Background:The backup nurses are created to meet emergencies in the case of inadequate nursing staff and emergency circumstances,and there are no clear definitions of the core competencies for training and evaluation ...Background:The backup nurses are created to meet emergencies in the case of inadequate nursing staff and emergency circumstances,and there are no clear definitions of the core competencies for training and evaluation of backup nurses in the acute care hospitals in China.Methods:This study used a modified Delphi process where an initial list of potential competencies is established following a framework of training need analysis(TNA),literature review,and focus groups.This process generated as a list of 47 core competencies,which is presented to an expert panel(n=20)for consideration in two rounds.Results:As determined by the survey,a combination of 26 core competencies in three specified categories is identified:professional practice ability,critical thinking ability,and interpersonal skills.A total of 154.99 h is required to complete all 26 core competencies,and each item has a corresponding evaluation method.Conclusions:The core competencies provide a scientific basis for the hospital nursing managers to train and evaluate backup nurses,and it may ensure consistency in standards across the country.展开更多
With decades of hard work,socialism with Chinese characteristics has crossed the threshold into a new era.The transformation of the principal contradiction in the new era has imposed new and higher requirements on the...With decades of hard work,socialism with Chinese characteristics has crossed the threshold into a new era.The transformation of the principal contradiction in the new era has imposed new and higher requirements on the rural elderly care service system.However,the current service system based on welfare-multiplex and urban community environment is often difficult to operate in the rural areas of central and western China.And the urban home care service for the aged is inappropriate to the rural reality;community service for the aged faces difficulties in practice;institution care for the aged develops slowly;the synergy among different elderly care service models is poor.Through observing the rural areas of central and western China in the field for a long time,this paper proposes to build the rural elderly care service system based on family supporting,supported by community mutual assistance care,supplemented by institution care for the aged,combined with medical care,and localized with diversified forms for targeted groups according to different realities.And the system should follow the fundamental guidance of development-oriented family policy,adhere to the governance mode of multiple subjects with one core and respect rural reality,which could provide a feasible way for the reform and reconstruction of the rural elderly care service system.展开更多
Background: Inadvertent postoperative hypothermia (IPH) is known to be associated with various adverse effects. The aim of this study was to evaluate the incidence, predictors and outcome of core inadvertent hypotherm...Background: Inadvertent postoperative hypothermia (IPH) is known to be associated with various adverse effects. The aim of this study was to evaluate the incidence, predictors and outcome of core inadvertent hypothermia on admission in the post-anesthesia care unit. Methods: Observational, prospective study in a Post-Anesthesia Care Unit. The study population consisted of adult patients after non-cardiac and non-neurologic surgery. Patients’ demographics, intraoperative and postoperative data were collected. Descriptive analysis of variables was used to summarize data and the Mann-Whitney U test, Fisher’s exact test or Chi-square test was used. Univariate and multivariate analyses were done with logistic binary regression with calculation of an Odds Ratio (OR) and its 95% Confidence Interval. Results: The incidence of IPH on admission was 32%. In univariate analysis: age, body mass index (BMI), high risk surgery, revised cardiac risk index (RCRI), type of anesthesia, use of forced-air warming, amount of intravenous crystalloids administrated, duration of anesthesia, duration of surgery and admission visual analogue scale (VAS) for pain > 3 were considered predictors of hypothermia. In multiple logistic regression analysis, age (OR 1.7, P = 0.045, for age > 65 years), RCRI (OR 3.18, P = 0.041, for RCRI > 2), duration of anesthesia (OR 1.52, P < 0.001) and admission VAS for pain (OR 2.05, P = 0.007) were considered independent predictors of IPH. Patients with IPH at PACU admission stay longer in the PACU. Conclusions: IPH was associated with a longer stay in the PACU. Age, comorbidities duration of anesthesia and pain at PACU admission were considered independent predictors for IPH.展开更多
Core body temperature(CBT)is increasingly attracting attention as crucial data during target temperature management(TTM).Accurate and continuous measurement of human CBT can effectively identify and monitor central hi...Core body temperature(CBT)is increasingly attracting attention as crucial data during target temperature management(TTM).Accurate and continuous measurement of human CBT can effectively identify and monitor central high fever,and provide a basis for the effective implementation during TTM,which is therefore of great significance for human health care and disease monitoring.The reliable core measurement sites are nasopharynx,esophagus,bladder,rectum,pulmonary artery,etc.,but the measurement methods in these sites are all invasive.At present,the medical field is more inclined to noninvasive data collection methods through monitoring an appropriate site(such as forehead,mouth,or axilla)depending on clinical circumstances,so as to ensure the comfort and security of patients to the greatest extent.This review will provide reference choosing more safe and accurate temperature measurement methods for patients during TTM by reviewing the sites and accuracy of invasive and noninvasive CBT measurements.展开更多
基金supported by the Science and Technology Bureau of Panyu District,Guangzhou,China (No. 2014-Z03-61)
文摘Background:The backup nurses are created to meet emergencies in the case of inadequate nursing staff and emergency circumstances,and there are no clear definitions of the core competencies for training and evaluation of backup nurses in the acute care hospitals in China.Methods:This study used a modified Delphi process where an initial list of potential competencies is established following a framework of training need analysis(TNA),literature review,and focus groups.This process generated as a list of 47 core competencies,which is presented to an expert panel(n=20)for consideration in two rounds.Results:As determined by the survey,a combination of 26 core competencies in three specified categories is identified:professional practice ability,critical thinking ability,and interpersonal skills.A total of 154.99 h is required to complete all 26 core competencies,and each item has a corresponding evaluation method.Conclusions:The core competencies provide a scientific basis for the hospital nursing managers to train and evaluate backup nurses,and it may ensure consistency in standards across the country.
文摘With decades of hard work,socialism with Chinese characteristics has crossed the threshold into a new era.The transformation of the principal contradiction in the new era has imposed new and higher requirements on the rural elderly care service system.However,the current service system based on welfare-multiplex and urban community environment is often difficult to operate in the rural areas of central and western China.And the urban home care service for the aged is inappropriate to the rural reality;community service for the aged faces difficulties in practice;institution care for the aged develops slowly;the synergy among different elderly care service models is poor.Through observing the rural areas of central and western China in the field for a long time,this paper proposes to build the rural elderly care service system based on family supporting,supported by community mutual assistance care,supplemented by institution care for the aged,combined with medical care,and localized with diversified forms for targeted groups according to different realities.And the system should follow the fundamental guidance of development-oriented family policy,adhere to the governance mode of multiple subjects with one core and respect rural reality,which could provide a feasible way for the reform and reconstruction of the rural elderly care service system.
文摘Background: Inadvertent postoperative hypothermia (IPH) is known to be associated with various adverse effects. The aim of this study was to evaluate the incidence, predictors and outcome of core inadvertent hypothermia on admission in the post-anesthesia care unit. Methods: Observational, prospective study in a Post-Anesthesia Care Unit. The study population consisted of adult patients after non-cardiac and non-neurologic surgery. Patients’ demographics, intraoperative and postoperative data were collected. Descriptive analysis of variables was used to summarize data and the Mann-Whitney U test, Fisher’s exact test or Chi-square test was used. Univariate and multivariate analyses were done with logistic binary regression with calculation of an Odds Ratio (OR) and its 95% Confidence Interval. Results: The incidence of IPH on admission was 32%. In univariate analysis: age, body mass index (BMI), high risk surgery, revised cardiac risk index (RCRI), type of anesthesia, use of forced-air warming, amount of intravenous crystalloids administrated, duration of anesthesia, duration of surgery and admission visual analogue scale (VAS) for pain > 3 were considered predictors of hypothermia. In multiple logistic regression analysis, age (OR 1.7, P = 0.045, for age > 65 years), RCRI (OR 3.18, P = 0.041, for RCRI > 2), duration of anesthesia (OR 1.52, P < 0.001) and admission VAS for pain (OR 2.05, P = 0.007) were considered independent predictors of IPH. Patients with IPH at PACU admission stay longer in the PACU. Conclusions: IPH was associated with a longer stay in the PACU. Age, comorbidities duration of anesthesia and pain at PACU admission were considered independent predictors for IPH.
基金supported by the Young Teacher Project of Beijing University of Chinese Medicine(No.:2018-JYB-JS155).
文摘Core body temperature(CBT)is increasingly attracting attention as crucial data during target temperature management(TTM).Accurate and continuous measurement of human CBT can effectively identify and monitor central high fever,and provide a basis for the effective implementation during TTM,which is therefore of great significance for human health care and disease monitoring.The reliable core measurement sites are nasopharynx,esophagus,bladder,rectum,pulmonary artery,etc.,but the measurement methods in these sites are all invasive.At present,the medical field is more inclined to noninvasive data collection methods through monitoring an appropriate site(such as forehead,mouth,or axilla)depending on clinical circumstances,so as to ensure the comfort and security of patients to the greatest extent.This review will provide reference choosing more safe and accurate temperature measurement methods for patients during TTM by reviewing the sites and accuracy of invasive and noninvasive CBT measurements.