Table of Content

15 May 2020, Volume 55 Issue 5

Previous Issue    Next Issue

Research Paper

Study on construction of non-pharmacological sleep intervention program for patients with shallow sedation in ICU

ZHOU Dan, YANG Qingmin, TANG Jianguo, GU Yanhong, WANG Jie, GONG Chen, WANG Guangpeng, QIAO Jiange

2020, 55(5):  645-651.  DOI: 10.3761/j.issn.0254-1769.2020.05.001

Asbtract ( )   HTML ( )   PDF (1024KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To establish a sleep management program appropriate for ICU patients in China,so as to improve the sleep quality of ICU patients. Methods The preliminary sleep management strategies were designed and the related evidence was obtained by retrieval of both domestic and oversea databases. The appraisal of literature was conducted by Jonna Briggs Institute 2010 evidence grade and quality evaluation methods. Then the Delphi method was adopted to make the strategies meet our national conditions. Results 30 sleep management strategies were established under 11 dimensions and 2 parts including “preconditions for the implementation of a non-pharmacological sleep intervention program for patients with shallow sedation in ICU” and“the constitution and implementation of a non-pharmacological sleep intervention program for patients with shallow sedation in ICU”. Conclusion The non-pharmacological sleep intervention program for ICU patients with shallow sedation constructed on the basis of evidence-based and Delphi method is scientific and practical,and it can be applied for sleep management of ICU patients.

Construction of eligibilities and responsibilities for stroke case managers

DENG Juan, LUO Qing, JI Yugui, LI Weihua, XIE Hongzhen

2020, 55(5):  652-658.  DOI: 10.3761/j.issn.0254-1769.2020.05.002

Asbtract ( )   HTML ( )   PDF (942KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To establish eligibilities and responsibilities for stroke case managers,and to provide references for training programs and work standards for stroke case managers in accordance with China’s national conditions. Methods Based on literature research,investigation of status of stroke patients management,expert meeting discussions and pre-consultations,a preliminary draft of eligibilities and responsibilities was constructed. Twenty experts from 8 provinces were consulted by Delphi expert consultation method. Results The effective recovery rates of the two rounds of expert consultations were 95.2% and 100%,respectively. In the second round of consultation,the authoritative coefficient of experts was 0.910,and the coordination coefficients of the first,second and third-level indicators of eligibilities and responsibilities were 0.193,0.155,0.141（P<0.005） and 0.445,0.156 and 0.134（P<0.005）,respectively. The final eligibilities for stroke case managers included three first-level indicators（basic conditions,professional ability,comprehensive ability）,seven second-level indicators and 17 third-level indicators. Responsibilities included four first-level indicators（assessment,planning,implementation,evaluation）,17 second-level indicators and 79 third-level indicators. Conclusion The eligibilities and responsibilities of stroke case managers determined by expert consultations are scientific,practical,feasible and innovative,which can provide theoretical basis for nursing practice of stroke case management.

Study on classification of obstetric nursing post tasks： a cluster analysis

YAN Di, XIA Haiou

2020, 55(5):  659-665.  DOI: 10.3761/j.issn.0254-1769.2020.05.003

Asbtract ( )   HTML ( )   PDF (1432KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To understand the characteristics and classification of the post tasks of obstetric nursing staff and provide a basis for scientific management of obstetric human resources and standardization of obstetric care responsibilities. Methods A total of 503 midwives and obstetric nurses from Shanghai were recruited to complete a self-designed questionnaire,and the results were analyzed by cluster analysis. Results The post tasks of obstetric clinics are clustered into 2 categories： Class Ⅰ-basic tasks are done by nurses who are characterized by medium degrees,junior professional titles and high working ages;Class Ⅱ-advanced tasks are divided into nurses in charge and obstetricians in charge. The parts of nurses responsibilities are done by the nurses who are characterized by medium-high degrees,junior-intermediate professional titles and high working ages. The post tasks of delivery rooms are clustered into 2 categories： Class Ⅰ is in the charge of midwives,including natural delivery and abnormal delivery,and the midwives who execute the part of abnormal delivery have higher professional titles and working ages. Class Ⅱ is mainly in the charge of obstetricians. The post tasks of postpartum wards are clustered into 5 categories： Class I is the routine nursing content;Class II is the identification of postpartum critical signs,and the third category is personalized counseling including postpartum psychological problem screening. The Class IV and V are neonatal related items. The nurses from different categories have no statistical significance in characteristics. Conclusion The specialty content and personnel classification management of obstetric clinics and postpartum wards need to be strengthened. The obstetric nursing human resources should be managed according to the post content. At the same time,the advanced experience of foreign countries should be used to standardize the division of maternity medical care duties to promote natural childbirth and reduce the trend of over-medicalization of midwifery services.

Special Planning——Coronavirus Diease 2019 Nursing

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

2020, 55(5):  666-669.  DOI: 10.3761/j.issn.0254-1769.2020.05.004

Asbtract ( )   HTML ( )   PDF (1090KB) ( )  

References | Related Articles | Metrics

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.

Triage management of one-move,two-precise and three-zero during the coronavirus disease 2019 epidemic

CHEN Yanfang, XIE Rihua, XIONG Ziyu, ZHANG Yinglan, ZHOU Lepeng, LUO Jinglan, WANG Jie, LIU Jingping, GUO Lixing, LI Manman, LI Weijian, LIU Chunhua

2020, 55(5):  670-674.  DOI: 10.3761/j.issn.0254-1769.2020.05.005

Asbtract ( )   HTML ( )   PDF (857KB) ( )  

Figures and Tables | References | Related Articles | Metrics

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.

Management strategies of coronavirus disease 2019 infection in outpatient departments of large general hospitals

JIA Dan, HE Qian, ZHAO Shuzhen, HU Xiaokun, ZENG Zhongyi, YANG Xiaorong, YANG Ling, GUO Yuan, GOU Yue, HU Xiaolan, WU Wei, HE Xiaoli

2020, 55(5):  675-678.  DOI: 10.3761/j.issn.0254-1769.2020.05.006

Asbtract ( )   HTML ( )   PDF (745KB) ( )  

References | Related Articles | Metrics

Objective In order to effectively prevent and control coronavirus disease 2019（COVID-19）epidemic,outpatient departments should reduce staff aggregation,cut off transmission channels,prevent cross-infection,and ensure medical safety while carrying out normal medical work. Methods We optimized the layout of space in the outpatient department by adjusting and controlling the access routes of patients,and reasonably allocated human resources through controlling the number of doctors,the amount of patient reservation and the flow of people. Moreover,we conducted the epidemiologic and related symptoms screenings for patients by information system platform,and established a strict and standardized three-level pre-examination triage system for effective and accurate screening. We also carried out the training of relevant protection knowledge of medical personnel in different posts. Results From January 28 to February 6,2020,82 high-risk patients have been screened out in our outpatient department after the implementation of a series of epidemic prevention and control measures. Among them,1 case was confirmed as positive and 1 was a suspected case. Conclusions During the COVID-19 epidemic,we adopted a multi-department linkage of the entire hospital,and established a standardized three-level pre-examination triage system,which can effectively conduct the early detection,early report,early isolation and early treatment towards suspected cases,so as to ensure the outpatient environment in safety.

Management and practice of standardized training of nurses during coronavirus disease 2019 epidemic based on information platform

FENG Mei, CAO Xiaoyi, GONG Shu, WEI Shenyi, WANG Lei, LI Jin, JIANG Yan, LI Jiping

2020, 55(5):  679-682.  DOI: 10.3761/j.issn.0254-1769.2020.05.007

Asbtract ( )   HTML ( )   PDF (1404KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To strengthen the standardized training of nurses and management of key links to ensure the multiple needs of epidemic rescue,training and personnel safety in the context of the outbreak of coronavirus disease 2019 （COVID-19） epidemic. Methods Based on hospital information platform,the nursing service department has strengthened management system,training system,prevention and control system. We have carried out reasonable and deep division of labor,coordinated grid management;scientific assessment of epidemic situation,dynamic human adjustment;special online training,to ensure the coverage of all staff;timely evaluation and assessment,focusing on practical exercises;real-time trend management,effective isolation management;full attention to humanity,and good psychological adjustment. Results 46 nurses were transferred in hospital wards to help decrease the infection risk during the epidemic. 4 special online trainings were completed,and the average training participation rate was more than 90%;the satisfaction rate of trainings was more than 95%. Due to daily on-line report mechanism,36 nurses reported their contact history with confirmed cases and then were isolated at home,and now all of them have been released from the quarantine. Conclusion The targeted management strategies during the epidemic can effectively guarantee the work safety of the training nurses,improve the cognition and ability,and ensure the standardized training in an orderly,efficient and safe manner.

Expert consensus on reprocessing procedures of reusable medical instruments for suspected or confirmed patients with coronavirus disease 2019

Central Sterile Supply Department, Nursing Professional Committee, Chinese Nursing Association, Writing Committee:CEN Ying, QIAN Liming, ZHANG Qing, YAO Zhuoya, WANG Jin

2020, 55(5):  683-683.  DOI: 10.3761/j.issn.0254-1769.2020.05.008

Asbtract ( )   HTML ( )   PDF (1375KB) ( )  

References | Related Articles | Metrics

Objective To standardize the processing of reusable medical instruments and supplies for suspected/confirmed patients with coronavirus disease 2019（COVID-19）. Methods With references to domestic and overseas relevant literature on COVID-19,relevant laws and regulations in China,technical guidelines on prevention and control,treatment and diagnosis of COVID-19 issued by the Chinese National Health Commission,we made the first draft of Expert Consensus on Reprocessing Procedures of Reusable Medical Instruments for Suspected or Confirmed Patients with COVID-19（hereinafter referred to as the Consensus）,combined with experience of nursing experts and reprocessing procedures made by experts in some provinces. After 4 rounds of online discussions and professional consultations,we had the final version of the Consensus. Results The Consensus includes requirements for basic principles,personnel protection,equipment and facilities,reprocessing procedures,environmental and supplies disposal. Conclusion The Consensus is of a certain scientific and practical nature,and provides guidancefor the scientific standardization of the reprocessing procedures of reusable medical instruments and supplies for suspected/confirmed patients with COVID-19.

Special Planning——Chronic Pulmonary Disease Nursing

Effects of a smoking cessation intervention based on Timing It Right in patients with chronic obstructive pulmonary disease

XIANG Qiu, ZHANG Chunjin, XU Suqin, LI Xiaopan

2020, 55(5):  684-689.  DOI: 10.3761/j.issn.0254-1769.2020.05.009

Asbtract ( )   HTML ( )   PDF (1140KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the effects of a smoking cessation intervention based on Timing It Right in patients with chronic obstructive pulmonary disease（COPD）. Methods Totally 104 COPD patients with tobacco dependence hospitalized in the department of respiratory and critical care medicine in a tertiary hospital were selected by convenient sampling and allocated into an experimental group and a control group with 52 cases in each group by random number table. The control group received respiratory routine nursing care,and brief smoking cessation intervention on the basis of “Clinical Guideline for Smoking Cessation in China（2015 edition）”,and regular follow-up visits;the experimental group received interventions above and a cessation intervention based on Timing It Right. The rate of smoking cessation,nicotine dependence degree,anxiety and depression were compared between 2 groups at 1 month and 6 months after discharge. Results The rate of smoking cessation in the experimental group at 1 month after discharge was 72.34%,which was higher than 40.82% in the control group. The rate of smoking cessation in the experimental group at 6 months after discharge was 85.11%,which was higher than 48.98% in the control group; the differences were statistically significant（P<0.05）. The score of nicotine dependence degree of the experimental group was significantly lower than that of the control group at both time points（P<0.05）. There was no significant difference in anxiety and depression between 2 groups（P>0.05）. Conclusion The smoking cessation intervention based on Timing It Right can effectively improve the rate of smoking cessation and reduce the degree of nicotine dependence in COPD patients with tobacco dependence,but no improvement has been found in anxiety and depression.

Construction of an early simple pulmonary rehabilitation programme for patients with COPD and its evaluation of effectiveness

ZHANG Yijing, LI Juan, SUN Li, YUAN Cheng

2020, 55(5):  690-695.  DOI: 10.3761/j.issn.0254-1769.2020.05.010

Asbtract ( )   HTML ( )   PDF (1049KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To construct an early simple pulmonary rehabilitation programme for patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） and to evaluate its effects. Methods From May 2018 to December 2018,97 patients with AECOPD were selected and randomly allocated into an experimental group（49 cases） and a control group（48 cases） using random number table. In addition to the treatment in the control group,the experimental group received an intervention of early simple pulmonary rehabilitation programme,including breath training,abdomen resistance training,weight training for upper and lower limbs,squat training by the bed,walking training,and climbing stairs training. The control group received routine treatment,health education,and family pulmonary rehabilitation guidance. Dyspnea（modified Medical British Research Council,mMRC） score,6 minutes walk distance（6 MWD）,COPD Assessment Test（CAT） score,lung function index,anxiety（Self-rating Anxiety Scale,SAS） score,and family rehabilitation training compliance were compared between 2 groups before and after the intervention. Results After the intervention for 3 months,mMRC score,6 MWD,CAT score,SAS score in the experimental group were better than those in the control group（P<0.05）. The number of patients with good family rehabilitation training compliance（51.02%） in the experimental group was more than that（16.67%） in the control group（P<0.05）. Conclusion The early simple rehabilitation programme for patients with COPD is safe and effective,which can improve exercise endurance,quality of life,dyspnea and anxiety symptoms,as well as increase family rehabilitation training compliance.

A qualitative study on coping strategies of pulmonary rehabilitation barriers in patients with chronic obstructive pulmonary disease

WANG Xiuxiu, JIANG Yuyu, WANG Shanshan, HUANG Wei, ZHOU Chunxiang, HUA Jiao, JIANG Wei, XU Guangqing

2020, 55(5):  696-702.  DOI: 10.3761/j.issn.0254-1769.2020.05.011

Asbtract ( )   HTML ( )   PDF (1096KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the influencing factors and coping strategies of pulmonary rehabilitation barriers in patients with chronic obstructive pulmonary disease（COPD）. Methods Objective sampling and theoretical sampling were used to select 9 patients with COPD,8 doctors and 7 nurses for semi-structured interviews from June,2016 to June,2017,and the data was analyzed by three-level coding of the grounded theory. Results The influencing factors of pulmonary rehabilitation barriers in patients with COPD included individual factors,family factors and pulmonary rehabilitation environment. The coping strategies of pulmonary rehabilitation barriers in patients with COPD included incentives,safety assurance,cooperation in pulmonary rehabilitation and promotion of pulmonary rehabilitation concept. Conclusion Coping with pulmonary rehabilitation barriers is one of the inevitable challenges to promote chronic disease management. Further identification of influencing factors of pulmonary rehabilitation and the proposal of coping strategies for pulmonary rehabilitation obstacles will provide references for the formulation and implementation of pulmonary rehabilitation plans for patients with COPD.

The effects of frailty on adverse health outcomes in patients with COPD: a systematic review

ZHAO Mei, ZHANG Qiang, NIE Liting, SUN Hong

2020, 55(5):  703-708.  DOI: 10.3761/j.issn.0254-1769.2020.05.0012

Asbtract ( )   HTML ( )   PDF (929KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To systematically evaluate the effects of frailty on adverse health outcomes in patients with chronic obstructive pulmonary disease（COPD）. Methods Several electronic databases（Pubmed,Web of Science,Wiley Online Library,Cochrane Library,EBSCO host,CINAHL,Springer Link,Scopus,CNKI,WanFang data,CBM and VIP） were searched from inception to August 2019,in order to collect relevant English or Chinese studies examining the association between frailty and at least one health outcome of COPD patients. The quality appraisal was conducted using NOS scale or AHRQ scale according to research type. Results A total of 12 studies involving 4 196 patients were adopted,including 7 cohort studies and 5 cross-sectional studies. Descriptive analysis of the systematic review was conducted according to the Integral Conceptual Model of Frailty proposed by Gobbens et al. Results shows that frailty is significantly associated with an increased risk of disability,decreased quality of life,increasedutilization of healthcare resources and increased risk of death. Conclusion Based on the systematic review,frailty is closely associated with a variety of adverse health outcomes in COPD patients. Therefore,domestic scholars should pay more attention to frailty. Early assessment,early identification and early intervention in frailty can help to prevent or delay the progression of frailty,which is of great significance to improve the health outcomes of COPD patients.

Expert consensus on pulmonary rehabilitation nursing of chronic respiratory diseases

GONG Yucui, CHEN Jieya, LI Pingdong, ZHANG Guolong, ZENG Qiuxuan, LI Jiaying

2020, 55(5):  709-709.  DOI: 10.3761/j.issn.0254-1769.2020.05.013

Asbtract ( )   HTML ( )   PDF (1240KB) ( )  

References | Related Articles | Metrics

Objective To standardize an expert consensus on pulmonary rehabilitation nursing of chronic respiratory diseases. Methods On the basis of literature review,5 experts were interviewed and 19 experts were consulted to establish the primary and secondary themes. 10 nursing experts in this field were invited to conduct peer review on the draft consensus to modify and improve the consensus content. Results After expert consultations,14 first-level themes and 40 second-level themes were established. The value of Ca（judgment coefficient）,Cs（familiarity coefficient） and Cr（authority coefficient） were 0.895,0.839 and 0.867,which indicated the expert consultation have high authority and credibility. The Kendall coefficients of first-round expert consultation were 0.121 and 0.151,and they were 0.205 and 0.149 in the second round（P<0.05）. In the first-round expert consultation,the coefficients of variation of the first and second themes were 0.197 and 0.200,and in the second round,they were 0.202 and 0.237. They were all less than 0.25,indicating that the expert’s judgment results were relatively consistent. Conclusion As this consensus was developed based on 19 clinical nursing professionals from across the country,it is scientific and authoritative. This consensus can not only benefit to clinical nursing practice,but also lay the foundation for the development of guideline,and it still needs further theoretical and empirical research verification.

Standards

Nursing practice guideline for multiple myeloma

Internal Medicine Nursing Committee of Chinese Nursing Association, Writing Committee:WEI Lili, WU Xinjuan

2020, 55(5):  721-721.  DOI: 10.3761/j.issn.0254-1769.2020.05.016

Asbtract ( )   HTML ( )   PDF (1140KB) ( )  

References | Related Articles | Metrics

Objective To develop evidence-based clinical practice guideline（CPG） for multiple myeloma patients,and to provide references for improving clinical practice and promote the clinical outcome of patients. Methods Based on the theoretical framework of JBI evidence-based health care model,this guideline was formulated strictly in accordance with the methodology of developing evidence-based CPG. After a draft guideline was developed,it was appraised according to AGREE（Appraisal of Guidelines Research and Evaluation） Instrument. Then the CPG was finalized based on evaluation results and the advice of experts. Results The recommendations of the CPG involved the care for patients with anemia and bleeding,kidney injury,bone injury,infection prevention,chemotherapy toxicity,hematopoietic stem cell transplantation,amyloidosis,hyperviscosity and so on. Conclusion This nursing practice guideline for multiple myeloma was constructed on the basis of best evidence,Chinese clinical practice and professional judgments,which can provide valuable references for nursing decision-making on multiple myeloma patients care.

Work guideline for needle-free insulin injection to diabetics

Diabetes Nursing Committee of Chinese Nursing Association, Writing Commitee:ZHAO Fang, ZHANG Mingxia, WU Quanying

2020, 55(5):  722-722.  DOI: 10.3761/j.issn.0254-1769.2020.05.017

Asbtract ( )   HTML ( )   PDF (1042KB) ( )  

References | Related Articles | Metrics

Objective To establish a nursing guideline for needle-free injection to diabetics. Methods The nursing problems in the needle-free insulin injection process were listed based on systematic literature research and references to experts’ clinical experience. A questionnaire to experts was designed. Based on Delphi Technique and expert meeting results,each item was modified and improved after objective evidence and expert opinions were summarized. Results A consensus was reached on 4 major themes: needle-free injection procedure,common problems and solutions,quality control and management,and health education. Conclusion Work guidelines for needle-free insulin injection to diabetics can provide the clinical nursing staff with some references on implementation of needle-free insulin injections.

Specialist Practice and Research

Formulation and evaluation of pre-operative skin preparation procedure

SHI Lanping, TANG Rong, WEI Yingying, XUAN Fanxin, JIANG Yuting, WU Lijuan

2020, 55(5):  723-726.  DOI: 10.3761/j.issn.0254-1769.2020.05.0018

Asbtract ( )   HTML ( )   PDF (619KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To formulate the pre-operative skin preparation procedure,guide clinical nursing practice and evaluate the effectiveness of application based on the authoritative guidelines. Methods Pre-operative skin preparation guidelines were searched and evaluated by Appraisal of Guideline for Research and Evaluation Ⅱ. The researchers extracted evidence,combined with clinical context and patients preferences to formulate “Pre-operative Skin Preparation Procedure（PSPP）” and applied it to patients. The clinical effect of this procedure was evaluated through the establishing and monitoring of quality indicators. Results 5 guidelines,2 A-level recommandations and 3 B-level recommandations were finally included. 6 pieces of the best evidence were adopted,and PSPP was formulated and implemented. After 6 months of application,the compliance rate of each quality indicator was over 90%. The infection rates of type I surgical wounds were 0.19%,0.43% and 0.25% from 2016 to 2018 respectively,which were all below the National 3A standard（0.50%）. Conclusion The PSPP based on the guidelines applies the best evidence to clinical practice,provides nursing staff with scientific and authoritative practical guidance,and supports nursing staff to reach the evidence-based and standardized operation process,which is scientific and feasible.

Application of zero-pressure modified puncture technique in hemodialysis patients with difficult arteriovenous fistula

HONG Chengbo, JIANG Rui, LING Kourong, JIANG Weizhong, XIONG Weilü

2020, 55(5):  727-730.  DOI: 10.3761/j.issn.0254-1769.2020.05.0019

Asbtract ( )   HTML ( )   PDF (702KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the effects of zero-pressure modified puncture technique in hemodialysis patients with difficult arteriovenous fistula（AVF）. Methods The hemodialysis patients with difficult AVF at a hemodia-lysis center in a tertiary hospital from January 2014 to April 2016 were recruited and randomly allocated into an experimental group（n=64） and a control group（n=62）. The patients in the experimental group were punctured with the zero-pressure modified puncture technique,while the patients in the control group were punctured with routine method. The first-attempt success rate was compared between 2 groups. All patients were followed up for 36 months and relevant complications were recorded. Kaplan-Meier survival curve and log-rank test were conducted. Results The first-attempt success rate in the experimental group was significantly higher than that in the control group（P<0.01）;the incidence of the complications of AVF in the experimental group was significantly lower than that in the control group（P<0.01）;the duration without complication of AVF in the experimental group as（21.42±11.37） months was significantly longer than that in the control group as（14.71±9.18） months（P<0.01）. Conclusion For difficult AVF,zero-pressure modified puncture technique can increase first-attempt success rate,decrease complications of difficult AVF and significantly prolong the duration without complications.

The design and application of nursing handover record checklist of MECT based on standard communication model

WANG Hao, WANG Lina, ZHANG Xinna, LI Doujiang, WANG Xinli, LIU Jie

2020, 55(5):  731-734.  DOI: 10.3761/j.issn.0254-1769.2020.05.020

Asbtract ( )   HTML ( )   PDF (792KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the application effects of nursing handover checklist of MECT（Modified Electroconvulsive Therapy） based on standard communication model（current situation-background-assessment-suggestion,SBAR）. Methods A random sampling was adopted to select 186 patients treated with MECT in a hospital as study subjects,in which 93 patients treated from September to November in 2017 were in a control group（n=93）,and 93 patients from March to May in 2018 were in an experimental group（n=93）. In the experimental group,the self-design nursing handover checklist of MECT based on SBAR was utilized,while the control group used the traditional handover model. The handover time of pre and post-treatment,the incidence of handover problems and staff’s satisfaction level towards the handover record checklist were used to measure the results. Results There is no significant difference in handover time of pre-treatment with MECT handover record under SBAR mode. The treatment time have lengthened 2 seconds;the incidence of handover problems dropped from 22.6% to 8.6%. Conclusion This self-design nursing handover checklist of MECT based on SBAR can smooth the whole treatment process,and reduce problems of handover.

Nursing Management

A qualitative study on nursing experience of family-centered care in a department of neonatology

QIAN Geping, LU Chunmei, WANG Jue, MIAO Jing, HU Xiaojing

2020, 55(5):  735-739.  DOI: 10.3761/j.issn.0254-1769.2020.05.0021

Asbtract ( )   HTML ( )   PDF (802KB) ( )  

References | Related Articles | Metrics

Objective To explore the real experience of the family-center care（FCC） among nurses in a department of neonatology. To investigate difficulties and needs in the process of its implementation,with the purpose of providing references for the FCC. Methods The semi-structured interview was adopted. 61 nurses from a department of neonatology during January to March,2019 in a hospital in Shanghai were interviewed. Colaizzi analysis was used to analyze the data. Results Three themes on experience of implementing FCC among neonatal nurses were concluded as following. Nurses showed multiple emotional experience during FCC implementation. Implementation of FCC is effective and beneficial for new parents. There are still many obstacles existing in implementing FCC at present. Conclusion The implementation of FCC is the trend of neonatal care. Stress and demands of nurses should be emphasized during the process of implementation,and effective communication with newborn’s parents should be maintained. Meanwhile,the guidance and support,as well as the platform of further learning,provided by hospital authorities are significant for nurses to master the skills.

Nurses’ psychological experience of medication errors:a systematic review of qualitative studies

TAN Ran, CAO Yingjuan, XIA Jinghua, ZHANG Jinxin, LÜ Xiaoyan

2020, 55(5):  740-746.  DOI: 10.3761/j.issn.0254-1769.2020.05.022

Asbtract ( )   HTML ( )   PDF (1603KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective The purpose of this study was to systematically review the experience of nurses who made medication errors at work place,to provide theoretical basis to develop a medication errors management system and to construct nurse support programs in adverse events of medical safety. Methods A systematic search strategy identified qualitative studies exploring the experience of nurses who made medication errors. Articles from databases,including CBM,CNKI,VIP,Wanfang data,Joanna Briggs Institute Library,the Cochrane Library,PubMed,EMbase,Web of Science,EBSCO,PsycINFO,CINAHL Complete,and opengrey,were retrieved from inception to June 30th 2019. The quality of included studies was evaluated based on the Critical Appraisal Skills Programme for qualitative studies. The results were integrated by thematic synthesis. Results A total of 11 studies were included. A thematic synthesis identified three core themes:①Emotional experience. Most nurses had negative emotional experience,and they were eager for support and understanding from others,including patients,family members and colleagues. Strong and effective help and support can reduce the negative impact of nurses.②Medical response. Nurses have taken measures to avoid or reduce injuries timely,but their willingness to inform patients or their families and to report errors is low. ③Career impact and concerns. Medication errors had a positive or negative impact on nurses’ career. Conclusion The administrators and authorities of health institutes should pay more attention to the negative impact of nurses who made medication errors and give necessary help and support,assist them to better cope with errors as soon as possible and promote medication safety.

Nursing Education

Investigation on training of specialized nurses developed by nursing associations at all levels in China

DING Yanming, WU Xinjuan, WANG Xiuying, XIAO Yanyan, DENG Jun, TIAN Junye, LI Jing

2020, 55(5):  747-750.  DOI: 10.3761/j.issn.0254-1769.2020.05.023

Asbtract ( )   HTML ( )   PDF (537KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To explore the status of training of specialized nurses developed by nursing associations at all levels in China,in order to provide references for conducting better specialized nurse training. Methods Totally 241 training programs on specialized nurses carried out by 88 nursing associations in China from 31 provinces and cities as well as autonomous regions were enrolled using convenience sampling method and were investigated using a questionnaire. Results The types of specialist nurse training programs mainly included intensive care（35,14.5%）,intravenous therapy （27,11.2%）,emergency nursing （21,8.7%）,operating room nursing（21,8.7%）. Admission conditions for specialist nurse training:154 programs（63.9%） required a college degree;41（17%） required a bachelor’s degree or above;46（19.1%） had no academic qualification requirements;68（28.2%） had no requirement of working years;92（38.2%） had no requirement of working years in specialist positions. 89（36.9%） lasted for 5~8 weeks of training time;69（28.7%） lasted for 9~12 weeks. 145（60.2%） used electronic teaching materials,and 19（7.9%） had no teaching materials. 151（62.7%） did not carry out re-certification. Conclusion Qualification requirements,course design,training materials and re-certification for specialized nurse training from nursing associations at all levels in China should be unified and standardized.

Community Care

Study on the status and influencing factors of cognition and attitude of community residents on advance care planning in Zhengzhou

ZHU Tingting, CHEN Changying, LIU Dongling, ZHANG Jing, GAO Qiaoqiao, WANG Zichen, LI Jiayin, LIU Xuebing

2020, 55(5):  751-755.  DOI: 10.3761/j.issn.0254-1769.2020.05.0024

Asbtract ( )   HTML ( )   PDF (681KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the current status of cognition and attitude of community residents for advance care planning（ACP） in Zhengzhou and its influencing factors. Methods A multi-stage random sampling was used through a questionnaire survey on 342 residents from 4 communities in Zhengzhou. The factors influencing positive attitude of community residents were analyzed by logistic regression. Results The cognition of community residents to ACP in Zhengzhou was scored 0~5 [0（0,1）];the total score of attitude is 15~62 [40（26,49）]. Logistic regression analysis showed that age,the previous experience of caring for family or friends in hospital and the experience of family or friends receiving life support treatment were the influencing factors of positive attitude of community residents to ACP in Zhengzhou（P<0.05）. Conclusion The cognition of community residents to ACP is at a low level,while the overall attitude is positive. Senior residents,residents with experience of caring for relatives and friends in hospitals and experience of family or friends receiving life-sustaining treatment have a more positive attitude towards ACP. Health care workers should work with relevant organizations to promote the popularization and acceptance of ACP,and should also provide targeted education and services for different groups in order to promote ACP.

Vascular Access Nursing

Application of Internet plus multiple linkage on home-based continuous nursing care for PICC in children with malignant tumor

YAO Juan, MO Lin, GUO Xiaoli, DENG Zuoyong, LIU Keli, LI Xue

2020, 55(5):  756-761.  DOI: 10.3761/j.issn.0254-1769.2020.05.025

Asbtract ( )   HTML ( )   PDF (903KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To investigate the effects of Internet plus multiple linkage on home-based continuous care for PICC in children with malignant tumors. Methods Totally 130 children with PICC in a Chongqing hospital from September 2018 to September 2019 were randomly allocated into a control group and an experimental group with 65 cases in each group. The experimental group used Internet + multiple linkage mode to carry out home-based continuous nursing care;the control group used conventional home-based continuous nursing care. After 3 months of interventions,the incidence of complications,compliance of catheter maintenance,satisfaction of PICC special services,and catheter management ability of 2 groups were compared. Results 62 cases in the experimental group and 60 cases in the control group completed the study. The incidences of catheter complications in the experimental group were lower than those in the control group with statistical significance（P<0.001）,and the compliance of catheter maintenance,satisfaction of PICC special services,and self-management ability in the experimental group were better than those in the control group with statistical significance（P<0.05）. Conclusion Internet plus multiple linkage nursing care can improve the compliance of catheter maintenance and self-management efficiency of children with malignant tumors,reduce the incidence of complications of PICC at home,so as to promote the sustainable development of PICC specialty for children.

Academic Debate

The situation analysis of nursing postgraduate education under the new medical background

LIN Min, CHEN Jingli, ZHU Jianan, LI Yuling

2020, 55(5):  769-772.  DOI: 10.3761/j.issn.0254-1769.2020.05.0028

Asbtract ( )   HTML ( )   PDF (607KB) ( )  

References | Related Articles | Metrics

Under the background of new medical science development,the current situation of postgraduate nursing education and training has internal advantages and disadvantages,as well as opportunities and challenges. It is necessary to comprehensively weigh external opportunities and challenges against internal advantages and disadvantages,and put forward corresponding countermeasures. This review explores the current situation of postgraduate nursing education in China,analyzes its strengths and weaknesses under the new medical background and proposes feasible development strategies to promote the training of postgraduate nursing education,so as to provide theoretical basis for cultivation of talents to adapt to the future social development.

Evidence Synthesis Research

Summary of the best evidence for nursing management of thoracic drainage tube after pneumonectomy

LÜ Fangfang, YIN Jingjing, YANG Lijuan

2020, 55(5):  773-778.  DOI: 10.3761/j.issn.0254-1769.2020.05.029

Asbtract ( )   HTML ( )   PDF (943KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To retrieve the best evidence on management of thoracic drainage tube for patients after pneumonectomy and summarize the best available evidence for clinical nurses to provide evidence-based guidance for its management. Methods All evidence on management of thoracic drainage for patients after pneumonectomy was retrieved from databases and websites including UpToDate,Cochrane Library,Medline,PubMed. The retrieved evidence included guidelines,recommended practice,evidence summaries,systematic reviews and related original studies. The retrieval time is from the establishment of database to March 15,2019. Results A total of 13 pieces of evidence were included. Totally 30 pieces of best evidence were summarized from 6 aspects:the number of indwelling thoracic drainage tubes,observation,squeezing and negative pressure suction,treatment of clamping and disconnection,indication and timing of extubation,and management personnel. Conclusion Evidence users should select best evidence based on the clinical situation,patients’ willingness,the facilitating factors and the obstacles to apply the evidence in order to form a more scientific and evidence-based practice plan for management of thoracic drainage tube after pneumonectomy.

Evidence summary of exercise programs on patients with breast cancer-related lymphedema

ZHAO Huihui, ZHOU Chunlan, WU Yanni, LI Wenji, LI Xiaojin, LIU Liping, CHEN Liling

2020, 55(5):  779-785.  DOI: 10.3761/j.issn.0254-1769.2020.05.0030

Asbtract ( )   HTML ( )   PDF (883KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Objective To evaluate and summarize the best evidence of exercise instructions for breast cancer-related lymphedema,and to provide references for clinical practice. Methods We searched BMJ Best Practice,UpToDate,Cochrane Library,Joanna Briggs Institute（JBI） Library,JBI Clinical Online Network of Evidence for Care and Therapeutics（JBI CONNECT+）,National Institute for Health and Clinical Excellence（NICE）,National Guideline Clearinghouse（NGC）,Guideline International Network（GIN）,Scottish Intercollegiate Guidelines Network（SIGN）,National Comprehensive Cancer Network（NCCN）,Registered Nurses’ Association of Ontario（RNAO）,National Lymphedema Network（NLN）,International Society of Lymphology（ISL）,PubMed,CINAHL,Embase,Web of Science,Physiotherapy Evidence Database,China Guideline Clearinghouse,CNKI,Wanfang Database,CBM and VIP Database to collect guidelines,expert consensuses,evidence summaries and systematic reviews on exercise for patients with breast cancer-related lymphedema. The retrieval period was from the inception of databases to July 2019. 2 researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence. Results A total of 19 articles were incorporated,including 1 clinical decision,1 clinical practice recommendation,1 evidence summary,5 guidelines,3 expert consensuses,8 systematic reviews. A total of 23 pieces of best evidence including 8 dimensions were summarized,namely contraindication,pre-exercise assessment,pre-exercise test,exercise intensity,safety,exercise program,announcements and health education related exercise. Conclusion Exercise interventions can alleviate symptoms of lymphedema. Clinical staff should consider patients’ opinions and provide personalized exercise programs for patients with breast cancer-related lymphedema according to the clinical situation,in order to further improve effectiveness of the exercise and quality of life of patients.