Construction and implementation of the "Internet+nursing service" model based on the nurse-patient safety needs / 中国实用护理杂志

Objective:To explore the "Internet + nursing service" model based on the nurse-patient safety needs, and provide reference for development of "Internet + nursing service".Methods:The First Affiliated Hospital of Sun Yatsen University established a "Internet+ nursing service" management team in December 2019, developed an information platform, formulated and implemented a specific plan of the "Internet+ nursing service" model, including service objects, service projects and service modes. After the smooth operation of this model, the statistics of the nursing service projects and service times that had been carried out from September 2020 to March 2021, as well as the satisfaction of 21 patients who received nursing services would be counted.Results:From September 2020 to March 2021, 21 patients were provided with 55 on-site nursing services, and 151 operations in 16 projects were completed. No nursing-related adverse events occurred. The patients gave all five-star evaluations to the door-to-door service, the satisfaction score was 5 points, and the overall evaluation was 99.88 points.Conclusions:The pilot work of "Internet + nursing service" based on the nurse-patient safety needs has met the care needs of discharged patients and the safety needs of door-to-door services, guarantee the safety of nurses' door-to-door service effectively. And it provides reference for the development and improvement of "Internet + nursing service" related safety work in tertiary A-level hospitals.

The best evidence summary for prevention of hypothermia at birth in newborn / 中国实用护理杂志

Objective:To retrieve and summarize evidence for prevention of hypothermia at birth in newborn.Methods:Databases such as Up To Date, BMJ Best Practice, National Institute for Health and Care Excellence(NICE), Joanna Briggs Institute (JBI), Cochrane Library, Registered Nurses′Association of Ontario (RNAO), American Heart Association(AHA), Web of Science, PubMed, Chinese Biology Medical Literature database, Wanfang Med Online were searched to collect relevant evidence for prevention of hypothermia at birth in newborn, including guidelines, systematic reviews, evidence summaries and expert consensus. Two researchers independently evaluated the quality of the literature and extracted the data of the literature which met the criteria.Results:Six articles were selected, including 1 clinical decision support system, 2 guidelines, 1 systematic review and 2 expert consensuses. Nineteen pieces of best evidence were summarized.Conclusions:This study summarized the best evidence for the prevention of hypothermia at birth in newborn, and provided evidence-based support for clinical practice.

Analysis of role change and function of microsurgery staff in fighting against COVID-19 / 中华显微外科杂志

The outbreak of COVID-19 around the world has made more than two millions of confirmed patients and serious shortages of healthcare resources and medical staff in many countries. In the battle of fighting COVID-19 in Wuhan, many microsurgery staff across China were sent to Wuhan and put on duty in the treatment of COVID-19 patients. The purpose of this article is to review the personal experiences of microsurgery staff in fighting against COVID-19 as well as to analyse how to act professionally when facing the challenges and change of roles and meanwhile having to give full play to the professional advantages subject to make contributions to the battle of COVID-19. A reference is hereby provided for the microsurgery staff in dealing with a sudden and major epidemic outbreak in the future.

Application and effect evaluation of clohexidine wipes in patients with liver transplantation / 中国实用护理杂志

Objective@#To investigate the application of clohexidine wipes in patients after liver transplantation and the effect of infection prevention.@*Methods@#A total of 279 patients who received orthotopic liver transplantation in the first affiliated hospital of sun yat-sen university from January 2017 to December 2018 and were transferred to the intensive care department of our hospital after the surgery were selected as subjects. Among them, 145 patients who received liver transplantation between January and December 2017 were selected as the control group. From January to December, 2018, 134 patients after liver transplantation were enrolled as the intervention group, and were treated with clohexidine 2% gluconate wet wipes, and the hospital infection rate, infection rate, multiple drug-resistant bacteria infection rate, bath time consumption, and adverse reaction rate were compared between the two groups.@*Results@#The hospital infection rate of the control group was 20.00% (29/145), the infection rate of patients was 37.93%(55/145), the infection rate of multiple drug-resistant bacteria was 25.52%(37/145), and the infection rate of the intervention group was 11.19% (15/134), 24.63% (33/134), 14.93% (20/134). The differences were statistically significant (χ2=4.065, 5.709, 4.806, P<0.05). The bath time of the control group was (16.70±1.42) minutes, and the intervention group was (14.07±1.53) minutes. Compared with the control group, the bath time of the intervention group was saved, and the difference was statistically significant (t=9.637, P<0.01).No discomfort symptoms such as disinfectant allergy were found in both groups.@*Conclusion@#The application of clohexidine 2% gluconate wet wipes in the wiping bath of patients after liver transplantation had a good effect, significantly reducing the hospital infection rate, saving the time of wiping bath.

Research on the correlation between work effectiveness and job satisfaction of ICU specialist nurses / 中国实用护理杂志

Objective@#To study the correlation between job satisfaction and work effectiveness of ICU specialist nurses, to clarify the baseline level and influence factors, to increase the efficiency and satisfaction of the work, and to stabilize the ICU nurse team, to improve the quality of care.@*Methods@#The convenience sampling method was used to select 116 specialist nurses from the 3 three grade ICU hospitals in Guangzhou. Through the questionnaire survey of nurses′ general situation, work efficiency and job satisfaction, the methods of descriptive statistics, average number, standard deviation analysis, simple linear regression model analysis and multiple linear regression analysis were adopted to reveal the relationship between work effectiveness and job satisfaction of specialist nurses.@*Results@#The overall empowerment of ICU specialist nurses was 3.37 ±0.68. In the 6 dimensions of work efficiency, the average score of formal authorization was the lowest (3.01±0.93) and that of informal authorization was the highest (3.73±0.77). Multiple linear regression analysis showed that job satisfaction of nurses increased linearly with the increase of the scores of formal authorization and informal authorization (t=2.32, 3.78,P < 0.05). The total score of satisfaction was 55.03± 8.30. The work status dimension score was 35.16± 5.94, in the middle level limit; the work interpersonal relationship dimension score was 19.87 ± 2.82, in the high level. The work status satisfaction lagged behind the work interpersonal relationship satisfaction. Simple linear regression model analysis showed that the total score of satisfaction increased linearly with the average score of work efficiency, showing a positive linear correlation (t=9.891,P < 0.01). The regression equation was: y=27.12+8.273.@*Conclusions@#Because of the linear positive correlation between job efficacy and total score of satisfaction, nursing administrators should fully grasp the various factors affecting job efficacy in clinical management, and take targeted measures to improve the work efficiency of ICU specialist nurses, and ultimately improve the job satisfaction of nurses.

Research on the correlation between work effectiveness and job satisfaction of ICU specialist nurses / 中国实用护理杂志

Objective To study the correlation between job satisfaction and work effectiveness of ICU specialist nurses, to clarify the baseline level and influence factors, to increase the efficiency and satisfaction of the work, and to stabilize the ICU nurse team, to improve the quality of care. Methods The convenience sampling method was used to select 116 specialist nurses from the 3 three grade ICU hospitals in Guangzhou. Through the questionnaire survey of nurses′general situation, work efficiency and job satisfaction, the methods of descriptive statistics, average number, standard deviation analysis, simple linear regression model analysis and multiple linear regression analysis were adopted to reveal the relationship between work effectiveness and job satisfaction of specialist nurses. Results The overall empowerment of ICU specialist nurses was 3.37 ±0.68. In the 6 dimensions of work efficiency﹐the average score of formal authorization was the lowest (3.01±0.93) and that of informal authorization was the highest (3.73±0.77). Multiple linear regression analysis showed that job satisfaction of nurses increased linearly with the increase of the scores of formal authorization and informal authorization (t=2.32, 3.78,P<0.05). The total score of satisfaction was 55.03± 8.30. The work status dimension score was 35.16± 5.94, in the middle level limit; the work interpersonal relationship dimension score was 19.87 ± 2.82, in the high level. The work status satisfaction lagged behind the work interpersonal relationship satisfaction. Simple linear regression model analysis showed that the total score of satisfaction increased linearly with the average score of work efficiency, showing a positive linear correlation (t=9.891,P<0.01). The regression equation was: y=27.12+8.273x. Conclusions Because of the linear positive correlation between job efficacy and total score of satisfaction, nursing administrators should fully grasp the various factors affecting job efficacy in clinical management, and take targeted measures to improve the work efficiency of ICU specialist nurses, and ultimately improve the job satisfaction of nurses.

Comparison of hierarchical management core competence training of ICU nurses in China and England / 中国实用护理杂志

ICU nursing is a vitalpartof the development of specialized nursing in China, and the standardized training of the corecompetence of ICU nurses is the primary goal of the development of ICU nursing. This paper took the First Affiliated Hospital of Sun Yat-sen University in China and the Royal Free Hospital in London, the United Kingdom as example, and compared the hierarchical management and core competencies training status of ICU nurses in China and England to find out the similarities and differences, and then to put forward valuable suggestions for hierarchical management and the core competence training of ICU nurses in China.

Establishment of the real-time monitoring information system of ICU nursing quality indicators and applications / 中国实用护理杂志

Objective To establish a set of ICU care quality indicators real-time monitoring information system. Methods Based on the evaluation index system of ICU nursing safety quality, the real-time monitoring information system of ICU nursing quality indicators is established which quality evaluation index of structure quality、process quality and outcome quality is planted. To investigate the satisfaction of ICU medical staff in the use of informatization system and compare the quality of care quality before and after the use of the system. Results The satisfaction of ICU nurses in reducing working load, recording time, operation convenience, parameter acquisition and quality index monitoring were all greater than 90％. System before and after six months of intensive medicine nursing quality indicators, the overall quality had improved.The rate of ventilator recumbent incorrect position, the nonconformity rate of oral cavity clean, incidence of catheter-associated urinary tract infections, incidence of central line-associated bloodstream infection, incidence of ventilator associated pneumonia before information system were 2.03％ (118/5806), 0.53％ (10/1883), 0.51‰(4/7818), 0, 1.55‰(9/5614), which were lower than 4.90％(275/5614), 3.92％(69/1734), 3.12‰(24/7685), 1.06‰(8/7547), 4.81‰(27/5614) after six months (χ2=8.16-70.56, P<0.01).The accidental release rate of artificial airway was not statistically significant (P> 0.05). Conclusion The ICU nursing quality indicator real- time monitoring information system makes nursing management digital, improves the satisfaction of medical staff, and significantly improves the quality of care.

Investigation of nurses' scientific research competency and training demand in Chinese tertiary hospitals / 中华护理杂志

Objective To investigate nurses' scientific research competency and training demand in Chinese tertiary hospital.Methods It was a multi-stage large-scale survey.A total of 27 335 nurses from 22 provinces/autonomous regions/municipalities were recruited to complete the self-designed questionnaire,including demographic data(7 items),scientific research competency(objective index of 4 items,and subjective index of 6 subscales with 40 items),and training demand evaluation(6 subscales with 16 items).Results There were 1 130(4.14％) nurses who had managed or were managing the research projects as principal investigators(PIs),2 147(7.85％)nurses who had attended or were attending research programs,1 463(5.35％) nurses had published papers,and 557(2.04％) nurses obtained patents.The self-evaluated competency score was 25.00 (12.50,37.50)(rangedfrom 0 to 100)and training demand score was 53.13(37.50,75.00)(ranged from 0 to 100).Conclusion The nurses' scientific research competency should be improved and they had strong training demands.In order to improve nurses' research competency and quality,nursing administrators should pay more attention to post-graduate training focusing on research competency.

Application of Key Indicators of Tumor Internal Medicine Quality Evaluation in continuous improvement of specialized nursing quality / 中国实用护理杂志

Objective To explore the application effect of key indicators of oncology nursing quality evaluation in the continuous improvement of specialist nursing quality. Methods The Delphi method was used to cons-truct 14 key indicators of oncology nursing quality evaluation, and the key indicators were used to control the quality of specialist nursing in the tumor area. Data were collected and a database was established. Based on the data, the quality of the nursing care and continuous quality improvement were carried out. Results The results of the data from the first year (before the intervention in 2016) and the second year (after the intervention in 2017) were compared with the data of the key indicators of the quality evaluation of the specialist nursing. The results showed that the indicators had different degrees of decline. The data before and after intervention were: chemotherapy drug extravasation rate 0.20% (33/16 861) and 0.10% (20/19 957), and the incidence of severe pain was 1.65% (1 747/106 114) and 1.43% (1 521/106 462). The incidence of anxiety was 2.17% (2 305/106 114) and 1.53% (1 633/106 462), and the incidence of depression was 2.27% (2 408/106 114) and 1.28% (1 359/106 462). The difference was statistically significant (χ2=5.80-300.90, P<0.05); The other 9 indicators of process have improved to varying degrees. Conclusions 14 key indicators of oncology nursing quality evaluation are applied to the oncology ward for specialized nursing quality management and quality improvement, which can monitor the quality of key specialist nursing in real time and dynamically. It can accurately select clinical nursing priority improvement projects and improve specialist nursing. Quality;energy evaluation to improve the quality of specialist nursing quality; help improve the quality management of specialist nursing and ensure patient safety.

Application of nursing quality evaluating indicators in gastrointestinal surgery department / 中国实用护理杂志

Objective To evaluate the application of nursing quality indicators in gastrointestinal surgery department. Methods The indicator system was established by use of the Delphi method, applied in nursing quality control in gastrointestinal surgery department, and was used to analyze and improve nursing quality continuously according to the routine data collection. Results After the application of quality indicators for 6 months, the complications′ observation and prevention awareness rate of the patients increased from 75.00% to 92.00%(x2=4.200, P<0.05), and most of the process indicators had improved. Conclusions The nursing quality indicators provide basis for nursing quality management,and provide standards and guidance for clinical works.

The application effect of exothermic mattress to prevent hypothermia in preterm infants: a Meta-analysis / 中国实用护理杂志

Objective To evaluate the effects of exothermic mattress to prevent hypothermia in preterm infants. Methods SinoMed, Wanfang data, CNKI, VIP, PubMed, Embase and Web of Science were searched to collect relevant randomized or quasi randomized controlled trials on application of exothermic mattress to prevent hypothermia in preterm infants from database establishment to April 2017. A Meta-analysis was conducted by using RevMan 5.3 software. Results Four studies were included. The Meta-analysis showed that application of exothermic mattress significantly improved admission temperature in neonatal intensive care unit for infants less than 28 weeks (random effect model , weighted mean difference was 0.64, 95％CI 0.04-1.24, P=0.04) and increased risk of hyperthermia (fixed effect model, odds ratio was 3.18, 95％ CI 1.30- 7.77, P=0.01). Conclusions Exothermic mattress is efficacious in improving admission temperature for preterm infants.

Application of Plato analysis method in identifying the security risks of the clinical cases / 中国实用护理杂志

Objective To apply Plato analysis method to clinical cases which were reported from clinical nursing, finding out the key link of the risks which were related to the cases:the key age, the key period, the key spectrum of disease and the key projects, etc. To carry out the feedforward control of the quality of care, and ensure the quality and safety of nursing. Methods A database were set up including clinical special cases, high-risk cases, security hidden danger cases and emergency cases. Thetwo eightprinciple of Plato analysis method was used to find out the main factors, the principal contradiction, the key hazard and the key problems of the cases, etc. The aim was to provide guidelines of risk analysis, risk prevention and risk aversion for nurses, and improve their consciousness of security hidden danger, and reduce security hidden danger cases. Results The results of 207 cases collected from 2014 to 2015 showed that the main risks involved the age groups were 41-80 years old and 21-30 years old. The major risks involved the spectrum of disease were the nervous system, cardiovascular disease, surgical anesthesia related problems, kidney disease, cancer and respiratory system. The major risks involved the time were the midnight, morning and afternoon. The major risks involved the locations were sickroom, emergency room, auxiliary inspection departments and outpatient. The major risks involved items were disease mutation, psychological problems, medication safety and instrument safety, among the disease mutation, timely discovered, rescued 13 patients with heart and breathing pause, stop 13 patients who attempted suicide. Since the Plato analysis method was applied to identify the security risks of the clinical cases, the number of falling, all kinds of pipe shed, skin problems and suicides were decreased from 6, 6, 7, 5 in 2014 to 2, 2, 2, 1 in 2015, declining trend year by year. Conclusions Applying the Plato analysis method to identify the security risks of the clinical cases which can find out the main problems of cases and improve nursing quality and management efficiency.

Applying specialist nursing assessment indicator system to improve nurse′s assessment ability in orthopedic department / 中国实用护理杂志

Objective To investigate the effect of applying specialist nursing assessment indicator system on improving nurse′s health assessment ability in orthopedic department. Methods A specialist nursing assessment indicator system was developed by applying evaluation indicators of nursing care quality. That assessment indicator system consisted of 9 sub-indicators. They were assessments on local blood circulation, sensation and motion, muscle strength, pain, risk of developing pressure ulcer, risk of falling down and assessment on anal sphincter function, etc. In addition, standard assessment process was developed and applied to train 54 nurses in orthopedic department, in order to standardize and improve their ability on specialist nursing assessment. Furthermore, the assessment process was transferred into specific nursing interventions to improve nurse′s health assessment ability, too. The accurate rate on those 9 indicated assessments were evaluated and analyzed regularly, pre and post the indicator system application. In the present study, each of the 54 nurses was required to assess five patients basing on the items in the assessment indicator system. The total assessment times were 270. Results After applying the indicator system, the accurate rates of assessments on local blood circulation, sensation and motion, muscle strength, pain, risk of developing pressure ulcer, anal sphincter function and assessment on developing deep venous thrombosis were 98.89% (267/270), 99.63% (269/270), 99.26% (268/270), 97.41% (263/270), 98.15% (265/270), 91.85% (248/270), 98.15% (265/270), which were higher than 95.19%(257/270), 92.96%(251/270), 96.30%(260/270), 90.37%(244/270), 92.22%(249/270), 85.56%(231/270), 92.22%(249/270) of the time when the system was not used, and the difference was significant (χ2=5.34-16.82, P 0.05). Conclusions Applying the specialist nursing assessment indicator system was able to standardize nursing assessment behavior and improve nurse′s assessment ability. In addition, it was beneficial to improve the quality of specialist nursing care in orthopedic department.

Construction of pediatric nursing responsibility evaluation standard based on core abilities of nurses / 现代临床护理

Objective To construct evaluation standards for pediatric nursing responsibility. Methods With the method of expert enquiry for Delphi, coefficient of variation of each index through expert grading and Kendall W′s coordination coefficient were used to test the coordination degree in opinions among experts. After the coefficient of larger variation and lower weight were removed , the elements of nursing duty were ranked based on the weight by using hierarchy analysis method. Results The established practical pediatric nurses responsibility evaluation standard consisted of 3 modules, with 11 dimensions and 33 items. The Cr expert authority coefficient was between 0.77~0.90, with an average of 0.88. The variation coefficient of each index was low, ranging between 0.013 0.135 (<0.25). The Kendall W′s coordination coefficients of the primary, secondary and tertiary indicators were 0.482, 0.552 and 0.438, respectively, with significant differences in the coordination coefficient (P<0.001). Conclusion The experts are active and authoritative in participating in the standard establishment and they highly agreed on the standard , which indicates that the established the standard is reliable in a higher degree.

Effects of two methods for deep endotracheal sputum suction / 现代临床护理

Objective To explore the effects of two methods for deep endotracheal suction.Methods Forty patients who had ineffective airway clearance or lung infections or refused suction were randomly divided into observation group (n=21) and control group (n=19).Temporay airway was established by using oropharyngeal airway.Then,the control group received subglottic suction after pading the shoulder with ordinary pillow (≤10cm),while the observation group received subglottic suction after pading the shoulder with homemade pillow (=15cm).The two groups were compared in terms of sputum suction effect and mucosal injury.Results There was no incidence of mucosal injury in the observation group but three in the control group.The times of suctioning in the observation group were fewer than those of the control group and the volume for suctioning was larger as well (allP<0.05).Conclusion Deep endotracheal suction through oropharyngeal airway,shoulder elevation for 15cm,temporary indwelling of suction tubes can achieve better suction effect without corresponding complications.

An exploratory study on resilience and its influencing factors of nurses / 中华行为医学与脑科学杂志

Objective To explore the resilience and its influencing factors of nurses.Methods I 356 nurses from 11 comprehensive hospitals of Guangzhou were assessed by Conner-Davidson Resilience Scale,General Self-Efficacy Scale,Simplified Coping Style Questionnaire and Chinese Nurse Job Stress Scale.Results ①The score of nurses' resilience was (59.99± 13.59) and it was significantly lower (t=-t4.656,P＜0.001) than that of the domestic norm (65.4±13.9,n=560).There were statistic difference (P＜0.05) among the total score and 3 dimensions scores of resilience on different educational level and professional rank of nurses.②Nurses' resilience had a obvious positive correlation with the educational level,professional rank,self-efficacy,positive coping(P＜ 0.01),and a obvious negative correlation with the negative coping and job stress(P＜0.01).It can be assumed that educational level,self-efficacy,coping style and job stress had good predictive ability (47.4％).Conclusion The nurses have low resilience than general population.Educational level,self-efficacy,coping style and job stress are influencing factors of resilience.

The association of occupational stress, social support, type D personality with physical health of nurses / 中国实用护理杂志

Objective To investigate the association of occupational stress,social support,type D personality and physical health of nurses.Methods Cross-sectional study design was adopted.We used cluster sampling to investigate 1 287 nurses serving in one tertiary hospital and two second-class hospitals in Guangzhou.The questionnaire was anonymous answered.The content of questionnaire included the demographic data,occupational stress of nurses,social support,type D personality and physical health,etc.SPSS 13.0 was used for statistical analysis,including descriptive analysis,Pearson correlation analysis and path analysis.Results 1 192 of questionnaires were effective.The occupational stress was negatively related with the physical health status and social supports,and social support was positively related with the physical health status.The type D personality was negatively related with social supports and the physical health status,while positively related with occupational stress.Conclusions Occupational stress can make directly negative effect on the physical health.Social support has a directly protective effect on physical health.Type D personality makes direct and indirect negative effect on the physical health of nurses.

Using the EXIT(ex-utero intrapartum treatment)procedure in the preoperative and intraoperative caring of congenital diaphragmatic hernia of neonatus--report of 3 cases / 现代临床护理

Objective To report 3 cases of using the EXIT(ex-utero intrapartum treatment)procedure in the peri-surgical caring of congenital diaphragmatic hernia of neonatus.Methods Preparing and consulting of multiple clinical departments before operation,inhibit uterine contraction to avoid placental abruption.Keep puerperae and their babies warm.Result No complications happened to neither maternity nor neonatus.Conclusion Co-operations of multiple clinical departmens were essential to the successful using the EXIT(ex-utero intrapartum treatment)procedure in the congenital diaphragmatic hernia of neonatus.

Investigation of nutrition status and quality of life of perioperative patients with laryngeal cancer / 现代临床护理

Objective To investigate the nutrition status and quality of life(QOL)in the perioperative patients with laryngeal cancer and to analyze the effect of nutrition status on quality of life.Methods Sixty-six patients with laryngeal cancer were surveyed respectively by self-designed general situation questionnaire,nutritional risk srcreening 2002(NRS2002)and European organization for research and treatment of cancer quality of life core questionnaire(EORTC QLQ-C30).The impact of nutritional status on QOL was analyzed by the multiple linear regression analysis.Results The total score of nutritional risk of perioperative patients with laryngeal cancer was 3.53±1.51 and the incidence of nutritional risk was 28.79%.The nutrition status influenced on QOL, physiological function,cognitive function and pain area(P<0.05).Conclusion Nurses should assess the nutritional status of the patients and correct malnutrition without delay in order to improve the physical function and QOL of the patients.