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Objective:To determine the training direction, training program and to promote management of endoscopy nurses by understanding the role delineations and professional practice competencies of gastrointestinal endoscopy nurses in China through a questionnaire survey.Methods:A questionnaire of " role delineations and professional practice competencies for gastrointestinal endoscopy nurses in China" was designed, based on the overseas profile or standards of role delineations and the professional practice competencies. Cross-cultural factors were taken into consideration for a higher content validity, and comments from endoscopic experts were consulted. Questionnaires were sent to participants from 52 medical institutions in 30 provinces, autonomous regions, municipalities.Results:A total of 252 respondents returned questionnaires, whom from 47 medical institutions in 28 provinces, autonomous regions, municipalities. The respondents included 144 endoscopy nurses, aged 35.87±7.43, 53.5% with a junior professional title and 68.8% with a bachelor degree; 65 endoscopy physicians, aged 39.66±5.62, 46.2% with a junior professional title and 40.0% with a doctoral degree; 43 endoscopic-nurse managers, aged 43.12±5.78, 46.5% with a senior professional title and 90.7% with a bachelor degree. The mean score of respondents of the consistency of 12 role delineations and 10 professional practice competencies was over 3.5. The role delineations with the highest score of consistency were " technical assistance" (4.58±0.57), " hygiene and infection control" (4.54±0.62) and " care of endoscopic equipment" (4.47±0.65). The three future role delineations with the highest scores were " hygiene and infection control" (4.58±0.55), " technical assistance " (4.52± 0.62), and " health safety" (4.52±0.58). There was no significant difference in the scores among endoscopy nurses, endoscopy physicians and endoscopic-nurse managers of the consistency of 12 role delineations ( P>0.05). The most consistent professional practice competencies were " cooperation" (4.32±0.61) and " communication" (4.25±0.63), which were also the required professional practice competencies for future development (4.48±0.58, 4.46±0.58, respectively). There was a significant defference between the coincidence on status and the recognition on development of " evidence-based practice and research" competency (3.80±0.77 VS 4.20±0.73, P<0.001). There was no significant difference in the scores of 10 professional practice competencies for future development among endoscopy nurses, endoscopy physicians and endoscopic-nurse managers( P>0.05). Conclusion:There is a consensus among endoscopy nurses, endoscopy physicians and endoscopic chief-nurse managers on the status of the role delineations and the professional practice competencies, as those for future development of gastrointestinal endoscopy nurses in China. " Cooperation" and " communication" are two professional practice competencies that are acknowledged by all types of participants." Evidence-based practice and research" is the professional practice competencies that all the respondents believe that endoscopy nurses need to develop in the future.
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Objective To compare the diagnostic value of two different types of puncture needles guided by endoscopic ultrasonography for pancreatic solid masses.Methods The clinical data of 176 pancreatic solid tumor patients who received endoscopic fine needle aspiration (EUS-FNA) in Shanghai Changhai Hospital from January 2018 to December 2018 was retrospectively analyzed.The acquired specimens were analyzed by cytology and histology.The patients were divided into 25G acupuncture needle group (25G group,63 cases) and 22G acupuncture needle group (22G group,113 cases) according to the type of acupuncture needle.The satisfaction score of specimen,the positive rate of puncture and diagnostic accuracy of malignant masses were compared between the two groups.Results The satisfaction of specimen in 25G group (44.6 ± 18.8) was higher than 22G group (20.5 ± 18.1),and the differences were statistically significant (P =0.047).The positive rates of puncture were 79.3％ and 85.8％,respectively,and the differences were not statistically significant (P =0.267).Thirty nine of 176 patients underwent surgical resection.Thirty three cases of malignant were diagnosed pathologically.The accuracy of 25G and 22G group was 81.3％ and 86.9％,respectively,and the differences were not statistically significant.Conclusions The accuracy and positive rate of 25G and 22G needle in the diagnosis of pancreatic solid masses are comparable,but compared with 25G needle,22G needle can obtain more tissue specimen.
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Objective To evaluate the application effect of nursing management in the follow-up of patients with recurrent acute pancreatitis (RAP).Methods During January 2016 and January 2017,the clinical data of RAP patients admitted in Changhai Hospital of Navy Medical University was collected.Selfcontrol method was used to establish a prospective cohort study.Meticulous nursing management mode was applied to follow up the patients for 12 months.Patients' compliance,symptom improvement,patients' satisfaction and other markers are evaluated using questionnaires to assess the effect of meticulous nursing management once every 3 months.The data over 12 months were collected.Results Sixty-four RAP patients were finally included.The average follow-up period was 19.7 ±3.4 months.Before admission,the average disease course was(4.21 ± 3.95) years.30 patients (46.9％)had a history of drinking;33 patients (51.6％)had a history of smoking.25 patients (39.1％) had abnormal blood lipid and 40 patients (62.5％) had the dietary habit of high lipid and high protein.The etiology included alcohol (n =10,15.6％),high lipid (n =7,10.9％),biliary diseases (n =1,1.6％),idiopathic causes (n =46,71.9％) and abnormal BMI (n =49,76.6％).After the meticulous nursing management,the frequency of pancreatitis,VAS score of pain and alcohol intake situation was obviously lower than before intervention [(0.50 ±0.85) times/year vs(2.77 ±2.52)times/year;(1.84 ±2.54)vs(6.47 ±2.15);2 cases vs 30 cases].The number of patients who took medicine on time and BMI were obviously decreased[(52 cases vs 13 cases;(23.26 ± 3.85) kg/m2 vs (21.92 ± 4.27)kg/m2)],and the differences were statistically significant (P ＜0.01).Patients' satisfaction with this nursing model was 4.90 ± 0.56.Conclusions The implementation of the new meticulous nursing management model can effectively alleviate patient's symptom condition and improve the compliance behavior and life quality of the patients.
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Objective To check the nursing interns′ knowledge about emergency medications. Methods A self-designed questionnaire was used to investigate the knowledge of emergency medications (including dosage, indications and usage) and learning demands in 258 nursing interns. Results The mean score of all students was 18.06 ± 3.35,accounting for 82.2%(212/258)nursing interns expected to obtain the knowledge by the clinical teachers.Both different education backgrounds and training periods didn′t have significant influence on the scores of emergency medications. There were significant differences in total scores among practice nurses from different areas (F=2.87, P<0.05). Conclusion Generally,the nursing interns are not qualified enough to know emergency medications.We should focus on training nursing interns in pharmacological knowledge and the ability of their knowledge management cognition.
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ObjectiveTo investigate the value of double-balloon endoscopy for the diagnosis of small bowel Crohn disease(CD).MethodsData of 141 patients with suspected CD undergoing double-balloon endoscopy were reviewed.Diagnosis was made based on pathological,endoscopic findings and clinic follow-up results.Detection rates and diagnosis rates of small bowel CD were compared by double-balloon enteroscopy,CT enterography and capsule endoscopy.ResultsThe detection and diagnosis rates of small bowel CD by double-balloon endoscopy were 90.8％ ( 128/141 ) and 98.4％ ( 126/128),respectively.These two variables by CT enterography were 76.0％ (19/25) and 89.5％ (17/19),and those by capsule endoscopy were 60.0％ (15/25) and 93.3％ (14/15).ConclusionDouble balloon enteroscopy has high application value for the diagnosis of small bowel CD.For those contraindicated with endoscopy,CT enterography can be considered as a preferred auxiliary diagnostic modality.
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Objective To explore the efficacy and safety of endoscopic balloon dilatation of small bowel stricture in Crohn′s disease with single balloon enteroscopy (SBE).Methods Seven Crohn′s disease patients (four males and three females with a mean age of 37 years) were underwent 10 times dilatation.Before performance,Crohn′s disease with varying degrees of intestinal obstruction was confirmed by image and pathological examinations.There were 8 severe strictures,6 strictures in jejunum.The dilatation was performed step by step with controlled radial expansiondilator (CRE) balloon.After dilatation,the scope could reach the further small bowel was taken as a standard.Results The overall suecess rate was 8 of 10.The average diameter of intestinal stricture was expanded from (4.1 ± 2.5) mm before therapy to (10.2 ±1.5) mm (P＜0.01),and the average distance of the further small bowel that the scope reached was 62 cm.Two patients underwent twice and three times of dilatation.After the performance,all patients′ symptoms of abdominal pain and obstruction relieved obviously and there were no severe complication of bleeding or perforation.After the performance,the average follow-up time was 14 months,two patients were treated by surgery and the other two underwent dilatation treatment again because of the recurrence of symptoms.The median symptom-free time was 15 months and 70％ of patients were without symptom recurrence in one year.Conclusion Endoscopic balloon dilatation of small bowel stricture with SBE is a new technology of endoscopic treatment,which is safe and effective in the treatment of Crohn's diseasecomplicated with intestinal obstruction.
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Objective To investigate correlation between aspirin resistance(AR) and inflammatory factors. Methods One hundred and ten patients with coronary heart disease took aspirin 0.1 mg/d for 14 days.It was detected platelet aggregation function induced with adenosine disphosphate (ADP) and arachidonic acid (AA), and investigated correlation between AR and inflammatory factors. Interleukin-1? (IL-1?),interleukin-6 (IL-6) and high sensitive C-reaction protein (hs-CRP) levels. Results IL-6 level of patients with AR was significantly higher than that of aspirin sensitive (AS) patients. The other two index were not different between the two groups. Conclusion IL-6 levels could be used as predictor.