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Objective:To retrieve, appraise and synthesize the best available evidence on prevention and management of incontinence-associated dermatitis in adult inpatients.Methods:All the evidence on prevention and management of incontinence-associated dermatitis in adult inpatients was searched by computer from domestic and foreign electronic databases, guide.com and related professional websites from January 2010 to January 2020. Literature evaluation tools such as AGREEⅡ, AMSTAR were used for evaluation. Data extraction of documents that met the inclusion criteria.Results:A total of 28 pieces of relevant evidence were obtained. It includes 6 aspects: assessment and prevention, management of incontinence, cleaning, moisturizing and protection, treatment, monitoring and management.Conclusions:the 28 pieces of evidences in this study can better guide the medical staff in the prevention and management of incontinence-associated dermatitis in adult inpatients. It is suggested that the medical staff should carefully apply the evidence in combination with the specific clinical environment and the patient ′s will, and pay attention to the update of relevant evidence in time.
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Objective:To establish a prediction model of postoperative 1-year mortality risk in elderly patients undergoing hip fracture surgery and verify its efficacy.Methods:Patients of both sexes, aged ≥65 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅳ, who underwent an operation for traumatic hip fracture in the Second Affiliated Hospital of Wenzhou Medical University from January 2017 to December 2018, were enrolled and randomly assigned to model group and verification group in a ratio of 3∶1.The demographic characteristics, clinical data and results such as laboratory examinations were collected.In model group, the logistic regression analysis was used to recognize the independent risk factors for 1-year mortality after procedure, and the prediction model was established.In verification group, the prediction efficacy was analyzed using the receiver operating characteristic curve, and the degree of fitting was evaluated by Hosmer-Lemeshow goodness-of-fit test.Results:Multivariate logistic analysis indicated that age ≥84 yr, Charlson comorbidity index ≥2 points, Braden score on admission to hospital ≤16 points, preoperative urea nitrogen ≥8.8 mmol/L and postoperative albumin ≤ 29.6 g/L were the independent risk factors for 1-year mortality after hip fracture surgery in elderly patients ( P<0.05). The prediction model was established based on the risk factors mentioned above.The area under receiver operating characteristic curve was 0.870, and the sensitivity and specificity were 82.8% and 80.0%, respectively.The prediction model showed good fitting ( χ2=4.672, P=0.700). Conclusion:Age ≥84 yr, Charlson comorbidity index ≥2 points, Braden score on admission to hospital≤16 points, preoperative urea nitrogen ≥8.8 mmol/L and postoperative albumin ≤ 29.6 g/L are the independent risk factors for 1-year mortality after hip fracture surgery in elderly patients, and the prediction model established based on the above indicators has good efficacy.
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Objective To establish WeChat official account-based platform for evidence dissemination,and to evaluate the effects of the platform.Methods The WeChat official account-based platform for evidence dissemination was established,and big data analysis and sampling survey were adopted to analyze information and its communication effects published from December,2014 to September,2016.Results Totally 22 369 followers used the platform and conducted 404 232 hits on its pages in total.The most frequent searches were Evidence and Knowledge of evidence-based nursing.The WeChat Communication Index was 433.07.The overall evaluation score was 4.34± 0.67.Conclusion WeChat official account-based platform for evidence dissemination can promote the accessibility of evidence and receives high evaluation score from followers.
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Objective To develop training program of evidence implementation(EI) based on PARIHS model and to evaluate the effectiveness on clinical nurses for evidence-based nursing knowledge,attitudes and ability,and to understand the evaluation of participants about the methodological training.Methods A quasi-experiment design was conducted.A 6-month comprehensive evidence implementation training program was developed including methodological lecture,group discussion,EI case analysis,EI project development and implementation,and was carried out among 44 clinical nurses from 11 tertiary hospitals in Shanghai.The participants' EBN knowledge,attitudes and ability were measured by EBN knowledge,attitudes and ability questionnaire at 3 months and 6 months after training.Results Participants' EBN knowledge and ability were significantly improved at 3 months and 6 months after training(P＜0.05),and participants' EBN attitude had no significant difference before and after training (P＞0.05).The level of training satisfaction among participants was higher than 80.0％,and participants had finished 22 evidence implementation programs.Conclusion Evidence implementation training based on PARIHS can enhance clinical nurses' EBN knowledge and ability.Participants' EBN attitude hasn't been significantly improved.Participants have high satisfaction towards methodological training.
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Objective To develop a three-stage standardized and systematic training program framework and indicator systems for clinical midwives.Methods Based upon literature review,Delphi technique was used to formulate index system and indicators for midwives' training program through tworound expert consultation among 29 experts.Results After two-round expert consultation,the response rates were 96.7％ and 100.0％,respectively.Experts' authority coefficient was 0.874.The training program framework consisted of a three-level index system.Average importance scores of the three-level indexes were 4.10 to 4.97,4.07 to 4.97,and 4.00 to 5.00,respectively.And their variance coefficients were 0.037 to 0.119,0.037 to 0.130,and 0 to 0.141,respectively.Then a progressive and integrated three-year standardized training framework and index system for clinical midwives was finally formed,which totally contained 5 first-level indicators or training modules,including professional competence and safety awareness,specialized and basic knowledge,specialized practical skills,emergency management,and basic capacity for teaching and research.Conclusions The three-level framework and indicators for clinical midwives' training program has been proved to be acceptable,reliable and scientific,thus providing a theoretical and referential basis for training clinical midwives and improving teaching quality.
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Objective To understand the current status of paediatric medication safety,identify the existing problems on nursing research of paediatric medication safety and supply reference for paediatric medication safety.Methods 268 requested research papers published from 2003 to 2013 were retrieved from CNKI and CBM databases,and were analyzed by quantitative methods.Results Among 268 literatures,60.1％ were experience summaries and discussion.72.0％ didn't use any analyzing methods.64.6％ adopted qualitative analysis.Nine categories of these studies contents were concluded,among these,literatures dealing with medication management and medication safety education for parents came the first,accounting for 31.0％ and 15.3％; while those elaborating about information technology and medication safety education of nurses were the least,accounting for 4.1％ and 3.0％.Conclusions Most of the studies were qualitative comments and experience summaries which lack of rigorous designs and statistical methods.The research contents were scattered and difficult to be used in clinical environment.It is strongly recommended that studies on paediatric medication safety should be enhanced.Furthermore,nursing guideline should be constructed by evidence-based methodology to promote domestic paediatric medication safety.
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Objective To develop a suitable instrument for measuring health beliefs related to reproductive tract infections (RTIs) and testing its reliability and validity. Methods Within the framework of the Health Belief Model, 500 questionnaires of health beliefs related to RTIs were collected, its reliability and validity was analyzed. Results The instrument contained two subscales, all content validity index(CVI)were 1.0. RTIs-related health belief subscale extracted four factors, the cumulative variance was 75.91%;RTIs-related self-efficacy subscale extracted four factors,the cumulative variance was 68.19%. Scale statistics consisted with the structure and design structure. The dimensions Cronbach's α coefficient, test-retest reliability, split half reliability were greater than 0.70. Conclusions This scale has good reliability and validity and can be used for measuring health beliefs related to reproductive tract infections in women of childbearing age.
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Objective To evaluate the influence of hyperthermia on T helper subgroup (T help type1/T help type2,Th1/Th2) for patients with esophageal carcinoma. Methods 22 patients of esophageal carcinoma were randomly divided into two groups. Both group patients were treated by external radiation, the total dose was 64-66 Gy/30-33 fractions. Radiotherapy was the only therapy method in group A. Hypertbermia was used twice every week, with 8-10 fractions except for radiotherapy in group B. All patients were phlebetomized at the beginning and the end of radiotherapy for examining Th1/Th2 by flow cytometry. Results Th1 was significantly decreased in group A(t = 5.33, P < 0.01). All indexes in group B had no difference (t = - 1.41, P > 0.05). TheThl in group A was decreased much more than that in group B(t = 4.28, P < 0.05). Conclusion Hyperthermia could rectify the balance of Th1/Tb2.
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Objective To design nursing occupational safety and health curriculum reasonably.Methods With a semi-structured interview outline,focus group interviews among eight clinical nursing and nursing education specialists were conducted to develop the occupational safety and health curriculum design.Results It was important to set up nursing occupational safety and health curriculum.The main object,contents,teaching and evaluation methods were identified.Conclusions Occupational safety and health curriculum can be involved in nursing curriculum system to reduce occupational hazards and maintain physical and mental health of nursing students.