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Blockchain technology integrates a series of complex technologies such as distributed accounting,peer-to-peer transmission,cryptography,smart contracts,consensus algorithms,etc.,providing services for controlling,storing,sharing,and managing data.At present,clinical nursing data is growing exponentially,and blockchain technology can be well used to process a large amount of clinical nursing data,bringing many advantages to clinical nursing.This article provides an overview of the current research status of blockchain technology in clinical nursing,with a focus on application types,advantages,and difficulties and challenges in the application process.It also proposes suggestions for designing data models and formats that meet specifications and standards,providing decision support for the application and development of blockchain technology in clinical nursing in China,thereby improving the quality of nursing services.
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Objective:To investigate the current situation of geriatric nursing ability of clinical nursing teachers and analyze the influencing factors, and to identify demands of geriatric nursing training.Methods:From May to June 2023, a cross-sectional study was conducted among 2 408 clinical nursing teachers in 50 tertiary hospitals from 9 provinces and cities in East China, South China, Central China, North China, and Southwest China using the general information questionnaire, Geriatric Nursing Competence Scale for Clinical Nurses, and Geriatric Nursing Training Demands Questionnaire.Results:Among the clinical nursing teachers surveyed, there were 269 (11.17%), 938 (38.95%), and 1 201 (49.88%) teachers at low, medium, and high levels of geriatric nursing ability, respectively. The results of multinomial Logistic regression analysis showed that age, years of working in geriatric nursing, geriatric nursing related training, satisfaction with clinical nursing work, and interest in geriatric nursing work were common influencing factors in the low and medium level groups ( P<0.05), and professional title was a specific influencing factor in the medium level group ( P<0.05). The top three demands of geriatric nursing training content were geriatric nursing service model, knowledge of chronic disease management, and comprehensive geriatric assessment techniques. The top three demands of training forms were live streaming, field visits, and offline lectures. Conclusions:For clinical nursing teachers, demand-oriented geriatric nursing training should be strengthened, and attention should be paid to the satisfaction and interest in nursing work, so as to improve the teachers' geriatric nursing ability and strengthen the level of geriatric service.
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Objective To evaluate the clinical outcomes and complications of posterior spinal fusion surgery in the treatment of neurofibromatosis type 1(NF1)thoracolumbar kyphoscoliosis, and to explore the mode of perioperative care for nurses provided to the patients. Methods We used the retrospective analysis on the 134 patients with NF1 thoracolumbar kyphoscoliosis admitted to our department from March 2012 to April 2022 and analyzed the clinical outcomes and perioperative complications by using the related statistics. We evaluated the Perioperative care by the nurses in the treatment of NF1 to explore the mode of nursing to the patients with the NF1, by using specific observation points and evaluation indicators. Results NF1 kyphoscoliosis patients had poor preoperative nutritional status and lung function. NF1 kyphoscoliosis underwent longer operation time, lost more blood in operation, had higher osteotomy grade and more postoperative complications. All the patients successfully completed the operation in our group. The correction rate of scoliosis was (52.8±22.7)%, and the correction rate of kyphosis was (57.3±34.6)%. 25 patients had complications but no such serious complications as nerve damage. Conclusions The practice of the perioperative nursing to NF1 type scoliosis patients facilitates the shortening of the recovery period, the prevention or timely detection of complications, and improvement of the therapeutic effect.
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Objective:To investigate the status quo of multi-level pre-job training for clinical nursing teachers and analyze their training needs, so as to provide reference for the design of pre-job training for clinical nursing teachers.Methods:A cross-sectional survey method was used to investigate 172 clinical nursing teachers in a tertiary general hospital in Harbin from April 2020 to June 2020 with multi-level pre-job training mode. The status quo of pre-job training and the training needs of teachers were analyzed. SPSS 17.0 was used to process the original data statistically.Results:Among the 172 respondents, 138 teachers (80.2%) were under 35 years old, and 133 teachers (77.3%) had a bachelor's degree or less; 89 teachers (51.7%) confirmed that hospitals or departments would carry out pre-job training in a planned and organized way, 10 teachers (5.8%) said that hospitals or departments had never organized training, 41 teachers (23.8%) had never participated in pre-job training, and 80 teachers (46.5%) had participated in pre-job training 1-3 times. There were 5 duplicates in the first 8 training contents of in-hospital training and in-department training, including knowledge of common diseases, nursing procedures, communication skills, hospital rules and regulations, and teaching methods. The total score of training demand was (154.51± 40.35) points, and the overall demand rate was 81.3%, which was at the high level. The dimensions with the highest scoring rate were legal system and humanistic literacy, with a scoring rate of 83.0%. The dimension with the lowest score was teaching management, with a score of 74.9%. The scoring rate of training needs with the highest points won nine items respectively on students' basic quality (self-supervision, willingness to learn, professional quality, etc.) (84.7%), training of legal knowledge (84.4%), incompatibility of drugs commonly used in department (84.3%), nurse etiquette (83.3%), nursing risk prevention (83.1%), evaluation methods of student education (83.1%), nurse-patient communication skills (83.0%), nurses and patients medication observation points of commonly used drugs in the department (83.0%), and effects of commonly used drugs in department (82.9%). Among the top three training forms, 84 students (48.8%) received online learning, 74 students (43.0%) received lectures from experienced teachers in hospitals, and 72 students (41.9%) received experience exchange and sharing seminars.Conclusion:The talent structure of clinical nursing teachers in this hospital is relatively young, and the first education level is low. Therefore, the pre-job training of clinical nursing teachers should be strengthened vigorously. The awareness rate and participation rate of pre-job training are average, so we should strengthen the release of training information from various channels, improve the awareness rate of training activities, clarify the encouragement or reward measures to participate in pre-job training activities, and improve the participation rate of training activities. Pre-job training content is repeated at every level, with a gap between the training needs of teachers in clinical nursing teaching. It's suggested that the teaching hospitals combine with their training objects of training needs, take the online-offline mixed mode of training, reasonably plan training contents as a whole at all levels, avoid training content repetition and waste of teachers, and organize teachers to timely exchange and share experiences.
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Objective:To investigate the value of clinical nursing path teaching based on core competencies in the clinical teaching of urology nursing students.Methods:A total of 100 nursing students who received nursing internship in Department of Urology, China-Japan Union Hospital of Jilin University, were selected as subjects and were divided into observation group and control group using a random number table, with 50 students in each group. The students in the control group received traditional teaching, while those in the observation group received clinical nursing path teaching based on core competencies. After the end of teaching, the core competency evaluation form for nursing students was used to evaluate core competencies, and the self-learning ability evaluation tool for nursing students was used to evaluate self-learning ability. SPSS 22.0 software was used for t test. Results:Compared with the control group, the observation group had significantly higher scores of core competencies (operation skills, theoretical knowledge, self-development ability, clinical nursing ability, interpersonal communication ability, and critical thinking ability) ( P<0.05). The observation group had a significantly higher score of self-learning ability than the control group ( P<0.05). Conclusion:In the teaching of urology nursing students, the application of the clinical nursing path based on core competencies can significantly improve the core competencies of nursing interns and the quality of teaching.
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Objective:To explore the effect of clinical nursing teacher training mode guided by deep learning theory.Methods:The clinical nursing teacher training mode was constructed under the guidance of deep learning theory and in combination with the characteristics of clinical nursing teachers, led and implemented by the university teacher development center. The questionnaire guided by Kirkpatrick Model was used to investigate clinical nursing teachers who had completed the five-stage training. The effects and differences in reaction, learning, behavior, and result levels were compared between the training objects in six training sessions. A total of 138 questionnaires were collected, of which 129 questionnaires were valid, with a response rate of 93.48%. The SPSS 22.0 was used to conduct analysis of variance or chi-square test.Results:On the reaction level, there were significant differences in the satisfaction of trainees in training time, examination form, and organization management ( P<0.05); on the learning level, the trainees had different opinions on the effect of training on promotion and improvement of clinical nursing quality ( P<0.05); on the behavior level, the training objects had different tasks in undergraduate classroom teaching and in hospital and medical association education and training ( P<0.05); on the result level, the clinical nursing teachers who completed the training all participated in different types of nursing teaching. Conclusion:The clinical nursing teacher training mode based on deep learning theory can significantly improve the teaching ability of clinical nursing teachers and promote their professional development.
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ABSTRACT Objective: To clinically validate a terminological subset of the International Classification for Nursing Practice (ICNP®) to care for people with chronic kidney disease undergoing conservative treatment. Method: Prospective study of clinical validation assessment of 117 nursing diagnoses/outcomes statements and 199 nursing intervention statements. It was operationalized through the following steps: implementation of the Nursing Process in an outpatient clinic in Southeast Brazil; preparation of case studies; analysis of agreement between specialist nurses. The Kappa. Kruskal-Wallis coefficient of agreement and intraclass correlation coefficient (ICC) were used. Results: The sample consisted of 50 people with chronic kidney disease. Diagnoses/outcomes and interventions were evaluated with almost perfect/perfect agreement and excellent ICC. The Kruskal-Wallis test showed that there was no significant difference between the assessments. The study allowed the clinical validation of a subset with 110 nursing diagnoses/outcomes and 195 nursing interventions. Conclusion: Care for people with chronic kidney disease undergoing conservative treatment based on the proposed subset has become applicable to clinical practice.
RESUMEN Objetivo: Validar clínicamente un subconjunto terminológico de la Clasificación Internacional para Práctica de Enfermería (CIPE®) para la atención de personas con enfermedad renal crónica sometidas a tratamiento conservador. Método: Estudio prospectivo que evaluó la validación clínica de 117 declaraciones de diagnóstico/resultado y 199 declaraciones de intervención de enfermería. Fue operacionalizado a través de los siguientes pasos: implementación del Proceso de Enfermería en un ambulatorio del Sudeste de Brasil; preparación de estudios de caso; Análisis de concordancia entre enfermeros especialistas. Se utilizaron los coeficientes de concordancia Kappa. Kruskal-Wallis y coeficiente de correlación intraclase (CCI). Resultados: La muestra estuvo compuesta por 50 personas con enfermedad renal crónica. Los diagnósticos/resultados e intervenciones se evaluaron con una concordancia casi perfecta/perfecta y un CCI excelente. La prueba de Kruskal-Wallis mostró que no había diferencias significativas entre las valoraciones. El estudio permitió validar clínicamente un subconjunto con 110 diagnósticos/resultados y 195 intervenciones de enfermería. Conclusión: La atención a personas con enfermedad renal crónica sometidas a tratamiento conservador basado en el subconjunto propuesto se ha vuelto aplicable a la práctica clínica.
RESUMO Objetivo: Validar clinicamente um subconjunto terminológico da Classificação Internacional para a Prática de Enfermagem (CIPE®) para o cuidado às pessoas com doença renal crônica em tratamento conservador. Método: Estudo prospectivo. de avaliação de validação clínica de 117 enunciados de diagnósticos/resultados e 199 enunciados intervenções de enfermagem. Foi operacionalizado pelas seguintes etapas: implementação do Processo de Enfermagem em um ambulatório no Sudeste do Brasil; elaboração dos estudos de casos; análise de concordância entre enfermeiros especialistas. Utilizou-se o coeficiente de concordância de Kappa. Kruskal-Wallis e coeficiente de correlação intraclasse (CCI). Resultados: A amostra foi constituída por 50 pessoas com doença renal crônica. Os diagnósticos/resultados e intervenções foram avaliadas com concordância quase perfeita/perfeita e CCI excelente. O teste de Kruskal-Wallis mostrou inexistir diferença significativa entre as avaliações. O estudo possibilitou validar clinicamente um subconjunto com 110 diagnósticos/resultados e 195 intervenções de enfermagem. Conclusão: O cuidado às pessoas com doença renal crônica em tratamento conservador pautado no subconjunto proposto se tornou aplicável à prática clínica.
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Humans , Clinical Nursing Research , Renal Insufficiency, Chronic , Validation Study , Conservative Treatment , Standardized Nursing TerminologyABSTRACT
ABSTRACT Introduction Ankle injury is an acute soft tissue pathology where the ankle ligaments are distended, lacerated, or ruptured due to violence during sport. This joint is also one of the most vulnerable in sports. After an injury, immediate and adequate care is significant in reducing pain and complication. Objective Statistically analyze the sports injuries of the ankle cases, determining the principal reasons for injury and outlining preventive measures. Methods A statistical investigation on the sports injuries of 275 Qiqihar higher education students was performed with questionnaires and teaching practice methods. The research was focused on the injured structures and the injury causes analysis. In parallel, corresponding proposals aimed at preventing these sports injuries were raised. Results Joint injuries and ankle sprains followed by hematomas represented the most significant proportion of ankle injuries. The reasons are lack of physical fitness, lack of awareness of self-protection, inadequate preparation in the sporting environment facilities, and performing tasks outside what the superior specified was specified. Conclusion Medical work needs to increase dissemination so that people realize the causes of sports injuries. At the same time, it helps people master the care measures before and after the injury. This reduces the incidence of sports injuries and reduces the occurrence of complications. Evidence level II; Therapeutic Studies - Investigating the results.
RESUMO Introdução A lesão no tornozelo é uma patologia aguda dos tecidos moles na qual os ligamentos do tornozelo são distendidos, lacerados, ou rompidos devido a violência durante o esporte. Essa articulação é também uma das mais vulneráveis nos esportes. Depois de uma lesão, o cuidado imediato e correto é significativo para aliviar a dor e reduzir complicações. Objetivo Analisar estatisticamente os casos de lesões esportivas do tornozelo, levantando as principais razões de lesão e traçar condutas preventivas. Métodos Uma investigação estatística sobre as lesões esportivas de 275 estudantes do ensino superior de Qiqihar foi executada com questionário e métodos de prática de ensino. A pesquisa foi concentrada na análise das estruturas lesionadas e a causa da lesão. Paralelamente foram levantadas propostas correspondentes visando a prevenção dessas lesões esportivas. Resultados As lesões articulares e entorses do tornozelo seguidas por hematomas representaram a maior proporção de lesões no tornozelo. Dentre os motivos, destacaram-se a falta de preparo físico, falta de consciência de autoproteção, preparação inadequada nas instalações do ambiente esportivo e execuções de tarefas fora do especificado pelo superior. Conclusão O trabalho médico precisa aumentar a divulgação para que as pessoas percebam as causas das lesões esportivas. Ao mesmo tempo, ajuda as pessoas a dominar as medidas de cuidado antes e depois da lesão. Isso reduz a incidência de lesões esportivas e reduz a ocorrência de complicações. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.
RESUMEN Introducción La lesión de tobillo es una patología aguda de las partes blandas en la que los ligamentos del tobillo se distienden, desgarran o rompen debido a la violencia durante la práctica deportiva. Esta articulación es también una de las más vulnerables en el deporte. Después de una lesión, una atención rápida y correcta es importante para aliviar el dolor y reducir las complicaciones. Objetivo Analizar estadísticamente los casos de lesiones esporádicas del tobillo, levantando las principales causas de lesión y trazar conductas preventivas. Métodos Se realizó una investigación estadística sobre las lesiones deportivas de 275 estudiantes de educación superior en Qiqihar con métodos de cuestionario y práctica docente. La investigación se centró en el análisis de las estructuras lesionadas y la causa de la lesión. Paralelamente, se plantearon las correspondientes propuestas encaminadas a la prevención de estas lesiones deportivas. Resultados Las lesiones articulares y los esguinces de tobillo, seguidos de los hematomas, representaron la mayor proporción de lesiones de tobillo. Entre los motivos, destacaron la falta de preparación física, la falta de conciencia de autoprotección, la preparación inadecuada en las instalaciones del entorno deportivo y la ejecución de tareas fuera de lo especificado por el superior. Conclusión El trabajo médico debe aumentar la difusión para que la gente se dé cuenta de las causas de las lesiones deportivas. Al mismo tiempo, ayuda a las personas a dominar las medidas de cuidado antes y después de la lesión. Esto reduce la incidencia de las lesiones deportivas y disminuye la aparición de complicaciones. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.
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Humans , Male , Female , Athletic Injuries/nursing , Physical Fitness/physiology , Ankle Injuries/nursingABSTRACT
Objective. Analyzed in compared perspective perceptions about nursing care, nurse-patient interaction, and nursing care outcomes in two ICU nursing staff in a high-complexity hospital institution, whose Nursing are Delivery Models (NCDM) are differentiated by the proportion of nurses and nurse assistants (NA) per team and by the assigned tasks and responsibilities. Methods. Particularist ethnography with adaptation to virtual methodologies. It included the sociodemographic characteristics of 19 nurses and 23 NA, 14 semi-structured interviews, review of patients' clinical records, and a focus group. Coding, categorization, inductive analysis, validation of results with participants were conducted and thematic saturation was achieved. Results. Four themes were identified: i) Professionalized care: a nursing of superior value; ii) senses and feelings of care; iii) nursing workload, generating factors and impacts; and iv) nursing missed care as concrete expression of the nursing workload. Conclusion. Compared nursing teams perceived nursing care in different ways, since it was experienced based on the assigned responsibilities and the possibilities of interaction with patients. Nursing care in the NCDM of the ICU with prevalence of direct bedside care by nurses with support from NA, it was perceived as holistic, comprehensive, and empathetic; whereas in the ICU with prevalence of delegated care to NA, it was related with administrative leadership and management of the ICU. Regarding the results, the NCDM of the ICU of direct bedside care by nurses showed better performance in patient safety and was closer to the skill level and legal responsibility of the nursing staff.
Objetivo. Analizar en perspectiva comparada las percepciones sobre el cuidado de enfermería, el relacionamiento con los pacientes y los resultados del cuidado en dos equipos de enfermería de UCI de una institución hospitalaria de alta complejidad, cuyos Modelos de Atención de Enfermería (MAE) se diferencian por la proporción de enfermeras y Auxiliares de Enfermería (AE) por equipo y por las tareas y responsabilidades asignadas. Métodos. Etnografía particularista con adaptación a metodologías virtuales. Incluyó la caracterización sociodemográfica a 19 enfermeras y 23 AE, 14 entrevistas semiestructuradas, revisión de historias clínicas de pacientes y un grupo focal. Se realizó codificación, categorización, análisis inductivo, validación de resultados con participantes y se logró la saturación temática. Resultados. Se identificaron cuatro temas: i) Cuidados profesionalizados: una enfermería de valor superior ii) sentidos y sentires del cuidado iii) carga de cuidado, factores generadores e impactos y iv) omisión del cuidado como expresión concreta de la carga de trabajo. Conclusión. Los equipos de Enfermería comparados percibieron el cuidado de enfermería de maneras distintas, pues se vivenció a partir de las responsabilidades asignadas y las posibilidades de relacionamiento con los pacientes. En el MAE de la UCI donde predomina el cuidado directo de enfermeras con apoyo AE, se percibió el cuidado como atención holista, integral y empática, mientras que en la UCI donde predomina el cuidado delegado a AE se relacionó con el liderazgo administrativo y la gestión de la sala de UCI. En cuanto a resultados, el MAE de la UCI de cuidado directo por enfermeras mostró mejor desempeño en seguridad del paciente y fue más cercano al nivel de competencias y de responsabilidad legal de los equipos de enfermería.
Objetivo. Analisar em perspectiva comparativa as percepções sobre o cuidado de enfermagem, a relação com os pacientes e os resultados do cuidado em duas equipes de enfermagem de UTI de uma instituição hospitalar de alta complexidade, cujos Modelos de Assistência de Enfermagem (MAE) diferem pela proporção de enfermeiros e auxiliares de enfermagem (AE) por equipe e por tarefas e responsabilidades atribuídas. Métodos.Etnografia particularista com adaptação a metodologias virtuais. Incluiu a caracterização sociodemográfica de 19 enfermeiros e 23 EA, 14 entrevistas semiestruturadas, revisão de prontuários e grupo focal. Codificação, categorização, análise indutiva, validação dos resultados com os participantes foram realizadas e a saturação temática foi alcançada. Resultados. Foram identificados quatro temas: i) Cuidado profissionalizado: enfermagem de valor superior ii) sentidos e sentimentos do cuidado iii) sobrecarga do cuidado, fatores geradores e impactos e iv) omissão do cuidado como expressão concreta da carga de trabalho. Conclusão. As equipes de Enfermagem compararam o cuidado de enfermagem percebido de diferentes maneiras, uma vez que foi vivenciado a partir das responsabilidades atribuídas e das possibilidades de relacionamento com os pacientes. No MAE da UTI onde predomina o cuidado direto por enfermeiros com apoio do EA, o cuidado foi percebido como cuidado holístico, integral e empático, enquanto na UTI onde predomina o cuidado delegado ao EA, estava relacionado à liderança administrativa e gestão da sala da UTI. Em termos de resultados, o MAE da UTI de cuidado direto por enfermeiros apresentou melhor desempenho na segurança do paciente e se aproximou mais do nível de competências e responsabilidade legal das equipes de enfermagem.
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Clinical Nursing Research , Critical Care Nursing , Nursing Care , Nursing Services , Nursing, Team , Health Services AdministrationABSTRACT
Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.
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Objective:To explore the application effect of clinical nursing pathway based on enhanced recovery after surgery (ERAS) concept in perioperative nursing of gastric cancer in the elderly, so as to provide basis for the selection of clinical nursing plan.Methods:A total of 92 patients with gastric cancer who underwent surgical treatment in Hefei Second People′s Hospital from January 2018 to July 2020 were enrolled. They were divided into the observation group and the control group by random number table method, 46 cases in each group. The control group was given routine nursing intervention, while the observation group was given clinical nursing pathway based on ERAS concept for intervention. The postoperative recovery, improvement of nutritional indexes, postoperative complications were compared between the two groups.Results:The first bowel sound time, first exhaust time, first defecation time, leaving bed time, indwelling time of urinary catheter, and postoperative hospitalization time were (18.43 ± 1.80) h, (43.67 ± 8.79) h, (53.06 ± 5.18) h, (22.65 ± 4.95) h, (29.08 ± 2.69) h, (13.93 ± 2.19) d in the observation group, while (22.96 ± 2.24) h, (47.98 ± 8.46) h, (57.97 ± 5.65) h, (31.30 ± 5.73) h, (35.40 ± 3.66) h, (15.48 ± 2.40) d in the control group, there were significant differences between the two groups ( t values were 2.40-10.69, all P<0.05). There was no significant difference in the nutritional indexes before intervention between the two groups( P>0.05). After intervention, the levels of serum total protein, serum albumin and hemoglobin were (64.43 ± 6.22), (35.43 ± 3.07), (125.88 ± 4.75) g/L in the observation group, while (55.97 ± 5.25), (29.96 ± 2.64), (120.05 ± 5.07) g/L in the control group, there were significant differences between the two groups ( t=7.05, 9.16, 5.69, all P<0.05). The incidence of postoperative complications was 4.35%(2/46) in the observation group, 19.57%(9/46) in the control group, there was significant difference between the two groups ( χ2=5.06, P<0.05). Conclusions:The clinical nursing pathway based on ERAS concept can effectively ensure the nutrition needed by patients with gastric cancer during postoperative rehabilitation, accelerate rehabilitation process, and reduce the incidence of postoperative complications.
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Objective:To acquire more scientific, accurate and efficient unplanned extubation (UEX) quality management data by using information technology to directly take the quality index data of unplanned extubation from the nursing medical record system.Methods:From June 2019 to August 2019, a knowledge base of pipeline management including the name of pipeline, pipeline evaluation, pipeline care measures, and reasons for unplanned extubation of pipeline was established in Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine. Through the analysis of each node of pipeline management, pipeline management system was established. And the non-planned pipeline management data set was directly collected to the nursing quality management system for statistics and analysis, which was verified.Results:In clinical application from September 2019 to september 2020, the direct collection of unplanned extubation quality index data saved 496 hours of nursing labor costs per month, and the accuracy of direct data collection increased from 95.8% (161/168) in trial operation to 100.0% (494/494). The underreporting rate of adverse events decreased to 0. Satisfaction with the application of the quality index management system for unplanned extubation was (4.35 ± 0.73) points.Conclusions:The direct collection of quality index data for unplanned extubation improves the accuracy of the data. Nurses no longer need to report unplanned extubation incidents. The clinical nursing information system and the nursing management system are interconnected to improve the management efficiency of unplanned extubation. It is worthy of application and promotion in clinic.
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@#Objective To analyze the current status and influencing factors of job competence of clinical nursing teachers. Methods A total of 673 clinical nursing teachers from 35 second-level and above hospitals in Anhui Province were selected as research subjects using convenient sampling method. Their job competence was evaluated using the Clinical Nursing Teacher Post Competency Evaluation Scale. Results The score of job competence of clinical nursing teachers was 87.1±9.7. The results of multiple linear regression analysis showed that with the increase of service length and clinical teaching years,the job competence score of clinical nursing teachers increased(all P<0.05). For those who thought the higher the satisfaction with the teaching atmosphere of the hospital,the hospital teaching training can meet their requirements and the higher the willingness to accept the teaching training,the higher their job competence score(all P<0.05). Conclusion There is still much room for improvement in job competence of clinical nursing teachers in Anhui Province. The length of service,clinical teaching years, hospital teaching atmosphere,teaching training meeting demand,and willingness to accept clinical teaching training are the influencing factors of job competence of clinical nursing teachers.
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ABSTRACT Objective: To evaluate the effectiveness of acupuncture associated with pelvic floor muscle training for the control of urinary incontinence following radical prostatectomy. Method: Open-label, parallel randomized clinical trial. The intervention group (n = 33) underwent eight sessions of systemic acupuncture associated with pelvic floor muscle training and the control group (n = 31) performed only pelvic floor muscle training. The outcome variable was urinary incontinence assessed by the Pad Test and Daily Pad Used, before treatment (T0), after four weeks (T1) and after eight weeks of treatment (T2). Data analysis was performed using a longitudinal model of Generalized Estimating Equations, significance level of 0.05. Results: The control group showed greater urinary loss compared to the intervention group at T1 (p = 0.006) and at T2 (p < 0.001). Both groups showed improvement in the level of urinary incontinence over time, but the improvement was greater in the intervention group (p < 0.001). Conclusion: Acupuncture associated with pelvic floor muscle training was effective in reducing urinary incontinence in prostatectomized men. Brazilian Registry of Clinical Trials:RBR-3jm5y2
RESUMEN Objetivo: evaluar la efectividad de la acupuntura asociada al entrenamiento muscular de piso pélvico para el control de la incontinencia urinaria post-prostatectomía radical. Método: ensayo clínico aleatorizado paralelo, del tipo abierto. El grupo intervención (n = 33) fue sometido a ocho sesiones de acupuntura sistémica asociada al entrenamiento muscular de piso pélvico y el grupo control (n = 31) solamente al entrenamiento muscular de piso pélvico. La variable desfecho fue incontinencia urinaria evaluada por el Pad Test y Daily Pad Used, antes del tratamiento (T0), después de cuatro semanas (T1) y después de ocho semanas de tratamiento (T2). El análisis de datos fue realizado por modelo longitudinal de Ecuaciones de Estimaciones Generalizadas, nivel de significancia de 0,05. Resultados: el grupo control presentó mayor pérdida urinaria en comparación al grupo intervención en T1 (p = 0,006) y en T2 (p < 0,001). Ambos grupos presentaron mejor nivel de incontinencia urinaria a lo largo del tiempo, sin embargo la mejora fue mayor en el grupo intervención (p < 0,001). Conclusión: la acupuntura asociada al entrenamiento muscular de piso pélvico fue efectiva para la reducción de la incontinencia urinaria en hombres prostatectomizados. Registro Brasileño de Ensayos Clínicos:RBR-3jm5y2
RESUMO Objetivo: Avaliar a efetividade da acupuntura associada ao treinamento muscular do assoalho pélvico para o controle da incontinência urinária pós-prostatectomia radical. Método: Ensaio clínico aleatorizado paralelo, do tipo aberto. O grupo intervenção (n = 33) foi submetido a oito sessões de acupuntura sistêmica associada ao treinamento muscular do assoalho pélvico e o grupo controle (n = 31) somente ao treinamento muscular do assoalho pélvico. A variável desfecho foi incontinência urinária avaliada pelo Pad Test e Daily Pad Used, antes do tratamento (T0), após quatro semanas (T1) e após oito semanas de tratamento (T2).A análise de dados foi realizada por modelo longitudinal de Equações de Estimações Generalizadas, nível de significância de 0,05. Resultados: O grupo controle apresentou maior perda urinária em comparação ao grupo intervenção em T1 (p = 0,006) e em T2 (p < 0,001). Ambos os grupos apresentaram melhora no nível de incontinência urinária ao longo do tempo, porém a melhora foi maior no grupo intervenção (p < 0,001). Conclusão A acupuntura associada ao treinamento muscular do assoalho pélvico foi efetiva para a redução da incontinência urinária em homens prostatectomizados. Registro Brasileiro de Ensaios Clínicos:RBR-3jm5y2
Subject(s)
Prostatectomy , Urinary Incontinence , Acupuncture , Clinical Nursing Research , Pelvic Floor Disorders , Lower Urinary Tract SymptomsABSTRACT
Resumo: A mucosite oral (MO) é uma das mais importantes complicações da quimioterapia e radioterapia no Transplante de Células-Tronco Hematopoéticas (TCTH), além de ser um evento estomatológico bastante frequente, influencia diretamente a qualidade de vida dos pacientes. A aplicabilidade da Ozonioterapia é uma hipótese a ser testada cientificamente para a prevenção e tratamento da MO destes pacientes, devido ser um poderoso agente oxidante, e desencadear reações oxidativas com impacto de ações bactericidas, fungicidas, moduladoras do estresse oxidativo e do sistema imunológico. Os objetivos foram verificar a eficácia da Ozonioterapia para o manejo da mucosite oral, como terapia complementar ao tratamento convencional, em pós-transplantados de células-tronco hematopoéticas; Produzir um protocolo para utilização de água ozonizada como colutório por profissionais de saúde. Quanto ao método trata-se de um Estudo de Intervenção Clínica, randomizado, realizado com pacientes maiores de sete anos de idade, submetidos ao TCTH e, com diagnóstico de MO, internados no Serviço de Transplante de Medula Óssea do Complexo Hospital das Clinicas, da Universidade Federal do Paraná, Curitiba. Utilizada a técnica de randomização simples, com os participantes alocados no Grupo Controle (GC; n=8) ou Grupo de Intervenção (GI; n=9); no GI, foram submetidos a lavado bucal com Água para Injeção (AIE) ozonizada a 9,94 Mig/ml, duas vezes ao dia, adicionado ao protocolo de rotina do serviço. Como resultados foram observados Graus III e IV no GC, enquanto o Grau II foi predominante no GI, com p<0,05 do dia D+6 até o D+11. O escore de dor obteve p = 0,05 no D+11; com p<0,05 entre D+6 e D+11. A diferença média dos dias de internação foi de 7,3 dias menor para o GI. Frente aos resultados positivos alcançados com o Protocolo de pesquisa foi desenvolvida uma tecnologia assistencial, na modalidade de um protocolo, denominado Água Ozonizada como Colutório: Protocolo para utilização do Ozônio por profissionais de saúde, para o serviço cenário da pesquisa. Concluindo, foi evidenciada diferença estatística significativa entre o GI e GC quanto à gravidade da MO, dos escores de dor e na redução dos dias de internação dos pacientes submetidos ao TCTH. Fica assim demonstrada a eficácia da AIE ozonizada no manejo da MO em pacientes pós-TCTH, mediante a confirmação da hipótese alternativa de que a terapia complementar com a mescla O2/O3 pode contribuir para atenuar a sintomatologia, como a redução dos escores de dor e gravidade da lesão, e assim favorecer a recuperação mais rápida do paciente devido, quando comparados ao grupo controle. Para sustentar a segurança e qualidade desta prática, que poderá ser aplicada em outros cenários, foi desenvolvido e registrado na Câmara Brasileira do Livro, um protocolo assistencial.
Abstract: Oral mucositis (OM) is a key complication of chemotherapy and radiotherapy in Hematopoietic Stem Cell Transplantation (HSCT), besides being a very frequent stomatological event. It directly influences the quality of life of patients. The applicability of ozone-therapy is a hypothesis to be scientifically tested for the prevention and treatment of OM of these patients, owing to the fact that it is a powerful oxidizing agent, as well as it triggers oxidative reactions, impacting bactericidal actions, fungicides, modulating oxidative stress and the immune system. The objectives were to verify the efficacy of ozone therapy for the management of oral mucositis, as a complementary therapy to conventional treatment, in post-transplanted hematopoietic stem cell patients; as well as to produce a protocol for the use of ozonized water as a mouthwash by health professionals. Regarding the method, this is a Randomized Clinical Intervention Study conducted with patients over seven years of age, submitted to HSCT and, diagnosed with OM, hospitalized in the Bone Marrow Transplantation Service of the Hospital das Clinicas Complex, Federal University of Paraná, Curitiba. The simple randomization technique was used, with the participants allocated in the Control Group (CG; n=8) or Intervention Group (IG; n=9); in GI, they were submitted to oral washing with Water for Injection (WI) ozonized at 9.94 Mig/ml, twice a day, added to the routine protocol of the service. As results, Grade III and IV were observed in the CG, while Grade II was predominant in IG, with p<0.05 from day D+6 to D+11. The pain score was p = 0.05 in D+11; with p <0.05 between D+6 and D+11. The average difference in the duration of hospitalization was 7.3 days lower for the IG. In the face of the positive results achieved with the research Protocol, a care technology was developed in the modality of a protocol, denomination of Ozonized Water as Mouthwash: Protocol for the use of ozone by health professionals, applied to the health service being researched. As conclusions, a statistically significant difference was made between the IG and CG regarding the severity of OM, pain scores and the reduction of hospitalization days for patients submitted to HSCT. Thus, the efficacy of ozonized WI in the management of OM in patients after HSCT is demonstrated, by confirming the alternative hypothesis that complementary therapy with the O2/O3 mixture can contribute to attenuate symptomatology, such as the reduction of pain and severity scores of the lesion, therefore favoring faster patients' recovery when compared to the control group. To support the safety and quality of this practice, in order to be applied in other scenarios, a care protocol was developed and registered in the Brazilian Book Chamber.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Patients , Quality of Life , Stomatitis , Hematopoietic Stem Cell Transplantation , Patient Safety , Ozone TherapyABSTRACT
Objective:To explore the application of integrated medical-nursing management model for clinical nursing teaching in neonatology department.Methods:A total of 28 undergraduate nursing students having internship in neonatology department from August 2018 to February 2020 were enrolled in the study, among which 15 nursing students from August 2018 to May 2019 were selected as the control group, and 13 nursing students from August 2019 to February 2020 were selected as the observation group. The control group was given traditional teaching, and the observation group was given integrated teaching of medical care. The theoretical scores, nursing operation, comprehensive quality, total scores and teaching satisfaction of the two groups were compared. SPSS 19.0 was used for t test. Results:The theoretical scores of the observation group and the control group were (96.31±0.85) points and (88.47±1.92) points, respectively. Nursing operation scores of observation group and control group were (95.18±2.06) points and (93.15±2.13) points. Comprehensive quality of observation group and control group were (96.23±1.48) points and (90.47±1.88) points. The total scores of the observation group and the control group were (96.83±1.27) points and (91.20±1.31) points, respectively. All the differences were statistically significant ( P<0.05). Ther were significant differences between the two groups in terms of teaching satisfaction including teaching methods, contents, teachers' satisfaction and total satisfaction( P<0.05). Conclusion:In the clinical nursing teaching of neonatology department, the integrated medical-nursing management model is helpful to improve the clinical comprehensive quality and teaching satisfaction of undergraduate nursing students.
ABSTRACT
Objective: to compare the efficacy of 80% (w/v) alcohol, rubbed for 30 and 60 seconds, in the manual processing of stainless-steel wash bowls, after cleaning with running water and neutral detergent. Method: experimental study conducted in a hospital in the state of São Paulo, Brazil, on 50 bowls randomly divided into two groups of 25 bowls each for interventions of 30 and 60 seconds of rubbing with 80% (w/v) alcohol. Results: based on the microbiological analyses collected, before and after the interventions for both groups, partial efficacy of the disinfectant was observed even when extending rubbing time. In both groups, there was a higher prevalence of survival of Pseudomonas aeruginosa, with 14 strains that were resistant to carbapenems, being, specifically, 11 to imipenem and three to meropenem. Conclusion: stainless-steel bed wash bowls decontaminated for reuse by 80% (w/v) alcohol, after cleaning with running water and neutral detergent, showed to be reservoirs of hospital pathogens. The use of bed wash bowls for patients with intact skin would not have worrying consequences, but considering those with non-intact skin and the contamination of professionals' hands, the results in this study justify the search for other decontamination methods or the adoption of disposable bed baths.
Objetivo: comparar a eficácia do álcool 80% (p/v), friccionado por 30 e 60 segundos, no processamento manual de bacias de banho em aço inoxidável, após limpeza com água corrente e detergente neutro. Método: estudo experimental realizado em hospital do estado de São Paulo, Brasil, com 50 bacias randomicamente distribuídas em dois grupos de 25, para as intervenções de 30 e 60 segundos de fricção com álcool 80% (p/v). Resultados: das análises microbiológicas coletadas, antes e após as intervenções para os dois grupos, verificou-se eficácia parcial do desinfetante, mesmo ampliando o tempo de fricção. Em ambos os grupos, observou-se maior prevalência de sobrevida de Pseudomonas aeruginosa, 14 cepas resistentes a carbapenens, especificamente, 11 ao imipenen e três ao meropenen. Conclusão: bacias de banho no leito em aço inoxidável, descontaminadas para reuso com álcool 80% (p/v), após limpeza com água corrente e detergente neutro, apresentam-se como reservatórios de patógenos hospitalares. O uso das bacias de banho no leito para pacientes com pele íntegra não teria consequências preocupantes, mas para aqueles com pele não íntegra e pensando na contaminação das mãos dos profissionais, os resultados dessa pesquisa justificam a busca de outros métodos de descontaminação ou a adoção de banho de leito descartável.
Objetivo: comparar la eficacia del alcohol al 80% (p/v), frotado durante 30 y 60 segundos, en el proceso de descontaminación manual de palanganas de baño de acero inoxidable, después de lavarlas con agua corriente y detergente neutro. Método: estudio experimental realizado en un hospital del estado de São Paulo, Brasil, con 50 palanganas divididas aleatoriamente en dos grupos de 25, para intervenciones de 30 y 60 segundos de frotamiento con alcohol al 80% (p/v). Resultados: los análisis microbiológicos recolectados, antes y después de las intervenciones para ambos grupos, demostraron efectividad parcial del desinfectante, incluso cuando se extendió el tiempo de fricción. En ambos grupos, se observó una mayor prevalencia de supervivencia de Pseudomonas aeruginosa, 14 cepas resistentes a carbapenemas, específicamente 11 a imipenem y tres a meropenem. Conclusión: las palanganas de baño de cama de acero inoxidable, descontaminadas para su reutilización con alcohol al 80% (p/v), después del lavado con agua corriente y detergente neutro, actúan como reservorios de patógenos hospitalarios. El uso de las palanganas de baño de cama no tendría consecuencias preocupantes para pacientes con la piel íntegra, pero para aquellos cuya piel no conserva su integridad y pensando en la contaminación de las manos de los profesionales, los resultados de esta investigación justifican la búsqueda de otros métodos de descontaminación o la adopción del baño de cama desechable.
Subject(s)
Humans , Stainless Steel , Brazil , Decontamination , Equipment Contamination/prevention & control , EthanolABSTRACT
Objective: to identify possible associations between a higher probability of falls among hemodialysis patients and laboratory values, comorbidities, pharmacological treatment, hemodynamic changes, dialysis results and stabilometric alterations. Method: this was a retrospective case-control study with hemodialysis patients. Patients in a hemodialysis unit who had suffered one or more falls were included in the case group. Patients from the same unit who had not suffered falls were the controls. Data were gathered from the patients' clinical history and also from the results of a balance test conducted six months before the study. Results: thirty-one patients were included (10 cases and 21 controls). Intradialytic body weight change was significantly greater among cases (p <0.05). Patients in the case group also presented greater lateral instability after dialysis (p <0.05). Other factors such as high blood pressure, antihypertensives, beta-blockers, and lower heart rates were also associated with falls. Conclusion: a greater intradialytic weight change was associated with an increase in risk of falls. Nursing staff can control these factors to prevent the incidence of falls in dialysis patients.
Objetivo: identificar la posible asociación entre los valores analíticos, comorbilidades, tratamiento farmacológico, cambios hemodinámicos, resultado de la diálisis y alteraciones estabilométricas con una mayor probabilidad de caídas en pacientes en hemodiálisis. Método: estudio retrospectivo de casos y controles en pacientes en hemodiálisis. Se consideraron como casos pacientes de una unidad de hemodiálisis que habían sufrido una o varias caídas. Los controles fueron pacientes de la misma unidad que no sufrieron caídas. Se obtuvieron los datos de la historia clínica de los pacientes y, también, se valoró una prueba de equilibrio realizada 6 meses antes a dichos pacientes. Resultados: se incluyeron 31 pacientes (10 casos y 21 controles). El cambio de peso durante la diálisis fue significativamente mayor en el grupo de personas que sufrieron una caída (p <0,05). Los pacientes que sufrieron una caída presentaron mayor inestabilidad lateral después de la diálisis (p <0.05). Otros factores como la hipertensión arterial, los antihipertensivos, los betabloqueantes y las frecuencias cardiacas más bajas también se relacionaron con las caídas. Conclusión: un mayor cambio de peso intradiálisis se relaciona con mayor riesgo de caídas. El control de estos factores por parte del personal de enfermería podría prevenir la incidencia de caídas en pacientes dializados.
Objetivo: identificar a possível associação entre valores laboratoriais, comorbidades, tratamento farmacológico, alterações hemodinâmicas, resultado da diálise e alterações estabilométricas com uma maior probabilidade de quedas em pacientes de hemodiálise. Método: estudo caso-controle retrospectivo em pacientes de hemodiálise. Foram analisados os casos de pacientes de uma unidade de hemodiálise que sofreram uma ou mais quedas. Os controles foram pacientes da mesma unidade que não sofreram quedas. Os dados foram obtidos a partir do histórico clínico dos pacientes e, também, de um teste de equilíbrio realizado seis meses antes nesses pacientes. Resultados: 31 pacientes foram avaliados (10 casos e 21 controles). A alteração de peso durante a diálise foi significativamente maior no grupo de pessoas que sofreu uma queda (p <0,05). Pacientes que sofreram queda apresentaram maior instabilidade lateral após a diálise (p <0,05). Outros fatores, como hipertensão, anti-hipertensivos, betabloqueadores e frequência cardíaca mais baixa, também foram associados às quedas. Conclusão: uma maior alteração do peso intradialítico está relacionada a um maior risco de quedas. O controle desses fatores pela equipe de enfermagem poderia prevenir a incidência de quedas em pacientes em diálise.
Subject(s)
Humans , Body Weight Changes , Accidental Falls , Clinical Nursing Research , Risk Factors , Renal Dialysis , Postural BalanceABSTRACT
Objective: to assess the effect of a care intervention focused on meeting the needs of family members of surgical patients during the surgery waiting time, when compared to conventional care. Method: a study with a quasi-experimental design that was developed from December 2019 to February 2020 and included 313 family members (Intervention Group=149 and Control Group=164) from a private hospital. The intervention consisted in four moments: "knowing the surgical environment and process", "information when the surgery starts", "information when the surgery ends", and "family-patient reunion". The "satisfaction" variable was assessed through the "Patient Satisfaction with Nursing Care Quality Questionnaire" instrument. The data were analyzed using descriptive and analytical statistics. The study observed the ethical principles in research. Results: the family members in the Intervention Group presented greater satisfaction with Nursing care, 90.07(9.8), when compared to the Comparison Group, 78.72(16.38), with an 11.35-point increase(p=0.000). Conclusion: the results showed that the families that received the intervention on the patient's status during the surgery waiting time were more satisfied with Nursing care in comparison to the conventional intervention.
Objetivo: evaluar el efecto de una intervención de cuidado centrada en satisfacer las necesidades de los familiares de pacientes intervenidos quirúrgicamente durante la espera quirúrgica en comparación con el cuidado convencional. Método: diseño cuasi experimental que se desarrolló durante los meses de diciembre de 2019 a febrero de 2020 que incluyó 313 familiares (grupo de intervención = 149 y grupo de control = 164) de un hospital privado. La intervención estuvo compuesta por cuatro momentos: "conocer el ambiente y proceso quirúrgicos", "información sobre el inicio de la cirugía", "información sobre elfin de la cirugía", "reencuentro familia-paciente". La variable de satisfacción se midió a través del instrumento "Cuestionario satisfacción del paciente con la calidad del cuidado de enfermería". Los datos fueron analizados con estadística descriptiva y analítica. El estudio tuvo en cuenta los principios éticos en investigación. Resultados: los familiares del grupo de intervención presentaron una mayor satisfacción con el cuidado de enfermería 90,07 (9,8) comparado con el grupo de comparación 78,72 (16,38), con un aumento de 11,35 puntos (p = 0,000). Conclusión: los resultados demostraron que las familias que recibieron la intervención sobre el estado del paciente durante el tiempo de espera quirúrgico tuvieron una mayor satisfacción con la calidad del cuidado de enfermería en comparación con la intervención convencional.
Objetivo: avaliar o efeito de uma intervenção assistencial voltada para o atendimento das necessidades dos familiares de pacientes operados durante a espera no centro cirúrgico em comparação ao atendimento convencional. Método: estudo quase-experimental desenvolvido entre os meses de dezembro de 2019 e fevereiro de 2020 incluindo 313 familiares (grupo intervenção = 149 e grupo de comparação = 164) de um hospital privado. A intervenção consistiu em quatro momentos: "conhecer o ambiente e o processo cirúrgico", "informações sobre o início da cirurgia", "informações sobre o término da cirurgia", "reunião família-paciente". A variável de satisfação foi medida por meio do instrumento "Questionário de satisfação do paciente com a qualidade dos cuidados de enfermagem". Os dados foram analisados com estatística descritiva e analítica. O estudo levou em consideração os princípios éticos em pesquisa. Resultados: os familiares do grupo intervenção apresentaram maior satisfação com os cuidados de enfermagem 90,07 (9,8) em relação ao grupo de comparação 78,72 (16,38), com aumento de 11,35 pontos (p = 0,000). Conclusão: os resultados demonstraram que as famílias que receberam a intervenção sobre a condição do paciente durante o tempo de espera cirúrgica relataram maior satisfação com a qualidade dos cuidados de enfermagem se comparados à intervenção convencional.