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Objective To investigate the effect of early warning score system combined with(situation,background,ssessment,recommendation,SBAR)communication model in early warning of high-risk neonates,therefore to provide an effective communication method for an effective communication method to assess the changes of condition in neonates.Methods A before-after study model was adopted in the study.A total of 270 high-risk neonates admitted to the ward of the Department of Neonatology in a tertiary hospital between August and September 2022 were selected as research subjects.The high-risk neonates admitted in hospital in August were assigned in a control group,and those admitted in September were assigned in an trial group,with 135 neonates per group.Routine care was carried out in the control group,while early warning scoring combined with SBAR communication model were applied in the trial group on top of the cares offered to the control group.The occurrence of early warning events,concordance rate of nurse warning event and doctor handling events,and the satisfaction rate of doctors with the nursing performance were compared between the two groups.Results A total of 63.6%of early warning events were triggered by nurses in the control group,while it was 92.6%in the trial group,with a statistically significant difference between the groups(χ2=16.622,P<0.001).The consistency of handling of early warning events between the nurses and doctors in the trial group(Kappa coefficient=0.926)was higher than that in the control group(Kappa coefficient=0.641).The satisfaction rates of the doctors with the nurses about specialist knowledge,ability in emergency events,mastery of disease,timely observation of disease progress,collaboration between doctors and nurses,working enthusiasm,communication capability and the psychological quality in the trial group were all significantly higher than those in the control group[80.0%-95.0%vs.30.0%-55.0%,all P<0.01].Conclusions The Early Warning Score system combined with SBAR communication model can help nurses to accurately evaluate the changes of disease in neonates,complete the communication with doctors timely and effectively.It improves the observation,communication and handling capability among the nurses as well as the satisfaction rate of doctors with nursing work.
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ObjectiveTo investigate the clinical features and high risk of very preterm infants with late-onset bacterial sepsis，so as to propose feasible prevention and treatment suggestions． MethodsTotally 94 very preterm infants with late-onset bacterial sepsis from the Neonatology Department of Women’s Hospital of Jiangnan University were recruited from February， 2012 to January， 2024. Their clinical data， including the perinatal situation， clinical symptoms， pathogens， risk factors and treatment， were collected and analyzed. ResultsThe incidence rate of very preterm infants with late-onset bacterial sepsis were 8.40 for 100 live birth babies. The major pathogens of the infections among these very premature infants included gram-positive bacteria （71.1%）. Logistic regression analysis showed that long term（≥7 d）use of antibiotics， invasive mechanical ventilation， indwelling central venous catheter（≥7 d）， and vaginal delivery were high risk factors of very preterm infants with late-onset bacterial sepsis， the relative risk （OR） values were 2.787， 4.243， 3.033 and 2.174， respectively. ConclusionThe gram-positive bacteria are the main pathogens of late-onset bacterial sepsis in very preterm infants. Long term（≥7 d）use of antibiotics， invasive mechanical ventilation， indwelling central venous catheter（≥7 d）and vaginal delivery are high risk factors of very preterm infants with late-onset bacterial sepsis. The incidence of late-onset bacterial sepsis in very preterm infants can be reduced by strengthening perinatal management， shortening the time of antibiotic application and reducing invasive operations.
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OBJECTIVE：To est ablish the working mode of the first pharmaceutical ward rounds of clinical pharmacists in our hospital，in order to provide a useful reference for establishing a national standardized pharmaceutical ward rounds model. METHODS：By sharing the clinical cases of the first pharmaceutical ward rounds ，the work content and process of the first pharmaceutical ward rounds in our hospital were introduced. RESULTS & CONCLUSIONS ：The clinical pharmacist ’s first pharmaceutical ward round in our hospital mainly includes self introduction of clinical pharmacists ，diagnosis of patients ’condition under the guidance of doctors ，collection and evaluation of patients ’previous medication information （including previous medication varieties ，usage methods ，efficacy and safety evaluation ），assistance for doctors in formulating initial treatment plan ， carrying out initial medication and diet education ，and intensive communication and cooperation with nurses. The development of first pharmaceutical ward rounds promotes the rational use of drugs in clinic ，elevates the hospitalization satisfaction of patients and improves the professional quality of clinical pharmacists.
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Objective To investigate the protective effect of inhibition of hypoxia inducible factor－1 alpha (HIF－1α) and activation of Wnt signaling pathway on brain injury in neonatal rats.Method A total of 312 newborn SD rats were used to establish cerebral white matter damage model (WMD) on day 3.And they were randomly assigned into the model group (WMD group), post－modeling HIF－1αdecomposition inhibition group (PHI group), and post－modeling HIF－1αdecomposition inhibition with activation of Wnt signaling pathway group (PHI+activated Wnt group ) and post－modeling HIF－1αdecomposition inhibition with inhibition of the Wnt signaling pathway group (PHI+inhibition Wnt group).Brain tissues were taken on day 1, 3, 7 and 14 after modeling, respectively.The changes of oligodendrocyte precursor cell (OPC) and oligodendrocyte ( OL ) in brain tissues at different time points were observed by tissue immunofluorescence.The expression of HIF－1αprotein in the brain tissue of each time point was measured by western blot technique.The mRNA level of HIF－1αand Wnt7a in the brain tissue of each time point was detected by RT－qPCR technique.Behaviors of rats were tested by the suspension experiment , the open field experiment and the dark experiment , at 28 d after modeling.Result The numbers of OPC on 1 d and 3 d after modeling and the number of OL on 7 d and 14 d after modeling in PHI +activated Wnt group were significantly higher than the other three groups.The content of HIF－1αin WMD group was the least on 1, 3, 7 and 14 d, but the content of PHI+activated Wnt group was the highest , and the difference was statistically significant (P＜0.05).On 1, 3, 7 and 14 d after modeling, the expression level of HIF－1αand Wnt7a in PHI+activated Wnt group were higher than those in the other three groups , the difference was statistically significant (P＜0.05), and Wnt7a expression was positively correlated with the change of HIF－1α(P＜0.05).There was no significant difference of suspension experiment at 28 d after modeling between groups. Compared with other groups , WMD group had the lowest score on open field experiment ( P＜0.05).The PHI+activation Wnt group had better memory function , and then the PHI group , WMD group.The latent time of dark experiment were significantly shorter in PHI +acitivation Wnt group.There were more mistaken time of dark experiment in WMD group compared with PHI +activation Wnt group.Conclusion Inhibition of HIF－1αdecomposition and activation of Wnt signaling pathway have partially repair effect on brain injury in neonatal rats.