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Objective:To construct a sensitive index system of nursing quality for patients with acute ischemic stroke patients undergoing interventional thrombectomy, so as to provide a scientific basis for interventional thrombectomy care for acute ischemic stroke.Methods:Taking the "structure-process-result" three-dimensional quality model as the theoretical framework, through evidence-based literature search, the item pool was drawn up, and finally the indicators and their weights at each level were determined by two rounds of Delphi method in December 2021 and January 2022 and analytic hierarchy process.Results:The positive coefficients of the two rounds of inquiries to experts were 0.92 and 1.00, respectively, the authority coefficients were 0.913 and 0.917, and the Kendall coefficients were 0.141 and 0.202, respectively. The final index system consisted of 3 primary indicators, 9 secondary indicators and 50 three-level indicators.Conclusions:The nursing sensitive quality index system for patients with acute stroke patients undergoing interventional thrombectomy constructed in this study has high reliability and scientificity, which can provide target incentives for clinical nurses and provide reference for the development of specialized nursing sensitive quality indicators.
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Objective To construct sensitive, scientific and practical breast nursing quality evaluation indicators, and provide evidence for hospital breast nursing quality evaluation and monitoring. Methods Potential sensitive indicators of nursing quality were initially built by referencing the development process of the nursing quality indicators national database system of United States, by retrieving the domestic and foreign documents, by combining with breast cancer diagnosis and treatment guidelines, nursing textbooks, and nursing negative events, by clinical investigation and group discussion. An expert survey paper was prepared and three rounds surveys were conducted to revise and fix the sensitive indicators of breast nursing quality. Results The positive coefficients of the three rounds of expert consultation were 100％ , the authoritative coefficients of the three rounds were 0.847,0.851,0.849, respectively. The coordination coefficient of the three rounds of experts was 0.371-0.476、0.597-0.736、0.739-0.873, P<0.01, and finally 4 sensitive indicators of breast specialist care quality were established. Conclusions The nursing quality sensitive indicators were constructed by Delphi method. They comply with the principles of scientificity and rigorousness, and have the characteristics of breast nursing. They can be verified by clinical practices in the role of nursing quality control and evaluation, and gradually achieve effective data sharing to clinical guidelines to help the development of specialist care.
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Objective To investigate the effect of sensitive indicators of nursing quality in the management of elderly inpatients in neurology department. Methods A total of 160 inpatients in the department of neurology who were admitted between January 2016 and December 2017 were selected as study subjects. The patients were divided into pre-implementation (January to December 2016) and post-implementation (2017 Month-December) with 80 cases each. Traditional nursing Quality Management mode was adopted before implementation, and the management mode of nursing quality sensitive index was adopted after implementation. These two with priority improvement indicators, adverse events in nursing care, patient satisfaction and so on were compared. Results After the implementation, the correct rate of risk assessment, the implementation rate of nursing specifications, the correct rate of drug delivery, the rate of graded care execution, and the rate of individualized rehabilitation training were significantly higher than before implementation.The difference was statistically significant (χ2=4.103-5.769, P<0.05). The incidence rate of adverse events such as stress injury was 3.75% (3/80), which was significantly lower than that before implementation 20.0% (16/80). The difference was statistically significant (χ2=7.206, P<0.05). The patient satisfaction rate was 96.25%(77/80), which was significantly higher than 87.50% (70/80) before implementation.The difference was statistically significant (χ2=4.103, P<0.05). Conclusion The implementation of the sensitive index of nursing quality can improve the nursing quality of elderly inpatients in the department of neurology, reduce the occurrence of nursing adverse events and improve the satisfaction of patients.
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Objective To study serum insulin level change and its clinical significance in the patients with chronic kidney dis-ease (CKD).Methods 800 cases of patients with chronic kidney disease were observed with 400 cases of healthy people as control group at the same time.According to whether there was a complication of diabetic,chronic nephropathy was divided into two groups:diabetic nephropathy chronic renal failure group (425 cases)and non-diabetic nephropathy chronic renal failure (375 cases).According to the classification standard,chronic renal failure and the diabetic nephropathy group was di-vided into four groups:type 1 diabetes (105 cases),type 2 diabetes (135 cases),gestational diabetes (95 cases),diabetes with other reasons(90 cases).Relevant clinical information was collected,including age,gender,height,weight,and the cor-responding body mass index (BMI)was calculated based on height and weight.After some laboratory examinations,related parameters of the research were collected,including object of urea(Urea),serum creatinine (SCr),fasting plasma glucose (FPG),fasting insulin (FIns).According to the corresponding formula,insulin sensitive index (ISI)and glomerular filtration rate (GFR)were calculated based on the above parameters.Statistical comparison was made after collection.Results Urea, Scr,FPG and FIns of the patients with chronic kidney disease were significantly higher than those of normal control group (t=36.788,35.612,137.216,9.294;all P=0.000 respectively).Age,gender and BMI calculatedfrom height and weight in three groups had differences,but they were not statistically significant (F=1,363,P=0.256;F=1.577,P=0.454;F=1.641,P=0.194),and had no effect on the occurrence of chronic kidney disease development.Comparison of patients with different types of diabetes and chronic kidney disease,when a group had higher FIns and lower ISI,it also had a smaller GFR,and the differences between groups were statistically significant (F=12.01,P=0.000;F=3.891,P=0.009;F=3.774,P=0.011).Conclusion The serum insulin were closely related to CKD.Observing the serum insulin can have a dee-per understanding of the disease development,make a more effective treatment and predict the probability to be recover.
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Objective To explore the possible correlation between serum highly sensitive C reactive protein (hs CRP) and blood glucose, insulin, lipids ,insulin sensitivity index (SI),acute insulin response(AIR), and adiponectin in subjects with impaired glucose tolerance (IGT) or newly diagnosed type 2 diabetes mellitus(DM). Methods SI and AIR were assessed by the reduced sample number of Bergman′s minimal model method by intravenous glucose tolerance test in subjects. Meanwhile body mass index (BMI), waist hip ratio (WHR), the serum lipid profile, hs CRP, adiponectin levels were measured. Results Compared with normal control (NC) group[SI(6.6?2.4) 10 -4 (min?mU/L) -1 ,adiponectin7.77(6.35 10.70 mg/L),hs CRP0.40(0.21 1.67mg/L)], the SI and serum adiponectin in IGT group [(1.5?1.1) 10 -4 (min?mU/L) -1 , 4.29(3.59 6.22 mg/L) respectively] and type 2 DM group [(1.5?1.0)?10 -4 (min?mU/L) -1 , 3.46(2.37 4.72 mg/L) respectively] were significantly decreased (all P