基于TeamSTEPPS的出院准备联动干预在老年缺血性卒中患者中的应用

目的探讨基于Team STEPPS的出院准备联动干预在老年缺血性卒中患者中的应用。方法选取2022年10月—2023年9月在安徽医科大学附属巢湖医院神经内科住院的106例老年缺血性卒中患者为研究对象,按入院时间将2022年10月—2023年3月入院的51例患者作为对照组,予以常规出院护理及随访;2023年4月—2023年9月入院的55例患者为干预组,实施基于Team STEPPS的出院准备联动干预。比较两组患者的出院准备度、主要照顾者过渡期的准备情况以及出院90 d患者日常生活活动能力、不良事件发生及非计划再入院情况。结果干预组患者出院准备度评估量表总分及4个维度得分、主要照顾者过渡期准备情况评估量表总分及8个维度得分均高于对照组,差异有统计学意义(P均<0.01)。干预组患者出院90 d日常生活活动能力评分为55(40,65)分,高于对照组的40(20,55)分,差异有统计学意义(P<0.01)。干预组患者出院90 d发生跌倒/坠床2例、压力性损伤3例、非计划性拔管4例,均低于对照组的8、10、11例,差异有统计学意义(P均<0.05)。干预组患者出院90 d非计划再入院2例,少于对照组的8例,差异有统计学意义(P=0.046)。结论基于Team STEPPS的出院准备联动干预可提升老年缺血性卒中患者出院准备度,改善主要照顾者过渡期的准备情况,提高患者出院90 d后日常生活活动能力,降低不良事件发生及非计划再入院,为老年缺血性卒中患者出院准备提供一定的临床依据。

基于TeamSTEPPS风险防控模式的护理在气管切开患者感染防控中的应用

目的 探讨基于强化临床表现和医疗安全的团队策略与工具(Team STEPPS)?风险防控模式的护理在气管切开患者感染防控中的应用。方法 选取2021年1月~2022年12月在安庆市第一人民医院入住的82例气管切开患者。其中2021年41例为对照组,实施常规的气管切开术后护理;2022年41例为观察组,在常规的气管切开术后护理基础上,基于Team STEPPS风险防控模式的护理措施。比较两组患者感染高风险事件发生率、医护合作情况、患者满意度。结果 观察组患者感染高风险事件发生率低于对照组,医护合作得分、患者满意度明显高于对照组(P<0.05)。结论 基于Team STEPPS风险防控模式的护理在气管切开患者感染防控中应用,降低了感染风险发生的事件、医护合作程度明显增强,患者的满意度提高显著,值得在临床推广应用。

美国Pac-12 Team Green对我国大学体育赛事可持续发展的启示

本文采用文献资料法、逻辑分析法等研究方法,探究了美国Pac-12 Team Green的发展历程、构成、特征,并提出了其对我国大学体育赛事可持续发展工作的启示。研究认为:Pac-12 Team Green是美国大学体育界中首创的可持续性发展平台,主要的发展特征是贯彻绿色与可持续发展理念、多元化合作与资源整合、赛事融入绿色科技。Pac-12 Team Green对我国大学开展可持续发展工作的启示:成立绿色体育联盟、制定体育赛事绿色可持续发展评价标准、大学体育赛事融入可持续发展理念、加大对体育赛事可持续发展实践的宣传。

Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery

BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

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.

Normothermic regional perfusion mobile teams in controlled donation after circulatory death pathway: Evidence and peculiarities

To facilitate the implementation of controlled donation after circulatory death(cDCD)programs even in hospitals not equipped with a local Extracorporeal Membrane Oxygenation(ECMO)team(Spokes),some countries and Italian Regions have launched a local cDCD network with a ECMO mobile team who move from Hub hospitals to Spokes for normothermic regional perfusion(NRP)implantation in the setting of a cDCD pathway.While ECMO teams have been clearly defined by the Extracorporeal Life Support Organization,regarding composition,responsibilities and training programs,no clear,widely accepted indications are to date available for NRP teams.Although existing NRP mobile networks were developed due to the urgent need to increase the number of cDCDs,there is now the necessity for transplantation medicine to identify the peculiarities and responsibility of a NRP team for all those centers launching a cDCD pathway.Thus,in the present manuscript we summarized the character-istics of an ECMO mobile team,highlighting similarities and differences with the NRP mobile team.We also assessed existing evidence on NRP teams with the goal of identifying the characteristic and essential features of an NRP mobile team for a cDCD program,especially for those centers who are starting the program.Differences were identified between the mobile ECMO team and NRP mobile team.The common essential feature for both mobile teams is high skills and experience to reduce complications and,in the case of cDCD,to reduce the total warm ischemic time.Dedicated training programs should be developed for the launch of de novo NRP teams.

Development of an Information-Based Leadership Evaluation Index System for School Management Teams:A Comprehensive Approach

In the context of educational informatization reform,there are many uncertain factors in the process of education development.To optimize the educational environment so that it can be effectively combined with information technology,teachers need to change their teaching ideas,strengthen the school’s own adaptability to informatization,and promote the development of informatization construction in schools.As a branch of information leadership,the management team should establish an evaluation index system for information leadership in order to ensure the construction of school informatization,so as to provide a boost for the integration of school resources and information technology.Based on the overview and connotation of information-based leadership of the management team,this paper explores the construction of an evaluation index system of information-based leadership of the school management team,aiming to provide references for the research of relevant personnel in the future.

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.

Optimizing University Faculty Teams: Addressing the Talent Mobility Challenges in the Context of “Double First-Class” Initiative

With the advancement of the“Double First-Class”initiative,universities are increasingly focusing on attracting top-tier talent to enhance faculty quality and strengthen academic disciplines.The blind competition for high-end talent among universities reflects an overshadowing of academic values by economic considerations,neglecting the growth patterns of top talent and the development laws of higher education.This study investigates and reflects on the real-world challenges of faculty mobility in universities,aiming to provide effective guidance for managing university faculty teams.

Evaluation of Attending Medical Teams and Their Impact on the DRG Components of Cholecystectomy

Objective:This study assessed the role of the attending medical team in the cost control of the cholecystectomy DRG components.Methods:The association between team structure,workflow,and treatment outcomes was analyzed using a mixed-methods approach combining quantitative data and qualitative interviews from 628 patients.Results:Inter-professional teamwork significantly affected length of stay,treatment costs,and recurrence rates,with experienced teams performing better in terms of emergency response and collaborative efficiency.Patient satisfaction was generally high,indicating that good teamwork enhances treatment outcomes.Significance:The study highlights the importance of optimizing team configuration to improve the quality,efficiency,and cost control of healthcare.

敦煌文化在数字领域中的设计研究——以Team Lab为例

敦煌壁画在中国古代艺术中占据着至关重要的地位,其独特的艺术风格和丰富的文化内涵使其成为中国古代文化的瑰宝之一。而提及对敦煌壁画的保护和传承,“数字敦煌”居功至伟。在此基础上,敦煌壁画的数字艺术设计得以蓬勃发展。本文旨在探究敦煌壁画在数字领域下的设计研究,通过对日本Team Lab及其作品的分析,探索敦煌文化在数字领域中的设计创新实践及其所面临的挑战,并展望其未来的发展。

TeamSTEPPS模式在消化内镜室综合管理中的应用效果

目的探讨提高医疗质量与患者安全的团队策略和工具包(TeamSTEPPS)模式在消化内镜室综合管理中的应用效果。方法选取2021年6月至2022年2月河南省直第三人民医院消化内镜室收治的118例肠息肉患者作为对照组,接受常规管理;选取2022年3—9月河南省直第三人民医院消化内镜室收治的126例肠息肉患者作为研究组,接受TeamSTEPPS模式综合管理。对比两组护理风险、不良事件发生率、护理质量、患者满意度。结果两组管理后护理风险评分均高于管理前(P<0.05),研究组管理后急救药品、消毒隔离、护理安全、仪器使用以及岗位安全等护理风险评分高于对照组(P<0.05);研究组不良事件发生率低于对照组(P<0.05);两组管理后护理质量评分高于管理前(P<0.05),管理后,相较于对照组,研究组技能操作、专科护理、病房护理、基础护理、消毒护理及分级护理评分均较高(P<0.05);研究组患者对服务态度、手术护理、专业素质等护理满意度高于对照组(P<0.05)。结论TeamSTEPPS模式下综合管理有助于减少消化内镜室护理不良事件发生,提高护理质量与患者对护理满意度。

基于Team STEPPS的出院准备护理对股骨头缺血性坏死术后患者的影响

目的:研究基于提高医疗质量和患者安全的团队策略和工具包(team strategies and tools to enhance performance and patient safety,Team STEPPS)的出院准备护理对股骨头缺血性坏死(ANFH)术后患者的影响。方法:选取清远市人民医院2022年1—8月收治的76例ANFH术后患者为研究对象,采用随机数字表法分为观察组和对照组,各38例。对照组实施术后常规护理,观察组在对照组基础上实施基于Team STEPPS的出院准备护理。对比两组自我管理能力、遵医行为情况。结果:护理后,两组运动锻炼、认知性症状管理与实践、与医生交流得分及总分升高,观察组高于对照组(P<0.05);护理后,两组功能锻炼、工作活动、日常起居、定期复查得分及总分升高,观察组高于对照组(P<0.05)。结论:基于Team STEPPS的出院准备护理可以提高ANFH患者术后居家自我管理能力及遵医行为。

Challenges of Nurse Tutors’ Classroom and Clinical Performance When Teaching

Introduction: Nursing is a dual profession that involves teaching both in class and at the clinical area. Nurse tutors meet a lot of challenges in their profession through their cognitive, affective and psychomotor nursing performance. The aim of this paper is to determine the challenges of nurse tutor clinical affective, cognitive and psychomotor performance in Malawi. Methods: Mixed methods design was employed. Quantitatively, 129 students and 82 nurse tutors randomly selected were involved for the five ranked Likert Scale questionnaire, and 42 nurse tutors were involved in in-depth. While 8 focus group discussions were conducted in 8 nursing colleges. Descriptive and inferential statistics were used quantitatively for predictive variable of nurse tutor work experience and student study experience to compare with the dependent variables from the 39 cognitive, affective and psychomotor attributes. Results: Both nurse tutors and students are not impressed with nurse tutors cognitive, affective and psychomotor performance during teaching. There is inadequate clinical orientation to students [OR ≤ 0.302;95%CI (0.096 ± 2.955);p ≥ 0.042] and inadequate funding from college administration [OR ≤ 1.013;95%CI (0.271 ± 3.793);p ≥ 0.985] as a result it creates much pressure on teaching. Conclusion: There is a need to develop an effective teaching strategy that would be conducive and easy to use for the limited resource environments in Malawi.

基于Team STEPPS模型强化呼吸道管理在机械通气病人中的应用

目的:探讨基于Team STEPPS模型强化呼吸道管理在机械通气病人中的应用。方法:回顾性分析2022年1月—11月在医院重症监护室(ICU)接受机械通气的124例病人的临床资料,根据气道管理方式不同分为对照组(50例)和研究组(74例)。对照组病人接受常规护理干预,研究组病人接受基于Team STEPPS模型强化呼吸道管理。比较两组机械通气时间;ICU入住时间;入住ICU第1天和第7天的动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))及氧合指数变化;并记录两组住院期间并发症发生情况。结果:研究组机械通气时间和ICU入住时间均短于对照组(P<0.05);两组入住ICU第7天PaO_(2)、SaO_(2)及氧合指数高于第1天,且研究组均高于对照组(P<0.05);研究组病人住院期间并发症总发生率低于对照组(P<0.05)。结论:基于Team STEPPS模型的强化呼吸道管理可缩短机械通气病人机械通气时间和ICU入住时间,改善病人血气指标,纠正低氧血症状态,降低并发症发生率,改善病人预后。

Utilization of the Teaching Strategies among Nurse Tutors in Malawi Nursing Colleges

Background: There are numerous teaching strategies that suit the pedagogical learning, but not all can yield the desired outcome and be properly applied by nurse tutors in both classroom and clinical area. Therefore, identifying the utilization of the teaching strategy for nurse tutors is very detrimental in nursing education. Methods: Descriptive exploratory design which utilized both qualitative and sequential quantitative methods was applied to Iterated Purposive Probability Sampling (IPPS) of 10 nursing colleges in Malawi. This was done to 129 student and 82 nurse tutors in two structured questionnaires, 40 in-depth interviews and 10 focus groups. There were 56 variables for the teaching strategy under five ranked Likert scale and the Cronbach’s Alpha was found to be 0.964 without standardisation and it was 0.963 after standardisation. Results: Direct teaching strategies like the lecture method are very common although nurse tutors prefer to combine with other interactive instructions. There is statistical association of use of role play and group discussion methods and nurse tutor work experience with odds ratios of OR ≤ 1.624;CI(0.576 ± 4.579);p ≥ 0.359 and OR ≤ 1.397;CI(0.882 ± 2.306);p ≥ 0.147 respectively. The ability to use different teaching strategies competently is still very limited among nurse tutors in Malawi nursing colleges. This compromises quality of learning among nursing students in the colleges. Conclusion: Developing a new teaching strategy that could combine the different attributes in the variety of the teaching instructions can promote the quality of nursing education in Malawi.

Clinical application of multidisciplinary team-and evidence-based practice project in gynecological patients with perioperative hypothermia

BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97±2.04,which was significantly increased compared with the score of 21.27±1.57 observed by researchers at baseline(P<0.001).The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03±3.16 and 13.93±2.64 to 4.30±1.15 and 3.53±0.78,respectively,with statistically significant differences(P<0.001).The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17±1.68 to 26.93±1.11,also with statistical significance(P<0.001).CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations,improve nurses'awareness and behavioral compliance with gynecological hypothermia management,and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’negative emotions and enhancing their cognitive function.

The Way to Realize the Morality-establishing and Talent-cultivating Responsibilities of Postgraduate Tutors in Agricultural and Forestry Universities

With the continuous expansion of postgraduate enrollment in China,the phenomenon of postgraduate tutors'experiencing dereliction of duties,morality and behavior in colleges and universities has become prominent in recent years.It has repeatedly attracted widespread attention from the whole society,producing a negative impact on postgraduate education.Agricultural and forestry universities take root at the grassroots level,serve agriculture,rural areas and farmers,have simple and practical education characteristics,and have made positive adjustments to mutual assistance between teachers and students,teachers'self-examination and regulatory system.This article analyzes the reasons for the current unethical and dishonest behaviors of postgraduate tutors in colleges and universities from the perspective of postgraduate tutors,and puts forward the implementation mechanism of the morality-establishing and talent-cultivating responsibilities of postgraduate tutors in agricultural and forestry universities combined with the school-running characteristics and practical experience of agricultural and forestry universities,so as to provide a reference for the construction of postgraduate tutor teams in colleges and universities.

Teamwork Optimization with Deep Learning Based Fall Detection for IoT-Enabled Smart Healthcare System

The current advancement in cloud computing,Artificial Intelligence(AI),and the Internet of Things(IoT)transformed the traditional healthcare system into smart healthcare.Healthcare services could be enhanced by incorporating key techniques like AI and IoT.The convergence of AI and IoT provides distinct opportunities in the medical field.Fall is regarded as a primary cause of death or post-traumatic complication for the ageing population.Therefore,earlier detection of older person falls in smart homes is required to improve the survival rate of an individual or provide the necessary support.Lately,the emergence of IoT,AI,smartphones,wearables,and so on making it possible to design fall detection(FD)systems for smart home care.This article introduces a new Teamwork Optimization with Deep Learning based Fall Detection for IoT Enabled Smart Healthcare Systems(TWODLFDSHS).The TWODL-FDSHS technique’s goal is to detect fall events for a smart healthcare system.Initially,the presented TWODL-FDSHS technique exploits IoT devices for the data collection process.Next,the TWODLFDSHS technique applies the TWO with Capsule Network(CapsNet)model for feature extraction.At last,a deep random vector functional link network(DRVFLN)with an Adam optimizer is exploited for fall event detection.A wide range of simulations took place to exhibit the enhanced performance of the presentedTWODL-FDSHS technique.The experimental outcomes stated the enhancements of the TWODL-FDSHS method over other models with increased accuracy of 98.30%on the URFD dataset.