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Objective:To explore the effect of nurse led cooperative integrated nursing model in children with hypospadias, provide reference for the integration of collaborative medical care and patient care, improve the nursing level of nurses and the quality of child care.Methods:By adopting a quasi experimental study method, from January 2020 to December 2021, the clinical data of 84 male children undergoing hypospadias surgery in the Department of Urology, Children ′s Hospital of Nanjing Medical University were retrospectively analyzed, and 84 accompanying staff were included in the study. Among them, 42 children admitted from January to December 2020 and 42 accompanying staff served as the control group, and 42 children admitted from January to December 2021 and 42 accompanying staff served as the intervention group. The control group adopted the routine perioperative nursing mode, and the intervention group adopted the nurse-led collaborative integrated nursing mode. The anxiety and satisfaction of the caregivers in the two groups, the medical fear, medical compliance and postoperative pain of the children in the two groups, and the incidence of postoperative complications of the children in the two groups were compared. Results:After intervention, the satisfaction score of the intervention group ′s accompanying staff and the score of the patient ′s medical compliance were (96.46 ± 3.27) and (2.93 ± 0.89) points. The control group ′s scores were (85.24 ± 5.71) and (1.75 ± 0.63) points. The differences between the two groups were statistically significant ( t=9.52, -8.40, both P<0.05). The anxiety score of the accompanying staff in the intervention group was (44.33 ± 2.43) points, and the medical fear score and postoperative pain score of the patients were (20.76 ± 2.92) and (3.06 ± 0.57) points, respectively. The control group′s scores were (67.11 ± 3.36), (33.58 ± 3.84) and (6.24 ± 0.71) points, respectively. The differences between the two groups were statistically significant ( t=23.47, 12.51, 22.66, all P<0.05). The total incidence of postoperative complications in the intervention group was 4.76% (2/42), while in the control group was 52.38% (22/42). The difference was statistically significant ( χ2=23.33, P<0.05). Conclusions:The nurse led collaborative integrated nursing mode has a positive effect on relieving the negative emotions of caregivers and children, improving the satisfaction of hospitalization, improving the quality of care for children, and reducing the incidence of postoperative complications of children.
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OBJECTIVE：To pro vide reference for rational use of antibiotics in pediatric department. METHODS ：Clinical bacterial strains isolated from children outpatients and inpatients were collected from West China Guang ’an Hospital of Sichuan University（called“our hospital ”for short ）during Jan. 2014 to Jun. 2019. Distribution and drug resistance of bacteria were analyzed retrospectively. RESULTS ：During 2014-2019，total of 4 692 strains were detected ，accounting for 29.56％ of total ；those were mainly from sputum （3 749 strains，79.90％），blood（203 strains，4.33％）and secretion （137 strains，2.92％）specimen. Among them ，1 488 strains of Gram-positive bacteria （31.71％）were mainly Streptococcus pneumoniae （711 strains，15.15％） and Staphylococcus aureus （574 strains，12.23％）；3 204 strains of Gram-negative bacteria （68.29％）were mainly 2 466 strains of Haemophilus influenza （52.56％）. Totally 172 strains of methicillin-resistant S. aureus and 1 517 strains of β-lactamase producing H. influenzae were detected ；the detection rates were 29.97％ and 61.52％ ，respectively. Resistance rates of H. influenza to ampicillin，cefaclor and cefuroxime were higher than 50％，and the overall trend was on the rise ，resistance rates of cefotaxime ， rifampin and ofloxacin were all lower than 6％. Resistance rates of S. pneumoniae to erythromycin and tetracycline were more than 70％，and the resistance rate to erythromycin was increasing year by year. Resistance rates of S. pneumoniae to β-lactams and quinolones were generally lower than 20％. No resistant strains of linezolid and vancomycin were found. Resistance rate of S. aureus to penicillin G was more than 90％. S. aureus was relarively sensitive to aminoglycosides ，macrolides and tetracyclines ；no furantoin，linezolid and vancomycin-resistant strains were found. CONCLUSIONS ：Gram-negative bacteria are the main pathogens isolated from children in our hospital ，and most of them are H. influenza e，S. pneumon iae and other caustic bacteria. The detection rate of drug-resistant and enzyme producing strains is high ， and the resistance rate of several pathogens to commonly used 0826-2600251。E-mail：wenxiaozheng269@sina.com antibiotics is increasing year by year. Drug resistance is severe. In order to delay the emergence and spread of drug-resistant pathogens in real time and further standardize the use of pediatric antibiotics.
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Objective To explore the impact of metacognitive technology psychological intervention technology on perioperative school-age children′s psychological condition, designed to find an efficient, fast method to intervene preoperative psychological condition, to eliminate their fear of emotional,coping with stress reaction in the effective time. Methods A total of 70 cases of school-age children who were treated from December 2016 to March 2017 were selected randomly and divided into the experimental group (35 cases) and the control group (35 cases). Both groups performed routine preoperative,intraoperative and postoperative nursing,and the experimental group was performed by the special person on the basis of conventional care when waiting for the operation. The changes of the fear index were compared between two groups of patients(T1),preoperative waiting(T2),pre-anesthesia(T3) and one day after surgery(T4). Results The scores of T1,T2,T3 and T4 in the experimental group were 7.000,7.929,2.686,0.971.The scores of T1,T2,T3 and T4 in the control group were 6.929,7.543,8.286 and 3.400.There was no significant difference in the fear index between the two groups at time T1 and T2 (t=0.796, 1.627, P>0.05). The fear index of T3 and T4 was significantly lower than that in the control group. The difference was statistically significant (t=298.637, 400.463, P<0.05). Conclusions The metacognitive technique can significantly improve the psychological status of the children in perioperative school age,and improve the adaptability and tolerance of the children.
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Objective To study the changes of serum brain natriuretic peptide(BNP),uric acid(UA)and procalcitonin(PCT)levels in children patients with dilated cardiomyopathy(DCM).Methods 24 children pa-tients with DCM and 24 children undergoing healthy physical examination from March 2015 to September 2016 were selected as the observation group and control group.The observation group was divided into differ-ent Ross grade groups according to the improved Ross heart failure grade scoring.The levels of serum BNP, UA and PCT in each group were detected and their correlation with the main echocardiographic indicators was analyzed.Results The levels of BNP,UA and PCT had statistical difference between the observation group and control group(P<0.05);the BNP and UA levels had statistical difference among different Ross grades (P<0.05),moreover which were increased along with the severity increase,but the PCT level had no statisti-cally significant(P> 0.05);the BNP level was positively correlated with the DCM severity(r= 0.713,P=0.000),the UA level was positively correlated with the DCM severity(r=0.489,P=0.002),while the corre-lation between the PCT level and DCM severity had no statistical significance(r=0.288,P=0.076);the BNP had obvious correlation with main echocardiographic indicators(P<0.05).Conclusion The levels of serum BNP,UA and PCT in children patients with DCM are changed significantly,in which BNP and UA may be the good markers for reflecting the disease severity and progression or prognosis.
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Objective To investigate the efficacy of preemptive analgesiawith ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine for circumcision in pediatric patients.Methods Forty-five pediatric patients with ASA grade Ⅰ undergoing elective circumcision were randomly divided into 3 groups (n=15 each).The same intravenous compound anesthesia was used in the three groups.The pediatric patients underwent ultrasound-guided modified dorsal penile nerve block with a mixture of 0.1 ml/kg of 0.2% ropivacaine and 0.8% lidocaine before operation in group A and group B.The pediatric patients were given ketorolac tromethamine 1 mg/kg intramuscular injection before operation in group A and group C.The total consumption of propfol and sufentanil, occurrence of intraoperative body movement and respiratory depression, emergence time, time from waking up to going out of PACU and adverse reactions such as postoperative agitation, nausea, vomiting and pruritus were aslo recorded.The requirement for postoperative paracetamol suppositories was recorded.Results Compared with group C, the total consumption of propfol and sufentanil were significantly decreased, incidence of body movement andrespiratory depression were significantly decreased, the emergence time and time from waking up to going out of PACU was significantly shortened, requirement for paracetamol suppositories were significantly decreased in group A and group B(P<0.05).Compared with group B, incidence of requirement for paracetamol suppositories was significantly decreased in group A (P<0.05).No pediatric patients developed postoperative nausea, vomiting, pruritus and incidence of emergence agitation had no statistical difference in the three groups.Conclusion Preemptive analgesia with ultrasound-guided modified dorsal penile nerve block combined ketorolac tromethamine is safe and effective when used for circumcision in pediatric patients, and it has good efficacy of postoperative analgesia.
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OBJECTIVE:To promote the safe use of Heparin sodium injection for children. METHODS:According to litera-ture retrieve,questionnaire survey and field investigation,Health care failure mode and effect analysis method(HFMEA)was ad-opted to search for the failure modes of Heparin sodium injection for children,and preventive strategies were established and imple-mented based on these failure modes. Its effects were evaluated by comparing the error rate and risk priority number rating (RPN value)before and after the implementation. RESULTS:Totally 5 risk points of Heparin sodium injection requiring immediate inter-vention were obtained from RPN value,including wrong dose of Heparin sodium injection in prescribing,pharmacists'unclearness for the calculation method of the dose of Heparin sodium injection in dispensing,and nurses'no performing of double check sys-tem before infusion in administration,etc. After implementing related countermeasures,related error of Heparin sodium injection was decreased from 8 cases to 1 case,and error rate was declined from 3.76% to 0.51%(P<0.01). The RPN values of 5 failure modes were decreased from 112.08,91.56,115.78,94.52,99.23 to 28.02,23.91,27.71,23.63,20.55,respectively. CONCLU-SIONS:HFMEA can prospectively conduct systematical analysis for Heparin sodium injection for children. Implementing related countermeasures based on the current situation of our hospital can reduce the related error of Heparin sodium injection and promote the medication safety of children.
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Objective To investigate the clinical effect of creatinine phosphate sodium combined with Xinjikang Granules in treating children with viral myocarditis ,and provide reference for clinical treatment .Methods 160 children patients with viral myo‐carditis from January 2011 to January 2015 were selected and randomly divided into the control group and the observation group ac‐cording to the digital table method ,80 cases in each group .The control group used the symptomatic treatment of fructose diphos‐phate (FDP) ,vitamin C ,coenzyme Q10 and ribavirin ,while the observation group used creatine phosphate sodium and Xinjikang Granules on the basis of control group .The clinical effects ,ECG improvement ,cardiac enzymes and troponin I levels were compared between the two groups .Results The effective rate in the observation group was 87 .50% ,which was significantly higher than 70 .00% in the control group ,the difference was statistically significant (χ2 =7 .320 ,P=0 .004);the effective rate of ECG improve‐ment in the observation group was 90 .00% ,which was significantly higher than 75 .00% in the control group ,the difference was statistically significant (χ2 = 6 .234 ,P=0 .005);the levels of AST ,CPK ,LDH ,CK‐MB ,HBDH and cTnI after treatment in the two groups were significantly improved compared with before treatment ,the differences were statistically significant (P< 0 .05) ,the levels of AST ,CPK ,LDH ,CK‐MB ,HBDH ,and cTnI after treatment in the observation group were (29 .98 ± 4 .66)U/L ,(184 .41 ± 5 .97)U/L ,(314 .25 ± 9 .84)U/L ,(22 .29 ± 2 .98)U/L ,(268 .37 ± 8 .64)U/L and (0 .13 ± 0 .04)μg/L respectively ,which showed the statistical differences compared with the control group ,[(33 .49 ± 4 .98)U/L、(196 .49 ± 6 .71)U/L、(328 .64 ± 11 .14)U/L、(26 .53 ± 3 .44)U/L、(298 .68 ± 10 .64)U/L、(0 .25 ± 0 .05)μg/L ,P<0 .05] .Conclusion Creatinine phosphate sodium in treating children with viral myocarditis has significant clinical effect ,and is worthy of clinical promotion and application .
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OBJECTIVE: To learn the development of studies about medication errors in children patients, so as to provide references for formulating guideline of our country. METHODS: Review the latest studies about children's medication errors, state the incidence of medication errors, and analyze the risk factors according to the children medication errors taking places. Also some effective interventions are listed. RESULTS: Medication errors occurred in all kinds of medical facilities, however with their own features. As to solutions, the electronic order-entry system, drug standardization, expanding the regulatory role of pharmacist, and strengthening guardians with drug of children education programs were effective. CONCLUSION: Medication error in children is a common problem, especially in dosage errors, which needs various efforts and cooperation within prescribing, dispensing, administration, follow-up monitoring, and many other intensive cares.
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Objective To explore the application of Chinese version of PedsQLTM Multidimensional Fatigue Scale(PedsQLTM MFS) in children with leukemia.Methods 141 children with leukemia and their main caretakers (one parent) were surveyed with the Chinese version of PedsQLTMMFS.Results The Cronbach α was 0.836-0.949 and 0.761-0.930 for parent-proxy scale and children's self-report scale respectively.The correlation coefficients between each item and its subscale were higher than those between each item and other subscales.The scores of parent-proxy scale and children's self-report scale were positively correlated with the correlation coefficient as 0.373-0.738,P＜0.01.Conclusions The Chinese version of PedsQLTMMFS has good reliability and validity.It is a reliable scale in measuring fatigue in children with leukemia.
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Objective To describe fatigue among children with acute lymphoblastic leukemia (ALL)receiving chemotherapy in hospital and explore its related factors.Methods A total of 100 hospitalized children with ALL receiving chemotherapy and their main caregivers were surveyed on demographic information,treatment data,Wong-Baker facial scale and the PedsQLTMMFS Multidimensional Fatigue Scale.Results The incidence of fatigue was 99％ (99/100).The total score of fatigue scale was (56.71±17.32) on average.Multiple linear regression modeling showed that the factors related with fatigue included the time of dexamethasone use,childen's sleep quality,hemoglobin content,pain score,the time for the present chemotherapy,age and main caregivers' self-rating health status (P＜ 0.05 or 0.01).Conclusions Fatigue is serious among children with ALL receiving chemotherapy and is related with demographic factors,diseases,treatment condition and health status of the caregivers.
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Objective To explore the effective perioperative nursing measures for congenital cleft lip and palate children.Methods 43 cases of congenital cleft lip and palate children treated in our hospital from January 2010 to December 2011 were given perioperative nursing measures.Results The wound healing time was 6～7 days,with an average time of 6.6 d.After operation,a survey was carried out to investigate the satisfaction degree of the parents,the results showed that postoperative satisfaction degree of the parents reached 100％.Conclusions Nursing intervention is of great significance on the efficacy of cleft lip and palate surgery,the implementation of comprehensive nursing interventions can obtain desirable clinical effect,and increase the satisfaction degree of children's parents.
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Objective To explore hospice home care method of dying children.Methods In 58 cases of dying children at home were given personalized hospice care plan,then the questionnaire were adopted to investigate the related indexes and the results were analyzed.Results In home hospice care,parents had a high recognition and satisfaction to children's pain management and symptom care.The parents with different education background had significant difference in recognition extent of psychological support,games support and death education.The parents anxiety and depression mood got effective mitigation through hospice home care of dying children.Conclusions Implementation of personalized home hospice care can increase life quality of dying children and improve adverse mood of their parents.
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Objective To explore the clinical effect of holistic nursing in the operation room for surgical children patients. Methods 120 patients required surgical treatment were selected and divided into the control group(45 cases)and the observation group(75 cases)randomly.The control group was given routine nursing,the observation group was given holistic nursing including preoperative interview,psychological care and all the preparations,strict check upon going into the operation room and before surgery,to help children keep graceful position,to cooperate closely with the anesthetist and surgeon,to observe the condition of patients and give good infusion management,to give continued observation of the disease condition after surgery,to make children safe escort back to the ward,and to make transfer with ward nurses.The treatment effect was compared between two groups. Results Two groups of children passed the period of operation and anesthesia safely,without appearing accidental situation.The satisfaction degree of the observation group was significantly higher than the control group.One case appeared operation accident and two cases appeared anesthesia awareness in the control group,and they were correctly handled.No one appeared operation accident and anesthesia awareness in the observation group.The differences between the two groups were significant. Conclusions Application of holistic nursing in the operation room for children patients puts forward higher requirements for nurses.It can help children cooperate with surgery better to achieve better surgical results,which is worthy of promotion.
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Objective To discuss the nursing intervention of Rey syndrome in children patients.so as to search effective nursing measures.Methods 12 children patients with Rey syndrome received comprehensive nursing treatment with reducing intracranial pressure and were under continuous close observation.Slightest changes were feeded back timely,then effective nursing measures were taken to stabilize their illness,patients also received dietary therapy,medication nursing and rehabilitation training,etc.Results All patients ameliorated after 3 to 7 days,and achieved clinical recovery after 20 to 30 days without sequelae.Conclusions Early diagnosis and correct effective nursing care can improve curative rate and avoid the occurrence of complications and sequelae.
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Objective To investigate the understanding level of asthma related knowledge and the treatment compliance in parents of children with asthma in Tianjin. Methods Questionnaire survey was given to 93 randomly selected parents of children with asthma at our asthmatic clinic ,whose children began to receive regularly asthmatic administration for at least 6 months from June to July in 2009. Results 72.04% of the parents included into the survey knew that asthma was a chronic airway inflammatory disease; 100% of them adhered to use prescription inhaled corticosteroid (55.91%) or inhaled corticosteroid combined with an inhaled long-acting β2-agonist (44. 09% ) ;74. 68% of them believed that if the child is in a well control state, he/she could participate in exercise as healthy children. There were 93.55% and 97.85% children patients aged ＞ 5 had never used PEF meter or CACT respectively to monitor the ill conditions. 25.81% of the parents chose rapid-acting β2-agonist to deal with asthma at acute attack stage, while 19.35% chose to add antibiotics and 11.83% were unable to do anything. 43.01% of the parents worried that the long-term use of inhaled corticosteroid would have side effects on the growth and development of their children, although they chose to obey to the doctor's prescription. Conclusions The general understanding of asthma is good in the parents, whose children had received asthmatic administration regularly in Tianjin area,but there are still some weak links exist. The related education may help asthmatic children's parents to master the knowledge of asthma, give them correct recognition of the treatment and prevention of asthma,increase the treatment compliance. This work should be insisted continuously.
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The gift of tongues is not good for children preceding school age,and the effect through simple language communication is not fine;It is favorable for hospitalization,treatment and nursing through establishing benign communication relations with children.