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

Video：

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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.	麦倩婷. 临床护理路径在肾活检患者护理中的应用. 齐齐哈尔医学院学报, 2015, 36(22): 3428-3430.
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5.	施杰, 张璟, 刘伟. 206 例经皮穿刺肾活检出血相关并发症的临床分析. 临床肾脏病杂志, 2018, 18(7): 413-416.
6.	周华丽, 马洪丽, 顾琼, 等. 胃癌患者围手术期加速康复临床护理路径的构建及效果评价. 护理学杂志, 2019, 34(10): 20-22, 41.
7.	王瑞柳. 临床护理路径在县级医院混合痔病人中的应用. 护理研究, 2019, 33(5): 896-898.
8.	荆璇, 薛平, 袁丽荣. IKAP 模式在慢性病管理中的应用研究进展. 护理研究, 2021, 35(8): 1441-1446.
9.	李爽, 牛巧红, 许慧娟, 等. 基于 IKAP 理论的协同护理干预在乳腺癌病人及家属中的应用效果. 护理研究, 2020, 34(22): 4058-4062.
10.	谢晓虹. 基于 IKAP 理论的延续护理模式在脑血管介入术患者中的应用. 中华现代护理杂志, 2020, 26(5): 631-635.
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13.	吴双. IKAP 护理对冠心病患者遵医行为、自我效能的影响. 中国继续医学教育, 2018, 10(36): 159-162.
14.	朱丹丹, 李世军, 黄丽璇, 等. 降低肾活检并发症发生率. 中国卫生质量管理, 2018, 25(2): 80-83.
15.	席志凤. 超声引导下肾穿刺活检 160 例并发症分析. 中国误诊学杂志, 2012, 12(2): 386.
16.	张如娣, 徐海娥, 黄和平. 肾穿刺活检术后尿潴留原因分析及护理. 护士进修杂志, 2007, 22(1): 56-57.
17.	樊蓉, 姜薇, 刘芳, 等. 肾活检术后不同卧位方式对患者舒适度及并发症的影响. 中国实用护理杂志, 2010, 26(29): 82-83.
18.	陈玥, 潘凌蕴. 经皮肾穿刺活检术后低血压的原因分析与护理. 循证护理, 2020, 6(6): 519-521.
19.	卜海华, 金丽萍, 胡君. 肾脏穿刺术患者继发体位性低血压的安全护理. 中国疗养医学, 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.	陈崇诚, 温月, 陈懿, 等. 慢性肾脏病随访管理对患者血压和肾小球滤过率的影响. 中华现代护理杂志, 2019(6): 682-685.
22.	马登艳, 张颖君, 陈懿, 等. 多学科整合模式在慢性肾脏病病人门诊随访管理中的应用. 护理研究, 2016, 30(24): 3017-3020.
23.	洪惠珍, 廖佩珊, 陈素燕. 提升初期慢性肾脏病个案收案人次专案. 台湾肾脏护理学会杂志, 2017, 16(2): 30-43.

1. 麦倩婷. 临床护理路径在肾活检患者护理中的应用. 齐齐哈尔医学院学报, 2015, 36(22): 3428-3430.
2. 刁永书, 文艳秋, 陈林. 肾脏内科护理手册. 2版. 北京: 科学出版社, 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. 刘敏, 王芳, 袁丽, 等. 拟行经皮肾穿刺患者取消穿刺计划的原因分析. 安徽医学, 2019, 40(4): 423-426.
5. 施杰, 张璟, 刘伟. 206 例经皮穿刺肾活检出血相关并发症的临床分析. 临床肾脏病杂志, 2018, 18(7): 413-416.
6. 周华丽, 马洪丽, 顾琼, 等. 胃癌患者围手术期加速康复临床护理路径的构建及效果评价. 护理学杂志, 2019, 34(10): 20-22, 41.
7. 王瑞柳. 临床护理路径在县级医院混合痔病人中的应用. 护理研究, 2019, 33(5): 896-898.
8. 荆璇, 薛平, 袁丽荣. IKAP 模式在慢性病管理中的应用研究进展. 护理研究, 2021, 35(8): 1441-1446.
9. 李爽, 牛巧红, 许慧娟, 等. 基于 IKAP 理论的协同护理干预在乳腺癌病人及家属中的应用效果. 护理研究, 2020, 34(22): 4058-4062.
10. 谢晓虹. 基于 IKAP 理论的延续护理模式在脑血管介入术患者中的应用. 中华现代护理杂志, 2020, 26(5): 631-635.
11. 医政医管局. 《国家卫生健康委办公厅关于印发有关病种临床路径(2019 年版)的通知》. (2020-01-02)[2021-06-01]. http://www.nhc.gov.cn/yzygj/s7659/202001/b3c9e097b0c1471a969d7a63be471759.shtml.
12. 吴惠, 符秀梅, 王德仙, 等. IKAP 管理模式在老年高血压患者中的应用. 中国老年学杂志, 2019, 39(6): 1458-1460.
13. 吴双. IKAP 护理对冠心病患者遵医行为、自我效能的影响. 中国继续医学教育, 2018, 10(36): 159-162.
14. 朱丹丹, 李世军, 黄丽璇, 等. 降低肾活检并发症发生率. 中国卫生质量管理, 2018, 25(2): 80-83.
15. 席志凤. 超声引导下肾穿刺活检 160 例并发症分析. 中国误诊学杂志, 2012, 12(2): 386.
16. 张如娣, 徐海娥, 黄和平. 肾穿刺活检术后尿潴留原因分析及护理. 护士进修杂志, 2007, 22(1): 56-57.
17. 樊蓉, 姜薇, 刘芳, 等. 肾活检术后不同卧位方式对患者舒适度及并发症的影响. 中国实用护理杂志, 2010, 26(29): 82-83.
18. 陈玥, 潘凌蕴. 经皮肾穿刺活检术后低血压的原因分析与护理. 循证护理, 2020, 6(6): 519-521.
19. 卜海华, 金丽萍, 胡君. 肾脏穿刺术患者继发体位性低血压的安全护理. 中国疗养医学, 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. 陈崇诚, 温月, 陈懿, 等. 慢性肾脏病随访管理对患者血压和肾小球滤过率的影响. 中华现代护理杂志, 2019(6): 682-685.
22. 马登艳, 张颖君, 陈懿, 等. 多学科整合模式在慢性肾脏病病人门诊随访管理中的应用. 护理研究, 2016, 30(24): 3017-3020.
23. 洪惠珍, 廖佩珊, 陈素燕. 提升初期慢性肾脏病个案收案人次专案. 台湾肾脏护理学会杂志, 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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