ABSTRACT
AIM: To explore the nursing workforce allocation in intensive care units (ICUs) of COVID-19-designated hospitals during the epidemic peak in China. DESIGN: A nationwide cross-sectional online survey. METHODS: A total of 37 head nurses and 262 frontline nurses in 37 ICUs of COVID-19-designated tertiary hospitals located in 22 cities of China were surveyed. The self-reported human resource allocation questionnaire was used to assess the nursing workforce allocation. RESULTS: The average patient-to-nurse ratio was 1.89 ± 1.14, and the median working hours per shift was 5 h. The top four majors of front-line nurses in ICUs were respiratory (31.30%), lemology (27.86%), intensive care (21.76%) and emergency (17.18%). We also found that a smaller average patient-to-nurse ratio (odds ratio [OR]: 0.328, 95% CI: 0.108, 1.000), longer average weekly rest time per person (OR: 0.193, 95% CI: 0.051, 0.729) and larger proportion of 6-9 working years (OR: 0.002, 95% CI: 0.001, 1.121) decreased the occurrence of nursing adverse events.
ABSTRACT
The role of triplet excited state compounds (TESC) in contaminants degradation by advanced reduction processes (ARPs) is rarely reported. In this study, Salicylic acid derivatives (SAD, e.g. Salicylic Acid (SA) and Sulfosalicylic acid (SSA)) were applied in ultraviolet activated sulfite process (UV/Sulfite) to generate TESC and enhance the decomposition of chloroquine derivatives (CQD, antiviral drugs being used for treating COVID-19 infection, e.g. chloroquine phosphate (CP)). The results indicated that the pseudo 1st order rate constant of CP (kobs-CP) increased by 2.76 and 6.26 fold, which increased from 9.10 × 10–4 s–1 in UV/Sulfite process to 2.51 × 10–3 s–1, 5.72 × 10–3 s–1 in UV/Sulfite/SA and UV/Sulfite/SSA process respectively. Similar phenomena were observed in other CQDs. Transient absorption spectra demonstrated that both triplet excited state SAD (3SAD*) and hydrated electron (eaq–) were the reactive intermediates in UV/Sulfite/SAD process, and contribute to the abatement of CP. The enhancement of SAD on contaminants degradation in UV/Sulfite/SAD process could attribute to the strong acceleration of eaq– toward the formation of 3SAD* in its photosensitive process, where SAD with intramoleuclar hydrogen bond would not undergo a directly photoionization process after absorbing a photon but undergo intersystem crossing to transform into 3SAD* which was then ionized to eaq– by biphotonic process, and constitute a hydrated electrons mediated photosensitization cycle with the supplement of eaq– from UV/Sulfite process. The higher CP degradation rate in UV/Sulfite/SSA process than that in UV/Sulfite/SA process was ascribed to a higher second order rate constant of 3SSA* toward CP and a higher yield of 3SSA*, which resulted from its higher intramolecular hydrogen bond energy enhancing photosensitization and photoionization.
ABSTRACT
Objectives: To study the application effect of negative pressure sealing drainage technology combined with silver ion sterilization nursing solution in the nursing of necrotizing fasciitis. Methods: Medical records of patients with necrotizing fasciitis, treated in our hospital from June 2019 to June 2021, were selected. Patients were retrospectively assigned into two groups based on the debridement method used: debridement with silver ion sterilization nursing solution Group-I, or debridement with negative pressure sealing drainage technology combined with silver ion sterilization nursing solution. Group-II. Wound healing, dressing change times, healing time, treatment cost and patient satisfaction in both groups were statistically compared. Results: The wound healing rate of patients in Group-II group was higher than that of Group-I on the 5th, 10th and 15th day after operation (P < 0.05). Dressing change times, healing time and treatment cost of patients in the Group-II were lower than those of Group-I (P < 0.05). Patient satisfaction in the Group-II was 91.4% (54 / 59), which was higher than that of Group-I (75.4% (40 / 53) (P < 0.05). Conclusions: Negative pressure sealing drainage technology combined with silver ion sterilization nursing solution in the nursing of necrotizing fasciitis is effective. It can promote wound healing, shorten the healing time, reduce the times of wound dressing change and treatment cost. It also improves the overall patient satisfaction, making it an efficient method in clinical application.
ABSTRACT
Ribavirin (RBV) is an antiviral drug used for treating COVID-19 infection. Its release into natural waters would threaten the health of aquatic ecosystem. This study reports an effective approach to degrade RBV by the trace N-oxyl compounds (2,2,6,6-tetramethylpiperidine-N-oxyl (TEMPO) and N-Hydroxyphthalimide (NHPI)) enhanced UV activated free chlorine (UV/Chlorine) process. The results indicated that TEMPO and NHPI at low concentrations (0.1 µM and 1 µM, respectively) could strongly enhance RBV degradation in both deionized water with different pHs and practical surface water. The enhancement was verified to be attributed to the transformation of TEMPO and NHPI into their reactive forms (i.e., TEMPO+ and PINO), which generations deeply relied on radicals. The two N-oxyl compounds inhibit ClO⢠yield by hindering the reaction of free chlorine vs. HO⢠and Clâ¢. The analyses on acute toxicities of RBV degradation products indicate that UV/Chlorine/N-oxyl compounds process can detoxify RBV more efficiently than UV/Chlorine process.
ABSTRACT
BACKGROUND: Appropriate allocation of nursing staff is key to ensuring efficient nursing in hospitals, and is significantly correlated with patient safety, nursing quality, and nurse job satisfaction. However, there are few studies on nursing workforce allocation in the isolation wards of COVID-19 designated hospitals globally. This study aims to better understand the nursing workforce allocation in the isolation wards of COVID-19 designated hospitals in China, and provide a theoretical basis for efficiently deploying first-line nurses in China and across the world in the future. METHODS: An online survey was conducted among the head nurses (n = 229) and nurses (n = 1378) in the isolation wards of 117 hospitals (selected by stratified sampling), using a self-reported human resource allocation questionnaire. RESULTS: The average bed-to-nurse ratios of different isolation wards were different (Z = 36.742, P = 0.000). The bed-to-nurse ratios of the ICU, suspected COVID-19 cases ward, and confirmed COVID-19 cases ward, were 1:1.88, 1:0.56, and 1:0.45, respectively. The nurse work hours per shift in different isolation wards were also different (Z = 8.468, P = 0.014), with the specific values of the ICU, suspected COVID-19 cases ward, and confirmed COVID-19 cases ward, being 5, 6, and 6 h, respectively. A correlation analysis showed that the average work hours per shift was proportional to the overtime work of nurses (rs = 0.146), the proportion of nurse practitioners was proportional to the overall utilization rate of nursing human resources in the wards (rs = 0.136), and the proportion of nurses with college degrees was proportional to teamwork (rs = 0.142). The proportion of nurses above grade 10 was inversely proportional to teamwork and psychological problems (rs = 0.135, rs = 0.203). The results of multiple stepwise regression analyses showed that the work hours of nurses per shift was the main factor affecting nurse satisfaction and that the proportion of nurses and the work hours of nurses per shift were both independent factors affecting the length of stay (LOS) of patients. CONCLUSION: Hospitals in China have made good nursing workforce allocations during the COVID-19 pandemic, but there are certain shortcomings. Therefore, scientific and efficient nursing workforce allocation practice plans should be established to improve the ability of hospitals to deal with public health emergencies and are urgent problems that need to be addressed soon.