Discussion of the clinical case oriented management model

Abstract

Objective To explore effect of clinical case oriented management on nurses comprehensive ability, psychological and critical mind. Methods In 2014 on implementation of routine clinical case management model as control group, collected 97 cases of clinical cases. In 2015 on implementation of the clinical case oriented management model as observation group, collected 110 cases of clinical cases. Compared two methods of management to improve nurse management theoretical knowledge, clinical practice ability and deal with size of case skills help. When/after clinical special case found influence for nurses, including psychology, work in nursing work will, enthusiasm, independent ability to deal with related cases and nurse critical thinking ability, etc. Results The proportion of nurses thought that it was helpful to improve management of theoretical knowledge, clinical practice ability and deal with size of case skills and case analysis of satisfaction were 98.79% (244/247), 99.19% (245/247), 98.79% (244/247), 99.60% (246/247) in observation group, and 88.57% (217/245), 87.35% (214/245), 87.76% (215/245), 90.61% (222/245) in control group. The differences were statistically significant (χ2=21.390-27.571, P < 0.01). The proportion of nurse considered that special case on psychological effects of nursing work, engaged in willingness and enthusiasm were main factor were 15.79% (39/247), 13.77% (34/247), 11.34% (28/247) in observation group, and 31.84% (78/245), 31.02% (76/245), 30.61% (75/245) in control group. The differences were statistically significant (χ2=17.475, 21.097, 27.611, P < 0.01). After special case, percentage of nurses to independently handle case, help others, loss rates were 97.57% (241/247), 2.02% (5/247), 0.40% (1/247) in observation group, and 85.71% (210/245), 12.24% (30/245), 2.04% (5/245) in control group. The proportion of nurses to independently handle case in observation group was higher than that in control group, but ratio of nurses to help others, loss rates in observation group were lower than those in control group, differences were statistically significant (χ2=22.647, P < 0.01).Critical thinking score, observation group of nurses in search for truth, open mind, analytical ability, system organization, judging thinking self-confidence, curiosity, cognitive maturity, such as total score were respectively (43.24±4.01), (43.03±4.12), (47.66±4.23), (44.21±3.92), (44.00±4.97), (52.13±4.44), (48.23±4.85), (319±14.57) points. The control group nurses were respectively (39.00±3.56), (38.90±3.28), (43.65±2.47), (40.55±1.99), (39.00±3.40), (47.87±4.01), (41.89±5.11), (292.23±6.02) points. The differences were statistically significant(t=12.15-24.19, P < 0.01). Conclusions The clinical case oriented management can improve nurses comprehensive ability, reduce adverse impact of special case for nurses, improve clinical nurses' critical thinking ability, to ensure patient safety. Key words: Clinical cases; Quality management; Model