Effect analysis of applying high-quality service model to surgical nursing

BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.

Effects of high-quality neurosurgical nursing care on improving clinical nursing quality

BACKGROUND With continuous advancements in medical technology,neurosurgical nursing is constantly developing and improving to provide higher-quality nursing services.AIM To explore the effects of different types of high-quality nursing care on clinical nursing quality and patient satisfaction in neurosurgical nursing.METHODS Eighty patients who received neurosurgical treatment in the Affiliated Hospital of Southwest Medical University from June to December 2020 were selected as study participants and categorised into study and control groups.The study group comprised 40 patients who received 4 different types of high-quality nursing care,whereas the control group comprised 40 patients who received conventional nursing care.After a specific period,nursing satisfaction levels and adverse event and complication rates were compared between the two groups.RESULTS Satisfaction with high-quality care was higher than that with conventional care,and high-quality health services and regional services showed the highest satisfaction levels,with an average score of 12 on the Glasgow scale.The satisfaction levels of the study and control groups were 75%and 57%,respectively,with a statistically significant difference(t=7.314,P<0.05).During the nursing period,the adverse event and complication rates were the highest in patients with level III pathology grade and those who underwent neurosurgery(40.02%and 85.93%,respectively),and the difference was statistically significant.CONCLUSION In neurosurgical nursing,employing appropriate high-quality nursing methods can effectively reduce adverse event and complication rates in patients,thereby improving the quality of nursing care and increasing clinical nursing value.

Impact of a High-Quality Nursing Model on Patient Outcomes in Rheumatology:A Randomized Controlled Study

Objective:To enhance the overall nursing effectiveness in the rheumatology and immunology department,explore specific strategies to improve nursing quality using a high-quality care model,and develop a comprehensive nursing system.Methods:A total of 120 hospitalized patients with rheumatoid arthritis from 2022 to January 2024 were selected.These patients were randomly divided into two groups:an observation group(60 patients)and a control group(60 patients).The control group received conventional nursing care,which included creating a good care environment,providing drug guidance,and offering psychological support.In the observation group,a high-quality nursing model was implemented with a focus on meeting the specific needs of the patients.The two groups were compared in terms of complication rates,treatment compliance,nurse-patient disputes,patient satisfaction with nursing care,sleep quality(PSQI score),and pain levels(VAS score).Results:The incidence of complications in the observation group was 3.33%,significantly lower than that of the control group,with a statistically significant difference(P<0.05).Nursing compliance in the observation group was 100%,and patient satisfaction was 96.67%,both higher than in the control group,with a statistically significant difference(P<0.05).Additionally,the VAS pain score in the observation group decreased to 2.12±1.89,and the PSQI sleep quality score decreased to 6.89±0.33,both lower than in the control group,with statistically significant differences(P<0.05).Conclusion:Focusing on the needs of patients through a high-quality nursing model provides targeted care that improves overall nursing effectiveness for patients with rheumatoid arthritis.This approach enhances patient satisfaction with nursing care,increases treatment compliance,reduces the incidence of complications and nurse-patient disputes,improves sleep quality,and alleviates pain.This model holds significant value for broader applications.

Core competencies and perceived training needs of nurses in the background of Internet plus nursing service:a qualitative descriptive study

Background:The Internet plus nursing service program is being piloted in China,which has become a new home nursing service model led by nurses.To enable safe and effective homecare service delivery,nurses working in the program need a high level of competency.However,the content of these core competencies and the training needs of nurses for Internet plus nursing services are still unknown.Aim:To describe nurses’perceptions of core competencies and training needs to work in the Internet plus nursing service program,thereby providing a reference for the development of training programs.Methods:A qualitative descriptive study using semi-structured interviews was conducted on 15 nurses with experience of working in the Internet plus nursing service program.Interviews were audio-recorded and transcribed verbatim,and the data were analyzed using thematic analysis.Results:Core competencies involved comprehensive assessment competence,direct care practice competence,health education and consulting competence,risk estimation and response competence,and communication competence.Training needs involved complex operational items,knowledge of chronic disease management,professional communication,risk identification and response,nursing standards,norms,and procedures,and utilization of information technology.Conclusions:The training system may be developed based on nurses’core competencies and their training needs to promote professional development of the Internet plus nursing service.

Analysis of the Current Situation of“Internet Plus Nursing Service”

In the era of“Internet Plus,”technologies like big data,the Internet of Things,and cloud computing have revitalized nursing services in China,leading to the emergence of the“Internet Plus Nursing Services”model.This model facilitates on-site nursing care for discharged patients and special groups with mobility challenges,further advancing the construction of a Healthy China and enabling more people to access high-quality and continuous nursing services.Governments at all levels should actively improve the systems related to“Internet Plus Nursing Services”and simplify the appointment and operation processes.It is also essential to standardize the medical waste disposal process to ensure the quality of on-site nursing services,protect the legitimate rights and interests of both caregivers and patients and safeguard patient privacy and security.Additionally,building a robust“Internet Plus”platform to promote“online appointment of nurses”services,integrate nursing resources,and foster the healthy development of“Internet Plus Nursing Services”is crucial.

Investigation and Analysis of Factors Influencing the Quality of Community Nursing Services in Laishan District,Yantai City

Objective:The purpose of this study is to conduct an in-depth investigation and analysis of the factors affecting the quality of community nursing services in Laishan District,Yantai City,and provide suggestions for improving the quality of the services.Method:The community nursing services in Laishan District,Yantai City were investigated through questionnaires and on-site observations.Result:The content of nursing services was correlated with the professional titles of the staff.The guidance given to patients and caregivers was significantly correlated with the educational level of community nursing personnel.Therefore,this indicates that the professional titles and educational backgrounds of the community nursing personnel have a significant impact on the quality of service provided.Conclusion:The role of professional title evaluation can be optimized,further enhancing the educational level of nurses in surrounding communities,optimizing service content and methods,etc.,in order to improve the quality of community nursing services in the region.

Stress perceptions of nurses serving in home healthcare services during the COVID-19 pandemic:A qualitative research

Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.

Improvement in Patient Mobility Following Short-Term Rehabilitation in Skilled Nursing Facilities

Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient outcomes.

Analysis of the Effect of Implementing Humanized Care Service in Severe ICU Patients

Objective:To analyze the effect of implementing humanized nursing service intervention for severe patients in the intensive care unit(ICU).Methods:A hundred severely ill ICU patients who were treated from January 2021 to December 2022 were selected and grouped into a control group and an observation group.The control group adopted routine nursing services and the observation group adopted humanized nursing services.The nursing outcome of the two groups was analyzed.Results:The nursing risk incidence of the observation group was lower than that of the control group(P<0.05).The scale of comfort and nursing satisfaction in the observation group was higher than those in the control group(P<0.05).Conclusion:The implementation of a humanized care service for ICU patients lowered nursing risk incidences and increased the physical comfort and nursing satisfaction of these patients.

Research on the Path to High-Quality Development of Grassroots Libraries in the Era of Artificial Intelligence in Henan

Since the age of digital intelligence,the government has introduced policies to actively promote the intelligent transformation of grassroots public cultural services.Based on the investigation and analysis of the development status quo of grassroots libraries in Henan Province,we put forward the path of high-quality development of grassroots libraries in Henan,namely,improving the mechanism and system,leading with digital intelligence technology,empowering by Yellow River culture(the heritage and values rooted in the history and traditions of the Yellow River region),and driven by users’demand.

Effectiveness of Comprehensive Nursing Management in Enhancing Blood Donation Outcomes and Donor Experience: A Comparative Study

Objective:To assess the management effect of comprehensive nursing management on blood donation services in blood stations.Methods:Sixty-four individuals who donated blood at a blood station between September 2021 and September 2023 were selected and randomly assigned into two groups of 32 each.The first group received comprehensive nursing management,while the second group received routine nursing management.Blood donation indexes and observational indexes such as adverse reactions were compared between the groups.Results:The total blood donation volume and qualified blood donation volume were higher in the first group than in the second group.The amount of discarded blood and the rate of blood discards were lower in the first group compared to the second group(P<0.05).Additionally,the adverse reaction rate in the first group was lower,the blood donation comfort scores were higher,the psychological state scores were lower,and the quality of care scores were higher than those in the second group(P<0.05).Conclusion:Comprehensive nursing management can improve the efficiency of blood donation,reduce the rate of blood discards,decrease the incidence of adverse reactions,alleviate negative psychological states of blood donors,and enhance both the comfort level of blood donation and the quality of care provided.

Effect of precise nursing service mode on postoperative urinary incontinence prevention in patients with prostate disease

BACKGROUND Patients with benign prostatic disease often experience detrusor morphological changes and dysfunction.In severe cases,it leads to bladder detrusor dysfunction,resulting in dysuria,frequent urination,urgent urination,incomplete urination,and other symptoms including renal function injury.An operation to restore normal urination function and to control postoperative complications,as far as possible,is the most common method for benign prostatic disease.AIM To observe the effect of precise nursing service mode on postoperative urinary incontinence prevention in patients with prostate disease.METHODS In total,130 patients diagnosed with benign prostatic disease,from January 2018 to June 2021,in our hospital,were selected and divided into observation and control groups according to their treatment options.Sixty-five cases in the control group were given routine nursing mode intervention and 65 cases in the observation group received precise nursing service mode intervention.The intervention with the observation group included psychological counseling about negative emotions,pelvic floor exercises,and post-hospital discharge care.The complications of the two groups were counted,and the general postoperative conditions of the two groups were recorded.The urinary flow dynamics indexes of the two groups were detected,and differences in clinical international prostate system score(IPSS)and urinary incontinence quality of life questionnaire(I-QOL)scores were evaluated.RESULTS Postoperative exhaust time(18.65±3.23 h and 24.63±4.51 h),the time of indwelling catheter(4.85±1.08 d and 5.63±1.24 d),and hospitalization time(8.78±2.03 d and 10.23±2.28 d)in the observation group were lower than in the control group.The difference was statistically significant(P<0.05).After the operation,the maximum urinary flow rate(Qmax)increased(P<0.05),the residual urine volume(RUV)decreased(P<0.05),and the maximum closed urethral pressure(MUCP)was not statistically significant(P>0.05)compared to pre-operation.The Qmax of the observation group was higher than that of the control group,while the RUV was lower than that of the control group.There was no significant difference in MUCP between the observation and control groups(P>0.05).The I-QOL score of the two groups improved(P<0.05),and the IPSS decreased(P<0.05).After the operation,the I-QOL score of the observation group was higher than that of the control group,and the IPSS was lower than that of the control group(P<0.05).There were no significant differences in the incidence of urethral injury(1.54%and 3.08%),bladder spasm(0.00%and 1.54%),and secondary bleeding(1.54%and 4.62)between the observation and control groups(P>0.05).CONCLUSION The precise nursing service mode can reduce the incidence of postoperative urinary incontinence in patients with prostate disease,thus improving postoperative urodynamics and rehabilitation,and quality of life.

The level of patients’ satisfaction and perception on quality of nursing services in the Renal unit, Kenyatta National Hospital Nairobi, Kenya

Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer services that are perceived as quality and satisfying in order to meet the biophysical and psychological needs of the patients. Study design: This was a descriptive cross-sectional study undertaken at the Renal unit of Kenyatta National Hospital (KNH). Purpose: The study aimed at determining the level of satisfaction and perception of the quality of nursing services in the Renal unit. Methodology: The study population included all patients who were seeking dialysis services during one month period of data collection. The sample size was 151 following data collection. Data collection tools consisted of semi-structured questionnaires which were administered with the aid of research assistants as well as checklists which were self administered. Data analysis and results: Analysis of data was performed using the statistical package of social sciences (SPSS) version 16. Results of data analysis were presented in form of descriptive statistics which included mean, standard deviation and percentages. Regression analysis, t-test and ANOVA were conducted to determine demographic predictors of patient satisfaction with the nursing services. The results of the study revealed that patients in the Renal unit were generally satisfied with the nursing services. The aggregate mean score for all patients on Likert scale was 71.2 out of 105, with a standard deviation of 16.8. Level of satisfaction was 67.8%. The findings also showed that there was no association between demographic characteristics with the levels of satisfaction with the nursing services. Recommendation: The hospital should keep the patients’ level of satisfaction high and maintain it through the provision of more dialysis machines and hiring more nurses.

Preliminary construction of evaluation indicator system for inpatients'nursing service needs in tertiary general hospital

Objectives:To construct a comprehensive evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and to provide evidence for identifying and meeting the needs of inpatients'nursing services.Method:We used the Delphi method to conduct two rounds of expert consultations with 41 experts.Result:The indicator system consisting of 5 first-level indicators and 48 second-level indicators was preliminarily constructed.Conclusions:We formed an evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and classified it into five categories:hospital environment,nursing attitude,nursing skills,information exchange,and emotional support.The indicator system is scientific and reliable.It can provide a basis for nursing staffs to identify and meet the needs of inpatients'care services.

Nursing homes’social responsibility and competitive edge:a cross‐sectional study on elderly choices about care service and price levels in Zhejiang Province,China

Background In the context of China's aging population,meeting consumer demand is an essential way for nursing homes to fulfill social responsibilities and improve competitive advantages.However,since little is known about the elderly's service level and price choices for nursing home care,this study aims to explore the non-disabled elderly's nursing home admission intention,service level,and price choices.Methods A cross-sectional survey of 402 non-disabled respondents was conducted in three different income level cities of Zhejiang Province,in July and August 2018.Multinomial logistic regression and multiple linear regression were used to identify the determinants of admission intention,service level choice,and price choice.Results Education,residence,and number of children were significantly associated with nursing home admission intention.Compared to those with no intention,the elderly with higher income and household wealth were less likely to have conditional intentions,and those living with the family were less likely to have unconditional intentions.Compared to medium-level services,the elderly with higher monthly income(relative risk ratio[RRR]3.07,95%confidence interval[CI]:1.801 to 5.233),household wealth(RRR 5.451,95%CI:2.249 to 13.216),and age(RRR 1.528,95%CI:1.004 to 2.326)were more likely to prefer high-level services,while older adults with higher monthly income(RRR 0.516,95%CI:0.344 to 0.774),and those with pensions(RRR 0.267,95%CI:0.076 to 0.931)were less likely to prefer low-level services.The elderly's price preference increased by 398 CNY as monthly income increased by 1000 CNY,and by 270 CNY as the housing number increased by one.Having pensions increased price preference(468 CNY),whereas having health insurance decreased price preference(–690 CNY).Conclusion The elderly's intention of nursing home admission was primarily affected by sociodemographic factors,while price and service level choices were primarily affected by financial factors.Nursing homes should use the market segmentation method to provide precision nursing home care for different groups of non-disabled elderly.

Application Value of High-Quality Nursing Intervention in Patients with Cirrhotic Ascites

Objective:To study the application value of high-quality nursing intervention in patients with cirrhotic ascites.Methods:From February 2018 to February 2020,80 patients with cirrhotic ascites,treated in Yancheng No.1 People’s Hospital,were selected as the subjects for this study.The patients were divided into two groups based on the type of nursing intervention:a routine group and an observation group,with 40 cases in each group.The routine group received routine nursing,and the observation group received high-quality nursing intervention on the basis of routine nursing.The nursing effects and adverse reactions of the two groups were observed and compared.Results:The total effective cases in the observation group were 39 cases,with a total effective rate of 97.5%;the total effective cases in the routine group were 33 cases,with a total effective rate of 82.5%.The total effective rate of the observation group was significantly higher than that of the routine group(P<0.05).In the routine group,there were eight cases of adverse reactions,in which the incidence of adverse reactions was 20.0%,whereas there were only two cases of adverse reactions in the observation group,in which the incidence of adverse reactions was 5.0%.The incidence of adverse reactions in the observation group was significantly lower than that in the routine group(P<0.05).Conclusion:The application of high-quality nursing intervention in patients with cirrhotic ascites can improve the nursing effect and reduce the occurrence of adverse reactions;thus,it should be popularized in clinical settings.

Bibliometric analysis of continuous nursing service model in stroke patients

Objective:Through the collection and research of literature,analyze the application status,deficiencies,development status,current research hotspots and development trends of stroke patients with continuous nursing care,so as to further develop continuous nursing care for stroke patients.Related research provides reference and clinical nursing work provides the theoretical basis.Methods:Search the relevant literature on continuity care of stroke patients collected from the establishment of the database to November 22,2020 in CNKI,Wanfang database,PubMed,Embase,Web of science,and Weipu database,and use Note Express to sort the documents that meet the standards,and apply Microsoft Excel software establishes a database for information extraction and statistical description of the included literature.Results:A total of 669 related documents were included.The number of related documents published began in 2008 with the first related introduction articles,which increased year by year from 2014 and reached its peak in 2019;the first author came from 31 provinces,autonomous regions and municipalities directly under the Central Government.It mainly includes Henan,Jiangsu,Shandong,Guangdong and Hubei provinces.A total of 297 articles have been published by authors from related regions;a total of 51 articles have been funded by scientific research funds;the types of literature research are relatively rich,and research institutions are mainly concentrated in hospitals and colleges;There are 1,383 authors published in the literature,and the average number of authors is 2.06 per article;a total of 375 articles have been completed by 2 or more authors,and the co-authoring rate is 56.05%.Conclusion:The research on continuity care of stroke patients shows an increasing trend,but the quality of literature,research institutions,and scientific research funding are still very small.It is recommended that follow-up research should pay attention to improving the writing level of thesis,increase funding,expand the cooperation team and establish special Continuous nursing team and scientific research team to improve the psychological and physiological problems of stroke patients,and at the same time improve the quality of papers written by authors.

Effect of High-Quality Nursing on Patients with Hemorrhagic Fever with Renal Syndrome

Objective:To explore and analyze the effect of high-quality nursing on patients with epidemic hemorrhagic fever with renal syndrome.Methods:Ninety patients with epidemic hemorrhagic fever with renal syndrome treated in Huyi District People’s Hospital from October 2021 to January 2022 were randomly divided into an experimental group and a control group,with 45 cases in each group.The control group received routine nursing and the experimental group received high-quality nursing.The effect of routine nursing and high-quality nursing were compared and analyzed based on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),the degree of satisfaction with nursing care,and the patients’quality of life.Results:Before nursing,there was no significant difference in the patients’psychological state between the two groups(P>0.05);after nursing,there was significant difference in the patients’psychological state between the two groups(P<0.05);the degree of satisfaction with nursing care of the experimental group was significantly higher than that of the control group(P<0.05);comparing the quality of life of the two groups,the quality-of-life score of the control group was significantly lower than that of the experimental group(P<0.05).Conclusion:For patients with epidemic hemorrhagic fever with renal syndrome,high-quality nursing can significantly and effectively improve their psychological state,level of satisfaction with nursing care,and quality of life.

Investigation and Analysis of Continuing Nursing Education Status and Needs of In-Service Nurses in Tibet

Objective: To investigate and analyze the current status of continuing nursing education (CNE) of in-service nurses in Tibet and their demand for continuing education. Methods: 663 active nurses in Tibet were taken as the research objects, and the self-developed questionnaire was used to investigate the current status and needs of CNE, and the correlation between the CNE needs of active nurses and their personal conditions was analyzed. Results: This study shows that 65.61% (435/663) of active nurses have not participated in any CNE, and 91.86% (609/663) of active nurses believe that they need to participate in CNE. The problems faced by active nurses in participating in CNE include funding restrictions, time limitation and ability limitation. Logistic stepwise regression analysis reveals that the age of active nurses and working years of nurses are negatively correlated with the funding restrictions for participating in CNE (P < 0.05). It is relatively more difficult for young nurses with less working experience to obtain funding for participating in CNE. Moreover, there is a negative correlation between age, educational level and the ability of nurses to participate in CNE (P < 0.05). Younger nurses with lower educational level are more difficult to participate in CNE due to personal ability. There is a positive correlation between the length of working experience and the time limitation faced to participate in CNE (P < 0.05). Senior nurses are too busy with their work to participate in CNE due to limited time. Conclusion: The problems faced by active nurses in Tibet in participating in CNE come from funding, time and ability. Young nurses with limited working experience cannot participate in CNE resulting from limited ability and funds;while senior nurses are mainly restricted by time. It is recommended that hospitals and nursing management in Tibet should solve these problems faced by nurses in participating in CNE by implementing a flexible scheduling system, and providing funding or implementing an incentive system, to enhance the confidence of active nurses in participating in CNE.

A family nurse-led intervention for reducing health services’utilization in individuals with chronic diseases:The ADVICE pilot study

Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.