Improving the sense of belonging of the elderly in nursing institutions is of great significance to enhance their sense of self-worth and self-identity，and further meet the spiritual needs of the elderly in nursing institutions. This paper reviewed the concept，current situation，evaluation tools and influencing factors of the elderly’s sense of belonging in nursing institutions，and proposes that there is a lack of tools to measure the sense of belonging of the elderly in nursing institutions，and the intervention strategies with caregivers as the core needs to be further explored.
To summarize the nursing experience of a patient with diabetic nephropathy who underwent xenogeneic islet transplantation after kidney transplantation. The key points of nursing mainly include：establishing a multidisciplinary diagnosis and treatment team before surgery，improving relevant examinations and preparations，and ensuring the safety of surgery；postoperative dynamic anticoagulant therapy and bleeding observation and nursing to prevent rejection and infection. The goal-oriented blood glucose management was implemented in the whole process，and systematic health education and personalized psychological nursing were carried out.After careful specialized nursing，the patient recovered on the 26th day of hospitalization and was discharged from hospital. Up to now，the patient has completely separated from exogenous insulin treatment.
Objective To summarize the best evidence on the management of neurogenic bowel dysfunction in adults with brain injury and to provide a reference for clinical care practice. Methods A systematic search of evidence on the management of neurogenic bowel dysfunction in patients with brain injury was conducted in computerized decision systems，guideline websites，professional association websites，and comprehensive databases from the establishment of databases to October 1，2022. Types of included evidence included clinical decision making，guidelines，evidence summaries，best practices，recommended practices，expert consensuses，systematic reviews，and Meta-analysis. The literature was independently evaluated by 2 experts trained in evidence-based methodological systems for the quality of the literature，and the evidence of the included literature was extracted，integrated and graded. Results A total of 18 papers were included，including 4 guidelines，3 expert consensus articles，1 evidence summary，1 recommended practice article，and 9 systematic reviews，and the overall quality of the literature was high. 38 pieces of evidence were summarized in 9 areas：assessment and timing of intervention，behavioral intervention，dietary management，assisted defecation，transanal irrigation，pharmacological intervention，electromagnetic stimulation intervention，complication prevention and control，and health education. Conclusions This study summarized the latest best evidence for the management of neurogenic bowel dysfunction in adults with brain injury，and provided a reference basis for clinical nursing practice. The best evidence should be reasonably selected for localized and individualized application in clinical practice，and the best evidence should be continuously updated to standardize nursing practice.
Objective The purpose is to translate the Hematology Information Needs Questionnaire（HINQ） into Chinese，and to test its reliability and validity. Methods The cross-cultural adaption guide of Beaton was used to translate the scale. The reliability and validity of the HINQ were tested through a survey of 362 patients with hematologic neoplasms in a tertiary specialized hospital in Tianjin by convenience sampling from October to December 2021. Results 345 valid questionnaires were collected. The Chinese version of the scale included 7 dimensions of disease（with 10 items），treatment（with 19 items），etiology（with 3 items），sleep and physical changes（with 6 items），self-care（with 7 items），medical tests and prognosis（with 11 items），psycho-social aspect（with 6 items），with a total of 62 items. In exploratory factor analysis，the cumulative variance contribution of 7 common factors was 73.963%. The item-level content validity index of the Chinese HINQ is 0.830~1.000，the scale-level content validity index is 0.949；Cronbach’s α coefficient for the overall scale was 0.986，and the Cronbach’s α coefficients of each dimension ranged from 0.903~0.976； the test-retest reliability of the total scale was 0.896，and the split half reliability coefficient was 0.917. Conclusion The scale has good reliability and validity，and it can be used as an assessment tool for the information needs of patients with hematologic neoplasms.
Exercise rehabilitation is an important mean to promote early rehabilitation of patients with acute decompensated heart failure（ADHF） during hospitalization. This paper reviews the related research on exercise rehabilitation of patients with ADHF,summarizes the exercise styles,exercise methods,influencing factors and intervention effects,and enriches the intervention content for early rehabilitation of patients with ADHF.
Objective Risk factors for catheter-related thrombosis in totally implantable venous access ports （TIVAP） in tumor patients were analyzed by systematic analysis. Methods Computerized retrieval of PubMed，EMbase，Web of Science，the Cochrane Library，CBM，WanFang Data，CNKI and VIP databases was carried out. Case-control studies and cohort studies about TIVAP catheter-related thrombosis risk factors in tumor patients were collected from the database establishment to August 2021. 2 researchers independently screened the literature，extracted data，and evaluated the risk of bias in the included studies. Meta-analysis was performed using RevMan5.3 software. Results A total of 22 studies were included，including 4 case-control studies and 18 cohort studies，with a total of 10526 patients. The results of meta-analysis showed that tumor clinical stage[OR=3.06，95%CI（2.16，4.35），P<0.001]，implantation location[OR=0.69，95%CI（0.53，0.89），P=0.005]，body mass index（BMI）[OR=1.95，95%CI（1.21，3.13），P=0.006]，tumor metastasis[OR=2.72，95%CI（1.38，5.38），P=0.004]，infusion port material [OR=0.73，95%CI（0.56，0.95），P=0.020]，hypercoagulable state[OR=2.69，95%CI（1.94，3.73），P<0.001] and diabetes history[OR=0.50，95%CI（0.33，0.76），P=0.001] are independent risk factors for catheter-related thrombosis in tumor patients with TIVAP. Conclusion Current evidence shows that the location，material，tumor stage，tumor metastasis，BMI，concomitant hypercoagulability，and diabetes are independent risk factors for TIVAP catheter-related thrombosis in cancer patients. Clinical nursing care should be strengthened for high-risk patients with the above risk factors，in order to reduce the incidence of catheter-related thrombosis and improve the clinical outcomes of patients.
Objective To implement evidence-based practice of oral intake management during labor,develop review indicators,analyze obstacles and facilitators during implementation,and formulate reform strategies. Methods With the Joanna Briggs Institute evidence-based health care model as the guiding framework,an evidence-based practice team was formed after the clinical nursing problem was identified to search,evaluate and summarize the evidence,and to develop review indicators as well as review methods. Obstacles and facilitators were analyzed according to the baseline review results,and reform strategies were formulated. Results Totally 18 pieces of best evidence were included and 13 review indicators were formulated. There were 9 indicators with accurate execution rate of <60% and 5 of them were 0. The main obstacles were the lack of attention and relevant knowledge of midwives,the lack of assessment tools for risk factors of restricting oral intake during labor,specific dietary recommendations,management procedures as well as educational materials for different groups. The main facilitators were strong organizational leadership,multi-disciplinary team support,and high maternal and family participation and etc. Accordingly,corresponding reform strategies were formulated. Conclusion The review indicators constructed based on best evidence and combined with professional judgment were scientific,effective,appropriate and feasible. The analysis of obstacles and facilitators and the formulation of reform strategies can provide a guarantee for promoting the clinical practice of oral intake management during labor.
Objective To understand the current situation of the development and operation of midwifery clinics in Jiangsu Province,and to analyze the factors that affect the opening of midwifery clinics,so as to provide references for the construction of midwifery clinics and policy formulation of related service systems in the future. Methods From January 2021,a self-designed questionnaire on the development status of midwives outpatient clinics in Jiangsu Province was used to investigate the development status of midwives outpatient clinics in 107 secondary and above medical institutions in 13 cities in Jiangsu Province. Results Among the 107 hospitals,48（44.86%） offered midwifery outpatient clinics;11（22.92%） hospitals only opened clinics for 4 hours per week. The proportion of midwife outpatient clinics and weekly outpatient visits in specialized maternal and child health care hospitals were higher than those in general hospitals,and the proportion of midwifery outpatient clinics in tertiary hospitals was higher than that in secondary hospitals（P<0.05）. The visiting staff of tertiary hospitals and specialized maternal and child health care hospitals are highly educated（P<0.05）. Maternal and child health care specialized hospitals started intervention management earlier in gestational age,and carry out simulated delivery more often（P<0.05）. All hospitals with midwifery clinics do not have a dedicated electronic medical record system. The top 3 influencing factors for not opening midwifery outpatient clinics in 59 hospitals are the lack of hospital policy support,insufficient staff,and not knowing how to conduct them. Conclusion The prevalence rate of midwives outpatient clinics in medical institutions in Jiangsu Province is less than 50%;the prevalence rate of midwives outpatient clinics in general hospitals and secondary hospitals should be increased;the time and quality of outpatient consultations in hospitals with midwifery outpatient clinics should be accelerated;the establishment of the outpatient electronic medical record system in midwives clinics should be accelerated. It is recommended to provide further support and supervision on policies such as human resources,visiting hours,software information,quality control,et al.
Objective To retrieve，evaluate，integrate the evidence of catheter related skin injuries prevention practices in cancer patients with PICC from home and abroad，and then summarize the relevant best evidence to provide evidence-based practice for clinical standardized management of catheter related skin injuries. Methods Evidence on prevention of catheter related skin injuries in cancer patients with PICC was systemically retrieved in the websites and databases，namely the BMJ Best Practice，UpToDate，Guidelines International Network，National Guideline Clearinghouse，National Institute for Health and Care Excellence，Scottish Intercollegiate Guidelines Network，Registered Nurses Association of Ontario，Intravenous Nurses Society，National Comprehensive Cancer Network，Oncology Nursing Society，medlive，Cochrane Library，Joanna Briggs Institute，PubMed，Embase，CINAHL，Taiwan academic literature database，CNKI，WanFang，VIP，SinoMed，including clinical decision-making，guidelines，evidence summaries，best practice，recommended practice，systematic reviews，expert consensuses，and government documents. The literature retrieval period was from the database construction to September 12，2021. The guidelines were individually evaluated by 4 experts，and the remaining literature was independently evaluated by 2 researchers. The literature that met the criteria was extracted and graded. Finally，the expert group integrated the evidence and summarized the evidence topics. Results A total of 12 articles were involved，including 1 government document，3 guidelines，4 evidence summaries，3 expert consensuses，and 1 systematic review. Finally，7 evidence topics and 26 pieces of best evidence were formed，including assessment，skin cleaning and antisepsis，dressing selection，operation and securement techniques，skin protection at PICC insertion site，patient education，supervision and training. Conclusion The best evidence of catheter related skin injuries in cancer patients with PICC can provide resources preparation for clinical transformation and offer nurses clinical decision-making for scientific and effective nursing practice. Specialist nurses should reasonably choose the best evidence for localized application，and constantly update the best evidence，standardize nursing practice，and ensure the safety of patients.
Objective To investigate the status and factors associated with fear of progression in recipients of renal transplantation. Methods By using the convenient sampling method,221 recipients of renal transplantations were selected from February to June 2021 in a tertiary hospital in Changsha. General information questionnaire,Fear of Progression Questionnaire-Short Form,Positive Psychological Capital Questionnaire,Brief Illness Perception Questionnaire,Distress Disclosure Index were used to conduct the investigation. Results The score of fear of progression of recipients of renal transplantation was (28.13±7.87) ;51 cases (23.08%) were≥34 points;the positive psychological capital score was (124.05±21.06) ;the illness perception score was (37.67±11.10) ;the distress disclosure score was (36.09±8.98). Multiple linear regression analysis showed that illness perception and positive psychological capital were the influencing factors of fear of progression (P<0.05),which explained 35.3% of the total variation. Conclusion The incidence of fear of progression in recipients of renal transplantation is high,which is generally in the middle level. Clinicians should pay attention to the psychological status of renal transplant recipients,and reduce recipients’ illness perception,enhance patients’ positive psychological capital,and reduce their fear of disease progression.
Objective Through systematic evidence retrieval and literature quality evaluation,the best evidence for respiratory muscle training in patients with chronic obstructive pulmonary disease (COPD) was extracted and summarized,so as to provide research-based evidence for respiratory muscle training in the clinical settings. Methods The evidence search was performed across 17 databases and official websites systematically,including UpToDate,BMJ Best Practice,Joanna Briggs Institute Library,Cochrane Library,British National Institute for Health and Care Excellence,Registered Nurses’ Association of Ontario,Canada,British Thoracic Society,Canadian Thoracic Society,American Thoracic Society,Thoracic Society of Australia and New Zealand,Web of Science,PubMed,Embase,Sinomed,CNKI,and Wanfang Database. The guidelines,expert consensuses,evidence summaries,systematic reviews,and randomized controlled trials were included. The retrieval timeframe was ranged from the establishment date of the databases or websites to October 31,2020. All literature was independently evaluated by 2 researchers,and they determined whether the literature met the standards and then extracted the data. Results A total of 12 pieces of literature were eligible for inclusion. They were 2 guidelines,2 expert consensuses,2 evidence summaries,and 6 systematic reviews. There were 21 pieces of best evidence with 7 dimensions being summarized,namely training purposes,training subjects,training places,training plans,training methods,quality control,and effectiveness evaluation. Conclusion The best evidence of respiratory muscle training in patients with COPD was summarized. It is recommended that health care professionals should fully consider the allocation of medical resources when they apply the evidence and formulate individualized and feasible training programs based on the needs and preferences of patients.
To summarize the nursing points of early complications in 14 cases after parental living intestine transplantation and to provide references for clinical nursing. Key points of nursing：to set up an interdisciplinary cooperation team and carry out targeted treatment and nursing care according to the different characteristics of early postoperative complications;to predictively assess and prevent anastomotic vascular thrombosis;to early detect bleeding and actively assist in hemostasis treatment;to monitor infection signs and carry out infection controlling strategies strictly;to strengthen the management of transplanted enterostomy and the monitoring of rejection,and alert to acute rejection. Among transplant recipients in this group,there were 5 cases of bleeding,5 cases of infection,2 cases of acute rejection,1 case of giving up treatment,1 case of death within 30 days after transplantation. With timely and accurate monitoring,treatment and nursing care,12 cases survived and had perfect digestion and absorption function. In（20.58±5.79） d after the transplantation,the patients were out of parenteral nutrition and returned to normal oral feeding gradually.
Objective To construct a structural equation model of cognitive function of patients with spinal cord injury（SCI） and its influencing factors,and to analyze the path of action of each factor on the cognitive function of SCI patients,so as to provide a basis for targeted cognitive function intervention programs. Methods From October 2019 to November 2020,the convenience sampling method was adopted to include 357 patients with SCI from 8 tertiary hospitals in Anhui Province. The General Situation Questionnaire,the Montreal Congnitive Assessment,and Hamilton Depression Table,Self-Efficacy Rehabilitation Outcome Scale,Social Support Rating Scale,the Revised Piper Fatigtle Scale,Pittsburgh Sleep Index Scale were employed,and a structural equation model was used to analyze the path of action of each influencing factor. Results Depression,self-efficacy,fatigue,sleep,and social support all affect the cognitive function of patients through different pathways. Depression negatively affects cognitive function with the direct and indirect effects of -0.245 and -0.282 respectively;self-efficacy positively affects cognitive function with the direct and indirect effects of 0.503 and 0.012,respectively;fatigue negatively affects cognitive function with a direct effect of -0.131;sleep negatively affects cognitive function with the direct and indirect effects of -0.353 and -0.210,respectively;social support positively affects cognitive function with direct and indirect effects of 0.110 and 0.874,respectively. Conclusion The cognitive function of patients with SCI is affected by the interaction of multiple factors. Medical staff should pay attention to the evaluation of the patient’s cognitive function and its influencing factors in clinical work,and take effective measures to improve the patient’s cognitive function in time.
Objective To explore a novel triage management mode during the coronavirus disease 2019（COVID-19）epidemic,so as to reduce missed cases,in-hospital cross-infection,and improve satisfaction of patients and their family members. Methods During the COVID-19 epidemic,we moved the triage points to the entries of departments of outpatient,emergency and inpatient by setting up tents. The precise management of triage staff and facilities was enhanced,and the precise triage procedures and information was developed. Results From January 25 to February 20,2020,we triaged a total of 37,698 patients and visitors,among which 301 cases were triaged to the COVID-19 fever clinic,639 cases to the general fever clinic,and 160 cases were suspected as COVID-19 and quarantined,and 3 cases were confirmed as COVID-19 and referred to the designated treatment hospital. Even though the total volume of triage was large,we achieved zero missed detection of suspected patients with COVID-19,zero occurrence of in-hospital cross-infection,and zero complaint from patients and their family members in our hospital. Conclusion The triage management of One-Move and Two-Precise is an effective way and is worth applying to the prevention and control during COVID-19 epidemic or potential infectious disease outbreaks in the future.
Objective To design and develop a two-dimensional informationalized nursing dashboard for clinical nurses’ decision-making in general wards,so as to solve the manual identification of patients’ important information and cross-space communication,providing nurses with accurate and intuitive information display and communication channels.Methods The information items of the two-dimensional informationalized nursing dashboard were confirmed by current situation investigation,literature search and expert meeting. Data were automatically acquired from the hospital information platform,and then were analyzed,classified and presented. After used by nurses in general wards in our hospital for half a year,its effects were evaluated using interview method.Results The nursing informationalized dashboard extracted key information from two dimensions（whole wards and single patient）,including 62 items in four categories,namely 15 items of patient data,37 items of nursing evaluation,9 items of nursing tasks,and 1 item of remark information. It realized the direct reading and real-time updating of data,improved working efficiency of nurses and brought positive psychological feelings to nurses.Conclusion The two-dimensional informationalized nursing dashboard can realize automatic information transmission,resource sharing and change the inherent clinical nursing working mode,which is practical and innovative.
Objective To explore and evaluate the effects of the management scheme of early activity for elderly patients with hip fracture.Methods Based on the postoperative activity model of the Affiliated Hospital of Southampton University of England,combined with the thoughts and practice of our hospital’s clinical nursing procedure,the early activity management scheme for elderly patients with hip fracture was formed. Totally 248 elderly patients with hip fracture treated in our hospital from January 1st,2017,to December 31st,2018,were selected as the experimental group,receiving early activity management scheme. 214 patients from January 1st,2014,to December 31st,2016,were selected as the control group,receiving routine nursing scheme. The differences in the first ambulation time,the longest walking distance 3 days after surgery,length of hospitalization,activity of daily living ability,and quality of life between two groups were compared.Results The first time of ambulation was （1.84±0.73） days in the experimental group and（5.23±2.17） days in the control group;the longest distance of walking in the experimental group was（82.55±23.12） m on the 3rd day after surgery,and that in the control group was（29.41±10.97） m;the length of hospitalization in the experimental group was（9.27±1.71） days,and that in the control group was（11.39±2.53） days,and there was significant difference between the two groups（P<0.05）. The scores of activity of daily living at discharge in the experimental group and quality of life 3 months after discharge were higher than those in the control group（P<0.05）.Conclusion The early activity management scheme for elderly patients with hip fracture is helpful for early ambulation,to shorten length of hospitalization and improve quality of life.
Triage Management of One-Moving, Two-Accurate and Three-zero during the COVID-19 epidemic
