The effect of clinical hierarchical nursing intervention on patients with acute non-variceal upper gastrointestinal bleeding

Introduction: Acute non-variceal upper gastrointestinal bleeding has high risk of rebleeding, severely affecting patients’ life. While this risk of rebleeding can be effectively reduced via targeted clinical hierarchical nursing intervention.

Object: To investigate the effect of clinical hierarchical nursing intervention on patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB).

Design: Randomized controlled study.

Methods: A total of 150 ANVUGIB patients treated in the Department of Gastroenterology in our hospital from January 2017 to October 2020 were selected and equally divided into two groups according to random number table method. The control group received routine care for ANVUGIB, including routine health education, health monitoring, medication care, etc. The nursing staff in the intervention group were divided into four different levels: senior, intermediate, junior and assistant nursing staff, and they were assigned with different responsibilities and nursing contents. The baseline conditions of the two groups of patients were compared, and the evaluation indexes include: incidence of bleeding-related complications during hospitalization, rebleeding situation within 1 month after discharge, quality of life, medical compliance, mastery rate of disease knowledge, comfort level, and nursing satisfaction.

Results: There was no significant difference in the basic condition between the two groups (p > 0.05), showing comparability. The incidence of complications and rebleeding during hospitalization in the observation group were both 4.00%, which were significantly lower than those in the control group (χ2 = 6.996, 4.127, p < 0.05). After nursing intervention during hospitalization, the scores of physiological function, physiological functioning, body pain, general health, vitality, social function, mental health and emotional function of ANVUGIB patients in the observation group were significantly higher than those in the control group at discharge (p < 0.05). In addition, the mastery rate of disease knowledge, comfort level and nursing satisfaction of ANVUGIB patients in the observation group were significantly higher than those in the control group (p < 0.05). Although the compliance rate in the observation group was higher than that in the control group, no significant difference was found (p > 0.05).

Conclusion: Clinical nursing intervention can significantly reduce the incidence of complications and rebleeding in patients with acute non-variceal upper gastrointestinal bleeding, and improve their quality of life, comfort level and nursing satisfaction.

Hierarchical nursing; Acute non-variceal upper gastrointestinal bleeding; Rebleeding; Quality of life; Compliance

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