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Objective To explore the risk factors and predict the risk of delirium in patients with mechanical ventilation in intensive care unit(ICU).Methods Data were collected from ICU patients hospitalized from June 2016 to June 2017.Logistic regression model was used to analyze the risk factors of delirium in ICU patients with mechanical ventilation,and the ROC curve was used to calculate the area and optimal cut-off value of the curve.Results This study included 398 patients with 163 cases of delirium,and the incidence of delirium was 41.0％.Logistic regression model showed that using physical restraint (OR=3.084),receiving sedation (OR=2.255),duration of mechanical ventilation(OR=1.146) and ICU length of stay(OR=1.111) were independent predictors of delirium.ROC curve showed that the area under the curve was 0.580,0.566,0.787,and 0.774,respectively,and the cut-off value for mechanical ventilation duration and ICU length was 7 days and 8 days,respectively.Conclusion The incidence of delirium in ICU patients with mechanical ventilation is still high.Physical restraint,sedation,mechanical ventilation time of duration more than 7 days and ICU length of stay greater than 8 days can cause ICU delirium.
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Objective To systematically review the nursing preventive interventions and their effects on venous thromboembolism (VTE) in ICU patients. Methods We searched PubMed, Cochrane Library, EMBASE, SCI, CINAHL, Science Direct, BM, CNKI, WanFang and VIP, to collect the randomized controlled trials of nursing prophylaxis on VTE in ICU patients. Results 57 studies were included, meta-analysis provided that: the incidence rates of VTE and bleeding between Intermittent Pneumatic Compression Devices(IPC) group and low molecular weightheparin group in severe trauma patients had no statistical significance (P=0.14); comparing with graduated compression stockings (GCS) only group, the incidence rates of deep vein thrombosis(DVT) were lower in combination with IPC and GCS group (P=0.003);comparing with routine nursing group, the incidence rates of VTE were lower in IPC group and GCS group (P<0.01), the blood flow velocity and the average velocity of venous flow in lower limbs were increased in IPC group (P<0.01). The results of descriptive analysis show that early comprehensive nursing interventions and corresponding nursing interventions after risk assessment can reduce the incidence of VTE in ICU. Conclusion According to the present projects, using IPC, GCS, adopting early comprehensive nursing interventions and giving corresponding nursing interventions after DVT risk assessment are the effective interventions on ICU VTE.
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Objective To analyze the background and connotation of the maker education 2.0 and the innovativeness of the nursing maker education 2.0, and put forward the blended teaching of the nursing maker education 2.0. Methods The present situations of the maker education 2.0 and the connections between the maker education 2.0 and the nursing education were analyzed through documents and descriptive research, and the blended teaching program of the nursing maker education 2.0 was designed through exploratory research. Results Maker education 2.0 has gradually became an important way to cultivate students' innovation ability, and all kinds of schools tried to implement the maker education 2.0, but there has not been relevant research reports in nursing. Conclusions The blended teaching of the nursing maker education 2.0 can triggerthe reform of the nursing education. We should research the developmental mechanism and supporting theory, etc. of the nursing maker education 2.0 to explore much further for more knowledge about its application results.
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Objective To systematically analyze the risk factors of venous thromboembolism (VTE) occurrenced in intensive care unit(ICU).Methods The literatures on risk factors for ICU-acquired VTE were retrieved from PubMed,Cochrane Library,Embase,ScienceDirect,CNKI,WanFang,VIP and CBM Databases.Then the data was extraction and quality assessment was performed.The RevMan 5.3 software was used for conducting the Meta-analysis.Results Fifteen articles were included,involving 939 VTE cases.The meta analysis results of different factors were the renal insufficiency(OR =14.60),deep v ein thrombosin(DVT)/pulmonary embolism (PE) history(OR=8.23),rencent surgery history(OR =6.75),age＞ 60 years old(OR =4.84),shock(OR =4.36),malignant tumors (OR=2.76),central venous catheter(OR=2.54),heart function grade＞3(OR=2.27),mechanical ventilation(OR=1.57),D-dimer(WMD=423.99),APACHE Ⅱ score(WMD=4.25).Conclusion The risk factors of developing VTE in ICU are renal insufficiency,DVT/PE history,recent surgery history,age≥60 years old,shock,malignant tumors,central venous catheter,heart function grade＞3,mechanical ventilation,D-dimer and high APACHE Ⅱ score.
ABSTRACT
Objective To systematically review the nursing preventive interventions and their effects on venous thromboembolism (VTE) in ICU patients. Methods We searched PubMed, Cochrane Library, EMBASE, SCI, CINAHL, Science Direct, BM, CNKI, WanFang and VIP, to collect the randomized controlled trials of nursing prophylaxis on VTE in ICU patients. Results 57 studies were included, meta-analysis provided that: the incidence rates of VTE and bleeding between Intermittent Pneumatic Compression Devices(IPC) group and low molecular weightheparin group in severe trauma patients had no statistical significance (P=0.14); comparing with graduated compression stockings (GCS) only group, the incidence rates of deep vein thrombosis(DVT) were lower in combination with IPC and GCS group (P=0.003);comparing with routine nursing group, the incidence rates of VTE were lower in IPC group and GCS group (P<0.01), the blood flow velocity and the average velocity of venous flow in lower limbs were increased in IPC group (P<0.01). The results of descriptive analysis show that early comprehensive nursing interventions and corresponding nursing interventions after risk assessment can reduce the incidence of VTE in ICU. Conclusion According to the present projects, using IPC, GCS, adopting early comprehensive nursing interventions and giving corresponding nursing interventions after DVT risk assessment are the effective interventions on ICU VTE.