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Objective:To explore the effect of simulation teaching combined with case-based learning (CBL) on the practice of thoracic surgery nursing students.Methods:Cluster sampling method was adopted to select 30 practice nurses of the thoracic surgery department of 2019 as the control group, and traditional teaching was adopted. Another 30 thoracic surgery practice nurses of 2020 were selected as the research group, and simulation teaching combined with CBL was adopted. After the training, the two groups of practice nurses were assessed on theory and basic skills, and the nurses' recognition of teaching was assessed through questionnaire surveys. SPSS 22.0 was used for t test and chi-square test. Results:After the training of practical nurses, the research group had better performances of theoretical and basic skills tests than the control group, with significant differences ( P<0.001). The practice nurses of the research group did significantly better than those of the control group in such 8 dimensions as improving basic nursing skills, improving autonomous learning ability, improving the clinical thinking ability, enhancing our emergency response ability, improving the ability of theory combined with practice, improving training interest in learning, training team cooperation ability, cultivating the ability of doctor-patient communication and so on ( P<0.05). Conclusion:The combination of simulation teaching and CBL applied in the practice of thoracic surgery nursing students can improve the proficiency of nurses' nursing skills and improve the quality of clinical teaching.
ABSTRACT
OBJECTIVE:To investigate the perioperative prophylactic use of antibiotics in thoracic surgery department of 7 hos-pitals in Nantong city,and to provide reference for rational drug use in clinic. METHODS:In retrospective study,6652 dis-charged patients with thoracic surgery were selected from 7"third-level hospitals"of Nantong city during 2015-2016. The gender, age,length of stay,preoperative medication,medication timing,classification of incision,operation time,drug name,usage and dosage,route of administration,drug combination and prognosis were analyzed statistically. According to the relevant regulations of special rectification and the principle of perioperative antibiotics use,the rationality of antibiotics use was evaluated. RE-SULTS:Among 6652 patients,there were 2761 cases of typeⅠincision and 3891 cases of typeⅡincision. All of them used anti-biotics. Primary prophylactic time was 0.5-2 h before operation in 5282 cases,accounting for 79.40％;1370 cases were given medicine more than 2 h before surgery or after surgery,accounting for 20.60％. Totally 1070 cases received prophylactic medica-tion within 48 h,accounting for 16.09％;5582 cases received prophylactic medication more than 48 h,accounting for 83.91％. A total of 5702 cases were given only one antibiotic,and 950 cases received two-drug combination. A total of 6342 patients used an-tibiotics irrationally,accounting for 95.34％. Eight categories 15 kinds of antibiotics were involved. β-lactam/β-lactamase inhibi-tors,fluoroquinolones and cephalosporins were mostly used. CONCLUSIONS:After the implementation of special rectification, there are still many irrational phenomena in the prophylactic use of antibiotics in thoracic surgery department of 7 hospitals in Nan-tong city. Some indexes exceed the national standard and still need to be further managed and improved.