Nurses’ clinical alarm-related behaviors and influencing factors in China

Objective:To explore the nurses’behaviors regarding clinical alarms,analyze the related influencing factors,and provide rationales for alarm management.Methods:A cross-sectional survey was conducted in China.The self-made questionnaire of nurses’clinical alarm-related knowledge,attitude,and behavior(NCAKAB)was used.Results:The valid response rate was 98.66%(n=2368).The average nurses’clinical alarm-related behaviors(NCAB)score was 65.14±7.95(out of 85).The dimension scores of NCAB from high to low were alarm learning(4.02±0.85,out of 5),alarm response(27.99±3.64,out of 35),alarm setting(19.24±3.88,out of 25),alarm recognition(7.63±1.68,out of 10)and alarm notification(6.25±1.84,out of 10).There were significant differences in alarm behavior scores between nurses of different ages(F=4.619,P=0.000),nursing stints(F=9.564,P=0.000),professional titles(F=4.425,P=0.004),departments(F=9.166,P=0.000),and hospital levels(t=2.705,P=0.007).The study showed that nurses’total alarm behavior scores were positively correlated with the total alarm knowledge score(r=0.267;P<0.001)and the total alarm attitude score(r=438;P<0.001).Conclusions:Nurses scored highest in alarm learning,followed by alarm response,alarm setting,alarm recognition,and alarm notification behavior.The factors that influenced alarm behavior included age,title,department,nursing stint,hospital level,professional title,alarm-related training,willingness to participate in alarm-related training,whether or not departments have improved alarm management over the last 3 years,and whether or not departments have formulated norms for alarm management.Nurses with higher scores for clinical alarm knowledge had higher correlating scores for alarm behavior;similarly,nurses with higher scores for clinical alarm attitude had higher scores for alarm-related behavior.

Optimized cutoff maternal age for adverse obstetrical outcomes: a multicenter retrospective cohort study in Urban China during 2011 to 2012

Background:China’s two-child policy has led to a trend of aging in pregnancy which was associated with adverse outcomes.This study aimed to identify the clinically cutoff maternal age for adverse obstetric outcomes in China.Methods:This secondary analysis of a multicenter retrospective cohort study included data of childbearing women from 39 hospitals collected in urban China during 2011 to 2012.Logistic regression was used to assess the adjusted odds ratios(aOR)of adverse outcomes in different age groups in comparison to women aged 20 to 24 years.The adjustments included the location of the hospital,educational level,and residence status.Clinically cutoff age was defined as the age above which the aOR continuously become both statistically(P<0.05)and clinically(aOR>2)significant.Results:Overall,108,059 women were recruited.In primiparae,clinically cutoff maternal ages for gestational diabetes(aOR:2.136,95%confidence interval[CI]:1.856-2.458,P<0.001),placenta previa(aOR:2.400,95%CI:1.863-3.090,P<0.001),cesarean section(aOR:2.511,95%CI:2.341-2.694,P<0.001),hypertensive disorder(aOR:2.122,95%CI:1.753-2.569,P<0.001),post-partum hemorrhage(aOR:2.129,95%CI:1.334-3.397,P<0.001),and low birth weight(aOR:2.174,95%CI:1.615-2.927,P<0.001)were 27,31,33,37,41,and 41 years,respectively.In multiparae,clinically cutoff ages for gestational diabetes(aOR:2.977,95%CI:1.808-4.904,P<0.001),hypertensive disorder(aOR:2.555,95%CI:1.836-3.554,P<0.001),cesarean section(aOR:2.224,95%CI:1.952-2.534,P<0.001),post-partum hemorrhage(aOR:2.140,95%CI:1.472-3.110,P<0.001),placenta previa(aOR:2.272,95%CI:1.375-3.756,P<0.001),macrosomia(aOR:2.215,95%CI:1.552-3.161,P<0.001),and neonatal asphyxia(aOR:2.132,95%CI:1.461-3.110,P<0.001)were 29,31,33,35,35,41,and 41 years,respectively.Conclusions:Early cutoff ages for gestational diabetes and cesarean section highlight a reasonable childbearing age in urban China.The various optimized cutoff ages for different adverse pregnancy outcomes should be carefully considered in childbearing women.