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Correlation between preoperative frailty and short-term postoperative complications in elderly breast cancer patients
LU Ping, WANG Xiaojie, GUO Hailing
Chinese Journal of Nursing    2024, 59 (8): 916-921.   DOI: 10.3761/j.issn.0254-1769.2024.08.003
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Objective To investigate the relationship between preoperative frailty and short-term postoperative complications in elderly breast cancer patients. Methods A convenience sampling method was used to select 231 elderly breast cancer patients who underwent elective surgery in a tertiary care hospital in Beijing from July 2022 to December 2022. General information on elderly patients was collected and the frailty assessment was performed 1 day before surgery,and the occurrence of complications in elderly patients was followed up 30 days after surgery. Results Among the 214 elderly breast cancer patients,37 patients had complications within 30 days postoperatively. Binary logistic regression analysis showed that the risk of complications at 30 days postoperatively was 5.532 times higher in elderly breast cancer patients with preoperative frailty than it in non-frail patients(P< 0.05). Elder breast cancer patients with problems of decreased free movement,increased resistance/loss of endurance,and weight loss had a high risk of postoperative complications. Conclusion Preoperative frailty affects the occurrence of complications in elderly breast cancer patients within 30 days after surgery and suggests that nursing staff should strengthen perioperative health management for elderly breast cancer patients with preoperative frailty and actively prevent the occurrence and development of frailty.

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Development of health science popularization works for the prevention of deep vein thrombosis in patients after joint replacement
WANG Yu, XU Yuan, DENG Haibo, WANG Lei, WANG Xiaojie, HAO Yufang, ZHU Liyun, LIU Jia, SUN Jianhua, AN Ranxun, MA Yufen, WU Xinjuan
Chinese Journal of Nursing    2024, 59 (6): 699-705.   DOI: 10.3761/j.issn.0254-1769.2024.06.008
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Objective To develop evidence-based health science popularization works for the prevention of deep vein thrombosis(DVT) in patients after joint replacement. Methods In this study,guided by the Guideline International Network patient guideline formulation manual and Patient Education Materials Assessment Tool,we conducted semi-structured interviews to clarify the health science themes. These themes were matched with relevant evidence,and the relevant evidence recommendation items for each theme were refined. It is translated into easily understandable language and other forms. 12 representatives(doctor,nurse,patient,science popularization expert and evidence-based methodology expert) conducted an external review of the quality of these science popularization works. Results Prevention of post-operative DVT,patients’ main concerns and the most urgent need for action were extracted from a total of 6 scientific topics. After the matching with 22 pieces of evidence,a health education content system for the prevention of DVT after total joint arthroplasty was created. According to the system framework and evidence,as well as the preferences and needs of patients,a popular science manual and popular science video were created,with the final external review rate of 94%~100% and the coefficient of variation of 0~0.101. The revised health science works for the prevention of DVT after joint replacement included popular science manuals-trifolds and popular science videos. The copyright of both popular science manuals(copyright number:Guozuo Dengzi-2022-L-10159159) and popular science videos(copyright number:Guozuo Dengzi-2022-I-10162339) have been registered. Conclusion The method of developing science popularization works on the prevention of DVT in patients after joint replacement is scientific. It can provide a methodological reference for the development of other science popularization works.

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Obstacle factors of the best evidence application for the prevention of deep vein thrombosis after joint replacement
XU Yuan, WU Xinjuan, YANG Xu, WANG Yu, PANG Dong, WANG Xiaojie, LIU Jia, SHANG Gaopeng, JIANG Ying, ZHU Liyun, MA Yufen
Chinese Journal of Nursing    2022, 57 (8): 958-963.   DOI: 10.3761/j.issn.0254-1769.2022.08.010
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Objective To explore the barriers in the clinical use of evidence-based deep vein thrombosis prevention after joint replacement,and to provide bases for clinical measures. Methods The interview outline was developed based on the Theoretical Domains Framework(TDF) from July to August 2020. Totally 16 nurses working in the department of orthopedic at a tertiary A hospital in Beijing were selected for semi-structured interviews by convenient sampling,and the content analysis was conducted based on the results. The content of the transcribed text is analyzed,and specific topics and codes are classified according to the relevant fields of TDF. Results In clinical practice,the department has used the HIS system to assess DVT risks,but the nurses do not have a good grasp of the assessment scale,and the case information need to be retrieved,which has caused certain obstacles to the development of the assessment work. Nurses have the awareness to carry out health education and nursing prevention,but due to the lack of auxiliary tools,it is difficult to attract patients’ attention,and thus they lose the will to act,and hold doubts about the prevention effects. Nurses master health education related content and can implement physical and drug prevention,and the department has carried out prevention effect evaluation. However,due to the lack of relevant procedures,there are differences in behaviors among nurses. Combined with TDF,the above obstacles are classified into 5 domains:knowledge,environmental factor,motivation and target,result expectation,and code of conduct. Conclusion There is a variety of obstacles that affect the prevention of deep vein thrombosis after joint replacement in clinical application. It is necessary for the department to carry out the reform of evidence-based nursing practice on the basis of obstacles and promote the clinical application of the best evidence for the prevention of deep vein thrombosis after joint replacement.

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Expert consensus on risk assessment and prevention of venous thromboembolism in general surgical patients
The Surgical Nursing Committee of Chinese Nursing Association, The Nursing Group of Chinese Society of Surgery of Chinese Medical Associaton, (Writing Committee:MA Yufen, XU Yuan, WANG Xiaojie, DENG Haibo, WANG Lei, SUN Jianhua, LIU Ge, GUO Yaping, GENG Qian, WANG Yu, ZHU Liyun, LU Qiaodan, AN Ranxun)
Chinese Journal of Nursing    2022, 57 (4): 444-448.   DOI: 10.3761/j.issn.0254-1769.2022.04.009
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Objective To explore the expert consensus on risk assessment and preventive nursing of venous thromboembolism(VTE) in general surgical patients. Methods This consensus was drafted through a systemic literature review on VTE prevention and the interviews of nursing experts. The draft was thereafter reviewed by a total of experts in related fields,and it was finalized after 2 rounds of expert consultation. Results 4 domains with 26 components were established through a modified Delphi method. The effective recovery of the ques-tionnaire was 100%;the expert judgment coefficient was 0.960;the familiarity was 0.912;the authority coefficient was 0.936. The Kendall coefficients of the first and second level topics in the 2 rounds were 0.149 and 0.261,and 0.122 and 0.203,respectively,with statistically significant differences(P<0.05). The consensus includes risk factors for VTE in general surgical patients,risk assessment,risk response,education and quality control,and it is applicable to perioperative patients of general surgery. Conclusion The consensus was based on the recommendations of 25 clinical nursing experts. The results are scientific,rigorous and authoritative,and can provide guidance for clinical nursing staff in the prevention and control of VTE in general surgical patients.

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Evidence application review and obstacle factors analysis for prevention of deep venous thrombosis after joint replacement
WANY Yu, XU Yuan, DENG Haibo, WANG Xiaojie, SUN Jianhua, MA Yufen, PANG Dong, YANG Xu, ZHU Liyun, LIU Jia, CAO Haiying, SHANG Gaopeng, CAO Jing, WU Xinjuan
Chinese Journal of Nursing    2022, 57 (24): 2949-2956.   DOI: 10.3761/j.issn.0254-1769.2022.24.001
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Objective To carry out evidence-based nursing for the prevention of deep vein thrombosis(DVT) in patients after joint replacement,to formulate review indicators,to analyze the obstacles and promoting factors in the practice of evidence-based nursing,and to formulate action strategies. Methods Based on the Knowledge to Action framework as the theoretical guidance,a total of 24 pieces of evidence for DVT prevention nursing in patients after joint replacement in suitable clinical situations were included;6 examination criteria and 33 examination indexes were formulated;the preventive behavior of nurses was observed on-site with patients as a unit. Furthermore,based on the results of the baseline review,brainstorming was used to analyze the barriers and facilitators in evidence-based practice,and action strategies were formulated. Results Totally 24 pieces of best evidence were included. According to the best evidence,33 examination indexes and 6 examination criteria were established. The clinical compliance rate of the 6 examination criteria ranges from 0% to 100%. Among them,there is room for improvement in health education(0),mechanical prevention(62%),pharmacological prevention(81%) and quality control(21%). Obstacle factors include the lack of tools and nursing processes,lack of knowledge,insufficient attention,busy work,as well as low understanding and low participation. Facilitating factors include strong organizational leadership,medical team cooperation,sufficient equipment,etc. Accordingly,corresponding action strategies have been formulated. Conclusion Based on evidence and clinical experience,we formulated the scientific,appropriate and maneuverable indicators. At present,there is a certain gap between the evidence for the prevention of deep vein thrombosis in patients after joint replacement,and we should fully utilize these facilitating factors,overcome obstacles,implement improving measures,and promote the effective application of evidence.

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Research progress of health-related quality of life assessment tools for patients with deep vein thrombosis
LU Qiaodan, WANG Lei, DENG Haibo, XU Yuan, WANG Xiaojie, SUN Jianhua, ZHU Liyun, AN Ranxun, ZHOU Xinyi, WANG Yu, MA Yufen
Chinese Journal of Nursing    2022, 57 (22): 2791-2795.   DOI: 10.3761/j.issn.0254-1769.2022.22.016
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This paper reviews the existing assessment tools,outlines the development process,main contents,and application status of universal and disease-specific health-related quality of life assessment tools for patients with DVT,analyzes the characteristics and limitations of existing tools,and aims to provide references for clinical selection of appropriate assessment tools and for the development of health-related quality of life assessment tools for patients with DVT in accordance with the cultural background of China.

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Evidence summary for prevention of deep venous thrombosis in patients after joint replacement
WANG Yu, XU Yuan, WANG Xiaojie, SUN Jianhua, MA Yufen, PANG Dong, ZHU Liyun, LIU Ge, CAO Jing, LU Qiaodan, WU Xinjuan
Chinese Journal of Nursing    2021, 56 (9): 1408-1414.  
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Objective To comprehensively retrieve and analyze evidence related to deep vein thrombosis(DVT)prevention after joint replacement and to summarize the best evidence. Methods We systematically searched for evidence on DVT prevention after joint replacement in BMJ Best Practice,UpToDate,JBI,YiMaiTong,GIN,NGC,NZGG,NICE,SIGN,NHMRC,CPG Infobase,CINAHL,EMBASE,PubMed,WOS,Wanfang and CNKI databases to collect relevant clinical decisions,evidence summaries,clinical guidelines and expert consensuses. The timeframe of data search ran from January 2015 to November 2020. 2 researchers independently evaluated the quality of the articles,and classified the evidence according to the Joanna Briggs Institute evidence-based pre-grading system(2014 edition). Results A total of 13 articles were included,including 3 clinical decisions,2 evidence summaries,4 guidelines and 4 expert consensuses. Combined with professional judgment,16 pieces of best evidence in 6 aspects were summarized,including risk assessment,health education,preventive measures of nursing care,mechanical prophylaxis,pharmacological prophylaxis,and promotion of clinical implementation of preventive measures. Conclusion The best evidence summarized on the prevention of DVT in patients after joint replacement can provide evidence for clinical nursing work.

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A field research based on the best evidence of nursing care for the prevention of deep vein thrombosis after joint replacement
WANG Yu,XU Yuan,MA Yufen,WANG Xiaojie,YANG Xu,CAO Jing,JIANG Ying,WANG Jingjing,SHANG Gaopeng,ZHU Liyun,LU Qiaodan,WU Xinjuan
Chinese Journal of Nursing    2021, 56 (4): 521-526.   DOI: 10.3761/j.issn.0254-1769.2021.04.007
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Objective To understand the work content of deep vein thrombosis (DVT) preventive care after hip and knee replacement,and to clarify the gap between the current practice and the best evidence. Methods From June to October 2019,we used the field research methods to conduct a 5-month participatory observation about the nursing work in the joint surgery ward in a level A tertiary hospital in Beijing. We used the three-level coding method of qualitative research to conduct field notes analysis. Results Through the care experience of participating in 391 cases of preventing DVT after hip and knee replacement,this study clarified the work content of preventive care,and extracted 4 work content themes,namely Education,Enforcement,Evaluation and E-recording,which fit with the best evidence. However,there is a partial gap between the implementation effect and the best evidence,and it still needs further development in enhancing health education and early activities promotion. Conclusion Through the field research,we have learned about the nursing work content in preventing DVT after hip and knee replacement,and the gap between the present situation and the best evidence and the possible reasons. Carrying out evidence-based nursing research and constructing scientific,normative and clinically feasible standardized preventive nursing plans are the best ways to prevent DVT after hip and knee replacement.

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Bibliometric analysis on abroad studies of venous thromboembolism prevention
ZHU Liyun, WANG Lei, XU Yuan, WANG Xiaojie, WANG Yu, TIAN Mengyuan, DENG Haibo, YANG Xu, LU Qiaodan, MA Yufen
Chinese Journal of Nursing    2021, 56 (12): 1906-1910.   DOI: 10.3761/j.issn.0254-1769.2021.12.025
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Objective To analyze the situation and hot trend of venous thromboembolism(VTE) prevention abroad,in order to provide references for clinical guidelines and scientific research for nursing staff in China. Methods Core journal articles related to venous thromboembolism and prevention from Web of Science(WOS) from 2005 to 2020 were retrieved. CiteSpace software was used for the bibliometric and cluster analysis. Results The volume of papers issued in the research of VTE prevention is on the whole increasing trend. The research mainly focuses on drug prevention,physical prevention,complications observation,risk identification and VTE prevention in patients with different diseases. Among them,“precautionary duration” “intermittent pneumatic compression devices” “stroke”“anticoagulation” “clinical practice guidelines” and “oral anticoagulants” are the hot spots in the current research frontier. Conclusion The prevention of VTE is attracting the attention of scholars. It is recommended to promote the development of VTE prevention research in China and continuously improve the quality of clinical care by specifying the focus of VTE prevention research,broadening the range of VTE prevention populations,and formulating VTE preventive care guidelines.

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Nursing human resources management in intensive care units of coronavirus disease 2019 by the national medical aid team
LI Qi, XU Yuan, WANG Xiaojie, DENG Haibo, WANG Lei, LI Zunzhu, JIAO Jing, SUN Jianhua, MA Yufen, WU Xinjuan
Chinese Journal of Nursing    2020, 55 (7): 1011-1015.   DOI: 10.3761/j.issn.0254-1769.2020.07.009
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Objective To explore the nursing human resources management strategies of the medical aid team to Hubei during the coronavirus disease 2019(COVID-19) epidemic and to improve the efficiency of nursing management. Methods Drawing on the command and decision-making system of health emergencies,and taking "emergency support-basis-action" as the conceptual model of nursing manpower management,we constructed a scientific,effective and practical ICU nursing manpower management model. Results There were 135 members in nursing aid team with 7 nursing groups being established to implement flexible management. Progressive trainings were carried out and clinical teaching was conducted for 30 times. A total of 109 critically ill patients with COVID-19 were admitted,including 75 patients with mechanical ventilation. Conclusion In response to the outbreak of COVID-19,the national medical aid team quickly established ICU nursing team,and formed a management model of nursing manpower based on "emergency support-basis-action" model to protect the critically ill patients with COVID-19 and to ensure the patients treatment and care being carried out smoothly.

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Co-word clustering analysis on hot-spots of Chinese nursing research on venous thromboembolism
WANG Yu, MA Yufen, DENG Haibo, YANG Xu, WANG Lei, WANG Xiaojie, XU Yuan, ZHU Liyun, LIU Ge, LIU Ying, WU Xinjuan
Chinese Journal of Nursing    2020, 55 (7): 1001-1005.   DOI: 10.3761/j.issn.0254-1769.2020.07.007
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Objective To describe the development and evolution of venous thromboembolism(VTE) nursing research in China,and to reveal research hotspots and frontiers. Methods Journal articles from CNKI and WanFang Database from the inception to 2019 were searched and retrieved with keywords of venous thromboembolism and nursing. CiteSpace software was used for the bibliometric and cluster analysis. Results The volume of papers issued in the nursing research of VTE is on the whole increasing trend. The direction of VTE nursing research involves the identification of high-risk groups and the development of nursing preventive measures. Among them,the elderly,the patients after joint replacement,the patients with malignant tumor and the patients after PICC catheterization have always been the research focus of the prevention of VTE. Conclusion As one of the specialized nursing direction,the nursing care of patients with VTE has been given more attention. Future research can explore effective methods in order to improve nurses’ knowledge for prevention of VTE,and develop intervention programs to promote the “flawless” VTE prevention

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Expert consensus on nursing prevention and control of venous thromboembolism in adult patients with coronavirus disease 2019
MA Yufen, DENG Haibo, WANG Xiaojie, XU Yuan, WANG Hui, WANG Lei, WANG Yu, ZHU Liyun, LU Qiaodan, SUN Jianhua, LIU Ge, WU Xinjuan
Chinese Journal of Nursing    2020, 55 (5): 666-669.   DOI: 10.3761/j.issn.0254-1769.2020.05.004
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Objective To establish an expert consensus on nursing prevention and control of venous thromboembolism(VTE) in adult patients with coronavirus disease 2019(COVID-19). Methods This consensus was drafted through a systemic literature review on COVID-19 diagnosis and management plan,VTE prevention and control,and interviewing nursing experts from front-line epidemic control. The draft was thereafter reviewed by a total of 18 experts in related fields. This consensus was finalized after 2 rounds of discussions and modifications. Results The expert consensus covers the following 5 topics,namely VTE risk factors,VTE risk assessment,VTE nursing prevention and control,VTE prewarning and monitoring,and health care education of VTE prevention and control after discharge. Conclusion The consensus was drafted and finalized on a scientific and practical basis,which can provide guidance for clinical nurses in prevention and control of VTE in adult patients with COVID-19.

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The establishment and implementation of neonatal care clinic
WEN Xiulan, LIN Yan, SUN Li, HE Fang, WANG Xiaojie, GUO Xiaoping, ZHOU Yan, CHEN Mei, LIU Meiyi
Chinese Journal of Nursing    2019, 54 (7): 1056-1059.   DOI: 10.3761/j.issn.0254-1769.2019.07.019
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Objective To establish and implement a neonatal care clinic for meeting the needs of neonatal continuing nursing service. Methods Regulations were set up,nurses were selected,and the neonatal care clinic was established for screening of neonatal jaundice and parenting guidance. Nurses,doctors and parents were investigated for evaluation of the clinic. Results A total of 16 nurses were selected for the clinic. From March to August 2017,there were 2,543 cases for neonatal care visits,and the number of cases for neonatal jaundice was the highest which was 2038(80.14%). All nurses believed that the clinic improved parents’ satisfaction with hospital and nursing work,and they agreed that specialist nursing capacity was improved;66.67% of the doctors considered that specialist nursing clinic was helpful to the diagnosis and treatment of patients;80% of the parents had a total score of 90 to 100 on evaluation of the neonatal care clinic. Conclusion The neonatal care clinic can effectively identify pathological jaundice and solve parenting problems from parents,improve professional and social status of neonatal specialist nurses and their confidence to be clinical nursing specialists,and received recognition from doctors and parents.

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Expert consensus on nursing prevention and control of venous thromboembolism in adult patients with COVID-19 

MA Yufen, DENG Haibo, WANG Xiaojie, XU Yuan, WANG Hui, WANG Lei, WANG Yu, ZHU Liyun, LU Qiaodan, SUN Jianhua, LIU Ge, WU Xinjuan
Chinese Journal of Nursing   
Accepted: 31 March 2020