Objective To investigate the application effect of electromagnetic navigation bedside nasoenteral intubation technology in elderly bedridden patients. Methods A total of 92 elderly patients with tube feeding in bed in a tertiary A hospital in Beijing from June 2021 to December 2022 were selected by convenience sampling method，and they were divided into an experimental group and a control group with 46 patients in each group by random number table method. The experimental group adopted the electromagnetic navigation bedside nasoenteral catheterization technique and the control group adopted the blind catheterization method. The total success rate of catheterization，the success rate of the first catheterization，the time taken for catheterization，the proportion of catheter tip reaching jejunum，and the incidence of catheter-related complications were compared between the 2 groups. Results There were no shedding cases in both groups. The success rate of total catheterization was 95.7% in the experimental group and 80.4% in the control group. The success rate of first catheterization was 95.7% in the experimental group and 71.7% in the control group. The time taken for catheterization was（12.37±4.19） min in the experimental group and（19.22±5.48） min in the control group. The proportion of catheter tip reaching the jejunum was 60.9% in the experimental group and 28.3% in the control group. The above data were compared between the 2 groups，and the differences were statistically significant（P<0.05）. In terms of the incidence of catheter-related complications，the incidence of epistaxis in the experimental group was 6.5% and it was 21.7% in the control group，and the difference was statistically significant（P=0.036）. The positive rate of fecal occult blood test was 2.2% in the experimental group and 17.4% in the control group，and the difference was statistically significant（P=0.030）. There was no significant difference in the incidence of nausea，vomiting and abdominal distension between the 2 groups（P>0.05）. No serious complications such as catheter ectopic placement，pneumothorax and perforation occurred in the 2 groups. Conclusion The application of electromagnetic navigation bedside nasoenteral intubation technology for elderly bedridden patients has a high success rate and takes a short time，which can improve the proportion of catheter tip reaching the jejunum and reduce the incidence of epistaxis and fecal occult blood test.
The support and cooperation of the multidisciplinary team during the ICU patient transferring is critical to ensure the safety of the transition. This paper introduces the development of the ICU transitional care model，secure，encourage，collaborate（SEC） transitional care model，and mainly describes the content of SEC transitional care model and its application in the field of ICU nursing. It is proposed that the content of SEC transitional nursing model is not specific enough，and its connotation can be enriched based on the actual clinical use in the future. A suitable transitional nursing scheme can be developed based on this model and the characteristics of Chinese medical institutions.
Objective To extract，summarize and evaluate the best evidence of self-management for patients with knee osteoarthritis（KOA），and to provide evidence-based evidence for improving self-management of patients with KOA. Methods We searched the guidelines websites，association official websites and integrated databases，for all literature on self-management of patients with KOA；the types of literature included clinical decision-making，guidelines，evidence summaries，expert-consensuses，systematic reviews and randomized controlled trials. The retrieval time was from January 2012 to October 2022. Results A total of 25 articles were included，including 11 guidelines，4 expert consensuses，1 clinical decision，4 systematic reviews and 5 randomized controlled trials. A total of 30 pieces of evidence were extracted. After sorting and discussion，the evidence was integrated into 4 areas，namely learning KOA related knowledge，exercise management，weight management and joint protection. Conclusion The evidence of self-management of patients with KOA is abundant，high quality and authoritative，which can provide evidence-based bases for clinical medical staff，so as to help patients with KOA carry out self-management more scientifically and effectively.
The nursing experience of a pregnant woman with ruptured cerebellar arteriovenous malformation and hemorrhage with consciousness disorder at 20+ weeks of pregnancy was summarized. The key points of nursing include：postoperative management of pregnancy combined with brain arteriovenous malformation composite surgery，nursing management of hypothermia treatment in the second pregnancy，the safety of patients and fetus and the whole prevention of complications；early rehabilitation training in stages，and postpartum management based on the recovery of neurological function. Through careful and professional treatment and nursing，the patient had a good prognosis，and was transferred to the rehabilitation department to continue rehabilitation treatment.
Hospital-acquired functional decline is common in elderly patients undergoing cardiac surgery，and it is closely related to a variety of adverse outcomes. This article reviews the current situation，adverse prognosis，assessment tools，assessment timing and influencing factors of hospital-acquired functional decline in elderly patients undergoing cardiac surgery，and also makes recommendations for further improvement of hospital-acquired functional decline，in order to provide a reference for clinical medical and nursing staff to explore suitable assessment tools，early identify the risk of hospital-acquired functional decline in elderly patients undergoing cardiac surgery and formulate personalized rehabilitation interventions.
Objective To evaluate the effect of fully immersive virtual reality technology on limb function of stroke patients. Methods We searched Chinese and English databases including PubMed，Embase，Cochrane Library，CINAHL，Web of Science，CNKI etc.，and clinical trials registry platforms from inception until October 2020. Randomized controlled trials that reported the effects of fully immersive virtual reality technology for limb function in stroke patients were retrieved. The references and grey literature included in the study were also retrieved. There were 2 researchers who independently retrieved articles，evaluated quality and extracted data. RevMan 5.4 software was used for Meta-analysis. Results A total of 9 studies involving 252 patients were finally included. Meta-analysis indicated that fully immersive virtual reality technology could improve upper limb motor function[MD=5.35，95%CI（3.04，7.67），P<0.01]，dexterity[MD=8.26，95%CI（5.09，11.43），P<0.01]，enhance lower limb balance function[MD=6.30，95%CI（3.14，9.46），P<0.01]，gait coordination[MD=-4.97，95%CI（-6.76，-3.18），P<0.01]. But there was no statistically significant difference in gait velocity[MD=10.29，95%CI（-4.03，24.62），P=0.16]. Descriptive analysis indicated that fully immersive virtual reality technology could significantly improve exercise endurance. Subgroup analysis according to intervention time found that when intervention time≥4 weeks，the experimental group had statistically significant differences on the upper limb dexterity[MD=9.06，95%CI（5.69，12.43），P<0.01] and lower limb gait coordination[MD=-5.25，95%CI（-7.24，-3.26），P<0.01]. Conclusion Fully immersive virtual reality technology can improve the limb function of stroke patients，but the effect on gait velocity was not significant. The subgroup analysis of evaluation indicators suggests that sufficient intervention time should be guaranteed. More and higher quality studies are needed to further verify this in the future.
Objective To investigate the status of dyadic coping in young and middle-aged type 2 diabetes patients,and to explore the influencing factors. Methods A total of 411 young and middle-aged type 2 diabetes patients were recruited from 2 tertiary hospitals in Zhengzhou from February to December 2020,and they were investigated with a general information questionnaire,Dyadic Coping Inventory（DCI） and Diabetes Self-efficacy Scale（DSES）. Results The total DCI score was 130.60±11.26 and the total DSES score was 93.11±18.93,showing significantly positive correlation（r=0.323,P<0.05）. Gender,duration of disease,family monthly income and self-efficacy were main factors affecting dyadic coping of patients（P<0.05 for all）. Conclusion The level of dyadic coping in type 2 diabetes patients are average and needs to be further improved. Self-efficacy can be used as the starting point to develop feasible and effective interventions to enhance dyadic coping of patients with type 2 diabetes in clinical nursing.
Objective The position competence level and influencing factors of sterilization personnel in Central Sterile Supply Department（CSSD） were investigated and analyzed to provide references for the standardized construction of sterilization personnel team in CSSD. Methods In June 2021,the convenience sampling was adopted to investigate 487 sterilization personnel in 238 hospitals in Henan province by a self-designed questionnaires on the competency of sterilization personnel in the sterilization supply center platform of Henan Hospital Central Sterile Supply Quality Control Center. Results The total score of the post competence of sterilization personnel in CSSD was（60.58±19.74）; regression analysis showed that the hospital level,sterilization working years,to the history of receiving training,the type of training received and the frequency of training were the main influencing factors for the post competency of sterilization personnel in CSSD. Conclusion The post competence of sterilization personnel in CSSD of Henan hospital is at a medium level,and those hospitals with lower level and no pressure steam sterilizer training have lower post competencies. The manager of CSSD should formulate targeted professional personnel training plans according to the weak competency factors of sterilization personnel,so as to improve the competency of sterilization personnel in CSSD,to ensure the quality of sterilization and the safety of patients.
Objective To extract,summarize and evaluate the best evidence of nutrition management in the elderly with sarcopenia,and to provide bases for guiding nutrition in the elderly with sarcopenia. Methods We searched all evidence about nutrition management for elderly patients with sarcopenia in the UpToDate,Joanna Briggs Institution,Cochrane Library,DynaMed,National Guideline Clearinghouse,Registered Nurses Association of Ontario,Scottish Intercollegiate Guidelines Network,National Institute for Health and Care Excellence,Guidelines International Network,WHO Guidelines,CPG,Yimaitong,PubMed,Web of Science,CNKI,CBM and YIIGLE. The types of the literature include clinical decision-making,guidelines,evidence summaries,expert-consensuses and systematic reviews. The retrieval time is from the establishment of the databases to January 20,2021. Results Finally,18 articles were included in this summary,including 1 guideline,6 expert consensuses,1 clinical decision-making and 10 systematic reviews. 32 pieces of evidence were summarized in 4 categories,including nutrition screening and assessment,nutrient intake,nutrition monitoring and health education. Conclusion Nutrition management can effectively improve sarcopenia. The evidence summary process of this study is scientific,rigorous and comprehensive. Clinical staff should select the best evidence according to the specific situation and individual factors of patients in the process of evidence transformation,so as to guide the elderly patients with sarcopenia to safely and effectively improve their nutritional status and quality of life.
Objective To design and make popular works of swallowing safety for the home-dwelling disabled elderly. Methods The evidence-based nursing and Delphi method were used to form the best evidence summary through literature retrieval and appraisal, evidence extraction and evidence level evaluation. The swallowing safety education system was constructed through 2 rounds of expert consultations. Based on this system, the content was refined and transformed into popular works, and then the popular works were designed and developed by multidisciplinary teams. Results 31 pieces of evidence were summarized from 8 aspects, such as safety education objective，identification of dysphagia，swallowing function exercise，oral management，etc. 2 rounds of consultations showed good initiative，authority and coordination，and the final system included 4 primary indicators，11 secondary indicators and 21 tertiary indicators. The popular works of swallowing safety included manuals，videos and audios，which were easy to understand，vivid and point-prominent. Conclusion The development method of popular works of swallowing safety for home-dwelling disabled elderly is scientific and feasible. It is suggested that creators should strengthen the scientificity，people-orientation and originality of popular works. This study can provide methodological references for other scholars to develop health popular works.
Objective This study is to explore the dyadic experiences of patients with young-onset dementia （YOD） and their primary caregivers. We aim to explore their interactions,challenges,and needs in order to provide empirical evidence for the development of precision intervention and supportive system for this population. Methods We purposively selected 12 dyads of persons with YOD and their primary caregivers and conducted in-depth semi-structured interviews with the dyads during the period between Jan to June 2021. We adopted conventional content analysis and dyadic qualitative analysis approach to analyze and synthesize the data. Results 4 major themes emerged as multiple challenges（daily life experiences,social interaction changes,a lack of social awareness of the disease,and role maladaptation）,stigma（self-conflict,personhood,a lack of sense of security,and perceptions of stigma in the socio-cultural context）,a lack of supportive resource and social vulnerability （the lack of knowledge of the disease,the lack of formal care provision,the lack of appropriate social support）,and available individual and social coping strategies（person-centered care,stress relief,and decreased social discrimination on YOD）. Conclusion The dyadic experiences of persons with YOD and their caregivers are unique and variant. There is an urgent need for family,community,health care system and the public to stay connected and provide substantial support for this population. Researchers need to actively conduct multi-disciplinary research to understand the needs and challenges of this population to develop tailored interventions to improve their experiences,quality of life and assist them move through to the later stage of their life.
To summarize the nursing experience of a child with pyoderma gangrenosum（PG） treated with vacuum sealing drainage（VSD）. The main points of nursing include the use of VSD to promote skin wound repair;to carry out targeted intervention measures in different stages of wound healing;timely pain intervention to increase the comfort of children;nutritional support according to the needs of the disease;monitoring special drug adverse reactions;to pay attention to the nursing of high fever,to maintain the stability of basic vital signs of children;to strengthen psychological care and health education. After 22 days of treatment,the child was discharged successfully from the hospital. Follow-up in the wound clinic and specialist clinic showed that the primary disease was under stable control and the skin damage healed well.
Objective An infusion drip counter is designed,and its application effect is evaluated. Methods An infusion drip counter was self-developed,and it consists of infusion set buckle,display,start/mode switch button,battery,buzzer,infrared sensor area,etc. In the laboratory,the infusion drip rate measured by the drip counter was compared with the infusion drip rate set by the infusion pump,in order to evaluate the accuracy of the counter. Convenience sampling method was used to recruit 200 emergency patients with infusion admitted from March to May 2020 in a tertiary hospital,and they were divided into an experimental group (n=103) and a control group (n=97) according to the seat number during the infusion. The experimental group used the drip counter for counting,and the control group used the manual counting for counting. The difference between the predicted infusion completion time and the actual infusion completion time was compared,as well as the incidence of the intravenous infusion complications such as phlebitis,extravasation,tube blockage,blood return,and the patient satisfaction rate in the 2 groups. The satisfaction rate of nurses using the drip counter was evaluated. Results In the laboratory test,the accuracy of the drip rate counting of this counter was 99.6%,and the drip rate displayed by the counter was compared with the drip rate set by the infusion pump,and the difference was not statistically significant (P=0.829). In the process of clinical application,the difference between the predicted infusion completion time and the actual infusion completion time of the experimental group was smaller than that of the control group;the incidence of blood return was lower than that of the control group;the patient satisfaction rate was higher than that of the control group;the differences were statistically significant (P<0.05). The satisfaction rate of nurses was 96.1%. Conclusion The infusion drip counter has high counting accuracy. The use of this drip counter is beneficial to control the infusion drip rate,reduce the incidence of blood return,and improve the patient’s satisfaction rate.
Objective To explore the research content,theoretical framework,adaptation process,the quality of the methodology and reporting of adaptation of guidelines in the nursing field in China. Methods The literature on the theme of the guidelines adaptation in clinical practice in China was systematically searched from PubMed,Cochrane Library,CINAHL,EMBASE,Scopus,Web of Science,CNKI,Wanfang,VIP database. 2 reviewers independently screened the literature,extracted the data and assessed the quality of the adaptation of guidelines by AGREEⅡ tool and RIGHT statement. Results A total of 23 studies were included. 69.6% of the studies were published in the last 3 years,and only 7 (30.4%) of the studies reported the funding support. In terms of research themes,65.2% of the studies focused on the care of diseases and their symptoms,and only 12 (52.2%) reported the methods used in the process of adaptation,among which 7 (30.4%) used ADAPTE methods. Methodological quality evaluation results showed that the area with an average score of more than 60% out of the 6 areas included scope and purpose,participants,and clarity of expression. The area with the lowest score was editorial independence. According to the quality evaluation results of the report,the areas with an average score of >4 among the 7 areas include basic information,background and recommendation,and the lowest score is funding and conflict of interest declaration and management. Conclusion The number of studies on adaptation of guidelines in the nursing field in China is increasing obviously,but the theoretical framework based on the adaptation of guidelines and the quality of the methodology and reporting of the adaptation guidelines are poor.
Objective To evaluate and summarize the evidence related to feeding difficulty in people with dementia for health care workers and decision makers. Methods All evidence on management of feeding difficulty in people with dementia was retrieved from domestic and foreign databases from January 2016 to December 2020,including clinical decisions,guidelines,expert consensuses,recommended practices,evidence summaries and systematic reviews. The researchers evaluated and collected the evidence according to relevant literature evaluation criteria. Results A total of 17 articles were included in this study,including 1 clinical decision,3 guidelines,3 expert consensuses,1 recommended practice,1 evidence summary,and 8 systematic reviews. A total of 40 pieces of best evidence were summarized from 3 aspects of organization policy,education,and practice. Conclusion Evidence involves a wide range and rich contents,and scientific and effective management measures can reduce the occurrence of feeding difficulty. In the process of clinical transformation of evidence,we should carefully select evidence,analyze the gap between evidence and clinical practice,and construct an evidence-based practice plan for feeding difficulty in people with dementia.
Objective To explore the effect of a modified chest strap after minimally invasive thyroid surgery. Methods A improved chest strap was developed,which can be adjusted and fixed according to the patient’s body and needs. At the same time,the ice pack device can be placed on the chest as needed. The chest strap and cold compress are maintained simultaneously during the use. From July 2019 to August 2020,82 patients underwent elective minimally invasive thyroid surgery. The patients were divided into a control group with 42 cases and an experimental group with 40 cases according to the time. The control group selected from July to December 2019 used traditional medical chest straps. The experimental group selected from January to August 2020 used improved vest-style chest straps. The pain scores,comfort,subcutaneous congestion,and satisfaction with the chest straps were compared between the 2 groups after using the chest straps. The patient’s pain score was evaluated by Numerical Rating Scale;the patient’s comfort score was evaluated by Kolcaba Comfort Scale;patients satisfaction was evaluated by a satisfaction questionnaire. Results The pain score in the experimental group was 2.1±0.2,which was lower than 2.9±0.2 in the control group（t=2.776,P=0.007）. The comfort score in the experimental group was 84.9±1.4,which was better than 79.7±1.1 in the control group（t=2.871,P=0.005）. 20% of patients in the experimental group had symptoms of subcutaneous congestion,while 31% of patients in the control group had subcutaneous congestion（χ2=1.290,P=0.256）. Patients’ overall satisfaction in the experimental group was 95%,which was significantly higher than 59.5% in the control group（Z=14.642,P=0.001）. Conclusion The use of the new and improved vest-style chest strap can reduce the patient’s pain and improve the patient’s comfort and satisfaction.
Objective To construct a hierarchical management scheme for physical restraint in the neurosurgery ICU patients and discuss its application effect. Methods Through the establishment of a project team,literature search and related issues discussion,a hierarchical management scheme for physical restraint in the neurosurgery ICU patients was developed. Using the convenience sampling method,304 patients admitted to the neurosurgery ICU of a tertiary first-class hospital in Beijing from April to September 2019 were selected,and they were divided into an experimental group with 156 cases and a control group with 148 cases according to admission time.The experimental group adopts a physical restraint hierarchical management plan,and the control group adopts the department's routine physical restraint nursing measures. The body restraint rate,average restraint time,restraint intensity,incidence of delirium,unplanned extubation,and the incidence of skin abnormalities at the restraint were compared between the 2 groups. Results After the intervention,the physical restraint rate,average restraint time,restraint intensity,and incidence of delirium in the experimental group were lower than those in the control group（P<0.05）;there were no unplanned extubation and skin abnormalities and other restraint-related complications in the 2 groups. Conclusion The graded management scheme for physical restraint in the neurosurgery ICU patients can significantly reduce the rate of physical restraint,shorten restraint time,reduce restraint intensity,and reduce the incidence of delirium,providing a basis for standardizing the use of physical restraint for neurosurgery ICU patients.
Objective To search,evaluate and summarize the best evidence of exercise intervention in the elderly with sarcopenia,and to provide bases for guiding exercise in the elderly. Methods We searched the UpToDate,JBI,Cochrane Library,DynaMed,NGC,RNAO,SIGN,NICE,GIN,CPG,Yimaitong,PubMed,Web of Science,CNKI and CBM,including guidelines,expert consensuses,clinical decision-making,evidence summaries and systematic reviews. The retrieval time is from the establishment of the databases to February 20,2021. Results 16 articles were included,including 1 guideline,3 expert consensuses,3 clinical decision-making and 9 systematic reviews. 29 pieces of evidence were summarized in 8 areas,namely exercise evaluation,exercise style,exercise intensity,exercise time,exercise plan formulation principles,management mode,precautions,and health education. Conclusion The process of evidence production is scientific,rigorous,comprehensive and of high quality. Exercise intervention can effectively improve the sarcopenia. In the process of evidence transformation,medical staff should choose the best evidence according to the specific situation and individual factors of patients,and guide the elderly to exercise safely and effectively and improve the quality of life.
Objective To optimize blood collection process for reducing waiting time of patients and avoiding large number of patients gathered in the area of blood collection. Methods An informationized blood collection registration platform was established consisting of blood-collecting registration module,intelligent distribution module and information backup storage module. Patients completed blood collection registration or appointment through self-service machine in hospital and APP in mobile phones to operate on the platform. The platform realized the intelligent allocation of blood collection patients from time and space. Time spent on the registration and waiting for blood collection before and after application of the platform was compared. Results After the application of the platform in 2018,the rate of reducing time on blood collection registration was 77.50% compared with that in 2017,and the difference was statistically significant（P<0.001）. The rate of reducing time on waiting for blood collection was 47.91%,and the difference was statistically significant（P<0.05）. Conclusion The application of the informationized blood collection registration platform optimized the process of blood collection,which can effectively reduce patients’ waiting time,and assign patients at different time intervals to avoid large numbers of people gathering. It was helpful to optimize the order of blood collection in the hospital,and reduce the occurrence of adverse events.
Objective To develop and implement an evidence-based nursing scheme for a patient with refractory skin ulcer of lower limb suffering from diabetes mellitus combined with essential thrombocytosis. Methods Using PICO principle,questions were put forward based on the clinical manifestations of the patient. We searched databases including UpToDate,Joanna Briggs Institute,Registered Nurses’ Association of Ontario,National Guideline Clearinghouse,National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,Cochrane Library,CINAHL,Embase,Pubmed,CBM,WHO and websites of various professional associations. We included all clinical guidelines,evidence summaries,and systematic reviews on chronic wound care. After evaluating the feasibility,suitability,clinical significance and effectiveness of the evidence,we applied them to the patient and observed its effect. Results A total of 15 studies were finally included,including 3 clinical decisions,5 guidelines,1evidence summary,and 6 systematic reviews. We have formulated a targeted nursing program for the patient. On the basis of traditional treatment and nursing care,the specific program was developed and combined with the willingness of the patient,including no stopping use of hydroxyurea; Wagner grading system was utilized to grade and assess the wound comprehensively; cleaning the wound with normal saline and Compound Cortex Phellodendri liquid coating; performing the first debridement by ultrasonic debridement and adjusting the debridement method in time with the results of the wound assessment according to the wound condition; selecting the suitable dressing and combining with systemic treatment. After 16 days of active treatment,the wound infection of the patient was controlled. There was no obvious secretion,no self-reported pain and the granulation tissue grew well. The wound area was reduced and the symptoms of dry skin around the wound disappeared. The symptoms were improved and the patient was discharged. Conclusions For patients with diabetes mellitus combined with essential thrombocytosis,we can give them targeted,scientific and effective nursing measures through evidence-based methods to reduce the pain of patients,shorten wound healing time and improve the quality of life of patients.
