ABSTRACT
Objective:To systematically review qualitative research on the experience and coping behaviors of moral distress among nurses, and to provide references for the formulation of targeted measures.Methods:Search nurses moral distress qualitative research in PubMed, Web of Science, CINAHL, Embase, CBM, CNKI, VIP, Wanfang Database from the establishment of the database to July 2021. The 2016 version JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of the eligible studies. The methods of pooled integration were used to integrate the results.Results:A total of 16 studies were included, and 11 categories were summarized and refined, form three integrated results: the source of nurses′ moral distress, the experience of nurses′moral distress, and the way nurses cope with moral distress.Conclusions:The nurses themselves and their managers should pay attention to the source of moral distress and their experience, and provide appropriate intervention and support to avoid and reduce moral distress and improve the quality of care.
ABSTRACT
Objective:In order to analyze the current research status of handover shift in nursing management, summarize, analyze and judge the existing literature, in order to provide reference for clinical nursing practice.Methods:Through literature review, it is planned to review the current situation, shortcomings and future development of nursing handover classes.Results:The handover process was generally divided into four stages, of which SBAR was the best practice tool for handing over key information. For the performance of handover shifts, NASR, PVNC-BR, HES and Handoff CEX were often used to evaluate the performance of shifts, and for the results of shifts, evaluations were mostly conducted at the levels of patient safety, process elements, and organizational management. At present, the use of electronic information systems, benign organizational culture and patient and family-centered clinical practice could effectively improve the efficiency and effectiveness of handover.Conclusions:The process and elements of the current shift mode are relatively complete, and the communication strategy is reasonable, but there are still many shortcomings and defects. This suggests that nursing managers should adopt scientific intervention methods and evaluation tools when paying attention to and reforming nursing handover in the future to continuously improve the quality of handover.
ABSTRACT
To develop a quality control checklist for the prevention and control of coronavirus disease 2019 （COVID-19） in fever clinic and isolation ward of the general hospital and to assess its application. Based on the relevant prevention and control plans and technical guidelines for COVID-19，Delphi method was used to identity items for evaluation，and a quality control checklist for the prevention and control of COVID-19 in the fever clinic and isolation ward was developed in Sir Run Run Shaw Hospital. The checklists included 8 dimensions and 32 items for fever clinic，7 dimensions and 27 items for the isolation ward. The appointed inspectors conducted daily quality control for each shift with this checklist. The expert authority coefficient was 0.88，the mean of the importance of each index in the quality control table was not less than 4.8，and the coefficient of variation was not more than 0.07. During the entire February 2020，8 problems were found and rectified on-the-spot with the application of the checklist. Quality inspection rate was 100% in both isolation wards and fever clinic. The compliance rate and accuracy rate of hand hygiene were 100%; the correct rate of wearing and removing protective equipment increased from 96% to 100%. During the same period，a total of 1915 patients were admitted to the fever clinic，including 191 suspected patients （all were isolated in the hospital，3 were confirmed）. There were no medical staff infected with COVID-19，no cross infection of patients and their families in the hospital. A quality control checklist for the prevention and control of COVID-19 has been developed and applied in the isolation wards and fever clinic，which plays an important role in preventing nosocomial infection.
Subject(s)
Humans , COVID-19 , Checklist , Fever , Hospitals, General , SARS-CoV-2ABSTRACT
Physiological parameters monitoring is essential to direct medical staff to evaluate, diagnose and treat critical patients quantitatively. ECG, blood pressure, SpO2, respiratory rate and body temperature are the basic vital signs of patients in the ICU. The measuring methods are relatively mature at present, and the trend is to be wireless and more accurate and comfortable. Hemodynamics, oxygen metabolism and microcirculation should be taken seriously during the treatment of acute critical patients. The related monitoring technology has made significant progress in recent years, the trend is to reduce the trauma and improve the accuracy and usability. With the development of machine vision and data fusion technology, the identification of patient behavior and deterioration has become hot topics. This review is focused on current parameters monitoring technologies, aims to provide reference for future related research.
Subject(s)
Humans , Intensive Care Units , Monitoring, Physiologic , Oxygen Saturation , Technology , Vital SignsABSTRACT
Regular assessment is a key to early detect and treat delirium. However, studies showed poor compliance and accuracy of delirium assessment by nurses. Moreover, delirium was characterized by acute onset and fluctuation of cognition. Therefore, delirium was frequently unrecognized. Postoperative delirium incidence in the intensive care unit was high and associated with poor outcome. Studies demonstrate delirium was preventable. Delirium prediction models were warranted to identify high-risk critically ill patients in order to apply preventive strategies. This article was to provide an overview of postoperative delirium and review postoperative delirium prediction models for surgical patients in the intensive care unit, thereby providing reference for development, validation as well as application of models in China.
ABSTRACT
The role of interprofessional collaboration in the health care system has been increasingly proven and has led to a shift in the way work is done in the health care industry. Following the trend of this development, interprofessional education has also been developed accordingly. As the main content of interprofessional education, inerprofessional collaboration compentence plays an important role in improving the practice level of interprofessional collaboration among medical personnel. In this paper, the research status of interprofessional collaboration compentence is summarized, and the theoretical research of interprofessional collaboration compentence and the practical research in clinical nursing are reviewed, and the thinking of interprofessional collaboration compentence of critical care nurses is put forward, in order to provide reference for the education and management of critical care clinical nurses
ABSTRACT
The change of nursing management is of great significance to improve the service quality and management level of the hospital. The authors summarized the research progress of shared governance model in hospital nursing management, including the development and connotation of the model, related influencing factors, evaluation tools and application results. The authors proposed the enlightenment of participating in shared governance to China′s nursing management, as well as related problems and suggestions for its implementation, so as to provide new ideas and scientific references for the transformation of nursing management in China.
ABSTRACT
The authors introduced the practice of shared governance in ICU nursing management. According to the standard of magnetic hospital, a shared governance committee was established to guide and motivate the clinical front-line nurses in ICU to participate in nursing affairs management and decision-making. After three years of practice, ICU nursing management mode has achieved the goal of participating in shared governance, enhancing nurses′ perception of patient safety culture and improving the level of work engagement.
ABSTRACT
Objective@#To evaluate the effects on reduction of peripherally inserted central catheter-related venous thrombosis by hand grip exercise.@*Methods@#A detailed search was performed to identify literature about the impact of handgrip exercise on peripherally inserted central catheter-related venous thrombosis, using the Cochrane Library and the databases of PubMed, CINAHL, Embase, CNKI, WanFang and CBM. The meta-analysis or descriptive review were performed after two authors in-dependently searching databases,extracting data and assessing quality of included studies.@*Results@#Seven RCTs were included in a total of 789 patients. Meta-analysis showed the effectiveness of handgrip exercise on reduction of peripherally inserted central catheter-related venous thrombosis (RR=0.27, 95% CI 0.17-0.42, P<0.01); and improving vein maximum velocity (WMD=6.53, 95%CI 3.34-9.73, P<0.01) and time-mean flow velocity (WMD=6.05, 95%CI 3.24-8.87, P<0.01).@*Conclusions@#Handgrip exercise can improve axillary vein blood flow parameters and reduce peripherally inserted central catheter-related venous thrombosis. Due to a small number of included studies and heterogeneity of indicators, multi-centered, high-quality RCTs with large sample size are needed in the future to assess the effect of handgrip exercise in PICC patients.
ABSTRACT
Objective@#To investigate the effect of an information module for delirium assessment in ICU.@*Methods@#The information module for delirium assessment was designed according to the route chart of the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU) information assessment. Totally 70 nurses Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were included in the application of the information module. The compliance and accuracy of the delirium assessment and acceptance of nurses' assessment of information module were compared.@*Results@#The information module for delirium assessment was implanted into the clinical critical information system. The rate of compliance and accuracy of delirium assessed was 55.9%(2 728/4 877), 64.2%(231/360) before the application of information module, and 92.0%(4 360/4 740), 92.5%(333/360) after the application of information module. The difference between two groups were statistically significant (χ2=1 611.531, 85.139, P<0.01). The score of nurses′ acceptance of the input method before and after the application of information module were 69.00±4.00, 100.56±3.50, and the difference were statistically significant (t=-49.70, P<0.01).@*Conclusions@#The information module for delirium assessment can simplify the assessment process, improve nurses′ compliance and accuracy to assess delirium, optimize critical care management and worth spreading.
ABSTRACT
Objective To evaluate the effects on reduction of peripherally inserted central catheter-related venous thrombosis by hand grip exercise. Methods A detailed search was performed to identify literature about the impact of handgrip exercise on peripherally inserted central catheter-related venous thrombosis, using the Cochrane Library and the databases of PubMed, CINAHL, Embase, CNKI, WanFang and CBM. The meta-analysis or descriptive review were performed after two authors in-dependently searching databases,extracting data and assessing quality of included studies. Results Seven RCTs were included in a total of 789 patients. Meta-analysis showed the effectiveness of handgrip exercise on reduction of peripherally inserted central catheter-related venous thrombosis ( RR=0.27, 95% CI 0.17-0.42, P＜0.01); and improving vein maximum velocity ( WMD=6.53, 95% CI 3.34-9.73, P＜0.01) and time-mean flow velocity ( WMD=6.05, 95% CI 3.24-8.87, P＜0.01). Conclusions Handgrip exercise can improve axillary vein blood flow parameters and reduce peripherally inserted central catheter-related venous thrombosis. Due to a small number of included studies and heterogeneity of indicators,multi-centered,high-quality RCTs with large sample size are needed in the future to assess the effect of handgrip exercise in PICC patients.
ABSTRACT
0bjective To translate and revise the Assessment of Interprofessional Team Collaboration Scale (AITCS) into Chinese, then to evaluate the reliability and validity of the Chinese version of AITCS. Methods The Chinese version of AITCS was translated from the original one, back-translated and adjusted for cultural adaptation. The reliability and validity were tested among 288 nurses, 81 physicians, 25 respiratory therapists, 10 physical therapists and 3 nutritionists from a tertiary hospital in Hangzhou using convenience sampling. Results The average of scale-level content validity index was 0.98, unanimity of scale-level content validity index was 0.84 and item-level content validity index was 0.89-1.00. Exploratory factor analysis extracted three common factors,which explained 61.427% of the total variance,and each item had high factor loading quality (>0.4). The correlations coefficients between each dimension score and the total score ranged from 0.801 to 0.898 (P<0.05),and the correlations coefficients between each dimension score ranged from 0.607 to 0.698 (P<0.05). The Cronbach α of AITCS was 0.909, split-half reliability was 0.835 and test-retest reliability was 0.763. Conclusion The Chinese version of the AITCS has been proved to be reliable and valid. It is a valuable tool for evaluating interprofessional team collaboration among the health professional providers in mainland China.
ABSTRACT
Objective To investigate the effects of a multidisciplinary round electronic checklist in ICU. Methods From October 2016 to September 2017,a total of 1 172 patients were provided with a multidisciplinary round electronic checklist. Another 886 patients with routine rounds between October 2015 to September 2016 were retrospectively analyzed. The duration of mechanical ventilation and ICU stay,the rate of nosocomial infection, the percentages of catheter days(central line catheter days,artificial airway days and urinary catheter days) and clinical staffs' satisfaction with the multidisciplinary collaboration were compared. Results The duration of mechanical ventilation and ICU stay in the intervention group were 1.42(0.68,3.63)days and 3.19(2.48,5.40)days respectively,in the control group were 2.16(1.40, 4.77) days and 4.14(3.46, 6.92) days respectively. The differences between two groups were statistically significant(t=2.084, 2.247, P <0.05). The application of a multidisciplinary round electronic checklist shortened the duration of mechanical ventilation and ICU stay. The percentages of catheter days and the rate of catheter-associated urinary tract infection were 0(0/6 269),60.34%(6 269/10 389)respectively,in the control group were 0.93‰(6/6 485),67.02%(6 485/9 676)respectively.The differences between two groups were statistically significant(χ2=96.187,Fisher's exact test=0.031,P<0.05).Besides,the level of multidisciplinary collaboration in ICU was greatly improved in the intervention group, 3.03 ± 0.11 vs. 4.13 ± 0.39 (t=24.587, P < 0.05). Conclusions A multidisciplinary round electronic checklist in ICU can improve the care quality and multidisciplinary collaboration.
ABSTRACT
For ICU patients, a structured dental assessment and recording system can effectively prevent adverse nursing events caused by tooth loss, and eliminate the potential risk of patients' safety. In addition, the structured recording system can effectively speed up nursing document input, facilitate compliance and acceptance of dental assessment improve work efficiency and quality, and eventually improve the informationization management of nursing.
ABSTRACT
The hospital optimized the lab order administration algorithm in ICU along with full-range IT-based monitoring.The new algorithm can effectively prevent preanalytical errors and improve nurse 's satisfaction in carrying out such orders.Nurse managers should closely monitor the compliance of personal digital assistant usage and analyze the causes of error for higher compliance.With such measures, we can maximize the function to intercept potential errors of the information system, and avoid preanalytical errors ultimately.
ABSTRACT
Objective To investigate the clinical effect of a new type of disposable heparin freedialysis tube in uremic patients without heparin dialysis. Methods A total of 110 patients withoutheparin dialysis were divided into control group and observation group by random digits table method with55 cases each. Based on the same pre dialysis and dialysis for heparin saline flushing of discontinuoussaline on the control group using the traditional dialysis pipe for hemodialysis without heparin, theobservation group used disposable non heparin dialysis pipe for hemodialysis without heparin. The numberof patients with venous catheter blockage, blood loss and completion of dialysis time in two groups wasrecorded. Results The number of patients with venous catheter blockage, blood loss and completion ofdialysis time was 6, 6, 47 cases in control group and 0, 0, 54 cases in observation group. The differences were statistically significant (χ2=4.407, 4.407, 4.356, P<0.05). Conclusions The new disposableheparin free dialysis tube can reduce the loss of blood and prolong the treatment time, and the operation issimple, safe and effective, and has good application value and application prospect.
ABSTRACT
Objective To develop and apply an ICU orientation program based on the Miller pyramid competency model. Methods 45 new ICU nurses in 2013 and 2014 were selected as the experimental group. The experimental group was oriented by the new program,including the orientation of preceptors, workshop-centered orientation courses, checklists-precepting and comprehensive competency evaluation methods. 39 new ICU nurses in 2011 and 2012 were selected as the control group. The control group was oriented by the conventional program,including focused theory classes and traditional precepting.New nurses′ satisfaction with the orientation and the competency were analyzed before and after intervention in two groups. Results Satisfaction with the orientation, self-evaluated competency and peer-evaluated competency in the experimental group were(16.71±1.19) scores, (126.52±3.31) scores and (90.00±2.68) scores respectively,which were much better than the control group and had statistically significant difference in two groups. Conclusions The ICU new nurse orientation program based on the Miller pyramid competency model can improve the new nurses′ satisfaction with the orientation and the competency after the orientation.
ABSTRACT
Objective To systematically evaluate the effectiveness of intermittent nasogastric feeding on enteral nutrition of critical patients. Methods The relevant randomized controlled trials were searched in the Cochrane Library, PubMed, EMbase, Web of Science, JBI Library and the databases of China National Knowledge Infrastructure (CNKI), China Scientific Journal Database by VIP (VIP), Wanfang Database. The studies were selected according to the inclusion and exclusion criteria by two reviewers. Meta- analysis was conducted by using RevMan 5.2. Results Nine RCTs were included involving 558 patients. The results of meta- analysis showed that intermittent nasogastric feeding was greater than continuous pump feeding in the incidence of constipation, OR=0.32, 95%CI 0.14~0.71, P0.05). Conclusions Intermittent nasogastric feeding and continuous pump feeding did not affect the incidence of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and the effects of nutrition. However, the incidence of constipation was significantly less in patients receiving intermittent nasogastric feeding.