Emergency Treatment and Nursing Care of a Patient with Multiple Injuries and Right Main Bronchus Rupture

Objective: To investigate the rescue and nursing process of a trauma patient with multiple injuries and rupture of the right main bronchus. Methods: A patient with multiple injuries and rupture of the right main bronchus admitted to the emergency department of the Shenzhen Hospital of the University of Hong Kong was selected as the research object on December 11, 2019. Results: In this case, the medical team treated the patient under the guidance of ATLS (Advanced Traumatic Life Support), and for the first time in our department, we used bronchoscopy to replace the double-lumen endotracheal tube for left lung single-lung ventilation, finally the patient was successfully treated. Conclusion: Through a literature search, it is found that the main bronchus rupture is less common in clinical practice. In the trauma group, the use of fiberoptic bronchoscopy and the replacement of a double-lumen tracheal tube for left lung single-lung ventilation can improve the treatment rate of such patients and is worthy of clinical application.

Clinical Application of Quantitative Nursing for Lower Cranial Nerves Injury after Cerebellopontine Angle Tumors

Objective: To retrospectively analyze the clinical utility of quantitative nursing measures of 10 cases of lower cranial nerves injury after cerebellopontine angle tumors surgery to provide the experience for improving the recovery rate and living quality of these patients. Methods: The clinical data of 10 cases of lower cranial nerves injury after cerebellopontine angle tumors surgery was analyzed. For problems such as dysphagia and dyspnea of these patients, the nursing care focused on strict monitoring, timely oxygen inhalation nursing, posture nursing, ventilator nursing, swallowing function training, etc. Results: After received quantitative care, 10 patients with lower cranial nerves injury after cerebellopontine angle tumors surgery were recovered well, and their symptoms such as dysphagia and dyspnea were gradually improved and safely discharged. Conclusion: Lower cranial nerves injury is one of the serious complications after removal of cerebellopontine angle tumors, which impacts the life and health of patients. Caregivers should accurately understand and analyze the symptoms, and quantitative and targeted nursing measures for posterior cranial nerves injury are helpful in the postoperative rehabilitation of patients and improve their living quality.

Traditional Chinese medicine nursing protocols for anal fistulae

Anal fistula is a common disease in anorectal department that typically describes a miscommunication between the anorectum and the perianal skin. At present, surgical treatment is effective for anal fistulae, but the formation of fistula is different due to individual difference, consequently leading to a limited efficacy of surgical treatment. TCM has recently shown its unique advantages in accelerating the wound healing after anal fistula surgery, but the standards for syndrome differentiation of anal fistulae are still in deficiency. Thereby, this article mainly explored the key points of common syndromes, TCM nursing methods and health guidance of anal fistulae, in order to further develop the advantages of TCM and standardize related nursing management .

Correlates of Anogenital Injuries in Adolescent Females

Objective: We sought to investigate correlates of anogenital injuries (AGIs) in adolescents. Methods: Our retrospective study included sexually assaulted female patients aged 12 to 17 reporting attempted or completed vaginal or anal penetration between 2002 and 2011. Forensic nurses performed anogenital examinations using colposcopy, digital macrovisualization, and toluidine blue dye application. We reviewed case files for AGIs and demographic and sexual assault characteristics. Results: Of the 1961 sexual assault examinations that met our inclusion criteria, 59.6% displayed AGIs. Our logistic regression model using 1752 examinations found the following variables associated with less injury: intercourse within 5 days prior to assault (OR 0.72, 95% CI = 0.55 to 0.95);post-coital interval of 49-72 (OR 0.50, 95% CI = 0.36 to 0.71), 73-96 (OR 0.41, 95% CI = 0.25 to 0.68), and 97-120 hours (OR 0.26, 95% CI = 0.13 to 0.51). Only lack of prior sexual experience was associated with increased injury (OR 2.01, 95% CI = 1.58 to 2.55). Conclusions: In our adolescent patient population, examination findings of AGIs correlate with variables related to time from assault and prior sexual experience.

Skin damage due to personal protective equipment among nursing staff in a dedicated coronavirus disease-2019 hospital of tribal India

Background:Nursing staff are at much greater risk of infection(Ebola virus diseases and severe acute respiratory syndrome)due to their exposure to highly infectious bodily fluids and droplet nuclei and the need for personal protective equipment(PPE)to reduce the transmission risk.Aim:The present study was conducted to estimate the prevalence of skin injuries and their types due to PPE usage among nursing staff in tribal India.Materials and Methods:This descriptive cross-sectional study was conducted in the dedicated coronavirus disease-2019(COVID-19)hospital for a period of 4 months among 144 nursing staff wearing Grade 2 and 3 PPE kits.Study subjects were approached through social networking websites and survey questionnaires(Google forms)according to relevant guides,and research literature was used to collect the details regarding baseline,duty,and skin injury characterization.Chi-square test was used to find the association between skin injury and baseline or duty characteristics,and the association was significant at a P<0.05.Results:It was observed that 54.7%of nursing staff were working for 6 or more hours and 16.5%of subjects were wearing the PPE kit for 5 or more hours per day.Skin injury was reported by 86.3%of the subjects after using PPE.Skin injuries among nurses were statistically significant with their current place of stay and daily duty hours(P<0.05).Conclusion:In this study,it was found that 86.3%of subjects had suffered from skin injuries by using PPE while caring for COVID-19 patients during duty hours,so an effective preventive measure should be adopted.

The competence of nursing students to prevent pressure injury - ascoping review

Objective: The purpose of the present study is to review the existing literatures to understand the competency ofnursing students to prevent the pressure injury. Methods: Arksey and O'Malley’s scoping review framework havebeen applied to understand the competency of nursing students on pressure injury prevention. A variety ofdatabases have been searched in this study, including PubMed, EMBASE, Web of Science, Cochrane Library,CNKI, Wanfang databases. Results: A total of 17 articles were selected and three main themes were summarized:“Knowledge and Attitude”, “Preparation” and “Educational situation and needs”. Conclusion: Although theattitudes towards pressure injuries were positive, the knowledge of nursing students on preventing pressure injurywas insufficient and their consciousness was weak. The controversy of the readiness of nursing students to preventpressure injuries has existed for a long time. Nursing students were severely lacking in pressure sore educationcourses and needed better education methods and more clinical practice opportunities.

Clinical Effect of Intelligent Emergency Nursing Mode in Patients with Severe Traumatic Brain Injury

Objective: Severe traumatic brain injury (sTBI) is one of the common acute and critical diseases in neurosurgery. So we aim to explore the clinical effectiveness of an intelligent emergency care model in patients with severe traumatic brain injury. Methods: Eighty patients with severe traumatic brain injury (sTBI) who were treated in Zhuji People’s Hospital of Zhejiang Province from January 2019 to December 2021 were selected as the study subjects. The patients were divided into an observation group and a control group with 40 patients in each group according to the random number table method. Patients in the control group received conventional first-aid nursing mode intervention, and the intelligent emergency nursing mode was used for the observation group based on the control group. Comparisons were conducted between the two groups on the time of arrival to the emergency room, the time from the emergency room to the operating room, Glasgow Coma Scale (GCS) score before surgery, GCS score when leaving the Intensive Care Unit (ICU), the average length of ICU stay, the average length of hospital stay, the total hospital costs. Results: The time of arrival to the emergency room, the time from the emergency room to the operating room, the average length of ICU stay, the average length of hospital stay, and the total hospital costs in the observation group were significantly lower than those in the control group, and the differences were statistically significant (All P Conclusion: Intelligent emergency nursing mode can shorten the time of sTBI rescue, the length of ICU stay, and the average length of hospital stay, reduce the total hospitalization cost, improve the prognosis, with good efficacy, reduce the total cost of hospitalization, and improve the prognosis with better efficacy.

Investigation on Sharp Instrument Injury and Self-Protection of Internship Nursing Students

Objective： To understand the situation of nursing students was stabbed by sharp instrument,in order to provide a scientific basis to take protective measures.Method：By using a self-designed questionnaire.The 100 nursing students were randomly selected from a hospital for retrospective investigation.There are 98 valid data.Results： The data shows that sharp instrument injury is more common in nursing students. Nursing students＇ protection consciousness is low, and protective ability is poor.Conclusion： Nursing students awareness of self- protection to sharp instrument injury is not enough,in order to avoid the risk of infection of nursing students occupation.When they entered the clinics, practice of systematic pre occupation safety education is very necessary;and the school and the hospital should actively implement the management standardized operation regulations;and put up student occupation injury management regulations;to improve the safety performance of nursing equipment.

Infection control and prevention in burn victims:The role of nurses

Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occur in the World Health Organization African and South-East Asia Regions.There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years.Hence,this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims.This review analyzed published studies using keywords such as burn injury,infection in burn patients,and nurses’involvement in infection prevention and control(IPC)on search engines such as PubMed,Science Direct,and Google Scholar.The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective;the date range chosen in the literature search was from 2015 to 2023.The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control.The study also found that nurses’responsibilities include proper hand hygiene,wound care,the use of personal protective equipment,antibiotic medication,cleaning the patient’s surroundings,and preventing patient cross-contamination.Burn injuries pose a significant risk to patients,necessitating infection control and prevention.Therefore,nurses in burn units should be informed on IPC practices and also educate patients,families,and coworkers on their importance.

Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals

This exploratory study used archived hospital data to investigate the relationships between the percentage of patients with physical restraints and the total fall rate as well as the injurious fall rate per 1000 patient-days. The two tested research questions were 1) What is the relationship between the restraint use rate and the total fall rate? 2) What is the relationship between the restraint use rate and the injurious fall rate? The results showed that a higher restraint use rate was associated with a higher total fall rate, yet a lower injurious fall rate in adult inpatient acute care settings. In efforts for fall and injurious fall prevention, front-line managers need to balance the frequency and appropriateness of physical restraint use with optimizing patients’ physical activity. Future research should explore the cause–effect relationship between physical restraint use and consequent injurious fall incidents.

持续质量改进联合护理质量指标在减少动静脉内瘘穿刺损伤中的应用研究

目的 探讨持续质量改进及护理质量指标控制在降低动静脉内瘘穿刺损伤发生的护理实践中的作用。方法 以降低动静脉内瘘穿刺损伤作为质量控制目标,以2022年8、11月于北京大学人民医院血液透析室应用动静脉内瘘作为血管通路的患者为研究对象,8月质量改进前治疗的123例患者为对照组,11月质量改进后的125例患者为观察组,通过联合采用动静脉内瘘穿刺损伤发生率、各内瘘穿刺方法占比、血管超声使用率、患者穿刺满意度作为护理质量指标,每月汇总分析指标结果及发生原因,针对性进行护理质量管理与改进措施。结果 对照组患者共穿刺1 810例次,发生穿刺损伤10例次,动静脉内瘘穿刺损伤发生率为0.55%(10/1 810);观察组患者穿刺1 733例次,发生损伤3例次,动静脉内瘘穿刺损伤发生率为0.17%(3/1 733)。疑难血管通路穿刺损伤发生率下降(P=0.039),绳梯穿刺法占比上升至63%,血管超声使用率由4%(5/123)增加至100%(P<0.001),患者对穿刺满意度增加(P<0.001)。结论 联合应用血液透析专科护理质量指标,实施持续质量改进管理,可降低动静脉内瘘穿刺损伤发生率。

六西格玛联合护理风险管理预防护理实习生针刺伤的干预研究

目的:探讨六西格玛联合护理风险管理在预防护理实习生针刺伤中的应用效果。方法:选取2021年1月—2022年6月于我院实习的80名护理实习生为研究对象,随机将其分为对照组和研究组,各40人。对照组给予常规管理,研究组给予六西格玛联合护理风险管理,比较两组针刺伤发生环节、针刺伤知识了解程度及实习满意度。结果:两组护理实习生准备阶段、注射阶段、处理阶段针刺伤发生环节比较,差异均无统计学意义(P>0.05);研究组基础知识、态度及行为评分均高于对照组,实习满意度高于对照组,差异有统计学意义(P<0.05)。结论:六西格玛联合护理风险管理能够增强护理实习生针刺伤知识了解程度,提升实习满意度。

脊髓损伤病人膀胱功能障碍风险预测模型及其应用

目的:构建脊髓损伤病人膀胱功能障碍风险预测模型,并进行效果检验。方法:采用便利抽样法将2021年1月—2022年12月110例脊髓损伤病人纳为研究对象,按照是否发生膀胱功能障碍分为障碍组和正常组,采用单因素、多因素Logistic回归分析筛选脊髓损伤病人膀胱功能障碍的独立危险因素,据此拟合风险预测模型的回归方程,检验模型预测效果。结果:共29例(26.36%)脊髓损伤病人发生膀胱功能障碍;多因素分析结果显示,病程、损伤部位、排尿方式、泌尿系统感染、膀胱顺应性、逼尿肌括约肌失调为脊髓损伤病人膀胱功能障碍的独立影响因素(P<0.05);预测模型Hosmer-Lemeshow卡方检验结果显示,χ^(2)=8.203,P=0.336;C-index为0.818;AUC为0.794[95%CI(0.750,0.837)],约登指数为0.690,最佳截断值0.122,敏感度为94.4%,特异性为74.6%;模型预测准确率为81.81%。结论:本研究在脊髓损伤病人膀胱功能障碍的危险因素基础上,建立的风险预测模型具有良好拟合程度和区分能力,且准确度较高,能为临床早期预防、早期筛选、早期治疗和管理脊髓损伤病人膀胱功能障碍提供一定依据。

ICU护士医用粘胶相关性皮肤损伤知信行现状及培训需求

目的调查ICU护士医用粘胶相关性皮肤损伤(medical adhesive-related skin injury,MARSI)的知信行现状及培训需求,为推进相关培训及提升MARSI管理提供参考。方法采用MARSI知信行量表及自行设计MARSI培训需求调查表,选取济宁地区710名ICU护士进行线上调查。结果ICU护士MARSI知识、态度、行为维度得分率分别为58.53%、90.65%、78.87%,知信行总得分率为77.56%;不同学历、ICU工作年限、职称、职务在知识维度中、态度维度中和行为维度中差异均有统计学意义(P<0.05);63.81%ICU护士认为目前MARSI专业培训不能满足现任工作需求,96.9%ICU护士有意愿参加MARSI专业培训。结论ICU护士MARSI知信行总体呈中等水平,亟待加强;护理管理者应建立ICU护士MARSI培训方案,完善MARSI干预策略,提高ICU护士预防MARSI的能力和水平。

针对性康复护理对肩袖损伤行关节镜手术患者术后肩关节功能恢复及护理满意度的影响

目的 分析针对性康复护理对肩袖损伤行关节镜手术患者术后肩关节功能恢复及护理满意度的影响。方法 选取2020年6月至2023年6月于厦门大学附属中山医院接受关节镜手术治疗的肩袖损伤患者100例,根据随机数字表法分为两组,对照组(50例)采取常规护理方法,观察组(50例)在此基础上施以针对性康复护理干预,对比两组的肩关节功能(欧美肩关节评分系统C-M)、生活质量(SF-36)、并发症发生率及护理满意度。结果 术后5个月时,观察组的C-M评分、SF-36评分均较对照组高(P <0.05);观察组并发症发生率较对照组更低(4.00%vs. 16.00%,P <0.05);观察组护理满意度较对照组更高(98.00%vs. 82.00%,P <0.05)。结论 将针对性康复护理用于肩袖损伤行关节镜手术患者,能使其肩关节功能得到更好恢复,减少并发症发生,提高生活质量与护理满意度。

优化型流程式护理干预对老年颅脑损伤患者的康复效果的观察

目的观察优化型流程式护理干预对老年颅脑损伤患者康复效果的影响,为治疗该病症提供方法。方法选取2022年1月—2023年7月启东市中医院神经外科收治的83例老年中重型颅脑损伤患者作为研究对象,按随机信封法将患者分为流程式干预组(n=41)和常规组(n=42)。2组患者均给予相同的基础治疗,流程式干预组患者接受优化型流程式护理干预,常规组患者接受常规护理,2组均连续干预3个月。比较2组患者生活能力评分、肢体活动评分、康复进程指标和并发症发生情况。结果干预后,流程式干预组患者的Barthel指数和Fugl-Meyer运动功能量表评分均高于常规组,首次下床活动时间、机械通气时间、昏迷时间、住院天数、住院费用均少于常规组,并发症总发生率低于常规组,差异均有统计学意义(P<0.05)。结论优化型流程式护理干预在老年颅脑损伤患者的康复过程中可促进患者日常生活能力恢复,促进康复进程,减少并发症发生,具有一定的临床应用价值。

颈部贯通伤伴颈动脉损伤合并脊髓损伤患者的急救护理

总结1例颈部贯通伤伴颈动脉损伤合并脊髓损伤患者的急救护理体会。针对患者因颈部贯通伤导致大量失血、血肿压迫气道等情况,采取多学科团队协同救治,颈动脉手指压迫止血,合并脊髓损伤的气道管理,血流动力学维持、预防低灌注脑梗等护理措施。经过紧急救治和护理,患者病情稳定后行急诊手术,术后第14天顺利出院。

一种可穿脱式功能减压袜在足部压力性损伤老年病人中的应用研究

目的:将实用新型专利产品一种可穿脱式功能减压袜应用于老年病人中实施压力性损伤管理,减轻其身体伤害,提高压力性损伤护理质量。方法:选择2020年1月—12月首都医科大学附属北京同仁医院崇文门院区急诊科收治的足部压力性损伤病人66例作为对照组,选择2021年1月—12月收治的足部压力性损伤病人60例作为试验组。对照组病人所有压力性损伤处采用常规压力性损伤治疗及护理干预,试验组所有压力性损伤处在常规压力性损伤护理的基础上使用本专利产品。比较两组压力性损伤处治愈情况、治愈所需时长、换药次数、换药费用等情况。结果:126例病人共有足部压力性损伤195处,其中对照组109处,试验组压力性损伤86处,双足小指骨突处压力性损伤16处(8.21%),双侧足跟79处(40.51%),双侧外踝41处(21.03%),双侧跖趾关节59处(30.25%)。经过倾向性评分匹配后,共76对压力性损伤处匹配成功,匹配后试验组压力性损伤处治愈时长较对照组更短、换药次数更少、换药费用更少(P<0.05)。结论:压力性损伤不仅降低病人的生活质量,给病人带来经济压力,而且消耗医药、护理资源,使用本专利产品可提高老年病人压力性损伤治愈效果,降低病人的医疗费用,减轻护士的劳动强度。

成人吸入性损伤肺康复管理最佳证据总结

目的检索、评价及汇总成人吸入性损伤肺康复相关证据。方法计算机检索BMJ Best Practice、UpToDate临床顾问、JBI图书馆、Cochrane图书馆、国际烧伤协会、欧洲烧伤协会、美国烧伤协会、日本皮肤病学协会、中国知网、万方数据库、中国生物医学数据库等网站中关于成人吸入性损伤相关的临床实践指南、专家共识、证据总结、系统评价及随机对照试验,检索时限为建库至2022年12月31日。进行文献质量评价后,根据主题对证据进行提取与汇总。结果根据纳入标准筛选出证据16篇,包括临床实践指南7篇、专家共识5篇、系统评价3篇、随机对照试验1篇。通过阅读、提取和归类,总结了对证据进行梳理,最终形成肺康复评估、肺康复模式、肺康复时机、肺康复时长、肺康复地点、肺康复方式、肺康复营养支持及效果评价8个维度,20条证据。结论本研究基于总结多个国家及地域成人吸入性损伤的肺康复管理证据,供医护人员根据临床实际情况选择证据进行干预。

实习护生针刺伤体验质性研究的meta整合

目的系统评价和整合有关实习护生针刺伤体验的质性研究,以期为制定针对性预防策略提供参考。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、Embase、EBSCO等中英文数据库,收集有关实习护生针刺伤相关的质性研究,检索时限均为建库至2023年10月。采用澳大利亚Joanna Briggs研究所循证卫生保健中心质性研究质量评价标准对纳入文献进行质量评价,并采用汇集性整合方法对结果进行整合。结果共纳入10篇文献,提炼出22个研究结果,归纳为3个整合结果(实习护生针刺伤发生的原因、针刺伤发生后的感受、希望获得的帮助),共8个类别。结论管理者应重视实习护生针刺伤后真实感受,并加强专业指导,学校和医院共同做好职业安全教育培训,完善实习护生职业防护支持系统,给予护生更多人文关怀,有效降低针刺伤风险。