior high school education level,116 junior and senior high school education level,80 technical secondary school and above education levels,180 cases were ethnic Han,and 40 cases were national minority,130 cases with their children lived in different places,90 cases with their children lived in the same city,98 cases with hypertension,23 cases with acute myocardial infarction,25 cases with heart failure,and 74 cases with arrhythmia.Through hospital admission,history of illness,medical history and follow-up data,the problems of the management of the accompanying staff rectification were discussed,and the external needs of accompanying family members were analyzed.Results:Before and after the rectification,the patients′mental health,emotional stability,and actively cooperate with each treatment nursing.Cross infection rate in hospital was decreased from the previous(32.0±4.5)% to(18.0±2.5)%.Patient length of hospital days was decreased from(6.0±1.2)days to(4.5±0.8)days.The credibility of medical personnel was increased from(88.0±2.2)%to(96.0±3.8)%.The number of secort was increased from(4.0±2.0)/d to(2.0±1.0)/d,and the visitation times was decreased(3.0±2.5)times/d to(1.0±0.5)times/d,which was statistically significant in before rectification(P<0.05).Among the unhealthy emotions during hospitalization,the lonely option accounted of the patients and caregivers was 95.4% and 80.3%,95.7% of patients and96.8% of caregivers believed that direct communication between doctors and patients was the best method for relieve bad emotion.Among the inpatients,75.4% of patients and 72.8% of caregivers could comply with the current caregivers.70.9% of patients and 72.1% of caregivers hoped to solve effectively alleviates patients′negative emotions to become the first choice in the choice of problems.Conclusion:Through the analysis of the problems of management of escort care and rectification,the caregivers actively cooperated with the medical staff to ensure the normal development of medical services,reduce the incidence of cross infection rate in hospitals,ensure the safety of patients,and discharge them safely.