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Objective Through conducting the project of quality improvement for intrahospital transport of critically ill patients from ward to ICU,to establish graded management under early warning to improve transport efficiency and quality.Methods Through setting up project team,setting goals of quality improvement,measuring and analyzing transport status,the graded management under early warning was established from three aspects:condition,equipment and transport personnel.The graded management under early warning was applied to clinical nursing practice to evaluate the effects.Results There was no statistical difference before and after the implementation of graded management under early warning in gender,age and condition of critical ill patients between two groups,but the time of transport was significantly reduced after the implementation,while there was no equipment failure,and the incidence of adverse events associated with devices decreased effectively.Conclusion The establishment and application of graded management under early warning has effectively reduced the risks of transport,improved efficiency and quality of transport.
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Objective To evaluate the use of transfer statements in inhouse transport of critical patients.Methods By means of continuous enrollment,123 critical patients were enrolled as a control group for conventional transport,and 111 such patients were enrolled as an observation group for transport using the transfer statement.Then the incidence of adverse events,transport during and nurse-nurse collaboration level of the two groups were compared.Results In the control group,its incidence of adverse events was 13.8%,the mean transport during was(19.5 ± 8.4)minutes,and the mean score for nurse-nurse collaboration level was ( 101.87 ± 7.13 ).In the observation group,its incidence of adverse events was 5.4%,the mean transport during was(13.5 ± 5.4)minutes,and the mean score for nurse-nurse collaboration level was(106.15 ± 8.86).Implementing the transfer statement has cut back the incidence of adverse events (P<0.05)and the transport duration significantly(t=3.833,P<0.01),while improving the level of nurse-nurse cooperation significantly(t= -4.261,P<0.05).Conclusions The transfer statement can increase the safety of patient transport,promote organization and coordination of nurses,and improve the efficiency of transport.
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@#Objective To explore the effect of Governor Vessel electroacupuncture in different time points on motor function and p75 neurotrophin receptor (p75NTR) after spinal cord injury. Methods A total of 180 adult male Sprague-Dawley rats were randomly divided into three groups (one day, three days and seven days after modeling), and each group was divided into normal control group, normal electroacupuncture group, sham operation group, model group and Governor Vessel electroacupuncture group with 12 cases in each group. The spinal cord injury model was established with the modified Allen's method. The normal electroacupuncture group and the Governor Vessel electroacupuncture group received electroacupuncture on Dazhui (DU14) and Mingmeng (DU04) acupoints. Basso-Beattic-Bresnahan (BBB) Scale was performed to assess the motor function of rats. The expression of p75NTR was detected with Western blotting. Results The BBB score of the model group and the Governor Vessel electroacupuncture group were significantly lower than that of the other three groups. The BBB score was significantly higher in the Governor Vessel electroacupuncture group than in the model group seven days after intervention (t=-4.510, P<0.001). The expression of p75NTR was siginificantly lower in the Governor Vessel electroacupuncture group than in the model group (P<0.01). Conclusion The expression of p75NTR increased after spinal cord injury. Governor Vessel electroacupuncture could improve the motor function, and inhibit the p75NTR expression of damaged spinal cord tissues.
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As the nerve regeneration has been researched more and more, nerve regeneration related signaling pathways after spinal cord injury (SCI) comes into the view. Inhibiting apoptosis signaling pathways may reduce the apoptosis, inflammation and nerve degenera-tion after SCI. Mitogen activated protein kinase (MAPK) signaling pathway plays an important role in regulation of gene expression, cell proliferation and apoptosis, and there was interaction among the four subordinate pathways. Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway does not only participate in the body cell survival, proliferation, differentiation and apoptosis, but also in the process of inflammatory and oxidative stress in the body. It has been found that blocking the Wnt signaling pathway after inju-ry in the central nervous system would inhibit neural axon regeneration. Exogenous Wnt3a can increase the number of neurons after SCI and promote the axon conduction and nerve function. Inhibiting mammalian target of rapamycin (mTOR) signaling pathway after SCI can signif-icantly reduce neuronal loss, cell death and well promote the functional recovery. When Notch signaling pathways are activated, neural stem cells proliferate actively and differentiation are inhibited, and stem cells enter the stage of differentiation as the pathway inhibited. Activa-tion of Ras homolog gene/Rho associated coiled coil forming protein kinase (Rho/ROCK) signaling pathways leads to the collapse of the growth cone, inhibition of axon regeneration, whereas the selective inhibition of Rho can promote axon regeneration and recovery of motor function after SCI.
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Objective To evaluate the effect of transitional care on the quality of life in patients with maintenance hemodialysis (MHD).Methods 101 MHD patients with symptoms of kidney ＜ 80 points were assigned into the interventional group (47 of 51 cases completed the study) and the control group (45 of 50 cases completed the study) by random number table method.The patients in the interventional group received transitional care for 6 months,while control group received routine care.The effects on function index,satisfaction index and clinical index were evaluated at the 3rd month and 6th month after intervention.Results 6 months after intervention,the scores of physical composite,mental composite,burden of kidney disease,symptoms/problems list,effects of kidney disease in the interventional group were 51.78±5.91,55.32±5.36,29.79±17.64,79.39±6.73,68.02±11.38,while the scores of the control group were 38.22±9.46,42.03±8.32,19.58±17.25,69.49±10.10,52.09±16.78,and the difference between the two groups was statistically significant (t=5.308-9.063,Z=-3.07,P ＜ 0.01).The scores of self-management behavior,health locus of control in the interventional group were 71.30-±5.42,25.74±2.42,while the scores of the control group were 65.0±8.74,22.47±3.97 (t=4.132,4.759,P ＜ 0.01).The nursing satisfaction in the interventional group scored 91.06±7.29,which was significantly higher than the control group scored 86.22±10.72 (Z=-2.45,P＜ 0.05).The level of serum phosphorus (PO4),Ca × PO4 products,parathormone (PTH) in the interventional group were (1.76±0.35) mmol/L,(51.02±10.04) mg2/dl2,464.56 ng/L,which were significanlty lower than (2.01±0.54) mmol/L,(57.41±17.38) mg2/dl2,625.78 ng/L in the control group (t=-2.691,-2.167,-2.000 in tum,P ＜ 0.01 or 0.05).Conclusions Transitional care achieves good effectiveness on the quality of life in patients with MHD.
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@#Spinal cord injury is a kind of central nervous system diseases with high morbidity. Acupuncture and moxibustion has unique advantages in treating spinal cord injury and its complications including neurogenic bladder, neuropathic pain, intestinal disorders, and muscle spasms. This article reviewed the researches of acupuncture and moxibustion treatment on spinal cord injury. It is presented to provide reference for clinical research.
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In order to promote our country's research on transitional care for patients with chronic kidney disease (CKD),the article summarized research progress on transitional care for patients with CKD,analysed the problems existed including lack of evidence-based basis,insugiciency of Intervention staff,one-sided intervention content and effect evaluation,etc,and put forward the corresponding countermeasures.
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Objeetive To investigate the relationship among social avoidance and acceptance of disability in burn patients.Methods Totally 127 patients were investigated using Social Avoidance and Distress Scale (SADS),Acceptance of Disability Scale (AODS),demographic information questionnaire and disease related information sheet.Results The points of burn patients' SADS was (21.38±6.75),One-way ANOVA showed that gender,marital status,special parts burns,amputation affected social avoidance significantly.The total score and factors scores of acceptance of disability were all negatively related to the score of social avoidance.Regression analysis showed that acceptance of disability,head burns,gender were the independent risk factors of depression.Conclusions Acceptance of disability were negatively related to social avoidance; Nurse can help them accept the reality of disability,develop the confidence to partici-pate in social communication,and improve the social adaptability.