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Model is a scientific thinking and operation method. It can provide guideline for resolving some nursing practice problems, and improve the quality of nursing service. Research on nursing model has received more and more attention. This paper analyzes the concept, classification, and development of the model, and describes its application in research on nursing model. According to background and research problem, researchers should analyze the characteristics of different methods of development and validation of model, and choose the approprate method. Thus, it can improve the scientificity and operability of results of nursing model.
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Objective:To analyze the application effect of cluster management measures in improving the quality of emergency medical treatment.Methods:By analyzing the problems existing in the work of emergency department, the cluster management scheme was formulated and the intervention measures were implemented from the aspects of intelligent information system, patient management system and medical service process. The accuracy and efficiency of emergency triage, the satisfaction of patients and medical staff, the incidence of medical complaints and disputes and the rate of sudden death were compared before and after cluster management.Results:Before and after the implementation of cluster management, the accuracy of triage classification was 95.0% and 98.7% respectively, and the triage time was (68.3±12.8) s and (50.5±7.2) s respectively( P<0.001). The satisfaction of patients, doctors and nurses increased, the number of complaints decreased from 15 to 5 in half a year, and the number of sudden death decreased from 39 to 23 with a significant difference( P<0.05). Conclusions:The application of cluster management measures in emergency management can improve the medical quality, the satisfaction of medical staff and patients, and ensure the safety of patients.
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Purpose@#This study aimed to examine the reliability and validity of the Chinese-translated Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) for nursing home residents. @*Methods@#A convenience sample of 204 nursing home residents were used for measuring the instrument performances. Demographics form and BREQ-2 developed by Markland were applied. @*Results@#The translated BREQ-2 model was a good fit for the results of confirmatory factor analysis, χ2 was 276.75, comparative fit index was .94, standardized root mean square residual was .05, and root mean square error of approximation was .07. Results in the BREQ-2 indicated good consistency, Cronbach's α coefficient of BREQ-2 was .78, and each of the five subscales were ranged from .78 to .83. The test–retest was valued .84, and the five subscales ranged from .75 to .89, which supporting the stability of instrument. @*Conclusion@#This study provided psychometric evidence for the application of BREQ-2 among nursing home residents in China.
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Purpose@#This study aimed to examine the reliability and validity of the Chinese-translated Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) for nursing home residents. @*Methods@#A convenience sample of 204 nursing home residents were used for measuring the instrument performances. Demographics form and BREQ-2 developed by Markland were applied. @*Results@#The translated BREQ-2 model was a good fit for the results of confirmatory factor analysis, χ2 was 276.75, comparative fit index was .94, standardized root mean square residual was .05, and root mean square error of approximation was .07. Results in the BREQ-2 indicated good consistency, Cronbach's α coefficient of BREQ-2 was .78, and each of the five subscales were ranged from .78 to .83. The test–retest was valued .84, and the five subscales ranged from .75 to .89, which supporting the stability of instrument. @*Conclusion@#This study provided psychometric evidence for the application of BREQ-2 among nursing home residents in China.
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Objective To evaluate the applicability of the Critical Care Pain Observation Tool (CPOT) in medical patients with mechanical ventilation. Methods A descriptive design was chosen for this study. A convenience sample of 110 medical patients with mechanical ventilation in ICU was selected, among which, 53 cases were sober (including 34 patients with pain and 19 patients without pain), 57 cases were non-sober. The CPOT was applied for evaluating the reliability, validity, reactive degree, sensitivity, specificity and ROC curve analysis. Results Cronbach alpha coefficient was 0.865. Intraclass correlation coefficient was 0.883. CVI was 1.00. Spearman correlation with Visual Analogue Scale (VAS) was 0.544. In known-group technique, only pain score was statistically significant in Ramsay score. In reactive degree, score was statistically significant in three testing points. The CPOT had a sensitivity of 94.1％and a specificity of 46.7％. The area under the ROC curve was 0.716. Conclusions The CPOT has good internal consistency, interrater reliability, content validity, reactivity, moderate criterion validity. Speciality in distinguishing pain and other symptoms is worse. Future research is warranted to further verify the applicability of the CPOT.
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In recent years shared decision-making and patient autonomy have been regarded as biomedical goals as the basis for treatment recommendations.However,uncertainty on decision-making situations,patient capacity of decision-making,health work environment and nursing model,has brought great challenges for shared decision-making.This article explored philosophical status of harmony nursing theory in shared decision-making situation,and provided suggestions on encouraging patients' participation in shared decision-making.The analysis also concluded that the situation analysis could be used as a possible path for the test of harmony nursing theory.
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Objective To explore the connotation of patient safety competency of nurses, and to provide references for the safety of education and patients' safety competency. Methods The connotation of patient safety competence of nurses was discussed through semi-structured interview and expert meeting method. Results Patient safety competency of nurses contained 7 aspects, including patient-centered care,team cooperation, safety risk management,information evidence-based application, patient safety culture, clinical safety and continuous quality improvement. Conclusions Patient safety competency of nurses is based on the knowledge, attitude and skill, and includes comprehensive abilities in all other aspects.
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Objective To analyze the research hotspots and future trend of nursing safety. Methods Biclustering analysis was adopted to analyze the nursing safety literature in PubMed and Wanfang databases from 2012 to 2016 through the bibliographic contribution system BICOMB and graph clustering toolkit gCLUTO 1.0. Results Domestic nursing safety research fronts from 2012 to 2016 focused on adverse events,quality care services, quality evaluation indicators, work errors and safety culture. On the other hand,overseas nursing safety researches focused on system analysis, nursing quality sensitive indicators, teamwork and nursing safety, and the impacts of nursing work environment on quality and safety. Conclusions Comprehensive means of multi-disciplinary teamwork can be called into play for in-depth study of deloping adverse events assessment tools, establishing a unified nursing sensitive indicator system and continuous improvement. The future research trends are establishing a national standardized nursing adverse events reporting system, using information technology to build a big data platform for information sharing and exploring nursing safety from the security environment and organization management.
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Objective:To study the CT features for solitary fibrous tumor (SFT) in the abdomen and pelvis and to improve the diagnostic accuracy.Methods:Fourteen patients with SFT were collected in our hospital from January,2011 to December,2015.Characteristic of images were analyzed and compared for 10 SFT,which located outside the abdominal organs with extragastrointestinal stromal tumors (EGIST),leiomyosarcoma,and schwannoma.Results:Necrosis and cystic formation were frequently present in SFT in the abdomen and pelvis.CE-CT showed serpentine vessels along the periphery,while pattern of enhancement was maplike inhomogeneous progressive.Comparing with the EGIST or schwannoma,the difference of CT value in non-contrast and the arterial phase were statistically significant (P＜0.05).The numbers of peritumoral circuity vessel were significantly different between SFT and EGIST (~=18.27,P＜0.008) or between SFT and schwannoma (x2=19.25,P＜0.008).Comparing with the leiomyosarcoma or schwannoma,SFT located outside the abdominal organs.We found that tumor necrosis rate was significantly different between SFT and leiomyoscarcoma (x2=8.00,P＜0.008).Conclusion:SFT in the abdomen and pelvis show certain CT characteristics.The CT value in noncontrast and at the arterial phase,tumor necrosis rate,and serpentine vessels along the periphery were pivotal in differentiating SFT from leiomyosarcoma,EGIST and schwannoma.
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OBJECTIVE@#To evaluate the diagnostic value of liver imaging reporting and classification criteria of data system (LI-RADS) MRI on primary hepatic carcinoma (HCC). @*METHODS@#The MRI images of 100 patients (72 patients with HCC, 4 with regenerative nodules, 13 with hemangioma, 4 with liver cyst, 3 with Liver abscess, 2 with inflammatory pseudotumor, 1 with hepatic arteriovenous fistula, 1 with Limitations of steatosis) with liver disease were collected in Xiangya Hospital from January, 2014 to January, 2015. All patients were at the risk of HCC. The images were reviewed according to the LI-RADS categorization by American College of Radiology (ACR) under a condition of blindness to the pathological data. The sensitivity, specificity and the area under the ROC curve in the diagnosis of HCC with the LI-RADS categorization were calculated by three associate professors from the Department of Radiology, Xiangya Hospital. @*RESULTS@#The area under the ROC curve was 0.925 in the 100 patients with HCC. Of the 100 pathologically confirmed patients, 20 cases were LR1 and LR2. However, the post-operation pathological examination showed benign tumor (negative predictive value was 100%). There were 25 HCC in 31 cases of LR3, 27 HCC in 29 cases of LR4 (positive predictive value was 93.1%). All of 20 cases of LR5 were HCC (positive predictive value was 100%). If LR1 and LR2 were considered negative, and LR3, 4, 5 were positive, then the sensitivity, the specificity and the area under the ROC curve was 100%, 71.4% and 0.925, respectively. If LR1, 2 and 3 were considered negative and LR4 and LR5 were positive, the sensitivity, the specificity and the area under the ROC curve was 100%, 90.9% and 0.974, respectively. @*CONCLUSION@#The MRI LI-RADS categorization is highly sensitive and specific in the diagnosis of HCC, which can improve the diagnostic accuracy.
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Humans , Carcinoma, Hepatocellular , Diagnosis , Liver Neoplasms , Diagnosis , Magnetic Resonance Imaging , ROC Curve , Sensitivity and SpecificityABSTRACT
Objective To investigate the current staffing of nurses and need of hospital nursing human resources in China.Methods Data were collected from 181 secondary and tertiary hospitals and 9774 nurses in mainland China by questionnaires.Results The average doctor-nurse ratio was 1 ∶ 1.39 in tertiary hospitals and 1 ∶ 1.31 in secondary hospitals.The doctor-nurse ratios in 164 hospitals (97.6％) and the proportion of nurses in health care staff in 105 hospitals (61.8％) had not reached the standard set by the Ministry of Health of China.62.3％ nurses held secondary diploma for their initial nursing education.The constituent ratio of nurses held secondary diploma decreased,while the ratio of nurses held advanced diploma and bachelor degree increased in the last 5 years from 2003 to 2007.Sixty percent of newly employed nurses were contract nurses in 2003.The proportion increased to 78％ in 2007,and in some regions it accounted for more than 90％ of new nurses.The needs and constituent ratio of nurses with.secondary diploma and advanced diploma would decrease while nurses with bachelor degree and master degree would increase in the next 5 years (from 2009 to 2013).Conclusions The nursing shortage is still severe in China,and nursing staff mainly held secondary diploma for their initial nursing education.Most of new nurses were employed as conwact nurses.The need of hospitals for nurses has increased,especially for nurses with higher educational level such as bachelor degree and master degree,while the need for secondary diploma hold ers have decreased.The need for advanced diploma holders has increased in the last 5 years and would decrease in the next 5 years,but they would still be the majority of employed nurses.The authors suggested that the staffing of nursing manpower,the work environments and career development of contract nurses should be improved,and the initial nursing education should be upgraded to meet the needs of hospitals.
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Objecflve To determine the prevalences of nutritional risk,undemutrition,overweight,and obesity as well as nutritional support and the changes of nutritional risks from admission to discharge or over a two-week period.Methods A consecutive sampling was performed.Dam were collected from general surgical depart-ments in three Beijing teaching hospitals from March to July in 2007.Patients were screened using Nutritional Risk Screening 2002(NRS2002)on admission and two weeks after admission(or discharge).The nutritional supper apphcation during hospital stay was recorded.NRS2002 score≥3 was classified as nutritional risk.BMI<1 8.5kg/m2 with impaired genend condition was defined as undemutrition.Results Among 300 enrolled patients,the NRS2002 WaS completed by 99.0%(297/300)of all patients.The nutritional risk and the prevalence of under_nutrition,overweight,and obesity was 30.0%,8.1%,38.3%,and 9.4%,respectively at admission.Fifty of 90(62.2%)patients who were at nutritional risk received nutritional support while 40 of 210(19.O%)non-risk patients received nutritional support.Especially among major abdominal surgery patients,56 of 90(71.6%)pa-tients who were at nutritional risk received nutritional supper while 35 of 81(43.2%)non-risk pafients received nutritional support.The prevalence of nutritional risk changed from 30.0%to 35.8%(X2=2.271,P=0.132).Conclusions NRS2002 is a feasible nutritional risk screening tool among general surgical pafienm in selected Bei-jing teaching hospitals.Nutritional support is somehow inappropriately apphed in general surgical hospitalized pa-tients.The prevalence of nutritional risk remains unchanged in general surgical patients during hospitalization.
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Objective To explore the program of cultivating the nursing master students according to the present situation of China.Methods Delphi method was used in this study.Results In the type of scientific research,the order were the basic knowledge of nursing,clinical knowledge,research ability,ability of adapting society,teaching,management and the community nursing ability.In the type of clinic,the order were the basic knowledge of nursing,clinical knowledge,ability of adapting society,management,research ability,teaching and the community nursing ability.Conclusion According to the present situation of our country,the basic knowledge of nursing and the clinical skills should not be ignored.