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Integrative nursing experience of a case with chronic refractory wound formation caused by drug extravasation
ZHANG Yuanyuan, LONG Xiuhong, LÜ Chan, LI Xian, WANG Yi, HUANG Lanying, TU Huiqiong, QIN Huijuan
Chinese Journal of Nursing    2024, 59 (7): 808-811.   DOI: 10.3761/j.issn.0254-1769.2024.07.006
Abstract839)   HTML6)    PDF (774KB)(44)       Save

To sum up integrative nursing experience of a case with chronic refractory wound formation caused by drug extravasation. The essentials of integrative nursing are:structured nursing intervention of “assessment-management-treatment” based on the Triangle of Wound Assessment;determination of the timing for integrative nursing according to the theory of TCM sores and ulcers;implementation of copper board scraping method to promote circulation of qi and blood;use of Huo-long Comprehensive Moxibustion Therapy to promote muscle regeneration. With the help of the cooperation of the multidisciplinary specialist nursing team,the wound was completely healed after 59 days of integrated traditional Chinese and Western medicine nursing interventions.

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Construction of a medication management program of elderly patients with polypharmacy after percutaneous coronary intervention
CHENG Ting, TU Hui, XIONG Xiaoyun, GUO Ting, ZHANG Weifang, PENG Ying
Chinese Journal of Nursing    2023, 58 (12): 1476-1482.   DOI: 10.3761/j.issn.0254-1769.2023.12.010
Abstract254)   HTML5)    PDF (894KB)(7)       Save

Objective To construct a program for elderly patients with polypharmacy after percutaneous coronary intervention,and to ensure the safety of patients’ polypharmacy throughout the process. Methods Based on evidence-based methods to retrieve domestic and foreign literature,and guided by the 4R crisis management theory,the first draft of the medication management program was formulated by the research group,and the final program was revised and established according to the experts’ opinions by Delphi method from January to July 2022. Results 15 experts participated in 2 rounds of consultations,and the effective recovery rate of questionnaire was 100%. The expert authority scores of 2 rounds were 0.90,and the importance and operability of the second round of expert opinions Kendall harmony were 0.216 and 0.289. The final program contained 4 primary indicators,7 secondary indicators and 23 tertiary indicators. Conclusion The constructed medication management program for elderly patients with polypharmacy after percutaneous coronary intervention is scientific and comprehensive,which can provide a theoretical basis and practical direction for the management of patients.

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Construction and application of a volume management program in vulnerable phase for patients with heart failure
CHEN Hua, XIONG Xiaoyun, SUN Xinglan, XIAO Dan, TU Hui, YI Fengyi, WEI Wenting, LIU Jiawen, SONG Yujie
Chinese Journal of Nursing    2022, 57 (13): 1541-1547.   DOI: 10.3761/j.issn.0254-1769.2022.13.001
Abstract872)   HTML2)    PDF (1137KB)(28)       Save

Objective To construct a volume management program based on Information-Knowledge-Attitude-Practice(IKAP) theory and to discuss its application effect for patients with heart failure in vulnerable phase. Methods The 4 process and capacity management architecture based on IKAP theory were constructed by the expert group discussion method. Using the convenience sampling method,94 patients with heart failure from May to October 2021 were selected as the experimental group,and the same number of patients from May to October 2020 were selected as the control group,both of whom were admitted to a tertiary first-class hospital in the city of Nanchang. The experimental group received the volume management program based on IKAP theory,and the control group received the routine care of the department. Finally,we evaluated the effect of the intervention. Results 94 patients in the experimental group and 92 patients in the control group were finally collected. There were statistically significant differences in self-care ability,weight management ability,B-type natriuretic peptide level,dry body mass compliance rate and readmission rate between 2 groups after the intervention(P<0.05). Conclusion The volume management program based on IKAP theory can improve self-care ability,weight management ability and dry body mass compliance rate of vulnerable patients with heart failure,and reduce B-type natriuretic peptide level and readmission rate in vulnerable phase.

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Summary of the best evidence for non-pharmacological interventions to improve anesthesia induction coordination in children undergoing surgery
YIN Qian, TU Huihui, TONG Xiaoru, CHEN Bo, WU Mengyu, GONG Xingrui
Chinese Journal of Nursing    2022, 57 (12): 1523-1530.   DOI: 10.3761/j.issn.0254-1769.2022.12.018
Abstract341)   HTML2)    PDF (996KB)(5)       Save

Objective To search,evaluate,and summarize the best evidence of non-pharmacological interventions to improve cooperation during anesthesia induction in children undergoing surgery,providing evidence-based evidence for clinical practice. Methods According to the “6S” evidence resource pyramid model,the domestic and foreign guide networks and databases including UpToDate,Cochrane Library,PubMed and Yimai Tong Guide were systematically searched. All the evidence of non-pharmacological interventions to improve anesthesia induction coordination in children undergoing surgery was involved,including guidelines,systematic reviews,evidence summaries,and expert consensuses. The retrieval time limit was from the establishment of the database to October 1,2021. Researchers conducted independent quality evaluation of the literature according to the relevant literature quality evaluation criteria,and they standardized data extraction of the final included literature based on professional judgment. Results Totally 15 pieces of the literature were included,including 7 clinical practice guidelines,7 systematic reviews and 1 expert consensus. Finally,20 pieces of best evidence about preoperative education,operating room environment setting,distraction technology,social intervention and the use of breathing masks were summarized. Conclusion The study summarizes the best evidence of non-pharmacological interventions to improve the anesthesia induction cooperation in children with surgery. Non-pharmacological interventions have high safety and operability for nurses,and clinical medical staff can combine the clinical situation and specific policies to carry out the evidence for clinical transformation and application,so as to improve the degree of anesthesia induction cooperation in surgical children.

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Influence of blood pressure fluctuation on operative side palm swelling in patients with radial artery compression after percutaneous coronary intervention
XIAO Dan, GUO Ting, TU Hui, LI Xin, LIU Jiawen, CHEN Hua, WEI Wenting, YI Fengyi, XIONG Xiaoyun
Chinese Journal of Nursing    2022, 57 (1): 56-60.   DOI: 10.3761/j.issn.0254-1769.2022.01.008
Abstract621)   HTML8)    PDF (577KB)(43)       Save

Objective To investigate the relationship between the changes of blood pressure and palmar swelling during radial artery compression in patients with radial artery percutaneous coronary intervention (PCI). Methods The patients who underwent radial artery PCI in the coronary heart disease unit of a tertiary general hospital in Nanchang from May 2018 to December 2020 were selected as the study subjects. The general data and the related indexes of decompression were analyzed retrospectively,and the blood pressure fluctuation during radial artery compression was described. Univariate regression analysis was used to analyze the influencing factors of palmar swelling on the operative side,and the blood pressure during radial artery compression was divided into nodes. The effects of different blood pressure on operative side palm swelling were analyzed by stratification,and the corresponding range of blood pressure at the highest risk of operation side palm swelling was further analyzed by trend regression. Results A total of 788 patients with radial artery PCI were included. Based on the analysis of patients’ baseline data,it was found that history of diabetes,history of hypertension,signs of heart failure and high average systolic blood pressure during radial artery compression were the risk factors of operative palmar swelling. However,multivariate stratified analysis of risk factors showed that systolic blood pressure ≥130 mmHg during radial artery compression increased the risk of ipsilateral palm swelling in patients with diabetic history (OR=1.09,P<0.001). In patients with or without heart failure signs and hypertension history,when the systolic blood pressure during radial artery compression was more than 130 mmHg,the 2 groups increased the risk of palmar swelling on the operative side. Furthermore,trend regression analysis showed that the average systolic blood pressure during radial artery compression was between 130 and 149 mmHg. Every 10 mmHg increase in systolic blood pressure had increased the risk of palmar swelling by 3.52 times[95%CI (1.37,13.22) ]. Conclusion During the period of radial artery compression,the average systolic blood pressure of patients is 130-149 mmHg,and the risk of palmar swelling on the operative side is the highest. It is suggested that clinical nurses should comprehensively consider the changes of systolic blood pressure when formulating the prevention plan for complications of palmar swelling on the operative side.

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