The Role of Grid-Style Nursing Management Model in Critically Ill Patients

Objective:This study aims to gain insight into the effects and potential advantages of the grid-style nursing management model in the care of critically ill patients.Methods:Eighty critically ill patients admitted to our hospital between May 2020 and May 2021 were selected and randomly divided into the control group and the grid group,each with 40 patients.The control group implemented traditional nursing management,while the grid group adopted a grid-style nursing management model.The quality of care,quality of life,nursing satisfaction,and treatment adherence of the two groups were compared.Results:Compared with the control group,the grid group had significantly higher quality of care and quality of life(P<0.001);in terms of nursing satisfaction,the score of the grid group was 8.26±0.85,which was significantly higher than that of the control group(6.65±0.77)(P<0.001);90.00%(36 patients)of the grid group showed good treatment adherence,significantly higher than 70.00%(28 patients)of the control group(P<0.001).Conclusion:The implementation of the grid-style nursing management model in critically ill patients can significantly improve the quality of care,quality of life,and satisfaction of patients,and effectively promote patients’treatment adherence.These positive results provide strong support for the promotion and application of this model in clinical care.

Clinical value of precise rehabilitation nursing in management of cerebral infarction

BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.

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.

Nursing team management and construction from the perspective of psychological contract

The psychological contract is a set of personal beliefs about the reciprocal obligations and rights established in an exchange relationship,and high-level fulfillment of psychological contract helps the development of a team.This study summarizes the concept and theoretical basis of psychological contract,the influencing factors and intervention status of nurse psychological contract,and constructs a psychological contract intervention model to provide reference and reference for better construction and management of nursing teams.

Study Protocol on Stroke Management: Role of Nurses and Physiotherapists at the Adult University Teaching Hospital, Lusaka Zambia

Background: Management of stroke patients requires a multidisciplinary approach. Literature presents unequivocal evidence of improved outcomes when patients are treated in a stroke unit by multi-disciplinary teams made up of medical doctors, nurses, physiotherapists and occupational therapists. Among the multidisciplinary team members, physiotherapists and nurses are the largest professional workforce working with both stroke patients and survivors. This study, therefore, aims at investigating the role of nurses and physiotherapists in the management of stroke patients at the Adult University Teaching Hospital. Methodology: This study shall utilize a convergent parallel mixed method design where both quantitative and qualitative data will be collected at the same time resulting in two data sets which will eventually be merged at the point of discussion. The quantitative component shall utilize an analytical cross-sectional approach while the qualitative component shall use a qualitative case study approach. The study will be conducted at the Adult University Teaching Hospital in Lusaka. Data will be collected from all the 287 nurses and 37 physiotherapists working in the Emergency Department, Medical Wards, Adult Intensive Care Unit and the Department of Physiotherapy. Quantitative data will be analyzed using Statistical Package for social sciences. Descriptive statistics shall be computed on the role of nurses and physiotherapists in stroke care. In addition, chi-square and fisher’s exact tests will be used in the test for associations between variables while binary logistic regression will be used in identifying predictors of the various roles played by nurses and physiotherapists in the management of stroke patients. Qualitative data will be analyzed using thematic analysis in order to generate new concepts and a substantive model of care for stroke patients. Conclusion: Despite research evidence of improved outcomes when stroke patients are managed by a multi-disciplinary team, data on the role of different members of the multidisciplinary care team in stroke management is almost non-existent from the Zambia context. It is therefore hoped that information obtained from this study will be used as a basis for recommending the streamlined role of the nurse and physiotherapist in both acute care and rehabilitation.

Evaluation of the Effectiveness of the Competency Model for Nursing Managers in the Training of Newly Appointed Head Nurses

Objective:To explore the effectiveness of the competency model for nursing managers in the training of newly appointed head nurses.Methods:Eighteen newly appointed head nurses from Yichang Central People’s Hospital,selected between August 2023 and July 2024,were chosen as the research subjects.Based on the nursing manager competency model,corresponding training programs were developed,and these 18 head nurses were trained accordingly.Results:After the training,all newly appointed head nurses passed the theoretical assessments,with a pass rate of 100.00%.The pass rates for two rounds of assessment were 100.00%and 94.54%,respectively.There was no significant difference in the performance evaluation scores between new and senior head nurses in terms of standardized services,nursing quality,nursing research and teaching,and patient satisfaction(P>0.05).Conclusion:The competency model for nursing managers has a significant effect on the training of newly appointed head nurses.It effectively enhances management awareness,facilitates role transition,and,to some extent,improves the management and leadership capabilities of head nurses.It holds high value for broader implementation.

中医护理技术分级标准及分级预测模型的构建

目的:制定中医护理技术分级标准及分级预测模型,为中医护理技术的分级提供科学依据。方法:2020年11月至2021年10月,采用德尔菲专家函询法及专家现场论证制定中医护理技术分级标准,邀请浙江省内中医护理专家应用中医护理技术分级标准对中医护理技术进行分级评定并构建分级预测模型。结果:根据技术的安全性、学习掌握难易程度及操作难易度将技术分为一级技术、二级技术和三级技术。咨询专家积极系数为94.44%,权威系数为0.913,肯德尔和谐系数为0.892~1.000。构建的技术分级预测模型总准确度为74.5%,ROC曲线下面积为0.904。结论:本研究构建的中医护理技术分级标准具有可靠性、科学性及实用性。技术分级预测模型具有较好的预测准确度,能为中医护理技术的分级评定提供科学依据。

基于Delphi法构建手术室围术期低体温预防管理评价指标体系

目的 构建手术室围术期低体温预防管理评价指标体系。方法 2022年2月,以结构-过程-结果三维质量评价模式为理论框架,参考相关文献拟定手术室围术期低体温预防管理评价指标体系,采用德尔菲法对来自手术室护理管理、院内感染、麻醉领域的23名专家进行2轮专家函询,采用优序图法确定指标权重系数。结果 2轮专家函询的积极系数分别为100.0%和95.7%,专家权威系数分别为0.946和0.934,各项指标变异系数(CV)均<0.25,Kendall’s W值分别为0.419和0.359(均P<0.001),最终构建了包含3项一级指标、9项二级指标、53项三级指标的手术室围术期低体温预防管理评价指标体系。结论基于Delphi法构建手术室围术期低体温预防管理评价指标体系有较好的科学性和可靠性,可为手术室护理管理者提供参考,有利于临床开展科学、规范、统一的质量评价。

基于互联网平台的5A护理模式在妊娠糖尿病患者中的应用效果

目的探究基于互联网平台的5A护理模式在妊娠糖尿病(GDM)患者中的应用效果。方法选取2019年7月至2022年2月在滨州市中心医院进行产检的115例GDM患者进行前瞻性研究,采用随机数字表法将其分为对照组和研究组。对照组58例,年龄22~33岁,予以临床常规护理干预;研究组57例,年龄22~35岁,予以常规护理增加基于互联网平台的5A护理模式干预。比较两组患者血糖[空腹血糖(FBG)、糖化血红蛋白(HbA1c)]控制情况、自我效能感[糖尿病管理自我效能量表(DMSES)、一般自我效能感量表(GSES)]、心理状态[妊娠相关焦虑量表(PAQ)、焦虑自评量表(SAS)、抑郁自评量表(SDS)]、自我管理能力[改良版糖尿病自我管理行为量表(SDSCA)]及妊娠结局情况。统计学方法采用t检验、χ^(2)检验。结果护理后,研究组FBG、HbA1c水平均低于对照组[(5.11±1.02)mmol/L比(5.62±1.12)mmol/L、(5.21±1.04)%比(5.74±1.15)%],差异均有统计学意义(t=2.55、2.59,均P<0.05);研究组DMSES、GSES评分均高于对照组[(168.47±18.72)分比(154.32±17.15)分、(35.27±3.92)分比(31.48±3.51)分],差异均有统计学意义(t=4.23、5.46,均P<0.05);研究组PAQ、SAS、SDS评分均低于对照组[(18.51±3.70)分比(21.42±4.28)分、(41.32±6.88)分比(45.51±7.58)分、(42.33±7.05)分比(45.62±7.61)分],差异均有统计学意义(t=3.90、3.10、2.40,均P<0.05);研究组SDSCA中饮食、运动、血糖监测、足部护理评分均高于对照组[(22.15±3.69)分比(20.41±3.40)分、(10.87±2.17)分比(9.43±1.89)分、(11.12±2.22)分比(10.21±2.04)分、(11.45±2.29)分比(10.31±2.06)分],差异均有统计学意义(t=2.63、3.80、2.29、2.81,均P<0.05)。研究组羊水过多、巨大儿发生率均低于对照组[5.26%(3/57)比18.97%(11/58)、7.02%(4/57)比24.13%(14/58)],差异均有统计学意义(χ^(2)=5.05、6.38,均P<0.05)。结论对GDM患者应用基于互联网平台的5A护理模式干预,孕期血糖水平得到明显控制,且自我效能感、心理状态及自我管理能力均有改善,有较好妊娠结局。

改良正念减压疗法在原发性肝癌切除术患者中的应用

目的探究改良正念减压疗法在原发性肝癌(primary liver cancer,PLC)切除术患者中的应用。方法选取2020年5月至2022年5月北京市和平里医院收治的160例PLC患者作为研究对象,按照随机数字表法分为对照组(n=80)和研究组(n=80)。对照组采用风险管理护理模式,研究组在对照组基础上联合改良正念减压疗法干预,比较两组患者干预前后癌症疲乏量表(cancer fatigue scale,CFS)评分、中文版压力知觉量表(Chinese perceived stress scale,CPSS)评分、心理弹性水平、疼痛程度、心理应激程度和满意度。结果研究组患者干预后躯体疲乏、情感疲乏、认知疲乏CPSS评分均显著低于对照组(均P<0.05),坚韧性、自强、乐观评分和疼痛改善程度均显著优于对照组(均P<0.05)。两组患者干预后焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评分较干预前均显著降低(均P<0.05),且研究组患者干预后SAS和SDS评分均显著低于对照组(均P<0.05)。两组患者干预后CFS各项评分均较干预前显著降低(均P<0.05),且研究组降低幅度显著大于对照组(均P<0.05)。研究组患者的干预满意度显著高于对照组(P<0.05)。结论采取风险管理护理模式联合改良正念减压疗法干预PLC患者,能显著降低术后并发症发生率,缓解患者疼痛、疲乏感和心理应激反应,减轻患者的知觉压力并有效改善患者的心理弹性,提升生活质量。

基于柯氏模型构建神经重症护士血管内低温培训体系

目的 依据柯氏模型框架构建神经重症护士血管内低温在职培训评价指标体系,为神经重症护士血管内降温在职培训质量评价提供参考标准。方法 成立研究小组,其次以柯氏模型为理论框架,通过文献回顾初步拟定评价指标,采用德尔菲专家函询法,筛选指标并确定条目,构建神经重症护士血管内降温在职培训评价指标体系。结果 共有15名专家参加咨询,两轮函询问卷回收率分别为100.00%、93.75%,收回的问卷均为有效问卷,专家积极性较高;专家的权威系数分别为0.873、0.863,咨询结果较可靠;肯德尔协调系数分别为0.111、0.289,P<0.001,差异具有统计学意义,专家意见协调程度较好。最终确定的神经重症护士血管内低温在职培训评价指标体系包括4项一级指标、11项二级指标和33项三级指标。结论 我国神经重症护士培训工作处于发展起步阶段,制定一套科学、规范又复合我国实际情况的神经重症护士血管内低温在职培训评价指标体系十分必要。本研究基于柯氏模型构建的神经重症护士血管内低温在职培训评价指标体系具有科学性、可靠性、实用性以及神经重症专科的特色,可为开展神经重症护士血管内低温在职培训提供参考。由于时间的限制,该评价体系尚未进行实证研究,其中各级指标的测评方式及具体内容还有待进一步验证。

5A护理模式在日间全髋、全膝关节置换手术患者院前管理中的应用

目的:评价5A护理模式在日间全髋、全膝关节置换手术患者的应用效果,为优化日间手术患者院前管理提供参考。方法:采用便利抽样法选取2023年6月—11月在浙江省某综合三级甲等医院行日间全髋、全膝关节置换术的296例患者为研究对象,按照入院时间分为对照组和观察组。对照组采用日间常规院前管理流程,观察组在此基础上增设5A护理模式,开展院前管理。比较2组患者术前焦虑、当日手术取消率、退住院率、术前检查缺项率、满意度。结果:观察组患者术前焦虑情况改善优于对照组(P<0.05)。2组患者当日手术取消率、退住院率、术前检查缺项率比较,差异无统计学意义(P>0.05)。观察组患者满意度均值得分高于对照组,差异有统计学意义(P<0.05)。结论:应用5A护理模式进行院前管理,可缓解全髋、全膝关节置换手术患者术前焦虑状况,提高满意度。

营养支持链式管理在胃癌围术期患者中的应用

目的探讨围术期营养支持链式管理对胃癌患者术后营养状况及营养知信行水平的影响。方法将胃癌患者162例按住院时间分为对照组82例(2021年6—12月入院)、干预组80例(2022年1—6月入院)。对照组实施常规围术期营养管理,干预组实施营养支持链式管理,术后1个月比较2组患者的营养状况及营养知识知信行水平。结果干预组术后1个月总蛋白<60 g/L占比为5.00%,低于对照组的14.63%;干预组术后1个月白蛋白<35 g/L占比为3.75%,低于对照组的13.41%;干预组术后1个月体质量指数(BMI)正常范围者占比83.75%,高于对照组的59.75%,差异有统计学意义(P<0.05)。干预组术后1个月营养知识、支持态度、支持行为维度得分以及营养知信行总分均高于对照组,差异有统计学意义(P<0.05)。结论围术期实施营养支持链式管理能有效增加患者营养摄取量,改善胃癌患者术后营养状况,提升患者营养知信行水平和生活质量。

基于九宫格思维模型的手术室护理管理在胸腔镜手术中的应用效果

目的探究基于九宫格思维模型的手术室护理管理在胸腔镜手术中的应用效果。方法选取2021年1月—2023年1月医院收治的接受胸腔镜手术的患者104例为研究对象,按照组间基线资料可比的原则分为对照组和观察组,各52例。对照组采取常规模式管理,观察组在对照组基础上给予九宫格思维模型的护理管理。比较两组患者的手术效率、护理质量、患者和手术医师对手术室护理工作的满意度。结果观察组患者手术准备时间、手术操作时间、连台手术周转时间均短于对照组,差异有统计学意义(P<0.05)。观察组患者手术配合、无菌操作、文书记录、危急病处理、心理护理、专科知识、健康教育等护理质量评分均高于对照组,差异有统计学意义(P<0.05)。观察组患者对心理疏导、入室宣教、护理水平、体位干预、服务态度等手术室护理工作的满意度高于对照组,差异有统计学意义(P<0.05)。观察组手术医师对手术器械与物品准备、手术配合、应急能力、特殊器械的保管及使用、术中器械传递、护理工作态度、无菌操作、护理技能、责任意识、仪器操作水平等手术室护理工作的满意度高于对照组,差异有统计学意义(P<0.05)。结论基于九宫格思维模型的手术室护理管理在胸腔镜手术中应用效果明显,有助于提高手术效率、护理质量及患者、手术医师对手术室护理工作的满意度。

医疗联合体模式下延续性护理在口腔正畸患者居家自我管理中的作用及对正畸效果的影响

目的:探讨医疗联合体模式下延续性护理在口腔正畸患者居家自我管理中的作用及对正畸效果的影响。方法:选取2021年12月-2022年5月笔者科室开展常规护理的患者72例为对照组,选取2022年7月-2022年11月开展医疗联合体模式下延续性护理的患者72例为观察组。比较两组自我管理能力、正畸效果、口腔维护情况、红色美学效果及复诊情况。结果:干预后,两组自我管理行为、自我管理环境、自我管理认知评分均增高,且观察组高于对照组(P<0.05)。干预后,观察组正畸总有效率高于对照组(P<0.05)。干预后,观察组牙龈指数、菌斑指数均低于对照组(P<0.05)。干预后,观察组红色美学指数大于对照组(P<0.05)。干预期间,观察组按时复诊率高于对照组,托槽脱落率、黏膜损伤率低于对照组(P<0.05)。结论:医疗联合体模式下延续性护理在口腔正畸患者中应用可提高患者居家自我管理能力,改善正畸效果、口腔维护情况、红色美学效果与复诊情况。

《护理管理学》教学中基于成果导向理念的BOPPPS教学设计与实践

目的 探讨基于成果导向教育(OBE)的教学设计在《护理管理学》课程教学中的实践效果,旨在提高专业课程的课堂教学效果,促进护理人才培养。方法 针对《护理管理学》课程教学中的“主动难、理解难、应变难”问题,以OBE理念为指导基于BOPPPS模型构建教学模式,并于2021年9月至2022年4月,在上海交通大学护理学院74名大学四年级护理本科生中实施;通过问卷调查、课后反思及小组汇报对教学效果进行评价。结果 90%以上的学生对总体教学设计、学习效果表示满意,100%的学生参与了线上及线下讨论。由学生提交的课后反思内容及临床护理质量持续改进案例设计分析可见,该课程设计有助于提升学生的学习兴趣和综合能力、促进专业知识学习教学目标的达成。结论 在《护理管理学》课程中应用基于OBE理念的BOPPPS教学设计可有效提高护理本科生对课堂知识的掌握度、理解度和应用度,使其获得成就感,形式正向循环。

聚焦解决模式对主动脉夹层动脉瘤病人自我管理能力、自我感受负担及负性情绪的影响

目的:探讨聚焦解决模式对主动脉夹层动脉瘤病人自我管理能力、自我感受负担及负性情绪的影响。方法:选取华中科技大学同济医学院附属同济医院心外科2021年1月—2022年12月收治的65例主动脉夹层动脉瘤病人为研究对象,按照入院时间顺序将2021年1月—12月入院的32例病人设为对照组,将2022年1月—12月入院的33例病人设为观察组。对照组给予常规护理,观察组在常规护理的基础上采用聚焦解决模式进行心理干预。干预前后采用主动脉夹层动脉瘤病人自我管理能力量表、自我感受负担量表、医院焦虑抑郁量表进行测评。结果:两组干预后自我管理能力量表总分、自我感受负担量表总分、医院焦虑抑郁量表总分及焦虑、抑郁评分比较,差异均有统计学意义(均P<0.05)。结论:聚焦解决模式的应用有助于提高主动脉夹层动脉瘤病人的自我管理能力,减轻自我感受负担,缓解负性情绪。

肺泡蛋白沉积症患者全肺灌洗术中的风险管理

总结12例肺泡蛋白沉积症患者行全肺灌洗术中应用霍尔三维模型进行风险管理的护理经验。针对疾病特殊性及全肺灌洗术的多重风险,对患者风险分级管控,提前预警;引入霍尔三维模型,以全肺灌洗术围手术期为线轴,以专科知识及思辨逻辑能力系统排查及处理风险隐患,提升安全护理效能。该组患者住院治疗护理4~29 d,症状好转出院。

能力素质冰山模型管理在手术室护理管理中的应用效果

目的:观察能力素质冰山模型管理在手术室护理管理中的应用效果。方法:选取2022年1—6月该院手术室76名护理人员实施常规手术室护理管理,选取2022年7—12月该院手术室76名护理人员实施能力素质冰山模型管理。比较两组护理管理质量[服务质量量表(SERVQUAL)]评分、管理前后护理人员核心能力[注册护士核心能力量表(CIRN)]评分、手术室不良事件发生率和患者满意度。结果:观察组有形性、可靠性、响应性、保证性、移情性等SERVQUAL各维度评分均高于对照组,差异有统计学意义(P<0.05);管理后,观察组批判性思维与科研、临床护理、领导能力、人际关系、法律与伦理实践、专业发展、教育与咨询等CIRN各维度评分均高于对照组,差异有统计学意义(P<0.05);观察组患者手术室不良事件发生率为3.00%(3/100),低于对照组的10.00%(10/100),差异有统计学意义(P<0.05);观察组患者满意度为97.00%(97/100),高于对照组的90.00%(90/100),差异有统计学意义(P<0.05)。结论:能力素质冰山模型管理应用于手术室护理管理可提高护理管理质量评分、护理人员核心能力评分和患者满意度,降低手术室不良事件发生率,效果优于常规手术室护理管理。

医护药共同管理模式对心脏瓣膜置换术后患者抗凝管理的效果研究

目的评估医护药共同管理模式对心脏瓣膜置换术后患者抗凝管理的效果,以探索心脏瓣膜置换术后患者抗凝管理的新模式。方法采用整群抽样法选取2022—2023年海南省人民医院心脏外科收治的264例心脏瓣膜置换术患者作为研究对象,其中2022年1~6月收治的132例患者纳入对照组,实施医护共同管理模式;2023年1~6月收治的132例患者纳入干预组,实施医护药共同管理模式。分别于出院时和出院后6个月采用华法林抗凝知识问卷调查表、华法林抗凝治疗依从性问卷调查表、华法林抗凝监测记录表、抗凝宣教满意率问卷调查表评价两组患者的抗凝知识掌握程度、抗凝依从性(包括服药依从性、监测依从性和生活方式依从性)、INR值达标率、抗凝不良事件发生率和抗凝宣教满意率。结果出院时和出院后6个月,干预组患者的抗凝知识掌握程度好的患者分别为102例(72.7%)和74例(56.1%),明显高于对照组的82例(62.1%)和37例(28.1%),差异均有统计学意义(P<0.05);出院时和出院后6个月,两组患者的抗凝依从性总分和三个维度得分比较差异均无统计学意义(P>0.05);两组患者出院时和出院后6个月的INR值达标率比较差异均无统计学意义(P>0.05),但两组患者出院后的INR值达标率均明显低于出院时,差异均有统计学意义(P<0.001);出院时和出院后6个月,两组患者的抗凝不良事件发生率比较差异均无统计学意义(P>0.05),但出院后6个月,两组患者的抗凝不良事件发生率均高于出院时,差异均具有显著统计学意义(P<0.01);出院时两组患者的抗凝宣教满意率比较差异无统计学意义(P>0.05),出院后6个月的抗凝宣教满意率比较差异亦无统计学意义(P>0.05),同时,出院后6个月两组患者的抗凝宣教满意率均低于出院时,差异均具有统计学意义(P<0.05)。结论医护药共同管理模式能够提高心脏瓣膜置换术后患者的抗凝知识掌握程度和抗凝宣教满意率,适用于心脏瓣膜置换术后患者的抗凝管理。但即便引入临床药师增强了住院期间抗凝管理力度,对出院后的抗凝管理效果仍然影响甚微,需要继续探索心脏瓣膜置换术后患者出院后的抗凝管理新思路。