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
Objective To investigate the effect of penehyclidine hydrochloride combined with low tidal volume ventilation on lung function in patients with lower abdominal operation.Methods Sixty elderly patients who underwent elective lower abdominal operation were divided into three groups by random digits table method:the conventional tidal volume group (group A),penehyclidine hydrochloride combined with conventional tidal volume group (group B) and penehyclidine hydrochloride combined with low tidal volume group (group C),20 cases in each group.The patients in group B and group C were given penehyclidine hydrochloride 0.01 mg/kg before induction of anesthesia.The patients in group A were given equal volume of saline.After induction of anesthesia and mechanical ventilation modes:the patients in group A and group B were given tidal volume 10 ml/kg,the patients in group C were given tidal volume 6 ml/kg.After mechanical ventilation in anesthetized (T1),1 h after anesthesia (T2),2 h after anesthesia (T3),8 h after anesthesia (T4),24 h after anesthesia (T5),the level of tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),pH,arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2),the calculation of oxygenation index (PaO2/FiO2) were measured and compared.The pulmonary complications after operation 1 day were recorded.Results The level of TNF-α,IL-6 in three patients at T1 had no significant difference (P ＞ 0.05).The level of TNF-α,IL-6 at T2-5 in group C were significantly lower than those in group A and group B (P ＜ 0.05).Compared with group A and group B,the level of PaO2 and PaO2/FiO2 at T2-5 were increased in group C (P ＜ 0.05).None pulmonary complications were occurred in three groups.Conclusions Penehyclidine hydrochloride combined with low tidal volume ventilation may improve arterial oxygen in patients with lower abdominal operation,reduce the lung injury induced by mechanical ventilation,protective effect on lung function.