Objective To investigate the current situation of ethical conflict among ICU nurses in tertiary general hospitals in China，and to analyze the influencing factors to provide evidence for the mitigation of ethical conflict. Methods A multi-stage sampling method was used to investigate 1608 ICU nurses from 28 tertiary general hospitals in 7 geographical regions in China from December 2021 to April 2022. The Chinese version of nursing ethics conflict questionnaire-intensive care version was adopted. The univariate analysis and multiple logistic regression were used to analyze the influencing factors. Results A total of 1 516 valid questionnaires were collected. The score of ethical conflict among ICU nurses in tertiary hospitals in China was 75.5（35.0，125.0）. Logistic regression analysis showed that region，ICU type，age，education level，position and whether they had received ethical training were the influencing factors of ICU nurses’ ethical conflict（P<0.05）. Conclusion The ethical conflict of ICU nurses in China is expected to be alleviated. Nursing managers should identify the population at risk of ethical conflict，pay attention to counseling and psychological support，and develop personalized strategies to abate the ethical conflict of ICU nurses.
Objective To explore the relationship between cardiovascular disease（CVD） risk perception and overall risk，and to provide evidence for formulating targeted intervention strategies. Methods A total of 735 participants including physical examination subjects and patients with diabetes or hypertension from a tertiary Grade A hospital in Hangzhou were recruited from March to July 2022. The general information questionnaire，CVD overall risk assessment model and risk perception assessment tool were used to investigate the correlation between the absolute risk perception and the overall risk value of different demographic characteristics，and to compare the difference between the absolute risk perception and the overall risk. Results A total of 692 valid questionnaires were collected with a recovery rate of 94.1%. The median（P25，P75） of CVD overall risk was 1.0%（0.2%，6.4%），and the median（P25，P75） of absolute risk perception was 2.0 （1.0，3.0）. The absolute risk perception of CVD was positively correlated with the total risk value（rs=0.181，P<0.001）；stratified analysis showed that there was no significant correlation between risk perception and objective CVD risk among people aged 40~59，with low weight or obesity，ethnic minorities，education level of primary school or below，single，smokers，drinkers，diabetes or not，taking anti-diabetic or not，hypertension，blood pressure medications，and hypercholesterolemia（P>0.05）. There was a significant difference between the absolute risk perception classification and the overall risk classification（χ2=16.17，P=0.003）. The risk underestimation，accurate perception and overestimation rates were 30.3%，56.5% and 13.2%，respectively. Conclusion CVD risk underestimation is common. Medical staff should focus on the characteristic population whose risk perception is inconsistent with the overall risk，and formulate targeted intervention strategies to improve their risk perception and reduce the risk of CVD.
Objective The differences between fall risk and risk perception of hospitalized elderly patients were analyzed to provide references for improving fall assessment strategies，improving the accuracy of fall perception of hospitalized elderly patients，and accurately preventing falls. Methods A total of 468 hospitalized elderly patients in Zhejiang province were recruited from December 2022 to February 2023. The general information questionnaire，the Fall Risk Perception Scale for Older Adults and Morse Fall Scale were used to investigate the difference between fall risk and risk perception. Results In this group，the fall risk was 45.0（30.0，55.0），showing a high level，and the fall risk perception was 62.5（47.3，75.0），showing a medium level. There was no significant difference in the risk perception scores of hospitalized elderly patients with different risk levels（H=4.048，P>0.05）. There were 169 cases（67.6%） of under-perception in the high-risk group，38 cases（32.8%） of under-perception in the middle risk group，35 cases（30.2%） of over-perception in the middle risk group，and 66 cases（64.7%） of over-perception in the low risk group. The factors affecting fall risk and risk perception are basically similar. Univariate analysis showed that age，smoking，drinking，vision，activity pattern，sleep，medical payment and fall history in the last 3 months were influencing factors of fall risk in hospitalized elderly patients（P<0.05），and age，education level，drinking，sleep and fall history in the last 3 months were influencing factors of fall risk perception in hospitalized elderly patients（P<0.05）. The main difference was that education was related to risk perception，but not to fall risk. Conclusion Elderly hospitalized patients have a higher risk of falling，and there are problems of fall perception bias. It is suggested that in the prevention of falls，it is not only necessary to evaluate the fall risk of elderly hospitalized patients，but also to evaluate the perception of their own risk，so as to achieve individualized and precise protection.
The perioperative nursing care of a child with type Ⅲ gaucher disease with severe kyphosis is summarized. Nursing points include preoperative multidisciplinary collaborative diagnosis and treatment,adequate preoperative preparation,prevention of neurological damage,implementation of individualized rapid plans,postoperative care for paralytic intestinal obstruction,infection prevention,safety management,and psychological health of children and their families. After active treatment and meticulous care by the medical team,the child was discharged 18 days later. After 1 year of following up,he is in good condition and has returned to the normal school and family life.
Cardiovascular disease risk perception is the basis for individuals to adopt health promotion behaviors,and it is crucial to implement the primary prevention strategy of cardiovascular disease and reduce the incidence of cardiovascular disease. This paper reviews the content,characteristics and application of risk perception assessment tools for cardiovascular disease at home and abroad from the perspectives of their universality and specificity. On the basis of further defining the concept of risk perception,it is suggested to develop risk perception assessment tools for cardiovascular disease and conduct localized validation studies,providing a basis for follow-up risk communication and risk intervention by medical staff.
To summarize the experience and effectiveness of non-slow down post-pyloric feeding in 15 severe burn patients with prone position ventilation. We established a multi-disciplinary prone position ventilation and enteral nutrition team,dynamically adjusted the personalized and precise nutrition plans,managed the target feeding rate,and implemented the intra-abdominal pressure oriented and non-slow down feeding strategy,and effectively prevented gastrointestinal intolerance. After careful care of 15 patients,the standard rate of enteral nutrition within 24 to 48 hours was 20%~60%,and the standard rate within a week was 50% to 95%. The gastrointestinal tolerance was good. The intra-abdominal pressure oriented and early post-pyloric non-slow down feeding is safe and effective in severe burn patients with prone ventilation.
Objective An early motor rehabilitation nursing program for stroke patients based on Modified Barthel Index（MBI） grading was constructed to guide clinical nurses to perform precise early motor rehabilitation for stroke patients,in order to provide a basis for developing guidelines for rehabilitation nursing care of stroke patients.Methods Based on literature review and expert meetings,a draft of motor rehabilitation nursing program for stroke patients was constructed. The Delphi method was used to conduct 2 rounds of expert consultations to determine the early rehabilitation nursing program for stroke patients.Results In the first round,17 experts were consulted,and the response rate was 94.12%;in the second round,16 experts were consulted,and the response rate was 100%. The expert authority coefficient was 0.90. After 2 rounds,the coefficient of variation of items was 0 to 0.24,Kendall’s coefficient was 0.226（P<0.001） and the importance value was 4.13 to 5.00. Finally,an early motor rehabilitation nursing program classified by MBI was formed,including 5 first-level indicators（fully dependent,heavily dependent,moderately dependent,mildly dependent and basic self-care） and 47 second-level indicators（rehabilitation）.Conclusion The nursing program constructed in this study is reliable and scientific,and it can provide references for the research and practice of rehabilitation training for stroke patients.
Objective This article summarized the experience in the prevention and control of coronavirus disease 2019（COVID-19） epidemic in non-isolated areas in a general hospital,in order to provide references to implement prevention and control methods of nosocomial infection in non-isolated areas for other general hospitals. Methods Based on refined management theory,we professionally developed the standards for prevention and control of COVID-19 in non-isolated areas,systematically implemented various prevention and control measures,performed gridding audit,effectively communicated among teams and between doctors and patients assisted by information techniques,and reported results by data for quality improvement. Results There was no secondary COVID-19 infections among staff in the hospital. The rate of mask wearing,the screening rate of epidemiological history and the rate of medical supplies disinfection were all 100% in the hospital. The accuracy rate of mask wearing of patients and their families was 73.79% and the compliance of their hand hygiene was 40.78%. Conclusion Refined management strategies for the prevention and control of COVID-19 infection in non-isolated areas of the general hospital are effective. The accuracy rate of mask wearing and hand hygiene compliance of patients and their families need to be further improved.
