应用JCI标准建立标准化护理对重症心力衰竭患者血压水平影响的应用

摘要

Objective To investigate the effects of standardized care guided by JCI criteria on blood pressure levels, compliance, and disease outcome in patients with severe heart failure. Methods 94 patients with severe heart failure received in Beijing Chaoyang Integrative Medicine Emergency Medical Center from March 2017 to July 2018 were divided into two groups according to random number table method, with 47 cases in the control group and 47 cases in the intervention group. . The control group received routine nursing of cardiology, and the intervention group implemented standardized care guided by JCI standard on the basis of the control group: using the standardized language of "CICARE"; conducting the "medical care responsibility management system" mode, explaining the "patient instructions", Through the ＂salt control spoon＂, ＂control blood pressure＂, ＂pressure reduction＂, ＂Ba Duan Jin＂ and other forms of health education; out-of-hospital follow-up is based on the ＂sparrow health platform＂ to set up ＂healthy steward＂ to improve the ＂health document＂. The blood pressure level, changes of cardiac function index, treatment compliance and quality of life were compared between the two groups. Results Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels in the two groups were lower than those before intervention (P＜0.05), and those in the intervention group were lower than those in the control group (P＜0.05). The cardiac function indexes of the two groups were improved compared with those before intervention (P＜0.05), and the intervention group was better than the control group (P＜0.05). The treatment compliance of intervention group was 91.49%, which was higher than 74.47% of control group (P＜0.05). The Minnesota Living with Heart Failure Questionnaire (LiHFe) scores of the two groups were lower than those before intervention (P＜0.05), and those in the intervention group were lower than those in the control group (P＜0.05). Conclusion Standardized nursing guided by JCI standard for patients with severe heart failure can effectively improve their treatment compliance, significantly reduce blood pressure level, significantly improve cardiac function and quality of life.%目的 探讨JCI标准指导的标准化护理对重症心力衰竭患者血压水平、依从性及疾病转归的影响.方法 将北京朝阳中西医结合急诊抢救中心于2017年3月至2018年7月接收的94例重症心力衰竭患者按照随机数字表法分成两组,对照组与干预组各47例.对照组给予心内科常规护理,干预组在对照组基础上实施JCI标准指导的标准化护理:使用"CICARE"的标准化语言通沟;进行"医护责任制管理"模式,讲解"患者说明书"、通过"控盐勺"、"操控血压""降压操"、"八段锦"等多种形式进行健康宣教;院外随访是在基于"麻雀健康平台"设立"健康管家"完善"健康档案".对比两组血压水平、心功能指标变化情况、治疗依从性以及生活质量.结果 干预后两组收缩压(SBP)、舒张压(DBP)水平与干预前相比均降低(P＜0.05),且干预组均低于对照组(P＜0.05);两组心功能指标与干预前相比均有改善(P＜0.05),且干预组均优于对照组(P＜0.05);干预组治疗依从性91.49%,较对照组的74.47%高(P＜0.05);两组明尼苏达心力衰竭生活质量调查表(LiHFe)各维度评分与干预前相比均降低(P＜0.05),且干预组均低于对照组(P＜0.05).结论 对重症心力衰竭患者实施JCI标准指导的标准化护理,可有效提高患者治疗依从性,明显降低患者血压水平,显著改善心功能以及生活质量.