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Objective:To analyze the implementation of evidence-based nursing indicators for deep open wound pain management and its difficulties.Methods:From May to October 2018 at Department of Traumatology and Orthopaedics, Nanfang Hospital, 2 nurses were selected by objective sampling and 20 patients with deep open wound by convenient sampling. According to the 13 best practices in nursing guidelines for pain management, we formulated a no-pain dressing change program for deep open wounds on the basis of the research evidence in wound care and pain management. After the program was implemented, its effect on pain relief was evaluated. Practical Application of Clinical Evidence System (PACES) and software GRiP were used to evaluate the whole implementation process. IBM SPSS 21.0 was used to analyze the pain scores before and after implementation.Results:The results of PACES showed that the implementation rate of best practices by the 2 nurses increased significantly during the project period and remained at a reasonable level one month after the project. The patients＇ pain scores before dressing were 3.2±2.3 and 3.5±1.2 at the baseline evaluation and the follow-up evaluation 1, respectively; the pain scores during dressing at the base evaluation and the subsequent evaluation 1 were 5.4±2.3 and 4.2±2.4. The effect of implementation of evidence-based nursing indicators for deep open wound pain management on pain relief was significant ( P<0.05). Conclusions:This project improved the implementation rate of the best pain management practices in dressing change for deep open wounds, but the implementation encountered difficulties in interdisciplinary cooperation and organizational structure. This study may provide a reference for other evidence-based nursing projects aiming at transforming evidence-based nursing guidelines into clinical practice.
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Objective To investigate the current situation of quality of care for people with disabilities and the related factors. Methods In November, 2015, 399 disabled persons from five special service institutions in Hubei, China were conveniently sampled, and investigated with the Chinese version of Quality of Care and Support (QOCS) for people with disability scale and demographic questionnaire. Results The total score of QOCS was (38.11±6.24), and the proportion of total score in the dimensions of caring provision, caring environment and caring information were more than 70%. The score of QOCS was various with the age, domicile, employment, medical insurance, monthly household expenditure and expenditure for food of the people with disabilities, and the age (β=0.06, P<0.01) and medical insurance (β=-0.850, P<0.001) were the independent factors related with the score of QOCS. Conclusion People with disabilities self-reportedly satis-fied in the quality of care in Hubei, and it can be improved from the increase of medical insurance level.
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@#Objective To investigate the quality of life, quality of care and support and social integration in persons with severe disabilities, and to analyze the relationship of quality of life with quality of care and support and social integration. Methods From September, 2015 to March, 2016, 399 persons with severe disabilities in Wuhan, China were investigated with World Health Organization Quality of Life-Disability Scale, World Health Organization Quality of Care and Support Scale-Disability Scale and Social integration Scale. Results The quality of life was in middle level in persons with severe disabilities, and positively correlated with the scores of quality of care and support (r> 0.11, P<0.05) and social integration (r>0.39, P<0.01). Conclusion The quality of life is related with the quality of care and support and social integration in persons with severe disabilities. Policy and support system should be targeted on it for the social security and rehabilitation.