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Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.
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Objective:To understand the current situation of knowledge, attitude and practice about target temperature management (TTM) in patients with severe traumatic brain injury (STBI) among intensive care unit ICU nurses and analyze the influencing factors, so as to provide a reference for conducting ICU nurses′ TTM training for patients with STBI.Methods:Applying the method of cross-sectional study, from November to December 2022, a stratified whole-group sampling method was used, stratified by first-, second-, and third-level hospitals, and a self-designed questionnaire on the current status of ICU nurses′TTM for patients with STBI was used to investigate the current status of knowledge, attitude, and practice of neurosurgical ICU, emergency ICU, and comprehensive ICU nurses in 22 second- and third-level hospitals in 11 cities in Gansu Province, and multiple linear regression analysis was used to analyze the factors influencing ICU nurses′ knowledge, attitude, and practice scores.Results:A total of 543 valid questionnaires were returned, and the scores of ICU nurses on the TTM total score, knowledge, attitude and practice dimensions of STBI patients were (76.75 ± 10.42), (7.38 ± 2.74), (39.57 ± 4.87), (29.80 ± 7.18) points respectively. The results of multiple linear regression analysis showed that the factor influencing ICU nurses′ scores on the TTM knowledge dimension for STBI patients was having attended TTM-related training ( t = 2.16, P<0.05); the factors influencing ICU nurses′ scores on the TTM attitude dimension for STBI patients were college, bachelor′s degree and the position of nurse practitioner ( t = 2.65, 2.91, 2.14, all P<0.05); and the factors influencing ICU nurses′ scores on the TTM practice dimension for STBI patients were the age group of 36 to 45 years old, the department having TTM-related criteria and having knowledge of TTM-related guidelines ( t = -2.46, 2.64, 3.85, all P<0.05). Conclusions:ICU nurses have a more positive attitude toward TTM in patients with STBI, but the level of knowledge and practice needs to be improved. Managers should conduct relevant training according to the current situation and influencing factors to improve ICU nurses′ knowledge and practice of TTM in patients with STBI, ensuring the effectiveness and safety of TTM.
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Objective:To systematically integrate the attitudes and experiences of medical staffs towards the family presence during resuscitation and provide a reference for the development of family presence during resuscitation clinical practice in China.Methods:To search PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, CBM and Wanfang database for qualitative studies on medical staff's attitudes and experiences of family presence during resuscitation since its inception to August 2022. The quality of the literature was evaluated using the Australian JBI Centre for Evidence-Based Health Care (2017) quality assessment criteria for qualitative studies, which were integrated using a pooled integration approach.Results:A total of 12 papers were included to distil the findings of 74 studies, which were summarized to form 10 new categories and 4 consolidated findings including medical staffs′ attitudes towards and reasons for family presence during resuscitation, the impact of family presence during resuscitation on the resuscitation team, the impact of family presence during resuscitation on patients and families, and the real-life dilemmas and recommendations for medical staffs to allow family presence during resuscitation.Conclusions:We should pay attention to the difficulties and needs of family presence during resuscitation by medical staff, take into account the medical context in China, and improve the humanistic care system in our hospitals by considering hospital management, clinical practice, and the demands of patients and their families, in order to improve the accessibility of family presence during resuscitation by the medical staff.
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Objective To explore the influencing factors of deliberated acute pesticide poisoning (APP), so as to provide prevention and health promotion for the disease. Methods The deliberated APP patients related factors questionnaire was used to investigate deliberated APP and non-deliberated APP patients. The data was analyzed with Structural Equation Modeling. Results APP was directly affected by cognitive factors, psychological factors and social environment factors. Their standardized regression coefficients were -0.831, -0.752 and -0.469 respectively. Cognitive factors had a direct effect on psychological factors and social environment factors. APP was affected indirectly by cognitive deviation, absolutization, copying manner, social support, pesticide management and negative life events. Their standardized regression coefficients were 0.757, 0.541, 0.773, 0.576, 0.824 and 0.782, respectively. Conclusions Paying attention to the influencing factors for deliberated APP patients, improving sociological influencing factors, improving coping style and provide social support and strengthen pesticide management is benefided to reduce the incidence of APP.