Application of clinical nursing pathway based on information-knowledge-attitude-practice theory in percutaneous renal needle biopsy_West China Medical Journal

Authors：

LIU Min , DUAN Difei , CHEN Yi ,  MA Dengyan

Department of Nephrology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

MA Dengyan, Email: mdy5104@163.com

Keywords：

Information-knowledge-attitude-practice theory; Clinical nursing pathway; Percutaneous renal needle biopsy; Chronic kidney disease

DOI：

10.7507/1002-0179.202105280

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Objective To explore the application and effect of clinical nursing pathway based on information-knowledge-attitude-practice (IKPA) theory in percutaneous renal needle biopsy.Methods This is a historical control study. A total of 460 patients who underwent percutaneous renal biopsy in West China Hospital of Sichuan University between April and December 2020 were prospectively recruited as the pathway group, and a clinical nursing pathway based on IKAP theory was implemented. By contrast, the data of 617 patients who underwent percutaneous renal biopsy and received routine care in the same hospital between April and December 2019 were retrospectively collected as the control group. The length of hospital stay, hospitalization expenses, the incidences of postoperative complications (macroscopic haematuria, perirenal hematoma, and acute urinary retention), the incidence of postoperative postural hypotension, and the management enrollment rate of chronic kidney disease patients were compared between the two groups.Results The length of hospital stay [median (lower quartile, upper quartile): 8 (7, 11) vs. 8 (7, 12) d] and the hospitalization expenses [median (lower quartile, upper quartile): 7380.50 (6401.86, 8789.21) vs. 8167.00 (6816.50, 10044.50) yuan] were less in the pathway group than those in the control group, the incidences of postoperative macroscopic haematuria (1.52% vs. 6.97%) and perirenal hematoma (2.61% vs. 5.02%) were lower in the pathway group than those in the control group, the management enrollment rate of chronic kidney disease patients was higher in the pathway group than that in the control group (26.09% vs. 6.16%), and the differences between the two groups were statistically significant (P<0.05). The differences in the incidences of acute urinary retention (8.26% vs. 11.18%) and postoperative postural hypotension (0.00% vs. 0.81%) between the two groups were not statistically significant (P>0.05).Conclusion The application of clinical nursing pathway in percutaneous renal needle biopsy can effectively reduce the length of hospital stay and hospitalization expenses, and improve the management enrollment rate of chronic kidney disease patients.

Citation： LIU Min, DUAN Difei, CHEN Yi, MA Dengyan. Application of clinical nursing pathway based on information-knowledge-attitude-practice theory in percutaneous renal needle biopsy. West China Medical Journal, 2021, 36(7): 872-876. doi: 10.7507/1002-0179.202105280 Copy

1.	麥倩婷. 臨床護理路徑在腎活檢患者護理中的應用. 齊齊哈爾醫學院學報, 2015, 36(22): 3428-3430.
2.	刁永書, 文艷秋, 陳林. 腎臟內科護理手冊. 2版. 北京: 科學出版社, 2015: 24-25.
3.	National Kidney Foundation. KDOQI clinical practice guide-line for diabetes and CKD: 2012 update. Am J Kidney Dis, 2012, 60(5): 850-886.
4.	劉敏, 王芳, 袁麗, 等. 擬行經皮腎穿刺患者取消穿刺計劃的原因分析. 安徽醫學, 2019, 40(4): 423-426.
5.	施杰, 張璟, 劉偉. 206 例經皮穿刺腎活檢出血相關并發癥的臨床分析. 臨床腎臟病雜志, 2018, 18(7): 413-416.
6.	周華麗, 馬洪麗, 顧瓊, 等. 胃癌患者圍手術期加速康復臨床護理路徑的構建及效果評價. 護理學雜志, 2019, 34(10): 20-22, 41.
7.	王瑞柳. 臨床護理路徑在縣級醫院混合痔病人中的應用. 護理研究, 2019, 33(5): 896-898.
8.	荊璇, 薛平, 袁麗榮. IKAP 模式在慢性病管理中的應用研究進展. 護理研究, 2021, 35(8): 1441-1446.
9.	李爽, 牛巧紅, 許慧娟, 等. 基于 IKAP 理論的協同護理干預在乳腺癌病人及家屬中的應用效果. 護理研究, 2020, 34(22): 4058-4062.
10.	謝曉虹. 基于 IKAP 理論的延續護理模式在腦血管介入術患者中的應用. 中華現代護理雜志, 2020, 26(5): 631-635.
11.	醫政醫管局. 《國家衛生健康委辦公廳關于印發有關病種臨床路徑(2019 年版)的通知》. (2020-01-02)[2021-06-01]. http://www.nhc.gov.cn/yzygj/s7659/202001/b3c9e097b0c1471a969d7a63be471759.shtml.
12.	吳惠, 符秀梅, 王德仙, 等. IKAP 管理模式在老年高血壓患者中的應用. 中國老年學雜志, 2019, 39(6): 1458-1460.
13.	吳雙. IKAP 護理對冠心病患者遵醫行為、自我效能的影響. 中國繼續醫學教育, 2018, 10(36): 159-162.
14.	朱丹丹, 李世軍, 黃麗璇, 等. 降低腎活檢并發癥發生率. 中國衛生質量管理, 2018, 25(2): 80-83.
15.	席志鳳. 超聲引導下腎穿刺活檢 160 例并發癥分析. 中國誤診學雜志, 2012, 12(2): 386.
16.	張如娣, 徐海娥, 黃和平. 腎穿刺活檢術后尿潴留原因分析及護理. 護士進修雜志, 2007, 22(1): 56-57.
17.	樊蓉, 姜薇, 劉芳, 等. 腎活檢術后不同臥位方式對患者舒適度及并發癥的影響. 中國實用護理雜志, 2010, 26(29): 82-83.
18.	陳玥, 潘凌蘊. 經皮腎穿刺活檢術后低血壓的原因分析與護理. 循證護理, 2020, 6(6): 519-521.
19.	卜海華, 金麗萍, 胡君. 腎臟穿刺術患者繼發體位性低血壓的安全護理. 中國療養醫學, 2014, 23(2): 164-165.
20.	Benvenuto LJ, Krakoff LR. Morbidity and mortality of or thostatic hypotension: implications for management of cardiovascular disease. Am J Hypertens, 2011, 24(2): 135-144.
21.	陳崇誠, 溫月, 陳懿, 等. 慢性腎臟病隨訪管理對患者血壓和腎小球濾過率的影響. 中華現代護理雜志, 2019(6): 682-685.
22.	馬登艷, 張穎君, 陳懿, 等. 多學科整合模式在慢性腎臟病病人門診隨訪管理中的應用. 護理研究, 2016, 30(24): 3017-3020.
23.	洪惠珍, 廖佩珊, 陳素燕. 提升初期慢性腎臟病個案收案人次專案. 臺灣腎臟護理學會雜志, 2017, 16(2): 30-43.

1. 麥倩婷. 臨床護理路徑在腎活檢患者護理中的應用. 齊齊哈爾醫學院學報, 2015, 36(22): 3428-3430.
2. 刁永書, 文艷秋, 陳林. 腎臟內科護理手冊. 2版. 北京: 科學出版社, 2015: 24-25.
3. National Kidney Foundation. KDOQI clinical practice guide-line for diabetes and CKD: 2012 update. Am J Kidney Dis, 2012, 60(5): 850-886.
4. 劉敏, 王芳, 袁麗, 等. 擬行經皮腎穿刺患者取消穿刺計劃的原因分析. 安徽醫學, 2019, 40(4): 423-426.
5. 施杰, 張璟, 劉偉. 206 例經皮穿刺腎活檢出血相關并發癥的臨床分析. 臨床腎臟病雜志, 2018, 18(7): 413-416.
6. 周華麗, 馬洪麗, 顧瓊, 等. 胃癌患者圍手術期加速康復臨床護理路徑的構建及效果評價. 護理學雜志, 2019, 34(10): 20-22, 41.
7. 王瑞柳. 臨床護理路徑在縣級醫院混合痔病人中的應用. 護理研究, 2019, 33(5): 896-898.
8. 荊璇, 薛平, 袁麗榮. IKAP 模式在慢性病管理中的應用研究進展. 護理研究, 2021, 35(8): 1441-1446.
9. 李爽, 牛巧紅, 許慧娟, 等. 基于 IKAP 理論的協同護理干預在乳腺癌病人及家屬中的應用效果. 護理研究, 2020, 34(22): 4058-4062.
10. 謝曉虹. 基于 IKAP 理論的延續護理模式在腦血管介入術患者中的應用. 中華現代護理雜志, 2020, 26(5): 631-635.
11. 醫政醫管局. 《國家衛生健康委辦公廳關于印發有關病種臨床路徑(2019 年版)的通知》. (2020-01-02)[2021-06-01]. http://www.nhc.gov.cn/yzygj/s7659/202001/b3c9e097b0c1471a969d7a63be471759.shtml.
12. 吳惠, 符秀梅, 王德仙, 等. IKAP 管理模式在老年高血壓患者中的應用. 中國老年學雜志, 2019, 39(6): 1458-1460.
13. 吳雙. IKAP 護理對冠心病患者遵醫行為、自我效能的影響. 中國繼續醫學教育, 2018, 10(36): 159-162.
14. 朱丹丹, 李世軍, 黃麗璇, 等. 降低腎活檢并發癥發生率. 中國衛生質量管理, 2018, 25(2): 80-83.
15. 席志鳳. 超聲引導下腎穿刺活檢 160 例并發癥分析. 中國誤診學雜志, 2012, 12(2): 386.
16. 張如娣, 徐海娥, 黃和平. 腎穿刺活檢術后尿潴留原因分析及護理. 護士進修雜志, 2007, 22(1): 56-57.
17. 樊蓉, 姜薇, 劉芳, 等. 腎活檢術后不同臥位方式對患者舒適度及并發癥的影響. 中國實用護理雜志, 2010, 26(29): 82-83.
18. 陳玥, 潘凌蘊. 經皮腎穿刺活檢術后低血壓的原因分析與護理. 循證護理, 2020, 6(6): 519-521.
19. 卜海華, 金麗萍, 胡君. 腎臟穿刺術患者繼發體位性低血壓的安全護理. 中國療養醫學, 2014, 23(2): 164-165.
20. Benvenuto LJ, Krakoff LR. Morbidity and mortality of or thostatic hypotension: implications for management of cardiovascular disease. Am J Hypertens, 2011, 24(2): 135-144.
21. 陳崇誠, 溫月, 陳懿, 等. 慢性腎臟病隨訪管理對患者血壓和腎小球濾過率的影響. 中華現代護理雜志, 2019(6): 682-685.
22. 馬登艷, 張穎君, 陳懿, 等. 多學科整合模式在慢性腎臟病病人門診隨訪管理中的應用. 護理研究, 2016, 30(24): 3017-3020.
23. 洪惠珍, 廖佩珊, 陳素燕. 提升初期慢性腎臟病個案收案人次專案. 臺灣腎臟護理學會雜志, 2017, 16(2): 30-43.

West China Medical Journal

Application of clinical nursing pathway based on information-knowledge-attitude-practice theory in percutaneous renal needle biopsy

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