Table of Content

15 November 2020, Volume 55 Issue 11

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Research Paper

Construction and application of airway nursing in cardiac enhanced recovery after surgery

WANG Zheyun,YANG Yan,WANG Yan,ZHAO Zhigang,YE Jiaxin,FU Qiaomei

2020, 55(11):  1605-1611.  DOI: 10.3761/j.issn.0254-1769.2020.11.001

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Objective Based on the cardiac enhanced recovery after surgery,airway nursing was developed,and the results of application were observed. Methods Patients undergoing cardiac surgery of a tertiary hospital in Nangjing from July 2018 to June 2019 were included. Among them,685 patients from January to June 2019 who were received airway nursing in cardiac enhanced recovery after surgery were allocated as the study group. Another 704 patients in the control group from July to December 2018 received routine care. We compared the results of duration of mechanical ventilation,length of ICU stay,cost of hospitalization,incidence of complications（postoperative atelectasis,ventilator-associated pneumonia,aspiration,delirium,ICU re-transfer）,number of postoperative blood gas analysis and sputum aspiration between the 2 groups. Results The duration of mechanical ventilation,the length of ICU stay,hospitalization expenses,postoperative blood gas analysis and sputum suction were significantly lower in the study group（P<0.05）. The incidence of complications was reduced except aspiration（P<0.05）. Conclusion Airway nursing in cardiac enhanced recovery after surgery can improve the quality of nursing care,and accelerate the rehabilitation of patients.

Construction and application of a multi-center stroke nursing quality control system

CAI Weixin,YIN Zhike,ZHANG Ran,MIAO Yajie,LU Pengwei,LI Jinglian

2020, 55(11):  1612-1619.  DOI: 10.3761/j.issn.0254-1769.2020.11.002

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Objective To establish systematic,scientific,and clinically applicable sensitive indicators of stroke nursing quality and to build an information-based big data platform for nursing quality. Methods Based on sensitive indicator development process of the US National Nursing Quality Indicators Database,evidence-based analysis and expert meeting were adopted to establish the nursing quality sensitive indicators. We researched Pubmed,Embase,CINAHL,CNKI,Wanfang data and nursing sensitive indicators websites to construct stroke-related nursing quality sensitive indicators. According to the constructed sensitive indicators,a case report form of stroke nursing quality was developed,and the stroke nursing quality control system was built based on the China Stroke Center Alliance（CSCA） Database Platform. 9 hospitals in China used this system to input the data of the sensitivity index of stroke nursing. Results Through literature search,83 stroke nursing quality sensitive indicators were included. 11 nursing sensitive indicators were finally included by expert meetings,including NIHSS score rate,swallowing function evaluation rate,prevention rate of deep venous thrombosis,prevention rate of aspiration pneumonia,nutrition risk screening rate within 48 hours after admission,the placement rate of good limb position,early activity rate,implementation rate of health education,incidence of stress injury,incidence of urinary tract infection,incidence of post-stroke depression. When constructing the case report form of stroke nursing quality,17 hospitals participated and filled in the form,and a total of 298 cases were completed. 9 hospitals filled in 1 827 pieces of data of nursing sensitive indicators in the stroke nursing quality control system. Among the 11 indicators,the top 2 implementation indicators were health education rate（97.3%） and good limb position rate（96.5%）. Conclusion The stroke nursing quality sensitive indicators and information-based big data platform for nursing quality constructed in this study can better guide nursing intervention and quality control,so as to achieve continuous quality improvement of stroke nursing.

Construction and application of data collection model of nursing monitoring in pediatric intensive care unit

FU Weijia,GU Ying,ZHANG Xiaobo,HU Jing,SHEN Weijie,HUANG Qin

2020, 55(11):  1620-1623.  DOI: 10.3761/j.issn.0254-1769.2020.11.003

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Objective To construct the nursing monitoring data collection model of pediatric intensive care units and carry out clinical application,so as to improve the recording quality of medical and nursing data of critically ill children in ICU and the working efficiency of medical staff. Methods On the basis of the clinical information system（CIS）,a modern,informationalized and integrated mobile nursing system was established for the process construction of rescue mode,resuscitation mode,blood transfusion mode and special mode. Data collection patterns and nurses’ satisfaction were investigated from January 1,2019 to January 1,2020 in the ICU in different clinical scenarios. Results The rescue mode was started for 328 times;blood transfusion mode was started for 8 014 times;recovery mode was started for 1 622 times. A total of 4 323 cases were recorded by electronic medical records,including 1 793 cases of PICU,1 600 cases of NICU and 930 cases of CICU. The overall satisfaction score of nurses to the nursing monitoring data acquisition mode system was 92.47±1.62 scores. Conclusion The construction of different data collection modes of the PICU effectively integrates the document writing workflow for handling first aid,resuscitation and blood transfusion. The manual and informatic double-checking process ensures the scientific and effective bedside data collection in the ICU. The work procedures of nurses were simplified;the quality of nursing documents was improved;the nurse’s satisfaction with the working environment was improved.

Specialist Practice and Research

Evidence-based nursing practice of peristomal irritant dermatitis in patients with urostomies

LI Jiamin,PANG Dong,LU Qian,DING Yanming,HUANG Yanbo,CHE Xinyan,ZHANG Jianfeng

2020, 55(11):  1624-1629.  DOI: 10.3761/j.issn.0254-1769.2020.11.004

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Objective To apply the best evidence for the management of peristomal irritant dermatitis in patients with urostomies into practice,so as to improve the quality of ostomy nursing care. Methods Guided by the Knowledge to Action Framework（KTA）,the appropriate evidence for the management of peristomal irritant dermatitis in patients with urostomies was selected and adjusted based on opinions of stakeholders. An evidence-based nursing plan was developed and applied into the clinical practice by education and training, quality monitoring, enriching resources,et al. Implementation rates of review indicators, the knowledge of nurses and patients,and incidence of peristomal irritant dermatitis were compared before and after the application of the plan. Results After application of the evidence-based practice plan, the implementation rates of the 6 review indicators were improved from 0~96.00% to 77.03%~100%. The knowledge scores of nurses increased from 57.86±11.49 to 69.17±11.21,and the accuracy of knowledge of patients increased from 0~96.00% to 72.00%~100%（all P<0.05）. The incidence of peristomal irritant dermatitis reduced from 32.00% to 12.00%（P>0.05）. Conclusion The application of the best evidence for the management of peristomal irritant dermatitis can standardize behaviors of nurses,increase the knowledge of nurses and patients,and reduce the incidence of peristomal irritant dermatitis.

Development of a symptom experience assessment scale for liver transplantation recipients and the test of its reliability and validity

CHEN Xiao,ZHANG Yuxia,YU Jingxian

2020, 55(11):  1630-1634.  DOI: 10.3761/j.issn.0254-1769.2020.011.005

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Objective To develop a symptom experience measurement scale for liver transplantation recipients and to test its reliability and validity,so as to lay the foundation for effective symptom assessment and management. Methods Guided by the framework of Symptom Experience Model,a systematic scoping review on symptom experience of liver transplantation recipients was conducted and interviews of liver transplantation recipients on their symptoms were carried out. A preliminary comprehensive pool of items was then formed, evaluated and supplemented through expert reviews. Finally,project analysis and exploratory factor analysis were employed to identify the best potential structure of the scale. Results The symptom experience measurement scale of liver transplantation recipients contains 20 items which can be subfactored into 6 dimensions,namely reduced ability of activity,mental dimension, neurological dimension,digestion,sleep,bile duct obstruction. The 6 dimensions can explain 61.619% of total variance. The cronbach’s alpha coefficient was 0.791;split-half reliability coefficient was 0.746;content validity index was 0.917. Conclusion The scale has good reliability and validity,and can be used to evaluate symptom experience of liver transplantation recipients.

A longitudinal study on the correlations between symptom clusters and quality of life in patients with lung cancer during perioperation

LI Jingjing,LÜ Xiaoqing,LIU Shanshan,WANG Bingqing,TONG Huanhuan,XIA Lili,SONG Yongxia,HONG Jingfang

2020, 55(11):  1635-1641.  DOI: 10.3761/j.issn.0254-1769.2020.11.006

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Objective To investigate symptom clusters and quality of life（QOL） in patients with lung cancer during perioperation at different time points,and to analyze the correlation between 2 variables,so as to provide a basis for guiding clinical dynamic management of symptom clusters and improving patients’ QOL. Methods From January to September 2019,a longitudinal study was conducted among 217 lung cancer patients during perioperation from a thoracic department at a tertiary first-class hospital in Hefei City,Anhui Province. Patients were investigated by a demographic questionnaire,Chinese Version of M.D. Anderson Symptom Inventory-Lung cancer（MDASI-L） and Chinese version of Functional Assessment of Cancer Therapy-Lung scale（FACT-L） on the first day of admission,2~4 days post-operation,and 1 month post-operation. Symptom clusters were extracted by the knowledge-based complex systems’ entropy partition method,and the correlations between symptom clusters and QOL were analyzed by Spearman correlation analysis. Results At the first day of admission,4 symptom clusters（respiratory,pain-fatigue-sleep disturbance,psychosomatic,and neurological） were found in all the respondents;at 2~4 days post-operation and 1 month post-operation patients had increased gastrointestinal symptom cluster,and there were totally 5 symptom clusters. The symptoms included in the corresponding symptom clusters differed significantly over the treatment time. At different time points,the differences in QOL scores and all dimension scores（except social/family well-being） of lung cancer patients were statistically significant（P<0.001）. At the first day of admission,severity scores of the respiratory symptom cluster was negatively correlated with QOL scores and all dimension scores of patients（P<0.01）. At 2~4 days post-operation,severity scores of respiratory and pain-fatigue-sleep disturbance symptom clusters in patients were negatively correlated with QOL scores（P<0.05）. At 1 month post-operation,severity scores of 5 symptom clusters of patients were negatively correlated with QOL scores（P<0.01）. Conclusion Lung cancer patients have multiple stable symptom clusters during chemotherapy which is negatively correlated with their quality of life. Dynamic management of symptom clusters by medical staff is expected to improve the quality of life of lung cancer patients during perioperation.

Study on moisture-associated skin damage of patients with negative pressure wound therapy

ZHU Shoulin,JIANG Qixia,LI Laijuan,PENG Qing,HUANG Xiuling

2020, 55(11):  1642-1647.  DOI: 10.3761/j.issn.0254-1769.2020.11.007

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Objective To observe and analyze characteristics of occurrence and prognosis of moisture-associated skin damage （MASD） during negative pressure wound therapy（NPWT） between outpatient and inpatient,so as to provide bases for effective interventions. Methods From January 2018 to June 2019,39 cases in the General Hospital of Eastern Theater Command were selected as experimental group,40 cases in the First People’s Hospital of Lianyungang were selected as control group by convenience sampling method. The expected NPWT treatment and individualized standard moisture therapy （MT） were conducted and patients were followed up until the wounds were healed or for 3 months. The incidence of NPWT related MASD was the primary outcome indicator. The secondary outcome indicators were the time of occurrence,the time of healing of NPWT related MASD,the wound area and depth reduction rate of 14 days after NPWT,as well as wound healing rate and healing time in 3 months follow-up. Results There was a case dropped in the exposed group and no dropped case in the non-exposed group. In 2 groups,the incidence of NPWT related MASD was 17.95%（7/39） and 22.50%（9/40）;the occurrence time was（3.86 ±1.57）d and （3.33±1.12）d;the healing time was （5.14±1.77）d and （5.44±1.13）d,respectively. The differences were not statistically significant（all P>0.05）. The reduction rates of wound area and depth in 14 days of NPWT,the healing rate and healing time of 3 months follow-up between 2 groups were also close（P>0.05）. Conclusion There was a high incidence of NPWT related MASD in the family and hospital environment,and the time of occurrence and healing time were close. Early detection and active interventions can reduce the short-term and long-term effects of wound treatment. Considering the cost and convenience,family mode NPWT may be an exploratory direction of chronic wound care in the future.

Self-management experience of cancer patients after chemotherapy on home fall prevention：a qualitative study

TIAN Lu,CHEN Ying,LONG Yanhui,CUI Jinrui,WU Meiliyang

2020, 55(11):  1648-1652.  DOI: 10.3761/j.issn.0254-1769.2020.11.008

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Objective This study aims to explore the real self-management experience of cancer patients after chemotherapy on home fall prevention and to identify influencing factors of implementing self-management on home fall prevention,so as to provide references for the further construction of intervention strategies. Methods The purpose sampling method was used,and a total of 20 cancer patients treated with chemotherapy were interviewed by semi-structured in-depth interviews. Themes were identified and analyzed by Nancy phenomenological method. Results The overall ability of cancer patients after chemotherapy to prevent falls at home is poor. After chemotherapy,cancer patients had problems with the knowledge about self-management of home fall prevention,the skills of home fall prevention and poor compliance of self-management. The themes,including the hopelessness for disease recovery,the lack of information on prevention of falls at home and limited condition,were found to be the most common barriers for implementing fall prevention measures,while the support from nurses/family members and strongly healthy responsibility were motivating factors for patients to prevent falls at home. Conclusion Understanding the perception of home fall prevention for chemotherapy patients provides the information for education of fall prevention and assists nurses to form strategies and measures to promote patients safety.

Effects of mobile health application based on case management on self-care behavior and empowerment ability of patients with Type 2 diabetes mellitus

YUAN Xiaodan,CHEN Xue,HU Jiaqi,ZHOU Qianqian,ZUO Panpan,YAO Ping,LOU Qingqing

2020, 55(11):  1653-1658.  DOI: 10.3761/j.issn.0254-1769.2020.11.009

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Objective To explore the feasibility of case management combining mobile medical application（mHealth APP） for patients with type 2 diabetes（T2DM） and its impact on self-management behavior and empowerment abilities. Methods A total of 300 inpatients with type 2 diabetes in a tertiary hospital in Jiangsu were enrolled from April 2017 to March 2018,and they were randomly divided into 2 groups：case management control group（n=150） and case management combining mHealth APP intervention group（n=150）. Both groups received case management during hospitalization. After discharge,the patients in the control group continued to receive case management,while the intervention group was managed by mHealth APP on the basis of the control group. The biochemical indexes were monitored and the SDSCA scale and DES-SF scale were completed before the intervention and 12 months after the intervention. Results Before the intervention,there was no statistically significant difference between the 2 groups. The total scores and the score of each dimension（Diet,Exercise,Blood Glucose Monitoring,Medication and Foot Care）in SDSCA,and the DES-SF score were higher than those before the intervention（P<0.01）. 12 months after the intervention,there were no significant difference in the total score and each dimension score of self-management behavior between the 2 groups（P>0.05）. But we found that the total time of nursing management and specialist nursing outpatient service in one year was significantly less than that of the control group（P<0.01）,and the improvement of the total score and items 4,8 of the DES-SF scale in the intervention group was significant than that in the control group（P<0.05） after one-year intervention. In the intervention group,HbA1c,HOMA-IR and TC were significantly reduced after 12 months of intervention（P<0.01）,and self-management behaviors and empowerment ability were significantly improved after 12 months of intervention（P<0.01）. Conclusion The case management combining mHealth APP can stimulate the inherent potential of self-care of patients with type 2 diabetes. It can improve various metabolic indicators and self-management capabilities while saving time and human resources effectively.

Development and application of game software for health-care education in children with type 1 diabetes

WANG Li,WU Liping,WANG Ping,LIN Qin,HU Wenxin,YANG Wei,MA Qinxiang,LI Hong,GUI Fengjiao

2020, 55(11):  1659-1664.  DOI: 10.3761/j.issn.0254-1769.2020.11.010

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Objective Combined with physical and mental characteristics of children,we developed health education game software for children with type 1 diabetes,so as to provide references for health education of children with chronic diseases. Methods The health education software for children with type 1 diabetes was developed in the form of games with questions and answers. It is convenient to select children with type 1 diabetes admitted to Department of Endocrinology in our hospital from November 2017 to April 2019 as research subjects. According to the time of admission,they are allocated into an experimental group and a control group,with 16 cases in each group. In the experimental group,game software was used for health education;the control group received traditional health education. Before and after the implementation,the knowledge of disease theory of children,satisfaction of children and parents and satisfaction of nurses were compared. Results The theoretical test score of the experimental group was significantly higher than that of the control group（P<0.05）. 87.5% of the children and their parents thought that the game software was novel and easily acceptable for children,and it could stimulate their willingness to learn actively,which was helpful for children to learn disease knowledge. Satisfaction of nurses with all dimensions of software was high,and the overall satisfaction was 94.67%. Conclusion The software is convenient,professional,practical,interesting and easily acceptable for children. Through the application of game software,we can improve health education mode for children by improving their learning participation and theoretical knowledge level.

Construction of evaluation index system for core competence of clinical nutrition specialist nurses

HUANG Shiju,ZHONG Meinong,CAI Youdi,ZHOU Xueling,HE Xiaolan,LI Xiaoling,LUO Qian,CHEN Miaoxia

2020, 55(11):  1665-1672.  DOI: 10.3761/j.issn.0254-1769.2020.11.011

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Objective To establish an evaluation index system of core competence for clinical nutrition specialist nurses. Methods The first draft of the evaluation index system of core competence for clinical nutrition specialist nurses was prepared by referring to domestic and foreign literature and research group discussions. 18 experts were consulted with 2 rounds of Delphi consultations to complete the screening and modification of indicators and to determine the weights. Results The evaluation index system of core competence for clinical nutrition specialist nurses was formed,including 5 first-level indicators（clinical nutrition professional ability,leadership and management ability,professional humanistic traits,guidance and collaboration ability,professional development ability）,14 second-level indicators,and 72 third-level indicators. The effective response rates of 2 rounds of expert consultations were both 100%,and the expert authority coefficients were both 0.910. The Kendall coordination coefficients of the first,second and third level indicators in the second round were 0.602,0.558,0.347（P<0.001）. Conclusion The evaluation index system of core competence of clinical nutrition specialist nurses is scientific,reasonable,comprehensive and targeted,which can provide references for the training and evaluation of clinical nutrition specialist nurses.

Nursing Management

Development of a vertical nursing administration model and practice strategies in tertiary hospitals

TANG Leiwen,YANG Lili,CHEN Xiangping,ZHU Chenping,XIANG Weilan,QIN Jianfen,QI Haiou,PAN Hongying,ZHUANG Yiyu

2020, 55(11):  1673-1679.  DOI: 10.3761/j.issn.0254-1769.2020.11.012

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Objective To develop a vertical nursing administration model and practice strategies,so as to advance the reform of nursing management model in tertiary hospitals. Methods Based on a literature systematic review and semi-structured interviews,2 rounds of expert consultations with 20 experts in tertiary hospitals from 16 provinces and cities were conducted by Delphi method. Results The authority coefficients of 2 rounds were 0.93 and 0.94. The Kendall’s coefficients of coordination were ranged from 0.043 to 0.233. The vertical nursing administration model and practice strategies were finalized and they consisted of 6 dimensions（including vertical and flat organizational structure,transformational leadership,standardized nursing professional practice,organizational empowerment,innovation and practice,and support system）,17 elements and 60 implementing measures. Conclusion The vertical nursing administration model and practice strategies are scientific,practical and comprehensive,which could provide a guidance for nursing management reform in tertiary hospitals.

Investigation on nurses practice environment in tertiary hospitals in Shandong Province

ZHANG Xiaoman,MA Xinlu,LIU Yujie,LI Zhenxiang

2020, 55(11):  1680-1684.  DOI: 10.3761/j.issn.0254-1769.2020.11.013

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Objective To investigate nurses practice environment in tertiary hospitals in Shandong Province,which can provide a basis for the improvement and construction of a healthy nurse practice environment. Methods The convenience sampling method was used to investigate 56 776 nurses from 59 tertiary hospitals in Shandong Province by the Nursing Work Index-Revised（NWIR） from March to December 2018. Results The mean score of NWIR was 79.20±19.15. The items of “the hospital has a systematic training program for newly recruited nurses”,“nurses in the work team are qualified for nursing work” received the highest scores. The items of “the system of salary allotment is reasonable in hospital”,“the level of salary of nurses is reasonable in all sectors of the society”,“nurses have opportunities to participate in hospital internal management”,“nurses have opportunities to become members in the hospital management committee” and “nurses have opportunities to participate in hospital management decisions making” got the lowest scores. Multiple linear regression analysis showed that gender,age,education,professional title,years of work,whether being recruited by government agencies had an impact on the nursing practice environment scores（P<0.05）. Conclusion Nurses practice environment in tertiary hospitals in Shandong Province is generally optimistic,but it still requires continuous improvement. The nursing managers and experts should focus on the establishment and improvement of the authorization management mechanism,encourage nurses to actively engage in hospital affairs,and give much attention to the career development of male nurses and medium seniority nurses,so as to continuously improve and optimize the nursing practice environment.

Community Care

Study on the effect of clown care on mood in the elderly in nursing homes

YAO Lipei,ZHANG Peili,DING Yongxia,LI Junli,SUN Huiqun,CUI Xiaohong,JIN Yali

2020, 55(11):  1685-1689.  DOI: 10.3761/j.issn.0254-1769.2020.11.014

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Objective To establish an application plan for clown care in the elderly in elderly institutions and explore its effects. Methods A clown care team was established,and the localized and personalized individual intervention and group intervention programs were determined through theoretical research,pre-experiment and qualitative research methods. 34 older adults in the nursing home received the clown care program for 1.5-2 hours twice a week by flexibly using of humor,improvisation,songs and games,etc. The Geriatric Depression Scale（GDS）,UCLA Loneliness Scale（ULS-6）,Positive and Negative Emotion Scale（PANAS） and semi-structured interviews with the elderly were used to evaluate the effect of the programe. Results After the intervention,the negative emotion,loneliness and depression scores of the elderly in the nursing home decreased,and the positive emotion scores increased significantly. The difference was significant（P<0.05）. Older people think that clown care can meet their social,respect and self-realization needs to a certain extent,but it needs more team members and further enrich- ment of the content. Conclusion Clown care can improve the depression status of elderly people in nursing homes,maintain positive emotions,suppress negative emotions and alleviate their loneliness.

Factors influencing the adjustment to nursing home life of elderly residents

YONG Binbin,XIAO Huimin,ZHENG Yijing

2020, 55(11):  1690-1696.  DOI: 10.3761/j.issn.0254-1769.2020.11.015

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Objective To investigate the current status of psychological adjustment of elderly residents in nursing homes and its predictors. Methods A total of 248 elderly residents were recruited from 10 nursing homes from April 2019 to June 2019,and they were investigated by Katz Activity of Daily Living（Katz ADL）,Nursing Home Adjustment Scale（NHAS）,Chinese Perceived Stress Scale（CPSS）,Social Science Research Solutions（SSRS） and General Self-efficacy Scale（GSES）. Multiple linear regression was used to identify predictors of adjustment to the nursing home life for elderly residents. Results The total score of NHAS was（87.83±15.33）,and the mean score was（3.82±0.67）. Multiple linear regression analysis showed that social support,satisfaction with nursing homes,making friends and perceived stress were the predictors of nursing home adjustment（P<0.05）. Conclusion Nursing home staff should consider the influencing factors in assisting the elderly to achieve successful adjustment to nursing homes.

Vascular Access Nursing

Application of mobile ultrasonic out-of-plane vascular puncture in the installation of tube in arm port

YUE Chaoli,SUN Li,XU Haiping,WANG Yanli,LIU Kouying

2020, 55(11):  1697-1700.  DOI: 10.3761/j.issn.0254-1769.2020.11.016

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Objective To explore the application effect of mobile ultrasound out-of-plane vascular puncture in the implantation of the arm port. Methods A total of 83 patients with malignant tumors were selected as research subjects in Nanjing by convenience sampling. From March to June 2020,42 patients were selected as the experimental group and received the mobile ultrasound out-of-plane vascular puncture method. From June to July 2019,41 admitted patients were selected as the control group and received the puncture by conventional ultrasound guidance. The success rates of the first vascular puncture and guide wire insertion,the time duration of successful catheter placement,the score of pain during the puncture,and arm port related early complications were compared. Results The success rate of first blood vessel puncture in the experimental group （97.62%） was higher than that of the control group （78.05%）. In the experimental group,the success rate of guide wire insertion（97.65%） was higher than it in the control group（70.73%）. The time duration of catheter placement in the experimental group was（16.50±1.70） min which was lower than that in the control group（18.56±1.99） min. The pain score of the experimental group（1.62±0.54） was lower than it in the control group（2.56±0.74）. All differences above were statistically significant （P<0.05）. Only 1 complication occurred in the experimental group,but there were 5 in the control group,and the difference between the 2 groups was not statistically significant（P>0.05）. Conclusion The mobile ultrasound out-of-plane vascular puncture method can improve the success rate of the first catheter placement of the arm port,reduce the pain of patients and shorten the time of puncture which is worthy of clinical application.

Clinical Practice

Nursing care of 11 patients with severe acute pancreatitis and diabetic coma caused by diabetic ketoacidosis

ZHANG Xing,GAO Lingling,GUO Xiaodi,HU Xiling

2020, 55(11):  1701-1705.  DOI: 10.3761/j.issn.0254-1769.2020.017

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To summarize the key points of observation and nursing care of 11 patients with severe acute pancreatitis and coma caused by diabetic ketoacidosis. To improve prognosis of the disease and guarantee patients’ safety,key points of nursing are summarized as following：sufficient early liquid resuscitation to avoid complications;correcting internal environment disorder and maintaining blood glucose homeostasis;providing early nutritional support;implementing psychological nursing care and health education. As a result,11 patients were in stable conditions after positive rescue and careful nursing care. They were discharged after 15~20 days.

Risk assessment and nursing highlights of postoperative hyperperfusion syndrome in patients with carotid artery occlusion surgery

LIANG Jingjing,ZHU Chenghong,SUN Fangzhen,WANG Mingzhu,LIU Yune

2020, 55(11):  1706-1709.  DOI: 10.3761/j.issn.0254-1769.2020.11.018

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To summarize the risk assessment and nursing highlights of postoperative hyperperfusion syndrome in 65 patients with carotid artery occlusion surgery. By establishing a risk assessment management team,summarizing high-risk factors,formulating risk assessment form,patients were evaluated and classified into different levels. Nursing highlights included strengthening the risk management of patients with high-risk,improving early warning consciousness,implementing three-level blood pressure management method to control blood pressure,and the close observation of the patients. Under the above risk assessment and nursing care,the incidence of high perfusion syndrome was 3.08%,which was lower than the reported 5.4%. All the patients were discharged with full recovery.

Evidence Synthesis Research

Effectiveness of high intensity interval training in cancer patients：a meta-analysis

LIU Yu,JIANG Tongtong,YU Yitong,SHI Tieying,XU Pengzhu,LI Fanglin,LIU Binghan

2020, 55(11):  1710-1717.  DOI: 10.3761/j.issn.0254-1769.2020.11.019

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Objective To evaluate the effectiveness of high intensity interval training（HIIT） in cancer patients. Methods We searched databases including Cochrane Library,PubMed,Embase,Web of Science,CINAHL,CNKI,Wanfang,VIP,and CBM from inception to January 2019,and included randomized controlled trials（RCTs） reporting the effectiveness of HIIT in cancer patients. Literature screening,information extraction and quality evaluation were conducted by 2 reviewers,and RevMan 5.3 software was adopted for meta-analysis. Results A total of 8 RCTs with 970 patients were included in this meta-analysis. The results showed that HIIT could increase VO₂peak,muscular strength[SMD=0.23,95%CI（0.07,0.58）,P<0.01;MD=2.38,95%CI（1.08,3.68）,P<0.001] and improve cancer related fatigue[SMD=-0.26,95%CI（-0.48,-0.04）,P=0.02],and improve quality of sleep and quality of life[SMD=-0.25, 95%CI（-0.47,-0.04）,P<0.05;SMD=0.28,95%CI（0.13,0.43）,P<0.001]. The effectiveness on anxiety and depression was not statistically significant[SMD=0.05,95%CI（-0.12,0.22）,P=0.54;MD=-0.08,95%CI（-0.25,0.09）,P=0.34]. Conclusion HIIT is effective on improving VO₂peak,muscle strength,quality of sleep,cancer related fatigue and quality of life. As all the studies included in this meta-analysis are foreign literature with heterogeneity among some outcome indicators,pilot trials with small samples can be carried out in the future to further explore the applicability and feasibility of HIIT in cancer patients in China,so as to provide more evidence for the implementation of HIIT for cancer patients.

Review

Research progress on an assessment tool of patient-reported outcomes for pancreatic cancer patients

DONG Li, LU Fangyan, LÜ Feicui, DING Weiyan

2020, 55(11):  1718-1722.  DOI: 10.3761/j.issn.0254-1769.2020.11.020

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This paper reviewed the patient-reported outcomes and assessment tools for patients with pancreatic cancer and summarized the characteristics and application of generic and specific patient-reported outcome measures. We also proposed and analyzed the existing problems and put forward related suggestions for patient-reported outcome measures, so as to provide references for the localized development of patient-reported outcome measures in patients with pancreatic cancer and for clinical nurses to select appropriate assessment tools and carry out related research.

Research progress on the prognostic models for recurrent venous thromboembolism

LI Jing,LI Xing,ZHAO Qiong,WANG Yanyan

2020, 55(11):  1723-1727.  DOI: 10.3761/j.issn.0254-1769.2020.11.021

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After discontinuation of oral anticoagulants,venous thromboembolism in patients with high recurrence rates seriously affects the quality of life. This paper reviews the recurrence of venous thromboembolism prediction model from the applicable people,predict performance and evaluation indexes published abroad in recent years. This review summarizes the current research status at home and abroad for recurrence of venous thromboembolism in China,aiming to provide references for the construction and use of prediction model.

Application progress of digital technology in patients with cardiac rehabilitation

LIU Yuwen,LI Qingyin

2020, 55(11):  1728-1732.  DOI: 10.3761/j.issn.0254-1769.2020.11.022

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Cardiac rehabilitation and secondary prevention is an important part of life management and care for patients with cardiovascular diseases. Digital technology has been widely used in cardiac rehabilitation/secondary prevention abroad,and it has achieved similar or better results than traditional cardiac rehabilitation programs. The goals of nursing more patients with cardiovascular disease in the whole life process have been achieved with less human resources. This paper introduces the origin and development,common tools and concepts of digital technology applied in cardiac rehabilitation and secondary prevention,and expounds the specific implementation process and application effect of digital technology in cardiac rehabilitation/secondary prevention.

Research progress of nursing emergency education under the background of epidemic diseases

ZHAO Xin,WU Yu,ZHAO Hong,DANG Yan,LI Yunfeng

2020, 55(11):  1733-1739.  DOI: 10.3761/j.issn.0254-1769.2020.11.023

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With the characteristics of contingency and serious harm,the epidemic situation has a great impact on public health,social economy,politics and culture. Nursing emergency education refers to all kinds of nursing emergency education activities for nurses. Through nursing emergency education,nurses can not only effectively master the basic emergency nursing knowledge and skills,but also further clarify the emergency treatment procedures in emergency situations,so as to improve the emergency handling ability. The paper expounds the current situation of nursing emergency education under the background of epidemic diseases,summarizes the content and form,effect evaluation of nursing emergency education at home and abroad,analyzes the effects of nursing emergency education under the background of epidemic situation,and puts forward the factors hindering the implementation of nursing emergency education,so as to provide references for promoting nursing emergency education and clinical nursing emergency training in colleges and universities.

The development status and enlightenment of senior midwifery nurses in the United States

JIA Lei,WANG Yin

2020, 55(11):  1740-1744.  DOI: 10.3761/j.issn.0254-1769.2020.11.024

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Certified nurse midwives are midwives who have obtained a postgraduate degree,received nursing training before midwifery education and certification. They belong to a kind of senior practice nurses. This article reviewed the origin and definition,education level,core competence,certification requirements and practice scope of senior midwifery nurses,as well as its impact on maternal and neonatal in the United States. The article also analyzed challenges in the development of senior midwifery nurses in China,so as to provide references for their development in China.

Innovation of Nursing Instruments

Design and clinical application of a special injection tube for pulmonary surfactant in neonates

LE Qiong,ZHANG Lan,LIU Hui,WU Lifen,DENG Xianfeng

2020, 55(11):  1745-1748.  DOI: 10.3761/j.issn.0254-1769.2020.11.025

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Objective To use a special injection tube for neonatal alveolar surfactant to explore the best way to administer neonatal alveolar surfactant. Methods To design a special injection tube for neonatal alveolar surfactant. 126 neonates with respiratory distress syndrome admitted to the neonatal ICU of a tertiary hospital in Wuhan from April to September 2019 were selected as the research subjects,and were divided into an experimental group and a control group according to the order of admission. 66 cases in the experimental group received a special injection tube for neonatal alveolar surfactants for intratracheal administration;60 cases in the control group had traditional scalp needles and ordinary tracheal intubation methods for intratracheal administration. The differences of SpO₂ fluctuations,heart rate fluctuations,and drug reflux during the medication in the 2 groups were observed and the administration time was calculated. Results The differences in SpO₂ fluctuations and heart rate fluctuations in the experimental group were smaller than those in the control group（P<0.05）. The incidence of drug reflux in the experimental group was lower than that in the control group,and the administration time was shorter than that in the control group with statistical significance（P<0.05）. Conclusion The special injection tube for neonatal alveolar surfactants is easy to operate,and it can reduce the fluctuation of SpO₂ and heart rate of neonates during the administration process,ensure the stability of neonatal vital signs. It can also reduce the incidence of drug reflux,drug waste and the administration medicine time.

Preparation and application of cleaning support device for double-joint rongeur

SHI Min,GAO Chunhong,SONG Jin,SHEN Cuixia,ZHANG Xiang

2020, 55(11):  1749-1751.  DOI: 10.3761/j.issn.0254-1769.2020.11.026

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Objective To design and investigate the application effects of the cleaning support device of double-joint rongeurs in ultrasonic cleaning. Methods 260 double-joint rongeurs used in October 2019 were selected as the research objects, and they were randomly divided into an experimental group and a control group, with 130 pieces in each group. The experimental group used the cleaning support device of the double-joint rongeur while the control group had the “convex” double-joint spreader to open the handle of the instrument. The cleaning effects were evaluated by visual inspection and ATP biofluorescence assay, and the incidence of joint closures and the time spent using the spreader were recorded. Results The qualified rate of the double-joint rongeur cleaning effect in the experimental group was higher than that in the control group, and the difference was statistically significant（P<0.001）. The incidence of instrument joint closure in the experimental group was 0.8%, and it was 10.0% in the control group. The difference between the 2 groups was statistically significant （P=0.020）. The placement in the experimental group took （0.5±0.2） min, and it took （1.1±0.3） min in the control group, with statistically significant difference（P<0.001）. Conclusion The cleaning support device of the double-joint rongeur not only saves working time, but also can effectively open the clamp end and shaft section of the double-joint rongeur, which significantly improves the cleaning quality of the double-joint rongeur.

Overseas Knowledge

From human to benevolence—study experience of clinical nursing in Jing Hu hospital of Macau

ZHANG Yanning,BO Haixin

2020, 55(11):  1752-1756.  DOI: 10.3761/j.issn.0254-1769.2020.11.027

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Through the visiting exchanges with Jing Hu hospital Ophthalmology Center of Macau,Jing Hu History Museum,Jing Hu Nursing College,Oncology,Palliative Care Center,Central Sterile Supply Room,Central Operating Room and 9North（9N） Comprehensive Ward,we learn nursing concept,new technology and new methods of care and qualification certification and training of specialist nurses from Jing Hu hospital of Macau,which improves the whole working process and the new understanding of nursing work mode of Jing Hu hospital of Macau. Due to the differences in system and culture,the operation mode and nursing care are different between hospitals to some extent. However,the concept of "benevolence" has been deeply rooted in people’s hearts. The author hopes to continue to strengthen the communication between the 2 sides and the 3 places to exchange experiences in order to better provide professional nursing services for patients.

Translation of the Chinese version of the City Birth Trauma Scale and the test of its reliability and validity

SHEN Zichen,ZHOU Yang,ZHU Dongmei,ZHU Jun,WEI Jiajie,CAO Weiping

2020, 55(11):  1757-1761.  DOI: 10.3761/j.issn.0254-1769.2020.11.028

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Objective To translate the English version of City Birth Trauma Scale（City BiTS） into Chinese,and to preliminarily test its reliability and validity. Methods According to the Brislin translation model,the English version of City BiTS was translated into Chinese,and then was back-translated and modified for cultural adaptation followed by the guidelines. From June 2019 to October 2019,328 parturients in 2 tertiary hospitals in Zhenjiang were included by a convenience sampling method for a questionnaire survey,in order to evaluate its reliability and validity. Results The Chinese version of City BiTS contained 29 items. 2 common factors were extracted from the response scale （Q3~Q22） through exploratory factor analysis,and the factor cumulative variance contribution rate was 54.907%. The Cronbach’s α coefficient of the total scale was 0.934,and 0.896~0.906 for the 2 dimensions. The test-retest reliability of the total scale was 0.908;the split-half reliability was 0.821. The Scale-Content Validity Index（S-CVI） was 0.93,and the Item-Content Validity Index（I-CVI） ranged from 0.83 to 1.00. Conclusion The Chinese version of the City BiTS has good reliability and validity under the Chinese culture background. It provides a reliable research tool for the diagnosis of postpartum post-traumatic stress disorder（PTSD） in China,and provides a basis for psychological interventions by medical staff.