Analysis on the Status Quo and Influencing Factors of Nurses’ Patient Safety Attitude Cognition in Emergency Department of 34 Hospitals / 中国医学伦理学

To understand the current status of emergency nurses’ patient safety attitude cognition and its influencing factors, 746 emergency nurses from 34 hospitals were investigated with the revised Chinese version of the safety attitude questionnaire. The results showed that the total mean score of patient safety attitude of emergency nurses was (3.98±0.40) points, which was above the middle level. Among them, the mean scores of team cooperation, safety atmosphere, management perception, work satisfaction, working condition, and stress perception were (4.14±0.85) points, (3.85±0.81) points, (3.90±0.81) points, (3.91±0.85) points, (3.86±1.06) points, and (3.89±0.59) points, respectively. Multiple linear regression analysis showed that length of service and grade of hospital were the influencing factors of emergency nurses’ patient safety attitude (P<0.05). It is suggested that the managers should incorporate patient safety culture into the training and management of emergency nurses, especially strengthen the safety culture education for junior nurses; the secondary hospital should also focus on enhancing team cooperation training for emergency nurses and improving the working environment of them, so as to reduce unsafe behaviors in nursing work and ensure patients’ safety.

Survey on Workplace Violence among Medical Staffs in a Third Grade Class - A Hospital in Xi'an City / 中国医学伦理学

Objective:To explore the incidence and epidemiological features of workplace violence among medi-cal staffs in a Third - grade Class - A hospital in Xi'an,and to provide scientific basis for the hospital and relevant health management departments to make workplace violence prevention and control measures. Methods: Using Hospital Workplace Violence Questionnaire, a survey was conducted among medical staffs in a Third - grade Class - A hospital in Xi'an to investigate the occurrence of workplace violence over the past one year. Results:A-mong the 1174 respondents,655 suffered workplace violence in the past one year,with a rate of 55. 79％ ;the vio-lence occurred mainly in day shift and wards;the perpetrators were mainly middle - aged,male and the families of patients;69. 42％ of the respondents thought the workplace violence were unavoidable and 87. 31％ of the respond-ents considered that the top measures that can be taken to prevent the workplace violence was "the correct media o-rientation";the main coping methods of medical staffs were patience explanation and forbearance,and after suffering workplace violence,the medical staffs would feel grievances,anger,declining enthusiasm for work and even didn't want to do medical care. The main measures that the hospital had taken to prevent workplace violence mainly in-cluded the security patrol,installing cameras in wards and keeping light bright at night in working area. Conclu-sions:Workplace violence is common among medical staffs. To prevent and control hospital workplace violence,it is recommended that:① Hospital employ more security personals and should particularly strengthen security work in high - risk period,high - risk departments;②it should strengthen the training of medical staff on the prevention and control of workplace violence and strengthen popularization of the relevant legal knowledge to the client;③it should strengthen the communication and cooperation with media and promote the correct media orientation;④it should smooth the patient feedback channels and timely correct the existing problems.

Effects of different stent configurations on shunt failure and hepatic encephalopathy after transjugular intrahepatic portosystemic shunt / 中华消化杂志

Objective To compare the effects of different stent configurations on shunt failure,hepatic encephalopathy,and hepatic myelopathy after transjugular intrahepatic portosystemic shunt (TIPS).Methods From March 2014 to June 2015,the clinical data of 73 hospitalized,patients who met the inclusion and exclusion criteria,and underwent TIPS for upper gastrointestinal hemorrhage caused by cirrhotic portal hypertension were retrospectively analyzed.According to the stent configuration during operation,patients were divided into simple coated stent group (hepatic vein,portal vein and hepatic parenchyma coated stent,23 cases),simulated Viatorr stent group (hepatic vein and hepatic parenchyma coated stent plus portal vein bare stent,27 cases) and combined stent group (hepatic vein and portal vein hare stent plus hepatic parenchyma coated stent,23 cases).Patients were followed up for one year,the incidences of shunt failure,hepatic encephalopathy and hepatic myelopathy within one year after TIPS of three groups were compared.Chi-square test,Fisher exact probability method and variance analysis were performed for comparison among groups.Cox regression analysis was used for difference analysis in imbalance of variables and incidence of outcome events among the three groups.Results The portal vein pressure gradient of simple coated stent group,simulated Viatorr stent group and combined stent group decreased from (22.15±4.52),(23.01±5.48) and (21.13±4.49) mmHg (1 mmHg=0.133 kPa) to (9.15±2.94),(11.20±3.27) and (8.75+4.06) mmHg after operation,respectively.Before and after operation,the differences in portal venous pressure gradient were statistically significant of three groups (t=10.488,7.188 and 7.850,all P＜0.05).The shunt failure rates of simple coated stent group,simulated Viatorr stent group and combined stent group were 13.0％ (3/23),18.5％ (5/27) and 30.4％ (7/23),respectively.The results of Cox regression analysis indicated that there was no statistically significant difference in shunt failure rates among different stent configurations after TIPS (P=0.339).The incidences of hepatic encephalopathy of simple coated stent group,simulated Viatorr stent group and combined stent group postoperative were 69.6％ (16/23),33.3％ (9/27) and 30.4％ (7/23),respectively,the difference was not statistically significant among the three groups (P＞ 0.05).The results of Cox regression analysis showed that the relative ratio values (95％ confidence interval) of incidence of postoperative hepatic encephalopathy of simple coated stent group compared with simulated Viatorr stent group and combined stent group were 2.901 (1.279 to 6.584) and 2.735 (1.123 to 6.658),and the differences were statistically significant (both P＜0.05).The incidences of hepatic myelopathy of simple coated stent group,simulated Viatorr stent group and combined stent group were 8.7％ (2/23),3.7％ (1/27) and 4.3％ (1/23),respectively,and there was no statistically significant difference in the incidence of hepatic myelopathy among three groups after operation (P＞0.05).During one-year follow-up,among 73 patients,two patients died,one in simple coated stent group and the other in combined stent group.The one-year survival rate after TIPS was 97.3％.Conclusions One year after operation,the incidences of shunt failure are similar between simple coated stent group,simulated Viatorr stent group and combined stent group.One year after operation,the incidence of hepatic encephalopathy is similar between simulated Viatorr stent group and combined stent group which are both lower than that of simple coated stent.The incidence of hepatic myelopathy is low,and its association with TIPS remains to be further investigated.

Investigation on workplace violence among nursing staff in a third-grade Class-A comprehensive hospital in Xi′an city / 中国实用护理杂志

Objective To investigate the current status of workplace violence among Nursing Staff. Methods The Modified Version of Hospital Workplace Violence Questionnaire was used to investigate 792 nursing staff about their experiences of workplace violence over the past one year in a third-grade Class-A comprehensive hospital in Xi′an city. Results The prevalence of workplace violence among 792 participants was 58.08%(460/792), Outpatient department, Emergency department, Obstetrics and Gynecology department, Pediatrics department were the high-risk areas of workplace violence. Day-shift was the main period of workplace violence occurred. The families of patients, middle-aged, male were the main perpetrators. 72.60%(575/792) of the respondents thought the workplace violence were unavoidable. Correct media orientation (89.33%, 707/792) was considered as the primary measure for preventing workplace violence. Patience explanation (74.13%, 341/460), forbearance (53.04%, 244/460) were the main methods for coping with hospital workplace violence. Grievances (75.38%, 347/460), anger (65.65%, 302/460), part of them even wanted to resign (21.84%, 100/460) after experiencing workplace violence were their feelings. Security patrols (81.63%, 647/792), wards installed cameras (77.43%, 613/792) and bright lights (53.42%, 423/792) in the night work areas were the main measures to prevent workplace violence that the hospital had taken to prevent workplace violence. Conclusions Workplace violence among nursing staff is common. It is suggested that hospitals and the relevant government departments should conduct further intervention research, to formulate feasible administrative riot guiding for reducing the incidence of workplace violence.

Exploring Effective Way for Improving Operating Room Nurses′Humanistic Exploring Effective Way for Improving Operating Room Nurses′Humanistic Quality by Using the Morning Shift Time Quality by Using the Morning Shift Time / 中国医学伦理学

Objective:To explore the effective way of cultivating the operating room nurses′humanistic quality by using the morning shift and to improve operating room nurses′comprehensive quality .Methods:The operating room nurses were divided into five specialist groups according to the nurses′levels, helping each group to determine the training topic of humanistic quality training , via taking a variety of training methods to promote operating room nurses′humanistic quality by making good use of the morning shift time .Results: Through taking a variety of training methods to promote the operating room nurses′humanistic quality by making good use of the morning shift time, the operating room nurses′humanistic care ability , theoretical knowledge , professional skills were improved significantly(P<0.05),and the operating rooms doctors, surgical patients′satisfaction of operating room nurses′service were improved ( P<0 .05 ) .Conclusion:Making good use of the morning shift time to improve the nurses′humanistic quality , at the same time , the nursing service quality and patients satisfaction were also improved .