RESUMO
Objective:To explore the applification value of self-manufacture anti-fall alarm system on elderly inpatients at high risk of falls.Methods:A total of 110 elderly inpatients at high risk of falls were randomly assigned to experiment group (55 cases) and control group (55 cases), the control group were given routine care of fall prevention, the experiment group was carried out self-manufactured anti-fall alarm system. Patients were followed up for 2 weeks, the fall rates in two groups were recorded, the fall efficacy was assessed by modified fall efficacy scale at enrollment and discharge, the nursing care satisfaction was eveluated by nursing needs and satisfaction scale.Results:There was no fall patient in the experiment group, and 4 fall patients (7.3%) in the control group, the fall rate was significantly decreased in the experiment group compared to the control group ( χ2 value was 4.151, P=0.042). The scores of take a bath or a shower, get in/out of bed, answer the door or telephone, walk around the inside of your house and total MFES scores were significantly increased in the experiment group compared to the control group [(4.55±0.81)points, (6.68±1.39)points, (5.23±1.14)points, (5.97±0.86)points, (67.98±4.28)points vs. (3.13±0.49)points, (5.27±0.94)points, (4.57±1.10)points, (4.57±0.55)points, (63.17±3.66)points], the differences was statically significant ( t value was 3.090-11.049,all P<0.05). The scores of service and technology, environment and guidance, overall evaluation were significantly increased in the experiment group compared to the control group [(51.60±13.75)points, (46.76±14.18)points, (5.97±0.72)points vs (45.67±9.17)points, (41.65±10.82)points, (5.29±0.90)points], the differences was statically significant ( t value was 2.124-4.424,all P<0.05). There were 91.7% (11/12) nurses satisfacted to the self-manufactured anti-fall alarm system. Conclusion:Self-manufactured anti-fall alarm system can effectively prevent fall incidence and promote fall efficacy and nursing care satisfaction of elderly inpatients at high risk of falls.
RESUMO
Objective To observe the effect and safety of the endovascular hypothermia through hypothermic intravenous infusion device in the treatment of patients with severe craniocerebral injury compared with conventional surface cooling. Methods A total of 66 cases of patients with severe cranio-cerebral injury were randomly divided into the observation group and the control group with 33 cases in each group according to envelop randomization. The control group received surface cooling, and the observation group was given surface cooling plus endovascular hypothermia through hypothermic intravenous infusion device. The target temperature was 35 ℃maintained for 3-5 days, and natural rewarming was applied at the speed of 0.1-0.5℃/h to 36.0-37.3℃. The time to reach target temperature, the constant stability, the incidence rate and severity of complication such as shiver, arrhythmia, skin injury and agitation were recorded and compared between two groups, as well as the heart rate, breathing rate, pulse rate, blood pressure and Glasgow Coma Scale (GCS) scores after 72 h of treatment. Glasgow Outcome Scale scores 30 days after treatment and nursing workload were also calculated and compared. Results The cooling speed, time to reach target temperature and the ability to maintain at 35℃were (1.3±0.2)℃/h, (2.3±0.2) h and (6.5± 1.8)%in the observation group, respectively, compared with (0.5±0.1)℃/h, (3.6±0.6) h and (11.3±2.2)%in the control group, which had significant differences (t=1.862, 2.112, 2.408,P < 0.05). The occurrence rates of shiver, arrhythmia, skin damage and dysphoria and restlessness in the observation group were 33.33%(11/33), 9.09%(3/33), 6.06%(2/33) and 27.27%(9/33), respectively, which were much lower than those in the control group 84.85%(28/33), 15.15%(5/33), 33.33%(11/33), 54.55%(18/33),χ2=1.764-2.733,P<0.05. The heart rate, breathing rate, pulse rate, systolic blood pressure and GCS score after 72 h of treatment were(68.31 ± 3.73)times/min,(16.60 ± 1.52)times/min,(136.35 ± 3.71)mmHg(1 mmHg=0.133 kPa),(34.61 ± 1.05)℃, (9.91±4.05)points in the observation group, while(58.31±3.62)times/min,(19.81±1.83)times/min,(150.66± 2.70)mmHg,(35.65 ± 1.36)℃,(7.63 ± 3.17)points in the control group, and there were significant differences between two groups(t=2.275-3.035, P < 0.05).Besides, the ice-changing ice and turning-over time in the observation group were both remarkably reduced compared with control group, (14.03±3.11) min/h vs (38.12± 2.70) min/h (t=3.356, P<0.05) , (15.08±3.07) min/h vs (26.16±2.54) min/h ( t=3.021, P<0.05). Patients with good recovery, mild disability, severe disability, death in the observation group were 16, 13, 3 and 1 case, while 6, 11, 9, 7 cases in the control group (χ2=2.351,P < 0.05). Conclusions The endovascular hypothermia through hypothermic intravenous infusion device can rapidly reduce and effectively maintain target temperature, reduce the incidence rate of complication, improve the vital signs and decrease the nursing workload in order to improve neurological outcome in the treatment of patients with severe craniocerebral injury.