The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consec...The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.展开更多
Aims and objectives:To evaluate intensive care unit(ICU)nurses'knowledge of the updated guidelines for the prevention of intravascular catheter-related infections;to identify the factors that affect the nurses'...Aims and objectives:To evaluate intensive care unit(ICU)nurses'knowledge of the updated guidelines for the prevention of intravascular catheter-related infections;to identify the factors that affect the nurses'knowledge and to explore the barriers to adherence to evidence-based guidelines in clinical practice in China.Methods:Cross-sectional surveys were carried out in Chinese ICUs from January 2013 to March 2014.The nurses'demographic information,knowledge of the guidelines,and barriers to adherence were assessed by a validated questionnaire and then analyzed statistically.Results:The questionnaires were completed by 455 ICU nurses from 4 provinces of China.The mean score was 8.17 of 20,and higher scores were significantly associated with province,years of experience,and years of ICU experience.Forty-nine(10.7%)nurses had not heard of the guidelines,whereas 231(50.7%)nurses heard of the guidelines but did not receive training for them.Trained nurses'scores were higher than untrained nurses'scores.The three main barriers to compliance with the guidelines were an unfamiliarity with them,an excessive workload due to a shortage of nurses,and a lack of training.Conclusions:ICU nurses'knowledge of the updated guidelines is quite low,which could be a potential risk factor for patient safety.Multidisciplinary interventions and continuous.展开更多
Objective The aim of the study was to evaluate catheter-related infection rate(CRIR)for patients receiving minimally invasive esophagectomy(MIE),to identify the optimal catheterization approach and relationship betwee...Objective The aim of the study was to evaluate catheter-related infection rate(CRIR)for patients receiving minimally invasive esophagectomy(MIE),to identify the optimal catheterization approach and relationship between CRIR and post-operative complications.Methods In total,168 patients with esophageal carcinoma and undergoing MIE combined with preoperative deep venous catheterization(DVC)were analyzed in our institution(Qingdao Municipal Hospital,China),from 2014 to 2018.After completing DVC,catheter-tips together with intraductal venous blood samples were sent to the microbiology lab for bacterial strain culture.CRIR was statistically evaluated for the following clinical variables:gender,age,smoking status,drinking status,past history,tumor location,histologic grade,pathological T,N,and M category,anastomotic location,anastomotic leakage,anastomotic stricture,chylothorax,pneumonia,recurrent laryngeal nerve(RLN)injury,reflux esophagitis,catheterization site,and catheter-locking days.Results Among the 144 patients recruited in our study,105 catheters were inserted into the jugular vein and 39 catheters into the subclavian vein.The median age of these patients was 63 years(range:42–79 years),and the median catheter-locking period was seven days(range:4–21 days).Four catheters were identified with three types of strain colonizations,including Staphylococcus epidermidis,Staphylococcus aureus and Blastomyces albicans.Statistical data showed that patients diagnosed with catheter-related infection were likely to incur anastomotic leakage(66.67%,P<0.001)and pneumonia(27.27%,P<0.001);features such as tumors located in the upper esophagus(13.6%,P=0.003),and over seven catheterlocking days(10.00%,P<0.001)were attributed to a high CRIR.Conclusion Although both jugular and subclavian veins can be catheterized for patients with MIE,DVC is associated with more than seven catheter-locking days and upper esophagectomy,due to high CRIR.Furthermore,catheter-related infection is related to anastomotic leakage and pneumonia.展开更多
BACKGROUND Mycobacterium abscessus(M.abscessus)is a rapidly growing mycobacterium and ubiquitous in the environment,which infrequently causes disease in humans.However,it can cause cutaneous or respiratory infections ...BACKGROUND Mycobacterium abscessus(M.abscessus)is a rapidly growing mycobacterium and ubiquitous in the environment,which infrequently causes disease in humans.However,it can cause cutaneous or respiratory infections among immunocompromised hosts.Due to the resistance to most antibiotics,the pathogen is formidable and difficult-to-treat.CASE SUMMARY Here,we present a case of catheter-related M.abscessus infections in a patient with motor neurone disease.Catheter and peripheral blood cultures of the patient showed positive results during Gram staining and acid-fast staining.The alarm time of catheter blood culture was 10.6 h earlier than that of peripheral blood.After removal of the peripherally inserted central catheter,secretion and catheter blood culture were positive.M.abscessus was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and 16S rDNA sequencing.CONCLUSION For catheter-related M.abscessus infection,rapid diagnosis and timely and adequate antimicrobial therapy are crucial.展开更多
Objective:To systematically evaluate the clinical effects of cluster nursing intervention in preventing central venous catheter-related infection in intensive care unit.Methods:A randomized controlled study was search...Objective:To systematically evaluate the clinical effects of cluster nursing intervention in preventing central venous catheter-related infection in intensive care unit.Methods:A randomized controlled study was searched from China National Knowledge Internet(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),Chinese Biomedical Literature Service System(SinoMed),PubMed,Embase and Cochrane library databases from the establishment to May 1,2020.Two reviewers independently evaluated and cross checked the quality of the study.Revman 5.3 was used to conduct the meta-analysis.Results:A total of 21 randomized controlled trials with 6,030 patients were included.Meta-analysis showed that the incidence of central venous catheter-related infection(relative risk(RR)=0.29,95%confidence interval(CI)[0.23,0.37]),the incidence of catheter plugging(RR=0.25,95%CI[0.16,0.39])and catheter prolapse(RR=0.18,95%CI[0.11,0.29])were significantly different between the two groups.Conclusion:Cluster nursing intervention could prevent central venous catheter-related infection in intensive care unit.展开更多
文摘The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.
文摘Aims and objectives:To evaluate intensive care unit(ICU)nurses'knowledge of the updated guidelines for the prevention of intravascular catheter-related infections;to identify the factors that affect the nurses'knowledge and to explore the barriers to adherence to evidence-based guidelines in clinical practice in China.Methods:Cross-sectional surveys were carried out in Chinese ICUs from January 2013 to March 2014.The nurses'demographic information,knowledge of the guidelines,and barriers to adherence were assessed by a validated questionnaire and then analyzed statistically.Results:The questionnaires were completed by 455 ICU nurses from 4 provinces of China.The mean score was 8.17 of 20,and higher scores were significantly associated with province,years of experience,and years of ICU experience.Forty-nine(10.7%)nurses had not heard of the guidelines,whereas 231(50.7%)nurses heard of the guidelines but did not receive training for them.Trained nurses'scores were higher than untrained nurses'scores.The three main barriers to compliance with the guidelines were an unfamiliarity with them,an excessive workload due to a shortage of nurses,and a lack of training.Conclusions:ICU nurses'knowledge of the updated guidelines is quite low,which could be a potential risk factor for patient safety.Multidisciplinary interventions and continuous.
文摘Objective The aim of the study was to evaluate catheter-related infection rate(CRIR)for patients receiving minimally invasive esophagectomy(MIE),to identify the optimal catheterization approach and relationship between CRIR and post-operative complications.Methods In total,168 patients with esophageal carcinoma and undergoing MIE combined with preoperative deep venous catheterization(DVC)were analyzed in our institution(Qingdao Municipal Hospital,China),from 2014 to 2018.After completing DVC,catheter-tips together with intraductal venous blood samples were sent to the microbiology lab for bacterial strain culture.CRIR was statistically evaluated for the following clinical variables:gender,age,smoking status,drinking status,past history,tumor location,histologic grade,pathological T,N,and M category,anastomotic location,anastomotic leakage,anastomotic stricture,chylothorax,pneumonia,recurrent laryngeal nerve(RLN)injury,reflux esophagitis,catheterization site,and catheter-locking days.Results Among the 144 patients recruited in our study,105 catheters were inserted into the jugular vein and 39 catheters into the subclavian vein.The median age of these patients was 63 years(range:42–79 years),and the median catheter-locking period was seven days(range:4–21 days).Four catheters were identified with three types of strain colonizations,including Staphylococcus epidermidis,Staphylococcus aureus and Blastomyces albicans.Statistical data showed that patients diagnosed with catheter-related infection were likely to incur anastomotic leakage(66.67%,P<0.001)and pneumonia(27.27%,P<0.001);features such as tumors located in the upper esophagus(13.6%,P=0.003),and over seven catheterlocking days(10.00%,P<0.001)were attributed to a high CRIR.Conclusion Although both jugular and subclavian veins can be catheterized for patients with MIE,DVC is associated with more than seven catheter-locking days and upper esophagectomy,due to high CRIR.Furthermore,catheter-related infection is related to anastomotic leakage and pneumonia.
文摘BACKGROUND Mycobacterium abscessus(M.abscessus)is a rapidly growing mycobacterium and ubiquitous in the environment,which infrequently causes disease in humans.However,it can cause cutaneous or respiratory infections among immunocompromised hosts.Due to the resistance to most antibiotics,the pathogen is formidable and difficult-to-treat.CASE SUMMARY Here,we present a case of catheter-related M.abscessus infections in a patient with motor neurone disease.Catheter and peripheral blood cultures of the patient showed positive results during Gram staining and acid-fast staining.The alarm time of catheter blood culture was 10.6 h earlier than that of peripheral blood.After removal of the peripherally inserted central catheter,secretion and catheter blood culture were positive.M.abscessus was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and 16S rDNA sequencing.CONCLUSION For catheter-related M.abscessus infection,rapid diagnosis and timely and adequate antimicrobial therapy are crucial.
文摘Objective:To systematically evaluate the clinical effects of cluster nursing intervention in preventing central venous catheter-related infection in intensive care unit.Methods:A randomized controlled study was searched from China National Knowledge Internet(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),Chinese Biomedical Literature Service System(SinoMed),PubMed,Embase and Cochrane library databases from the establishment to May 1,2020.Two reviewers independently evaluated and cross checked the quality of the study.Revman 5.3 was used to conduct the meta-analysis.Results:A total of 21 randomized controlled trials with 6,030 patients were included.Meta-analysis showed that the incidence of central venous catheter-related infection(relative risk(RR)=0.29,95%confidence interval(CI)[0.23,0.37]),the incidence of catheter plugging(RR=0.25,95%CI[0.16,0.39])and catheter prolapse(RR=0.18,95%CI[0.11,0.29])were significantly different between the two groups.Conclusion:Cluster nursing intervention could prevent central venous catheter-related infection in intensive care unit.
