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Objective:To analyze the application value of PAD (Presentation-Assimilation-Discussion) class and case teaching combined with brainstorming in the practice teaching of nursing students in the department of cardiovascular surgery.Methods:A total of 81 undergraduate nursing students who practiced in the Department of Cardiovascular Surgery, The First Affiliated Hospital of Air Force Medical University from June 2019 to April 2020 were selected as the research objects. They were randomly divided into the control group ( n=40, brainstorming teaching) and the observation group ( n=41, PAD class combined with case teaching). After one month of intervention, the teaching effect on the two groups of nursing students were evaluated through the nursing students' clinical communication ability scale, Chinese version of self-assessment of clinical reflection and reasoning (SACRR), and competency inventory for registered nurse (CIRN). And the teaching quality was assessed by the clinical nursing teacher teaching behavior assessment scale. SPSS 22.0 was used for t-test. Results:The scores of each dimension and total scores of clinical communication ability scale, Chinese version SACRR and CIRN of nursing students in the observation group were higher than those in the control group ( P<0.05). The scores of nursing teaching behavior evaluation of clinical teachers in the observation group were higher than those in the control group ( P<0.05). Conclusion:The combination of PAD class and case teaching with brainstorming can improve the clinical communication ability of nursing students in cardiovascular surgery practice, help to promote the transformation of their clinical thinking ability, improve their core competences, and play an important role in improving the teaching quality.
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Objective:To compare the effect of systematic nursing in operating room and routine nursing in reducing intraoperative stress injury in patients with spinal fracture and spinal cord injury.Methods:A retrospective case-control study was conducted to analyze the clinical data of 285 patients with cervical or thoracolumbar fracture associated with spinal cord injury admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University from January 2018 to December 2019, including 168 males and 127 females, with the age of 38-59 years [(47.8±8.5)years]. All patients underwent posterior decompression and fusion with internal fixation. Of all, 138 patients received systematic nursing in operating room including systematic evaluation and management before, during and after operation (observation group), and 147 patients received routine nursing including only intraoperative preventive care of pressure ulcer (control group). The incidence of pressure injury on the day after operation, degree of injury and location of injury at postoperative 3 days, and area of injury on the day after operation and at postoperative 3 days were compared between the two groups. The degree of injury was evaluated using the new stress injury staging assessment published by the American National Pressure Ulcer Advisory Panel (NPUAP).Results:The incidence of pressure injury in observation group [5.1% (7/138)] was lower than that in control group [12.2% (18/147)] on the day after operation ( P<0.05). The incidence of stage I, stage II, and stage III pressure injury in observation group [2.9% (4/138), 2.2% (3/138), 0.0%] was also lower than that in control group [8.2% (12/147), 3.4% (5/147), 0.6% (1/147)] at postoperative 3 days ( P<0.05). There was no significant difference in the incidence of pressure injury in the knee, chest, face and anterior superior iliac spine between the two groups ( P>0.05). The total proportion of pressure injury in the face and anterior superior iliac spine was 71% (5/7) in observation group, showing no significant difference from that in control group [83% (15/18)] ( P>0.05). The area of injury was (3.2±1.2)cm 2 and (3.2±1.1)cm 2 in observation group on the day after operation and at postoperative 3 days, lower than that in in control group [(5.1±1.5)cm 2 and (5.1±1.4)cm 2] ( P<0.01). Conclusion:Compared with the routine nursing, systematic nursing in operating room can significantly reduce the incidence, degree and area of intraoperative pressure injury in patients with spinal fracture accompanied by spinal cord injury, and deserves clinical promotion.