基于短暂性脑缺血发作单病种护理质量管理的实践探讨

杨敏 张芳 张丽娟

【摘要】 目的：探討基于短暂性脑缺血发作（TIA）单病种护理质量管理的实践效果。方法：选取南昌大学第二附属医院2021年1月—2023年3月收治的TIA患者100例。按照随机分组原则将患者分为对照组和研究组，各50例。对照组开展基于TIA单病种临床路径护理的优质护理，此基础上，研究组实施基于TIA单病种护理质量管理。比较两组对TIA健康知识知晓评分，跌倒/坠床风险评分、压力性损伤风险评分、肌力情况及出院指导落实率。结果：干预前，两组对TIA健康知识知晓评分、跌倒/坠床风险评分、压力性损伤风险评分及肌力分级情况比较，差异均无统计学意义（P>0.05）；出院时，两组对TIA健康知识知晓评分、压力性损伤风险评分均较干预前升高，跌倒/坠床风险评分均较干预前降低，差异均有统计学意义（P<0.05）；研究组出院时对TIA健康知识知晓评分、压力性损伤风险评分均高于对照组，跌倒/坠床风险评分低于对照组，差异均有统计学意义（P<0.05）。出院时，两组肌力分级均较干预前改善，且研究组优于对照组（P<0.05）。研究组出院指导落实率为100%，高于对照组的88.00%，差异有统计学意义（P<0.05）。结论：基于TIA单病种护理质量管理有助于提升TIA患者对疾病健康知识知晓情况，降低跌倒及压力性损伤风险，提高护理质量，促进患者康复。

【关键词】 短暂性脑缺血发作 单病种 质量管理

Discussion on the Application of Nursing Quality Management Based on Single Disease of Transient Ischemic Attack in Practice/YANG Min， ZHANG Fang， ZHANG Lijuan. //Medical Innovation of China， 2024， 21（08）： 0-083

[Abstract] Objective： To explore the practical effect of nursing quality management based on single disease of transient ischemic attack （TIA）. Method： A total of 100 TIA patients admitted to the Second Affiliated Hospital of Nanchang University from January 2021 to March 2023 were selected. According to the principle of randomization， the patients were divided into control group and study group， 50 cases each. The control group carried out high-quality nursing based on TIA single disease clinical pathway nursing. On this basis， the study group implemented nursing quality management based on TIA single disease. The health knowledge score， fall/bed fall risk score， stress injury risk score， muscle strength and discharge guidance implementation rate were compared between the two groups. Result： Before intervention， there were no significant differences in TIA health knowledge score， fall/bed fall risk score， stress injury risk score and muscle strength grade between the two groups （P>0.05）. At discharge， TIA health knowledge scores and stress injury risk scores were higher in both groups than those before intervention， and fall/bed fall risk scores were lower than those before intervention， the differences were statistically significant （P<0.05）. The TIA health knowledge score and stress injury risk score of the study group were higher than those of the control group at discharge， and the fall/bed fall risk score was lower than that of the control group， the differences were statistically significant （P<0.05）. At discharge， the muscle strength grading of both groups were improved compared with those before intervention， and the study group was better than that of the control group （P<0.05）. The discharge guidance implementation rate in the study group was 100%， which was higher than 88.00% in the control group， the difference was statistically significant （P<0.05）. Conclusion： Nursing quality management based on TIA single disease is helpful to improve the health knowledge of TIA patients， reduce the risk of falls and stress injuries， improve the quality of nursing， and promote the recovery of patients.

[Key words] Transient ischemic attack Single disease species Quality management

First-author's address： Department of Neurology， the Second Affiliated Hospital of Nanchang University， Nanchang 330006， China

doi：10.3969/j.issn.1674-4985.2024.08.018

短暂性脑缺血发作（TIA）是由于视网膜缺血或脑局部缺血引起的一种无责任病灶证据的短暂性神经功能缺损性疾病，临床发病以男性居多，且發病率随着年龄呈上升趋势[1-2]。TIA发作后一般无后遗症，但由于患者的不够重视，可导致TIA反复发作，最终成为脑卒中发作的高危影响因素[3-4]。因此，需引起足够重视。单病种护理质量管理是以“患者为中心”，衡量医院护理服务质量和技术水平的重要措施，也是规范护理质量管理的重要手段[5]。近年来，随着我国医疗改善的不断深入，为单病种护理质量管理的临床实践创造了基础条件。然而，临床中却未见关于TIA单病种护理质量管理的相关报道。基于……