论文部分内容阅读
目的分析2型糖尿病临床路径实施过程中产生变异的种类及原因,提出初步的解决方案,为临床路径的进一步顺利开展提供借鉴。方法将南京医科大学第一附属医院2011年6月—2012年6月期间纳入2型糖尿病临床路径管理系统的781例病例录入Excel,SPSS 13.0软件统计不同变异类型的发生率。结果 781例病例中总变异率高达30%,与医院系统相关的变异占25.22%,与患者和疾病相关的变异占51.3%,与医务人员相关的变异占23.48%;可控变异占48.7%,不可控变异占51.3%;正性变异占48.27%,负性变异占51.73%。结论临床路径变异产生的根本原因是疾病和患者以及临床路径本身的局限性,对于患者应加强宣教,对于变异多的疾病可以尝试建立多级别的分支路径。
Objective To analyze the types and causes of variations in the clinical pathways of type 2 diabetes mellitus and to propose preliminary solutions to provide a reference for the further smooth development of clinical pathways. Methods The 781 cases included in the clinical path management system of type 2 diabetes in the First Affiliated Hospital of Nanjing Medical University from June 2011 to June 2012 were entered into Excel and SPSS 13.0 software to calculate the incidence of different types of mutations. Results The total mutation rate was as high as 30% in 781 cases, 25.22% in hospital system, 51.3% in patients and disease-related diseases, 23.48% in medical staff, 48.7% in controllable variables, Uncontrollable variation accounted for 51.3%; positive variation accounted for 48.27%, negative variation accounted for 51.73%. Conclusion The root causes of clinical pathological variation are the limitations of the disease, the patients and the clinical path itself. For patients, the mission should be strengthened, and multi-level branches pathways should be tried for the most varied diseases.