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Objective:To construct the evidence-based care bundles for enteral nutrition-related diarrhea in ICU patients and evaluate its effectiveness.Methods:Evidence-based care bundles for enteral nutrition-related diarrhea in ICU patients were constructed according to the best evidence from 5 guidelines. 12 best evidences were summarized, and 12 cluster schemes for diarrhea management were constructed. 175 patients admitted to ICU of Shandong Provincial Hospital Affiliated to Shandong First Medical University from June to December 2020 were selected as the pre implementation group which was given enteral nutrition nursing according to routine nursing measures, and 186 patients admitted to ICU from March to October 2021 were selected as the post implementation group which received nrusing care with evidence-based cluster schemes. The rate of diarrhea in ICU patients undergoing enteral nutrition support before and after using best evidence was compared, and awareness of best evidence among nurses before and after training, and implementation of various measures by nurses after the plan were also compared.Results:After the care bundles were applied, the incidence of diarrhea decreased from 26.29% (46/175) to 11.83% (22/186) with statistically significant difference ( χ2=12.33, P<0.05). The diarrhea knowledge score was improved from 52-100 (75.79 ± 10.18) points to 72-100 (90.00 ± 6.71) points and had a significant difference ( t=-8.88, P<0.05). After the care bundles were applied, the rate of ICU nurses′ diarrhea identification and evaluation, analysis of influencing factors of enteral nutrition associated diarrhea, nasal feeding, selection of enteral nutrition formula and drug were 94.83% (55/58), 91.38% (53/58), 100.00 (58/58), 93.10% (54/58), 94.83% (55/58),significantly improved than 68.97% (40/58), 63.79% (37/58), 81.03% (47/58), 62.07% (36/58), 70.69% (41/58) before applied ( χ2 values were 8.66-14.33, all P<0.01). The implementation rate after the plan was more than 95.00%. Conclusions:The application of the evidence-based care bundles can effectively reduce the incidence of enteral nutrition diarrhea in ICU patients, improve nursing practice and the quality of care.
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objective:This paper summarizes the nursing care of a case of severe acute pancreatitis complicated with intra-abdominal hypertension by ultrasonic-guided enema.Methods:One patient with severe acute pancreatitis internal high pressure from February 28, 2021 in Shandong Provincial Hospital Affiliated to Shandong First Medical University setting indiidualized enema scheme, advantage of the characteristics of ultrasonic visualization, before and after the enema examine case of intestinal cleaning and waste water accumulation, enema, positioning enemator catheter and cutting-edge position, ensure the accuracy of the enema, normal irrigation using configuration at the same time, the relaxation anal sphincter and so on, to observe the therapeutic effects enema.Results:After careful treatment and nursing, the patient achieved satisfactory results of exhaust and defecation, enema, abdominal distention improved, intra-abdominal pressure returned to normal, 10 days later, the condition was stable and transferred to the general ward.Conclusions:For the nursing of patients with severe acute pancreatitis complicated with intra-abdominal hypertension, it is particularly important to reduce intra-abdominal pressure by enema. Nurses should make reasonable use of new technology to implement individualized enema nursing, promote the excretion of stool, reduce intra-abdominal pressure, and facilitate the early recovery of the disease.
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Objective:To analyze the compatibility of prescriptions for infertility (female) in the Dictionary of Traditional Chinese Medicine Prescriptions. Methods:The prescriptions for infertility (female) in the Dictionary of Traditional Chinese Medicine Prescriptions were collected and analyzed by association rules analysis, mutual information method, complex system entropy clustering and unsupervised entropy hierarchical clustering with the Traditional Chinese Medicine Inheritance Support System (v2.5). Results:A total of 302 prescriptions were collected for the treatment of infertility (female), involving 352 kinds of traditional Chinese medicine, with warm nature as the main property and sweet taste as the main flavor, followed by pungent and bitter flavor, mainly belonging to liver, spleen, kidney and heart meridian. Thirty seven prescriptions were used more than 30 times, and the top ten were Angelicae sinensis radix, Chuanxiong rhizoma, Poria, Rehmanniae radix praeparata, Paeoniae radix alba, Ginseng radix et rhizoma, Cyperi rhizoma, Atractylodis macrocephalae rhizoma, Cinnamomi cortex and Rehmanniae radix. There were 40 common drug combinations for 60 times, the top four including Angelicae sinensis radix- Chuanxiong rhizoma, Angelicae sinensis radix- Paeoniae radix alba, Rehmanniae radix praeparata- Angelicae sinensis radix and Chuanxiong rhizoma-Paeoniae radix alba. Thirteen core combinations of 3-5 herbs were obtained by complex system entropy clustering, and 13 new prescriptions were formed by further clustering. Conclusions:According to the Dictionary of Traditional Chinese Medicine Prescriptions, prescriptions for infertility (female) are mainly used to regulate qi and blood, nourish the five zang organs, and properly matching with those for regulating qi to open depression, drying dampness to dissipate phlegm, and warming meridians to dredge stagnation.