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Objective:To explore the Application value of hospital-community-family integrated service in nursing management of children with bronchial asthma.Methods:From December 2018 to February 2019 in Haikou Hospital Affiliated to Xiangya Medical College of Central South University, 90 children with asthma were selected and divided into control group (45 cases) and observation group (45 cases) according to random digital table method. The patients in the control group received routine hospitalization diagnosis and health education, while the patients in the observation group received integrated management services of family type medical care. Six months after the intervention, the clinical efficacy, the number of acute attacks, psychological state, quality of life, length of stay and cost of the two groups were compared.Results:The total effective rate of the observation group (95.56%, 43/45) was significantly higher than that of the control group (82.22%, 37/45), the difference was statistically significant ( χ2 value was 4.050, P<0.05). The times of acute attack, the times of readmission, the time of hospitalization and the expenses of the children in the observation group were (7.36±2.19) times, (4.22±1.78) times, (13.89±4.32) d, (3 023.83±219.76) yuan respectively, which were significantly lower than those in the control group (12.03±3.98) times, (7.03±2.43) times, (21.73±5.32) d, (5 032.33±324.23) yuan, and the difference was statistically significant ( t values were 6.258-34.381, P<0.01). The scores of Self-rating Anxiety Scale (31.23±4.84) and Self-rating Depression Scale (37.62±2.61) in the observation group were significantly lower than those in the control group (36.11±2.72, (43.27 ± 2.94), the difference was statistically significant( t values were 5.896, 9.641, P < 0.01). The scores of symptom (6.50±1.63), emotion and activity(6.33±1.02), quality of life (6.54±0.98) in the observation group were significantly higher than those in the control group (5.77±1.55, 5.45±0.98, 5.78±0.67), the differences were statistically significant ( t values were - 2.177, - 4.173, - 4.295, P < 0.05 or 0.01). Conclusions:The application of hospital-community-family integrated care service in the nursing management of children with bronchial diseases can effectively improve the clinical therapeutic effect, reduce the number of acute episodes and hospitalization time, improve the psychological status and quality of life of children, which is worthy of wide clinical promotion.
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Objective To investigate and analyze the prevalence of pressure ulcer and other skin injuries, and the implementation of pressure ulcer prevention measures among inpatients in Class ⅢGrade A hospitals in Hainan province. To provide basis for fomulating bundle of care model to prevent and intervent pressure ulcer, and establishing early warning management model on nosocomial pressure ulcer in ClassⅢGrade A hospitals in Hainan province. Methods A cross-sectional survey was conducted on inpatients from 7 ClassⅢGrade A hospitals in Hainan province. A investigation was performed by a self-designed inpatients'questionnaire and qualified tools on pressure ulcer and other skin injuries. Statistical analysis of data using by SPSS19.0 software. Results The content validity index of the self-designed inpatients'questionnaire and qualified tools on pressure ulcer and other skin injuries was 0.91, Cronbach α coefficient was 0.93. The prevalence of pressure sores was 2.28% (165/7 248), of which 66.06% (109/ 165) was family involvement, 30.30% (50/165) was hospital acquired, 3.03% (5/165) was community involvement,and 0.61% (1/165) was both from family and hospital acquired. Medical instrument related pressure ulcer accounted for 18.18%(30/165) of the total number of pressure ulcer. The most common site of pressure ulcer was the sacrococcygeal region, accounting for 47.94% (93/194). The proportion of pressure ulcer in stageⅡwas the highest (35.57% , 69/194). 52.01% (647/1 244) of patients at risk of pressure ulcer did not use the anti-pressure devices,and 81.40% (1 013/1 244) of patients' main compression sites were not covered by dressings.35.50%(442/1 244) of patients did not according to plans or regularly turn over, only 56.19% (699/1 244) patients turned over every 2 hours. 61.57% (442/1 244) patients who have pressure ulcer did not have anti-pressure ulcer signs. Among other skin injuries: the prevalence of incontinence related dermatitis was 0.88%(64/7 248), and the prevalence of avulsion skin injury was 0.37%(27/7 248). Conclusions The incidence of acquired pressure ulcer in ClassⅢGrade A hospitals in our province is slightly higher than other domestic investigation results. The reasons may be that anti-pressure devices in hospital configuration are not enough, lack of the tailored bundle of prevention measures of pressure ulcer, and failure to establish an effective early warning management model on pressure ulcer etc. So prevention and treatment of pressure ulcer should have a further standard management. Instrument related pressure ulcer and incontinence related dermatitis should also attract the attention of clinical nurses and managers.
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Objective To study the effects of mild hypothermia on cognitive function , synapsinⅠexpression and synaptic ultrastructure of hippocampus in epileptic rats induced by global cerebral ischemia. Methods Forty-eight male SD rats were randomly divided into control (NC) group, sham-operated (Sham) group, normothermic epilepsy (NT) group and mild hypothermic epilepsy (HT) group. The model of postischemic audio-genetic seizure was established by chest compression. Hypothermia intervention was given to HT group. Immunocytochemistry was conducted to detect the expressions of synapsin I in hippocampus at days 1 , 3, 14. the synaptic ultrastructure and cognitive function were respectively observed by electron microscope and Morris water maze. Results Compared with NC and Sham group, the expression of synapsinI in NT group was decreased, the escape latency was prolonged and across platform number decreased (P < 0.05). The synapses were decreased in number, and mitochondria was viewed swelling, synaptic membranes unclear, myelin fractured. Compared with NT group, the expression of synapsinⅠin HT group had no obvious change in 24 h but was significantly increased in days 3 and 14 (P < 0.01); The escape latency was decreased and the number of cross platform increased (P < 0.01); Synaptic structure was clear, with interface growing and postsynaptic density thickened. Conclusion Mild hypothermia may improve the cognitive function of the epileptic rats induced by global cerebral ischemia by upregulating the expression of synapsinⅠand alleviating the damage of synaptic structure.
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Objective To explore the application effect of self management mode during internship of nursing interns.Methods 100 nursing students were randomly divided into the experimental group (self management group)and the control group(traditional pattern group),50 cases in each gronp,The control group adopted strict practice management according to the traditional method,the experimental group adopted self management mode.Times of being late,absenteeism,academic achievement and operation performance were compared between two groups.Results Times of being late,absenteeism in the experimental group were less than those of the control group,while academic achievement and operation performance in the experimental group were significantly lower than the control group,the difference between the two groups were statistically significant.Conclusions The implementation of self management mode for nursing interns can effectively improve the nursing students' ability of self management,improving the teaching quality,ensure nursing safety.It is worthy of clinical application.