Objective
To discuss the running effect of the modified hospital-community integrated two-way-referral service mode in day surgery.
Methods
The hospital-community integrated two-way-referral service mode in day surgery was built in May 2014 by our center, and applied in the communities’ health service network in Chenghua District, Wuhou District, and Jinjiang District. From March 2017 some improvements of the mode were made, such as assigning specific person for the management of two-way-referral, conducting lectures in communities to train the community medical staff, and carrying out gratuitous treatment. The community acceptance rate and patients satisfaction were retrospectively analyzed between March of 2016 and March of 2017, and the number of upward referral (from community to hospital) was retrospectively analyzed between March to June of 2016 and March to June of 2017.
Results
The community acceptance rate was elevated from 81.3% to 99.1% and the patients satisfaction was improved from 95.4% to 100.0%, and the differences between the two periods were statistically significant (P<0.05). The number of upward referral increased from 0 to 23.
Conclusions
The modified hospital-community integrated service mode could optimize the course of surgery appointment, and make it convenient for patients. Furthermore, it also adjusts the reasonable allocation of medical resource effectively and promotes the implementation of national hierarchical medical system.
As the popularity of thoracoscopic day surgery for pulmonary nodules increases, there is a growing demand among patients for information about the surgical approach, process, and recovery. To enhance patients’ understanding of the surgery, alleviate anxiety, facilitate postoperative recovery, and improve patient satisfaction, the Day Surgery Nursing Committee of Sichuan Tianfu New Area Medical Association has convened experts in the field to discuss the health education model and content for the perioperative period of thoracoscopic pulmonary nodule day surgery, reaching an expert consensus. The consensus underscores the importance of leveraging hospital intelligent information systems and integrating diverse educational methods to provide patients with comprehensive and individualized health education.
Objective To explore the application of enhanced recovery after surgery (ERAS) combined with the active health concept in the nursing care of lung cancer patients, and its impact on patients’ compliance with rehabilitation exercises, hospitalization satisfaction, incidence of postoperative complications, and length of hospital stay. Methods A prospective study design was adopted. Lung cancer patients admitted to the Department of Thoracic Surgery, West China Tianfu Hospital of Sichuan University between April and July 2025 were enrolled. Using a non-concurrent control method in a quasi-experimental study, the patients were divided into two groups. The control group received routine ERAS nursing, while the intervention group received additional active health interventions on top of ERAS. These interventions included patient participation in personalized plan formulation, patient empowerment (self-evaluation and independent recording of exercise status), daily one-on-one bedside guidance with positive psychological encouragement from nurses, and optimized perioperative education protocols. Four indicators were compared between the two groups: daily exercise frequency from admission to one month after discharge, hospitalization satisfaction, incidence of postoperative complications, and length of hospital stay. Results The intervention group demonstrated significantly better outcomes than the control group in terms of average daily in-hospital exercise frequency (2.2±0.5 vs. 1.6±0.7; t=5.797, P<0.001), planned average daily out-of-hospital exercise frequency on the day of discharge (3.2±0.9 vs. 1.9±0.8; t=9.038, P<0.001), actual average daily out-of-hospital exercise frequency (3.6±1.5 vs. 2.4±1.4; t=4.932, P<0.001), and satisfaction score on the day of discharge (97.9±4.4 vs. 95.8±5.5; t=2.378, P=0.019). No statistically significant difference was observed between the two groups regarding the incidence of postoperative complications or length of hospital stay (P>0.05). Conclusions The nursing model combining ERAS with the active health concept can effectively increase the frequency of rehabilitation exercises and improve hospitalization satisfaction among lung cancer patients. This combined model is superior to ERAS nursing alone and is worthy of clinical promotion and application.
Objective To evaluate the effect of nursing intervention based on active health concept on self-care ability, anxiety, and depression of patients with lung cancer during perioperative period. Methods Using a quasi-randomized controlled trial design, patients with lung cancer surgery in Department of Thoracic Surgery, West China Tianfu Hospital of Sichuan University from April to July 2025 were selected and divided into an intervention group and a control group according to the time of admission. The control group received routine enhanced recovery after surgery (ERAS) nursing, while the intervention group received multi-stage active health intervention based on ERAS. Exercise of Self-care Agency Scale (ESCA) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate the nursing effects before intervention (T0), at the end of intervention (T1) and 1 month after discharge (T2). Linear mixed models were used for statistical analysis. Results A total of 132 patients were enrolled, including 69 in the intervention group and 63 in the control group. At T0, demographic and clinical characteristics were comparable between the two groups (P>0.05), except for depression scores (6.39±1.38 vs. 6.85±1.46, P<0.05). At T1 and T2, the ESCA scores in the intervention group were significantly higher than those in the control group (T1: 24.50±6.07 vs. 19.04±13.76, P<0.05; T2: 25.32±9.45 vs. 20.03±8.47, P<0.05). Furthermore, both anxiety scores (T1: 15.80±1.24 vs. 17.70±0.82; T2: 17.34±0.83 vs. 17.90±0.41) and depression scores (T1: 5.49±0.92 vs. 6.35±0.60; T2: 5.35±0.56 vs. 6.06±0.35) were significantly lower in the intervention group compared to the control group (P<0.05). Conclusions Perioperative nursing based on the concept of active health can effectively improve the self-care ability of patients with lung cancer and relieve anxiety and depression. This approach provides empirical evidence for deepening patient-centered care within ERAS and is worthy of further clinical promotion and optimization.
Pectus excavatum is the most common chest wall deformity. Severe pectus excavatum can significantly impact both the physiological and psychological health of patients, necessitating timely therapeutic intervention. The Nuss procedure is currently the preferred surgical approach for treating moderate to severe pectus excavatum. However, in cases of severe pectus excavatum, the placement of the corrective steel bar through the anterior mediastinum poses a substantial risk of injury to the heart, major blood vessels, and lung tissue. This article reports a case of a 17-year-old patient with severe pectus excavatum combined with Marfan syndrome. CT examination revealed a Haller index of 14.07, with severe sternal depression leading to significant narrowing of the anterior mediastinal space and complete displacement of the heart into the left thoracic cavity, resulting in an extremely high surgical risk. We employed a simplified sternal elevation technique in conjunction with the Nuss procedure for treatment. During the operation, a sternal retractor was used to elevate the sternum, thereby enlarging the retrosternal space and facilitating the successful completion of the Nuss procedure. This approach effectively avoided damage to the heart and major blood vessels, resulted in no surgical complications, and achieved a satisfactory corrective outcome.
ObjectiveTo investigate the effect of quality control circle (QCC) activity in reducing the temporarily stopping rate of day surgery.MethodsThe QCC activity was carried out from December 2018 to October 2019. By determining the theme of the activity and drawing up the plan, a retrospective analysis of pre-hospital day surgery stoppage status and reasons was performed based on 2 696 patients who had reserved surgery in the day surgery center from December 2018 to February 2019. Based on the data, the goal was determined, and measures were developed and confirmed from May to August 2019. Then the measures were standardized and implemented continuously from September to October 2019. The rate of surgical cessation before the implementation of the measures (from December 2018 to February 2019) was compared with that after the implementation of the measures (from September to October 2019).ResultsAfter the QCC activity, the temporarily stopping rate decreased from 2.89% to 1.34%, and the difference was statistically significant (P<0.001).ConclusionThe QCC activity can effectively reduce the temporarily stopping rate of day surgery, and lay the foundation for continuously promoting the optimization of day surgery resources and quality improvement.
Objective To analyze the causes of unplanned overnight recovery of patients after same-day surgery and put forward countermeasures. Methods The data of same-day surgery patients in the Day Surgery Center of West China Tianfu Hospital of Sichuan University between February 2022 and May 2023 were selected. Patients who recovered overnight were defined as the unplanned overnight recovery group, and patients discharged on the same day after surgery were defined as the normal same-day group. The factors of unplanned overnight recovery after same-day surgery were analyzed. Results A total of 4 259 patients were enrolled, of whom 107 patients had unplanned overnight recovery, 4 152 patients were discharged on the same day after surgery, unplanned overnight recovery group accounted for 2.51% (107/4 259). Except for gender and age (P>0.05), there were significant differences between the two groups in the following six aspects: late starting time of surgery, longer distance from home, medical insurance settlement restrictions, pain, postoperative complications, and patient’s own factors (P<0.05). The results of logistic regression analysis showed that the late starting time of surgery [odds ratio (OR)=9.386, 95% confidence interval (CI) (2.993, 29.432), P<0.001], long distance from address [OR=4.828, 95%CI (2.015, 11.568), P<0.001], medical insurance settlement restrictions [OR=10.667, 95%CI (3.712, 30.658), P<0.001], pain [OR=30.514, 95%CI (7.688, 121.115), P<0.001], postoperative complications [OR=9.642, 95%CI (2.425, 38.342), P=0.001], and patient’s own factors [OR=16.087, 95%CI (10.358, 24.985), P<0.001] were risk factors for unplanned overnight recovery in same-day surgery patients. Conclusions The unplanned overnight recovery of same-day surgery patients in West China Tianfu Hospital of Sichuan University is related to six factors: late starting time of surgery, long distance from home, medical insurance settlement restrictions, pain, postoperative complications, and patient’s own factors. Medical staff can take corresponding measures to reduce the unplanned overnight recovery rate of same-day surgery by strict access standards, optimizing surgical scheduling, formulating individualized enhanced recovery after surgery programs, improving support for patient after discharge, and strengthening perioperative health education.
