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ObjectiveTo observe the intervention effect of cluster nursing in post-MECT delirium，and explore a new method of post-MECT delirium nursing. MethodsA total of 154 inpatients who met the diagnostic criteria of International Classification of Diseases，tenth edition（ICD-10） and received MECT treatment for the first time were selected and they were randomly divided into control group （n = 77） and study group （n = 77）. The intervention lasted for one course of MECT， 6-12 times MECT as one course. Both groups recieved MECT routine nursing， while the study group was given cluster nursing on the basis of routine nursing. After each treatment， Richmond Agitation Sedation Scale （RASS） and nursing adverse events record form were used to collect data. The incidence and duration of post-MECT delirium and the incidence of nursing adverse events caused by post-MECT delirium were compared between the two groups. ResultsAfter one course of MECT， the incidence of post-MECT delirium was 11.80% in the study group and 16.67% in the control group， the difference was statistically significant （χ2= 6.314， P<0.05）. The duration of post-MECT delirium in the study group was（5.78±2.73）min and（11.20±4.44）min in the control group， the difference was statistically significant （t=3.403， P<0.05）. The incidence of nursing adverse events caused by post-MECT delirium was 7.13% in the study group and 12.70% in the control group， and the difference was statistically significant （χ2=10.940， P<0.01）. ConclusionThe implementation of cluster nursing can reduce the incidence of post-MECT delirium， shorten the duration and reduce the nursing adverse events caused by post-MECT delirium.
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Objective To investigate the effect of the perioperative cluster nursing on the postoperative infections in children patients after ventriculo-peritoneal shunt. Methods 92 patients with hydrocephalus from January 2016 to March 2017 in our hospital were included in the study.The control group who hospitalize from January to June 2016 were managed with routine nursing during the perioperative period.After the implementation,the cluster nursing measures constructed by the focus group interviews were added in the intervention group who hospitalized from July 2016 to March 2017. Results Compared with the pre-implementation,the positive rate of PCT was insignificantly different on days 2 and 4 after the operation (P>0.05).However the difference was statistically significant on the 6th day (P<0.05),the postoperative infection rate significantly lower than that of the control group and so it was with the hospital stay. Conclusion The cluster nursing by focus group interviews can lower the infectious rate and shorten the hospital stay,worthy of clinical promotion.
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Objective To explore the effect of using cluster nursing measures on expectoration in mechanical ventilation patients after craniocerebral operation. Methods Convenient sampling and controlled trials at not the same period were used. Sixty-seven mechanical ventilation patients after craniocerebral operation were selected as the research objects in Department of Neurosurgery Intensive Care Unit (ICU) of the First Hospital Affiliated to Wenzhou Medical College. Thirty-two patients treated from June 2015 to June 2016 were assigned in the control group, and they were given routine respiratory nursing care; 35 patients admitted and treated from July 2006 to July 2017 were included in the intervention group, and they were given evidence-based cluster nursing intervention measures on the basis of routine care. The differences in expectoration effect, arterial blood gas analysis index, incidence of pulmonary infection and prognosis of patients in two groups were compared. Results Compared with control group, the amount of expectoration in the intervention group was significantly increased (mL/d: 49.69±9.45 vs. 33.72±10.63, P < 0.05), while the daily number of sputum suction (times: 21.57±2.31 vs. 28.76±22.66), the time needed for each sputum suction(s: 6.81±1.74 vs. 9.28±2.52), respiratory frequency (bpm: 26.26±1.83 vs. 28.58±1.36), incidence of pulmonary infection [0 vs. 12.5% (4/32)], time of mechanical ventilation (days: 6.37±2.51 vs. 8.92±3.32), time of ICU stay (days: 7.49±3.87 vs. 10.33±2.12), time of hospital stay (days: 10.31±1.99 vs. 14.56±3.57), fatality rate [8.6% (3/35) vs. 21.9% (7/32)] in the intervention group were significantly decreased (all P < 0.05); after treatment the arterial partial pressure of oxygen (PaO2) and pulse oxygen saturation degree (SpO2) were significantly increased than those before treatment, and the arterial partial pressure of carbon dioxide (PaCO2) was significantly decreased than that before treatment, and the degrees of improvement in the intervention group on 5 days were significantly better than those in the control group [PaO2(mmHg, 1 mmHg = 0.133 kPa): 60.89±3.44 vs. 57.34±2.49, PaCO2(mmHg): 41.06±4.32 vs. 45.22±4.78, SpO2: 0.986±0.030 vs. 0.963±0.023, all P < 0.05]. Conclusion The cluster nursing measures can effectively improve the expectoration effect for mechanical ventilation patients after craniocerebral surgery, reduce the mortality and incidence of pulmonary infection, shorten the stay in ICU and improve the prognosis, suggesting that the measures be worthy to be applied widely in clinics.
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Objective@#To evaluate the effect of ICU mechanical ventilation patients with cluster nursing and conventional nursing, and provide the basis for the clinical work.@*Methods@#Randomized controlled trials (RCTs) related to the ICU mechanical ventilation patients with cluster nursing and conventional nursing were collected through the databases such as CBM、CNKI, Wanfang Data, VIP Data. Meta-analyses were conducted for the included studies by the RevMan 5.3 software.@*Results@#A total of 12 qualified research literatures were included, with a total sample size of 1478 cases, the test group 742 cases, the control group 736 cases. Meta-analysis showed that cluster nursing intervention can reduce the time of ICU patients with mechanical ventilation (Z=14.00, P<0.01), reduce the time at ICU (Z=41.89, P<0.01), reduce the incidence of ventilator associated pneumonia (Z=8.33, P<0.01) and reduce the patient mortality (Z=2.79, P<0.01).@*Conclusions@#The results of this meta-analysis showed that cluster nursing measures were statistically significant in reducing mechanical ventilation complications in ICU patients compared with conventional nursing measures. However, in view of the methodological quality and limitations of this study included in the literature. Suggestions for future research to carry out large sample, high quality, multicenter randomized controlled study, make the ICU mechanical ventilation in patients with cluster nursing measures to constantly update and perfect, as well as to seek more evidence-based nursing support evidence.
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Objective To explore the effects of cluster nursing intervention on cognitive improvement in the caregivers of senile dementia.Methods Totally 95 caregivers of senile dementia selected from a grade 3 A hospital in Chongqing City were employed the cluster nursing intervention.The Alzheimer's disease knowledge assessment (ADKS) scale was used to conduct the assessment before and after intervention.Results The ADKS total score before intervention in the caregivers of senile dementia was (19.970±2.216) points,which after intervention was (23.400± 1.270) points,the difference was statistically significant (P=0.000).The ADKS scores at high,middle and low score segmentations after intervention were significantly higher than those before intervention(P＜0.05),in which the difference between the low score segmentation and middle score segmentation was more significant.Conclusion The cluster nursing intervention has obvious improvement effect on the cognitive situation in the caregivers of senile dementia,especially for the group of lower ADKS scores.
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Objective To study the effects of cluster nursing intervention on dysuria in hospitalized patients after renal biopsy. Methods A total of 106 hospitalized patients undergoing renal biopsy during April. 2016 to September. 2016 were divided into control group (50 cases) and experimental group (56 cases) by random number table method. The control group were implemented with traditional methods of care and the experimental group were implemented with cluster nursing intervention.The incidence of dysuria, first average urination time and post-operative urination pattern were compared between two groups. Results The incidence of dysuria in the experimental group was 10.7%(6/56), which was significantly lower than 28.0% (14/50) of the control group (χ2=5.156, P<0.05).The first average urination time of experimental group was (2.95±1.17) hours, which was lower than (5.04±2.27) hours of the control group (t =5.401, P<0.05). The proportion of patients with post-operative self-urination in the experimental group was significantly higher than that in the control group (χ2=6.152, P<0.05). Conclusions Cluster nursing intervention can reduce the incidence of dysuria, shorten the first average urination time, promote post-operative self-urination of patients after renel biopsy and enhance comfort.
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Objective To investigate the effect of cluster nursing in the prevention of aspiration pneumonia in patients with cerebral infarction. Methods A total of 72 patients with acute cerebral infarction from January 2014 to January 2014 were recruited and divided into 2 groups with 36 cases each by random digits table method. The patients in control group were given diet nursing, nursing of sputum ejection, education of disease related knowledge and another routine nursing methods. While cluster nursing such as the application of swallowing function training, feeding management, homemade angle measuring instrument for position management were conducted on the patients in intervention group. The difference of incidence of aspiration pneumonia, improvement of swallowing function, and patient satisfaction between two groups were compared. Results The incidence of aspiration pneumonia was 5.56%(2/36) in intervention group and 25.00%(9/36) in control group, and the difference was statistically significant (χ2=5.258, P=0.022).The swallowing function ratings after treatment in intervention group was also obviously better than that in control group, and the difference was statistically significant (χ2=7.943, P=0.036). The patient satisfaction was 94.44%(34/36) in intervention group and 63.89%(23/36) in control group, and the difference was statistically significant(χ2=17.526,P=0.000). Conclusions Cluster nursing can effectively reduce the risk of aspiration pneumonia in acute cerebral infarction patients, and help to improve the patients' swallowing function and relationship between nurses and patients, has certain clinical application value.
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Objective To explore the effects of cluster nursing intervention on cognitive improvement in the caregivers of senile dementia.Methods Totally 95 caregivers of senile dementia selected from a grade 3 A hospital in Chongqing City were employed the cluster nursing intervention.The Alzheimer's disease knowledge assessment (ADKS) scale was used to conduct the assessment before and after intervention.Results The ADKS total score before intervention in the caregivers of senile dementia was (19.970±2.216) points,which after intervention was (23.400± 1.270) points,the difference was statistically significant (P=0.000).The ADKS scores at high,middle and low score segmentations after intervention were significantly higher than those before intervention(P＜0.05),in which the difference between the low score segmentation and middle score segmentation was more significant.Conclusion The cluster nursing intervention has obvious improvement effect on the cognitive situation in the caregivers of senile dementia,especially for the group of lower ADKS scores.
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Objective To investigate the effect of cluster nursing on quality of life and mental state of cervical cancer patients receiving chemotherapy. Methods 72 cervical cancer patients receiving chemotherapy were randomly divided into control group and observation group.The control group was given routine care and the observation group was given cluster nursing on the basis of routine care.The quality of life core questionnaire (EORTC QOL-C30) and Symptom Checklist SCL-90 score were tested at the end of treatment. Results Compared with the control group, after using cluster nursing, the EORTC QOL-C30 functional areas of physical function role function, cognitive function , social function, emotional function of patients in the observation group were significantly improved( <0.05), the main symptoms of nausea areas vomiting and pain were decreased significantly ( <0.05),and sleep,diet,diarrhea and constipation were improved significantly (<0.05) . SCL-90 scale showed that the somatization,obsessive-compulsive symptoms,depression and anxiety in observation group were decreased significantly compared with the control group ( <0.05),the somatization, obsessive-compulsive symptoms and anxiety were increased significantly in control group compared with China norm (<0.05) .Conclusion Cluster nursing on patients with cervical cancer receiving chemotherapy can effectively improve quality of life and reduce the incidence of negative emotions.