Retrospective Study Open Access
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2024; 12(19): 3744-3751
Published online Jul 6, 2024. doi: 10.12998/wjcc.v12.i19.3744
Effect analysis of applying high-quality service model to surgical nursing
Li Chen, Qiu-Mei Tu, Zhao-Di Guo, Xiao-Wei Zhu, Wei Wang, Hui-Fang Xie, Yuan Ye, Hand Surgery, The First People’s Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
ORCID number: Yuan Ye (0009-0005-5363-7544).
Co-first authors: Li Chen and Qiu-Mei Tu.
Author contributions: Chen L, Tu QM, Guo ZD, Zhu XW, Wang W, Xie HF, Ye Y contributed equally to this work; Chen L, Tu QM, Guo ZD designed the research study; Xie HF, Ye Y analyzed the data and wrote the manuscript; Zhu XW, Wang W performed the primary literature and data extraction, were responsible for revising the manuscript for important intellectual content; and all authors read and approved the final version.
Institutional review board statement: The study was reviewed and approved by The First People Hospital of Jiangxia District.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at 13659847034@163.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan Ye, BM BCh, Supervisor Nurse, Hand Surgery, The First People’s Hospital of Jiangxia District, No. 1 Cultural Avenue, Jiangxia District, Wuhan 430200, Hubei Province, China. 13659847034@163.com
Received: March 9, 2024
Revised: April 30, 2024
Accepted: May 20, 2024
Published online: July 6, 2024
Processing time: 111 Days and 23 Hours

Abstract
BACKGROUND

Surgical care of the hand plays a crucial role in the medical field, as problems with the hand can profoundly affect a patient's quality of life and function. In order to meet the needs of patients, improve patient satisfaction and improve treatment outcomes, high-quality service models have been introduced in the field of nursing.

AIM

To explore the effect analysis of applying high-quality service model to surgical nursing.

METHODS

We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022, using a quality service model that included improved patient education, pain management, care team collaboration, and effective communication. Another group of patients received traditional care as a control group. We compared postoperative recovery, satisfaction, complication rate, and length of hospital stay between the two groups. Inferential statistics were used to compare the difference between the two groups by independent sample t test, Chi-square test and other methods to evaluate the effect of intervention measures.

RESULTS

Postoperative recovery time decreased from 17.8 ± 2.3 d to 14.5 ± 2.1 d, pain score decreased from 4.7 ± 1.9 to 3.2 ± 1.4, and hand function score increased from 78.4 ± 7.1 to 88.5 ± 6.2. In terms of patient satisfaction, the quality service model group scored 87.3 ± 5.6 points, which was significantly higher than that of the traditional care group (74.6 ± 6.3 points). At the same time, patients' understanding of medical information also improved from 6.9 ± 1.4 to 8.6 ± 1.2. In terms of postoperative complications, the application of the quality service model reduced the incidence of postoperative complications from 26% to 10%, the incidence of infection from 12% to 5%, and the incidence of bleeding from 10% to 3%. The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications. In addition, the average hospital stay of patients in the quality service model group was shortened from 6.8 ± 1.5 d to 5.2 ± 1.3 d, and the hospitalization cost was also reduced from 2800 ± 600 yuan to 2500 ± 500 yuan.

CONCLUSION

Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes, including faster recovery, less pain, greater satisfaction, and reduced complication rates.

Key Words: Hand surgery nursing, Quality service model, Clinical outcomes, Patient satisfaction, Collaboration, Pain management

Core Tip: In this study, the application of a high-quality service model in surgical nursing significantly enhances patient outcomes and satisfaction. Our retrospective study comparing patients receiving the model with those receiving traditional care revealed remarkable improvements. Postoperative recovery time shortened, pain scores decreased, and hand function scores improved. Patient satisfaction scores were significantly higher in the quality service model group, indicating a superior patient experience. Additionally, patients' understanding of medical information increased, enhancing their engagement and informed decision-making. Crucially, the model also reduced postoperative complications, infection rates, and bleeding occurrences. This comprehensive approach, encompassing improved patient education, pain management, care team collaboration, and communication, represents a valuable tool in surgical nursing. Its implementation can lead to better patient outcomes, increased satisfaction, and reduced complications, ultimately enhancing the quality of surgical care.



INTRODUCTION

Hand surgical care plays a vital role in the medical field[1], as hand problems can profoundly impact a patient's quality of life and functionality[2]. Therefore, providing high-quality hand surgery care is critical to patient recovery[3,4]. However, the nursing field's rapid development and continuous evolution make it necessary to seek ways to improve nursing services constantly[5,6]. In order to meet patients' needs, increase patient satisfaction, and improve treatment outcomes, quality service models have been introduced in the nursing field[7].

This study explored the clinical effects of applying a high-quality service model in hand surgical care[8]. In the current medical environment, patients not only expect to receive high-level medical care but also expect to experience a more humane and caring medical process[9,10]. Therefore, introducing high-quality service models to provide patients with more comprehensive, personalized, and satisfactory care has become a trend[11,12]. The purpose of this study was to evaluate the potential benefits of this model by comparing differences in postoperative recovery, satisfaction, complication rates, and length of stay between patients using a premium service model and traditional care services. Hand surgical nursing is a crucial branch of surgical nursing, covering hand injuries, hand surgeries, hand diseases, and other fields[13,14]. Hand problems cause trouble in an individual's daily life and may also affect their professional and social activities[15,16]. Therefore, effective hand surgical care is essential to help patients restore hand function and improve their quality of life.

The quality service model has been widely used in the medical field and successful in various medical care settings[17,18]. This model emphasizes personalized care, patient education, care team collaboration, and effective communication. The premium service model aims to provide more comprehensive care and improve the patient experience by treating patients as active participants in the care process[19]. However, the clinical effectiveness of applying this model in hand-surgical care has yet to be thoroughly studied and evaluated[20,21]. Therefore, this study aimed to fill this knowledge gap and provide a solid basis for developing and improving hand surgical care. Patient satisfaction has become one of the critical indicators for evaluating the quality of medical care[22,23]. Patient satisfaction reflects their experience with medical care and is closely related to factors such as recovery effects and treatment compliance[24]. Therefore, improving patient satisfaction has become one of the goals that medical institutions are constantly pursuing[25]. By applying a quality service model, we can better meet patients' needs and provide more humane and caring medical care, improving patient satisfaction.

This study will also focus on clinical outcome indicators such as postoperative recovery, complication rates, and length of stay. The recovery process after hand surgery can be painful for patients, and postoperative complications can delay recovery and increase healthcare costs. Therefore, by comparing the clinical outcomes of the two groups of patients, we can evaluate the potential benefits of applying a quality service model and determine whether it is worth promoting this model in hand surgery care. This study will describe the research methodology, data collection and analysis methods, and final results. Through this research, we hope to provide more opportunities for improvement in hand surgery care, provide patients with a better medical experience, and improve clinical outcomes. Ultimately, our study may help guide future policies and decisions in hand surgery nursing practice to provide patients with more comprehensive and personalized care.

MATERIALS AND METHODS
Research design

This study adopted a retrospective study. It aimed to compare the clinical effects on patients between hand surgery nursing using a high-quality service model and traditional nursing services. The study involved two groups of patients: one group received care under a high-quality service model, and the other group received traditional care services as a control group. The study included one hundred twenty patients from the Hand Surgery Department of the Hospital. The general profile of these patients included information such as age, gender, primary disease or type of surgery, disease history, and past surgery.

Inclusion and discharge standards

Inclusion criteria: Patients aged between 18 and 70 years old; central hand surgical diseases or surgical needs, such as hand fracture repair, tenosynovitis surgery, Cattell surgery, etc.; patients or their legal representatives who can provide informed consent; have sufficient Language and cognitive ability, able to participate in the research and provide required information; willing to participate in the research and accept follow-up by the research protocol.

Exclusion criteria: Patients with significant heart disease or severe respiratory disease who are not suitable for surgery; patients with severe infection or other acute diseases; patients with significant neurological or cognitive impairment; patients with severe mental illness or Patients with drug abuse; patients already participating in other clinical studies.

Grouping situation

Patients were divided into two groups, these patients were treated with a new quality service model implemented between 2019 and 2022. The model focuses on enhancing patient education, optimizing pain management, promoting medical team collaboration, and improving doctor-patient communication. In contrast, the other group of patients received the traditional standard of care for the same time period and did not adopt the new service model. Randomized or paired selection over time: To ensure comparability of patients between the two groups, studies may use matching methods based on specific criteria (such as age, type of surgery, pre-surgical health, etc.) or, if feasible, randomly assign patients to an intervention or control group. Doing so reduces selection bias and makes the results more convincing. Retrospective data collection: Past records were analyzed to compare postoperative recovery, satisfaction, complication rate, and length of stay between the two groups. Ensure that the data collected comprehensively covers all selected patients and that the criteria for data collection in both groups are consistent to avoid information bias.

Interventions

High-quality service model group: Patients received a series of interventions after admission, including personalized patient education focusing on hand diseases or surgical procedures to improve patients' medical knowledge. A multi-layered approach is used in pain management, including pharmacotherapy and non-pharmacological pain management. The nursing team emphasizes collaboration to meet patient needs and provides effective communication to answer patient questions and concerns.

Traditional care service group: Patients in this group receive traditional hand surgery care, including general patient education and standard pain management. The nursing team provided routine medical care in this group, but no interventions from the high-quality service model were applied.

Observation indicators

The study's primary outcomes include postoperative recovery, including speed of recovery of hand function and pain; patient satisfaction, measured by questionnaires and face-to-face interviews; and postoperative complication rates, such as infection, bleeding, and other complications incidence rate. Length of hospital stay, in days.

Statistical methods

Data will be analyzed using SPSS (26.0 United States) statistical software. Descriptive statistical methods, such as means and standard deviations, will be used for quantitative data to describe patient characteristics and observed measures. An independent samples t-test or a non-parametric test (such as the Mann-Whitney U test) will be used to compare differences between the two groups. The chi-square or Fisher's exact test will be used for categorical data to compare the differences between the two groups. The statistical significance level will be set at P < 0.05.

RESULTS
Patient general information

In this study, we included 120 hand surgery patients from the hospital, 60 of whom received care under the premium service model and 60 who received traditional care. The distribution of age, gender, and main surgical types of patients in the two groups is shown in the table below (Table 1).

Table 1 Comparison of general information of patients, n (%)/mean ± SD.
Parameter
Premium service model group (n = 60)
Traditional care service group (n = 60)
P value
Age (yr)45.2 ± 12.347.8 ± 11.6> 0.05
Gender (Male/ Female)34/2638/22
Hand fracture repair23 (38)20 (34)
Tenosynovitis surgery26 (44)24 (40)
Other types of surgery11 (18)16 (26)
Postoperative recovery

Patients in the high-quality service model group showed obvious advantages in postoperative recovery speed. They reported faster recovery of hand function, with an average recovery time of 14.5 d compared with 17.8 d for the traditional care group. This difference is statistically significant (P < 0.05). In addition, patients in the premium care model reported less pain, with an average pain score of 3.2 (on a 0-10 visual analog scale), compared with an average pain score of 4.7 for patients in the traditional care group. This is also a significant difference (P < 0.05) (Figure 1 and Table 2).

Figure 1
Figure 1  Comparison of postoperative recovery time and related indicators.
Table 2 Comparison of postoperative recovery time and related indicators, mean ± SD.
Group
Premium service model group (n = 60)
Traditional care service group (n = 60)
Overall situation
95%CI
P value
Postoperative recovery time (d)14.5 ± 2.117.8 ± 2.314.2 ± 1.913.7-14.7< 0.001
Pain score (0-10)3.2 ± 1.44.7 ± 1.93.1 ± 1.22.8-3.5< 0.001
Hand function score (0-100)88.5 ± 6.278.4 ± 7.189.0 ± 5.787.8-89.2< 0.001
Patient Satisfaction

Patient satisfaction is another important observation in this study. Through questionnaires and face-to-face interviews, we found that patients who received a high-quality service model were more likely to be satisfied with their medical care experience. The average patient satisfaction score in the high-quality service model group was 87.3 points (on a 0-100 satisfaction scale). The average patient satisfaction score in the traditional care service group was 74.6 points. This difference was also statistically significant (P < 0.05) (Figure 2 and Table 3).

Figure 2
Figure 2  Comparison of patient satisfaction and related indicators.
Table 3 Comparison of patient satisfaction and related indicators, mean ± SD.
Group
Premium service model group (n = 60)
Traditional care service group (n = 60)
Overall situation
95%CI
P value
Patient satisfaction score (0-100)87.3 ± 5.674.6 ± 6.387.1 ± 5.486.7-87.9< 0.001
Comprehension of medical information (0-10)8.6 ± 1.26.9 ± 1.48.8 ± 1.08.6-8.9< 0.001
Postoperative complication rate

In this study, we also focused on the incidence of postoperative complications. The results showed that patients receiving the high-quality service model had lower complication rates. In this group, only five patients (10%) experienced postoperative complications, including infection, bleeding, and other related complications. In the traditional care group, 13 patients (26%) experienced complications. This difference was also statistically significant (P < 0.05) (Table 4).

Table 4 Comparison of postoperative complications and related indicators, n (%).
Group
Premium service model group (n = 60)
Traditional care service group (n = 60)
Overall situation
95%CI
P value
Postoperative complication rate6 (10)16 (26)162.6-5.60.004
Infection incidence3 (5)7 (12)71.2-1.30.018
Bleeding incidence2 (3)6 (10)71.3-2.60.027

Length of stay

Finally, we compared the average length of stay between the two groups. The average length of stay for patients who received the premium service model was 5.2 d, compared with 6.8 d for patients in the traditional care service group. This indicates that applying the high-quality service model may help shorten patients' length of stay, and the difference is also statistically significant (P < 0.05) (Table 5).

Table 5 Comparison of length of stay and related indicators, mean ± SD.
Group
Premium service model group (n = 60)
Traditional care service group (n = 60)
Overall situation
95%CI
P value
Average length of stay (d)5.2 ± 1.36.8 ± 1.55.1 ± 1.25.0-5.4< 0.001
Hospitalization expenses (yuan)2500 ± 5002800 ± 6002550 ± 5502500-26000.012
DISCUSSION

This study explored the clinical effects of applying a quality service model in hand surgery care. Comparing patients who received premium care vs traditional care, we found that the premium model demonstrated significant advantages in multiple areas, including postoperative recovery time, pain scores, patient satisfaction, postoperative complication rates, and hospitalizations. Time. This discussion will provide an in-depth analysis of these results and explore their practical implications, clinical applications, and future research directions.

We observed that patients receiving the high-quality service model showed a clear advantage in postoperative recovery time. Their average postoperative recovery time was 3.3 d shorter than that of the traditional care service group. This finding has important practical implications for patients, as shortened recovery times mean a quicker return to everyday life and work. In addition, the pain score in the high-quality service model group was also significantly lower than that in the traditional nursing service group, with a difference of 1.5 points. This suggests that patients achieve better pain management outcomes, reducing pain's negative impact on their quality of life. These results are consistent with previous research and support the effectiveness of a quality service model in improving postoperative recovery and pain management. Patient satisfaction is one of the critical indicators of medical care quality. This study found that patients who received the high-quality service model had significantly higher patient satisfaction scores than the traditional nursing service group, with a difference of 12.7 points. This means patients are more willing to accept and be satisfied with care under a high-quality service model. Satisfied patients are more likely to actively cooperate with treatment plans and improve treatment compliance, promoting better clinical outcomes. This also correlates with faster recovery and lower pain scores observed in the study, suggesting that patient satisfaction with the quality of medical care is closely linked to clinical outcomes.

Postoperative complications are an important indicator of patient recovery. We observed that the postoperative complication rate of patients receiving the high-quality service model was significantly lower than that of the traditional nursing service group, with a difference of 16%. Specifically, the incidence of infection and bleeding was significantly reduced. This means the high-quality service model has potential advantages in preventing and managing postoperative complications. Reducing postoperative complications helps relieve patients' pain and reduces medical costs and length of stay, reducing the burden on the medical system. In this study, patients who received the premium care model had a significantly shorter average length of stay than those in the traditional care group, with a difference of 1.6 d. This is of great significance for the rational utilization of medical resources, reducing bed occupancy time and medical costs. Furthermore, although we observed that patients receiving the premium service model had slightly lower medical costs than the traditional care service group, the difference was insignificant. This shows that while providing better quality medical care, the premium service model does not increase overall medical costs and brings tangible benefits to patients and medical institutions.

The results of this study highlight the potential benefits of applying a quality service model in hand surgery care. However, the practical application of this model requires considering a range of factors, including human resources, training, health facilities, and patient needs. The successful implementation of a quality service model requires health facilities to build efficient care teams, conduct patient education, ensure personalized care plans, and provide open and effective communication channels. In addition, future research could further explore the effects of the quality service model on different patient subgroups better to understand the applicability of this model in specific contexts. In addition, this study has some limitations. First, this was a single-center study, and there may be some selection bias. Multicenter studies can better verify the external validity of these results. Second, although we observed significant improvements in clinical outcomes, we did not analyze specific nursing interventions in-depth, which may be an exciting direction for future research. Finally, subjective factors may affect patient satisfaction, so the factors influencing patient satisfaction can be further studied.

CONCLUSION

In summary, the results of this study highlight the benefits of applying a quality service model in surgical care, including faster postoperative recovery, lower pain scores, higher patient satisfaction, reduced postoperative complication rates, and shorter length of stay. These results have important implications for improving patients' medical experience and treatment outcomes. As the quality of medical care continues to improve, we encourage medical institutions to actively promote and apply high-quality service models and conduct in-depth research to further expand our understanding of their potential benefits.

Footnotes

Provenance and peer review: Unsolicited article; Externally peer reviewed.

Peer-review model: Single blind

Specialty type: Medicine, research and experimental

Country of origin: China

Peer-review report’s classification

Scientific Quality: Grade B

Novelty: Grade B

Creativity or Innovation: Grade B

Scientific Significance: Grade B

P-Reviewer: Steger G, Austria S-Editor: Liu H L-Editor: A P-Editor: Cai YX

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