ABSTRACT
Background@#To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. @*Methods@#Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. @*Results@#Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). @*Conclusions@#In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.
ABSTRACT
Objective To investigate the current status of nurses'' needlestick injuries during venous blood sampling, evaluate effective prevention strategies.Methods A stratified cluster sampling method was used to investigate clinical nurses in China by questionnaire, contents of questionnaire included the general information of nurses, training and management on venous blood sampling among nursing staff, adherence to wearing gloves before blood sampling, the occurrence of needlestick injuries during the process of venous blood sampling in the past year and so on.Results A total of 2 861 questionnaires were distributed, and 2 575 valid questionnaires were recovered.93.17％ of the investigated nurses had participated in the training of venous blood sampling regularly;87.15％ received regular check of venous blood sampling;before venous blood sampling, only 72.74％ knew whether the patient had bloodborne infectious disease;only 61.01％ wore gloves during blood sampling.Incidence of needlestick injuries during venous blood sampling was 20.78％ in the past year.There was no significant differences in the incidence of needlestick injuries when using 3 different types of needles(Pearson x2=1.649, P=0.438).48.21％ of needlestick injuries occurred during disposing medical waste.Conclusion The training and management on nurses'' venous blood sampling is better in China, but incidence of needlestick injuries is still high.It is necessary to formulate safety operation regulations of venous blood sampling, standardize the operation procedures and specify the contents of training, so as to correct nurses'' unsafe behavior during venous blood sampling.
ABSTRACT
Objective To evaluate the correlation between serum procalcitonin concentration and systemic inflam-matory response syndrome (SIRS)score in patients with bacterial bloodstream infection.Methods In January-De-cember,2012,96 patients with bacterial bloodstream infection in a hospital were selected as trial group,and these patients were divided into three groups(group A,B and C)according to SIRS score;84 patients without bacterial in-fection was as control group,PCT concentration of all patients were detected,and the correlation between PCT con-centration and SIRS score was analyzed.Results Among 96 patients with bacterial bloodstream infection,7 (7.29%)died (4 were in group B and 3 in group C);there was no death case in control group.PCT concentration in control group,group A,B and C of trial group were (0.28±0.09)ng/mL,(0.63±0.13)ng/mL,(3.68±1.01)ng/mL,and(7.45±1.53)ng/mL,respectively,the difference between each group was significant(P<0.01).Pairwise comparison of four groups showed statistical difference (P<0.001).Spearman correlation analysis on PCT concen-tration and SIRS score was conducted,correlation coefficient r=0.874(P<0.001)suggested positive correlation be-tween serum PCT concentration and SIRS score.Conclusion PCT concentration in patients with bacterial blood-stream infection and SIRS score is positively correlated,PCT concentration and SIRS score can be used as two mark-ers for assessing the extent and prognosis of bacterial bloodstream infection.
ABSTRACT
Objective To investigate the activities associated with nurses’occupational exposure to bloodborne pathogens and the source patients’infection status during blood collection process,so as to provide a basis for developing occupational exposure prevention strategies.Methods Data about occupational exposure to bloodborne pathogens during blood collection process in a hospital from August 2011 to September 2013 were monitored.Results A total of 89 times of bloodborne ex-posure occurred among HCWs,including 75 times of arterial blood collection and 14 venous blood collection.The top three procedures of occupational exposures were rebounding of needles after needles were pulled out (28.09%,n=25),concen-trated cleaning up of rubbish at the end of blood collection (20.22%,n=18),and touching blood and body fluids by skin and mucous membrane (14.61%,n=13).48.31% (n=43)source patients infected with at least hepatitis B virus,hepati-tis C virus ,hepatitis E virus,Treponema pallidum,and human immunodeficiency virus ,51.69%(n=46)source patients were not infected ,after proper handling,none of nurses were infected during blood collection .Conclusion Developing safe blood-withdraw needle,putting sharp instrument into sharp instrument container,wearing gloves,and intensifying training of standard and occupational precaution are important strategies for the reducing of the occurrence of bloodborne exposure of clinical nurses during blood collection process .