Early Nursing Intervention in Children with Viral Meningitis

Aim: To explore the effect of a WeChat peer education program in children with severe viral meningitis combined with respiratory failure. Design: Retrospective cohort study. Methods: Patients who had severe viral meningitis combined with respiratory failure, were admitted to the hospital from March 2017 to June 2018, and who received the WeChat-based nursing intervention were included. Patients who received routine nursing were used as controls. The family’s emotional state, self-care ability, and rehabilitation were analyzed. Results: There were 37 patients in the WeChat group (19 boys (51.3%) and 18 girls (48.7%);mean of 5.1 ± 2.4 years of age) and 37 controls (20 boys (54.1%) and 17 girls (45.9%);mean of 5.9 ± 2.4 years of age) (all P > 0.05). After nursing, improvements in the self-assessed anxiety score and self-assessed depression score were better in the WeChat group (anxiety: -29.2% vs. -20.3%, P = 0.015;depression: -25.2% vs. -15.4%, P = 0.009). After nursing, the improvements in the condition management ability scale and condition management difficulty scale scores were better in the WeChat group (ability: +80.5% vs. +44.4%. P = 0.001;difficulty: +58.4% vs. +37.8%, P = 0.003). After nursing, the improvement in the Fugl-Meyer score was better in the WeChat group (+138.0% vs. +53.0%, P Conclusion: Early nursing intervention combined with WeChat peer education can improve the emotional state of children with severe viral meningitis combined with respiratory failure and their caregivers. Impact: Viral meningitis is associated with a good prognosis, but central nervous system complications can be observed. Early intervention is the key to a good prognosis. Internet-based nursing and coaching can improve self-efficacy and care ability in patients with various conditions, as well as improve the emotional state of the children and their caregivers. The research might have an impact on any children’s hospital that deals with viral meningitis.

Impact of early refined nursing program on prognosis of middleaged and elderly patients with cognitive dysfunction combined with cerebral infarction

BACKGROUND Cerebral infarction is a local or extensive necrosis of brain tissue.Subsequently,the corresponding neurological deficits appear.The incidence of cerebrovascular diseases in China is increasing gradually.After the onset of cerebrovascular disease,the most common sequelae include movement disorders,language disorders,and cognitive dysfunction.AIM To investigate the effect of early refined nursing program on the prognosis of middle-aged and elderly patients with cerebral infarction combined with cognitive dysfunction.METHODS A retrospective study was conducted to divide 60 patients with cerebral infarction and cognitive impairment into an experimental group(n=32)and a control group(n=28).The experimental group received early intensive care every day,and the control group received daily routine care.The scores of the Mini-Mental State Examination(MMSE)and the Trail Making Test(TMT),as well as the latency and amplitude of the event-related potential P300,were used as main indicators to evaluate changes in cognitive function,and changes in BDNF,TGF-β,and GDNF expression were used as secondary indicators.RESULTS Both groups experienced notable enhancements in MMSE scores,with the experi-mental group demonstrating higher scores than the control group(experimental:28.75±2.31;control:25.84±2.87).Moreover,reductions in TMT-A and TMT-B scores were observed in both groups(experimental:TMT-A 52.36±6.18,TMT-B 98.47±10.23;control:TMT-A 61.48±7.92,TMT-B 112.63±12.55),with the experimental group displaying lower scores.P300 Latency decreased(experimental:270.63 ms±14.28 ms;control:285.72 ms±16.45 ms),while amplitude increased(experimental:7.82μV±1.05μV;control:6.35μV±0.98μV)significantly in both groups,with superior outcomes in the experimental cohort.Additionally,the levels of the growth factors BDNF,TGF-β1,and GDNF surged(experimental:BDNF 48.37 ng/mL±5.62 ng/mL,TGF-β152.14 pg/mL±4.28 pg/mL,GDNF 34.76 ng/mL±3.89 ng/mL;control:BDNF 42.58 ng/mL±4.73 ng/mL,TGF-β146.23 pg/mL±3.94 pg/mL,GDNF 30.25 ng/mL±2.98 ng/mL)in both groups,with higher levels in the experimental group.CONCLUSION For middle-aged and elderly patients with cerebral infarction and cognitive dysfunction,early refined nursing can significantly improve their cognitive function and prognosis.

Application Value of Early Comprehensive Rehabilitation Nursing in Patients with Occupational Asthma

Background Occupational asthma is a type of asthma caused by exposure to asthma-causing substances in an occupational setting. Its incidence is closely related to the degree of industrial development, but also related to the nature of asthma. In some specific industries, such as workers who are exposed to asthmatic isocyanates for a long time, the incidence of occupational asthma can reach 5%-10%, and the incidence of occupational asthma can even reach 50% or higher among workers engaged in the detergent industry who are in contact with proteolytic enzymes for a long time. Objective To analyze the clinical value of early comprehensive rehabilitation nursing for patients with occupational asthma, methods a total of 48 patients with occupational asthma who were admitted from January 2020 to December 2022 were divided into control group and study group by random number table method The disappearance time of chest tightness and shortness of breath, the disappearance time of wheezing and cough, and the FEV1, forced vital capacity (FVC) and peak expiratory flow (PEF) indexes before and after treatment were compared between the two groups after nursing, the disappearance time of clinical symptoms in the study group was shorter than that in the control group, and the levels of FEV1, FVC and PEF were higher than those in the control group, and the P < 0.05 was significantly improved.

Application Effect of Early Rehabilitation Nursing in Elderly Cerebral Infarction Patients with Dysphagia

Objective:To observe the application effect of early rehabilitation nursing in elderly cerebral infarction patients with dysphagia.Methods:120 cases of elderly cerebral infarction patients with dysphagia were divided into 60 cases in the control group and 60 cases in the observation group by the double-blind method,and conventional nursing and early rehabilitation nursing were implemented respectively.Swallowing function,quality of life,adverse events,and nursing satisfaction were compared before and after nursing care.Results:After nursing,the swallowing function score of the observation group(1.01±0.18 points)was lower than that of the control group,and the quality of life score(160.63±9.95 points)was higher than that of the control group(P<0.05);the incidence rates of aspiration and aspiration pneumonia in the observation group(5.00%and 3.33%)were lower than that of the control group(P<0.05);the total nursing satisfaction of the observation group(98.33%)was higher than that of the control group(P<0.05).Conclusion:Early rehabilitation nursing can reduce the degree of dysphagia in elderly patients with cerebral infarction,reduce the incidents of aspiration and aspiration pneumonia,and improve the quality of life,with high nursing satisfaction.

Application of early enteral nutrition nursing based on enhanced recovery after surgery theory in patients with digestive surgery

BACKGROUND Postoperative nursing can improve the restlessness and gastrointestinal function of patients with tracheal intubation under general anesthesia in digestive surgery.Wide application of various nursing methods and routine nursing in periop-erative nursing of patients with general anesthesia in digestive surgery.AIM To investigate the impact of early postoperative enteral nutrition nursing based on the enhanced recovery after surgery(ERAS)theory on postoperative agitation and gastrointestinal recovery in patients undergoing general anesthesia that experienced tracheal intubation.METHODS The data of 126 patients with digestive surgery from May 2019 to February 2022 were retrospectively analyzed.According to different nursing methods,they were divided into control group and observation group,with 63 cases in observation group and 63 cases in control group.The patients in the control group had standard perioperative nursing care,whereas those in the observation group got enteral nourishment as soon as possible after surgery in accordance with ERAS theory.Both the rate and quality of gastrointestinal function recovery were compared between the two groups after treatment ended.Postoperative anes-thesia-related adverse events were tallied,patients'nutritional statuses were monitored,and the Riker sedation and agitation score(SAS)was used to measure the incidence of agitation.RESULTS When compared to the control group,the awake duration,spontaneous breathing recovery time,extubation time and postoperative eye-opening time were all considerably shorter(P<0.05).There was no significant difference in the recovery time of orientation force between the two groups(P>0.05);however,the observation group had a lower SAS score than the control group(P<0.05).The recovery time for normal intestinal sounds,the time it took to have the first postoperative exhaust,the time it took to have the first postoperative defecation,and the time it took to have the first postoperative half-fluid feeding were all faster in the observation group than in the control group(P<0.05);Fasting blood glucose was lower in the observation group compared to the control group(P<0.05),while the albumin and hemoglobin levels were higher on the first and third postoperative days;however,there was no statistically significant difference in the incidence of anesthesia-related adverse reactions between the two groups(P>0.05).CONCLUSION The extremely early postoperative enteral nutrition nursing based on ERAS theory can reduce the degree of agitation,improve the quality of recovery,promote the recovery of gastrointestinal function,and improve the nutritional status of patients in the recovery period after tracheal intubation under general anesthesia.

Effect of an inpatient nursing risk early warning and control system in Shanghai:A retrospective study of adverse events

Purpose:To avoid the nursing risk of inpatients,reduce the occurrence of nursing errors and improve the safety of inpatients.Methods:We established a nursing risk early warning and control system,which includes a safety supervisory network,risk screening and early warning tools,and a risk control process.Results:The qualified rates of risk control measures to prevent pressure ulcers,unplanned extubation and fall/fall from bed all increased.The incidence of reported nursing errors decreased.The number of mistakes in medication-giving decreased.Conclusion:The establishment of an inpatient early warning and control system could effectively avoid nursing risk,improve risk prevention abilities,improve patient safety,and improve nursing quality.

Development of Nursing Protocol for Preventing Interruptions during Clinical Examinations and Treatments in the Early Days of Hospitalization for Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing interruptions during clinical examinations and treatments performed in the early days of hospitalization for acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the research, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 11 nurses in dementia care to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 73 subjects (84.9%) considered effective for patients, in terms of prevention of interruptions during clinical examinations and treatments in the early days of hospitalization. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 84.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We consider that this nursing protocol will be useful especially for newly graduated/employed nurses as a procedure manual which can reduce their anxiety or stress caused by lack of knowledge or experiences.

Contextualisation of Early and Enhanced Clinical Exposure Model through Development of Curricula for Advanced Practice Nursing and Midwifery

Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and developed curricula have been implemented using the Early and Enhanced Clinical Exposure Model with a view to producing Advanced Practice Nurses and Midwives who are competent to meet diverse health care needs and contribute to improving patient outcomes.

Early Rehabilitation Nursing for Stroke Patients with Hemiplegia in Neurology Department

Objective:To study the clinical nursing effect of early rehabilitation nursing on stroke patients with hemiplegia in neurology department.Methods:Stroke patients with hemiplegia treated in our hospital from March 2018 to March 2020 were selected for the present study.Twenty patients in each group were divided into two groups by random number table method,either in experimental group or control group.Routine nursing was used in the control group,while early rehabilitation nursing was carried out in the experimental group.The clinical nursing effect of the two groups of patients was compared.Results:After nursing,the neurological function of the patients was significantly improved(P<0.05),the improvement of the experimental group was better than that of the control group(P<0.01),the daily activities of the patients in the experimental group were significantly improved,and the score of the experimental group was higher than that of the control group(P<0.05).After nursing,anxiety and depression scores in the experimental group were significantly lower than those in the control group(P<0.05),and the recovery of limb function in the experimental group was better than that in the control group(P<0.05).Conclusion:The implementation of early rehabilitation nursing measures plays an important role in the recovery of stroke patients with hemiplegia by promoting the recovery of neurological function,improving the psychological state of patients,and promoting the recovery of limbs.

I-Nursing住院患者安全评估预警系统的研发与应用

为了自主研发i-nursing患者安全评估与预警系统,提高临床护理评估信息化程度与工作效率。本研究改变传统的纸质表单、人工计算、人工筛选患者安全风险的方式,使用研发软件进行护理评估,智能计分、智能筛选风险,并提供护理建议与策略,与HIS系统对接生成护理记录。与传统的方式相比,本系统在评估用时、评估的准确率、防范措施的全面性、护理人员满意度等方面均明显提高。

Early mobilization implementation for critical ill patients:A cross-sectional multi-center survey about knowledge,attitudes,and perceptions of critical care nurses

Objective To explore critical care clinicians’knowledge,attitudes and perceptions toward early mobilization of critically ill patients in ICUs.Design A cross-sectional national survey was conducted.From January to August 2020,ICU nurses in 11 hospitals were surveyed by using a questionnaire on the knowledge,attitudes and perceptions of ICU early mobilization.Results Totally 512 nurses completed the questionnaire.The respondents’mean score for knowledge of early mobilization was 6.89±2.91.The level of knowledge was good in 2.5%(13/512),fair in 52.3%(268/512).The attitudes toward early mobilization were positive in 31.4%(161/512).In terms of perceived implementation of ICU early mobilization,42.9%(220/512)of nurses did not believe that this should be a top priority in intensive care.The attitudes of nurses from different ICUs were significantly different(F=3.58,P<0.05).The knowledge(7.34±2.78 vs.6.49±2.97,t=3.37,P<0.001)and attitudes(3.82±0.58 vs.3.52±0.56,t=5.63,P<0.001)of nurses who had early mobilization related training were higher than those of nurses who had no training.Conclusions The importance of early ICU early mobilization is increasingly recognized by critical care providers.However,there is still a gap in the knowledge,attitudes and perceptions of ICU early mobilization among nurses.In future studies,it is necessary to further systematically identify the reasons leading to the gaps in these aspects and implement targeted interventions around these gaps.Meanwhile,more nurses should be encouraged to participate in decision-making to ensure the efficient and quality implementation of ICU early mobilization practices.

基于早期干预的康复护理模式在脑性瘫痪高危儿中的应用

目的 探究基于早期干预的康复护理模式在脑性瘫痪高危儿中的应用价值。方法 选取2022年1月至12月嘉兴市妇幼保健院新生儿重症监护室收治的脑性瘫痪高危儿112例。根据家长意愿将其分为观察组和对照组,每组各56例。对照组给予常规护理模式,观察组在常规护理的基础上采用基于早期干预的康复护理模式。在矫正1月龄和矫正3月龄时,使用全身运动质量评估方法对两组患儿的中枢神经发育情况进行评价。结果 观察组患儿矫正1月龄和矫正3月龄的正常率均显著高于对照组(P<0.05)。结论 基于早期干预的康复护理模式对脑性瘫痪高危儿的神经发育有一定的促进作用,可在临床早期护理中推广应用。

体外循环心脏外科手术病人气管插管拔除后早期饮水的临床实践研究

目的:评价早期经口饮水在体外循环心脏外科手术后气管插管拔除病人中的安全性及可行性。方法:采用便利抽样法,选取山东省青岛市某三级甲等医院心血管外科重症监护室于2022年3月1日—5月31日行体外循环下心脏外科手术的病人123例作为对照组(常规拔管后4 h经口饮水),选取于2022年6月1日—9月30日行体外循环下心脏外科手术的病人120例作为观察组(实施拔除气管插管后早期经口饮水干预方案)。记录两组病人口渴程度、口腔黏膜湿润程度,呛咳、恶心呕吐、误吸、吸入性肺炎发生率以及病人对护理工作的满意度,同时记录两组的平均饮水时间。结果:观察组病人的口渴程度得分和口唇黏膜湿润度评分均低于对照组,差异有统计学意义(P<0.05);两组病人饮水呛咳、恶心呕吐、误吸、吸入性肺炎发生率比较,差异无统计学意义(P>0.05);观察组病人对护理工作满意度评分为(93.01±6.17)分,明显高于对照组(90.29±7.32)分,差异有统计学意义(P<0.05);观察组平均饮水时间为(18.75±14.92)min,明显短于对照组(245.06±17.56)min,差异有统计学意义(P<0.05)。结论:经过安全评估,体外循环心脏手术后气管插管拔除病人立即评估并早期经口饮水有利于缓解术后口渴程度,增加口腔黏膜湿润程度,减轻口咽部不适感,改善病人舒适度,提高病人对护理工作满意度,且未增加相关临床并发症的发生率,临床实践安全可行。

早期精细化护理干预联合序贯式营养治疗对脑卒中后吞咽功能障碍患者的疗效观察

目的探讨早期精细化护理干预联合序贯式营养治疗对脑卒中后吞咽功能障碍患者的疗效。方法选取2021年1月至2023年6月四川大学华西医院收治的124例脑卒中后吞咽功能障碍患者为研究对象,在组间基线特征可比的原则上,采用随机数字表法分为对照组和观察组,每组62例。对照组给予常规护理干预联合常规营养治疗,观察组给予早期精细化护理干预联合序贯式营养治疗,两组患者均连续治疗3个月。比较分析两组患者治疗前后的吞咽功能、胃肠道屏障功能[二胺氧化酶(DAO)、D-乳酸]、营养状况[白蛋白(ALB)、血红蛋白(Hb)、转铁蛋白(TF)、前白蛋白(PA)]、心理状况与生活质量[症状自评量表-90(SCL-90)评分、吞咽障碍特异性生活质量量表(SWALQOL)评分]。结果治疗前,两组患者的吞咽功能比较差异均无统计学意义(P>0.05);治疗3个月后,两组患者的吞咽功能与治疗前比较均明显改善,且观察组优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者的DAO、D-乳酸、ALB、Hb、TF、PA、SCL-90评分、SWAL-QOL评分比较差异均无统计学意义(P>0.05);治疗3个月后,两组患者的DAO、D-乳酸、SCL-90评分与治疗前比较均降低,且观察组低于对照组,差异均有统计学意义(P<0.05);治疗3个月后,两组患者的ALB、Hb、TF、PA、SWAL-QOL评分与治疗前比较均升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。结论早期精细化护理干预联合序贯式营养治疗有利于改善脑卒中后吞咽功能障碍患者的吞咽功能、胃肠道屏障功能、营养状况及心理状况,且可提高患者的生活质量,值得临床应用。

基于KANO模型的护理干预在早期肺癌患者术后的应用效果观察

目的探究早期肺癌患者术后护理中采用基于KANO模型护理干预的临床效果。方法选取2022年1月至2022年12月漯河医学高等专科学校第二附属医院收治的68例肺癌术后患者为研究基础病例,采用病历号随机抽签模式分为研究组(n=34)、对照组(n=34)。对照组患者采用一般性术后护理干预,研究组患者采用基于KANO模型的护理干预,比较两组患者并发症发生率、营养状况指标、生活质量。结果研究组患者并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组护理干预后前白蛋白(PA)、转铁蛋白(TFN)、血清白蛋白(ALB)、体质量指数(BMI)水平均高于护理前,且研究组患者营养状况指标高于对照组,差异有统计学意义(P<0.05)。两组护理干预后生活质量评分均高于护理前,且研究组患者生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论早期肺癌患者术后采用基于KANO模型的护理干预可降低并发症发生率,改善机体营养状况,提高生活质量,值得应用。

优化溶栓护理流程联合超早期个性化护理对急性脑梗死溶栓患者康复效果及并发症的影响

目的探讨优化溶栓护理流程联合超早期个性化护理应用于急性脑梗死溶栓患者的临床效果。方法80例急性脑梗死溶栓患者随机分为两组,参照组予以常规护理,观察组予以优化溶栓护理流程联合超早期个性化护理干预,比较两组的康复效果和并发症。结果护理后,观察组的NIHSS评分低于参照组,Barthel评分高于参照组,并发症总发生率低于参照组(P<0.05)。结论优化溶栓护理流程联合超早期个性化护理可明显提高急性脑梗死溶栓患者的康复效果,降低并发症发生风险。

改良预警评分对预防干细胞移植术后环孢素相关脑病的影响

目的:分析改良预警评分对预防干细胞移植术后环孢素相关脑病的影响。方法:选取2021年1月-2022年1月我院干细胞移植术后使用环孢素治疗的80例病人为研究对象,通过早期预警评分(MEWS)和改良早期预警评分工具找出截断点;对80例移植术后采用环孢素治疗的病人运用改良早期预警评分工具评分,并就改良早期预警评分工具评分截断点进行预警干预,统计分析环孢素相关脑病病人的发生率,同时对病人的预后情况进行研究分析。结果:本组病人中共计发生14例环孢素相关脑病,环孢素相关脑病发生率为17.5%;改良早期预警评分分值与病人预后呈正相关,分值越高其预后情况越差,两者相关系数为0.41(P<0.05);早期预警评分≥4分者收入重症监护室和自动出院/死亡占比高于早期预警评分0~<4分者,改良早期预警评分≥3分者收入重症监护室和自动出院/死亡占比高于改良早期预警评分0~<3分者;3分为改良早期预警评分的最佳截断点,敏感度为98.02%,特异度降为92.85%;环孢素相关脑病发生率由20.0%降至2.5%。结论:与早期预警评分相比,改良早期预警评分对使用环孢素的病人发生环孢素相关脑病风险的判定准确度更高,临床医师可以更加明确是否需要将病人的监护级别提高,以保障医疗资源合理使用的同时最大限度地提高病人的预后。

早期胃癌患者内镜黏膜下剥离术后疲劳预测模型的构建

目的探究早期胃癌患者胃内镜黏膜下剥离术后疲劳(POF)的危险因素,建立并验证早期胃癌POF风险预测模型。方法采用便利抽样法选取2020年10月-2022年12月于我院治疗的232例早期胃癌患者为研究对象,使用一般资料表、中文版多维度疲乏症状量表、阿姆斯特丹术前焦虑与信息需要量表、匹兹堡睡眠质量量表、艾森克人格问卷简式量表收集相关数据,通过单因素分析和二分类logistic回归分析发生术后疲劳的危险因素,并建立列线图预测模型,选取2023年1-6月在我院治疗的72例患者对模型进行验证。结果经检验,年龄、性别、睡眠障碍、病灶切除面积、气质类型、术后疼痛和胃肠功能紊乱是早期胃癌患者POF发生的独立危险因素,并以此建立早期胃癌患者POF的列线图模型,经验证该模型具有较好的准确度(H-L检验:χ^(2)=2.822,P=0.945)和区分度(AUC=0.0.909,95%CI:0.937~0.980,P<0.001),最大约登指数为0.648,灵敏度为0.832,特异度为0.813,截断值0.319,校准曲线为斜率近似于1的直线。结论该模型预测效果良好,可为医护人员对早期胃癌POF高风险人群筛查提供参考,及时采取预防性措施。

督导式预警性护理模式对Ⅱ型呼吸衰竭患者的作用效果

目的探讨督导式预警性护理模式在Ⅱ型呼吸衰竭患者中的应用价值。方法选取南阳市第一人民医院2022年1月至2023年3月就诊的136例Ⅱ型呼吸衰竭患者,根据护理方法分为研究组(68例)和常规组(68例)。常规组接受常规护理干预,研究组在常规组基础上联合督导式预警性护理模式,比较两组血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、最大通气量(MVV)]、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、睡眠质量[匹兹堡睡眠质量量表(PSQI)]、运动恐惧[恐动坦帕评分(TSK)]、并发症发生率。结果干预后研究组PaO_(2)、FEV_(1)、FVC、MVV高于常规组,研究组PaCO_(2)低于常规组(P<0.05);干预后研究组SAS、TSK、SDS、PSQI评分低于常规组(P<0.05);研究组并发症总发生率低于常规组(P<0.05)。结论督导式预警性护理模式可减轻Ⅱ型呼吸衰竭患者运动恐惧、负性情绪,改善患者血气指标、肺功能,提升患者睡眠质量,降低并发症发生率。

基于循证构建血液透析导管相关性血流感染早期识别及护理流程管理方案

目的:基于循证构建血液透析导管相关性血流感染早期识别及护理流程管理方案,以期提高临床护理质量,降低血液透析病人导管相关性血流感染发生率。方法:基于循证护理的方法,检索、评价、汇总国内外关于预防血液透析导管相关性感染护理管理的最佳证据,构建导管相关性血流感染早期识别及护理流程管理方案基本框架,采用德尔菲专家咨询法对17名专家开展两轮函询,确定方案各级条目,通过层次分析法确定条目权重。结果:两轮函询专家权威系数依次为0.862,0.860;Kendall′s W值分别为0.546(χ^(2)=76.804,P<0.001)、0.614(χ^(2)=93.371,P=0.005),最终筛选并确定包括2个一级条目、10个二级条目、35个三级条目的早期识别及护理流程管理方案。结论:基于循证构建的血液透析导管相关性血流感染早期识别及护理流程管理方案科学、可靠,能够为血液透析病人导管相关性血流感染的早期识别和管理提供依据。