ABSTRACT
Objective To investigate the effects of precautionary rescue nursing intervention on the nursing quality score and efficacy of rescue for neonates with hypoxic ischemic encephalopathy. Methods One hundred children with neonatal hypoxic ischemic encephalopathy admitted to the First Hospital of Hebei Medical University from January 2017 to December 2018 were enrolled. Fifty children from January to December 2017 were assigned in the routine rescue nursing group; and 50 children from January to December 2018 were in the precautionary rescue nursing group. The routine rescue nursing group received routine rescue nursing; and the precautionary rescue nursing group was given pre-planned rescue nursing intervention. The rescue success rate, rescue time, Apgar score within rescue for 5 minutes, poor prognosis, etc. were recorded in both groups; the infant intelligence development scale was used to evaluate the situation of children's development of IQ in 6 months; a self-made questionnaire was used to investigate the rate of satisfaction in 100 children family guardians; the hospital's self-made Nursing Quality Assessment Form was applied to assess the quality of care of nursing staff. Results The rescue successful rate and the 5-minute Apgar score of the precautionary rescue nursing group were significantly higher than those of the routine rescue nursing group [rescue success rate: 98.0% (49/50) vs. 72.0% (36/50), Apgar score: 8.43±1.28 vs. 5.74±1.39], and the rescue time and poor prognosis rate were significantly lower than those in the routine rescue nursing group [rescue time (minutes):3.18±1.20 vs. 6.78±2.23, poor prognosis rate: 2.0% (1/50) vs. 14.0% (7/50), both P < 0.05]. The 6-month intelligence index and psychomotor index in the precautionary rescue nursing group were significantly higher than those in the routine rescue nursing group (intelligence index scores: 96.43±5.85 vs. 85.40±8.90, psychomotor index scores:97.38±4.03 vs. 78.43±10.22, both P < 0.05). The satisfaction rate in precautionary rescue nursing group was obviously higher than that in the routine rescue nursing group [92.0% (46/50) vs. 76.0% (38/50), P < 0.05]; the rescue technology, rescue efficiency, rescue effect, humanistic care score in precautionary rescue nursing group were significantly higher than those in the routine rescue nursing group (8.12±0.89 vs. 2.74±1.02, 8.23±1.24 vs. 3.01±0.83, 7.80±1.33 vs. 3.44±1.25, 8.03±1.32 vs. 3.29±1.38, respectively all P < 0.05). Conclusion The precautionary rescue nursing intervention used for neonates with hypoxic ischemic encephalopathy can significantly improve the rescue effect, degree of satisfaction to nursing and the quality of nursing care, so that it is worthy to be applied clinically.
ABSTRACT
Objective To study the application effect of systematic emergency nursing process in treatment of neonatal hypoxic ischemic encephalopathy (HIE). Methods One hundred and four neonates with HIE who were treated in the First Hospital of Hebei Medical University from January 2016 to January 2018 were selected as the subjects of this study, and they were divided into a control group and a study group according to different nursing care process, with 52 cases in each group. The infants in the control group were resuscitated according to conventional traditional first aid measures, while the infants in the study group received systematic emergency nursing care process on the basis of routine first aid (including the preparation of early rescue drugs and equipment; warmth kept in the whole course, the room temperature controlled in 30 - 32 ℃; rapid assessment of maternal delivery methods and procedures, delivery of the newborn and assessment of babies general conditions; performance of preliminary resuscitation for neonate, tracheal intubation for mechanical ventilation, and external chest compression if necessary; close monitor of the vital signs of newborn; symptomatic treatment; reassessment of the baby's disease condition). The successful rescue rate, total rescue time, hospitalization time, neonatal Apgar score and quality of nursing care before and after resuscitation were compared between the two groups. Results The successful rescue rate of the study group was higher than that of the control group [96.2% (50/52) vs. 82.7% (43/52), P < 0.05], and the total rescue time (minutes: 8.9±2.1 vs. 12.4±3.2) and hospitalization time (days: 8.1±2.2 vs. 11.4±2.9) in study group were shorter than those in control group, all the differences being statistically significant (all P < 0.05). After resuscitation for 5 minutes, the Apgar scores of the newborns in the two groups were higher than those before the resuscitation (study group: 8.3±1.1 vs. 2.2±0.7, control group: 6.7±2.0 vs. 2.1±0.9), and after resuscitation for 5 minutes, the Apgar score of the study group was higher than that of the control group (8.3±1.1 vs. 6.7±2.0), the difference being statistical significant (P < 0.05). The scores of rescue technique (5.0±2.9 vs. 2.7±0.6), humanistic care (5.6±2.1 vs. 2.8±0.9), rescue efficiency (5.3±1.2 vs. 3.0±0.6), and rescue effect (5.7±1.3 vs. 2.9±0.8) in the study group were all higher than those in the control group (all P < 0.05). Conclusion The systematic emergency nursing care process can effectively elevate the successful rescue rate of neonates with HIE, shorten the total rescue time and hospitalization time, enhance the rescue effect, and improve the quality of nursing care, thus it is worthy to be widely applied clinically.