Application and evaluation of improved surgical aseptic technique curriculum in specialty nurse training in Henan Province

Objective:To develop and apply a novel surgical aseptic technique curriculum in specialty training for operating room(OR)nurses.Methods:As surgical environments were improved,related specifications were revised.The proposed surgical aseptic procedure was discussed,improved,and recorded as procedure videos.In the new training program,traditional theoretical lecture training was replaced with sequential theoretical lessons and video demonstration,operation presentation,and skill competition.At the end of the training,the trainees were given questionnaires to assess training outcomes.Differences in student satisfaction regarding the proposed training program and conventional training programs were then compared.Results:A GPA of 3.61±0.58 was recorded after the new training program was implemented.The minimum and maximum average scores of each item were 3.05±0.43 and 4.61±0.33,respectively The satisfaction rate of the trainees in 2013 was significantly higher than that in 2011(t=2.14,P=0.039).Conclusion:Novel surgical aseptic technique and application in the curriculum design of training for OR nurses should be developed to enhance their mastery of theoretical and practical skills and to modify their behaviors.

Research on Improvement Strategies of Psychological Training and Stage Expressiveness in Percussion Performance

With the continuous development of music education,percussion,as an important form of performance,has led to growing attention to the psychological training of its performers.This study aims to explore how psychological factors in percussion performance impact stage expressiveness and to propose corresponding psychological training strategies.By analyzing relevant domestic and international literature,we found that psychological training not only enhances performers’confidence and alleviates performance anxiety but also contributes to an overall improvement in performance quality.This study shows that methods such as emotional management and cognitive restructuring exhibit promising application potential in practice.Therefore,exploring a systematic psychological training program is significant for improving the stage expressiveness of percussion performers.

Anesthetic management for small bowel enteroscopy in a World Gastroenterology Organization Endoscopy Training Center

AIM:To study the anesthetic management of patients undergoing small bowel enteroscopy in the World Gastroenterology Organization(WGO) Endoscopy Training Center in Thailand.METHODS:Patients who underwent small bowel enteroscopy during the period of March 2005 to March 2011 in Siriraj Gastrointestinal Endoscopy Center were retrospectively analyzed.The patients' characteristics,pre-anesthetic problems,anesthetic techniques,anesthetic agents,anesthetic time,type and route of procedure and anesthesia-related complications were assessed.RESULTS:One hundred and forty-four patients underwent this procedure during the study period.The mean age of the patients was 57.6 ± 17.2 years,andmost were American Society of Anesthesiologists(ASA) class Ⅱ(53.2%).Indications for this procedure were gastrointestinal bleeding(59.7%),chronic diarrhea(14.3%),protein losing enteropathy(2.6%) and others(23.4%).Hematologic disease,hypertension,heart disease and electrolyte imbalance were the most common pre-anesthetic problems.General anesthesia with endotracheal tube was the anesthetic technique mainly employed(50.6%).The main anesthetic agents administered were fentanyl,propofol and midazolam.The mean anesthetic time was 94.0 ± 50.5 min.Single balloon and oral(antegrade) intubation was the most common type and route of enteroscopy.The anesthesia-related complication rate was relatively high.The overall and cardiovascular-related complication rates including hypotension in the older patient group(aged ≥ 60 years old) were significantly higher than those in the younger group.CONCLUSION:During anesthetic management for small bowel enteroscopy,special techniques and drugs are not routinely required.However,for safety reasons anesthetic personnel need to optimize the patient's condition.

Constructing a caring training content for nurse managers:a Delphi study

Objective: To design a scientific, feasible caring training content for nurse managers. Methods: Training content came from review of literature;all the content were sorted out, analyzed, and compiled by the research team. Then, a Delphi method was used to collect opinions from experts on the caring training contents. Results: A 22-member multidisciplinary panel was engaged in a two-round Delphi process to assess the importance of the items and to identify any additional elements. Consensus was obtained on 23 items that belonged to four modules. There were 10 items related to caring knowledge and caring ability, six items related to caring leadership, three items related to caring education, and four items related to caring research. Conclusions: The four-module integrated training contents achieved in this study represented the core caring knowledge and skills that a nurse manager who worked in hospital needed to know. Nurse managers can choose any module to have a system learning according to their practical needs, totally or separately.

A Training System of Pear Trees for Simplified High-density Cultivation

In view of the deficiencies of training technologies during constructing pear orchards by modern simplified dense-planting cultivation with ordinary pear seedlings widely used in production,a simple and easy-to-operate training method was proposed,mainly including constructing fence nets,determining low main trunks,leaving buds at the northwest position,multiple bud removal,winding and notching,simplified branch supporting,and simplified branch pulling.

Usefulness of Detailed Analysis with Operative Procedure of Total Laparoscopic Hysterectomy (TLH) Done a Single Surgeon, to Master the Surgical Technique of TLH and Gain Higher Proficiency

Objective: To analyze the relationship between the numbers of cases experienced and the operation time for a single surgeon aiming to master the TLH surgical technique. Material and Methods: Retrospective data analysis of women who underwent TLH for benign diseases between April, 2014 and March, 2016 was conducted by a single surgeon in a single hospital (Showa University of Fujigaoka Hospital). We divided the main procedures of the TLH operation into five sections, and measured the time required for each section. These cases were divided into three groups, group 1, 2, and 3. Results: There were 54 cases of TLH over two years for a single surgeon, and 21 cases that included essential operative procedures were divided into three groups of seven cases each. The average duration of the surgery (min.) was 178.3 ± 48.2 in the group 1, 128.3 ± 15.6 in the group 2, and 111.3 ± 15.9 in the group 3. A significant reduction in the required time was observed between group 1, 2, and 3 groups. As the number of cases increased, the operation time became statistically significantly shorter for every section except B and D. The skill growth rate was different at each section. Conclusion: For a single surgeon, as the number of surgical cases increased, we recognized the increased skill with the procedure in every section and the rate of skill growth differed for different sections. The difference of growth rate for each section implied that the number of operative cases required for a surgeon in each section was different.

Positioning Training Tool for Radiography

Accurate positioning reduces the X-ray exposure of the subject and produces a valuable X-ray image for diagnosis. This paper describes the development of a positioning training tool that supports those studying to be radiological technologists in learning the positioning technique efficiently. Students perform the positioning on a personal computer using a three-dimensional computer graphics (3DCG) phantom constructed from computed tomography (CT) image data and confirm the produced plane image corresponding to the positioned phantom. It is expected that students will be able to undertake positioning training using our tool anywhere and at any time without using X-ray equipment. Repeated use of our training tool will help students attain a deep understanding of anatomy and acquire positioning skills efficiently and accurately.

Effectiveness of one-to-one feedback methods of teaching with proper metered-dose inhaler technique and correcting errors in chronic obstructive lung disease patients

Objective:To determine the most common mistakes made during the use of a metered-dose inhaler(MDI),and the effect of the repeated trainings performed with demonstration method by providing one-to-one feedback on these mistakes.Methods:This is a quasi-experimental study with a control group.A total of 100 chronic obstructive pulmonary disease(COPD)patients(50 in the control group and 50 in the experimental group)were included in the research.“Patient Information Form(PIF)”(to determine the descriptive characteristics of patients)through the face-to-face interview method,using“MDI Skill Assessment Form”(MDISAF)(it is composed of 10 skill steps about the use of MDI)through observation method was used.Patients in both the groups were asked to use MDI and their abilities regarding use of MDI were assessed.Then in the intervention group,usage of MDI was explained by a nurse via demonstration and placebo MDI.Trainings were repeated on days 1,3,and 5 as from hospitalization of the patient.In the intervention group,three methods were used in this study:“face-to-face training,”“one-to-one,”and“with feedbacks and repeated.”Routine training regarding use of MDI was given by the nurses in the clinic to patients in the control group.The use of an MDI was assessed using MDISAF before training and after the training on the first,third and fifth days of hospitalization.On the seventh day,the last measurement was performed.Percentage,chi square,and mean were used to assess the data.Results:After repetitive training with one-to-one feedback,several differences between the groups in favor of the experimental group were found in 7 of the 10 skill levels of the MDI.There was a significant difference after“training”between the groups in the third,fourth,fifth,sixth,seventh,eighth and ninth MDI steps in posttest measurement(P<0.05).Evaluating the skills of the groups to use MDI from pretest to posttest,it was determined that while the intervention group made less mistakes in steps in which mistakes were made mostly,the control group continued to make mistakes.Conclusions:Inhaler technique intervention with repeated,face to face,and one-to-one feedback trainings can significantly enhance the MDI techniques in COPD patients.The patients in the intervention group made less mistakes during MDI application and their application skills improved.It may be asser ted that the training provided to the intervention group was effective for using the device correctly,while the training provided in the clinic for the control group was inadequate.

Effect of sinew-regulating and bone-setting manipulating combined with exercise training in the treatment of joint injury of distal radio-ulnar

Objective: To observe the effect of the joint injury of the distal radio-ulnar joint. Methods: 60 patients with Distal Radioulnar Joint (DRUJ) injury were divided into observation group and control group according to random number method. 30 cases were included in each of the two groups.Before and after treatment in patients with Visual Analogue Scale (Visual Analogue Scale, VAS) score, forearm pronation and supination electromyographic activity, methods of electric integral value (integral electromyogram, iEMG) and Wrist in patients with self assessment Scale (Patient - Rated Wrist Evaluation, PRWE) score evaluation, comparison, and the clinical observation on diagnosis of disease and curative effect of traditional Chinese medicine standard (assessment process by blind method).Results: compared with the two groups before and after treatment, VAS score decreased, forearm pronation and postpronation activity increased, iEMG value increased, and PRWE scale score decreased (all P < 0.05), and the curative effect of the treatment group was better than that of the control group (P < 0.05). The total effective rate of the treatment group [93.3% (28/30)] was higher than that of the control group [50%(15/30), P < 0.05].Conclusion: the combined exercise training of muscle and bone setting technique can effectively alleviate the pain of patients with radial ulnar joint injury, improve the rotation of the forearm, increase the recruitment of the anterior rotatory muscle, and improve the wrist function of patients, and the effect is better than if combined with forearm support fixation.

认知行为治疗联合注意力训练对精神分裂症幻听干预效果的随机对照试验

目的:评价认知行为治疗(CBT)联合注意力训练技术(ATT)对精神分裂症患者幻听的干预效果。方法:选取符合疾病和有关健康问题的国际统计分类第十次修订本(ICD-10)精神分裂症的诊断标准且有幻听症状的患者60例,随机分为CBT组30例(26例完成)和CBT+ATT组30例(25例完成)。CBT组只接受4周的幻听认知行为干预,CBT+ATT组在幻听认知行为基础上增加注意力训练技术干预共6周。在基线及12周后,采用精神症状评定量表-幻听分量表(PSYRATS-AH)和住院精神病人社会功能评定量表(SSPI)评估两组患者的幻听症状及社会功能,采用注意控制量表(ACS)评估CBT+ATT组患者的注意控制能力。结果:12周后,CBT+ATT组PSYRATS-AH总分[(-6.8±2.2)vs.(-4.2±1.5)]及幻听频率、持续时间、痛苦数量、对声音的控制的差值(干预后得分-基线得分)均低于CBT组(均P<0.05),CBT+ATT组SSPI总分[(13.9±2.9)vs.(11.6±4.2)]及因子I、因子III的差值均高于CBT组(均P<0.05)。结论:本研究显示认知行为治疗联合注意力训练可更有效地改善精神分裂症患者的幻听症状和社会功能。

以胜任力为导向的临床护士呼吸治疗培训目标与内容的构建研究

目的在医院呼吸治疗师数量无法满足临床需求的情况下,构建具有科学性和实用性的护士呼吸治疗培训目标与内容,为今后探索医院内培养护士承担呼吸治疗工作提供基础。方法以“Knowledge(知识)、Skill(技能)、Ability(能力)和Other Attributes(其他特质)”为框架,基于文献回顾、半结构式访谈、德尔菲法确定护士呼吸治疗培训目标与内容。结果2轮专家函询问卷的有效回收率为95%(20/21)、100%(20/20),第二轮函询专家的权威系数为0.912。培训目标包含一级条目3项,二级条目24项;培训内容包含4项一级条目(呼吸专业理论知识、呼吸专业治疗技能、职业能力及专业素质、呼吸治疗质量控制与改进)、16项二级条目、81项三级条目。结论本研究构建实用、科学、符合临床需求的护士呼吸治疗培训目标与内容,可为呼吸治疗相关培训及工作的开展提供参考。

中国女子手球队底线射门技术精准化训练设计及效果研究

本文采用文献资料法、逻辑分析法、秩合比法等研究方法,对比分析第25届女子手球世锦赛前8强队伍和中国女子手球队的底线射门技术运用情况。结果显示:(1)中国女子手球队底线射门RSR值分别为0.500、0.494、0.478、0.344,属C级低水平。(2)针对中国女子手球队底线射门技术短板,聚焦“提高底线射门技术水平”,采用“目标分级原则”对训练目标进行三级分解;训练周期划分为4个阶段,每3周为1个训练阶段,每1周为1个训练单元;训练内容分为个人专项射门训练、阵地配合下底线射门训练、快攻反击下底线射门训练。(3)训练效果:底线射门多变性、对抗下射门能力、创造射门机会方面提高明显;底线射门动作改善、区域配合下射门技术运用、疲劳状态时射门能力、控制失误能力方面提高较大;底线专项射门技术和底线阵地射门技术与集训进度呈明显线性正相关趋势。

疼痛专科护士中医疼痛管理培训知识体系的构建研究

目的构建疼痛专科护士中医疼痛管理培训知识体系,为中国疼痛护理人才中医疼痛管理培训提供参考。方法以核心能力理论为指导,通过文献研究和半结构式访谈构建中医疼痛管理培训知识体系初稿,2024年1月—2月采用德尔菲法对17名专家进行2轮函询。结果2轮函询的积极系数分别为100%和94.12%,权威系数均为0.899,肯德尔和谐系数为0.406~0.606(均p<0.001)。最终形成包括5个一级指标、12个二级指标和35个三级指标的疼痛专科护士中医疼痛管理培训知识体系。结论构建的疼痛专科护士中医疼痛管理培训知识体系具有科学性、可靠性,可为中国疼痛护理人才规范化、同质化的中医疼痛管理培训提供指导和借鉴。

中医适宜技术联合盆底肌肉训练治疗产后压力性尿失禁临床观察

目的 对产后压力性尿失禁患者进行中医适宜技术干预治疗,并观察效果。方法 将60例患者随机分为治疗组和训练组,并对其进行相应治疗,观察2组1 h尿垫试验结果、Sandvik尿失禁指数和国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)评分改善情况,以及临床疗效。结果 治疗后,治疗组1 h尿垫试验结果、Sandvik尿失禁指数和ICI-Q-SF评分改善均优于训练组。治疗结束时,治疗组总有效率为86.7%(26/30),高于对照组的63.3%(19/30)(P<0.05)。6个月随访时治疗组总有效率86.7%(26/30)亦高于对照组的56.7%(17/30)(P<0.05)。结论 在产后女性中,压力性尿失禁的发生是值得关注的问题。将中医适宜技术与凯格尔训练联用干预产后压力性尿失禁达到巩固、延长疗效的目的。

气道廓清技术联合三球式呼吸训练在慢性阻塞性肺疾病肺功能改善中的价值分析

目的 分析慢性阻塞性肺疾病(COPD)患者采取气道廓清技术联合三球式呼吸训练对肺功能的改善价值。方法 筛选本院2022年10月至2023年10月收治94例COPD患者进行研究,采用随机数字表法分成对照组和观察组,每组各47例。对照组行常规对症支持治疗与缩唇腹式呼吸训练,观察组在此基础行气道廓清技术联合三球式呼吸训练。治疗前及治疗后(出院前)观察两组患者肺功能、动脉血气分析、呼吸困难量表(MMRC)、COPD自我评估测试问卷(CAT)。结果 治疗后,观察组第1秒用力呼气容积(FEV_(1))、最大呼气中段平均流速(MMEF)高于对照组(P<0.05);两组FEV_(1)/用力肺活量(FVC)比较无统计学意义(P>0.05)。治疗后,观察组血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、pH值高于对照组(P<0.05);二氧化碳分压(PaCO_(2))低于对照组(P<0.05)。治疗后,观察组MMRC评分、CAT评分低于对照组(P<0.05)。结论 COPD患者采取气道廓清技术联合三球式呼吸训练,能够促进肺功能改善,调节血气水平,缓解呼吸困难,提高生活质量。

3D打印模型结合翻转课堂在脊柱外科微创培训中的应用

目的探讨翻转课堂联合3D打印模型教学在脊柱外科微创培训中的应用效果。方法选择2020年5月—2022年5月在浙江大学医学院附属第二医院脊柱外科微创中心进修的42名学员为研究对象,随机分为研究组和对照组,研究组21名进修学员采用翻转课堂联合3D打印模型教学,对照组21名进修学员采用单纯翻转课堂方法进行授课讲解。2组学员分别进行了出科考试测验和满意度问卷调查。结果2组进修学员培训前检测成绩、微创理论知识成绩,差异无统计学意义(P>0.05)。研究组学员在培训结束后其出科脊柱微创临床知识成绩及微创基本技能操作、微创手术技巧提高和总体满意度均高于对照组,差异均有统计学意义(P<0.05)。结论应用3D打印模型教学结合翻转课堂可明显提高脊柱外科进修学员的学习质量和总体满意度,提升脊柱微创培训的效果。为脊柱外科微创培训的一种新型教学模式。

术中吲哚菁绿成像在胃肠外科教学中的运用

目的:比较荧光腹腔镜术中吲哚菁绿成像技术教学法与单纯腹腔镜手术教学法在胃肠外科住培医师教学中的作用与效果差异。方法:选取医院胃肠外科轮转的住培医师86名,随机分成两组,每组43名住培医师,试验组采用腹腔镜技术联合术中吲哚菁绿成像法进行术中教学,对照组采用单纯腹腔镜技术教学。比较两组的出科考试成绩及住培结束后无记名填写的“胃肠外科教学评估”调查问卷。结果:试验组学员的出科考试总成绩优于对照组,差异有统计学意义(P<0.001);在外科解剖项目得分上,试验组学员成绩显著高于对照组(P<0.05)。试验组学员胃肠外科教学评价满意度明显优于对照组,差异有统计学意义(P<0.05)。与对照组相比,试验组学员兴趣度显著提高,差异有统计学意义(P<0.05),学习主动性得到提高,外科解剖难点问题得到解决(P<0.05)。结论:在胃肠外科住培医师带教中,腹腔镜辅助术中吲哚菁绿成像教学法优于单纯腹腔镜手术教学。

以提升研究生核心能力为导向的大型仪器平台工作优化

大型仪器是高校的重要资源,也是研究生科研能力和创新意识培养的重要支撑,平台需要不断优化和完善,从而培养研究生扎实的专业基础、完善的实验技能和持续的创新能力。因此,仪器的管理运行、技术推进、教学辅助和科研助力是大型仪器平台的重要任务。南京农业大学生命科学大型仪器平台从课程设置、教学模式、互动培训等方面强化教学,同时从技术指导、资源积累、科研融合等角度助力科研,促进了学生能力提升和科研进步。大型仪器平台的工作优化对高校的研究生培养起到了很好的辅助作用。

基于多目标进化的超限超重货物运输专列路径优化方法

针对超限超重货物运输专列路径优化问题,引入限界改造和桥梁加固要素,以铁路运能损失、运输时间和运输费用的最小化为优化目标,构建铁路超限超重货物运输专列路径优化模型;考虑专列同时运送多件超限超重货物的特点,设计货物综合投影算法,并以Pareto支配关系框架下的NSGA-Ⅱ多目标进化算法为基础,结合基于移动不可行解的自适应惩罚函数的约束处理技术及超限超重货物运输专列开行特征,提出一种基于多目标进化的铁路超限超重货物运输专列路径优化算法。实例分析结果表明:该方法能高效合理地处理路径优化任务中的多个目标;与常用的3种约束多目标算法相比,设计的优化算法能使计算耗时降低0.24%~29.94%、超体积指标值提高4.25%~13.11%,并得到一组收敛性和多样性更好的相对最优方案。该方法克服了传统专列路径优化中单纯依靠经验或从备选方案中择优的弊端,可为铁路超限超重货物运输专列路径决策提供技术支持。

三分球投篮技术及其训练方法的研究

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