ABSTRACT
Objective:To explore the management effect of information nurses in the reception of new surgical instruments and to provide a reference for improving the quality of instrument management in central sterile supply department.Methods:This was a quasi-experimental study. A total of 45 packages of 227 pieces received from January to July 2021 in central sterile supply department of the First Affiliated Hospital of Zhengzhou University were selected as the control group by convenience sampling method, and the conventional mode was used to receive new surgical instruments. Another 51 packages of 259 pieces received from November 2021 to June 2022 were selected as the observation group, and the information nurse management system was set up to receive new surgical instruments. The observation and comparison of the time to complete the receipt of new surgical instruments in central sterile supply department, the incidence of adverse events in the operation process and the satisfaction of medical and nursing staff with the management of new surgical instruments were conducted.Results:The receiving time for newly added surgical instruments of the observation group was 6.00(5.00, 8.00) hours and that of the control group was 28.00(20.00, 42.50) hours, with a statistically significant difference between the two groups ( Z = - 8.26, P<0.01). The incidence of adverse events of new surgical instruments was 0.4%(1/259) in the observation group and 6.2%(14/227) in the control group, there was significant difference between the two groups ( χ2 = 13.52, P<0.01). The satisfaction degree of medical staff in the observation group was 100% (50/50), higher than 72% (36/50) in the control group, and the difference between the two groups was statistically significant ( χ2 = 16.28, P<0.01). Conclusions:The implementation of the post of information nurse in the special post responsibility system in the management of new surgical instruments can effectively manage the specifications of surgical instruments, reduce the receiving time and the occurrence of adverse events, improve the satisfaction of medical staff.
ABSTRACT
To evaluate the effectiveness and recent safety of emergency and selective percutaneous coronary intervention [PCI] in elderly patients [ >/= 80 years old] with acute myocardial infarction [AMI]. 120 elderly patients with coronary heart disease [CHD] were divided into AMI group [with 55 cases] and non-myocardial infarction group [control group with 65 cases]. Among the AMI group, there were 18 cases underwent emergency PCI within 12 hours after the onset, [AMI emergency PCI group], the rest 37 cases were AMI selective PCI group. In the control group, 2 cases had stable angina pectoris, 59 cases unstable angina pectoris and 4 patients old myocardial infarction. The lesions were classified according to the practice guidelines of American College Of Cardiology/American Heart Association [ACC/AHA]. The hospitalized major adverse cardiac events [MACE] and complications in the patients were recorded and statistically analyzed. The AMI group had a higher total Gensini score, lower left ventricular ejection fraction [LVEF], less mean stents and contrast agent dosage and shorter operation time, compared with the control group. The difference was statistically significant. Though the average postoperative length of stay in AMI emergency PCI group was longer than that of AMI selective PCI group, but the difference had no statistical significance. To all the included patients, there were 50 cases with lesions in one branch, 43 cases in two branches and 27 cases in three branches. And the immediate PCI success ratio in AMI group was lower than that in control group [80% VS. 96.9%, P= 0.003], without significant difference in the distribution number of diseased vessels and complete reconstruction ratio [P>0.05]. The incidence of the total complications in AMI emergency PCI group was higher, compared with the non-emergency group [with 102 cases] and AMI selective PCI group [P<0.001, P=0.039]; and the occurrence rate of complication in AMI group was higher than that of the control group [P<0.001]. The emergency PCI for elder patients with AMI is safe and worthy of promotion