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Objective:To construct the evaluation index system of the core competence of neonatal specialist nurses, so as to provide reference for clinical training of neonatal specialist nurses.Methods:From January 2020, through literature review, theoretical analysis, interview, Delphi method and superiority chart, the evaluation index and weight of core competence of neonatal specialist nurses were determined.Results:Totally 28 experts in China were invited for 3 rounds of consultation. The effective recovery rate of the questionnaires was 93.33%(28/30) in the first round. The effective recovery rate of the questionnaires was 100.00%(28/28) in the second and third rounds. The authority coefficient of the experts was 0.85 in the third round. The Kendall′s coefficients of concordance of the first-level indexes, second-level indexes and third-level indexes were 0.150, 0.221 and 0.161, respectively. The final evaluation index system of the core competence of neonatal specialist nurses included 5 first-level indicators, 17 second-level indicators and 58 third-level indicators.Conclusions:The evaluation index system of the core competence of neonatal specialist nurses constructed in this study has certain scientific, reliable and clinical application value, which is conducive to the training of newborn specialized nurses in China.
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Objective:To retrieve, evaluate and integrate relevant evidence on the management of the developmentally supportive environment in the neonatal intensive care unit(NICU), and to provide clinical references.Methods:Evidence on NICU environmental management was retrieved from Guidelines International Network, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guide Network, National Guideline Clearinghouse, Registered Nurses′ Association of Ontario, Yimaitong and other Websites, BMJ Best Practice, UpToDate, Cochrane Library, PubMed, Embase, Wanfang Database, CNKI and other database.The evidence included guidelines, evidence summaries, best clinical practice manuals, expert consensus and systematic reviews.The date limit was from the establishment of the databases to March 31, 2021.Results:Totally 16 articles were involved, including 4 guidelines, 9 systematic reviews, and 3 expert consensus.Finally, 20 pieces of best evidence on four aspects were su-mmarized: sound, light, touch, and smell.There were 11 A-level recommendations and 9 B-level recommendations.The evidence suggested that health care workers should reduce noise and protect premature infants from being exposed to bright light, noxious gases, and negative touch stimuli.Besides, benign auditory and olfactory stimuli, circadian light, and mother-infant skin-to-skin contact should be used to promote the development of premature infants.Conclusions:This study is a summary of the recommendations on NICU environmental management.It is well-designed and has achieved fruitful results, showing great significance for reducing environmental stress of premature infants in the NICU.However, the current recommended methods for providing benign stimulation require validation of more high-quality, well-designed research.It is recommended that medical staff should selectively apply the evidence to clinical practice according to the actual situation.
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OBJECTIVE@#To explore the feasibility of enhanced recovery after surgery (ERAS) in treatment of children with congenital choledochal cyst.@*METHODS@#One hundred and thirty children with congenital choledochal cysts admitted in the Children's Hospital of Zhejiang University from June 2017 to June 2019 were divided into ERAS group (=65) and control group (=65) according to admission order. The intestinal tract condition during operation, time of operation, surgical results, time for eating after operation, abdominal drainage after operation, length of hospital stay after operation, total hospital expenses and complications were compared between two groups.@*RESULTS@#Compared with the control group, the satisfaction of intestinal operation field, recovery of gastrointestinal function after operation,time required for the volume of peritoneal drainage fluid to be less than 50 mL,time of abdominal drainage tube removal, and length of hospital stay were all improved in ERAS group (<0.05 or <0.01).ERAS group had more peritoneal effusion after removal of abdominal drainage tube (<0.01), but the incidence of edema after operation was lower (<0.05). The satisfaction of parents in the two groups was similar, but the cooperation of parents in the ERAS group was improved (<0.05) and the total cost of hospitalization was reduced (<0.01).@*CONCLUSIONS@#ERAS has advantages over the traditional scheme and can be used in the clinical treatment of children with congenital choledochal cyst.
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Criança , Humanos , Estudos de Casos e Controles , Cisto do Colédoco , Economia , Cirurgia Geral , Recuperação Pós-Cirúrgica Melhorada , Padrões de Referência , Tempo de Internação , Complicações Pós-OperatóriasRESUMO
Objective To assess the efficacy of immunoprophylaxis against mother-to-infant transmission of hepatitis B virus (HBV) in a real-world setting since the implementation of charge-free hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine in China. Methods The screening rate and the prevalence of hepatitis B surface antigen (HBsAg) in 61 790 puerperants, and the administration of combined immunoprophylaxis in infants of HBsAg-positive mothers in Rugao City of Jiangsu Province from July 1, 2011 to June 30, 2016 were retrospectively analyzed. HBV infection status of infants born to HBV infected mothers was followed up after 7 months of age. HBsAg-positive infants and their mothers were followed up again for HBV markers in April 2018. Fisher's exact test and Cochran-Armitage trend test were used to statistically analyze the differences between groups and various years, respectively. Results All 61 790 puerperants were screened for HBsAg and the prenatal screen rate was 98.6% (60 937/61 790) with an increasing trend over time (χ2trend=750.908, P<0.001). HBsAg-positive puerperants accounted for 5.5% (3 397/61 790) with a decreasing trend over time (χ2trend=32.667, P<0.001). In total, 778 offspring (399 boys and 379 girls) of 759 HBsAg-positive mothers were followed up at (13.7±6.9) months of age, among which 751 (96.5%) were administered and 25 (3.2%) were probably administered standard combined immunoprophylaxis after birth, and the rest two (0.3%) were not. Fourteen infants (1.8%) were HBsAg positive and all born to mothers with positive hepatitis B e antigen (HBeAg). None of the 538 infants born to HBeAg-negative mothers was HBsAg-positive. HBsAg-positive rate in infants born since 2013 was lower than those in 2011 and 2012 (χ2trend=13.352, P=0.000 3). Eleven HBsAg-positive mothers and their children were followed up again 4–5 years later in April 2018. HBV DNA levels of all mothers were within the range of (7.34–28.2)×107 IU/ml except one case of spontaneous HBeAg seroconversion. One out of the 11 infected children also had HBeAg seroconversion. Phylogenetic analysis of HBV S gene showed that the 11 pairs of mothers and children were all infected with HBV of genotype C. Conclusions The implementation of charge-free HBIG and hepatitis B vaccine for newborns achieves fruitful results in Rugao city as the mother-to-infant transmission of HBV in the real-world had been further reduced to a similar level reported in literature survey.
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The nursing management information system for pediatric outpatient transfusion was constructed based on the refined management concept. It is designed to correct the current heavy workload, crowded conditions and low satisfaction. By comparing the indicators before and after the application and those of management concern, the system proves that it can effectively improve the quality of transfusion nursing in pediatric outpatient department, reduce the occurrence of nursing defects, and improve the satisfaction of nurses, patients and parents, hence worthy of promotion.
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ObjectiveA preliminary study on pediatrics nursing-sensitive qualityindicators was carried out to construct a systematic, scientific and sensitive quality system. Methods Delphi method was used to conduct two rounds of questionnaires for 55 pediatric nursing experts, used SPSS20.0 statistical software for data analysis. Analytic hierarchy process method was used to determine the weight of the indicators. Results The final determination agreed rate of experts equal to 75 percent, the importance of assignment mean was>3.5 and the variation coefficient<0.25, which including 5 structure indicators, 17 process indicators and 18 outcome indicators. Conclusion The evaluation system of pediatrics nursing-sensitive quality indicators was constructed in preliminary which could provide the reference and basis for pediatric nursing managers.
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Objective To investigate the effect of bedside comprehensive ability training and critical thinking on the improvement of the personality maturity of pediatric nurses. Methods A total of 102 nurses with pediatric working years within one year were selected,and then they were arranged to receive critical thinking in combination with bedside comprehensive ability training for 6 months. After the training, pediatric nurses′ critical thinking ability, bedside comprehensive ability and personality maturity were evaluated. Results Before training, the total score of Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) , total score of bedside comprehensive ability, personality maturity score were 288.21±25.44, 75.24±2.51, 84.01±32.26, after training, they were respectively 324.18±25.93, 92.65±3.17, 125.57±35.47. Comparison of the scores before training and after training showed statistically significant difference(t=7.071, 30.750, 6.190,P < 0.05 or 0.01). Setting personality maturity as the dependent variable, and and CTDI-CV and bedside comprehensive ability as the independent variables, regression analysis showed that CTDI-CV and bedside comprehensive ability had a positive impact on the personality maturity. Conclusions The ability of pediatric nurses' critical thinking ability and bedside comprehensive ability training can promote the improvement of personality maturity of pediatric nurses.
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Objective:To explore the value of tumor specific growth factor (TSGF) and combined tumor markers (AFP,CEA,Ft,TSA) in the diagnosis of malignant tumor.Methods:TSGF was measured by chemical method and combined tumor markers by chemical method and ELISA method.The results in 170 cases with malignant tumors and 60 cases with non-tumor patients were analyzed.Results:In cases of single TSGF measurement,the positive rate was 82% in liver carcinoma,87% in lung cancer,and 86% in carcinoma of stomach,colon,or rectum.The positivity rate of TSGF plus combined tumor marker determination was 97.5%,97.7%,and 97.5% respectively.Conclusion:TSGF plus combined tumor marker determination improve the positivity rate for tumor diagnosis,provide evidence for localization,and promote early diagnosis.