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Construction and application of a rehabilitation management programme for urinary incontinence after prostate cancer surgery
GU Jie, MA Qianyun, GAO Xu, LI Huizhen, MENG Xiaohong, XIE Shuangyi, FAN Fan, ZHOU Yi, CAO Jie
Chinese Journal of Nursing    2023, 58 (9): 1029-1036.   DOI: 10.3761/j.issn.0254-1769.2023.09.001
Abstract1305)   HTML5)    PDF (1094KB)(45)       Save

Objective This study aims to construct a rehabilitation management programme for urinary incontinence after prostate cancer surgery,and to apply the programme to clinical practice,so as to provide references for future work. Methods Through evidence-based literature search and qualitative research,a grief rehabilitation management programme for urinary incontinence after prostate cancer surgery was formed. From January to March 2022,15 experts were consulted using Delphi method,and a rehabilitation management programme for urinary incontinence after prostate cancer surgery was formed. From May to July 2022,the convenience sampling was used to select patients with urinary incontinence after prostate cancer surgery in the urology clinic of a hospital in Shanghai. The experimental group was given the urinary incontinence rehabilitation management program,while the control group was given the routine nursing. The application effect of the programme was evaluated by the International Consultation on Incontinence Questionnaire-Short Form and 24-hour urinary pad test. Results The final programme included 6 first-level items,15 second-level items,and 43 third-level items. The expert authority coefficients were 0.88 and 0.98,and the Kendall harmony coefficients were 0.17 and 0.12(P<0.001). The ICIQ-SF scores and 24-hour pad weight at 1 month and 3 months after surgery in the intervention group were lower than the control group(P<0.05). Conclusion The application of the rehabilitation management programme improved the recovery of postoperative incontinence and reduced the 24-hour pad weight of patients at 1 month and 3 months after surgery. The programme can be popularized and applied after further verification.

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Evidence-based practice of target temperature management in patients with traumatic brain injury
MENG Xiaojing, LI Xiang, FENG Yingpu, FAN Jingli, HUO Xiaoran, ZHANG Chunxia, ZHOU Limin, GAO Min
Chinese Journal of Nursing    2023, 58 (19): 2309-2318.   DOI: 10.3761/j.issn.0254-1769.2023.19.001
Abstract735)   HTML2)    PDF (1176KB)(19)       Save

Objective To apply the best evidence of target temperature management in patients with traumatic brain injury to clinical practice and to evaluate its effect. Methods Followed the application model of JBI evidence-based nursing center,16 review indicators were developed based on the best evidence,and the evidence-based continuous quality improvement model was taken as the theoretical framework. From June 2021 to April 2022,the evidence-based practice was applied to patients with traumatic brain injury in neurosurgery ICU according to the baseline review,practice change and review of change effect after evidence application,and the implementation rate,target temperature management related knowledge level,evidence-based ability,patient complication rate and organizational culture level were compared. Results After evidence-based practice,the implementation rates of the first and second rounds of reviews for various review indicators have improved compared to the baseline,with significant increases in the implementation rates of review indicator 2,3,7,8,9,10,11 and 13(P<0.05). There was a significant decrease in the incidence of grade 3 chills in the 3 groups of patients before and after the baseline review,the first review,and the second review(χ2=7.680,P=0.021). Before and after the implementation of the baseline review,the first round of review,and the second round of review,the scores of the nurses’ knowledge status questionnaire on target temperature management for patients with traumatic brain injury,and the evidence-based practice influencing factors questionnaire were all improved(F=3.827,P=0.025;F=4.997,P=0.009),while the scores of the nurses’ evidence-based nursing practice obstacle scale were lower than those before the implementation(F=4.174,P=0.018). The level of organizational culture has improved compared to it before implementation(F=7.421,P=0.024). Conclusion Through the continuous improvement of evidence-based practice,target temperature management for patients with traumatic brain injury in neurosurgery ICU can effectively standardize the diagnosis and care behavior of medical staff and reduce the incidence of patients’ complications,but it still needs continuous quality supervision and review in the later stage.

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Evidence summary for prevention and management of central venous catheter occlusion
LI Huaiyan, LI Yuling, YU Jing, MENG Xiaohong, CUI Yingqin
Chinese Journal of Nursing    2022, 57 (23): 2842-2850.   DOI: 10.3761/j.issn.0254-1769.2022.23.004
Abstract1046)   HTML11)    PDF (1247KB)(83)       Save

Objective To search,evaluate and summarize the best evidence for prevention and management of central venous catheterization. Methods According to the "6S" evidence model,related databases including BMJ Best Practice,UpToDate,NGC,JBI evidence-based database,Scopus platform,Yimaitong Guide.com,CINAHL,CNKI,Wanfang Database,CBM were searched from top to bottom. All evidence related to the prevention and management of central venous catheterization from August 2011 to August 2021 was included,involving clinical practice guidelines,systematic reviews,evidence summaries,best practice,expert consensuses,and original literature. 2 researchers independently evaluated the quality of relevant literature and standardized the integration and summary of the evidence finally included in the literature. Results Totally 14 pieces of the literature were included,involving 3 guidelines,3 systematic reviews,4 evidence summaries,3 expert consensuses and 1 meta-analysis. Finally,28 pieces of best evidence were formed,including 6 dimensions,namely intravenous treatment team,cathetering site and method,catheter flushing tool and operation,blockage prevention strategy,blockage treatment strategy,and patient education. Conclusion The best evidence for the prevention and management of central venous catheter blockage is helpful for clinical nurses to formulate personalized catheter blockage prevention strategies according to the actual situation of patients,to standardize the management strategies of catheter blockage,so as to reduce the incidence of central venous catheter blockage and ensure the safety of patients.

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Chinese expert consensus on cardiac rehabilitation nursing care
Geriatric Nursing Committee of Chinese Nursing Association, Committee of Cardiac Rehabilitation and Prevention of Chinese Association of Rehabi-litation Medicine, Organ Rehabilitation Committee of Chinese Elder Health Care Association, Writing Committee: SHEN Lin, MENG Xiaoping, CHEN Xiaoming, ZHU Liyue, WANG Mei, CAO Yingjuan
Chinese Journal of Nursing    2022, 57 (16): 1937-1941.   DOI: 10.3761/j.issn.0254-1769.2022.16.003
Abstract2360)   HTML139)    PDF (843KB)(1139)       Save

Objective To form the Chinese expert consensus on cardiac rehabilitation nursing care,so as to standardize the work related to cardiac rehabilitation nursing. Methods The first draft was initially formed,based on a comprehensive review of domestic and foreign cardiac rehabilitation guidelines,expert consensuses,systematic reviews,original research and other literature,as well as related disease diagnosis and treatment plans,management consensuses and related literature. Results The draft was thereafter reviewed by a total of 37 experts in related fields. This consensus was finalized after 3 rounds of discussions and modifications. The expert consensus covers the following 4 topics,namely the work goals of cardiac rehabilitation nursing care,the qualifications,training,core competencies and responsibilities of cardiac rehabilitation nursing care,the components of cardiac rehabilitation nursing care,and quality control of cardiac rehabilitation nursing care,and the safety management of cardiac rehabilitation patients. Conclusion The consensus was formed on the basis of comprehensive expert opinions and relevant guidelines,consensuses and clinical research on cardiac rehabilitation,which can provide guidance for medical institutions to carry out cardiac rehabilitation nursing practice.

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Construction of clinical audits and analysis of obstacles for evidence-based physical restraint in ICU patients
Rui CAO,Fen HU,Xiaoping ZHU,Yinghui JIN,Ling WANG,Xiaolin CHENG,Lan DENG,Xinbo DING,Zheng CAO,Jing MA,Meng XIAO
Chinese Journal of Nursing    2019, 54 (4): 485-489.   DOI: 10.3761/j.issn.0254-1769.2019.04.001
Abstract1281)   HTML1)    PDF (991KB)(25)       Save

Objective To implement evidence-based nursing practice for standardized physical restraint in adult ICU patients,to construct clinical audits,so as to analyze obstacles and facilitators during implementation. Methods The study was based on Johns Hopkins evidence-based health care model. A team was formed to summarize best practice evidence and to construct audits,and then to perform clinical audits. The team also analyzed the obstacles and facilitators and formulated strategies.Results Totally 23 items were included and 12 clinical audits were constructed. The obstacles mainly included lack of system-level instruments and practice-level insufficient knowledge,attitude,and behavior among nurses. Conclusion The study was based on evidence and combined with judgements from professionals. The clinical audits were scientific,practical,and applicable,which can provide basis for evidence-based practice.

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