Application of “Structure-process-result” Three-dimensional Quality Evaluation Model in the Prevention and Treatment of VTE in Surgical Inpatients

Ying YANG; Renlan LI; Lei SONG; Dongmei ZHUANG; Peiyu FAN; Si LI

doi:10.12259/j.issn.2095-610X.S20230625

Volume 44 Issue 6

Jun. 2023

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2023 > 44(6): 169-174

Ying YANG, Renlan LI, Lei SONG, Dongmei ZHUANG, Peiyu FAN, Si LI. Application of “Structure-process-result” Three-dimensional Quality Evaluation Model in the Prevention and Treatment of VTE in Surgical Inpatients[J]. Journal of Kunming Medical University, 2023, 44(6): 169-174. doi: 10.12259/j.issn.2095-610X.S20230625

Citation:

Ying YANG, Renlan LI, Lei SONG, Dongmei ZHUANG, Peiyu FAN, Si LI. Application of “Structure-process-result” Three-dimensional Quality Evaluation Model in the Prevention and Treatment of VTE in Surgical Inpatients[J]. Journal of Kunming Medical University, 2023, 44(6): 169-174. doi: 10.12259/j.issn.2095-610X.S20230625

Citation:

Ying YANG, Renlan LI, Lei SONG, Dongmei ZHUANG, Peiyu FAN, Si LI. Application of “Structure-process-result” Three-dimensional Quality Evaluation Model in the Prevention and Treatment of VTE in Surgical Inpatients[J]. Journal of Kunming Medical University, 2023, 44(6): 169-174. doi: 10.12259/j.issn.2095-610X.S20230625

PDF( 645 KB)

Application of “Structure-process-result” Three-dimensional Quality Evaluation Model in the Prevention and Treatment of VTE in Surgical Inpatients

doi: 10.12259/j.issn.2095-610X.S20230625

Second Department of General Surgery，Yan’an Hospital Affiliated to Kunming Medical University，Kunming Yunnan 650051，China

Received Date: 2023-03-17
Available Online: 2023-06-16
Publish Date: 2023-06-25

Abstract

Abstract

Objective To explore the application effect of “structure-process-outcome” three-dimensional quality evaluation model in the prevention and treatment of surgical inpatients with VTE. Methods A total of 400 patients admitted to Department of General Surgery in Yan’an Hospital of Kunming City from July 2020 to June 2021 were selected as research subjects, and were divided into control group and experimental group using random number table method, with 200 patients in each group. The control group received hospital VTE prevention and treatment nursing following the hospital regulations. The experimental group received the “structure-process-result” three-dimensional quality evaluation model, which was applied to the prevention and management system of VTE in the hospital, and was optimized from three dimensions: structure, process and result. The incidence of VTE, patient satisfaction, patient service perception and nursing quality score of the two groups were compared. Results The incidence of VTE in the experimental group was significantly lower than that in the control group （χ² = 4.592, P < 0.05）. There were significant differences in patient satisfaction （t = -8.811.91, P < 0.001） and service perception （t = -11.813, P < 0.001） between experimental group and control group. There were differences in five dimensions of service perception between the experimental group and the control group, namely, service system （t = -7.401, P < 0.001）, nursing professionalism （t = -8.347, P < 0.001）, executive ability （t = -5.73, P < 0.001）, demand feedback （t = -8.024, P < 0.001）, nurse-patient relationship （t = -9.799, P < 0.001）. The experimental group scored significantly higher on patient satisfaction and service perception than the control group. In addition, the nursing quality of the experimental group showed statistically significant differences, SD scores of nursing quality gradually decreased, and nursing quality gradually stabilized. Conclusion The application of the “structure-process-result” three-dimensional quality evaluation model can reduce the incidence of VTE in surgical inpatients and promote the high-quality development of nursing teams.
- Quality evaluation system,
- Venous thromboembolism,
- VTE prevention

FullText(HTML)

References(23)

References

[1]	李晓强,张福先,王深明. 深静脉血栓形成的诊断和治疗指南(第三版)[J]. 中国血管外科杂志(电子版),2017,(4):201-208.
[2]	邱贵兴,戴尅戎,杨庆铭,et al. 预防骨科大手术后深静脉血栓形成的专家建议-深静脉血栓形成预防座谈会纪要[J]. 中华骨科杂志,2005,25(10):636-640.
[3]	肖红卫综述,王素伟审校. 骨科深静脉血栓形成危险因素及发病机制的研究进展[J]. 医学信息,2010,23(8):3046-3048.
[4]	中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组. 肺血栓栓塞症诊治与预防指南[J]. 中华医学杂志,2018,98(14):1060-1087. doi: 10.3760/cma.j.issn.0376-2491.2018.14.007
[5]	Acute N C G C,Conditions C. Venous Thromboembolism. Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital[J]. Bmj,2010,334(334):1053-1054.
[6]	None. Correction to Endorsements in: Antithrombotic Therapy and Preventionof Thrombosis,9th ed: American College of Chest Physicians Evidence-BasedClinical Practice Guidelines[J]. Chest,2012,141(4):1129-1132.
[7]	Donabedian A. Evaluating the Quality of Medical Care [J]. 2005, 83（4）: 691-729.
[8]	皮静虹,付欣桐,陈俊宇,等. 采用结构-过程-结果三维质量评价模式实施CABG延续护理实践[J]. 昆明医科大学学报,2021,42(3):176-180.
[9]	全国肺栓塞和深静脉血栓形成防治能力建设项目专家委员会《医院内静脉血栓栓塞症防治质量评价与管理指南(2022版)》编写专家组. 医院内静脉血栓栓塞症防治质量评价与管理指南(2022版)[J]. 中华医学杂志,2022,102(42):3338-3348. doi: 10.3760/cma.j.cn112137-20220623-01373
[10]	Guyatt G H ,Eikelboom J W ,Gould M K ,et al. Approach to outcome measurement in the prevention of thrombosis in surgical and medical patients[J]. Chest,2012,141(2):e185S-e194S.
[11]	Falck-Ytter Y,Francis C W,Johanson N A,et al. Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis,9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.[J]. Chest,2012,141(2):e278S. doi: 10.1378/chest.11-2404
[12]	Theochari N A , Theochari C A , Kokkinidis D G , et al. Venous thromboembolism after esophagectomy for cancer: a systematic review of the literature to evaluate incidence, risk factors, and prophylaxis[J]. Surgery Today, 2022, （2）: 1-11.
[13]	中华人民共和国卫生部. 中国护理事业发展规划纲要(2011-2015年)[J]. 中国护理管理,2012,12(2):5-8.
[14]	CAPRINI J A. Thrombosis risk assessment as a guide to quality patient care[J]. Disease-a-Month,2005,51(2-3):70-80. doi: 10.1016/j.disamonth.2005.02.003
[15]	刘婉丽. 探讨将柔性管理应用于血管外科护理管理中的效果[J]. 中国卫生产业,2019,16(29):49-50.
[16]	Parasuraman A V,Zeithaml V A,Berry L L. Servqual a multiple-item scale for measuring consumer perceptions of service quality[J]. Journal of Retailing,1988,64(1):12-40.
[17]	邓妍, 胡露红, 崔金锐, 等. 基于Servqual模型的个案管理服务质量量表的汉化及信效度检验 [J]. 护理学杂志, 2021, 36（24）: 4.
[18]	侯进,蔡利强,康建忠,等. 基于SERVQUAL量表的以家庭医生为主体的社区中医药健康管理服务评价[J]. 中国全科医学,2019,22(28):5.
[19]	李康, 贺佳. 医学统计学[M]. 第6版. 医学统计学, 2013.
[20]	Murray D W,Carr A J,Bulstrode C J. Pharmacological thromboprophylaxis and total hip replacement[J]. Journal of Bone & Joint Surgery-british Volume,1995,77(1):3-5.
[21]	Autar R. Evidence based venous thromboprophylaxis in patients undergoing total hip replacement (THR),total knee replacement (TKR) and hip fracture surgery (HFS)[J]. International Journal of Orthopaedic and Trauma Nursing,2011,15(3):145-154. doi: 10.1016/j.ijotn.2011.01.001
[22]	彭明琦,李梅,谢爱玲,等. 基于能级进阶模式的护士分层培训的研究现状[J]. 中华现代护理杂志,2017,23(12):6.
[23]	田孝东,杨尹默. 加速康复外科中国专家共识及路径管理指南(2018版)外科部分解读[J]. 协和医学杂志,2018,9(6):485-489. doi: 10.3969/j.issn.1674-9081.2018.06.002

Relative Articles(20)

Relative Articles

[1]	Li WANG, Yajuan SHANG, Ting GAO, Hui FAN, Zhenfeng LIU. Visualization Analysis of Research Trends in Lower Extremity Deep Vein Thrombosis Based on Web of Science. Journal of Kunming Medical University, 2024, 46(): 1-9.
[2]	Jiashuo Chang, Zhengyong Zha, Guangsi Zou, Xianli Huang, Qiuyan Su, Zhenggan Gao. Application of Different Inferior Vena Cava Filters Placed in the Renal Vein for Endovascular Treatment of Deep Venous Thrombosis. Journal of Kunming Medical University, 2024, 46(): 1-8.
[3]	Binbin MA, Ning WANG, Jianping LIU, Kaiquan ZHANG, Yongli GAO, Gaohui LI, Chen ZHANG. Risk Factors of Deep Vein Thrombosis after Soft Tissue Trauma of Lower Extremities. Journal of Kunming Medical University, 2023, 44(8): 110-116. doi: 10.12259/j.issn.2095-610X.S20230817
[4]	Jing CHEN, Hongli FANG, Yangqiong LIU, Yangjuan BAI, Li DENG. Building Nursing Quality Evaluation Index System for Health Management Center. Journal of Kunming Medical University, 2022, 43(4): 170-174. doi: 10.12259/j.issn.2095-610X.S20220429
[5]	Jie WU, Jun LIU, Yan ZHANG, Li REN, Yan-li DANG. The Mechanism of Histones and TLRs in Venous Thrombotic Diseases. Journal of Kunming Medical University, 2021, 42(5): 165-169. doi: 10.12259/j.issn.2095-610X.S20210530
[6]	Ying YANG, Ren-lan LI, Lei SONG, Bin HE, Dong-mei ZHUANG. Application and Effect Evaluation of Integrated Intervention of Multiple Follow-up Methods in Discharged Patients with High Risk of Surgical Venous Thromboembolism. Journal of Kunming Medical University, 2021, 42(6): 170-174. doi: 10.12259/j.issn.2095-610X.S20210636
[7]	Yang Ying , He Bin , Zhuang Dong Mei , Song Lei , Gu Yan Hua , Li Cai E , Li Xia . . Journal of Kunming Medical University, 2020, 41(07): 175-178.
[8]	Hu Xin Yu , Zhang Nan , Dong Xian Xiang , Duan Wei Gang , Yun Yu . Update of Treatment for Lowering Serum Urate. Journal of Kunming Medical University, 2019, 40(03): 131-135.
[9]	Yuan Ying , Li Yuan Yuan , Guo Fang Yuan , Yang Hong Ying . D-dimer Monitoring and Application of Low Molecular Weight Heparin in Prevention of Venous Thrombotic Disease after Gynecological Operation. Journal of Kunming Medical University, 2017, 38(04): 109-112.
[10]	Zhang Fu Hou . Research Progress of Galectin in Mchanism of Venous Trombosis. Journal of Kunming Medical University,
[11]	Dong Zhong Li . Monocytes/Macrophages Promote Venous Thrombosis Organization and Recanalization：Mechanism and Research Progress. Journal of Kunming Medical University,
[12]	Liu De Hong , Shao Ju Wei , Xiang Shu Tian , Liu Chen , Wang Peng , Li Ying Wen . Comparison of BRAVO Sequence and TRICKS Sequence on Cerebral Venous Sinus Thrombosis. Journal of Kunming Medical University, 2016, 37(11): 121-125.
[13]	Zhao Gang . . Journal of Kunming Medical University, 2015, 36(01): 1-1.
[14]	Geng Yu Liu . . Journal of Kunming Medical University,
[15]	Wen Wei . . Journal of Kunming Medical University,
[16]	Zhang Yue Ping . . Journal of Kunming Medical University,
[17]	Liu Jun . . Journal of Kunming Medical University,
[18]	Bu Rui . . Journal of Kunming Medical University,
[19]	. . Journal of Kunming Medical University,
[20]	. . Journal of Kunming Medical University,