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    15 April 2019, Volume 54 Issue 4
    Research Paper
    Construction of clinical audits and analysis of obstacles for evidence-based physical restraint in ICU patients
    Rui CAO,Fen HU,Xiaoping ZHU,Yinghui JIN,Ling WANG,Xiaolin CHENG,Lan DENG,Xinbo DING,Zheng CAO,Jing MA,Meng XIAO
    2019, 54(4):  485-489.  DOI: 10.3761/j.issn.0254-1769.2019.04.001
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    Objective To implement evidence-based nursing practice for standardized physical restraint in adult ICU patients,to construct clinical audits,so as to analyze obstacles and facilitators during implementation. Methods The study was based on Johns Hopkins evidence-based health care model. A team was formed to summarize best practice evidence and to construct audits,and then to perform clinical audits. The team also analyzed the obstacles and facilitators and formulated strategies.Results Totally 23 items were included and 12 clinical audits were constructed. The obstacles mainly included lack of system-level instruments and practice-level insufficient knowledge,attitude,and behavior among nurses. Conclusion The study was based on evidence and combined with judgements from professionals. The clinical audits were scientific,practical,and applicable,which can provide basis for evidence-based practice.

    Construction of early enteral nutrition tolerance assessment and management for criti-cally ill patients
    Xuemei GONG,Xianghong YE,Yangyang XUE,Fangzheng JIANG,Weiqin LI
    2019, 54(4):  490-494.  DOI: 10.3761/j.issn.0254-1769.2019.04.002
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    Objective To establish early enteral nutrition tolerance assessment and graded management for critically ill patients.Methods The first draft of management program was established by review of related original studies at home and abroad and group discussion. Two rounds of expert consultation were conducted via Delphi method to finalize the management program.Results The management program consisted of 2 first-level items,12 second-level items and 30 third-level items. The expert authority scores of two rounds were 0.937 and 0.934.The expert coordination coefficients were 0.119 and 0.112.Conclusion There were high levels of coordination,enthusiasm,and authority in experts. The management program can be used as a basis for comprehensive assessment and graded management for critically ill patients.

    Effects of teach-back method on improving dietary adherence and nutritional status in peritoneal dialysis patients
    Jie CHEN,Xiaoping LOU,Hongxia SHEN,Beibei ZHAO,Jingjing KANG,Wenting DU,Xiao ZHENG,Wenjuan WANG,Wenjiao WANG,Shuchen WANG
    2019, 54(4):  495-500.  DOI: 10.3761/j.issn.0254-1769.2019.04.003
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    Objective To explore the effects of teach-back method on improving dietary adherence and nutritional status in peritoneal dialysis patients. Methods The lottery method was used to randomly determine patients with peritoneal dialysis in the new hospital district as the experimental group and patients in the old district as the control group,and 40 cases were conveniently selected in each group. The experimental group was applied with diet management based on teach-back method as well as routine diet management. The control group was applied with only routine diet management. Results Three months after discharge,there were significant differences in total scores of Renal Adherence Attitudes Questionnaire(RAAQ) and Renal Adherence Behaviour Questionnaire(RABQ)(t=5.856,P<0.001;t=6.168,P<0.001) between two groups,the intakes in three-day diet diary such as protein(t=4.124,P<0.001),dietary calories(t=-2.033,P=0.045),total calories(t=-2.061,P=0.043),sodium(t=-5.918,P<0.001),potassium(t=-2.352,P=0.021) and drinking water(t=-3.448,P=0.001) were significantly improved. The score of Subjective Global Assessment( χ2=6.646,P=0.010),the nutritional indicators such as hemoglobin(t=2.247,P=0.036) and albumin(t=2.547,P=0.017) were significantly improved. Conclusion Applying teach-back method into diet management among peritoneal dialysis patients can improve patients' dietary adherence,form a good diet behavior,and improve nutritional status.

    Effect of abdominal deep breathing exercises on gastrointestinal and psychological symptom clusters in patients with gastroesophageal reflux disease
    Fangchen GU,Meifeng WANG,Zheng LIN,Lin LIN,Qiugui BIAN,Yurong TANG
    2019, 54(4):  501-505.  DOI: 10.3761/j.issn.0254-1769.2019.04.004
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    Objective To investigate the effect of abdominal deep breathing exercises on gastrointestinal and psychological symptom clusters in patients with gastroesophageal reflux disease(GERD). Methods Eighty GERD patients were conveniently selected in a digestive outpatient clinic of a third-level grade-A hospital from July 2017 to February 2018. Patients were randomly divided into the experimental group and the control group with 40 cases in each group. Patients in the experimental group were given conventional drug therapy and routine care plus abdominal deep breathing exercises for 15~20 minutes each time,and twice a day. The control group received conventional drug therapy and routine care. The clinical outcomes including scores of symptom,depression,anxiety,and sleep quality of two groups were evaluated and compared before and 8 weeks after the intervention.Results After intervention,the scores of symptom,anxiety and depression,and Pittsburgh Sleep Quality Index(except hypnotic drug dimension) in two groups were significantly lower. After intervention,the scores of symptoms,anxiety and depression,Pittsburgh Sleep Quality Index(except sleep quality and hypnotic drug dimension) total score and score of each dimension in the experimental group were significantly lower than those in the control group(all P<0.05).Conclusion Abdominal deep breathing exercises can effectively relieve the gastrointestinal and psychological symptoms of patients with GERD.

    Application of theory of goal attainment in pelvic floor rehabilitation for patients with postpartum urinary incontinence
    Guorong FAN,Haixin BO
    2019, 54(4):  506-510.  DOI: 10.3761/j.issn.0254-1769.2019.04.005
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    Objective To explore the effect of theory of goal attainment in pelvic floor rehabilitation for patients with postpartum urinary incontinence(PPUI). Methods A total of 123 patients with PPUI were conveniently selected and randomly divided into the experimental group(n=62) and the control group(n=61). The experimental group received pelvic floor rehabilitation nursing based on theory of goal attainment as well as routine pelvic floor rehabilitation nursing care,while the control group only received routine pelvic floor rehabilitation nursing care. Before and after 6 weeks' intervention,the achievement of home-based rehabilitation training targets,pelvic floor rehabilitation efficacy,satisfaction degree and quality of life were evaluated by the compliance rate,1 hour pad test,Patient Global Impression of Improvement(PGI-I) and Incontinence Impact Questionnaire-7(IIQ-7).Results After pelvic floor rehabilitation,the compliance rate of home-based rehabilitation training,the effective rate of pelvic floor rehabilitation treatment,the satisfaction rate of patients in the experimental group were all higher than in the control group,the effect of urinary incontinence on the quality of life in the experimental group was lower than in the control group(all P<0.05).Conclusion Pelvic floor rehabilitation based on theory of goal attainment can improve the initiative of pelvic floor rehabilitation training,pelvic floor rehabilitation efficacy,satisfaction and quality of life of patients with postpartum urinary incontinence,and can promote the realization of the common goal of nurses and patients.

    Specialist Practice and Research
    The effects of comprehensive nursing intervention on gestational diabetes mellitus in high-risk pregnant women
    Baohua GOU,Huimin GUAN,Liyan GAO,Bingjie DING,Yanxia BI
    2019, 54(4):  511-515.  DOI: 10.3761/j.issn.0254-1769.2019.04.006
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    Objective To explore the preventive effects of comprehensive nursing intervention on gestational diabetes mellitus in high-risk pregnant women.Methods It was a randomized controlled trial. High-risk pregnant women were randomly divided into the experimental group and the control group. In addition to nursing care in the control group,the experimental group received comprehensive nursing intervention,including:the establishment of WeChat public account for health education and answering questions,monitoring and guidance of weight,regular follow-up,guidance from a nutritionist. The control group received routine obstetric care. All subjects received pregnancy care manual,participated the course of “nutrition and weight management during pregnancy” at least once,and received a questionnaire about lifestyle and diet. The subjects were followed up until delivery. The blood glucose of 75 g oral glucose tolerance test(75 g OGTT),BMI before pregnancy,weight at delivery,occurrence of gestational diabetes mellitus,and pregnancy outcomes were recorded.Results The incidence of gestational diabetes in the experimental group was 19.9%,it was 33.6% for the control group,and the difference was significant(P<0.05). The weight gain of the experimental group was lower than the control group,and the difference was statistically significant(P<0.05);the incidence of macrosomia in the experimental group was significantly lower than that in the control group(P<0.05). There was no significant difference in the rate of cesarean section and premature delivery between two groups(P>0.05).Conclusion Comprehensive nursing intervention in early pregnancy can effectively reduce the incidence of GDM in high risk population,reduce weight gain during pregnancy,and reduce the incidence of macrosomia.

    Salt taste sensitivity and its influencing factors in patients with chronic kidney disease
    Hongmei ZHANG,Xingxing YE,Liyang CHANG,Fenxia LUO,Ruyan FAN
    2019, 54(4):  516-519.  DOI: 10.3761/j.issn.0254-1769.2019.04.007
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    Objective To investigate the salt taste sensitivity and its influencing factors in patients with chronic kidney disease(CKD),for promoting the implementation of salt restriction dietary treatment.Methods Totally 625 CKD patients were recruited during December,2014 and March,2017 at three renal medical wards in a tertiary hospital in Hangzhou. The salt threshold measurement was used to assess salt taste sensitivity. Patient information on social demographic characteristics,disease status and previous salt restriction behaviors were collected to explore influencing factors.Results The average salt threshold was(0.34±0.22)%,and the number of patients with low(<0.2%),medium(0.2%~0.4%),and high salt threshold(>0.4%) were 67(10.7%),433(69.3%) and 125(20.0%),respectively. Multivariate logistic regression revealed that groups with a higher salt threshold were as follows:gender(male),older age,previous absence of salt restriction behaviors,decreased eGFR. Conclusion The salt threshold in CKD patients was higher than normal individuals. The salt threshold of patients should be taken into account in clinical guidance of salt restriction. Individualized salt restriction should be adopted for patients with different age,gender,and renal function,especially for patients with high salt threshold.

    Nursing care of patients with infected pancreatic necrosis without necrotic cavity lavage after debridement and drainage
    Xinran WANG,Zhiying ZHANG,Xiaoxue ZHANG,Yu ZHANG,Lixia ZHONG
    2019, 54(4):  520-522.  DOI: 10.3761/j.issn.0254-1769.2019.04.008
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    This paper summarized nursing experience of 115 patients with infected pancreatic necrosis underwent large-caliber wide channel drainage without necrotic cavity lavage after debridement and drainage. Nursing key point was:① Sustained low negative pressure was applied during bed rest to ensure drainage effect. ② Positive changes of body position were performed to improve drainage effect. ③ Single flushing was conducted using small-dose saline.④ Tube fixed technique should be mastered for large-caliber wide channel drainage.⑤ The occurrence of irritant dermatitis around the wound should be prevented.

    The effect of preoperative fasting optimization in patients with orthopaedic trauma undergoing elective surgery
    Yuan ZHAO,Guiling PENG
    2019, 54(4):  523-526.  DOI: 10.3761/j.issn.0254-1769.2019.04.009
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    Objective To investigate the effect of preoperative fasting on rapid recovery among patients with orthopaedic trauma undergoing elective surgery.Methods A prospective control study was conducted among 144 patients undergoing elective surgery in the department of traumatic orthopaedics in our hospital from January to June 2018,and 75 patients were assigned into in the intervention group and 69 patients in the control group according to the random number table method. In the intervention group,the preoperative fasting procedure was optimized,and maltodextrin and fructose beverages were given according to the preoperative time. The control group used the traditional fasting program at 24:00 a.m. the day before the surgery. The subjective feelings(anxiety,thirst,hunger,nausea,fatigue,dizziness,sweating,and stomach discomfort),blood sugar and adverse reactions were compared between two groups.Results The average preoperative length of food fasting in the intervention group was(7.6±0.9) h,and in the control group it was (14.4±5.0) h. There was significant difference between two groups(P<0.01). The average length of water fasting before surgery in the intervention group was (4.5±2.9) h,and that in the control group was(14.3±3.9) h. There was significant difference between two groups(P<0.01). In terms of subjective feelings,the perioperative anxiety,thirst and stomach discomfort in the intervention group were better than those in the control group(P<0.05). The blood sugar in the intervention group was significantly higher than that in the control group at 1 hour before surgery(P<0.001). There were no serious adverse reactions in both groups.Conclusion Preoperative fasting process optimization shortens the length of fasting,improves subjective feelings of patients,and is safe and feasible.

    Application of multiple-modality exercise combined with music imaging in nasopharyngeal carcinoma patients with radiotherapy and chemotherapy
    Qiansha WANG,Qingfeng WEI,Qingling ZHONG,Dong AN,Dan YU,Yaxin ZHAO,Yan XIONG,Juping LI
    2019, 54(4):  527-531.  DOI: 10.3761/j.issn.0254-1769.2019.04.010
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    Objective To investigate the effects of multiple-modality exercise combined with music imaging on cancer-induced fatigue and negative emotion in nasopharyngeal carcinoma patients with radiotherapy and chemo-therapy.Methods One hundred patients with nasopharyngeal carcinoma who were hospitalized for radiotherapy and chemotherapy in a tertiary hospital in Jiangxi Province were conveniently enrolled and randomly divided into the experimental group and the control group using random number table,with 50 cases in each group. The experimental group received routine nursing and multiple-modality exercise combined with music imaging. The control group received routine nursing of radiotherapy and chemotherapy. The scores of cancer-related fatigue,irritability,depression and anxiety were compared before and after intervention.Results The total scores of cancer-induced fatigue and the total scores of irritability,depression and anxiety in the experimental group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Multiple-modality exercise combined with music imaging can effectively alleviate the fatigue during the radiotherapy and chemotherapy of patients with nasopharyngeal carcinoma,and reduce their negative emotions.

    Nursing Management
    Construction of a core competency evaluation index system of organ transplant specialist nurses
    Ye XIAO,Xiaoxia WANG,Shanling PENG,Biaojun YU,Ying HAN
    2019, 54(4):  532-536.  DOI: 10.3761/j.issn.0254-1769.2019.04.011
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    Objective To construct the evaluation index system of core competence for organ transplant specialist nurses.Methods The first draft of evaluation index system was drawn up by referring to domestic and foreign literature,expert interviews and research group discussion. Totally 25 experts in China were consulted twice by Delphi method,and the weight of indexes at all levels was determined by analytic hierarchy process(AHP).Results The positive coefficients and authority coefficients for 2 rounds of consultation were 100% and 0.836. The coordination coefficient of expert opinions in the first,second and third level indexes were 0.404,0.449,and 0.308(P<0.001). The final evaluation index system of core competence of organ transplant specialist nurses included 7 first-level indexes(Theoretical Knowledge,Professional Skills,Critical Thinking Ability,Interpersonal Skills,Management Ability,Psychological Traits,and Specialty Development Ability),22 second-level indexes and 58 third-level indexes.Conclusion The evaluation index of core competence of organ transplant specialist nurses is logical and reliable,which can be used as reference for training organ transplant nurses.

    Construction of care service quality evaluation indicators for long-term care facilities and testing of reliability and validity
    Jing GAO,Yuhua XIAO,Guiling GENG,Qiong ZHANG,Haitao WANG,Wenxue DU
    2019, 54(4):  538-542.  DOI: 10.3761/j.issn.0254-1769.2019.04.012
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    Objective To construct the evaluation indicators of care service quality for long-term care facilities and test reliability and validity. Methods The primary evaluation indicators of care service quality for long-term care facilities guided by the SERVQUAL model were constructed through literature review and expert consultation. A questionnaire survey in 277 elderly people in seven nursing homes in Nantong was conducted. Consistency and construct validity of the evaluation indicators were tested. Results The evaluation indicators for care service quality for long-term care facilities included four dimensions(tangibility,reliability,responsiveness,and empathy),and 24 items. The Cronbach's α coefficient of the overall evaluation indicators was 0.945,and the split half reliability was 0.904. I-CVI was 1.00,and S-CVI was 1.00. Four factors were extracted in the factor analysis and the accumulated variance contribution rate was 61.763%. Correlation coefficients among each dimension scores ranged from 0.509 to 0.757,and correlation coefficients between each dimension score and the total score of the scale ranged from 0.760 to 0.942. Conclusion The evaluation indicators of care service quality for long-term care facilities has good reliability and validity,and can be used as an evaluation tool forcare service in long-term care institutions.

    Community Care
    Application of family dignity intervention in primary caregivers of elderly patients with mild cognitive impairment
    Dan CHEN,Xiaodong NING,Hui PAN,Chun YANG,Engui WAN
    2019, 54(4):  543-548.  DOI: 10.3761/j.issn.0254-1769.2019.04.013
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    Objective To explore the effects of family dignity intervention on care burden and negative emotions in primary caregivers of elderly patients with mild cognitive impairment(MCI). Methods We conveniently enrolled 80 pairs of MCI patients and their primary caregivers,and divided them into the experimental group(n=40 pairs)and the control group(n=40 pairs) based on the day of discharge. The control group was given conventional psychological care while family dignity intervention was added to the experimental group. Zarit Burden Scale,Hospital Anxiety and Depression Scale,and Herth Hope Index were used to evaluate the effects before and after the intervention. Results After the intervention,the care burden score and anxiety depression score of the main caregivers in the experimental group were significantly lower than those in the control group,and the hope index score was significantly higher than the control group,and the differences were statistically significant(P<0.05). Conclusion Family dignity intervention can significantly relieve the burden of primary caregivers of elderly patients with MCI,effectively alleviate their negative emotions and improve level of hope.
    Hospital Infection Control
    Investigation on management of drainage devices in secondary and tertiary hospitals in Henan Province
    Shan GAO,Fuqin LI,Menghua ZHANG,Hao LOU,Song ZHAO
    2019, 54(4):  549-553.  DOI: 10.3761/j.issn.0254-1769.2019.04.014
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    Objective To investigate the current situation of management on drainage devices in secondary and tertiary hospitals in Henan Province,so as to provide basis for regulated management in medical institutions. Methods A questionnaire survey was conducted in secondary and tertiary hospitals in Henan Province using stratified random sampling. Management of drainage devices and their liquid in operating rooms and surgical ICUs in two categories of hospitals were investigated and compared. Results The usage rate of disposable drainage bottles/bags was 93.88% and 100% in operating rooms and surgical ICUs,respectively. The reusable drainage bottles were used in 23(46.94%) operating rooms and 27(56.25%) surgical ICUs. In orthopedic or urologic surgery which produced a lot of waste liquid,the usage rate of the reusable drainage bottles in secondary hospitals was significantly higher than that in tertiary hospitals(37.50% v.s. 4.00%)(P<0.05). The used disposable drainage bottles/bags were directly discarded into medical waste bags in 36(71.43%) hospitals. The reusable drainage bottles were disposed by nurses in 28(57.14%) hospitals and the average length of disposing was(35.38±13.47) min. There were 29(59.18%) hospitals poured the postoperative drainage fluid into sewer line. Conclusion The major drainage devices were disposable drainage bottle/bag and reusable drainage bottle. There was no uniform standard for the disposal of drainage devices and their liquid. It is necessary not only to strengthen standardized management,but also to explore and improve the drainage system suitable to clinical practice in the future.
    Current status of ophthalmic microsurgical instruments cleaning and sterile packaging in 170 hospitals in China
    Lei QIN,Xiao CHANG,Youping LIANG,Wenzhe ZHOU,Peihua ZHANG,Xiaoqiong HUANG,Yanyan CHEN
    2019, 54(4):  554-557.  DOI: 10.3761/j.issn.0254-1769.2019.04.015
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    Objective To understand the cument situation in cleaning and packaging of ophthalmic microsurgical instruments in hospitals in China,and provide basis for putting forward specific solutions and implementing the guidelines for cleaning ophthalmic instruments. Methods Questionnaire survey was used to analyze the problems in cleaning of ophthalmic microsurgical instruments and sterile packaging materials in 170 hospitals in China. Results In 170 hospitals,55(32.4%) had equipped with special cleaning machines for ophthalmic microsurgical instruments. Ophthalmic microsurgical instruments were included in the management of central sterile supply departments in 104(61.2%) hospitals,61(35.9%) manually cleaned ophthalmic microsurgical instruments,111(65.3%) used enzymatic detergents to clean ophthalmic microsurgical instruments. Of the 113 hospitals using silicone oil,34(30.1%) used alkaline detergents and 12(10.6%) used non-medical detergents such as turpentine and cleanser essence. Non-woven(76.5%),paper-plastic(52.9%) and cotton(42.9%) were three most used sterile packaging materials. Conclusion The allocation rate of special cleaning machine for ophthalmic microsurgical instruments in domestic hospitals is low. Methods of cleaning and selection of cleaning agents needs to be standardized. Selection of packing materials for some hospitals are simple.

    Vascular Access Nursing
    Tip malposition and spontaneous correction of peripherally inserted central catheters among neonates
    Xiaochun CHEN,Qiong CHEN,Yanfen TONG,Yumei LI
    2019, 54(4):  558-561.  DOI: 10.3761/j.issn.0254-1769.2019.04.016
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    Objective To explore the occurrence of tip malposition of peripherally inserted central catheters(PICCs) and the possibility of spontaneous correction among neonates. Methods Incidence of PICC tip malposition in neonates with upper and lower limb catheterization from June 2015 to May 2018 was retrospectively reviewed and compared. The rate of spontaneous correction of tip malposition via different veins was calculated and reasons were analyzed. Results A total of 425 cases of neonatal PICC catheterization,and 72 cases had tip malposition,of which 22 cases were spontaneously corrected to the optimal position of superior and inferior vena cava within 48 h. The rate of malposition via upper limb was significantly higher than that via lower limb(P<0.01),however,the spontaneous correction rate via upper limb was also significantly higher than lower limb(P<0.01),especially the rate via internal jugular vein was as high as 71.4%. Conclusion Part of tip malposition of PICCs can be spontaneous corrected. PICCs with tip malposition identified by initial X-ray were not recommended for withdrawal or removal,which can be used as a peripheral vein. Imaging?guided catheter tracking within 24h after catheterization can be performed to determine spontaneous correction. PICCs without spontaneous correction can be re-catheterized,or used as peripheral venous catheter.

    wenti
    2019, 54(4):  562-567.  DOI: 10.3761/j.issn.0254-1769.2019.04.017
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    Basic Nursing
    The application and effect of ultrasonography guided intubation of Freka Trelumina nasojejunal tubes in critical patients
    Huan LIU,Chunyan WANG,Qianrong DING,Jing YANG,Yongming TIAN
    2019, 54(4):  568-571.  DOI: 10.3761/j.issn.0254-1769.2019.04.018
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    Objective To explore the feasibility and clinical efficacy of ultrasonography guided placement of Freka Trelumina nasojejunal tubes. Methods From December 2017 to September 2018,52 hospitalized patients who needed Freka Trelumina nasojejunaltube were enrolled into our study from a comprehensive ICU in a tertiary hospital. The method and process of ultrasonography guided intubation were recorded,and indicators such as successful rate,length of operation,adverse reactions,compliance and clinical effects were recorded for analysis. Results Totally 50 out of 52(96.15%) patients were successfully intubated and length of operation was(26.58±8.01) min. The awaken patients had good compliance,92.3% of the patients had no cough or slight cough during intubation,and nobody experienced pharyngeal injury,aspiration,gastrointestinal perforation or any other complications. All successfully intubated patients had satisfied catheter position,gastrointestinal decompression and enteral nutrition supporting,and no tube prolapse occurred. Conclusion Ultrasonography guided intubation of Freka Trelumina nasojejunaltube isa feasible and effective new method,and can be recommended for tube establishment of early enteral nutritionsupport in critical patients.

    Evidence Synthesis Research
    Quality appraisal and content analysis of guidelines on the assessment and management of eating problems among dementia patients
    Liyu LI,Yi WANG,Zhiwen WANG
    2019, 54(4):  581-588.  DOI: 10.3761/j.issn.0254-1769.2019.04.022
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    Objective To evaluate the quality and synthesize the recommendations of guidelines on the assessment and management of eating problems among dementia patients. Methods Guidelines involving recommendations of assessment and management of eating problems among dementia patients were searched in guideline networks,websites of Alzheimer's Disease associations and databases from inception to December 19,2018. AGREE-II and related quality assessment tools were used to evaluate the quality of the guidelines. The recommendations related to the assessment and management of eating problems of dementia were synthesized. Results A total of 450 articles were initially detected,and finally 6 guidelines as well as 1 expert consensus,4 best practices,and 2 recommended practices were included. The average scores of the AGREE Ⅱ were 87.50% for the scope and purpose,61.58% for the stakeholder involvement,45.14% for the rigor of development,78.70% for the clarity of presentation,35.07% for the application,and 33.33% for the editorial independence,which were rated as Grade B. The included expert consensus,best practices,and recommended practices were from China,the United States,and Australia,respectively. Recommendations related to eating problem assessment and management involved in nutrition and eating problem assessment,adjusting the eating environment,maintaining eating autonomy,adjusting food types and delivery methods,caregiver support,dysphagia coping measures,nutritional supplements,and enteral nutrition. Conclusion The guidelines are of moderate quality,and the applicability,independence and rigor of the guidelines need to be improved. The recommendations are scattered in different guidelines and lack targeted responses to specific eating problems,and some recommendations are still controversial.

    Evidence summary for prevention of perioperative hypothermia in patients
    Wenjing YU,Yao XIAO,Juanjuan HU,Xinglian GAO
    2019, 54(4):  589-594.  DOI: 10.3761/j.issn.0254-1769.2019.04.023
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    Objective To collect and summarize evidence for prevention of unplanned perioperative hypothermia. Methods We systematically search for evidence on prevention of unplanned perioperative hypothermia in PubMed,Up To Date,Cochrane Library,JBI,AHRQ,AORN,CINAHL,RNAO,NICE,CGC,CNKI,Wanfang,CBM and other data-bases,including guidelines,systematic reviews,best practices information sheet,evidence summary,expert consensus,etc. The retrieval period was from the inception of databases to August 29,2018. Two authors independently evaluated literature quality and extracted evidence. Results A total of 13 articles were included,including 2 guidelines,3 expert consensus,6 systematic reviews,1 best practice information sheet,and 1 evidence summary. The best evidence included preoperative assessment,temperature monitoring,preoperative interventions,intraoperative interventions,postoperative interventions and quality management. Conclusion Operating room nurses should regularly receive training on unplanned perioperative hypothermia,use scientific tools to assess the risks. Evidence users should select best evidence with consideration of hospital characteristics and clinical settings in order to reduce unplanned perioperative hypothermia.

    Overseas Knowledge
    Translation and reliability and validity of the Chinese version of the Cardiac Rehabilitation Inventory
    Junhong WANG,Zhenxiang ZHANG,Qiaofang YANG,Yongxia MEI,Peng WANG
    2019, 54(4):  632-636.  DOI: 10.3761/j.issn.0254-1769.2019.04.033
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    Objective To translate and test the reliability and validity of the Chinese version of the Cardiac Rehabilitation Inventory(CRI). Methods The CRI was translated and adapted according to Chinese culture following the translation and back-retranslation procedure. The reliability and validity of the Chinese version of CRI was tested among 220 cardiovascular disease patients conveniently sampled in a tertiary hospital in Zhengzhou. Results The Scale-Content Validity Index (S-CVI) was 0.96,and the Item-Content Validity Index (I-CVI) ranged from 0.83 to 1.00. Exploratory factor analysis extracted three factors,which could explain 56.415% of the total variance. The Cronbach's α for the total scale was 0.816,and the Cronbach's α for three dimensions ranged from 0.765 to 0.862. The test-retest reliability coefficient was 0.838,and the split-half reliability was 0.805. Conclusion The Chinese version of CRI has acceptable reliability and validity. It can effectively assess the individualized cardiac rehabilitation needs of patients with cardiovascular diseases.