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Objective:To explore the effect of the application of nursing decision support information system in the continuing nursing of stroke patients in convalescent period, and to provide guidance for the information-based whole process nursing of stroke patients in convalescent period.Methods:A total of 107 stroke patients in convalescent period admitted to 4 Grade Ⅲ Level A hospitals of Beijing city from March to November 2019 were selected. The patients were divided into control group (53 cases) and test group (54 cases) by coin tossing method. The control group followed uniformly formulated discharge health education manual for post-discharge management and follow-up, while the test group received health guidance and follow-up through the nursing decision support information system. Barthel Index and MOS SF-36 were used to evaluate the activities of daily living and quality of life of the two groups of patients before intervention and 3 and 6 months after the intervention, and the results were compared.Results:There was no significant difference in Barthel Index before the intervention between the two groups( P>0.05). After 3 months of intervention, the Barthel Index ≤ 49, 50-70 and ≥ 71 in the test group were 7, 17 and 27 cases respectively, and 16, 21 and 13 cases in the control group respectively, and the difference between the two groups was statistically significant ( Z=-2.95, P<0.01). After 6 months of intervention, the Barthel Index ≤ 49, 50-70 and ≥ 71 in the test group were 7, 12 and 32 cases respectively, and 10, 15 and 25 cases in the control group respectively,and the difference between the two groups was statistically significant ( Z=-2.21, P<0.05). There was no significant difference in MOS SF-36 before the intervention between the two groups( P>0.05). After 3 and 6 months of intervention, the total score of MOS SF-36 in the test group was (50.51 ± 14.57), (57.06 ± 14.85) respectively, and that in the control group was (42.02 ± 15.48), (45.58 ± 14.97) respectively, and the differences between the two groups were statistically significant ( t=2.84, 3.23, both P<0.05). Conclusions:The application of nursing decision support information system can effectively improve the daily life ability of patients, enhance the quality of life of patients.
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Objective:To explore the predictive value of artificial intelligence algorithm model for venous thromboembolism（VTE）in lower extremities of trauma patients.Methods:The data of 15，856 orthopedic inpatients were retrospectively collected from the information system database in Chinese PLA General Hospital from December 1992 to November 2017. The patients were divided according to whether they had thrombosis or not. Data pretreatment and feature extraction were carried out. Four artificial intelligence algorithms including Random Forest（RF），Bayes（Bayes），Decision Tree（DTC）and Gradient Boosting Tree（GBDT）were constructed to evaluate their clinical diagnostic efficacy in VTE. The original data were divided into training set and test set according to the ratio of 8∶2 by random stratified sampling method. By comparing the area under receiver operating characteristic curve（ROC）（AUC），true positive rate（TPR）and accuracy in the above methods，the efficiency of different models in clinical diagnosis of VTE was evaluated. According to the contribution degree of the features in the model，the important features were ranked to screen the independent risk factors of VTE.Results:For RF，Bayes，DTC and GBDT algorithm models，the AUC was 0.89，0.86，0.68，0.71，with the TPR for 0.29，0.44，0.38，0.66 and the accuracy for 0.97，0.94，0.95，0.76，respectively. The RF algorithm model had the highest accuracy and the largest AUC. Analysis of important features of artificial intelligence prediction models for VTE showed that the history of thrombosis was the primary predictor of adverse outcomes. The ranking of important clinical features represented by the RF model showed that the history of thrombosis，enoxaparin sodium injection dose，last glucose measurement and first glucose measurement after surgery were important predictive characteristics of VTE.Conclusions:The RF model has the highest accuracy in risk prediction of VTE in trauma patients，which can provide a reference for the formulation of VTE prevention strategies.
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Objective To explore the role of the key factors in nursing quality control. Methods The content was constructed from four aspects, that is, the standard of care measures, well-functioning nursing quality control system, timely feedback and training mechanism, continuous quality improvement measures. Results The nursing quality standard system was established, the quality of care and patient satisfaction with nursing work were both improved. Conclusions The application of the key factors is the basic guarantee for effective management of nursing quality, which provides high quality nursing service for patients in hospital.
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Objective To evaluate the effects of two different kinds of airway humidification for tracheostomy patients, and to provide their relevant clinical effect and suggestions for their use. Methods Online databases, including PubMed, EMBASE, JBI evidence-based nursing center library, the Cochrane Library, and Chinese databases (CNKI, Wanfang database, VIP, CBM) were searched systematically up to March 2015. Randomized controlled trials (RCTs) were considered eligible for inclusion if the following criteria were met: no history of respiratory tract infection; satisfactory nutritional status; tracheotomy performed; 18 years older. Two different humidification methods were used. Continuous airway humidification was used in the experiment group, while intermittent airway humidification was used in the control group. Two qualified reviewers reviewed the original articles, evaluating the quality of articles, and data were extracted independently. The enrolled RCTs were analyzed by Meta-analysis. Results A total of nine RCTs were included, containing 631 cases, among them 316 cases in expertment group, and 315 cases in control group. Continuous airway humidification was shown to be able to reduce the incidence of irritable cough [odds ratio (OR) = 0.20, 95% confidence interval (95%CI) = 0.12-0.34, P < 0.000 01], bleeding form mucosa of respiratory tract (OR = 0.25, 95%CI = 0.14-0.45, P < 0.000 01), sputum conglomeration (OR = 0.19, 95%CI = 0.10-0.39, P < 0.000 01), and pneumonia (OR = 0.29, 95%CI = 0.19-0.45, P < 0.000 01). The funnel plots were largely symmetrical, suggesting there was no publication bias in the Meta-analysis of two methods for airway humidification for tracheostomy patients. Conclusion Because the number of including articles was relative small, and the quality of some articles was poor, it is impossible to draw a reliable conclusion that continuous airway humidification could lower the incidence of complications for patients undergone tracheostomy.
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This article described the background,concept,characteristic and objective of the research-based nursing,systematically introducing the main measures including management mechanism, nursing service,nursing staff training,and nursing scientific development.Other areas covered include innovation management mechanism,updating service philosophy,improving nursing staff training,and constructing scientific research platform.
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Objective To investigate the cognition and care needs of the patients with acute stage fracture thus providing reference for the construction of intermediate care model. Methods The data of 504 patients with acute stage fracture from December 2014 to April 2015 were investigated through questionnaire, and analyzed. The issues included gender, age, marital status, cultural level, degree of understanding of intermediate care, care needs, etc. Results 63.29%(319/504) of the patients didn′t know intermediate care before they filled in the questionnaire,only 3.97%(20/504) of the patients understood the conception of intermediate care; different stage of age had different cognition towards intermediate care, the differences were statistically significant( χ2=148.771, P<0.01); different stage of age, sex, marital status, cultural level had different care needs, the differences were statistically significant (H/u=9.692-129.097, P<0.05). Conclusions At present, the majority of patients have no conception about intermediate care, so it is necessary to build the model of intermediate care. As nursing staff we should provide different help according to different type people, thus we can promote patients' physical and mental health, improve patient satisfaction to the greatest extent.
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Objective To discuss the effect of abdominal massage on the success rate of nasal-gastric catheter placement in elderly patients.Methods 100 patients with nasal-gastric catheter placement were divided into two groups by random digits table.50 patients of the experimental group received abdominal nassage after the placement of nasal-gastric catheter,while 50 patients of the control group received routine nursing care.The success rate of intubation and adverse effects were compared between the two groups at the 12th,24th,36th,48th,60th and 72th hour.Results Compared to the control group,the success rate of intubation at the 12th,24th,36th,48th,60th and 72th of the experimental group was higher [16％ (8/50) vs.4％ (2/50),56％ (28/50) vs.36％ (18/50),70％ (35/50) vs.48％ (24/50),74％ (37/50) vs.54％ (27/50),76％ (38/50) vs.56％ (28/50),80％(40/50) vs.60％ (30/50),x2=4.000,4.026,5.002,4.340,4.456,4.762,P＜ 0.05],and the abdominal distension was alleviated in the experimental group [10％ (5/50) vs.32％ (16/50),P＜0.01],while no significant differences were found in the incidence of adverse effects between the two groups (P＞0.05).Conclusions Abdominal massage can promote the gastrointestinal movement effectively and increase the success rate of nasal-gastric catheter placement in elderly patients.
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To explore the velocity difference between specifications and categories of liquid with the same pressure infusion bag in order to widen the specification range of the liquid for pressure infusion. Pressure infu-sion experiments were performed with three specifications of normal saline of 100, 250 and 500 ml to compare the veloci-ties of different specifications of liquid, and with 500 ml normal saline, (5%, 10% and 50%) glucose injection, 5% glu-cose and sodium chloride injection, 5% sodium bicarbonate injection, 10% fructose injection, 706 plasma substitute, 20%mannitol injection and etc to make clear the velocities of different categories of liquid. With the same pressure, there were no significant differences between the velocities of three specifications of liquid, and between those of cate-gories of liquid with the same specification and concentration; the difference was significant between the same category of liquid with different concentrations, and the velocity showed a negative correlation with the concentration. The pressure infusion bag is compatible with 100, 250 and 500 ml liquid, and the velocity may be constant in case some specification of liquid is replaced by another one. The velocity has to be regulated in case the concentration or category of the liquid changes, when the pressure infusion is performed.
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OBJECTIVE To norm the isolation and management of special infection patients and eliminate the incidence of hospital infections.METHODS The measures,the implementation of training and personal management,and details of control were determined.RESULTS The system management and isolation measures were implemented to effectively control the incidence of hospital infections.CONCLUSIONS The isolation and control of special infection patients are a systematic and rigorous work,it is very important to form a scientific,complete and easy to implement workflow and management system for the control of hospital infections.