Aim:Review the impact of master's-educated nurses on inpatient care in different healthcare systems and specialties.Background:Improved healthcare service quality and efficiency are needed due to a number of facto...Aim:Review the impact of master's-educated nurses on inpatient care in different healthcare systems and specialties.Background:Improved healthcare service quality and efficiency are needed due to a number of factors,including an aging population,advancing medical technology and increasingly complex methods of healthcare delivery.Overcoming these challenges requires nurses with more than a basic nursing education.However,masters training for Chinese nurses is a relatively new development,and,therefore,the cost effectiveness of master's-educated nurses in China and extent to which they contribute to improvements in access to Chinese healthcare services and the quality of those services remains unknown.Method:A systematic review of quantitative studies was conducted using PubMed and the China National Knowledge Infrastructure(CNKI).Studies were included in this review if they met the inclusion criteria.Results:Nine papers met the inclusion criteria and were included in this review.These studies indicated that palliative care,continuity of care,mental health,transition care,post-transplant care and central venous catheter care were improved when patient care was delivered by master's-educated nurses.Conclusion:Developing master's education for nurses may improve the current standard of health care and help meet modern challenges.This topic deserves additional attention at the academic and policy level.This review provides an important reference for Chinese nursing educators and policy makers.展开更多
Objective: To evaluate whether electroacupuncture(EA) would improve gastrointestinal function and clinical prognosis in patients with severe traumatic brain injury(TBI) complicocted by acute gastrointestinal injury(AG...Objective: To evaluate whether electroacupuncture(EA) would improve gastrointestinal function and clinical prognosis in patients with severe traumatic brain injury(TBI) complicocted by acute gastrointestinal injury(AGI). Methods: This multicenter, single-blind trial included patients with TBI and AGI admitted to 5Chinese hospitals from September 2018 to December 2019. A total of 500 patients were randomized to the control or acupuncture groups using a random number table, 250 cases in each group. Patients in the control group received conventional treatment, including mannitol, nutritional support, epilepsy and infection prevention, and maintenance of water, electrolytes, and acid-base balance. While patients in the acupuncture group received EA intervention at bilateral Zusanli(ST 36), Shangjuxu(ST 37), Xiajuxu(ST 39), Tianshu(ST 25), and Zhongwan(RN 12) acupoints in addition to the conventional treatment, 30 min per time, twice daily,for 7 d. The primary endpoint was 28-d mortality. The secondary endpoints were serum levels of D-lactic acid(D-lac), diamine oxidase(DAO), lipopolysaccharide(LPS), motilin(MTL) and gastrin(GAS), intra-abdominal pressure(IAP), bowel sounds, abdominal circumference, AGI grade, scores of gastrointestinal failure(GIF),Glasgow Coma Scale(GCS), Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ), Sequential Organ Failure Assessment(SOFA), and Multiple Organ Dysfunction Syndrome(MODS), mechanical ventilation time,intense care unit(ICU) stay, and the incidence of hospital-acquired pneumonia. Results: The 28-d mortality in the acupuncture group was lower than that in the control group(22.80% vs. 33.20%, P<0.05). Compared with the control group, the acupuncture group at 7 d showed lower GIF, APACHE Ⅱ, SOFA, MODS scores, D-lac,DAO, LPS, IAP, and abdominal circumference and higher GCS score, MTL, GAS, and bowel sound frequency(all P<0.05). In addition, the above indices showed simillar changes at 7 d compared with days 1 and 3 in the EA group(all P<0.05). Conclusion: Early EA can improve gastrointestinal function and clinical prognosis in patients with severe TBI complicated by AGI.(Registration No. ChiCTR2000032276)展开更多
文摘Aim:Review the impact of master's-educated nurses on inpatient care in different healthcare systems and specialties.Background:Improved healthcare service quality and efficiency are needed due to a number of factors,including an aging population,advancing medical technology and increasingly complex methods of healthcare delivery.Overcoming these challenges requires nurses with more than a basic nursing education.However,masters training for Chinese nurses is a relatively new development,and,therefore,the cost effectiveness of master's-educated nurses in China and extent to which they contribute to improvements in access to Chinese healthcare services and the quality of those services remains unknown.Method:A systematic review of quantitative studies was conducted using PubMed and the China National Knowledge Infrastructure(CNKI).Studies were included in this review if they met the inclusion criteria.Results:Nine papers met the inclusion criteria and were included in this review.These studies indicated that palliative care,continuity of care,mental health,transition care,post-transplant care and central venous catheter care were improved when patient care was delivered by master's-educated nurses.Conclusion:Developing master's education for nurses may improve the current standard of health care and help meet modern challenges.This topic deserves additional attention at the academic and policy level.This review provides an important reference for Chinese nursing educators and policy makers.
基金the Zhejiang Provincial TCM Science and Technology Plan Project(Nos.2012ZGG001 and 2019ZB039)。
文摘Objective: To evaluate whether electroacupuncture(EA) would improve gastrointestinal function and clinical prognosis in patients with severe traumatic brain injury(TBI) complicocted by acute gastrointestinal injury(AGI). Methods: This multicenter, single-blind trial included patients with TBI and AGI admitted to 5Chinese hospitals from September 2018 to December 2019. A total of 500 patients were randomized to the control or acupuncture groups using a random number table, 250 cases in each group. Patients in the control group received conventional treatment, including mannitol, nutritional support, epilepsy and infection prevention, and maintenance of water, electrolytes, and acid-base balance. While patients in the acupuncture group received EA intervention at bilateral Zusanli(ST 36), Shangjuxu(ST 37), Xiajuxu(ST 39), Tianshu(ST 25), and Zhongwan(RN 12) acupoints in addition to the conventional treatment, 30 min per time, twice daily,for 7 d. The primary endpoint was 28-d mortality. The secondary endpoints were serum levels of D-lactic acid(D-lac), diamine oxidase(DAO), lipopolysaccharide(LPS), motilin(MTL) and gastrin(GAS), intra-abdominal pressure(IAP), bowel sounds, abdominal circumference, AGI grade, scores of gastrointestinal failure(GIF),Glasgow Coma Scale(GCS), Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ), Sequential Organ Failure Assessment(SOFA), and Multiple Organ Dysfunction Syndrome(MODS), mechanical ventilation time,intense care unit(ICU) stay, and the incidence of hospital-acquired pneumonia. Results: The 28-d mortality in the acupuncture group was lower than that in the control group(22.80% vs. 33.20%, P<0.05). Compared with the control group, the acupuncture group at 7 d showed lower GIF, APACHE Ⅱ, SOFA, MODS scores, D-lac,DAO, LPS, IAP, and abdominal circumference and higher GCS score, MTL, GAS, and bowel sound frequency(all P<0.05). In addition, the above indices showed simillar changes at 7 d compared with days 1 and 3 in the EA group(all P<0.05). Conclusion: Early EA can improve gastrointestinal function and clinical prognosis in patients with severe TBI complicated by AGI.(Registration No. ChiCTR2000032276)
