ABSTRACT
The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.
Subject(s)
Humans , Consensus , Prone Position , Wakefulness , China , DyspneaABSTRACT
Objective:To summarize the best evidence of thirst management in ICU patients and provide evidence-based basis for dinical practice.Method:According to the "6S" evidence pyramid model, the literature on thirst management of ICU patients was systematically retrieved from relevant guidelines websites, evidence-based databases, association websites and original literature databases at home and abroad. The retrieval time was from the establishment of the database to June 31, 2022. Two researchers with evidence-based nursing training independently completed literature quality evaluation. To extract and summarize the evidence of the literature that meets the quality standard.Results:A total of 17 articles were included, including 8 randomized controlled trials, 5 quasi-experimental studies and 4 cross-sectional studies. The 18 pieces of best evidence were formed, including 5 aspects: basic requirements of thirst management, intervention evaluation, intervention methods, matters needing attention and health education.Conclusions:This study summarized the best evidence of thirst management in ICU patients. Nurses should translate and apply the best evidence in combination with the clinical situation and specific policies of the department to relieve the thirst symptoms of ICU patients.
ABSTRACT
Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.
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Objective:To visually analyze the general situation and development of pre-oxygenation research abroad, and provide a reference for further development of pre-oxygenation in China.Methods:Using the WOS core data set as the data source, CiteSpace V software was used to visually analyze the literature published from January 1, 2000 to November 29, 2019.Results:The number of papers has shown a rapid upward trend since 2013, the US has the most papers. Research hotspots mainly focus on tracheal intubation, intensive care unit, apnea oxidation, non-invasive ventilation and complications.Conclusion:The United States is in the leading position in the study of pre-oxygenation, and China is still in the initial stage in the study of pre-oxygenation. We should strengthen cooperation and exchange with developed countries such as Europe and America. The application of pre-oxygenation outside the operating room and the selection of pre oxygenation tools are the direction of further research.
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Objective:To analyze the current situation of fear, discharge preparation, family function and quality of life of breast cancer patients during chemotherapy, and to explore the influence of fear, discharge preparation and family function on their quality of life by constructing structural equation model.Methods:A total of 274 patients with breast cancer undergoing chemotherapy in Shanxi Cancer Hospital from January to July in 2019 were investigated with Quality of Life Instruments for Cancer Patients-Breast Cancer(QLICP-BR), Fear of Progression Questionnaire-Short Form(FoP-Q-SF), Readiness for Hospital Discharge Scale(RHDS) and Family APGAR Index(APGAR).Results:The total score of the quality of life was 137.78 ± 21.66, the total score of recurrence fear was 34.61±12.36, the total score of discharge preparation was 95.57±18.83, and the total score of family function was 7.53 ± 2.66. The structural model showed that fear, family function and discharge preparation had a direct predictive effect on quality of life, the direct effects were -0.468, 0.331 and 0.509, respectively ( P<0.01); fear had an indirect negative predictive effect on quality of life through the mediation of discharge readiness ( β value was -0.127, P<0.01), and family function had an indirect positive effect on quality of life through the mediation of discharge preparation. The predictive effect was ( β value was 0.124, P<0.01). Conclusions:Fear, discharge preparation and family function are important factors affecting the quality of life of breast cancer patients undergoing chemotherapy. Fear and family function can also indirectly affect the quality of life through discharge preparation.
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Objective:To study the feasibility of using bedside ultrasound in evaluating gastric residual volume in critical ill patients with enteral nutrition support.Methods:From May 2019 to August 2019, 60 patients were selected to receive enteral nutrition via gastric tube in ICU of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Patients were divided into the experimental group and the control group according to the odd and even number of beds, 30 patients in the experimental group with odd number of beds and 30 patients in the control group with even number of beds. Gastric residual volume was evaluated at 0, 4, 8, 12, 16, 20, 24 h of enteral nutrition. In the experimental group, the gastric residual volume was evaluated by bedside ultrasound and syringe suction at each time point. In the control group, only bedside ultrasound was used to evaluate gastric residual volume. The results of operation time, monitoring results at different time points, diarrhea and the utilization rate of gastrointestinal motility drugs target feeding time, vomiting, were compared between the two groups.Results:There was no statistical difference between the gastric residual amount monitored by ultrasound and the gastric residual amount monitored by suction ( P>0.05). The operating time of bedside ultrasound monitoring was (62.40 ± 4.00) s, the operating time of suction monitoring was (78.39 ± 12.15) s, and the operating time of bedside ultrasound monitoring was less than that of suction ( t value was 6.633, P<0.01). There was no significant difference in the rate of vomiting, diarrhea and gastrointestinal motility drugs between the two groups( P>0.05). The time to reach the target feeding amount in the control group was (3.04 ± 0.31) d, and the time to reach the target feeding amount in the experimental group was (4.19 ± 0.33) d. The time to reach the target feeding amount in the control group was less than that in the experimental group ( t value was 13.42, P<0.01). Conclusions:Bedside ultrasound can be used to evaluate the residual gastric volume of enteral nutrition support patients, guide the implementation of enteral nutrition, shorten the operation time, reduce the workload of nurses, and avoid the contamination of enteral nutrition preparation.