Application of Clinical Nursing Pathway in the Peri-Treatment Period of Immunoadsorption Therapy for Rheumatic Immune Diseases

Objective: The paper aims to investigate the clinical nursing pathway (CNP) in the application of immunosorption therapy in patients with rheumatic immune disease. Methods: Convenience sampling method was used to select inpatients who received immunoadsorption therapy from January 2020 to December 2022 in the rheumatology and Immunology department of a 3A hospital in Jingzhou City. 30 patients from January 2020 to June 2021 were selected as control group, and 30 patients from July 2021 to December 2022 were selected as observation group. The control group was given routine nursing. On the basis of the control group, the observation group used a clinical nursing pathway for intervention during the perioperative period of immunosorbent therapy. The incidence of adverse reactions, patient satisfaction, and nurse satisfaction during immunosorbent therapy between the control group and the observation group were compared. Results: After intervention, the incidence of adverse reactions in the observation group was significantly lower than that in the control group, while patient satisfaction and nurse satisfaction in the observation group were significantly higher than those in the control group. The results are all statistically significant (P Conclusion: Clinical nursing pathway is beneficial to reduce the incidence of adverse reactions in patients with immunoadsorption during peri-treatment and improve the satisfaction of patients and nurses.

Systematic evaluation of the clinical nursing pathway with the GRADE approach applied to functional exercise in patients with hip replacements before and after surgery

Objective:To evaluate the effect of the clinical nursing pathway applied to functional exercise in patients with hip replacements before and after the operation.Methods:The China National Knowledge Infrastructure(CNKI),WanFang Data,Chinese science and technology journal database(VIP),PubMed,Web of Science,EMBASE,CBM and the Cochrane Library(2015-5) were searched for randomized controlled trials(RCTs) on clinical nursing pathways for functional exercise in patients with hip replacements before and after surgery from June 2015 to January2010.The references included in the literature were also retrieved.To meet the literature standard,2reviewers independently selected and extracted data according to the inclusion criteria and assessed the risks of bias.RevMan 5.3 software was used in this meta-analysis.The quality of evidence was evaluated using grade profiler3.6 software,the level recommended for grading.Results:A total of 15 RCTs and 1248 patients were included.The meta-analysis showed that,in the clinical nursing path group,the Harris score of hip function[SMD = 3.35,95%CI(2.53.4.16),P < 0.00001]and incidence of thrombosis embolism[RR = 0.28,95%CI(0.15,0.53),P < 0.0001],pulmonary infection[RR = 0.33,95%CI(0.14,0.82),P = 0.02],urinary retention[RR = 0.22,95%CI(0.09.0.52),P = 0.0005],constipation[RR = 0.20,95%CI(0.10,0.40),P < 0.00001],patients' satisfaction for nursing care[RR = 1.26,95%CI(1.17,1.36),P< 0.000011 and shortened hospitalization times[SMD =-1.91,95%CI(-2.39.-1.43),P < 0.0001[were statistically significantly better than those in the control group.However,in reducing joint dislocations[RR- 0.25,95%CI(0.05,1.15),P = 0.08],pressure ulcers[RR = 0.25,95%CI(0.03,2.19),P=0.21],and incidence of complications[RR = 0.42,95%CI(0.15.1.12),P = 0.08],there was no statistically significant difference between the two groups.Funnel plot analysis of the average length of stay showed that there might be some publication bias in the literature.The GRADE evaluation results showed that the level of Harris scores for hip function was moderate and the incidence of thrombosis,urinary retention and satisfaction of patients regarding nursing were low,and the rest of the factors analyzed were very low.Conclusions:The effect of the clinical nursing pathway applied to functional exercises in patients with hip replacements before and after surgery was significantly better than that of routine nursing.However,it was restricted by the evaluation grade of the research results and the standardization and uniformity of the research.The results of the above study need to be verified by more high-quality RCTs.

Application of Clinical Nursing Pathway Combined with Cluster Nursing Mode in Biologic Treatment of Rheumatoid Immune Disease Patients

Objective: To investigate the effect of clinical nursing pathway (CNP) combined with cluster nursing mode in intravenous biologic treatment of rheumatoid immune disease patients. Methods: Convenience sampling method was used to select inpatients receiving biologics treatment in Rheumatology and Immunology Department of a grade A hospital in Jingzhou city from May 2020 to April 2022. 75 patients from May 2020 to April 2021 were selected as the control group, and 75 patients from May 2021 to April 2022 were selected as the observation group. The control group was given routine care. The observation group was treated with CNP combined with cluster nursing mode on the basis of the control group, and the incidences of adverse infusion reactions, total treatment time, patient satisfaction and nurse satisfaction were compared between the two groups. Results: There were statistically significant differences between the two groups after intervention (P Conclusion: Using CNP combined with cluster nursing mode is beneficial to reduce the incidence of adverse infusion reactions in patients, shorten the total treatment time, and improve the satisfaction of patients and nurses.

临床护理路径应用于冠状动脉粥样硬化性心脏病患者介入治疗效果的meta分析

目的通过meta分析来评价临床护理路径对冠心病患者介入治疗后的效果。方法利用计算机检索Cochrane Library、Web of Science、PubMed、Embase、Medline、中国期刊全文数据库、中国生物医学服务系统、维普中文期刊全文数据库以及万方数据库中关于临床护理路径对冠状动脉粥样硬化性心脏病(以下简称“冠心病”)介入治疗效果的随机对照试验,根据纳入标准筛选出符合质量的文献,严格评价后提取数据,采用RevMan 5.2进行meta分析。结果共纳入12篇文献,均为随机对照试验,共1237例患者,meta分析结果证明:观察组住院天数少于对照组(加权均数差为-2.62,95%置信区间为-3.52~-1.72,P<0.0001);观察组住院费用少于对照组(加权均数差为-4214.30,95%置信区间为-7266.91~-1161.69,P=0.007);观察组满意率高于对照组(相对危险度(relative risk,RR)为1.17,95%置信区间为1.09~1.26,P<0.0001),(标准均数差为1.31,95%置信区间为0.43~2.18,P=0.0030);观察组尿潴留的发生率低于对照组(RR=0.41,95%置信区间为0.26~0.65,P=0.0001);观察组出血和血肿的发生率低于对照组(RR=0.37,95%置信区间为0.22~0.62,P=0.0002);观察组迷走反射的发生率低于对照组(RR=0.33,95%置信区间为0.16~0.68,P=0.0030);观察组心律失常的发生率低于对照组(RR=0.43,95%置信区间为0.32~0.58,P<0.0001);观察组心源性休克的发生率低于对照组(RR=0.52,95%置信区间为0.31~0.89,P=0.0200)。结论临床护理路径能够缩短冠心病介入治疗后患者的住院天数,减少其住院费用,提高满意度,降低相关并发症(出血和血肿、迷走反射、心律失常、心源性休克)的发生率,然而由于纳入的文献存在偏倚的风险较高,其确切效果仍需更多临床高质量随机对照试验来证实。