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Objective To analyze the characteristics of lower respiratory tract infection occurring in patients after craniocerebral surgery in Intensive Care Unit (ICU) and explore its nursing countermeasures. Methods Sixty-eight patients with lower respiratory tract infection after craniocerebral surgery in the ICU of the First Affiliated Hospital of Wenzhou Medical University from January 2015 to March 2016 were selected as the study subjects. All patients were treated with dehydration to reduce intracranial pressure, hemostasis, anti-infection, anti-epilepsy, mild hypothermia, hypoglycemia and other symptomatic supportive treatments, and the corresponding nursing measures were given. The patients' primary diseases and etiological examination results were analyzed. Results Of the 68 patients complicated with lower respiratory tract infection after craniocerebral surgery, the majority of primary disease was craniocerebral injury, accounting for 45.59% (31/68). A total of 127 strains of pathogenic bacteria were isolated, mainly Gram-negative (G-) bacteria [92 strains (accounting for 72.44% )];followed by Gram-positive (G+) bacteria [19 strains (accounting for 14.96%)] and fungi [16 strains (accounting for 12.60%)]. The main pathogens of G- were Acinetobacter baumannii 21 strains (accounting for 23.14%), Klebsiella pneumoniae 13 strains (accounting for 14.94%), Burkholderia cepacia 10 strains (accounting for 11.49%), Pseudomonas aeruginosa 8 strains (accounting for 11.49%); the main pathogens of G+ was Staphylococcus aureus 6 strains (accounting for 5.89%). Conclusion The incidence of lower respiratory tract infection in ICU patients after craniocerebral surgery is high. It is necessary to prevent and control the related risk factors as soon as possible, and take energetic and effective nursing measures to reduce the incidence of lower respiratory tract infection.
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Objective To investigate the interference causes of indwelling gastric tube for patients undergoing laryngeal tumor surgery,and explore the appropriate clinical nursing countermeasures.Methods 60 cases of laryngeal cancer patients with indwelling gastric tube were divided into the control group and the observation group with 30 cases in each group.The control group used indwelling gastric tube with routine nursing,while in the observation group,the influencing factors for indwelling gastric tube were analyzed and per-tinent neasures were adopted timely.The satisfaction degree of patients,incidence of postoperative compli-cations,hospitalization time and effective rate of treatment were compared.Results The factors influ-encing use of indwelling gastric tube were tracheal extubation by patients,trachea cannula exodus,pipe blockage and postoperative complications.After timely expectant treatment and positive nursing,the nutri-tion intake and postoperative recovery were not affected.The related indexes of the observation group were better than those of the control group.Conclusions Patients after laryngeal cancer surgery need longtime indwelling gastric tube.Measures such as strengthening of education and propaganda,close observation of patients′ condition and timely expectant treatment should be given in order to ensure the normal use of gastric tube and reach desirable treatment effect.
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Objective To study the effect of evidence-based nursing on improving the nursing requirement of patients with ureter external drainage and inner stent drainage after urological operation. Methods 62 patients in department of urinary surgery from June 2009 to October 2011 were selected as research object,and they were randomly divided into the control group and the observation group with 31 cases in each group,the two groups adopted routine nursing mode and evidence-based nursing mode respectively.Then the nursing requirement and nursing effect before and three and five days after nursing were compared between two groups. Results All the patients existed needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the needs of patients between ureter external drainage and inner stent drainage showed no significant differences,improvement level of each items of the observation group after nursing were all better than those of the control group. Conclusions The patients with ureter external drainage or inner stent drainage have needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the evidence-based nursing mode can effectively improve the patients'demand situations of these items.
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Objective To analyze the reasons of abnormal extubation for the chemotherapy patients with PICC,and put forward preventive measures. Methods A retrospective investigation was carried out about the reasons for abnormal extubation in 583 chemotherapy patients with PICC in our hospital from December 2007 to September 2009. Results There were 63 cases of abnormal extubation in 583 patients, accounted for 10.8% of the total number. The reasons of abnormal extubation included: catheter-related infection, misplacement,prolapse, dilapidation and fracture, catheter occlusion,thrombosis and abandoning treatment. Conclusions Complications caused by PICC are the main reasons for abnormal extubation. Important care measures to prevent and deal with kinds of complications timely can reduce the incidence of abnormal extubation.
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Objective To probe into the related factors and nursing of nosocomial infection for infectious diseases ward. Methods 2198 cases of patients in infectious diseases ward of our hospital were selected from February 2008 to December 2009, prospective monitoring and retrospective analysis were simultaneously adopted. Results In cases of nosocomial infection, mainly respiratory tract was the infection site, where the upper respiratory tract infection rate was 30.52%, lower respiratory tract infection rate was 28.57%, higher than other parts, there were significant differences. At the same time, nosocomial infection due to indwelling catheter and the irrational use of antibiotics led to higher rates of infection, 19.23%and 17.69%, there were significant differences. In addition, we could see from the age of nosocomial infection, ≤ 3-year-old children and elderly patients ≥ 60 years old had higher infection rate, 9.43% and 9.71%, there were significant differences. Conclusions According to elements features of infectious disease outbreak in hospital ward, to take effective care and prevention measures to reduce the infectious diseases room of the hospital infection will be of great clinical significance.
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Objective To study the burden of main earegivers of patients with stroke and its influ-encing factors, besides, the corresponding nursing countermeasures were disucssed. Methods 56 main caregivers of stroke families were selected to complete caregiver burden inventory (CBI). Results The general level of burden of main caregivers was in the moderate level with score value (1.55±0.35),factors influencing the burden of caregivers included ADL index, number of caregivers who involved in nursing and hospitalization times. Conclusions Nurses should educate the stroke patients about their rehabilitation systematically to decrease the severity of stroke sequela and readmission times, besides, they should strengthen their family support to reduce the burden of caregivers and increase their health status both physically and psychologically.