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Objective To investigate the pressure changes of cuff in the tapered-cuff endotracheal tubes and the frequency of cuff pressure monitoring in patient with trachea intubation. Methods From December 2016 to October 2017, 80 patients with oral tracheal intubation in the emergency department were divided into group A (n =25) and group B (n =23) according to the principle of randomized control. Group A with odd number was treated and tapered-cuff endotracheal tubes and group B with ever number and cylindrical-cuff endotracheal tubes. Continuous cuff pressure monitoring device was used to continuously monitor the cuff pressure. The two groups were compared in terms of time for keeping the normal cuff pressure and cuff pressure (average pressure, maximum pressure and minimum pressure). Results The total time for keeping the normal cuff pressure in group A was significantly shorter than that in group B (P＜0.05). The average cuff pressure in group A was smaller than that of group B (P＜0.05). The maximum pressure in group A is larger than that in group B and the maximum cuff pressure in group A was smaller than that of group B (P＜0.05). Conclusion Compared with the cylindrical cuff catheter, the tapered-cuff tube can maintain the normal pressure for a shorter period and easily produce needed pressure. It is a need to enhance the monitoring of cuff pressure to ensure good airway closure and reduce artificial airway complications.
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Objective:To investigate the mastery and application of medical ethics basic knowledge in geriatric ward medical staffs,and the way which they receive relevant education. Methods:From November 2016 to January 2017,240 questionnaires about medical ethics were distributed among medical staffs in clinical department in the Chinese PLA General Hospital,among them,30 were medical groups and 210 were nursing groups;and a total of 233 valid questionnaires were collected. The nurses were divided into geriatric ward nursing group and non - geriat-ric ward nursing group,according to whether they work in the geriatric wards or not. Results:Only 2. 14％ and 7. 72％ participants fully and correctly answered the core concepts and basic principles of medical ethics,respec-tively. The rate of informed consent in medical staffs in geriatric group was significantly higher than that of non -geriatric group (92. 66％ vs 82. 11％ ,P = 0. 02);the patient' s privacy protection in geriatric nursing group was significantly higher than that of non - geriatric nursing group (92. 66％ vs 31. 57％ ,P < 0. 001). 28. 75％ of the respondents received medical ethics continuing education curriculum,and the proportion of correctly receiving ex-pectable death in these medical staffs (71. 40％ ) was significantly higher than that of other education pathway groups (36. 17％ ). Conclusion:Medical staffs lack more knowledge on medical ethics. Clinical work in geriatric medicine has higher demand for medical ethics knowledge,and continuing medical education can help to improve the cognitive level of medical ethics in medical staffs.
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To investigate the accuracy and feasibility of Brix value on monitoring gastric residual volume (GRV) in patients with enteral nutrition. Fifty patients with enteral nutrition via nasogastric tube were enrolled. The GRV was measured by both ultrasonography and Brix value. The results were compared according to the methods. The Pearson correlation coefficients showed that GRV measured by these two ways was positively correlated (r=0.986, P<0.05). Moreover paired sample t-test showed that the discrepancy was not statistically significant (P>0.05) between different measurements. The consistency was analyzed by Bland-Altman graph, showing that the two measurements were consistent. Brix value is recommended to measure GRV due to its convenience and easy operation.
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Objective To investigate the effect of health education on the improvement of home caregivers’knowledge and skills on indwelling gastric tube feeding.Methods Fifty home caregivers of senile patients with tube feeding were recruited in the study using a self-designed questionnaire,followed by pertinent health education based on the survey results.The effects of health education were compared between pre-and post-education in terms of their knowledge on tube feeding.Results The total score on knowledge after education was significantly higher than that before education(P<0.001).There were significant improvements in tube feeding temperature,volume,time for tube disinfection and judgment of tube’s place in the stomach after education(all P<0.05). Conclusion Through health education,we could increase the skills of caregivers in caring the patients with tube feeding and thus improve the life quality of these patients.
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Objective To explore the feasibility and complications of ultrasound-guided peripherally inserted central catheter (PICC) insertion in elderly patients. Methods Ultrasound-guided PICC insertion was performed in 37 elderly patients with modified Seldinger's technique. Eighteen (48.6%) patients had invisible or impalpable shallow veins in elbow joints. The post-insertion success rate and complications were analyzed. Results The success rate was 100% among these 37 elderly patients. The indwelling patency duration was (32.0 ± 19.8)days. Two catheters in 2 (5.8%) patients were removed on the 21st and 39th day because of deep venous thrombosis. PICCs remained in place in 18 (48.6%) cases. Conclusions Ustrasound-guided PICC insertion is a safe procedure with high success rate. It can also be applied in patient whose shallow vein is not visible or palpable in elbow joint.
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@# ObjectiveTo examine the test-retest reliability and measurement error in using a Jamar dynamometer to determine grip strength for elder men. Methods40 elder men with a mean age of 82 years old volunteered to participate in this study. The grip strength was administered twice using a Jamar dynamometer by specially trained testers; subjects were re-tested at the same time of day a week later by the same testers. ResultsThe infraclass correlation coefficient（ICC） was 0.99. The standard error of measurement (SEM and SEM%) were 1.18～1.69 and 4.11%～6.41%. The smallest real difference (SRD and SRD%) were 3.27～4.68 and 11.39%～17.75%. The Bland-Altman analysis revealed no systematic errors between test and retest. ConclusionThe Jamar dynamometer is reliable and with acceptable measurement errors to determine grip strength for elder men.
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Objective To seek the best method for security precaution of elderly inpatients.Methods Elderly patients(296 cases) from January to August in 2006 and elderly patients(336 cases) from January to August in 2007 were divided into the control group and the improved group.The improved group received selective safety precaution measures after assessment of crisis degree by nurse security scale.The control group was given routine security nursing measures.The hospitalization time and incidence of unsafe events were compared in the two groups. Results The two groups were different in the following aspects:hospitalization time, incidence of unsafe events,satisfaction degree of family members,shift time of nurses,satisfaction degree of nurses. Conclusions To supply selective security nursing for elderly patients after assessment of crisis degree by nurse security scale at the admission day could decrease the incidence of un-safe events and hospitalization time.At the same time it shortened the shift time and increased shift efficien-cy to realize the win-win relations between nurses and patients.