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Objective:To study the willingness of the medical staff of tertiary hospitals to be dispatched to work for a long time at the district hospitals under the " municipal trusteeship of district-ownership hospitals" mode, and explore the key factors that affect their long-term willingness, for references of optimizing the incentive system of the model.Methods:A questionnaire was designed as guided by the two-factor theory. In May 2019, a typical sample survey was made to investigate 103 medical staff of two tertiary hospitals in Beijing on their willingness to be dispatched to hospitals of district ownership. The survey covered such aspects as their basic personal information, hygiene factors(family responsibility, interpersonal connections expansion, mobilization and encouragement of leaders, etc.), and incentive factors(personal career development, greater potential giving play to their own talents, self-achievement, etc.). Descriptive analysis and univariate hypothesis testing were used to compare the differences of the dispatch willingness of staff of different characteristics. Meanwhile, an ordinal multinomial logistic regression model was built to analyze the influence factors of long-term dispatch willingness of these staff along with individual in-depth interviews.Results:The medical staff when they were dispatched to work at the entrusted hospitals for a long time, were concerned mostly with top six factors. These factors refered to a reasonable incentive(rewards)mechanism, family responsibility, colleague evaluation of the entrusted hospital, interpersonal connections expansion, personal career development, and potential unlocking. Those staff with dispatch experience had higher willingness to be dispatched than those without( P <0.05). The former saw higher of their personal career development resulting from the dispatch(3.91 points), while the latter saw higher their post-dispatch salary incentive mechanism(3.95 points). Compared with common medical staff, medium and high level management staff were more willing to be dispatched for a long time( H=14.536, P<0.001). Leadership mobilization in hygiene factors and personal career development in incentives factors were the key drivers for the long-term willingness of medical staff to be dispatched( P<0.05). Conclusions:The willingness of medical staff to be dispatched for a long time needs to be strengthened in the " municipal trusteeship of district-ownership hospitals" mode. Managers of the district-ownership hospitals should take into full consideration, the needs of different categories and levels of medical staff dispatched, guarantee the remuneration and performance pay of these staff, and enable their career track planning, hence mobilizing their incentives, and increase their willingness to work at such hospitals for a long time.
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Objective To investigate the current prevention status of hospital acquired venous thromboembolism(VTE) in Shandong province, to further improve the prevention and control of VTE system, and provide reference for prevention of hospital care to improve the quality of VTE. Methods An electronic questionnaire survey was conducted among nurses in 81 hospitals of Shandong province. The questionnaire mainly included three parts:basic information,the current prevention status of hospital acquired VTE and the training needs of nurses. A total of 3 766 valid questionnaires were recovered. Results 59.26%(48/81)hospitals established multi-discipinary team to prevent VTE,76.00%(38/50)of the tertiary hospitals established multi-discipinary team, which was higher than 32.26% (10/31) of the secondary hospitals, the difference was statistically significant (χ2=15.166, P=0.000). The VTE risk assessment scale had been routinely used to assess the risk of VTE in hospitalized patients,80.37%(352/438) tertiary hospital departments implemented grading nursing care while 71.43%(175/245) secondary hospitals departments implemented grading nursing care, the difference was statistically significant(χ2=7.120, P=0.008). Each level hospital mechanical preventive equipment configuration rate was less than 70%.Training needs of nurses:92.11%(3 469/3 766)nurses believed that it was necessary to organize the VTE related knowledge training for nurses,but there were significant differences in the training of nurses with different professional titles (Z=-12.607, P=0.000). 48.04%(1 149/2 392) nurses with junior grade professional titles were not trained. Conclusions The hospital attaches great importance to the prevention of hospital acquired VTE,but the construction level of VTE prevention system is unevenness, and primary hospitals should be further reinforced. The risk assessment scale selection lacks of uniform standards, mechanical preventive equipment allocation rate should to be further improved. And the training of primary nurses should be further strengthened.
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@#Objective To analyze the correlation of family function with parenting self-efficacy (PSE) in autism spectrum disorder (ASD) family. Methods Cohort study was carried out. From August, 2015 to February, 2016, caregivers of ASD children (n=142) and healthy children (n=131) were enrolled into investigation group (n=173) and control group (n=131). They were assessed with Family Assessment Device (FAD) and Tool to Measure Parenting Self-efficacy (TOPSE). Results There were significant differences in the scores of FAD and TOPSE between two groups (P<0.05). The scores of FAD were lower in the high income, urban ASD families than in the low income, rural ASD families (P<0.05). The scores of FAD negatively correlated with the scores of TOPSE in the ASD families (r=-0.152 to -0.257, P<0.05). Conclusion The family function and level of PSE of the ASD families was obviously inferior to the healthy families, and the worse the family function is, the lower the level of PSE will be. Individualized and family-centered intervention strategies should be developed to provide a good family environment for the rehabilitation of children with ASD.
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Objective To develop the knowledge-attitude-practice scale for evaluating intra-abdominal pressure measurement in ICU nurses and assess its reliability and validity preliminary. Methods Applied the methods of literature review and Delphi expert consultation to form the knowledge-attitude-practice scale for evaluating intra-abdominal pressure measurement in ICU nurses on the basis of the knowledge-attitude-practice framework. A total of 165 nurses from ICU department were finally involved. Items analysis, exploratory factor analysis, content validity, internal consistency test and split-half reliability were used to evaluate the scale. Results Factor analysis revealed five factors (23 items), accounting for 52.5%of the total variance. The Cronbach αcoefficient was 0.869 for the total scale and 0.612, 0.749 and 0.848 for the subscales of knowledge, attitude and practice. The split-half coefficient was 0.784. Conclusions The knowledge-attitude-practice scale has good reliability and validity, and can be used to assess the intra-abdominal pressure measurement in ICU nurses.
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Objective To evaluate the nursing effect of warming feeding formulation of the enteral nutrition associated diarrhea in the critically ill tube-fed patients. Methods A total of 60 patients with enteral feeding were enrolled and divided randomly into the warming group and the room temperature group with 30 cases in each group by random digits table method. The room temperature group received room temperature oral feeding by nutrition pump. The warming group used nutrition pump and heating rod was placed on the nutritional tube 50 cm far from patient's nose. A semi-quantitative scale based on stool volume and consistency was used for daily assessment of diarrhea. Results Patients were tube-fed for a mean duration of (11.20±2.98) and (10.93±2.69) days, respectively in the room temperature group and the warming group. There was no significant difference in these two groups (U=425.000, P > 0.05). The diarrhea score was 4.88 ±3.41 in the room temperature group and 5.51±4.44 in the warming group. There was no significant difference in these two groups (U=436.500, P > 0.05). The diarrhea per total feeding days was 10.42%(35/336) in the room temperature group and 16.24%(51/314)in the warming group. There was no significant difference in these two groups (χ2=4.862, P < 0.05). Conclusions The airtight enteral nutrition does not need warming when it is infused with the enteral nutrition pump at room temperature.
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Objective To investigate the effect of different reference transducer positions measurement on intra-abdominal pressure (IAP) in ICU patients. Methods 31 cases of patients in ICU in need of measuring IAP were studied from January 2015 to July 2015 in this study. In each patient, transvesical and the direct methods were both used to measure IAP. Three sets of IAP measurements were obtained in the supine position, using the different reference levels and kept as IAPpubis, IAPmidax, IAPphlebostatic. The results were compared using Spearman rank correlation,paired t test and Bland–Altman statistics. Results When symphysis pubis was uesd, the result of direct method was (9.82±4.01) mmHg, the result of indirect method was (8.77 ± 4.48)mmHg (P<0.05), the correction between two methods was 0.967, P<0.05. When midaxillary level was uesd to measure, the result of direct method was (11.74 ± 4.71) mmHg, the result of indirect method was (11.65 ± 4.63)mmHg, the correction between two methods was 0.972, P=0.10. When phlebostatic was uesd, the result of direct method was (10.98 ± 4.65) mmHg, the result of indirect method was (10.38 ± 4.75)mmHg, the correction between two methods was 0.970, P<0.05. The calculated bias between IAPmidax and IAPpubis was 2.9 mmHg, 95%agreement of limits was (-0.8-6.5) mmHg, and the maximum difference value was 11 mmHg. The calculated bias between IAPmidax and IAPphlebostatic was1.3 mmHg, 95%agreement of limits was-1.4-4.0 mmHg, and the maximum difference value was 4.2 mmHg. Conclusion In supine position, the value obtained via the bladder can reflect the true IAP, and the symphysis pubis or phlebostatic axis reference lines are not interchangeable with the midaxillary level.