Background: The emergence of carbapenemase producing Acinetobacter baumannii is increasingly reported nowadays and constitutes a major problem to the intensive care unit (ICU) patients with notable extensive-drug resi...Background: The emergence of carbapenemase producing Acinetobacter baumannii is increasingly reported nowadays and constitutes a major problem to the intensive care unit (ICU) patients with notable extensive-drug resistance ability. The study investigates carbapenemase producing A. baumannii strains exhibiting an extensively drug-resistant (XDR) phenotype, isolated from ICU patients in Khartoum. Methods: A total of 100 nonduplicate Gram-negative coccobacilli strains were obtained from microbiology laboratory of ICU patients’ clinical isolates. Molecular identification of A. baumannii was performed by targeting 16S rRNA gene using specifically designed primers. Then, XDR strains were determined by susceptibility testing (disc diffusion). For detection of carbapenemase genes Polymerase chain reaction (PCR) was carried out. Result: Of 100 ICU clinical isolates, 38 (38.0%) was confirmed A. baumannii strains, those strains showed 100% carbapenem resistance and 60.5% extensive drug resistance to the antibiotics tested. The frequency of carbapenemase producer was 57.9% (22/38) of carbapenem resistance A. baumannii (CRAB). The most common carbapenemase associated with resistance was blaOXA gene followed by blaNDM and blaGES A. baumannii isolates. The co-occurrence of blaOXA-48-like and blaNDM, blaOXA-23-like and blaOXA-51, and blaNDM-1 and blaOXA-51 was detected in 22.7%, 18.2% strains and 4.5% respectively. A unique characteristic of our findings was the coharbouring of the genes blaNDM-1, blaOXA-23-like, blaOXA-51 and blaOXA-143 in 9.1% strains (2/22), and this was the first report in the Khartoum city, Sudan. Conclusion: We have demonstrated for the first time a high prevalence of XDR-carbapenemase producing A. baumannii clinical isolates from ICU patients in Khartoum. Also an emergent blaOXA-143 was reported as High-Risk Clones. This highlights the routine mentoring of XDR-carbapenemase producing A. baumannii to avoid clone dissemination in our region hospitals.展开更多
Introduction: The ring system is one of the devices that are necessary for patients in hospital. Patients can use it in emergencies and call nurses for help. Patients who have a tracheal tube cannot make the simplest ...Introduction: The ring system is one of the devices that are necessary for patients in hospital. Patients can use it in emergencies and call nurses for help. Patients who have a tracheal tube cannot make the simplest requests, and they do not have verbal communication due to tracheal tube or tracheostomy tube. According to surveys, patients’ survival is 55.5% in intensive care unit (ICU). They experience severe stressful conditions. This project is designed to solve communicational problems for ICU patients. We have developed and successfully tested a new moveable “nurse call system” for ICU patient. Material Methods: this is an interventional study. Regarding the main goal of this project, it seems that the best design for “nurse call system” is horizontal panels. The Panel of device contains a touchable board, which consists of symbols that allow patients to select them despite of their physical limitation. When patient touches any symbol, the message will be sent and heard by the nurse and the patient as well, so the patient will be sure that the massages is received properly. A notepad device will be used on which patients are able to write too. It is finger touch, and has virtual keywords in both Persian and English alphabets. The voice messages and other data will be transmitted to the computer in central nurse station by a wireless accesses point. In this study, we evaluated the viewpoint of nurses and patients who have used this device. Results: 40 questionnaires were distributed, but 30 cases were collected. Results showed that 26.7% (8 cases) were men, 73.3% (22 cases) women. 26.7% (23 cases) were nurses, 6.7% (2 cases) doctor, 6.7% (2 cases) nurse assistant. 33.3% (9 cases) were in the morning shift, 66.7% (21 cases) worked in other shifts. About patient 60% (6 cases) were men, 40% (4 cases) women and in 98% comments were completely compliant and device was full consent. Conclusion: The Nurse Call system caused patients’ satisfaction. In addition, this device resolved many problems of patients and made it possible to have active communication with them.展开更多
目的探讨重症监护病房(intensive care unit,ICU)清醒患者创伤后成长(post-traumatic growth,PTG)的真实体验。方法采用描述性质性研究法,借鉴PTG模型设计访谈提纲,选取2022年8月-2023年7月贵阳市某三级甲等综合医院的15例急诊ICU清醒...目的探讨重症监护病房(intensive care unit,ICU)清醒患者创伤后成长(post-traumatic growth,PTG)的真实体验。方法采用描述性质性研究法,借鉴PTG模型设计访谈提纲,选取2022年8月-2023年7月贵阳市某三级甲等综合医院的15例急诊ICU清醒患者进行深入访谈,用Colaizzi现象学方法分析资料。结果萃取出承受多重创伤反应、与他人的关系改善、自我转变、创伤后的人生转变4项一级主题及15项二级主题。结论临床医护要关注清醒患者的积极经历,并根据其PTG心路历程制定心理干预措施,促进临床干预范式转变,促进康复。展开更多
目的系统评价ICU患者身体约束的真实体验。方法计算机检索PubMed、Cochrane Library、Ovid、Embase、外文医学信息资源检索平台(Foreign Medical Literature Retrieval Service,FMRS)、中国知网、万方数据库、中国生物医学文献数据库和...目的系统评价ICU患者身体约束的真实体验。方法计算机检索PubMed、Cochrane Library、Ovid、Embase、外文医学信息资源检索平台(Foreign Medical Literature Retrieval Service,FMRS)、中国知网、万方数据库、中国生物医学文献数据库和维普数据库,收集关于ICU患者身体约束真实体验的质性研究,检索时限为建库至2021年10月。采用Meta整合的方法对质性研究结果进行提取、归纳、整合、诠释。结果共纳入9篇文献,提炼出53个主要结果,整理为7个新类别,并综合成3个整合结果,分别为情感体验;躯体活动障碍;对身体约束的态度。结论ICU医护人员应充分理解和重视身体约束给患者带来的危害,不断优化ICU人文关怀策略,规范身体约束的管理,给予ICU患者足够的心理支持,促进患者的身心康复。展开更多
文摘Background: The emergence of carbapenemase producing Acinetobacter baumannii is increasingly reported nowadays and constitutes a major problem to the intensive care unit (ICU) patients with notable extensive-drug resistance ability. The study investigates carbapenemase producing A. baumannii strains exhibiting an extensively drug-resistant (XDR) phenotype, isolated from ICU patients in Khartoum. Methods: A total of 100 nonduplicate Gram-negative coccobacilli strains were obtained from microbiology laboratory of ICU patients’ clinical isolates. Molecular identification of A. baumannii was performed by targeting 16S rRNA gene using specifically designed primers. Then, XDR strains were determined by susceptibility testing (disc diffusion). For detection of carbapenemase genes Polymerase chain reaction (PCR) was carried out. Result: Of 100 ICU clinical isolates, 38 (38.0%) was confirmed A. baumannii strains, those strains showed 100% carbapenem resistance and 60.5% extensive drug resistance to the antibiotics tested. The frequency of carbapenemase producer was 57.9% (22/38) of carbapenem resistance A. baumannii (CRAB). The most common carbapenemase associated with resistance was blaOXA gene followed by blaNDM and blaGES A. baumannii isolates. The co-occurrence of blaOXA-48-like and blaNDM, blaOXA-23-like and blaOXA-51, and blaNDM-1 and blaOXA-51 was detected in 22.7%, 18.2% strains and 4.5% respectively. A unique characteristic of our findings was the coharbouring of the genes blaNDM-1, blaOXA-23-like, blaOXA-51 and blaOXA-143 in 9.1% strains (2/22), and this was the first report in the Khartoum city, Sudan. Conclusion: We have demonstrated for the first time a high prevalence of XDR-carbapenemase producing A. baumannii clinical isolates from ICU patients in Khartoum. Also an emergent blaOXA-143 was reported as High-Risk Clones. This highlights the routine mentoring of XDR-carbapenemase producing A. baumannii to avoid clone dissemination in our region hospitals.
文摘Introduction: The ring system is one of the devices that are necessary for patients in hospital. Patients can use it in emergencies and call nurses for help. Patients who have a tracheal tube cannot make the simplest requests, and they do not have verbal communication due to tracheal tube or tracheostomy tube. According to surveys, patients’ survival is 55.5% in intensive care unit (ICU). They experience severe stressful conditions. This project is designed to solve communicational problems for ICU patients. We have developed and successfully tested a new moveable “nurse call system” for ICU patient. Material Methods: this is an interventional study. Regarding the main goal of this project, it seems that the best design for “nurse call system” is horizontal panels. The Panel of device contains a touchable board, which consists of symbols that allow patients to select them despite of their physical limitation. When patient touches any symbol, the message will be sent and heard by the nurse and the patient as well, so the patient will be sure that the massages is received properly. A notepad device will be used on which patients are able to write too. It is finger touch, and has virtual keywords in both Persian and English alphabets. The voice messages and other data will be transmitted to the computer in central nurse station by a wireless accesses point. In this study, we evaluated the viewpoint of nurses and patients who have used this device. Results: 40 questionnaires were distributed, but 30 cases were collected. Results showed that 26.7% (8 cases) were men, 73.3% (22 cases) women. 26.7% (23 cases) were nurses, 6.7% (2 cases) doctor, 6.7% (2 cases) nurse assistant. 33.3% (9 cases) were in the morning shift, 66.7% (21 cases) worked in other shifts. About patient 60% (6 cases) were men, 40% (4 cases) women and in 98% comments were completely compliant and device was full consent. Conclusion: The Nurse Call system caused patients’ satisfaction. In addition, this device resolved many problems of patients and made it possible to have active communication with them.
文摘目的探讨重症监护病房(intensive care unit,ICU)清醒患者创伤后成长(post-traumatic growth,PTG)的真实体验。方法采用描述性质性研究法,借鉴PTG模型设计访谈提纲,选取2022年8月-2023年7月贵阳市某三级甲等综合医院的15例急诊ICU清醒患者进行深入访谈,用Colaizzi现象学方法分析资料。结果萃取出承受多重创伤反应、与他人的关系改善、自我转变、创伤后的人生转变4项一级主题及15项二级主题。结论临床医护要关注清醒患者的积极经历,并根据其PTG心路历程制定心理干预措施,促进临床干预范式转变,促进康复。
文摘目的系统评价ICU患者身体约束的真实体验。方法计算机检索PubMed、Cochrane Library、Ovid、Embase、外文医学信息资源检索平台(Foreign Medical Literature Retrieval Service,FMRS)、中国知网、万方数据库、中国生物医学文献数据库和维普数据库,收集关于ICU患者身体约束真实体验的质性研究,检索时限为建库至2021年10月。采用Meta整合的方法对质性研究结果进行提取、归纳、整合、诠释。结果共纳入9篇文献,提炼出53个主要结果,整理为7个新类别,并综合成3个整合结果,分别为情感体验;躯体活动障碍;对身体约束的态度。结论ICU医护人员应充分理解和重视身体约束给患者带来的危害,不断优化ICU人文关怀策略,规范身体约束的管理,给予ICU患者足够的心理支持,促进患者的身心康复。