Effects of the structure-process-outcome three-dimension quality assessment model on perioperative blood glucose management among elderly patients with hip fracture
10.3760/cma.j.issn.1674-2907.2018.31.012
- VernacularTitle:结构-过程-结果三维质量评价模式在老年髋部骨折患者围术期血糖管理中的应用
- Author:
Yujia LI
1
;
Haoru LI
;
Li ZHANG
;
Caizhen CHEN
;
Yongmin JING
;
Xiuguo ZHANG
Author Information
1. 河北医科大学第三医院创伤老年骨科
- Keywords:
Aged;
Hip fractures;
Blood glucose management;
Donabedian's three-dimension quality assessment model;
Structure-process-outcome model;
Nursing quality
- From:
Chinese Journal of Modern Nursing
2018;24(31):3773-3777
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application effects of Donabedian's structure-process-outcome three-dimension quality assessment model on perioperative blood glucose management among elderly patients with hip fracture. Methods From September 2016 to April 2017, a total of 129 elderly patients with hip fracture of the Third Hospital of Hebei Medical University were numbered according to admission order. From September to December 2016, a total of 62 cases were in control group receiving routine blood glucose management. From January to April 2017, 67 cases were in observation group treated with blood glucose management based on Donabedian's three-dimension quality assessment model. And then, we compared the blood glucose on admission and before discharge, waiting time before surgery, healing time of wound and cases of hypoglycemia. At the same time, we investigated the demands of training content of medical staff (n=133). Results There was no statistical difference in the first blood glucose 24 hours after admission and 2 hours after meal of patients between two groups (P＞0.05). After intervention, the waiting time before surgery, healing time of wound and incidence rate of hypoglycemia in observation group [(3.34±0.88) d, (4.43±1.38) d and (3/67, 4.5%)]were less than those in control group [(4.63±1.41) d, (6.47±2.24) d and (10/62, 16.1%)];the fasting blood glucose and blood glucose 2 hours after meal in observation group [(5.96±1.21), (7.60±0.96) mmol/L] were lower than those in control group [(10.80±1.14), (9.94±1.98) mmol/L]one day before discharge all with significant differences (P＜ 0.05). There was also significant difference in blood glucose 2 hours after meal in observation group before and after intervention (P＜0.05). The demands of training content of medical staff (n=133) included diet management, correct usage of insulin, oral hypoglycemic agents instruction, blood glucose monitoring management;the influencing factors on implementing blood glucose management involved busy work, inconsistent dinner time, insufficient knowledge, and so forth. Conclusions Blood glucose management process based on Donabedian's three-dimension quality assessment model can effectively control perioperative blood glucose among elderly patients with hip fracture, shorten waiting time before surgery as well as healing time of wound and reduce cases of hypoglycemia which makes for overall rehabilitation of patients.
