ABSTRACT
For effective resistance to virus attack and infection, reducing virus transmission chance, it is extremely important for the medical staff and related workers to have their own safe protection. This paper summarizes the development causes, common locations, and prevention ways about the device related pressure injuries on the face resulted from wearing medical-grade protective equipment for a long working time. The paper proposes the nursing strategy for device related pressure injuries and other nursing strategy is proposed to take care efficiently the device related pressure injuries. Meantime, a corresponding nursing strategy is also suggested to deal with the correlative skin diseases during the application of medical-grade protective equipment. These paper aims to provide reference for the prevention of device related pressure injuries and the care of skin-related diseases for clinical working staff, especially to the respectable personnel in front line of fighting against Corona virus disease 2019.
ABSTRACT
Objective@#To observe the influences of different follow-up methods on rehabilitation and compliance of patients with severe scar after burns.@*Methods@#From January 2012 to May 2016, medical records of 116 patients with severe scar after burns who were admitted to our unit, discharged after wound healing and conforming to the criteria, were retrospectively analyzed. They were divided into face-to-face follow-up group [n=59, 45 males and 14 females, aged (36±9) years] and routine follow-up group [n=57, 44 males and 13 females, aged (35±9) years] based on different follow-up methods they received. On the day of discharge and in post discharge month (PDM) 1, 3, and 6, the Vancouver Scar Scale (VSS) was used to evaluate the hypertrophic scar in joints, Activities of Daily Living (ADL) scale was used to evaluate the disability of patients in the 2 groups. In PDM 1, 3, and 6, Medical Compliance Behavior Questionnaire was used to investigate the medical compliance behaviors of patients in the 2 groups. Data were processed with chi-square test, t test with Bonferroni correction, and analysis of variance for repeated measurement.@*Results@#(1) The VSS score of patients in face-to-face follow-up group on the day of discharge was (11.1±0.7) points, which was close to (11.7±0.7) points of routine follow-up group (t=2.021, P>0.05). The VSS scores of patients in face-to-face follow-up group in PDM 1, 3, and 6 were (10.5±0.6), (8.6±0.7), and (4.7±0.5) points, which were significantly lower than (11.4±0.7), (10.9±1.0), and (9.4±0.8) points of routine follow-up group respectively (t=2.034, 2.033, 2.042, P<0.05 or P<0.01). (2) The ADL score of patients in face-to-face follow-up group on the day of discharge was close to that of routine follow-up group (t=1.781, P>0.05). The ADL scores of patients in face-to-face follow-up group in PDM 1, 3, and 6 were higher than those of routine follow-up group respectively (t=9.683, 8.584, 9.772, P<0.01). (3) The compliance rates of consisted rehabilitation, reasonable diet, and timing consultation of patients in face-to-face follow-up group were better than those of routine follow-up group respectively (χ2=19.015, 13.251, 8.652, P<0.01).@*Conclusions@#Compared with routine follow-up by phone, face-to-face follow-up can do better in evaluating the scar condition and ADL of patients with severe scar after burns, and improve the medical compliance rates of patients, which is worthy of clinical promotion.
ABSTRACT
Objective@#To explore the effects of multidisciplinary comprehensive intervention in integrated treatment of patients with extremely severe burns.@*Methods@#One hundred and ten patients hospitalized in our center from July 2013 to August 2017 met the criteria for inclusion in this study, and their medical records were retrospectively analyzed. According to the medical model at that time, 56 patients hospitalized from July 2013 to July 2015 received routine comprehensive treatment led by doctors, and they were included in the conventional intervention group. From August 2015 to August 2017, 54 patients were treated with integrated multidisciplinary interventions performed by a team consisting of physicians, intensive care nurses, burn nurses, intravenous infusion nurses, wound stoma nurses, and rehabilitation therapists, and they were included in the integrated intervention group. Acute Physiological and Chronic Health Assessment Ⅱ (APACHE Ⅱ) scores on admission and 4 weeks after treatment, incidences of pressure injury, wound sepsis, lung infection, and catheter-related infection during hospitalization, length of stay in intensive care unit (ICU) and total length of hospital stay, and Abbreviated Burn Specific Health Scale (BSHS-A) scores at discharge and 3 months after discharge were analyzed. Data were processed with t-test and chi-square test.@*Results@#The APACHE Ⅱ scores of patients in the two groups were close on admission (t=0.573, P>0.05). Four weeks after treatment, the APACHE Ⅱ scores of patients in the two groups were obviously lower than those on admission within the same group (t=5.697, 4.853, P<0.01), and the score of the integrated intervention group was obviously lower than that of the conventional intervention group (t=2.170, P<0.05). No pressure injury was observed in patients of any group during hospitalization. The incidences of wound sepsis, lung infection, and catheter-related infection of patients in the integrated intervention group were 18.5% (10/54), 3.7% (2/54), and 9.3% (5/54), respectively, significantly lower than 42.9% (24/56), 21.4% (12/56), and 26.8% (15/56) of the conventional intervention group, χ2=4.073, 6.075, 3.962, P<0.05. The length of stay in ICU of patients in the integrated intervention group was (50±5) d, obviously shorter than (62±4) d of the conventional intervention group (t=2.852, P<0.01). The total length of hospital stay of patients in the integrated intervention group was (115±8) d, obviously shorter than (140±7) d of the conventional intervention group (t=16.885, P<0.01). At discharge and 3 months after discharge, the scores of BSHS-A, physical function, psychological function, and general health status of 50 patients in the integrated intervention group were significantly higher than those of 48 patients in the conventional intervention group (t=2.886, 3.126, 2.416, 2.544, 2.033, 3.471, 2.588, 2.210, P<0.05 or P<0.01), while the scores of social function of patients in the two groups were close (t=1.570, 1.350, P>0.05).@*Conclusions@#Integrative treatment of patients with extremely severe burns by multidisciplinary comprehensive intervention can significantly alleviate the severity of burns, reduce the incidences of wound sepsis, lung infection, and catheter-related infection, shorten the length of stay in ICU and total length of hospital stay, and improve the quality of life.