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Objective:To analyze the correlation between capillary filling time (CRT) and lactate clearance rate in patients with septic shock, so as to provide reference for the clinical application of CRT in patients with septic shock.Methods:A prospective study was conducted on 70 patients with septic shock. CRT, mean arterial pressure (map) and sequential organ failure (SOFA) score, Acute Physiology and Chronic Health Evaluation Scoring System (APACHE Ⅱ) score, mechanical ventilation and lactate clearance rate were collected at 3 sites (forehead, knee and nail bed) respectively at 2 time points after admission and 6 hours after admission. The correlation between CRT changes and lactate clearance rate was compared.Results:When lactate clearance rate of more than 10% in 6 hours, the Pearson coefficients of the three sites were 0.823 for nail bed ( P<0.05), 0.232 for forehead and 0.254 for knee ( P>0.05). When lactate clearance rate of less than 10% in 6 hours, the Pearson coefficients of the three sites were 0.299 for nail bed, 0.247 for forehead and 0.254 for knee ( P>0.05). Conclusion:When lactate clearance rate of more than 10% in 6 hours, there is a good correlation between the CRT of nail bed and the lactate clearance rate of patients. The CRT of nail bed can be a practical tool for clinical evaluation of microcirculation.
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Objective:By building a patient safety oriented nursing-sensitive indicator system, this study aimed to help clinical evaluation and nursing for patients in prone position, to constantly optimize management of prone position and promote patient safety.Methods:First drew up initial indicators through literature search and personal interviews, then modified and finally formed the prone position nursing indicators within two rounds of experts consultation. Verified the indicators by evaluating nursing staff satisfaction after half-year′s implementation.Results:Finally, the indicator system included 9 first level, 13 second level and 71 third level indicators. The reliability of experts and the satisfaction of nurses were both high.Conclusions:With the purpose of patient safety, the nursing indicator system of prone position ventilation for critically ill patients are comprehensively covered ever aspect of key component. Specific effect needs to be further verified in the hospital management practice.
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Objective To develop a reasonable performance evaluation index system for ICU nursing workload based on the hospital information system and the "structure-process-result" model. Methods The preliminary indicators of ICU nurses' performance appraisal system were constructed by the research group. Delphi method was used for expert consultation to evaluate the importance of the indicators of the performance appraisal system. After summarizing, sorting out and modifying the expert opinions, the performance appraisal index system of ICU nurses was obtained. SPSS 19.0 software is used to describe the importance of experts' evaluation of indicators at all levels, such as mean, standard deviation, coordination coefficient of experts'opinions and degree of coordination. Results The effective recovery rate of expert consultation papers was 100% . In the first round of inquiry, the average of importance assignment was 2.05-5.00, the average of rationality assignment was 2.13-5.00, and the average of importance assignment in the second round was 4.57-5.00. The average of rationality assignment was 4.71-5.00. The coefficient of variation of all levels of indicators in the first round was 0.02-0.18, the coefficient of variation in the second round was 0.02-0.12, which was less than 0.2, the positive coefficient of experts was 100%, and the authoritative coefficient of experts in the second round was 0.86 and 0.88. After two rounds of Delphi expert consultation, the ICU nurses'performance appraisal index system was finally formed, including three first-level indicators and 37 second-level indicators. Conclusion This study is based on the information system, according to the "structure-process-result"model, using the expert consultation method to construct the ICU nursing workload performance assessment index system, and establish the weight of each index, the research results are helpful to further improve the performance appraisal system of ICU nursing staff and improve the scientific management level of ICU.
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In order to identify 35 key work items indicating the workload, difficulty of nursing technology and nursing risk of different wards scientifically, a mathematical model of classification of wards was established by literature review, conference discussions, expert consultation, brainstorming, and field measurement, and information technology as well. On such basis, scores of the wards were calculated, and the total scoring of each ward was ranked from high to low into three categories and six grades. Each grade of wards was assigned with different performance distribution weights. Such a mathematical model for ward categorizing and grading based on HIS system and key item and weights, can monitor ward nursing in real time, and provide nursing administrators at all levels with clinical risk early warning by means of vertical and horizontal comparisons. These administrators can take precautions in time in terms of human resources and materials. Ward categorizing and grading as an indicator for performance distribution ensures the rationality of such distribution, enhances nursing motivation and stabilizes front-line nursing teams in the end.
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Objective@#To develop a reasonable performance evaluation index system for ICU nursing workload based on the hospital information system and the "structure-process-result" model.@*Methods@#The preliminary indicators of ICU nurses' performance appraisal system were constructed by the research group. Delphi method was used for expert consultation to evaluate the importance of the indicators of the performance appraisal system. After summarizing, sorting out and modifying the expert opinions, the performance appraisal index system of ICU nurses was obtained. SPSS 19.0 software is used to describe the importance of experts' evaluation of indicators at all levels, such as mean, standard deviation, coordination coefficient of experts' opinions and degree of coordination.@*Results@#The effective recovery rate of expert consultation papers was 100%. In the first round of inquiry, the average of importance assignment was 2.05-5.00, the average of rationality assignment was 2.13-5.00, and the average of importance assignment in the second round was 4.57-5.00. The average of rationality assignment was 4.71-5.00. The coefficient of variation of all levels of indicators in the first round was 0.02-0.18, the coefficient of variation in the second round was 0.02-0.12, which was less than 0.2, the positive coefficient of experts was 100%, and the authoritative coefficient of experts in the second round was 0.86 and 0.88. After two rounds of Delphi expert consultation, the ICU nurses' performance appraisal index system was finally formed, including three first-level indicators and 37 second-level indicators.@*Conclusion@#This study is based on the information system, according to the "structure-process-result" model, using the expert consultation method to construct the ICU nursing workload performance assessment index system, and establish the weight of each index, the research results are helpful to further improve the performance appraisal system of ICU nursing staff and improve the scientific management level of ICU.
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To translate the Kolcaba brief general comfort questionnaire (GCQ) to Chinese and measure the applicability under the Chinese culture background. Methods This study was composed by two phases, the first phase was to measure the content validity of brief GCQ by 5 nursing specialist after GCQ was translated into Chinese. The second phase was to testing the reliability of the brief GCQ by investigating patients when they had undergone chest surgery operation before 48 hours. Results The overall CVI of brief GCQ was 0.86, the Cronbach's a was 0.92, the subscale ? was from 0.53 to 0.85. The total GCQ score about patients with chest surgery was 91.27?8.63. The lowest mean score was physical subscale: 2. 50?0. 47, the highest mean score was psychological sub-scale: 3.26?0.35. Conclusion The Kolcaba brief GCQ fit to use in China, but its content validity and the internal consistency should be tested in future study.
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Objective To explore the clinical features of acute myocardial infarction (AMI) complicated by cerebral infarction.Methods 857 AMI cases were divided into the groups with cerebral infarction and without cerebral infarction.The data were analyzed.Results The mean creatine kinase (CK) peak value,heart tip infarction,cardiogenic shock and arrhythmia were higher in the group with cerebral infarction than that in group without cerebral infarction (P
