Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.METHODS We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,2023.We compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein B1(HMGB1)]of all patients before and after treatment.RESULTS Before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(P<0.05).The serum CRP and PCT levels of patients were significantly decreased,and the difference was statistically significant compared with that of nursing group alone(P<0.05).The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.CONCLUSION The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.

Application of multidisciplinary collaborative nursing with family care for enhanced recovery after surgery in children with inguinal hernia

BACKGROUND Perioperative nursing can reduce the stress reaction and improve the prognosis of children.AIM To elucidate the influence of multidisciplinary collaborative nursing for enhanced recovery after surgery(ERAS)with family care in perioperative nursing children with an inguinal hernia and its impact on the prognosis.METHODS The data of 100 children with inguinal hernia were retrospectively analyzed.The participants were divided into three groups according to different nursing methods:Groups A(n=38),B(n=32),and C(n=30).Group A received multidisciplinary collaborative ERAS nursing combined with family care nursing;Group B received multidisciplinary collaborative nursing for ERAS;and Group C received routine nursing.The postoperative recovery results of the three groups were compared,including intraoperative blood loss and postoperative feeding time,time of getting out of bed,hospitalization time,and defecation time.Furthermore,the incidence of common complications was also compared between the three groups.RESULTS There was less intraoperative blood loss in Groups A and B than in Group C(P<0.05),and the time of getting out of bed and postoperative hospitalization and defecation times were also decreased in Group C(P<0.05).There was no significant difference in postoperative feeding time among the three groups(P>0.05).Each index had no statistical significance between Groups A and B(P>0.05).The incidence of urinary retention,infection,hematoma,and hernia recurrence in Group A was less than that in Group C(P<0.05).No significant difference was observed in the overall complication rate between Groups A and B and between Groups B and C(P>0.05).CONCLUSION The application of multidisciplinary collaborative nursing combined with family care in the perioperative care of children with an inguinal hernia for ERAS may promote postoperative rehabilitation for children and reduce the incidence of complications.

Effect analysis of applying high-quality service model to surgical nursing

BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.

Practical Exploration of Strengthening Team Communication and Cooperation in Head Nurse Nursing Management

This study explores the practical application of nursing management led by head nurses to enhance team communication and collaboration within clinical settings.By integrating leadership theories with nursing practice,this research adopts a qualitative methodology to examine the effects of strategic communication and teamwork enhancement initiatives.Through interviews,observations,and the analysis of case studies in various hospital departments,the study identifies key barriers to effective team communication and collaboration,including hierarchical structures,lack of standardized communication protocols,and insufficient training.Solutions implemented involve targeted communication skills training,the establishment of interdisciplinary teamwork protocols,and leadership workshops for head nurses.The outcomes indicate significant improvements in team efficiency,patient care quality,and staff satisfaction.This research underscores the importance of head nurses in fostering an environment conducive to open communication and collaborative practice,thereby advancing patient care and team performance.

Research progress on interdisciplinary cooperative learning in nursing

Multidisciplinary and interprofessional collaboration among medical staff is an effective way to reduce the incidence and complication of complex diseases and improve the quality of life.Therefore,it is very important to carry out interdisciplinary cooperative learning for nursing students in the education stage.This paper expounds the current situation of cross-disciplinary nursing education at home and abroad from the aspects of preparation and influencing factors of cross-disciplinary cooperative learning,teacher team building,teaching content and teaching methods,implementation time and place,in order to put forward suggestions for carrying out cross-disciplinary cooperative learning in college courses,and provide reference for many educators to carry out cross-disciplinary education and improve the comprehensive ability of nursing students.

Enhancers and hindrances to doctor-nurse interdisciplinary collaborative practice in Nigeria

The purpose of this study was to identify factors that enhance and hinder interdisciplinary collaborative practice (ICP) among doctors and nurses at the Nnamdi Azikiwe teaching hospital, Nnewi, southeast Nigeria. The study was a cross-sectional descriptive survey and the quantitative method of data collection was employed. The population was all doctors irrespective of area of specialty and all nurses employed and working in the hospital as at the time of study. Proportionate stratified and convenience sampling methods were used to select study participants according to their categories. Using validated structured questionnaire, data were collected from 110 doctors and 95 nurses in the teaching hospital on their perception on ICP and factors that enhance/hinder ICP. Data were analyzed using both descriptive and inferential statistics. Specifically, frequencies, percentages, standard deviation and graphic presentation were used for descriptive analysis of scores while the unpaired t test of mean score using Graph Pad Prism, Version 5.30 was used to determine the influence of profession, gender, and years of experience on perception of ICP at 0.05 level of significance. The study found that both doctors and nurses have positive perception on ICP. Their years of experience have significant influence on their perception. Clear individual roles and good working relationships enhance ICP while giving priority to professional status rather than expertise was seen as a prominent hindrance to ICP. The study recommends collaborative continuing education for doctors and nurses to enhance ICP in patient care. In addition, the inclusion of interdisciplinary collaborative practice programmme into the curriculum of medical and nursing students (where it does not exist) would go a long way to strengthen ICP and decrease hindrances when they graduate.

A Review of the Clinical Interdisciplinary Collaboration among Nurses and Physicians

Background: Care is a team effort that its continuity is not possible by a person alone. Nurses and physicians should have collaboration with other professions to solve care complex problems. Aim: We conducted a review of the literature to evaluate clinical nurses collaboration with other disciplines examined by qualitative approach. Method: We searched all articles that published from 1995 to 2014 in both English and Persian which had been performed interdisciplinary collaboration processes in the clinical nursing. These articles were done with qualitative approach for nurse’s collaboration with other disciplines. We searched using databases of Proquest, Scopus, pub Med, Science Direct, and Iranian databases of Sid, Magiran, Iran Medex. This review was performed using keywords matching with MESH terms such as interdisciplinary relations, nurse-physician relations, care team, collaboration, and their Persian equivalents at the first separately and then with AND/OR as combination. In most studies, the main structure was three components of collaboration process, context of collaboration and consequences that they were emphasized. Results & Conclusions: However context and processes were different but most studies reported outcomes similarity of interdisciplinary collaboration. Thus to achieve common goals between different disciplines working together is essential for effective care in clinical settings.

Corroborative Activities and Recognition Between Community Comprehensive Care Unit’s Nurses and Care Managers in Supporting Discharge of Elderly from Hospital - A Secondary Publication

Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the elderly from the hospital. Methods: A total of 300 nurses working in community comprehensive care wards and 360 care managers working in B City in A Prefecture were surveyed using an anonymous self-administered questionnaire. Results: The highest percentage of responses regarding necessary collaborative activities with multiple professions in supporting hospital discharge were the same for Ns and CMs. The items regarding practice with the highest percentages were “relationship as a team” for Ns, and “user-centered awareness” for CM. While these professionals were willing to share information about their patients’ lives after discharge, the percentage of those explaining their expertise was low. It is thought that collaborative activities focusing on these aspects would lead to more appropriate discharge support.

A qualitative study of nurse practitioner promotion of interprofessional care across institutional settings:Perspectives from different healthcare professionals

Objective:Interprofessional care,an aim of institutional healthcare settings globally,promotes safe,cost-effective,quality care.How professionals act to enable interprofessional care has not been described.The nurse practitioner role,with its expertise in both medicine and nursing,is known to enhance collaboration and promote interprofessional care delivery.The objective of this study was to identify,from the healthcare professionals'perspective,nurse practitioner strategies used to enhance interprofessional care.Method:A hermeneutic phenomenology design was employed.Healthcare professionals from acute care hospitals and associated long-term care residences(n=6)in one Canadian province were invited to participate.Individual interviews were held with healthcare professionals(n=52)who regularly work with a nurse practitioner.The participants were asked to share experiences that held significance or value in promoting interprofessional care.Results:Four valued role attributes were identified;consistent role presence,time to focus on the patient,effective communication,and respectful centrality.Identified strategies extending from the attributes included knowledge sharing,respectful negotiation,identifying patient issues,being open and transparent,listening to opinions,bridging professions,and working as the hub of the group.Multiple types of interprofessional relationships were perceived,with the hierarchical type as the most common.Conclusions:Nurse practitioners in acute care hospital and long-term care settings have valued attributes that can promote interprofessional care.Effective strategies to promote interprofessional care emerge from these role attributes.However,the interprofessional relationship type perceived could enhance or impede the contribution of the strategies to interprofessional care promotion.

基于大数据的多学科协作教学模式在全科病房护生实习带教中的应用

目的:研究基于大数据多学科协作教学模式在全科病房护生实习带教中的应用。方法:选择2018年4月至2020年4月我院全科病房实习护生98名,依据随机数表法分组。对照组接受常规教学,试验组接受基于大数据的多学科协作教学模式。比较两组综合护理能力考核成绩及满意度。结果:试验组理论考核、操作技能、病例分析、文献检索、语言表达及团队协作等综合护理能力考核成绩均高于对照组(P<0.05);试验组带教满意度高于对照组(P<0.05)。结论:基于大数据的多学科协作教学可提高理论考核、操作技能及团队协作等综合能力,增加护理满意度。

基于角色合作的TBL教学法在心内科护理实习教学中的应用

目的 探究基于角色合作的以团队为基础的学习(team-based learning,TBL)教学法在心内科护理实习教学中的应用效果。方法 选取2022年7月-11月在重庆医科大学附属第二医院心内科实习的31名心内科护理本科学生为对照组,2022年12月-2023年4月在重庆医科大学附属第二医院心内科实习的31名心内科护理本科学生为试验组。对照组采用传统教学模式,试验组采用基于角色合作的TBL教学法。教学活动结束后,对2组学生的带教效果、管床效果、教学满意度进行对比分析。结果 试验组平均理论成绩为(95.94±2.08)分,操作成绩为(96.13±1.36)分、护理质量评分(95.71±1.72)分,对照组分别为(91.00±2.70)分、(90.03±3.09)分、(90.39±2.39)分,试验组高于对照组,差异有统计学意义(P <0.001)。在出科考核中,试验组护理缺陷发生率为0,低于对照组的9.68%,差异有统计学意义(P<0.05)。试验组患者满意度为100%,高于对照组的80.65%,差异有统计学意义(P <0.05)。在学生的教学评价中,试验组的教学态度、教学形式、教学氛围、教学形式方面观察指标数据均优于对照组,差异有统计学意义(P <0.001)。结论 基于角色合作的TBL教学法可以提高学生的理论成绩、操作成绩及护理质量评分,降低护理缺陷发生率,提升学生教学评价满意度。

基于区块链的医联体护理协同管理系统的设计与实现

目的:设计一种基于区块链的医联体护理协同管理系统,为实现医联体护理协同管理提供技术支持。方法:该系统基于联盟链的5层技术架构进行设计,通过Linux系统搭建Fabric开发环境及网络配置,采用智能合约和Java语言软件开发工具包实现用户界面操作,使用Bootstrap和Jquery等技术搭建前端Web界面、Spring Boot搭建系统后端,并通过加密算法、哈希运算、智能合约、共识机制等技术实现联盟链成员管理、业务管理、数据存储与共享、患者病历管理及平台监管5个功能模块。结果:该系统完善了优质护理资源下沉与连续性护理机制,重构了积分激励机制,促进了护理共生网络协同进化,并使多节点交互,形成了协同合力。结论:该系统顺应全新模式下医联体整合型护理服务的发展趋势,对提升护理核心竞争力等方面起到重要推动作用,同时为构建适用于医联体场景的区块链方案提供了借鉴。

医护合作对口腔专科护士工作投入的影响

目的调查云南省口腔专科护士医护合作、护士工作投入的现状,探讨医护合作对口腔专科护士工作投入的影响。方法采用便利抽样法,于2024年1月至3月,采用一般资料调查问卷表、医护合作量表、Utrecht工作投入量表对251名云南省口腔专科护士进行调查。结果云南省口腔专科护士医护合作量表调查总分为(85.09±15.14)分,各条目总均分为(4.052±0.02)分,患者信息的交流维度总均分为(4.16±0.66)分,共同参与治疗或护理的决策维度(3.97±0.83)分,护士和医生的关系维度(4.05±0.91)分,分数以患者信息的交流、护士和医生的关系、共同参与治疗或护理的决策维度依次下降。护士工作投入量表调查总分为(50.75±15.69)分,总均分为(3.906±0.123)分,其中奉献维度均分为(4.04±1.30)分,专注维度均分为(3.89±1.22)分,活力维度均分为(3.83±1.21)分,得分从奉献维度、专注、活力维度均分依次下降。Pearson相关性分析结果显示,医护合作与口腔专科护士的工作投入呈中度正相关(r=0.574,P<0.001),量表中各维度与工作投入均呈中度正相关,(r=0.502-0.574,P<0.001)。单因素分析显示,性别、职务、收入对口腔专科护士工作投入得分有影响,多元线性回归分析显示,工龄大于5 a的护士医护合作得分显著高于工龄小于5 a的低年资护士(P<0.05),护士月收入正向影响工作投入得分(P<0.05),医护对于患者信息的交流显著正向影响工作投入得分(P<0.05)。结论云南省口腔专科护士医护合作处于较高水平,工作投入处于中等水平,口腔专科护士医护合作水平越高,工作投入程度越大。口腔专科护理管理者应考虑能够促进医护合作的各项措施,工作中构建团结和谐的医护合作关系,同时关注影响护士工作投入的因素,并采取相应的措施,促进口腔专科护士工作投入水平,提升口腔医疗护理服务质量。

护理主导多部门协作管理提升血培养标本质量的效果研究

目的 :评价护理主导的多部门协作管理模式对血培养标本质量提升的效果,为护理临床实践和质量改进提供参考。方法 :成立护理主导多部门协作管理团队,开展质量改进,比较措施实施前后血培养标本送检率、合格率、污染率,以及护士血培养知识、态度、行为的变化。结果 :2023年5月—6月血培养标本送检率、送检方式为双瓶双侧的比例分别为19.1%、61.3%,高于2022年同期的4.7%、35.6%,差异有统计学意义(P<0.05);2023年5月—6月和2022年同期污染率分别为2.9%和3.8%,呈下降趋势;2023年护士血培养相关知识、态度、行为得分分别为(12.69±2.81)、(5.89±0.44)、(36.73±3.40)分,高于2018年的(7.89±2.79)、(5.82±0.52)、(30.81±4.35)分,差异有统计学意义(P<0.05)。结论 :护理主导多部门协作管理模式下的质量改进策略,提高了血培养标本送检率和合格率,降低了血培养标本污染率,提高了护士血培养的知识、态度、行为水平,体现了护士在院感防控工作中的价值。

中医特色护理门诊医护协作出诊实践分析

目的 探讨脾胃病专科中医特色护理门诊医护协作出诊开展的可行性及成效。方法 运用医院选拔原则确定出诊护师,与专科医师合作开设脾胃病专科中医特色护理门诊。通过对2023年医护协作出诊和2019年护师单独出诊的脾胃病专科中医特色护理门诊就诊患者进行问卷调查,分析对医疗护理服务的满意度。结果 脾胃病专科中医特色护理门诊医护协作出诊开展以来,护理门诊量由2019年的35人次/月上升到2023年的148人次/月,出诊时间由2019年的1次/周增设至2023年的3次/周。2023年护理门诊医护协作出诊的就诊患者对医疗护理服务的满意度高于2019年护师单独出诊,差异有统计学意义(P<0.05)。结论 脾胃病专科中医特色护理门诊医护协作出诊的开展,拓展了中医护理服务内涵,满足患者日益增长的个体化、多元化需求,提高患者对医疗护理服务的满意度。

教师联合同伴反馈的实践合作学习模式在创伤护士救护技能培训中的应用

目的 探索基于实践合作学习模式的教师反馈联合同伴反馈在创伤护士救护技能培训中的应用效果。方法 按培训时间将创伤护士分为两组,2023年6-9月参加中国创伤救治培训护理版课程培训的护士514人为对照组,7-10月参加培训的护士510人为试验组。对照组按常规进行创伤救护技能培训,试验组实施基于实践合作学习模式的教师反馈联合同伴反馈的培训方法。培训结束后,对参加培训的创伤护士进行创伤救护知识考核,对试验组进行创伤急救团队配合技能考核,对28名学员进行课后座谈以了解应用效果。结果 试验组创伤救护知识考核成绩显著高于对照组(P<0.05);试验组创伤急救团队配合技能考核总分为85.41±8.68;座谈显示,学员认为此培训形式新颖,可使成员熟悉并掌握创伤急救团队配合流程,团队配合顺畅,但感觉培训压力较大。结论 基于实践合作学习模式的教师反馈联合同伴反馈的创伤救护技能培训,能提高创伤护士创伤救护知识,更好地掌握团队配合技能。

基于决策导向评价的多学科协作团队教学模式在肠造口护理教学中的应用

探讨基于决策导向评价的多学科协作团队教学模式在肠造口护理教学中的应用效果,为提高外科造口护理教学质量提供参考。研究结果表明,该模式有助于提升护生实习成绩、造口护理核心能力、共情能力和教学满意度,值得进一步推广应用。

专病一体化护理联合协同护理模式对老年慢性心力衰竭患者的影响

目的:探讨专病一体化护理联合协同护理模式对老年慢性心力衰竭(CHF)患者的影响。方法:选取2022年2月1日~2023年2月28日收治的98例老年CHF患者作为研究对象,依据入院时间采用抽签法分为对照组和观察组各49例,对照组给予常规护理,观察组在此基础上实施专病一体化护理联合协同护理模式;比较两组入院时、出院时、出院3个月的积极度评分,护理前后生命质量[简明健康状况调查问卷(SF-36)]评分、睡眠质量(明尼苏达心力衰竭睡眠质量量表)评分、自我护理(欧洲心力衰竭自我护理行为量表)评分、汉密顿焦虑量表(HAMA)评分、汉密顿抑郁量表(HAMD)评分,护理满意度。结果:干预后,两组积极度评分逐渐提高(P<0.01),观察组出院时、出院3个月积极度评分高于对照组(P<0.01);护理后,两组生命质量评分高于护理前(P<0.05),且观察组高于对照组(P<0.01);护理后,两组睡眠质量、自我护理评分及HAMA、HAMD评分低于护理前(P<0.05),且观察组低于对照组(P<0.01);观察组护理满意度高于对照组(P<0.01)。结论:专病一体化护理联合协同护理模式能够有效改善CHF患者的不良情绪和积极度,提高睡眠质量和生命质量,提升护理满意度。

循证理念指导下护士-家长协同干预策略在唇腭裂术后护理中的应用

目的:观察循证理念指导下护士-家长协同干预策略在唇腭裂术后护理中的应用效果。方法:选取2021年6月-2022年12月笔者科室收治的90例拟行唇腭裂术患儿,采用随机数字表法分为观察组(n=45)和对照组(n=45)。对照组给予常规术后护理,观察组在对照组基础上引进循证理念指导的护士-家长协同干预策略,两组均持续干预3个月。观察两组患儿术后恢复情况、疼痛程度、应对方式、康复依从性及并发症发生情况。邀请家属对护理模式进行满意度评价。结果:干预后,观察组住院时间、伤口愈合时间均短于对照组,术后72 h、7 d的疼痛评分低于对照组(P<0.05);观察组消极应对因子评分低于对照组,积极应对因子评分高于对照组(P<0.05);观察组Frankl治疗依从性量表评分高于对照组(P<0.05);观察组术后总并发症发生率与对照组比较差异无统计学意义(P<0.05)。结论:循证理念指导下护士-家长协同干预策略的引进可有效提高唇腭裂患儿术后护理效果,改善患儿应对方式和康复依从性,促进患儿术后恢复,提升护理满意度。

专科护士为主导的多学科协作康复护理对心脏瓣膜置换患者术后康复的影响

目的探讨专科护士为主导的多学科协作康复护理对心脏瓣膜置换患者术后康复的影响。方法选择2021年6月至2023年2月于河南省胸科医院行心脏瓣膜置换术治疗的96例患者为研究对象,按照护理方式不同将患者分为对照组和观察组,每组48例。对照组患者给予常规护理干预,观察组患者给予专科护士为主导的多学科协作康复护理干预。记录2组患者术后首次排气时间、首次排便时间、首次下床活动时间及重症监护时间、住院时间;于出院时、术后6个月时,采用6 min步行距离试验和明尼苏达心力衰竭生活质量量表(MLHFQ)评估患者的心功能状态和生活质量;术后6个月,记录2组患者不良心脏事件发生率。结果观察组患者首次排气时间、首次排便时间、首次下床时间、重症监护时间和住院时间显著短于对照组(P<0.05)。出院时,2组患者6 min步行距离比较差异无统计学意义(P>0.05);术后6个月,2组患者6 min步行距离显著长于出院时,且观察组患者6 min步行距离显著长于对照组(P<0.05)。出院时,2组患者MLHFQ评分比较差异无统计学意义(P>0.05);术后6个月,2组患者MLHFQ评分显著低于出院时,且观察组患者MLHFQ评分显著低于对照组(P<0.05)。对照组患者发生不良心脏事件8例(16.67%),观察组患者发生不良心脏事件2例(4.17%);观察组患者不良心脏事件发生率显著低于对照组(χ^(2)=4.019,P<0.05)。结论专科护士为主导的多学科协作康复护理可缩短心脏瓣膜置换患者术后恢复时间,改善心功能和生活质量,减少不良心脏事件的发生。