临床路径在儿童哮喘电子病历管理中的应用分析

Application analysis of clinical path in the management of children's asthma electronic medical records

目的应用临床路径对专科门诊儿童支气管哮喘电子病历进行系统规范化的管理,探讨临床路径在专科门诊中应用的可行性。方法根据指南及规范研发及制订儿科哮喘专科电子病历及临床路径。回顾分析2017年3月1日~2018年2月28日及2018年3月1日~2019年2月28日就诊厦门大学附属第一医院小儿呼吸哮喘专科门诊确诊为哮喘的患儿病历,其中将前者予常规治疗及护理的440例患儿作为对照组,将后者予临床路径干预的315例患儿作为路径组。统计两组患儿初次就诊后1个月、2个月、3个月和6个月的复诊率,比较两组患儿治疗后哮喘的控制率;分析临床路径与哮喘患儿复诊率及病情控制率的相关性。结果两组患儿复诊率、哮喘控制率之间差异显著(P<0.05):初次就诊后1个月、2个月、3个月和6个月路径组的复诊率显著高于对照组;治疗后路径组哮喘控制率显著高于对照组。结论临床路径的干预可使哮喘患儿的治疗更规范化及可控化,进而可提高儿童哮喘专科治疗的依从性及控制率,适合在基层开展电子病历的医院中推广应用,提高哮喘诊疗的规范。

Objective To systematically manage the electronic medical records of bronchial asthma in specialist clinic by applying clinical path,and to explore the feasibility of applying clinical path in specialist clinics.Methods According to the guidelines and specifications,the electronic medical records and clinical path of pediatric asthma specialists were developed and formulated.The medical records of children diagnosed with asthma in the Pediatric Respiratory Asthma Specialist Clinic of the First Affiliated Hospital of Xiamen University from March 1,2017 to February 28,2018 and from March 1,2018 to February 28,2019 were retrospectively analyzed.Among them,440 children who received conventional treatment and nursing were set as the control group,and 315 children who received clinical path intervention were set as the path group.The follow-up rates at 1 month,2 months,3 months and 6 months after the first visit of the two groups were counted.The control rate of asthma after treatment in two groups was compared.The correlation between clinical path and the follow-up rate and disease control rate in children with asthma was analyzed.Results There were significant differences between the two groups in the follow-up rate,asthma control rate(P<0.05).The follow-up rates in the path group at 1 month,2 months,3 months,and 6 months after the first visit were significantly higher than those in the control group.After treatment,the asthma control rate in the path group was significantly higher than that in the control group.Conclusion The intervention of clinical path can make the treatment of children with asthma more standardized and controllable,and then can improve the compliance and control rate of children's asthma specialist treatment.It is suitable for popularization and application in hospitals that carry out electronic medical records at the grassroots level,which can improve the standard of asthma diagnosis and treatment.