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Objective:To construct the evaluation index system of the core competence of neonatal specialist nurses, so as to provide reference for clinical training of neonatal specialist nurses.Methods:From January 2020, through literature review, theoretical analysis, interview, Delphi method and superiority chart, the evaluation index and weight of core competence of neonatal specialist nurses were determined.Results:Totally 28 experts in China were invited for 3 rounds of consultation. The effective recovery rate of the questionnaires was 93.33%(28/30) in the first round. The effective recovery rate of the questionnaires was 100.00%(28/28) in the second and third rounds. The authority coefficient of the experts was 0.85 in the third round. The Kendall′s coefficients of concordance of the first-level indexes, second-level indexes and third-level indexes were 0.150, 0.221 and 0.161, respectively. The final evaluation index system of the core competence of neonatal specialist nurses included 5 first-level indicators, 17 second-level indicators and 58 third-level indicators.Conclusions:The evaluation index system of the core competence of neonatal specialist nurses constructed in this study has certain scientific, reliable and clinical application value, which is conducive to the training of newborn specialized nurses in China.
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The epidemic of COVID-19 has become the topmost public health threat worldwide. The authors suggested that in addition to strengthening the organization and leadership of the abovementioned work, greater attention be paid to establishing and improving the prevention and control mechanism.Furthermore, special efforts should be given to the safety of the medical workers, by strengthening their infection monitoring and outbreak management. Medical workers in different work areas and positions should be placed under careful protection with due cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. Such special issues in the management of pediatric patients, as allocation of nurses, the screening and management of caregivers, the problem of breastfeeding, and the disinfection of children′s toys and diapers were discussed. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments, which aim to guide the prevention and control of COVID-19 nosocomial infection in the pediatric outpatient and ward.
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The pneumonia caused by the novel coronavirus (2019-nCoV), which began in December 2019, has become the most serious public health problem, threatening people's health and life. This threat is posing a severe challenge on the diagnosis and treatment of 2019-nCoV infection, the prevention and control of hospital cross infection of medical staff. It is suggested that in addition to strengthening the organization and leadership of the abovementioned work, establishing and improving the prevention and control mechanism deserve greater attention. Furthermore, special attention should be given to the safety of the medical staff, strengthening their infection monitoring and outbreak management. Medical staff in different work areas and positions should be placed under careful protection, cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments. These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.
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Objective To explore how the different intervention measures affect the outcome of central venous catheter-related thrombosis (CRT) in children. Methods A retrospective analysis was carried out to collect the clinical data of patients with CRT from the nursing management system of the Children′s Hospital Affiliated to Zhejiang University School of Medicine which reported by each nursing unit from January 1,2015 to December 31,2015. Results Totally 108 cases were included (72 boys and 36 girls), median age of 24.5 months (ranged from 1 month to 14 years old). Nearly 42.59% (46/108) patients suffered from neurological diseases. Nearly 55.56%(60/108) CRT was detected in the first week after catheterization. Once CRT conformed, there were four kinds clinical intervention options applied. Intervention 1: thrombolytic therapy with urokinase combined anticoagulation with nadroparin calcium. Intervention 2: anticoagulant therapy only. Intervention 3: thrombolytic therapy alone. Intervention 4: no medications. The differences of effective between the four kinds of intervention were statistically significant (χ2=13.380, P=0.004). The single-factor regression analysis was done to each relevant factor. Finally the multivariate regression analysis showed four factors had impacts upon the results. The factors were as follows:gender (OR=10.400, 95%CI 1.879-57.563, P=0.007);interval (OR=1.107, 95%CI 1.035-1.184, P = 0.003), size of thrombus(OR = 1.562,95%CI 1.033-2.362,P=0.035; Intervention 2 (OR =11.757, 95% CI 2.254- 61.327, P = 0.003), intervention 4 (OR = 35.397, 95% CI 3.493-358.760, P =0.003). Conclusions The earlier and small size thrombus is more soluble. Thrombolytic therapy or combined anticoagulation is more effective. It is recommended that if no contraindications presents, thrombolytic combined with anticoagulant therapy should start early standardized treatment.
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Objective To explore the effect of improving nursing evaluation system on the quality of life in patients with stage Ⅲ and Ⅳ stage non small cell lung cancer (NSCLC).Methods From January 2011 to December 2014,100 patients with NSCLC were randomly divided into observation group and control group , 5 0 cases in each group.The observation group was treated with 1 month as a treatment course.The control group was treated with rou-tine treatment and nursing.Before treatment and 2 months after treatment,serum tumor markers (CEA,CYFRA21 -1,NSE,CA125) were detected,the clinical symptom score,quality of life (KPS score) and body weight were recor-ded.Results (1)The total effective rates of the observation group and the control group were 88% and 90% respec-tively,the difference was not statistically significant (χ2 =0.381,P >0.05);(2)There were no significant differences in the clinical symptoms between the two groups (t =0.382,1.521,all P >0.05) before and after intervention.After intervention,the clinical symptoms of the two groups were lower than before intervention,the difference was statistical-ly significant (t =6.493,4.398,all P 0.05);After 6 months of intervention,the KPS score and body weight of the observation group were significantly higher than those in the control group,the differences were statistically significant (t =5.493,4.326,all P 0.05);(4) Before the intervention,there were no significant differences in serum tumor markers (t =0.483,1.264,1.762,1.264,1.795,1.678,1.253,1.469,all P >0.05);After intervention,ser-um markers in the two groups were significantly lower than before intervention,the differences were statistically signifi-cant (t =6.393,3.490,4.728,7.943,4.883,5.478,7.684,11.383,all P 0.05).Conclusion For patients with stage III,IV NSCLC,improving nursing evaluation and implementation system has no significant difference in reduce the level of tumor markers and long -term survival compared with the control group,and improve the nursing evaluation and implementation system has certain advantages in maintaining the quality of life of patients.
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Objective To develop the severity score of pediatric hand foot and mouth disease (HFMD),guide health care providers in the early detection and intervention of critical ill cases,in order to improve the survival rate and reduce the incidence of complications and mortality.Methods Based on PCIS,the severity score of HFMD in children was designed by adding fever and nervous system damage symptoms,which was the common symptoms of severe cases.The data of the cases who admitted in April 2008 to November 2010 (group A,88 cases) was retrospectively analyzed to evaluate the validity and credibility of the score.The score were prospectively applied to all of the HFMD cases who admitted from May 2011 to October 2013(group B,118 cases),delivering corresponding treatment and care measures based on scoring result as well.At last the outcome of the two groups was compared.Results It exhibited quite good consistency between the scores and the clinical condition of patients with HFMD.The general information of two groups was not significantly different,but the survival rate,the incidence of neurological sequel and the mortality between two groups were significantly different by x2 test.Conclusions The score can objectively and accurately assess the severity of HFMD in children.Clinical application of this scoring method to assess the children with HFMD can identify critical ill cases as early as possible.Corresponding intervention delivering in time may improve the outcome.It is proved to have positive clinical value to increase the survival rate,decrease the incidence of neurological sequel and the mortality of critical ill HFMD cases,and is worthy of clinical application in pediatric department.
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Objective To evaluate the clinical effect of treating chloasma with acupuncture and bloodletting therapy.Methods 176 cases with chloasma were recruited into two groups randomly. Acupuncture and bloodletting therapy was adopted in the treatment group (90 cases), and exclusive acupuncture was applied in the control group (86 cases). Results The effective rate was 96.7% in the treatment group and 51.2% in the control group. There was a significant statistical difference between two groups (P＜0.05). Conclusion The treatment of acupuncture and bloodletting therapy has a definite therapeutic effect on chloasma, being worthy of spread.