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Objective:To construct a standardized training program for full-time nursing postgraduate students, and to provide a basis for the training the high-quality nursing talents in hospitals.Methods:Through literature review and demi structured interview, preliminarily develop the training program was established from January to March 2021. Through two rounds of expert consultations of 16 experts, the standardized training program for nursing postgraduates was formulated.Results:The recovery rate of the two rounds were both 16/16. The expert authority coefficients of the two rounds of consultation were 0.819, respectively. The Kendall′s coordination coefficients of the two rounds of consultation were 0.329 and 0.334, respectively, and the difference was statistically significant ( P< 0.01). Finally, a standardized training program for entry-level nursing postgraduates was formed, which included five parts: training objects and quality requirements, training methods, training objectives, training contents and evaluation, with a total of 225 items. Conclusions:The standardized training program for nursing postgraduates formed is reliable, scientific and practical, which provides guidance and reference for the training and use of highly educated clinical nursing talents in hospitals.
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Objective:To analyze failure mode and effect analysis (FMEA) management model on the risk and satisfaction of PICC catheterization in children with leukemia undergoing chemotherapy.Methods:Totally 100 children with PICC catheterized leukemia were admitted to our hospital from June 2015 to December 2018, and their FMEA were managed. Find out the possible failure content and potential risk factors during PICC tube placement operation and maintenance, and calculate the risk value (RPN) according to the formula. Based on RPN values, specific prevention and treatment strategies were formulated and follow-up observation was monitored.Results:After the failure mode and effect analysis, the RPN scores of misevaluation, nonstandard operation, uncooperative children and insufficient preparation for use were (619.5 ± 11.7), (859.3 ± 18.7), (248.6 ± 20.6), (597.4 ± 8.4) points respectively, while those before the intervention were (1 347.5 ± 27.8), (1 127.4 ± 34.7), (427.3 ± 41.9) points, the difference was statistically significant ( t values were 9.563-14.279, P < 0.05). After the failure mode and effect analysis, the RPN scores of drug factor, child factor, ineffective sealing, infusion interruption, inadequate propaganda and maintenance were (598.4 ± 17.4), (537.2 ± 12.1), (407.3 ± 12.1), (178.4 ± 12.1), (8.4 ± 12.1) points, respectively. Before the intervention, the scores were (986.4 ± 30.7), (685.7 ± 17.8), (527.4 ± 23.6), (359.2 ± 29.4) and (148.3 ± 26.5) points, respectively. The differences were statistically significant ( t values were 11.092-19.634, P < 0.05). Conclusion:Failure mode and effect analysis applied to children with leukemia PICC pipeline placement and maintenance can improve the effectiveness of pipeline management and reduce the occurrence of pipeline maintenance risk events.
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Spinal cord stimulation (SCS) is a promising technique for treating disorders of consciousness (DOCs). However, differences in the spatio-temporal responsiveness of the brain under varied SCS parameters remain unclear. In this pilot study, functional near-infrared spectroscopy was used to measure the hemodynamic responses of 10 DOC patients to different SCS frequencies (5 Hz, 10 Hz, 50 Hz, 70 Hz, and 100 Hz). In the prefrontal cortex, a key area in consciousness circuits, we found significantly increased hemodynamic responses at 70 Hz and 100 Hz, and significantly different hemodynamic responses between 50 Hz and 70 Hz/100 Hz. In addition, the functional connectivity between prefrontal and occipital areas was significantly improved with SCS at 70 Hz. These results demonstrated that SCS modulates the hemodynamic responses and long-range connectivity in a frequency-specific manner (with 70 Hz apparently better), perhaps by improving the cerebral blood volume and information transmission through the reticular formation-thalamus-cortex pathway.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Brain , Consciousness , Physiology , Consciousness Disorders , Therapeutics , Hemodynamics , Physiology , Pilot Projects , Spinal Cord , General Surgery , Spinal Cord Stimulation , MethodsABSTRACT
Objective To reduce the incidence of peritoneal dialysis related peritonitis for patients in rural area and to improve management quality of peritoneal dialysis center.Methods We established multidisciplinary collaborative research group involving departments of nephrology,nutrition,infection,and quality control.Risk factors of peritoneal dialysis related peritonitis in rural patients were analyzed,and prevention measures were designed.The rate of peritoneal dialysis related peritonitis in 89 patients after implementation was analyzed.Results The rate of peritoneal dialysis related peritonitis was decreased from 43 patient·month per time to 67 patient ·month per time.Conclusion The compound pathway can effectively reduce the rate of peritonitis,improve patient satisfaction,and prolong dialysis age.
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Objective To systematically analyze and assess the risk of venous thromboembolism in the patients with rheuma‐toid arthritis(RA) .Methods The related literatures on the venous thromboembolism occurrence in the patients with RA published at home and abroad were performed the electronic retrieval .The obtained data were analyzed by adopting the RevMan5 .1 software . The data unable to merge were analyzed by adopting the descriptive analysis method .Results A total of 10 related papers were in‐cluded .The 3 indicators of venous thromboembolism occurrence rate ,deep vein thrombosis occurrence rate and pulmonary thrombo‐embolism occurrence rate were performed the meta analysis .The RR and 95% CI of the occurrence rates of venous thromboembo‐lism ,deep vein thrombosis and pulmonary thromboembolism were 2 .00(1 .71 ,2 .33) ,2 .31(1 .84 ,2 .90) ,2 .25(2 .23 ,2 .28) respec‐tively .Conclusion The risk degree of venous thromboembolism occurrence in the RA patients is higher than that in the non‐RA pa‐tients .
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Objective To investigate the occupational musculoskeletal injury of nurses in a thirdgrade and A-level general hospital in Zhengzhou,and analyze the relationship between occupational musculoskeletal injury and presenteeism.Methods 460 nurses were surveyed with questionnaires by convenience sampling,including nurses' demographic data,Nordic Standardized Questionnaires and Work Limitations Questionnaire.Results The annual incidence rate of OMSI in nursing staff was 82.38％.The parts of body which had high annual incidence rate of nurses' OMSI were lower back,neck and shoulder.The rates of presenteeism for no OMSI,one part OMSI and two or more parts OMSI were 35.14％,52.60％ and 59.68％.The scores of work efficiency decrease were (2.02±1.26),(4.67±2.53),(7.31±3.42).Conclusions Nurses' occupational musculoskeletal injury can result in presenteeism.The more serious occupational musculoskeletal injury is,the higher incidence rate of presenteeism,the more critical the presenteeism is.
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Objective To evaluate anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol in patients undergoing short surgery. Methods Fifty ASA Ⅰ or Ⅱ patients who scheduled for elective surgery under general anesthesia were enrolled in study. The anesthesia was induced with intravenous injection of midazolam 0.03 mg/kg and sevoflurane inhalation. Induction of anesthesia was started with 6% sevoflurane and fresh gas flow rate of 6 L/min. The inspired concentration of sevoflurane was reduced to 2% as soon as eyelash reflexes of these patients were abolished. At the same time, remifentanil 2 μg/kg was injected slowly over 1 min,and 30 s later,patients were mechanically ventilated after tracheal intubation. 2% sevoflurane was kept inhaling, and remifentanil and propofol were kept pumping for anesthesia maintenance. The mean arterial pressure (MAP), heart rate, pulse oxygen saturation (SpO_2) and bispectral index (BIS)were recorded before administration,at the time of the disappearance of eyelash reflex, immediately before tracheal intubation,and immediately after tracheal intubation. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was also recorded. And conscious recovery, spontaneous breathing recovery,the endotracheal extubafion time and OAAS score were recorded. Results All patients were successfully intubated at the first attempt. The satisfactory intubation conditions were found in 82% (41/50) of cases. The time period from sevoflurane inhalation to the disappearance of eyelash reflex was (73 ± 12) s. MAP,heart rate and SpO_2 remained stable and BIS was maintained at 45-55 before and after tracheal intubation, and all patients were quick recovery. Conclusion The anesthesia efficacy of sevoflurane combined midazolam and remifentanil and propofol without muscle relaxant in patients undergoing short surgery is smooth, safe and reliable.
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Objective To evaluate the efficacy of transarterial embolization(TAE) for intraperitoneal hemorrhage due to spontaneous rupture in hepato-cellular carcinoma(HCC).Methods 50 cases with ruptured HCC were divided into 4 groups according to the type of their previous treatment:group A,TAE followed by elective hepatectomy 12;Group B,TAE alone 12;Group C,emergency operation 13;Group D,medical conservative management.Results Celiac arterio-graphy done before the present treatment showed extravasation of contrast material in 6(25%) of the 24 patients in group A and B,and hypervascular tumor was observed in the rest.The hemostasis success rate of group A,B and C were 100%,which were much higher than that of group D(40%)(P
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Objective To find out about patients needs, better deliver patient oriented care, and enhance patients satisfaction towards the service. Methods An investigation by questionnaire was made into 552 randomly selected outpatients with regard to the factors influencing patients selection of hospitals when seeking medical service and the needs of outpatients when waiting to see the doctors. Results Among the major factors influencing patients selection of hospitals when seeking medical service are the medical expertise of doctors and patients confidence in them. Spread of knowledge about health, constant notice to patients waiting of how things are going, introduction to specialists, and provision of signs indicating the service process are areas of service that patients waiting to see the doctors hope to get or see improved. Conclusion Enhancing the medical expertise and the overall quality of the medical staff, intensifying the awareness of quality service and standardizing medical behavior are among the major steps that hospitals can take to deliver patient oriented service.