RESUMO
Objective:To survey the job satisfaction of online contracted nurses who provide " Internet plus nursing services" for reference of hospital managers in improving their management mechanism in this regard.Methods:Based on the two-factor theory, a questionnaire was designed and a purposive sampling method was used to survey the online contracted nurses in Anhui province in April and May 2022. The motivational factors included such five dimensions as workload, work content, colleague relationship, doctor-patient relationship, and their own development, and the healthcare factors included such three dimensions as salary, job recognition and social status. The questionnaire data and job satisfaction scores were analyzed descriptively, and the correlation between the overall job satisfaction of the online contracted nurses, while each dimension was analyzed by Pearson correlation analysis, and the influence of each dimension on job satisfaction was analyzed by stepwise regression analysis.Results:A total of 335 valid questionnaires were recovered. The mean score of job satisfaction of online contracted nurses was (2.26±0.38), with the highest score of (2.56±0.53) for salary satisfaction and the lowest score of (1.78±0.67) for job recognition, and each dimension was positively correlated with job satisfaction ( r=0.34-0.88, P<0.01). Regression analysis showed that workload ( B=0.07), salary ( B=0.11), job content ( B=0.23), social status ( B=0.12), and self-development ( B=0.15) were the main factors affecting their job satisfaction ( P<0.01). Conclusions:The job satisfaction of online contracted nurses was at a medium level, mainly influenced by workload, salary, job content, social status and their own development. It is recommended that hospitals implement multiple targeted measures to improve the job satisfaction of online contracted nurses and promote the healthy development of " Internet plus nursing services" .
RESUMO
Objective To investigate the effect of Shenfu Injection on acute renal injury (AKI) in children with congenital heart disease after operation. Methods Sixty-two children with atrial or ventricular septal defect, treated in Affiliated Hospital of Southwest Medical University from August 2016 to December 2018, were divided into two groups according to different treatment methods, such as conventional Western medicine treatment group and Shenfu Injection group, with 31 cases in each group. The children in Shenfu Injection group were given 20 mL Shenfu Injection from the beginning of anesthesia induction to the end of cardiopulmonary bypass, the children in Western medicine conventional treatment group were pumped with the same volume of normal saline. The anesthesia time, total operation time, cardiopalmonary bypass time, aortic clamping time, and the use of milrinone, dopamine, epinephrine, sodium nitroprusside and other drugs in the two groups were observed. The serum creatinine (SCr) level was measured by chemiluminescence method before operation (T0), at the beginning of operation (T1), at the beginning of cardiopulmonary bypass (T2), at the end of cardiopulmonary bypass (T3) and at the end of operation (T4), and the glomerular filtration rate (eGFR) was calculated. The mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), adrenaline (E) and noradrenaline (NE) in two groups were recorded at each time point. Results There was no significant difference in anesthesia time, total operation time, cardiopalmonary bypass time, aortic clamping time and the use of milrinone, dopamine, E and sodium nitroprusside between the Shenfu Injection group and Western medicine conventional treatment group (all P > 0.05). There was no significant difference in HR and CVP between the two groups at T0-T4 (all P > 0.05). There was no significant difference in MAP level between the two groups at T0 and T1( both P > 0.05), with the time prolonging, the MAP level of Western medicine conventional treatment group was significantly lower than that of T0, while MAP level of Shenfu Injection group was significantly higher than that of T0. At T2, the MAP level of Shenfu Injection group was significantly higher than that of the Western medicine conventional treatment group [mmHg (1 mmHg = 0.133 kPa): 66.6±6.5 vs. 53.1±6.7, P < 0.05]. There was no significant difference in E and NE between the two groups at T0 and T1 (P > 0.05), with the time prolonging, both E and NE decreased compared with those at T0 (both P < 0.05), but there was no significant difference at the same time point (all P > 0.05). At T0, there was no significant difference in SCr and eGFRs between the two groups (both P > 0.05), at T1, the SCr levels of two groups were significantly higher than those at T0, but the SCr level of Shenfu Injection group was significantly lower than that of Western medicine conventional treatment group (μmol/L: 42.43±15.91 vs. 56.58±16.80, all P < 0.05). From T2, the SCr levels of two groups began to gradually reduce, but it was still significantly higher than those at T0, the two groups reached the lowest level at T4, and the level of SCr in Shenfu Injection group was significantly lower than that of Western medicine conventional treatment group (μmol/L: 36.24±9.72 vs. 46.85±15.91, P < 0.05). Compared with T0, the eGFRs levels of the two groups were significantly lower at T1-T4, but gradually increased with time, reached the highest level at T4, and the eGFRs level of Shenfu Injection group was significantly higher than that of Western medicine conventional treatment group (mL·min-1·1.73 m-2: 113.7±12.1 vs. 79.6±12.5, P < 0.05). The incidence of AKI in Shenfu Injection group was significantly lower than that in Western medicine conventional treatment group [22.58% (7/31) vs. 64.52% (20/31), P < 0.05]. Conclusion Shenfu Injection can reduce the incidence of AKI in children with congenital heart disease after operation.
RESUMO
Objective To explore the assessment and intervention categorized for patients with permanent colostomy′s continue nursing problem based on the Omaha system. Methods Developing permanent colostomy′s continue nursing problem assessment form in the framework of Omaha system, using this assessment form to evaluate 46 patients′continue nursing problem and choose appropriate interventions. Results A total of 46 patients on the day of discharge had a total of 260 continue nursing problems. There were 5.7 nursing problems averagely for every patient. Incidence of more than 50%of the nursing problems had personal care, role change, mental health, sleep and rest, digestion- hydration and social; potential continue nursing problems was 90. There were 1.97 nursing problems averagely for every patient. The main potential continue nursing problems were two, respectively was colostomy complications and colostomy surrounding skin complications. Continue nursing intervention had a total of 727. There were 15.8 continue nursing interventions averagely for every patient. The most frequent interventions were for physiological and psychosocial domain. Conclusions Omaha Question Classification System can fully assess permanent colostomy′s continue nursing problem andset corresponding nursing intervention strategiesaccording to Omaha intervention system. More attention should be paid to psychosocial and health-related behavior problem. The most frequent interventions were health education, guidance, counseling and monitoring.
RESUMO
Objective To observe the effect of self-developed simple arteriovenous haemostat on compression hemostasis of the puncture point after withdrawing needlesfor venipuncture. Methods 160 inpatients with transfusion in the inpatient area of Neurology Department who are admitted from April 2015 to June 2015 were selected as the subject of study, and they were randomly divided into the control group and the observation group, with 80 cases for each group. The patients in the control group weretreated with conventional compression hemostasis, and they were continuously compressed for 5 minutes, while the observation group was treated with the simple arteriovenous haemostat (patent number ZL 201520184173.3) to make compression hemostasis. The nurses operated the haemostat for about 30 to 50 seconds, without waiting beside the patients. The haemostat was removed after 5 minutes. The incidence of subcutaneous congestion and puncture point bleeding, as well as the nurses' time on the local compression hemostasis of the puncture point and the comfort level and satisfaction of patients were compared between the two groups. Results The control group was 5 cases (6.25％) of the puncture point bleeding, 9 cases (11.25％) of subcutaneous congestion, 48 cases (60.00％) of comfortable feeling, 22 cases (27.50％) of common feeling, 10 cases (12.50％) of discomfort, 47 cases(58.75％) of satisfaction, 24 cases (30.00％) of common satisfaction and 9 cases (11.25％) of dissatisfaction. The observation group was 0 case of the puncture point bleeding, 2 cases(2.50％)of subcutaneous congestion, 77 cases(96.25％)of comfortable feeling, 2 cases(2.50％)of common feeling, 1 case(1.25％)of discomfort, 70 cases(87.50％) of satisfaction, 8 cases (10.00％)of common satisfaction and 2 cases(2.50％)of dissatisfaction. The observation group was better than the control group in compression hemostasis time, subcutaneous congestion, punctures point bleeding and satisfaction and comfort level, and the difference was statistically significant (P < 0.05). Conclusions The strength, position and time of compression hemostasis by simple arteriovenous haemostat are controllable, visual and constant, which can achieve the effect of standard compression by nurses, and has the value to be popularized in clinical practice.
RESUMO
Objective To investigate the effects of nutritional risk on incidence of pressure ulcer in hospitalized elderly patients,and to provide a basis for medical staff to carry out effective preventive measures.Methods Nutritional Risk Screening 2002 (NRS-2002) and nutrition index were applied in 150 elderly patients in the department of neurology for screening and evaluation of nutritional risk.Then the effect of nutritional risk on incidence of pressure ulcer in elderly patients was analyzed.Results 86 cases with nutritional risk and 64 cases without nutritional risk were found.The incidence of pressure ulcer was 16.67％ and 42.67％ respectively.The comparison was made among hemoglobin,serum albumin,pre-albu-min and total lymphocyte count,the difference was statistically significant between the two groups.The incidence of pressure ulcer in elderly patients with nutritional risk was 6.99 times higher than those without nutritional risk.Conclusions To given nutritional risk screening,active and reasonable nutritional support plan to hospitalized elderly patients can reduce the incidence of pressure ulcer.
RESUMO
Objective To investigate the effect of propofol on the cerebral injury induced by ketamine in neonatal rats. Methods Eighty 7-day-old SD rats of both sexes, weighing 12-20 g, were randomly divided into 4 groups (n = 20 each): normal saline (NS) group, ketamine-induced cerebral injury group (group K), propofol group (group P) and propofol combined with ketamine group (group PK). Group NS received intraperitoneal NS 1 ml. In groups K, P and PK, ketamine 70 mg/kg, propofol 70 mg/kg and propofol 70 mg/kg + ketamine 70 mg/kg were injected intraperitoneally once every 2 h for 3 times respectively. Ten rats in each group were selected and sacrificed at 24 h after emergence from anesthesia and the hippocampi obtained to determine the neuronal apoptosis (by TUNEL) and Bcl-2 and Bax protein expression(by immunohitochemistry). The apoptosis rate was calculated.The other 10 rats in each group were selected at 21 days after the intraperitoneal injection and the learning and memory functions (escape latency and frequency of crossing the original platform) were evaluated using Morris water maze. Results Compared with group NS, the apoptosis rate was significantly increased in group K, Bcl-2 protein expression was up-regulated in groups P and PK, and Bax protein expression was up-regulated, the escape latency was significantly prolonged and the frequency of crossing the original platform was significantly decreased in the other groups (P ＜ 0.05 .or 0.01 ). Compared with group K, the apoptosis rate was significantly decreased in group PK, Bax protein expression was down-regulated in group P, and Bcl-2 protein expression was up-regulated,the escape latency was significantly shortened and the frequency of crossing the original platform was significantlyincreased in groups P and PK ( P ＜ 0.05). Conclusion Propofol can reduce the cerebral injury induced by ketamine in neonatal rats, and the regulation of the Bcl-2 and Bax protein expression and inhibition of the neuronal apoptosis in hippocampus may be involved in the mechanism.
RESUMO
Objective To investigate the choice of treatment of tubal pregnancy.Methods 128 patients with tubal pregnancy were randomly divided into 43 patients of drug group,42 cases of laparoscopy group,43 cases laparotomy group.The differences of pregnancy status,time to pregnancy,tubal smooth the situation,length of stay,discharge of blood β-HCG were compared.Results Lapamscopic surgery therapy whose intrauterine pregnancy rate reached 80.9%,one year intrauterine pregnancy rate was up to 66.7%,tubal flow rate was 78.6%,and the pregnancy and discharge time was significantly shorter,and the level of β-HCG decresaed when they would go out hospital.Conclusion Laparoscopic surgery therapy had small trauma,better pregnancy rate,low ectopic pregnancy rate,better tubal patency rate,and it could improve fertility,and make discharging quickly,and was an effective treatment for patients with tubal pregnancy.