Application of arm circumference to nutritional risk screening among cancer patients / 预防医学

Objective@#To examine the application of arm circumference to evaluating the nutritional risk among cancer patients, so as to provide insights into nutritional risk screening among cancer patients.@*Methods@#Totally 332 cancer patients hospitalized in the Department of Oncology of The First Affiliated Hospital of Guangxi Medical University from September 2020 to March 2021 were selected as the study subjects. Subjects'demographic data and disease history were collected, and the height, body weight, arm circumference and serum nutritional indicators were measured. The indicators related to nutritional risk were identified by logistic regression models. The value of arm circumference in assessment of nutritional risk was examined among cancer patients using the receiver operating characteristic ( ROC ) curve analysis, and the Nutritional Risk Screening ( NRS 2002 ) scores were used as the gold standard.@*Results@#The subjects included 188 males ( 56.63% ) and 144 females ( 43.37% ), and had a mean age of ( 51.62±12.31 ) years. The detection rate of nutritional risk was 36.75% among the subjects according to NRS 2002, with 29.78% in males and 45.83% in females. Multivariable logistic regression analysis identified arm circumference as an independent factor affecting the nutritional risk among cancer patients ( P<0.05 ). The area under the ROC curve, cut-off, sensitivity and specificity of arm circumference in predicting nutritional risk were 0.857 ( 95%CI: 0.795-0.918, P<0.001 ), 24.4 cm, 83.3% and 78.6% among male cancer patients, and 0.727 ( 95%CI: 0.643-0.810, P<0.001 ), 23.9 cm, 78.2% and 57.6% among female cancer patients, respectively.@*Conclusions@#Arm circumference is feasible for screening nutritional risk among cancer patients. The cut-off value of nutritional risk was determined by arm circumference less than 24.4 cm in men and less than 23.9 cm in women with good accuracy.

Investigation report on nursing knowledge and attitude of patients with dysphagia in stroke in Nanning neurology nurses / 中国实用护理杂志

Objective@#To investigate the management knowledge and attitudes of dysphagia in stroke patients in Nanning neurology nurses, and to provide evidence for clinical knowledge training and improvement of clinical nursing quality.@*Methods@#A total of 360 neurology nurses from 7 different levels of hospitals in Nanning were investigated for knowledge and attitudes about stroke dysphagia management.@*Results@#The average score of management knowledge of neurological nurses was 54.52±15.51, and the average score of attitude was 45.12±3.90. There was significant difference in the knowledge score of nurses from different hospital level, ages and titles (t=-1.007, P=0.035; F=3.994, P=0.009; F=0.347, P=0.002). There was significant difference in the attitudes score of nurses from different ages and titles (t=7.435, P=0.007); 61.1% (220/360) of nurses did not learn stroke management guidelines for dysphagia; 60%(216/360) of nurses administered dysphagia were based on their own experience, 73.9%(266/360) of nurses believe that the reason for hindering their own swallowing management is the lack of relevant knowledge and skills.@*Conclusions@#Neurology nurses have a positive attitude towards stroke management of dysphagia, but lack of knowledge. Nurses with low age, low professional title and low working years have poor knowledge of management of stroke dysphagia. Nursing managers should carry out targeted training for nurses, provide more education and training opportunities to improve the knowledge and service quality of nurses with dysphagia.

Prevention and management practice of incontinence dermatitis based on index management / 中国实用护理杂志

Objective@#To improve the effectiveness of incontinence-associated dermatitis (IAD) prevention and management by establishment skin care quality indicators and controlling the implementation process of incontinence care.@*Methods@#The implementation rate of nursing measures (the treatment rate of incontinence, the effective collection of fecal implementation rate, and the rate of skin protection implementation) were used as the process indicators, and the incidence of IAD was used as the outcome indicators. 2747 incontinence patients from July to December 2016 before the implementation of the process control were used as the control group, and 3, 069 incontinence patients from July to December 2017 after the implementation of the process control were used as observation groups. Comparing the difference between the two groups of process indicators and outcome indicators.@*Results@#The control group's implementation rate of incontinence, effective collection of fecal implementation rate, and skin protection implementation rate were 54.2%, 63.8%, and 27.7%, respectively. The observation group was 91.8%, 94.8%, and 92.8%, respectively. The difference between the two groups was statistically significant. (χ2=5.032, P=0.025; χ2=6.574, P=0.010; χ2=20.038, P=0.000;). The incidence of IAD in the control group was 28.9%, and the incidence in the observation group was 11.2%. The difference between the two groups was statistically significant (χ2=288.402, P=0.000).@*Conclusion@#The establishment of incontinence nursing quality indicators and the implementation of process control will help improve the level of incontinence care and reduce the incidence of IAD.

Investigation report on nursing knowledge and attitude of patients with dysphagia in stroke in Nanning neurology nurses / 中国实用护理杂志

Objective To investigate the management knowledge and attitudes of dysphagia in stroke patients in Nanning neurology nurses, and to provide evidence for clinical knowledge training and improvement of clinical nursing quality. Methods A total of 360 neurology nurses from 7 different levels of hospitals in Nanning were investigated for knowledge and attitudes about stroke dysphagia management. Results The average score of management knowledge of neurological nurses was 54.52±15.51, and the average score of attitude was 45.12 ± 3.90. There was significant difference in the knowledge score of nurses from different hospital level, ages and titles (t=-1.007, P=0.035; F=3.994, P=0.009; F=0.347, P=0.002). There was significant difference in the attitudes score of nurses from different ages and titles (t=7.435, P=0.007); 61.1% (220/360) of nurses did not learn stroke management guidelines for dysphagia;60%(216/360) of nurses administered dysphagia were based on their own experience, 73.9%(266/360) of nurses believe that the reason for hindering their own swallowing management is the lack of relevant knowledge and skills. Conclusions Neurology nurses have a positive attitude towards stroke management of dysphagia, but lack of knowledge. Nurses with low age, low professional title and low working years have poor knowledge of management of stroke dysphagia. Nursing managers should carry out targeted training for nurses, provide more education and training opportunities to improve the knowledge and service quality of nurses with dysphagia.

Prevention and management practice of incontinence dermatitis based on index management / 中国实用护理杂志

Objective To improve the effectiveness of incontinence-associated dermatitis (IAD) prevention and management by establishment skin care quality indicators and controlling the implementation process of incontinence care. Methods The implementation rate of nursing measures (the treatment rate of incontinence, the effective collection of fecal implementation rate, and the rate of skin protection implementation) were used as the process indicators , and the incidence of IAD was used as the outcome indicators. 2747 incontinence patients from July to December 2016 before the implementation of the process control were used as the control group, and 3, 069 incontinence patients from July to December 2017 after the implementation of the process control were used as observation groups. Comparing the difference between the two groups of process indicators and outcome indicators. Results The control group's implementation rate of incontinence, effective collection of fecal implementation rate, and skin protection implementation rate were 54.2% , 63.8% , and 27.7% , respectively. The observation group was 91.8%, 94.8%, and 92.8%, respectively. The difference between the two groups was statistically significant. (χ2=5.032, P=0.025; χ2=6.574, P=0.010; χ2=20.038, P=0.000;). The incidence of IAD in the control group was 28.9%, and the incidence in the observation group was 11.2% . The difference between the two groups was statistically significant (χ2=288.402, P=0.000). Conclusion The establishment of incontinence nursing quality indicators and the implementation of process control will help improve the level of incontinence care and reduce the incidence of IAD.

Unmet needs in health training among nurses in rural Chinese township health centers: a cross-sectional hospital-based study / 보건의료교육평가

PURPOSE: Maintaining a sufficient and competent rural nursing workforce is an important goal of the Chinese health delivery system. However, few studies have investigated the health training status or conducted a needs assessment of rural Chinese nurses during this time of great transformations in health policy. This study was conducted to explore the current health training status of nurses working in rural Chinese township health centers (THCs) and to ascertain their perceived needs. METHODS: A cross-sectional survey using a self-administered structured questionnaire was conducted among 240 THC nurses in Guangxi Zhuang Autonomous Region, China from March 2014 to August 2014. The survey questionnaire was adapted from the Second Chinese Survey of Demographic Data and Training Demand for Health Professionals in THCs developed by the Ministry of Education. RESULTS: The nurses in THCs were young, with a low educational level. Their perceived needs for health training included further clinical studies at city-level hospitals to improve their skills and theoretical studies at medical universities in emergency medicine and general practice. Overall, 71.9% of the nurses with a secondary technical school background expected to pursue junior college studies, and 68.5% of the nurses with a junior college education expected to pursue a bachelor's degree. A decentralized program with theoretical studies at medical universities and practical studies at county hospitals was regarded as feasible by 66.9% of the respondents. CONCLUSION: Health-training programs for nurses in Chinese THCs must be improved in terms of coverage, delivery mode, and content. A decentralized degree-linked training program in which medical universities and city hospitals collaborate would be an appropriate mode of delivery.

Medical adhesive-related skin injury associated factors at PICC insertion site in patients with hematologic malignancies / 中国实用护理杂志

Objective To measure the prevalence and analyzed associated factors of medical adhesive-related skin injuries (MARSI) at PICC insertion site in patients with hematologic malignancies. Methods A cross- sectional observational study lasting two weeks was carried out in Department of Hematology. Skin assessment data and photographs of skin were collected during PICC maintenances by the same investigator. The related information was got out from the medical record. The observed skin injuries were classified by the dermatologist and PICC specialized nurse together. MARSI prevalence was calculated. The associated factors were analyzed statistically. Results All of the 153 patients with hematologic malignancies were included. The prevalence of total MARSI at PICC insertion site was 33.99%(52/153), including mechanical skin injury (22.87%,35/153), contact dermatitis (CD) ( 9.80%,15/153), moisture-associated skin damage (0.65%,1/153), folliculitis(0.65%,1/153), respectively. Multivariate analysis identified two independent risk factors for mechanical skin injury including age≥50 years old, P=0.016, odds ratio (OR)=5.919, 95%CI 1.389-25.220 and non-specialist nurses in PICC maintenance, P=0.013, OR=8.333,95%CI 1.566-44.360. History of skin allergies (P=0.000,OR=12.333,95%CI 3.669-41.454) and arsenic trioxide infusion through PICC(P=0.003,OR=4.565,95%CI 1.661-12.547) were associated with CD. Conclusions MARSI at PICC insertion site is a prevalent event in the patients with hematologic malignancies. Epidemiological data and independent risk factors are presented in our study, which provide a basis for future study in this area.

Peripherally inserted central catheter site with skin injury：progress of management and research / 中国实用护理杂志

Peripherally inserted central catheter (PICC) has become internationally widespread in various healthcare settings (hospital, clinics ,homecare, et al), mainly used for administration of chemotherapy drugs, hypertonic parenteral nutrition solution and infusion therapy in two extreme age patients (neonates, especially in premature infants;elderly), which provides necessary vascular access for medium to longer term transfusion therapy. The risks of complications related with PICC are still existed, and PICC site with impaired skin integrity is prevalent, but described by only paucity of literature. International evidence-based guidelines provide little strategy. Our study was to review PICC site with skin injury in order to better understand the etiology, evolution and familiar with the international nursing dynamics, and identify directions for future research in this field, promote to overcome the nursing conundrum, and provide a basis for construction of guidelines for the skin management of PICC.

Marking on intravenous infusion stand to increase the accuracy of head-of-bed elevation for lung cancer patients after surgery cancer patients after surgery / 中国实用护理杂志

Objective To evaluate the accuracy of head-of-bed elevation in postoperative lung cancer patients, in order to identify the compliance of patients and nurses, and to decrease the postoperative complications and restore rehabilitation. Methods 300 postoperative lung cancer patients were divided into two groups (150 patients in experimental group and 150 patients in control group) by random digital table method. The head of the beds were elevated according to the marking sign on the intravenous infusion stand in experimental group, whereas in control group nurses elevating the bed to the height that patients felt comfortable. The compliance of patients and nurses, the indwelling time of thoracic drainage tube, postoperative complication, and the length of hospital stay were recorded and analyzed. Results The compliance of nurses and patients in the experimental group were 98.7% (148/150) and 95.3% (143/150), respectively, compared to 93.3% (140/150) and 87.3% (131/150) in the control group (X2=5.56, 6.06, P<0.05). Significant difference was found in indwelling time of thoracic drainage tube between the experimental group [(96.0±27.8) h] and the control group [(103.1±24.1) h] . The length of hospital stay in experimental group was (7.9±2.1) d, compared with (8.4±2.2) d in control group (t=-2.45,-1.99, P<0.05). There was significant difference in postoperative complications between experimental group [12.0% (18/150)] and control group [20.7% (31/150)]( X2=4.12,P<0.05). Conclusions Evaluating the head of the bed accurately by the marking sign on intravenous infusion stand stand can promote the postoperative care outcome of lung cancer patients, decrease the postoperative complications and restore rehabilitation.

"Survey of the nursing ethics cognition status after carrying out the ""High quality nursing service demonstration project"" in Guangxi Zhuang Autonomous Region" / 中国实用护理杂志

Objective We aimed to investigate the nurses' ethics cognition status and its influencing factors after carrying out the High quality nursing service demonstration project in Guangxi Zhuang Autonomous Region.Methods From May to June 2014,379 clinical nurses from 59 hospitals of different grades in Guangxi Zhuang Autonomous Region were investigated with the self-designed questionnaire.Results After carrying out the High quality nursing service demonstration project,the total score of the nurses' ethics cognition were (51.29±3.46),which was higher than those in 2010.There was no statistical difference in cognition of medical confidentiality between 2014 and 2010,but it showed significant statistical differences in dimensions of medical optimization,informed consent,the value of life,t value was 11.389,7.448 and 2.126,P ＜0.05.The multiple linear regression analysis showed that nurse-job seniority and hospital hierarchy of clinical nurses were influencing factors of nurses' ethics cognition; educational levels,professional title and nurse-job seniority of clinical nurses were influencing factors of medical optimization; nurses' professional title was influencing factor of informed consent; nurse-job seniority,department and hospital hierarchy of clinical nurses were influencing factors of medical confidentiality; nurses' educational level was influencing factor of life value.Conclusions The High quality nursing service demonstration project contributes to improve the level of nurses' ethics cognition.We should strengthen the nursing ethics continuing education system,in order to improve the nurses' comprehensive ethics cognition.

Research in intermittent urethral catheterization combined with audio frequency electrotherapy and microwave therapy in the treatment of patients with spastic bladder after spinal cord injury / 中国实用护理杂志

Objective To discuss methods for recovery of bladder function and autonomous urination for patients with spastic bladder after spinal cord injury. Methods Patients in the experimental group(30 cases)received intermittent urethral catheterization 6 times per day,audio frequency electrotherapy and microwave therapy 2 times per day.The control group(30 cases)adopted routine urethral catheterization.The recovery of bladder function of the two groups Was observed.Results The rate of autonomous urination in the experimental group was higher than that of the control group(P＜0.01).Increase of bladder capacity and decrease of remnant urine volume in the experimental group was better than that of the control group(P＜0.05).Conclusions Intermittent urethral catheterization combined with audio frequency electrotherapy and microwave therapy could effectively promote the recovery of bladder function for patients with spastic bladder after spinal cord injury.

Construction of a harmonious nurse-patient relationship by evidence-based nursing / 中华医学教育探索杂志

This article aims to change the thought of nursing,explore the new ways of holistic nursing,strengthen the health education and carry on the study of the evidence-based medicine and the research into the evidence-based medicine. It also aims to enrich the evidences of evidence-based medicine in order to put the evidence-based medicine and nursing into the daily nursing practice and improve the nursing quality as well as reduce the nursing mistakes and nurse-patient disputes.