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The authors introduced the practice of shared governance in ICU nursing management. According to the standard of magnetic hospital, a shared governance committee was established to guide and motivate the clinical front-line nurses in ICU to participate in nursing affairs management and decision-making. After three years of practice, ICU nursing management mode has achieved the goal of participating in shared governance, enhancing nurses′ perception of patient safety culture and improving the level of work engagement.
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Regular assessment is a key to early detect and treat delirium. However, studies showed poor compliance and accuracy of delirium assessment by nurses. Moreover, delirium was characterized by acute onset and fluctuation of cognition. Therefore, delirium was frequently unrecognized. Postoperative delirium incidence in the intensive care unit was high and associated with poor outcome. Studies demonstrate delirium was preventable. Delirium prediction models were warranted to identify high-risk critically ill patients in order to apply preventive strategies. This article was to provide an overview of postoperative delirium and review postoperative delirium prediction models for surgical patients in the intensive care unit, thereby providing reference for development, validation as well as application of models in China.
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Objective:To explore the clinical application of a new type of medical drainage device designed to measure the intra-abdominal pressure of ICU patients.Methods:The 65 patients with severe acute pancreatitis treated in our hospital from April to September 2018 were selected as the experimental group; the 54 patients with severe acute pancreatitis treated from October 2017 to March 2018 were selected as the control group. Patients in the control group used traditional drainage bags to measure intra-abdominal pressure, while patients in the experimental group used a new-designed medical drainage device to measure intra-abdominal pressure. Compare the cost of consumables used for the first time in the experimental group with the control group, the incidence of acupuncture injuries, the incidence of urethral leakage, the incidence of rupture of the catheter balloon, and the satisfaction of the nurses. The 32 patients admitted from January to March 2018 in the control group were measured again using a new drainage device after the abdominal pressure measurement operation was stopped in order to compare the accuracy of the two methods.Results:The per capita consumable cost of the experimental group was 5.71 yuan, 0 cases of needle stick injury, 0 case of catheter leakage, which were lower than the control group (22.36 yuan, 1 case, 7 cases), the difference was significant ( P<0.05). The nurse operation satisfaction score was 13.85±0.93, which was higher than the control group (10.00±1.05). The difference was statistically significant ( t value was -20.323, P<0.05). Conclusion:In the operation of intra-abdominal pressure measurement, the use of a new type of medical drainage device can ensure the accuracy of the measurement, reduce the cost of consumables, needle stick injuries and the incidence of urinary catheter leakage, and improve nurse operation satisfaction.
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0bjective To translate and revise the Assessment of Interprofessional Team Collaboration Scale (AITCS) into Chinese, then to evaluate the reliability and validity of the Chinese version of AITCS. Methods The Chinese version of AITCS was translated from the original one, back-translated and adjusted for cultural adaptation. The reliability and validity were tested among 288 nurses, 81 physicians, 25 respiratory therapists, 10 physical therapists and 3 nutritionists from a tertiary hospital in Hangzhou using convenience sampling. Results The average of scale-level content validity index was 0.98, unanimity of scale-level content validity index was 0.84 and item-level content validity index was 0.89-1.00. Exploratory factor analysis extracted three common factors,which explained 61.427% of the total variance,and each item had high factor loading quality (>0.4). The correlations coefficients between each dimension score and the total score ranged from 0.801 to 0.898 (P<0.05),and the correlations coefficients between each dimension score ranged from 0.607 to 0.698 (P<0.05). The Cronbach α of AITCS was 0.909, split-half reliability was 0.835 and test-retest reliability was 0.763. Conclusion The Chinese version of the AITCS has been proved to be reliable and valid. It is a valuable tool for evaluating interprofessional team collaboration among the health professional providers in mainland China.
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Objective@#To evaluate the effects on reduction of peripherally inserted central catheter-related venous thrombosis by hand grip exercise.@*Methods@#A detailed search was performed to identify literature about the impact of handgrip exercise on peripherally inserted central catheter-related venous thrombosis, using the Cochrane Library and the databases of PubMed, CINAHL, Embase, CNKI, WanFang and CBM. The meta-analysis or descriptive review were performed after two authors in-dependently searching databases,extracting data and assessing quality of included studies.@*Results@#Seven RCTs were included in a total of 789 patients. Meta-analysis showed the effectiveness of handgrip exercise on reduction of peripherally inserted central catheter-related venous thrombosis (RR=0.27, 95% CI 0.17-0.42, P<0.01); and improving vein maximum velocity (WMD=6.53, 95%CI 3.34-9.73, P<0.01) and time-mean flow velocity (WMD=6.05, 95%CI 3.24-8.87, P<0.01).@*Conclusions@#Handgrip exercise can improve axillary vein blood flow parameters and reduce peripherally inserted central catheter-related venous thrombosis. Due to a small number of included studies and heterogeneity of indicators, multi-centered, high-quality RCTs with large sample size are needed in the future to assess the effect of handgrip exercise in PICC patients.
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Objective@#To investigate the effect of an information module for delirium assessment in ICU.@*Methods@#The information module for delirium assessment was designed according to the route chart of the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU) information assessment. Totally 70 nurses Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were included in the application of the information module. The compliance and accuracy of the delirium assessment and acceptance of nurses' assessment of information module were compared.@*Results@#The information module for delirium assessment was implanted into the clinical critical information system. The rate of compliance and accuracy of delirium assessed was 55.9%(2 728/4 877), 64.2%(231/360) before the application of information module, and 92.0%(4 360/4 740), 92.5%(333/360) after the application of information module. The difference between two groups were statistically significant (χ2=1 611.531, 85.139, P<0.01). The score of nurses′ acceptance of the input method before and after the application of information module were 69.00±4.00, 100.56±3.50, and the difference were statistically significant (t=-49.70, P<0.01).@*Conclusions@#The information module for delirium assessment can simplify the assessment process, improve nurses′ compliance and accuracy to assess delirium, optimize critical care management and worth spreading.
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Objective To evaluate the effects on reduction of peripherally inserted central catheter-related venous thrombosis by hand grip exercise. Methods A detailed search was performed to identify literature about the impact of handgrip exercise on peripherally inserted central catheter-related venous thrombosis, using the Cochrane Library and the databases of PubMed, CINAHL, Embase, CNKI, WanFang and CBM. The meta-analysis or descriptive review were performed after two authors in-dependently searching databases,extracting data and assessing quality of included studies. Results Seven RCTs were included in a total of 789 patients. Meta-analysis showed the effectiveness of handgrip exercise on reduction of peripherally inserted central catheter-related venous thrombosis ( RR=0.27, 95% CI 0.17-0.42, P＜0.01); and improving vein maximum velocity ( WMD=6.53, 95% CI 3.34-9.73, P＜0.01) and time-mean flow velocity ( WMD=6.05, 95% CI 3.24-8.87, P＜0.01). Conclusions Handgrip exercise can improve axillary vein blood flow parameters and reduce peripherally inserted central catheter-related venous thrombosis. Due to a small number of included studies and heterogeneity of indicators,multi-centered,high-quality RCTs with large sample size are needed in the future to assess the effect of handgrip exercise in PICC patients.
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For ICU patients, a structured dental assessment and recording system can effectively prevent adverse nursing events caused by tooth loss, and eliminate the potential risk of patients' safety. In addition, the structured recording system can effectively speed up nursing document input, facilitate compliance and acceptance of dental assessment improve work efficiency and quality, and eventually improve the informationization management of nursing.