Keep humanistic care help the development of high-quality nursing / 中国实用护理杂志

In the context of normalized prevention of COVID-19 epidemic and the in-depth promotion of building a healthy China, the consensus on integrating humanistic care into nursing work is taking root in the hearts of the people. As the guardian of people′s life and health and the main force in promoting the construction of a healthy China, the implementation of humanistic care by nurses in clinical work is crucial to improving the quality of nursing, improving patient outcomes, and promoting a harmonious relationship between nurses and patients. The acceleration of the current medical system reform process and the rapid release of the people′s demand for health services have further highlighted the urgency of improving the humanistic care capacity of nursing. This article focuses on improving nurses′ awareness, professional knowledge and skills of humanistic care, strengthening exploration and practice of nursing humanistic care management, focusing on creating a campus environment and culture of humanistic care for students, intensifying theoretical research on nursing humanistic care, integrating humanistic care into smart nursing, caring for nurses′ own development and physical and mental health, etc., will provide ideas for improving the humanistic care ability, helping the high-quality development of nursing, and promoting the construction of a healthy China.

Analysis of risk factors and construction of a prediction model for mild cognitive impairment in elderly inpatients in sub-plateau areas / 中华老年医学杂志

Objective:To investigate the prevalence of mild cognitive impairment(MCI)in elderly inpatients in high altitude areas, analyze the influencing factors, and then construct a risk factor model.Methods:A cross-sectional random sampling method was used to conduct a questionnaire survey among elderly patients over 65 years old hospitalized at Qinghai Provincial People's Hospital from October 2018 to February 2019.The survey contents included demographic data, lifestyles, physical activities and cognitive function.The occurrence of MCI was analyzed with descriptive epidemiological measures, a predictive model of influencing factors was established using Logistic regression analysis, and influencing factors were ranked.Results:There were a total of 1412 elderly people aged 65 and above, with 760 males, accounting for 53.8%.The ages of respondents ranged between 65-82 years, with an average age of(72.8±5.8)years.Of the subjects, 600 had MCI, with a prevalence of 42.4%.Male( OR=1.318, P=0.02), junior high school education or above( OR=0.521, P<0.001), bedriddenness( OR=2.658, P=0.002), lifestyle( OR=0.702, P=0.011), abnormal defecation( OR=1.625, P=0.005)and frailty( OR=1.536, P=0.002)were included into the predictive model of influencing factors.The area under the ROC curve in this study was 0.676(95% CI: 0.648-0.704), with sensitivity=0.553, specificity=0.741, and Youden index=0.274.When ordered by importance, the independent risk factors were frailty, male, abnormal defecation, bedriddenness, lifestyle, and education level. Conclusions:Male, frailty, abnormal defecation and long-term bedriddenness are risk factors for cognitive impairment in elderly people, whereas living with a partner and education above junior high school are protective factors.

Influence of male nurse training program on professional identity and career development of male nurses in a general hospital / 中国实用护理杂志

Objective:To establish and implement the training program of male nurses in general hospitals, and to explore the influence of the program on the professional identity and career development of male nurses.Methods:Male nurses in Peking Union Medical College Hospital were selected as the participants in October of 2019, and the training program consisting of management support, professional training, cultural construction and other contents was adopted to conduct intervention. Professional identity and career development were compared and analyzed before and after the intervention.Results:The total score of professional identity level of male nurses after intervention was (121.66±19.91) points, which was significantly higher than that before intervention (117.68±19.05), and the differences in all dimensions were statistically significant ( t value was 6.278, P<0.01). The score of successful in career after intervention (42.30±8.06) was significantly higher than that before intervention (41.81±8.00), and the differences in all dimensions were statistically significant ( t value was 3.928, P<0.01). Conclusion:The implementation of male nurse training program and scientific management of male nurses in general hospitals can effectively improve their professional identity level and promote their career development.

Male nurse: the need of nursing development and develop in need of nursing / 中国实用护理杂志

Male nurses are an important force in clinical nursing team and play an important role in clinical nursing; with the increasing number of clinical male nurses, nursing managers pay more attention to male nurses. Starting from the career development of male nurses, this paper summarized the professional advantages, practical difficulties, psychological state and future development trend of male nurses, which provided theoretical support for the self-development of clinical male nurses and the clinical positioning of male nurses by nursing managers. It laid a foundation for male nurses to play a key role in clinical practice.

The application of Kirkpatrick Model in the evaluation of standardized training effect of new nurses / 中国实用护理杂志

Objective:To evaluate the effect of standardized training for new nurses in the first year based on Kirkpatrick model as a theoretical framework.Methods:A cross-sectional study was conducted. New nurses' satisfaction with training, theoretical and operational assessment, job performance, core competence, turnover rate and other indicators were used, to evaluate the effect of standardized training for 62 new nurses in the first year.Results:At the reaction level, the overall satisfaction score of new nurses was 4.66±0.47; at the learning level, the theoretical assessment score was 95.32±2.38, the operational assessment score was 97.53±1.07, and the performance score was 97.12±1.64; at the behavioral level 88.45±9.75; and at the result level, there were no complaints and errors among new nurses, and the turnover rate was 1.6% (1/62). The theoretical and operational assessment scores were positively correlated with work performance, with r value of 0.424 and 0.399, respectively, and P = 0.001. The theoretical assessment scores were negatively correlated with the behavioral level, with the r value of -0.264 and P= 0.038. There were no correlation with the operational assessment scores and the behavioral level, with the r value of 0.147 and P value of 0.253. Conclusions:Kirkpatrick model validates the standardized training program for new nurses effectively, and provides scientific basis for improving the training program for new nurses. The results level of the training needs to be evaluated in the long term.

A status survey on clinical teaching towards postgraduates of master of nursing specialist in China / 中国实用护理杂志

Objective:To investigate the current status of clinical teaching towards postgraduates of master of nursing specialist(MNS) in China.Methods:Objective sampling was used to invest 390 MNS clinical nursing teachers in 36 hospitals across the country. The survey included the admission and evaluation criteria of teachers, the MNS postgraduates′ clinical teaching plan and implementation, and the assessment of MNS postgraduate ′s clinical practice ability, etc. Results:Among the criteria for clinical teachers for MNS postgraduates, 79.49% of departments required bachelor ′s degree or above, and 67.18% of departments requested medium-grade professional title or above; 47.44% of the departments demanded that clinical teachers had the research experience, 58.21% departments asked for the experience of articles publication. The main method of selecting clinical teaching teachers was examination (50%), while 31.28% departments had no definite criteria. The evaluation indicators of clinical teachers mainly depended on the results of students ′ clinical practice capability assessment (81.79%) and students ′ satisfaction (80%). Only 49.23% of the study objects knew the training objectives of MNS. The pivotal abilities of MNS graduate students were the ability of clinical nursing practice (91.79%) and clinical research (82.82%). The MNS postgraduate teaching plan of each department was mainly derived from the requirements of tutors and colleges (87.69%). The mode of clinical teaching was that one student was guided by a fixed clinical teacher (87.18%). Clinical practice assessment methods of MNS mainly included theoretical knowledge assessment (88.46%) and the performance of section lectures (82.56%). The assessment personnel were mainly clinical teachers (95.40%) and head nurses (83.51%). The self-assessment of clinical teachers was rated at the medium level about their performance on the postgraduate MNS students ′ clinical teaching. Conclusions:The homogenization and standardization of the construction of MNS clinical teaching base needs to be improved in China. In the field of defining the criteria of clinical teaching teachers, strengthening the construction of clinical faculty, perfecting the clinical teaching plan and evaluation system according to the cultivation objectives and specialist characteristics, and elevating the comprehensive medical education combined with clinical education and college education, further exploration is indispensable.

Investigation and analysis on risk factors of deep venous thrombosis of lower limbs in patients with orthopaedic bed rest / 中国实用护理杂志

Objective To study and analyze the risk factors of deep Venous Thrombosis of Lower limbs in patients with Orthopaedic bed rest. Methods 273 cases of patients with bed rest who were treated by Orthopaedic operation from November 2015 to March 2016 and from November 2016 to March 2017 in our hospital were.collected and divided into 2 groups according to whether there were deep venous thrombosis after operation, and A group had 232 patients who did not have deep venous thrombosis of lower limbs after Operation. B Group had 41 patients who had deep venous thrombosis of lower limbs after Operation. The two groups of patients were treated with orthopedic treatment, the researchers recorded the basic data of two groups of patients, and analyzed the risk factors of lower extremity deep venous thrombosis in patients with orthopedic Bed rest. Results In group B, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index≥1.7 mmol/L D-dimer≥500 μgP/L, operating time over 4 h were 54.10% (23/41), 58.54% (24/41), 75.61% (31/41), 60.98% (25/41), 58.50% (24/41), 63.41% (26/41), 48.78% (20/41), respectively.In group A, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/ m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index≥1.7 mmol/L D-dimer≥500ugP/L, operating time over 4 h were 24.14%(56/232), 23.28%(54/232), 13.36%(31/232), 23.28%(54/232), 21.12%(49/232), 10.78%(25/232), 9.91%(23/232), respectively, The difference between the two groups was statistically significant (χ2=3.602～11.623, all P < 0.05); Related risk factors for deep venous thrombosis in lower limbs logistic regression analysis showed that age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/ m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/ L D-dimer ≥ 500 μg/L, operating time over 4 h were the related risk factors for deep venous thrombosis in patients with bed rest after operation. Conclusion the risk factors for deep venous thrombosis of lower limbs in the elderly patients with bed rest after orthopedic operation are mainly age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases (such as hypertension, diabetes, etc.), bed rest for more than 5 days after operation, triglyceride index≥1.7 mmol/L D-dimer≥500 μg/L, operating time over 4 h, nursing staff should carry out nursing intervention according to the risk factors related to deep venous thrombosis of lower limbs to avoid the formation of deep vein thrombosis of lower limbs as far as possible.

Investigation and analysis on risk factors of deep venous thrombosis of lower limbs in patients with orthopaedic bed rest / 中国实用护理杂志

Objective@#To study and analyze the risk factors of deep Venous Thrombosis of Lower limbs in patients with Orthopaedic bed rest.@*Methods@#273 cases of patients with bed rest who were treated by Orthopaedic operation from November 2015 to March 2016 and from November 2016 to March 2017 in our hospital were.collected and divided into 2 groups according to whether there were deep venous thrombosis after operation, and A group had 232 patients who did not have deep venous thrombosis of lower limbs after Operation. B Group had 41 patients who had deep venous thrombosis of lower limbs after Operation. The two groups of patients were treated with orthopedic treatment, the researchers recorded the basic data of two groups of patients, and analyzed the risk factors of lower extremity deep venous thrombosis in patients with orthopedic Bed rest.@*Results@#In group B, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μgP/L, operating time over 4 h were 54.10% (23/41), 58.54% (24/41), 75.61% (31/41), 60.98% (25/41), 58.50% (24/41), 63.41% (26 /41), 48.78% (20/41), respectively.In group A, patient ratio of age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500ugP/L, operating time over 4 h were 24.14%(56/232), 23.28% (54/232), 13.36% (31/232), 23.28% (54/232), 21.12% (49/232), 10.78% (25/232), 9.91% (23/232), respectively, The difference between the two groups was statistically significant (χ2=3.602~11.623, all P < 0.05); Related risk factors for deep venous thrombosis in lower limbs logistic regression analysis showed that age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases, bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μg/L, operating time over 4 h were the related risk factors for deep venous thrombosis in patients with bed rest after operation.@*Conclusion@#the risk factors for deep venous thrombosis of lower limbs in the elderly patients with bed rest after orthopedic operation are mainly age greater than 65 years old, with a body mass index (BMI) of more than 25 kg/m2, with chronic diseases (such as hypertension, diabetes, etc.), bed rest for more than 5 days after operation, triglyceride index ≥ 1.7 mmol/L D-dimer ≥ 500 μg/L, operating time over 4 h, nursing staff should carry out nursing intervention according to the risk factors related to deep venous thrombosis of lower limbs to avoid the formation of deep vein thrombosis of lower limbs as far as possible.

Establishment of a model for ward categorizing and grading and its application in nursing management / 中华医院管理杂志

In order to identify 35 key work items indicating the workload, difficulty of nursing technology and nursing risk of different wards scientifically, a mathematical model of classification of wards was established by literature review, conference discussions, expert consultation, brainstorming, and field measurement, and information technology as well. On such basis, scores of the wards were calculated, and the total scoring of each ward was ranked from high to low into three categories and six grades. Each grade of wards was assigned with different performance distribution weights. Such a mathematical model for ward categorizing and grading based on HIS system and key item and weights, can monitor ward nursing in real time, and provide nursing administrators at all levels with clinical risk early warning by means of vertical and horizontal comparisons. These administrators can take precautions in time in terms of human resources and materials. Ward categorizing and grading as an indicator for performance distribution ensures the rationality of such distribution, enhances nursing motivation and stabilizes front-line nursing teams in the end.

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.

Quality control of multicenter nursing investigation research / 中华护理杂志

Quality management of scientific research is a systematic work,quality control of multicenter nursing research depends on perfect and effective quality management system,measures and procedures,as well as rigorous scientific attitude in project team. To establish and improve quality management system of scientific research,to for-mulate standard quality control procedures,to promote the usage of electronic data acquisition system in multicenter nursing researches,and to improve scientific,standard,and refined quality management of research are effective mea-sures to guarantee quality control of multicenter nursing research. This paper summarized quality control methods for multicenter investigation,to provide more experience for nursing researchers as references.

An evaluation index system of ward management: development and practice / 中华医院管理杂志

Objective To construct an evaluation index system of ward management,which can evaluate the efficiency of ward management fairly, and make the ward management more scientific and standardized.Methods Delphi method was used in semi-structured interview of 31 experts and 74 experts were subject to questionnaire consultation, so as to establish the index system.Results The index system of ward management so built consisted of three level-1 indexes of safety and quality, teamwork and patient satisfaction, six level-2 indexes of daily monitoring, service environment, adverse events, doctor-nurse cooperation, evaluation of administrators and patient satisfaction, and 25 level-3 indexes.Practice of this system in the past two years reduced adverse events and elevated quality of care.Conclusions This system as used clinically proves its operability and objectivity.

Multicenter survey on nurses' knowledge and attitude on common complications among bedridden patients in Chinese hospitals / 中华护理杂志

Objective To investigate the knowledge and attitude of nurses on prevention and intervention of common complications among bedridden patients in Chinese hospitals and to explore the influential factors.Methods It was a cross-sectional study.A total of 3 903 nurses from 6 tertiary hospitals,11 secondary hospitals and 8 primary hospitals from 6 provinces and cities were recruited by convenience sampling and surveyed using selfdesigned questionnaires.Results Nurses' average scoring rate of knowledge and attitude were 73.46％ and 85.02％.Level of hospitals,whether in ICU or not,age,working time,educational background,job title,position,employment form were influential factors for nurses' knowledge (P＜0.05).Meanwhile,level of hospitals,educational background,position,employment form were influential factors for nurses' attitude (P＜0.05).Conclusion Nurses took a positive attitude for prevention and intervention of common complications among bedridden patients,while the level of nurses' knowledge should be improved.

Design and application of the electronic data capture system in multi-center nursing study / 中华护理杂志

We designed and applied the electronic data capture system (EDC) in order to strengthen the re-search quality and improve the efficiency of data collection of multi-center nursing research. According to the needs of research,we reasonably designed the EDC structure and functions,including data collection,verification, summary and export. Further improvement was performed after EDC was inputted into using. By using EDC,resear-chers from sub-centers completed the data collection smoothly,and the data quality met with research requirements. The design and application of EDC could effectively guarantee the data quality and improve the research efficiency.

Ten cases of application experience of a high-pressure-resistant peripherally inserted central catheter / 中华临床营养杂志

Objective To summarize the placement, maintenance, and safety of a high-pressure resistant peripherally inserted central catheter. Methods Ten patients were peripherally placed with this catheter (included 4Fr-single lumen, 5Fr-dual lumen, and 6Fr-three lumen) using ultrasound-guided Seldinger technique in Peking Union Medical College Hospital in August 2010. The therapeutic effectiveness and safety were evaluated. Result Ten catheters were inserted successfully into the upper arms, with few complications noted during routine maintenance. Conclusions This peripherally inserted central catheter can be used for high-pressure injection, central venous pressure monitoring, and fast flow-speed transfusion. Therefore, it can be successfully applied for contrast-enhanced CT angiography and massive fluid infusion.

Study on the assessment of clinical nursing grade / 中国实用护理杂志

Objective To explore the concordance of nursing grades which are ordered by the nurses and the standards of nursing grade and the inpatients' needs. Methods 120 inpatients were rated using the three methods respectively, which were the nurses' order, the standards of musing grade and Bartbel index, and then compare the concordance of the nursing grades rated by the three. Results Then nurses' order was of well concordance with the standards of nursing grade and Barthel index,and the Kappa value was 0.862,0.611,P<0.01,respectively. Conclusions The nurses' order accords with the standards of nursing grade and the patients' needs, is helpful to develop the clinical work, and should be spreaded and exploited.

Prevalences of nutritional risk,undernutrition-overweight,and obesity as well as nutritional support in hospitalized general surgical patients in Beijing teaching hospitals / 中华临床营养杂志

Objecflve To determine the prevalences of nutritional risk,undemutrition,overweight,and obesity as well as nutritional support and the changes of nutritional risks from admission to discharge or over a two-week period.Methods A consecutive sampling was performed.Dam were collected from general surgical depart-ments in three Beijing teaching hospitals from March to July in 2007.Patients were screened using Nutritional Risk Screening 2002(NRS2002)on admission and two weeks after admission(or discharge).The nutritional supper apphcation during hospital stay was recorded.NRS2002 score≥3 was classified as nutritional risk.BMI<1 8.5kg/m2 with impaired genend condition was defined as undemutrition.Results Among 300 enrolled patients,the NRS2002 WaS completed by 99.0%(297/300)of all patients.The nutritional risk and the prevalence of under_nutrition,overweight,and obesity was 30.0%,8.1%,38.3%,and 9.4%,respectively at admission.Fifty of 90(62.2%)patients who were at nutritional risk received nutritional support while 40 of 210(19.O%)non-risk patients received nutritional support.Especially among major abdominal surgery patients,56 of 90(71.6%)pa-tients who were at nutritional risk received nutritional supper while 35 of 81(43.2%)non-risk pafients received nutritional support.The prevalence of nutritional risk changed from 30.0%to 35.8%(X2=2.271,P=0.132).Conclusions NRS2002 is a feasible nutritional risk screening tool among general surgical pafienm in selected Bei-jing teaching hospitals.Nutritional support is somehow inappropriately apphed in general surgical hospitalized pa-tients.The prevalence of nutritional risk remains unchanged in general surgical patients during hospitalization.

Development of an Instrument to Assess Swallowing Function in Patients with Stroke / 中国康复理论与实践

@#Objective To develop a new instrument to assess swallowing function which will be suitable for nurses to screen dysphagia in the patients with stroke.MethodsItems closely related to symptoms and signs of dysphagia were found with literature review, forming a preliminary instrument. All items retrieved were selected and modified by experts interview and a pilot study in patients with stroke. Then, a clinical nursing swallowing assessment tool (CNSAT) was formulated.ResultsTotally, seven items of symptoms and signs related to dysphagia in patients with stroke were found with literature review. All the seven items retrieved were selected again by experts interview and finally a CNSAT was formed with six modified items by a pilot study in 10 patients with stroke, each item with four choice based on its severity of their symptoms and signs.ConclusionCNSAT is a simple, convenient and safe instrument and suitable for nurses to assess swallowing function of patients with stroke.