Application and exploration of case-based learning in the teaching of patient safety course / 中华医学教育探索杂志

Objective:To explore the teaching effect of case-based learning (CBL) in patient safety course.Methods:A self-made CBL teaching effect questionnaire was used to conduct an online survey on 212 clinical medical undergraduates from a medical college in Chongqing.Results:A total of 212 questionnaires were collected, with 100% of effective recovery rate. Among the students, 91.0% believed that CBL teaching quality was high; 92.4% were satisfied with CBL teaching; 62.7% were the first to experience CBL teaching; 96.7% preferred CBL teaching; 94.3% said that in the future teaching, they would like to accept CBL Teaching. Most students thought that CBL played a vital role in stimulating learning interest, improving learning enthusiasm, activating classroom atmosphere, broadening learning ideas, exercising independent thinking ability, and facilitating the ability of theory connected with practice. Suggestions for the CBL teaching of patient safety courses are summarized into the following three keywords: multiple cases, more interactions, and more similar teaching.Conclusion:The application of CBL in the patient safety course is worth promoting, which is conducive to improving the teaching quality.

Ultrasonic evaluation of the effect of cartilage acetabular ,glenoid labrum and acetabular tissue on closed reduction of developmental dysplasia of hip / 中华超声影像学杂志

Objective To investigate the effect of cartilage acetabular ,glenoid labrum and acetabular tissue on closed reduction of developmental dysplasia of hip ( DDH ) by analyzing the outcomes of the ultrasound measurement on DDH before and after Pavik Harness treatment . Methods Graf method was used in ultrasound measurement before the treatment . Position of cartilaginous acetabulum and glenoid labrum and displacement direction of femoral head in 31 patients with hip dislocations ( type D ,type Ⅲ ,typeⅣ ,36 hips) were recorded . T he follow‐up testing with ultrasound measurement on the inside of the hip were performed after 1 －2 weeks of Pavik Harness treatment . M ediolateral dimension ,anteroposterior dimension and the area of maximum section of acetabular tissue were measured . Reduction effects were evaluated . Results T he success rate of reduction of dislocation hips with cartilaginous acetabulum on the head orientation was obviously higher than that on the foot orientation( P ＜0 .000 1) . T he success rate of reduction of dislocation hips with glenoid labrum on the head orientation was obviously higher than that on the foot orientation ( P ＝ 0 .001 6 ) . T here was a statistically significant difference in the success rate of different types of hip dislocation ( type D , type Ⅲ , type Ⅳ ) ( P＝ 0 .002 7 ) . T here were statistically significant differences in mediolateral dimension ,anteroposterior dimension and the area of maximum section of acetabular tissue between the reduction group and the group without dislocation ,the irreducible group and the group without dislocation ,the irreducible group and the reduction group ( P ＜ 0 .01) . Conclusions Ultrasonography is of great significance in the diagnosis and treatment of children with DDH . T he position of hip cartilaginous acetabulum and glenoid labrum ,types of hip dislocation and the volume of acetabular tissue have important effects on the success of the closed reduction .

Investigation and analysis on recognition of high-alert medications of physician's advice among clinical nurses from grade three and first-class hospital in chongqing / 中国实用护理杂志

Objective To investigate the recognition of physicians′ advice about high-alert medications among clinical nurses from grade three and first-class hospitals in Chongqing and to analyse the relevant training requirements. Methods Using a multistage stratified cluster sampling strategy, the physicians′ advice recognition questionnaire of High- alert medications for clinical nurses was administered to 3029 nurses in eight hospitals, to test the nurses′ advice recognition of high-alert medication and collecte training suggestions. Results More than 82.70％(1946/2353) of nurses responded correctly for 8 out of the 12 questions, the accuracy rate of pethidine hydrochloride injection test was 97.11％(2285/2353) and the dopamine hydrochloride injection test was only 28.56％(672/2353). The nurses′ recognition of physicians′ advice of high-alert medications in gender, department, working time and annual income was statistically significant (P<0.10). 81.34％(1914/2353) of the nurses were able to recognize 11 out of the total 24 wrong advices. Pre-job training、theoretical knowledge related to physicians′advice and case-based learning are the best training time, content and form. Conclusions The recognition level of high-alert medications by clinical nurses from grade three and first-class hospitals in Chongqing was not high and the clinical nurses with different gender, department, working time and annual income had different abilities, the targeted training for clinical nurses should be provided.

A bibliometrics research on nursing home by using GoPubMed / 重庆医学

Objective To analyze the current situation and trends of nursing home research to provide reference for further study.Methods The GoPubMed retrieval tool was used to retrieve the research literatures on the nursing home in PubMed database with the subject term "Nursing Homes",then the Excel2010 was used to statistically analyze the items such as the published literature's time distribution,geographical distribution,journals distribution,high-authors,related subjects.Results In total,46 436 articles were retrieved out.The publication amount was increased year by year.The largest publication amount was the United States,but China ranked at 21.Meanwhile the top 10 cities,top 10 journals and top 10 authors in publication amount were mainly in European and American countries,while China did not enter the ranks.The main research fields were community care,long-term care,etc.Conclusion In recent years,the research literatures about nursing homes present upward trend as a whole,but which are mainly concentrated in European and American countries.China is relatively weaker,so there is still much rising space.

Health-promoting Lifestyle in Patients after Percutaneous Coronary Intervention

BACKGROUND AND OBJECTIVES@#The purpose of this study was to determine the status of health-promoting behaviors in patients after percutaneous coronary intervention (PCI) and explore what factors affect healthy lifestyle behaviors.@*METHODS@#A total of 120 patients with coronary artery disease after PCI was included in this study. The Health Promoting Lifestyle Profile (HPLP) II was used to assess health-promoting lifestyle behavior. Data analysis was performed by t-test, analysis of variance, and multiple linear stepwise regression analyses.@*RESULTS@#The average age of the participants was 60.10±9.84 (range, 37–81) years old. Among the participants, 86.7% were men and 13.3% were women. In all, 24.2% of the patients had an excellent level of health-promoting lifestyle and 74.2% had a moderate level of health-promoting lifestyle. The spiritual growth scores were the highest, while stress management and physical activity scores were the lowest. The level of health-promoting lifestyle was higher for people with higher income and a diagnosis of stable angina.@*CONCLUSIONS@#Healthcare providers should focus on promoting physical exercise and stress management for patients after PCI. It is also necessary to keep an eye out for patients with low income and severe illness to encourage a health-promoting lifestyle in these subsets of patients.

Health-promoting Lifestyle in Patients after Percutaneous Coronary Intervention

BACKGROUND AND OBJECTIVES: The purpose of this study was to determine the status of health-promoting behaviors in patients after percutaneous coronary intervention (PCI) and explore what factors affect healthy lifestyle behaviors. METHODS: A total of 120 patients with coronary artery disease after PCI was included in this study. The Health Promoting Lifestyle Profile (HPLP) II was used to assess health-promoting lifestyle behavior. Data analysis was performed by t-test, analysis of variance, and multiple linear stepwise regression analyses. RESULTS: The average age of the participants was 60.10±9.84 (range, 37–81) years old. Among the participants, 86.7% were men and 13.3% were women. In all, 24.2% of the patients had an excellent level of health-promoting lifestyle and 74.2% had a moderate level of health-promoting lifestyle. The spiritual growth scores were the highest, while stress management and physical activity scores were the lowest. The level of health-promoting lifestyle was higher for people with higher income and a diagnosis of stable angina. CONCLUSIONS: Healthcare providers should focus on promoting physical exercise and stress management for patients after PCI. It is also necessary to keep an eye out for patients with low income and severe illness to encourage a health-promoting lifestyle in these subsets of patients.

A study on long-term care demand assessment indicators for the disabled elderly in nursing home / 中华护理杂志

objective To develop long-term care demand assessment indicators for the disabled elderly in nursing home.Methods The assessment indicators were formulated based on literature review,semi-structured interviews and expert meeting.Then,Delphi technique was used to identify the indicators through two rounds of consultation among 23 experts.Results The response rates of two rounds consultation were 74.19％ and 95.65％,and the authority coefficients of experts were 0.850 and 0.905.The coordination coefficients of two levels of indicators in the second round were 0.600 and 0.269,respectively (P＜0.001).The long-term care demand assessment indicators for the disabled elderly in nursing homes consisted of 5 first-level indicators and 40 seeond-level indicators.Conclusion The longterm care demand assessment indicators for the disabled elderly in nursing home is reliable and scientific,which can provide references for further developing long-term care contents for the elderly in the nursing home and standardizing quality of long-term care.

A qualitative research on nurse-physician collaboration experience in a tertiary general hospital of Chongqing / 中国实用护理杂志

Objective To comprehend the real experience of nurses and physicians towards nurse-physician collaboration in tertiary general hospital of Chongqing, thus to investigate and analyze its status and influencing factors. Methods A qualitative study was conducted to explore 17 nurses and physicians from different departments in tertiary general hospital of Chongqing. The data were collected through in-depth semi-structured interviews and analyzed using Colaizzi method. Results Three themes were extracted:the nurse-physician collaboration was the common requirement for nurses and physicians;the scale of the nurse-physician collaboration seemed to be limited and needed to be further enhanced;nurse-physician collaboration was influenced by multiple factors. Conclusions The necessity of nurse-physician collaboration is highly approved by nurses and physicians. The physicians and nurses should develop the ideas of nurse-physician collaboration, perform multiple activities of nurse-physician collaboration, improve nurse- physician communication, establish policy system of nurse- physician collaboration, and promote the full implementation of the nurse-physician collaboration.

A qualitative research on nurse-physician collaboration experience in a tertiary general hospital of Chongqing / 中国实用护理杂志

Objective To comprehend the real experience of nurses and physicians towards nurse-physician collaboration in tertiary general hospital of Chongqing, thus to investigate and analyze its status and influencing factors. Methods A qualitative study was conducted to explore 17 nurses and physicians from different departments in tertiary general hospital of Chongqing. The data were collected through in-depth semi-structured interviews and analyzed using Colaizzi method. Results Three themes were extracted:the nurse-physician collaboration was the common requirement for nurses and physicians;the scale of the nurse-physician collaboration seemed to be limited and needed to be further enhanced;nurse-physician collaboration was influenced by multiple factors. Conclusions The necessity of nurse-physician collaboration is highly approved by nurses and physicians. The physicians and nurses should develop the ideas of nurse-physician collaboration, perform multiple activities of nurse-physician collaboration, improve nurse- physician communication, establish policy system of nurse- physician collaboration, and promote the full implementation of the nurse-physician collaboration.

Investigation and prospect of clinical practice mode for intensive medical college nurses in Chongqing / 中国实用护理杂志

Objective To investigate the current situation of clinical practice mode of intensive care unit specialist nurses in Chongqing city, and to provide reference for the construction of standardized clinical practice mode of intensive care unit specialist nurses. Methods A self-designed questionnaire was used to investigate and analyze the 509 students who participated in the training of intensive care unit nurses in Chongqing city. Results Clinical practice time was 2 months, the practice base could meet the clinical practice needs of clinical nurses, clinical practice and assessment methods were varied, but the time arrangement was not reasonable (6.67%, 29/435), the practice content lacked the pertinence (5.52%, 24/435), the teaching method was not reasonable (2.76%, 12/435), the teacher capital was not qualified (1.38%, 6/435) and so on. Conclusions The clinical practice base and teaching staff needs to be improved, and the clinical practice pattern of intensive care unit specialist nurses is good, but the ability to recognize it is not in place. Should be guided by the needs of nurses, under the supervision of the health department, construction of training bases, training in line with the requirements of clinical teachers, strengthen the ability of students to understand, to help study the clinical application of knowledge and skills.

The progress of health education model of coronary heart disease / 中国实用护理杂志

This paper analyzes the present situation of health education in coronary artery disease,introduces six kinds of health education models which widely adopted now at home and abroad,such as health education path mode,PRECEDE-PROCEED model,and trans theoretical model.It aims to provide reference for the effective development of health education in coronary artery disease and puts forward prospect of the development of the information construction of health education in coronary artery disease.

Holistic nursing research in China: a systematic review / 中国实用护理杂志

Objective To systematically review the domestic studies on holistic nursing,so as to provide suggestions for evidence-based strategic decision about how to set upa long-term mechanism of holistic nursing.Methods The databases of China Biology Medicine (CMB),VIP,China National Knowledge Infrastructure (CNKI) and Wan Fang Data were searched to identify the relevant studies.Literatures were screened with data extraction in accordance with the predefined inclusive and exclusive criteria.The quality of literatures was assessed with the standard of Cochrane Handbook 5.0 and Crombie criteria,and the data were comprehensively analyzed with qualitative research methods.Results The total 33 cross-sectional studies were included.The results showed that the cognition of holistic nursing was good;10 literatures from the scope of business,organizational forms,strengthening the management and establish a system expounded how to implement the holistic nursing;Since our country carry out holistic nursing,effectwas significant,but there were still some problems.Discussing and solvingproblemsby using the method of evidence-basedwasthe future development direction.Conclusions The current researches about holistic nursing are lack of randomized controlled trials,most of which are the cross-sectional survey research.But the research content is wide.analyzing the present status and effect of holistic nursing,summarizing the experience and problems,promoting our country to set up a long-term mechanism of holistic nursing have the certain enlightenment function.

Patient safety culture assessment outcomes of medical workers in China:a systematic review / 中华医院管理杂志

Objective To systematically describe and analyze the patient safety culture assessment outcomes of medical workers in China,so as to provide scientific evidence for developing corresponding intervention measures.Methods Such databases as Web of Science,PubMed,Ovid,EBSCO,Google Scholar,CBM,VIP,CNKi and WanFang Data were used to collect studies published before December 2014,on patient safety culture assessment of medical workers in mainland China.Two reviewers independently screened,extracted and cross-checked the data,and the disagreements were resolved by discussion or by consulting a third reviewer.The qualitative synthesis method was used to analyze the study results.Results Of the total 1 721 records,65 studies were included,and most of them were cross-sectional studies.The patient safety culture assessment instruments were foreign scales by the translation and revision for the Chinese version for 52 studies,and self-made questionnaire for the other 13 studies.The main factors influencing the patient safety culture of Chinese medical workers included seniority,department,educational background,experience of patient safety training and so on.Conclusions Many studies have been carried out for patient safety culture,but the research obj ects mostly are nursing staffs,without extensive research on other professional medical workers.Hospitals should strengthen the teams,the patient safety training,and build patient safety culture that is fair and open to safeguard patient safety.

Pretreatments with hypertonic solution and cobalt chloride in bone marrow mesenchymal stem cell transplantation for treatment of degenerative disc disease / 中国组织工程研究

BACKGROUND:Stem cel therapy has been used for prevention and treatment of degenerative disc disease. Considering the special microenvironment in the intervertebral disc, the survival rate and differentiation ability of transplanted cels are decreased, which may lead to the poor efficacy of stem cel therapy. How to improve the survival ability and therapeutic effect of the transplanted cels is the focus of stem cel therapy for degenerative disc disease. OBJECTIVE: To investigate the effects of cobalt chloride combined with hypertonic solution pretreatment on bone marrow mesenchymal stem cels that wil be transplanted for treatment of degenerative disc disease. METHODS:(1)In vitro cel experiment: bone marrow mesenchymal stem cels were divided into three groups and subjected to normal culture medium (normal control group), 1% hypertonic mother solution (hypertonic group), 100 μmol/L cobalt chloride (hypoxia group), or 1% hypertonic mother solution plus 100 μmol/L cobalt chloride (combined group) for 1 week. Then, 2% hypertonic solution and 200 μmol/L cobalt chloride cobalt chloride were used to simulate the anaerobic and hypertonic environment intervenes in pretreated and untreated bone marrow mesenchymal stem cels for 24 hours. After that, RT-PCR was used to detect the expression of caspase-3 for apoptosis evaluation. (2)In vivo animal experiment: Sprague-Dawley rats were divided into model, cel transplantation and hypertonic plus hypoxic groups. Rat models of intervertebral disc degeneration were made in these three groups. After modeling, rats in these three groups were given no treatment, bone marrow mesenchymal stem cel transplantation or transplantation of bone marrow mesenchymal stem cels which were subjected to hypertonic and hypoxia pretreatments into the intervertebral disc. Two weeks later, immunohistochemistry and RT-PCR methods were used to detect cel distribution and related gene expression, respectively, thereby to evaluate the therapeutic effect of stem cels. RESULTS AND CONCLUSION: (1)In vitro cel experiment: caspase-3 mRNA expression was significantly reduced in pretreated bone marrow mesenchymal stem cels compared with the untreated cels (P < 0.05). (2)In vivo animal experiment: compared with the control group, the caspase-3 and interleukin-1β in the intervertebral disc and a number of degenerative indexes were decreased in the cel transplantation. Compared with the cel transplantation group, these indicators had better outcomes in the hypertonic plus hypoxic group (P < 0.05). These findings indicate that bone marrow mesenchymal stem cels have therapeutic potential for degenerative disc disease, and have better adaptability and transplantation effects by hypertonic and hypoxia pretreatments.

Study on the construction of training evaluation system of critical care nurses in Chongqing / 中华医学教育探索杂志

Objective To Establish an evaluation index system of critical care nurses training in Chongqing. Methods A panel of experts was formed with 20 experts from related fields. By the use of Del-phi method, we designed a questionnaire survey and took two rounds of expert consultation and revision, screening the intensive care nurse training evaluation index. SPSS 17.0 statistical software was used to assess the experts involved in the study and to determine the weight of indicators at all levels. Results In the course of the investigation, the experts participating in the initiative was very high, and the authority coeffi-cient (Cr) was 0.896. The training evaluation system of critical care nurses in Chongqing was initially iden-tified, including 3 first-level indicators, 7 second-level indicators 7, 21 third-level indicators. Conclusion The preliminary construction of critical care nurse training evaluation system in Chongqing can promote the ICU specialist nurse training effect and guarantee the training quality, and at the same time it provides some reference for the training and evaluation of the health administrative department.

Application of SBAR for nurse students morning rounds in operation room / 中华医学教育探索杂志

Objective To identify the effect of SBAR (situation, background, assessment, recom-mendation) in OR (operating room)nursing teaching rounds. Methods According to internship turns, rou-tine group (even number, Group A:68 students) and SBAR group (odd number, Group B:70 students) were chosen by drawing lots. Group A used conventional mode for history report, while Group B used SBAR mode. Students' performance was evaluated by OR nurse students' rounds standard scale and the reporting time was recorded. Each nurse students filled in Communication Self-efficacy Evaluation Form on the fifth week in OR. The information was input into excel. The results of the two groups were compared with SPSS 11, and the data were analyzed by chi square test and t test. Results The average reporting quality score was 16.74 for Group A, and 18.66 for Group B. The average score of Group B was higher than that of Group A. Compared with the cases scores above 18 between the two groups, the result was statistically significant, P=0.039. The average score of communication Self-efficacy in Group A was 42.88, while it was 44.94 in Group B, which showed that Group B had better score than that of Group A. Significant differences was found between the two groups when compared the cases with score above 45, P=0.010. The average reporting time was (2.42±1.16) minutes for Group A and (2.32±1.21) for Group B, and there is no significant differences between the 2 groups. Conclusion SBAR is helpful for improving students communication Self-efficacy, and making progress on nursing round reporting quality,and it is worth promoting in clinical teaching.

Study on the Quality Standard of Banlangen Dispensing Granules / 中国药房

OBJECTIVE:To establish the quality standard of Banlangen dispensing granules. METHODS:Thin layer chroma-tography(TLC)was used to identify Isatis indigotica,leucine and arginine,the items according to granules preparations and the ex-traction were detected. HPLC was conducted to determine the content of (R,S)-goitrin. The Shimadzu VP-ODS C18 column was used with the mobile phase of methanol-0.05% phosphoric acid (7∶93,V/V) at the flow rate of 1.0 ml/min. The detection wave-length was set at 245 nm,and the column temperature was room temperature. The sample size was 10 μl. RESULTS:TLC showed clear spots and good resolution. Particle size,moisture,dissolubility and microbial limit test were all conformed to the specifica-tion. The extraction limit was no less than 25.0%.(R,S)-goitrin showed a good linear relationship in the range of 1.565 9-50.109 8μg/ml(r=0.999 9,n=6). The average recovery was 99.25%(RSD=2.08%,n=9);the RSDs of precision,stability and repeatabili-ty tests were no more than 1.12%. The content of(R,S)-goitrin was initially determined as 0.35 mg/g. CONCLUSIONS:The estab-lished quality standard has increased content determination,and the control programs are more comprehensive and reasonable. It can be used for the quality control of Banlangen dispensing granules.

Study of the correlation between self-care capability and prognosis of patients with upper gastrointestinal bleeding caused by liver cirrhosis / 中国实用护理杂志

Objective To investigate the self-care agency level and analysis the relationship between the self-care ability level and the prognosis of the patients with upper gastrointestinal bleeding caused by liver cirrhosis.Methods In the first stage,78 cases of liver cirrhosis patients complicated with first eruption of upper gastrointestinal bleeding were selected,the Exercise of Self Care Agency Scale (ESCA)was adopted to assess the self care ability of patients,the results underwent analysis.In the second stage,according to the results that the proportion of scores accounted for total score ratio,the patients were divided into low,medium and high level groups.By prospective studies,through telephone follow-up and clinic follow-up,the evaluation items of patients were collected,and the survival status of patients within 3 months after discharge was compared.Results For patients with upper digestive tract bleeding caused by liver cirrhosis,the self-care scored (84.07±17.38) totally,among 78 patients selected,15.4％ (12/78) was in the low level,75.6％ (59/78) was in the medium level,9.0％ (7/78) was in the high level.The self-care ability increased in conjunction with decreased mortality rate.The mortality rate in the lower level group was 8/12,33.9％ (20/59) in the medium level group,1/7 in the higher level group,there was statistically significant difference,x2=6.3,P＜0.05.The MELD-Na scores in the lower,medium and higher level groups wererespectively 34.03±4.62,22.57±3.05,12.87±1.36,F=6.0,P＜0.05.Likewise,complication incidence rates were negatively correlated with self-care ability,r =-(0.525-0.189).Conclusions The self-care ability of patients with gastrointestinal bleeding caused by liver cirrhosis is in the medium level,and it exercises certain influence on prognosis of patients.Attention should be paid to cultivation of self-care ability of patients in clinic.

Study on the quality standard of common selfheal fruit-spike granules / 国际中医中药杂志

Objective To establish the quality standard of common selfheal fruit-spike granules. Mehtods Rosmarinicacid in the granules were identified by TLC. The extractives were tested by the method for determination of water-soluble extractives. The contents of rosmarinicacid were determined by HPLC. Results TLC had obvious characteristics with the spots clear and well-separated. The extraction limit was no less than 10.0%. Rosmarinicacid showed a good linear relationship at 0.062 5~2.008 0 mg/ml (r=0.999 8,n=6) with average recovery of 99.50% (RSD=1.21%,n=9). The content limitation of rosmarinicacid was discussed as 10.0 mg per pack according to the experiment data.Conclusion The method is easy-operated and accurate which has a good specificity for the quality control of common selfheal fruit-spike granules.

Study on feedback of operating room specialty certified nurse theoretical training and quality improvement / 中华医学教育探索杂志

Objective To explore curriculum and faculty qualification of Chongqing operating room (OR) specialty certified nurse theoretical tralning program by feedback of students, and to im-prove the quality of tralning. Method Relying on the national key project of the First Affiliated Hos-pital of Chongqing Medical University, Chongqing Health administration OR nurse specialist tralning program set additional courses related to research, teaching, patient safety and first ald tralning based on operation room specialist nurse tralning outline. 81 participants were given questionnalres issued by college of nursing after the 7th OR specialist nurse theoretical tralning, and statistics analysis was made of it. Result Effective questionnalres was100%. The overall judgment on theory tralning was high, with 92.60%of the students giving overall score above 150 points (out of 170);93.84%of students sat-isfied on teaching staff ratio while 95.06% students satisfied on course content. For the 17 items, the majority scores given by the students were ≥ 9 points (a 10-points scale), on the top of the list were item “Theoretical tralning helps to enhance professional theoretical level and guide clinical practice”“Teaching content meet needs of OR specialist nurses” “Teaching content is helpful to improve the core competence of specialist nurses” (all 96.30%, 78 out of 81), while the bottom was “Instructor create an environment which fosters student participation”(85.19%, 69 out of 81). Conclusion Chong-qing OR specialist theoretical tralning has good practical and guidance property, the content meet OR nurses needs, instructor ratio is reasonable, and students are highly satisfied with it. Instructors need to encourage students' participation in class interaction, and pay attention to improving their research capabilities.