CAJ | 학술논문

目的建立缺血性卒中患者院内精细化管理体系，并评价其实践效果。方法自2012年起成立精细化管理质控小组，在临床路径管理的基础上，实施院内精细化管理，加强缺血性卒中患者营养风险筛查和支持、晨峰血压管理、心理健康状态和生活自理能力的评估与干预。结果在实施精细化管理后，患者平均住院日由2012年的12.5天缩短到2014年的9.1天，溶栓率由2012年的20.7%提高到2014年的26.6%，死亡率由2012年的1.8%下降到了2014年的0.3%，再入院率由2012年的17.4%下降到了2014年的10.8%。差异有统计学意义（P<0.05）。结论建立缺血性卒中患者院内精细化管理体系，能有效降低患者的平均住院日、死亡率和再入院率，是保证卒中单元各质量指标的核心，同时促进团队建设和专科护士的培养。
목적건립결혈성졸중환자원내정세화관리체계，병평개기실천효과。방법자2012년기성립정세화관리질공소조，재림상로경관리적기출상，실시원내정세화관리，가강결혈성졸중환자영양풍험사사화지지、신봉혈압관리、심리건강상태화생활자리능력적평고여간예。결과재실시정세화관리후，환자평균주원일유2012년적12.5천축단도2014년적9.1천，용전솔유2012년적20.7%제고도2014년적26.6%，사망솔유2012년적1.8%하강도료2014년적0.3%，재입원솔유2012년적17.4%하강도료2014년적10.8%。차이유통계학의의（P<0.05）。결론건립결혈성졸중환자원내정세화관리체계，능유효강저환자적평균주원일、사망솔화재입원솔，시보증졸중단원각질량지표적핵심，동시촉진단대건설화전과호사적배양。
Objective To establish a delicacy management system on patients with ischemic stroke and evaluate its practice effect.Methods Delicacy management quality control group was established since 2012. Based on clinical path management, implemented delicacy management in hospital and strengthened the nutritional risk screening and support on patients with ischemic stroke, their morning peak blood pressure management, assessment and intervention of mental health status and life self-care ability.Results After the implementation of delicacy management, the average length of stay reduced from 12.5 days in 2012 to 9.1 days in 2014. The thrombolysis rate increased from 20.7% in 2012 to 26.6% in 2014. The mortality rate declined from 1.8% in 2012 to 0.3% in 2014. The re-admission rate reduced from 17.4% in 2012 to 10.8% in 2014. The difference was statistically significant (P<0.05).Conclusion Delicacy management system on patients with ischemic stroke can effectively reduce the average length of stay, mortality and re-admission rate, which is the core to ensure quality and promote team building and specialist nurses training.