Objective To analyze the clinical effect of individualized pain nursing intervention on the pain relieving after ambulatory laparoscopic cholecystectomy (LC) . Methods From March to June 2017, a total of 180 ambulatory LC patients were selected and randomly asigned into the control group and the intervention group with 90 cases in each group. Parecoxib sodium (40 mg) was preoperatively administrated half an hour before the surgery to the patients in both of the two groups. The patients in the control group were treated with routine nursing intervention, while the ones in the intervention group were given individualized pain nursing interventions, including regular pain assessment, preoperative pain health guidance, enhanced education for pain related knowledge, and following the nursing theory of enhanced recovery after surgery. Visual Analogue Scale (VAS) was used to measure the degree of postoperative pain, and the data of dormant pain were collected. Results There was no significant difference between the two groups in VAS one hour after the operation (P>0.05); the VAS scores 2, 6 and 12 hours after the operation gradually decreased in the two groups (P<0.05), and the scores of patients in the intervention group were much lower than those in the control group (P<0.05). The time of pain relieving in the intervention group and the control group was (3.25±1.72) and (5.39±2.06) hours, respectively, and the difference was statistically significant (P<0.05). The incidence of dormant pain in the intervention group (12.2%) was lower than that in the control group (33.3%), and the difference was statistically significant (P<0.05). Conclusion Individualized pain nursing interventions can effectively alleviate the postoperative pain and improve the quality of sleep in ambulatory LC patients.
ObjectiveTo explore the application of artificial intelligence in postoperative follow-up of day surgery patients, so as to establish an intelligent medical framework, promote the intelligent process of hospitals, and improve the management level of day surgery.MethodsThe artificial intelligence phonetic system was carried out by the Day Surgery Center, Renji Hospital, Shanghai Jiaotong University School of Medicine on June 1st, 2018. Through the system, the artificial intelligence voice system based on speech and semantic recognition technology was adopted to connect the data of the information center in the hospital to carry out postoperative follow-up of day surgery patients. We selected the 2 245 patients followed up by the artificial intelligence phonetic system from June 1st to November 30th 2018 (the AI follow-up group) and the 2 576 patients followed up by the traditional manual method from January 2nd to May 31st 2018 (the manual follow-up group), to compare the telephone connection rate, information collection rate, and call duration between them.ResultsThere was no statistically significant difference in telephone connection rate (85.70% vs. 86.68%) or information collection rate (98.86% vs. 98.48%) between the AI follow-up group and the manual follow-up group (P>0.05); but there was a statistically significant difference in call duration between the AI follow-up group and the manual follow-up group [(165.48±43.28) vs. (135.37±36.31) seconds, P<0.05], and the AI follow-up group had a longer call duration.ConclusionsThe application of artificial intelligence phonetic system in surgery has a good performance in call connection rate and information collection integrity. It plays an active role in improving efficiency, extending medical services and strengthening medical safety in the management of day surgery.
ObjectiveTo carry out health education to day surgery patients, assist the smoothness of their operation, promote early recovery of patients and improve the quality of nursing and patients' degree of satisfaction. MethodsA total of 1 888 operations from January to May, 2013 were chosen to be the control group; and 2 136 operations from January to May, 2014 were regarded as the trail group. Patients in the control group accepted routine nursing and health education, while patients in the trail group accepted health education before and after surgery, and through telephone during the follow-up period. ResultsThe rate of failure to keep the appointment, the readmission rates, and the satisfaction rate to the nursing work were 0.28%, 0.94% and 94.71% respectively in the trial group, while were 3.50%, 3.07%, and 90.20%, respectively in the control group. the differeces between the two groups were significant (P<0.05). ConclusionPersonalized health education can ensure the smooth operation of day surgery, advance wound healing of the patients, and improve the day surgery ward care quality and patient satisfaction.
With the rapid development of day surgery mode in China, day surgery management has shifted from extensive to refined, but there are still many problems in the information system of day surgery in Chinese hospitals. The Second Affiliated Hospital Zhejiang University School of Medicine has developed a day surgery information management system since 2018, established a pre-hospital and in-hospital day surgery ecological management, and integrated daily management concepts and management rules into the system through the whole-process information management. It realized the whole process, full data, closed-loop and path-based information management of day surgery. This paper introduces the day surgery information management system of the Second Affiliated Hospital Zhejiang University School of Medicine, and aims to share the experience of building the day surgery information management function module.
As one of the crucial measures in the action plan for improving health services, day surgery is committed to efficiently integrating medical resources and improving the quality of medical services. Nowadays, public hospitals in China are vigorously promoting the day surgery cases. The normalization of day surgery is also one of the major goals for the Department of Gastroenterology to meet the current medical needs and explore sub-professional development in line with the discipline’s advantages. Taking the current status of day surgery in the Department of Gastroenterology of West China Hospital of Sichuan University as an example, this paper explores and constructs the “Huaxi Model of Day Surgery in the Department of Gastroenterology”, focusing on the management mode, operation process, operation implementation, quality and safety assurance of day surgery, so as to facilitate the exchange of experiences.
As an advanced mode of diagnosis and treatment, day surgery is widely carried out in foreign countries. Although it started late in China, it has been gradually valued and vigorously promoted in medical and health field in recent years. The effective implementation of day surgery in hospital cannot be separated from the strong support of performance management system. Through introducing the performance management experiences in promoting day surgery mode in West China Hospital of Sichuan University, this article discusses how to construct an effective whole-course performance management system for day surgery combined with operation management through three mechanisms: the management committee mechanism, the operation management mechanism and the performance assessment mechanism, which are based on the structure-process-outcome dimensions of quality management system, at the three levels of hospital, department and position, so as to provide a reference for developing day surgery in China.
Objective To explore the effect of constructing the closed-loop management of the wound in the day surgery patients and to reduce the incidence of poor wound healing after day surgery. Methods The medical records of patients with closed-loop wound management mode in the Day Surgery Center of West China Hospital of Sichuan University from 2019 to 2020 were collected retrospectively. The general data of patients were collected, and the cases of delayed wound healing after operation were counted. Results A total of 17 801 patients were included, 9 802 in 2019 and 7 999 in 2020. Laparoscopic cholecystectomy and adult tension-free hernia repair were the most common methods of delayed wound healing in day surgery. In the closed-loop management mode, the incidence of delayed wound healing was 0.98% (174/17 801) and the incidence of dissatisfaction related to delayed wound healing was 0.034% (6/17 801). Conclusion The clinical application of the closed-loop management of the wound in the day surgery can promote the early healing of day surgery patients, guarantee the quality of day surgery, and improve patient satisfaction.
ObjectiveTo explore the standardized index system of quality control for single disease of day surgery in Shanghai municipal hospitals.MethodsFrom April to November 2020, through literature research and comprehensive analysis of research results, the framework of quality control index system for single disease of day surgery focusing on obstructive sleep apnea hypopnea syndrome surgery and laparoscopic cholecystectomy was constructed; Delphi method was used to evaluate the quality of day surgery in terms of results, objectivity, statistics, sensitivity, accessibility, quantifiability, importance, and guidance. Finally, the final indicators were screened out.ResultsAfter three rounds of Delphi investigation, 18 experts finally formed 14 general indexes and 14 personalized indexes (6 for obstructive sleep apnea hypopnea syndrome and 8 for laparoscopic cholecystectomy) in the single disease of day surgery quality control index system.ConclusionsThe general indexes and personalized indexes quantifying the quality control index for single disease of day surgery are conducive to the standardization and standardized management of day surgery, and can provide a reference for improving the medical quality and safety, and sustainable development of day surgery.
Day surgery can shorten the average hospital stay and enhance the recovery of patients, and has great social and economic benefits. In order to provide reference for the establishment of standardized operating room management, West China Hospital of Sichuan University summed up the experience of past years to develop this management specification for day surgery operating room. The main contents of this specification include: the principles of scheduling day surgery; the resource allocation of operating room; operating room nursing care, nursing points, and precautions. The release of this specification is conducive to the improvement of the nursing management for day surgery operating room, and the promotion of day surgery.
In order to optimize the postoperative rehabilitation path of patients undergoing fourth-level day surgery, West China Hospital of Sichuan University has learned from the abroad “recovery hotel” mode and innovatively regarded the primary rehabilitation institution as an extended service carrier for thoracoscopic lung nodule day surgery. This extended rehabilitation mode based on primary rehabilitation institutions is not only beneficial for shortening the hospitalization period and reducing medical costs, but also ensures medical safety through a standardized postoperative monitoring system, providing innovative solutions for the full process management of day surgeries. This article will introduce the specific implementation methods and preliminary practical results of the extended rehabilitation mode mentioned above.