ABSTRACT
【Objective】 To explore the effect of intelligent closed-loop mobile nursing management system in quality management of blood transfusion. 【Methods】 The mobile nursing system and the cold chain management system of our hospital were integrated to realize intelligent closed-loop management of blood transfusion. After consulting medical records, 789 blood recipients, admitted to the Department of Hematology of our hospital from January to December 2017 (before the implementation of closed-loop management), were selected as the control group, and 836 blood recipients, admitted during January to December 2018 (after the implementation of closed-loop management), were selected as the observation group. A self-designed blood transfusion standard management checklist was adopted, with the number of standard execution items as the numerator and the total number of checked items as the denominator to obtain the standard implementation rate. The checking rate of blood sample collection, blood transfusion rate within 30 min after blood issuing, the execution rate of double check specification and inspection specification, the completion rate of RBCs transfusion within 4 h and qualified rate of blood transfusion nursing record before and after the implementation of closed-loop management were compared by chi-square test or Fisher's exact probability method to evaluate the efficacy of blood quality management improvement. A total of 8 head nurses from clinical departments (Hematology Department, Cardiac Surgery Department, Operating Room, Comprehensive ICU) involved in blood transfusion were selected for semi-structured interviews. The interviews focused on the effect of intelligent closed-loop mobile nursing information system in quality management of clinical blood use, and the results of the interviews were analyzed. 【Results】 The double check execution rate of blood transfusion, the checking rate of blood sample collection specification, the transfusion rate within 30 min after blood issuing, the execution rate of blood transfusion inspection, the completion rate of RBCs transfusion within 4 h, the qualified rate of blood transfusion nursing record in the observation group and the control group after and before the implication of the intelligent closed-loop mobile nursing management system were 100%(836/836) vs 97.72%(771/789), 99.04%(828/836) vs 97.34%(768/789), 97.97%(819/836) vs 95.06%(750/789), 99.28%(830/836) vs 94.93%(712/789), 99.16%(829/836) vs 97.47%(769/789) and 100%(836/836) vs 89.73%(708/789), respectively, showing significant improvement (P < 0.05). The time spend on the record, summary and feedback of quality control results was significantly shortened. 【Conclusion】 The application of intelligent closed-loop mobile nursing management system in the quality management of clinical blood use can effectively improve the efficiency of blood transfusion, nursing quality and the safety of clinical blood use.
ABSTRACT
Objecfive To compare the clinical effectiveness of three different fixation methods for peripherally inserted central catheter(PICC).Methods Totally 120 patients requiting PICCs were randomized into suture securement group(group A),tape securement group(group B),and sutureless adhesive-hacked device (StatIock)securement group(group C),with 40 patients in each group.Patients were followed up throughout their entire catheter course,and the securement effectiveness,catheter-related complications,risk of skin injury,and patients'satisfaction were observed.Results The rate of catheter migration without function loss in group B (57.5%)was significantly higherthan in group A(12.5%,P=0.000)and in group C(7.5%,P=0.000).Catheter dislodgment rate in group B(15.0%)was also significantly higher than group A(0,P=0.034)and group C(0,JP=0.034).Phlebitis documented during their catheter course in group B(25.0%)were more than in group A(7.5%,P=0.034)and in group C(5.0%,P=0.012).In addition,the rate of cellulitis in group A was significantly higher than group C(20.0%vs.2.5%,P=0.034).The rate of skin injury in group A 0.005).Nearly half of patients in group A (52.5%)complained irritation and/or pain at the sucure site,which was significantly higher than in other two groups ( both P = 0.000 ).The patients' satisfaction rate was significantly lower in group A (12.0% ) than in the other two groups ( both P = 0.000), documented highest in group C (90.0%) (group C vs.group B, P = 0.004).Conclusions The availability of sutureless adhesive-backed de vice StatLock provides an alternative for securement of PICCs.It performs as well as suture securement in catheterfixing.Meanwhile, it can prevent catheter-related complications such as migration and dislodgment Furthermore, it avoids skin injuries during catheter fixation or securement.
ABSTRACT
In order to reconstruct a bone defect as a result of a complete excision of osteofibromatosis with pathological fracture of an extremity, free transplantation of double vascularized long fibula segments was performed in 4 cases of osteofibroas hyperplasia with fracture. After a follow up of 1～2years, the grafted fibula attained a good bony union, and the limbs regained normal length and function. This seems to be an ideal way to repair huge bone defects as a result of excision of bone tumor of extremities.
ABSTRACT
To explore the prevention of deterioration of damaged tissue in gunshot wounds in limbs in hot and humid environment, 18 healthy male mongrel dogs were divided into three groups randomly: hot and humid environment (HHE) group, normal environment (NE) group, and heat acclimatization (HA) group. Histopathological changes and bacterial quantity in wound tracks were observed at postinjury o, 1, 4, 6, 8, 12 and 24h. It was found that the swelling of limbs and local pathological changes in injured tissues of HA group were significantly less serious and appeared later than those of HHE group, but severer and appeared earlier than those of NA group. The period that the bacterial quantity reaching the critical point of infection was 8h in HHE group, 12h in HA group and NE group. It is concluded that the pathological changes in gunshot injury in dogs inflicted in hot and humid environment could be lessened by exercise with heat acclimatization.
ABSTRACT
To investigate the changes in serum enzymes (ALP、LDH、CK) in dogs suffered from gunshot wounds in limbs in hot and humid environment, 12 dogs were divided into two groups randomly: hot and humid environment (HHE) group and normal environment (NE) group. The contents of ALP, LDH and CK in peripheral blood were assayed at 0h, 2h, 4h, 6h, 8h, 12h and 24h postinjury. The results showed that the contents of serum enzymes tended to rise after gunshot injuries, especially CK. The changes in the contents of serum enzymes in HHE group appeared earlier and more obviously than those in NE group. In conclusion, the contents of serum enzymes coincided with the severity of local tissue damage, and change in the content of CK was more sensitive after tissue injury. The results suggested that hot and humid environment would aggravate systemic reactions and tissue damage after gunshot injuries.