Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyz...Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare systems.The practice of direct discharge from the ICU presents both opportunities and complexities.While it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support mechanisms.Implementing this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the transition.Through critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal recovery.The insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare processes.Ultimately,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies.展开更多
BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion...BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.展开更多
In this paper, to effectively treat chronic disorders and improve the standard of care, effective communication between patients and healthcare professionals was essential. The aim of the study was to review the liter...In this paper, to effectively treat chronic disorders and improve the standard of care, effective communication between patients and healthcare professionals was essential. The aim of the study was to review the literature on how good communication might improve treatment outcomes for Kenyan patients with chronic and terminal illnesses and to determine whether Cybernetic electronic communication can improve those outcomes even more. We uncovered the history of treatment outcomes for chronic and terminal diseases in this research study, both with and without communication at the core of the patient’s care plan. We discussed the importance of good communication in the treatment of patients with chronic and terminal illnesses and why it is a momentous endeavor comparable to medical diagnosis and treatment for the long-term health of patients. To locate pertinent material for the background literature study, we carried out a comprehensive literature search. Although the preliminary literature review was a continuation of the introduction research, it also highlighted the paucity of local Kenyan literature and suggested that improved communication might help patients with chronic and terminal illnesses have better treatment outcome. Methodology maintained the literature search, as a systematic literature review focused on core of the study, making separate sections of the same body necessary. This ensured that a methodological literature search section is as comprehensive as possible. We used an integrated PRISM model to limit a comprehensive literature search and a systematic literature review design as part of the overall process. Non-probability sampling and snowball approaches on literary papers over the previous 17 years were used in this arrangement. Since this was a multidisciplinary study, the four experts who also serve as authors were chosen from within their respective fields of expertise to design the study. They created search strategies, generated key words, looked up keywords in database engines, assessed the results of the literature using the PRISMA logical model, looked over successful literature, and triangulated their findings. The conclusions of the experts individually revealed a convergence of thoughts, beliefs, and practices across. The study concluded that even though there isn’t much research done in Kenya on the same subject;what is available illustrates how crucial good communication is for patients with chronic illnesses. The study’s findings also highlighted the positive effects of effective communication between patients and healthcare professionals on treatment plan adherence, patient satisfaction, and overall health outcomes. The results also noted that in order to improve patient care and outcome, Kenyan healthcare workers should underscore developing their communication skills. The study also found that the incorporation of cybernetics is crucial if a truly effective communication is required so as to enable centered care for patients with long-term diseases in Kenya. The goal of the Cybernetics is to activate genuinely effective communication in the care of Patients with long-term disease in Kenya. This study is organized to begin with an abstract, followed by keywords, an introduction, literature review, methodology, findings, discussion, and finally conclusions.展开更多
Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses ...Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses in the context of patient safety. We conducted a search of the published literature from Europe, Australia and the USA in the following databases: Cinahl, Cochrane, Maternity and Infant Care, Ovid, Pro-quest and PubMed, guided by PRISMA procedures. A total of 427 studies were screened, 15 full papers retrieved and nine studies included in the final thematic analysis. The selected papers address a broad spectrum of adverse patient safety events in obstetric care. The themes that emerged were: type of AEs, near-misses and their consequences, strategies to support and improve Patient Safety (PS) and domains related to the WHO Patient Safety competence outcomes. The findings of the first theme were grouped into the following categories: healthcare professionals’ perspectives on ethical conflicts, attributing blame and responsibility, and patients’ perspectives on lack of trust and involvement, as well as medication errors. The second theme, strategies to support interventions to improve PS, was based on two sub-themes: communicating effectively and gaining competence by learning from adverse events, while the third theme was domains related to the WHO Patient Safety competence outcomes. In conclusion, few studies have examined strategies for managing AEs despite the existence of programmes that target the implementation of changes, such as improved teamwork training. In addition to exploring strategies to make safety a priority for patients and healthcare professionals, it is of the utmost importance to improve communication with patients and between professionals in order to maintain and enhance safety. Efforts by organizations and individuals to continuously develop knowledge about the risk of AEs and the use of best practice guidelines are also essential.展开更多
Objective:To explore the preventive effect of comprehensive nursing intervention on arteriovenous fistula failure in patients in the hemodialysis room.Methods:82 patients with arteriovenous fistula in the hemodialysis...Objective:To explore the preventive effect of comprehensive nursing intervention on arteriovenous fistula failure in patients in the hemodialysis room.Methods:82 patients with arteriovenous fistula in the hemodialysis chamber treated in our hospital from July 2022 to October 2023 were selected as the research subjects.The random number table method divided them into a control group and an experimental group of 41 cases each.The control group received general nursing intervention measures,while the experimental group underwent comprehensive nursing intervention.The incidence of complications(internal fistula failure,bleeding,thrombosis,infection),psychological emotions(SAS scale,SDS scale),quality of life(physical pain,physiological function,emotional function,social function),and nursing satisfaction(very satisfied,basically satisfied,satisfied,dissatisfied)were compared between the two groups of patients.Results:The incidence of complications in the experimental group(4,9.76%)was significantly lower than that in the control group(29,70.73%);the SAS scores and SDS scores of the patients in the experimental group after intervention were both lower than those in the control group;the quality of life score(physical pain,physiological function,emotional function,and social function)was all higher than those of the control group;the post-intervention nursing satisfaction of the experimental group(40,97.57%)was also significantly higher than that of the control group(29,73.17%);and the listed differences were statistically significant(P<0.01).Conclusion:For patients with hemodialysis ventricular arteriovenous fistula failure,comprehensive nursing intervention can reduce the incidence of complications,relieve anxiety and stress,improve quality of life and nursing satisfaction,and achieve better preventive effects.展开更多
AIM:To quantify cumulative effective dose of intensive care unit(ICU)patients attributable to diagnostic imaging.METHODS:This was a prospective,interdisciplinary study conducted in the ICU of a large tertiary referral...AIM:To quantify cumulative effective dose of intensive care unit(ICU)patients attributable to diagnostic imaging.METHODS:This was a prospective,interdisciplinary study conducted in the ICU of a large tertiary referral and level 1 trauma center.Demographic and clinical data including age,gender,date of ICU admission,primary reason for ICU admission,APACHE Ⅱ score,length of stay,number of days intubated,date of death or discharge,and re-admission data was collected on all patients admitted over a 1-year period.The overall radiation exposure was quantified by the cumulative effective radiation dose(CED)in millisieverts(mS v)and calculated using reference effective doses published by the United Kingdom National Radiation Protection Board.Pediatric patients were selected for subgroupanalysis.RESULTS:A total of 2737 studies were performedin 421 patients.The total CED was 1704 m Sv with a median CED of 1.5 mS v(IQR 0.04-6.6 mS v).Total CED in pediatric patients was 74.6 mS v with a median CED of 0.07 mS v(IQR 0.01-4.7 mS v).Chest radiography was the most commonly performed examination accounting for 83% of all studies but only 2.7% of total CED.Computed tomography(CT)accounted for 16% of all studies performed and contributed 97% of total CED.Trauma patients received a statistically significant higher dose [median CED 7.7 mS v(IQR 3.5-13.8 mS v)] than medical [median CED 1.4 m Sv(IQR 0.05-5.4 m Sv)] and surgical [median CED 1.6 mS v(IQR 0.04-7.5 mS v)] patients.Length of stay in ICU [OR = 1.12(95%CI:1.079-1.157)] was identified as an independent predictor of receiving a CED greater than 15 mS v.CONCLUSION:Trauma patients and patients with extended ICU admission times are at increased risk of higher CEDs.CED should be minimized where feasible,especially in young patients.展开更多
Objective:In general hospitals,pharmaceutical care was carried out to reduce the incidence of adverse drug reactions(ADR),and this effect was significant.It can significantly reduce the incidence of adverse drug react...Objective:In general hospitals,pharmaceutical care was carried out to reduce the incidence of adverse drug reactions(ADR),and this effect was significant.It can significantly reduce the incidence of adverse drug reactions and improve the safety of drug therapy.The Joint Surgery Department and the Department of Neurology of Changle County People's Hospital in Shandong province were investigated for the effect of pharmaceutical care on reducing adverse drug reactions.Methods:120 patients were selected from the Department of Joint Surgery and Neurology,Changle County People's Hospital,Shandong Province from May 2015 to May 2020.According to the random table method,the patients were divided into experimental group(60 cases)and control group(60 cases).Control group:routine drug therapy.Experimental group:pharmaceutical care treatment was carried out jointly,and the incidence of adverse reactions was compared between the two groups.Results:The incidence of adverse reactions in experimental group was lower than that in control group.Conclusion:In general hospitals,pharmaceutical care is effective in reducing adverse drug reactions,which can significantly reduce the incidence of adverse drug reactions.At the same time,this improves the safety of drug treatment,which is worthy of clinical promotion.展开更多
目的分析总结门诊输注左氧氟沙星注射剂治疗中患者出现不良反应的特点、相关影响因素,试探讨相关预见性护理措施并评价护理效果。方法选取我院门诊2022年6月~2023年6月一年间输注左氧氟沙星注射剂246例。采用随机数表法将246例患者分为...目的分析总结门诊输注左氧氟沙星注射剂治疗中患者出现不良反应的特点、相关影响因素,试探讨相关预见性护理措施并评价护理效果。方法选取我院门诊2022年6月~2023年6月一年间输注左氧氟沙星注射剂246例。采用随机数表法将246例患者分为对照组和干预组,每组123例,对照组给予常规护理,干预组给予预见性护理,比较两组患者不良反应(Adverse drug Reaction,ADR)发生率,经分组护理后,246例患者中其中出现ADR 68例。分析ADR病例的年龄、性别、基础疾病类型、不良反应发生时间、既往用药过敏史、产生ADR时用药次数等特点,总结影响ADR的相关因素。结果6K干预组患者的ADR发生率显著低于对照组(P<0.05);68例ADR中,年龄偏大、具有用药过敏史、不良反应发生时间更早、首次用药即产生ADR、受累器官为中枢神经系统的患者的比率显著更高(P<0.05)。结论年龄偏大、具有用药过敏史、不良反应发生时间更早、首次用药出现ADR的患者在输注左氧氟沙星后更容易出现ADR,针对上述影响因素制定相关预见性护理措施,可有效减少ADR事件,有临床应用价值。展开更多
Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factor...Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factors associated with worse hearing function.Methods We conducted a single-centre retrospective study,and included adult patients admitted to the intensive care unit(ICU)of Kurashiki Central Hospital between January 2014 and September 2019,who had regular pure tone audiometry performed before and after ICU admission.Correlations between changes in PTA threshold and patient characteristics,were evaluated.The included ears were classified as those with worse hearing(>10 dB increase in the PTA threshold)and those without worse hearing,and the baseline characteristics were compared.Results During the study period,125 ears of 71 patients(male:female ratio,35:36;mean age,72.5±12.3 years)met the eligibility criteria.Age,sex,and the use of furosemide were not correlated with changes in PTA threshold.Univariate analysis showed that ears with worse hearing were associated with a lower serum platelet count than ears without worse hearing(153±85×10^(9)/L vs.206±85×10^(9)/L,respectively;P=0.010),and the rate of planned ICU admission(elective surgery)was higher in the worse hearing group(57.1% vs.28.8%,respectively;p=0.011).Conclusions Age,sex,and the use of furosemide did not have adversely affect hearing function.Low serum platelet count and planned admission appear to be risk factors for worse hearing.展开更多
In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and advers...In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.展开更多
文摘Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare systems.The practice of direct discharge from the ICU presents both opportunities and complexities.While it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support mechanisms.Implementing this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the transition.Through critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal recovery.The insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare processes.Ultimately,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies.
基金Supported by Zhejiang Medical and Health Science and Technology Program(Project Name:Construction and Application of Exercise Fear Intervention Program for Elderly Patients with Chronic Heart Failure Based on HBM and TPB Theory),No.2023KY180.
文摘BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.
文摘In this paper, to effectively treat chronic disorders and improve the standard of care, effective communication between patients and healthcare professionals was essential. The aim of the study was to review the literature on how good communication might improve treatment outcomes for Kenyan patients with chronic and terminal illnesses and to determine whether Cybernetic electronic communication can improve those outcomes even more. We uncovered the history of treatment outcomes for chronic and terminal diseases in this research study, both with and without communication at the core of the patient’s care plan. We discussed the importance of good communication in the treatment of patients with chronic and terminal illnesses and why it is a momentous endeavor comparable to medical diagnosis and treatment for the long-term health of patients. To locate pertinent material for the background literature study, we carried out a comprehensive literature search. Although the preliminary literature review was a continuation of the introduction research, it also highlighted the paucity of local Kenyan literature and suggested that improved communication might help patients with chronic and terminal illnesses have better treatment outcome. Methodology maintained the literature search, as a systematic literature review focused on core of the study, making separate sections of the same body necessary. This ensured that a methodological literature search section is as comprehensive as possible. We used an integrated PRISM model to limit a comprehensive literature search and a systematic literature review design as part of the overall process. Non-probability sampling and snowball approaches on literary papers over the previous 17 years were used in this arrangement. Since this was a multidisciplinary study, the four experts who also serve as authors were chosen from within their respective fields of expertise to design the study. They created search strategies, generated key words, looked up keywords in database engines, assessed the results of the literature using the PRISMA logical model, looked over successful literature, and triangulated their findings. The conclusions of the experts individually revealed a convergence of thoughts, beliefs, and practices across. The study concluded that even though there isn’t much research done in Kenya on the same subject;what is available illustrates how crucial good communication is for patients with chronic illnesses. The study’s findings also highlighted the positive effects of effective communication between patients and healthcare professionals on treatment plan adherence, patient satisfaction, and overall health outcomes. The results also noted that in order to improve patient care and outcome, Kenyan healthcare workers should underscore developing their communication skills. The study also found that the incorporation of cybernetics is crucial if a truly effective communication is required so as to enable centered care for patients with long-term diseases in Kenya. The goal of the Cybernetics is to activate genuinely effective communication in the care of Patients with long-term disease in Kenya. This study is organized to begin with an abstract, followed by keywords, an introduction, literature review, methodology, findings, discussion, and finally conclusions.
基金supported by The Japan Society for Promotion of Science(ID No.S15190)and awards to Professor Elisabeth Severinsson for her work at the Department of Midwifery and Women’s Health at the University of Tokyo.
文摘Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses in the context of patient safety. We conducted a search of the published literature from Europe, Australia and the USA in the following databases: Cinahl, Cochrane, Maternity and Infant Care, Ovid, Pro-quest and PubMed, guided by PRISMA procedures. A total of 427 studies were screened, 15 full papers retrieved and nine studies included in the final thematic analysis. The selected papers address a broad spectrum of adverse patient safety events in obstetric care. The themes that emerged were: type of AEs, near-misses and their consequences, strategies to support and improve Patient Safety (PS) and domains related to the WHO Patient Safety competence outcomes. The findings of the first theme were grouped into the following categories: healthcare professionals’ perspectives on ethical conflicts, attributing blame and responsibility, and patients’ perspectives on lack of trust and involvement, as well as medication errors. The second theme, strategies to support interventions to improve PS, was based on two sub-themes: communicating effectively and gaining competence by learning from adverse events, while the third theme was domains related to the WHO Patient Safety competence outcomes. In conclusion, few studies have examined strategies for managing AEs despite the existence of programmes that target the implementation of changes, such as improved teamwork training. In addition to exploring strategies to make safety a priority for patients and healthcare professionals, it is of the utmost importance to improve communication with patients and between professionals in order to maintain and enhance safety. Efforts by organizations and individuals to continuously develop knowledge about the risk of AEs and the use of best practice guidelines are also essential.
文摘Objective:To explore the preventive effect of comprehensive nursing intervention on arteriovenous fistula failure in patients in the hemodialysis room.Methods:82 patients with arteriovenous fistula in the hemodialysis chamber treated in our hospital from July 2022 to October 2023 were selected as the research subjects.The random number table method divided them into a control group and an experimental group of 41 cases each.The control group received general nursing intervention measures,while the experimental group underwent comprehensive nursing intervention.The incidence of complications(internal fistula failure,bleeding,thrombosis,infection),psychological emotions(SAS scale,SDS scale),quality of life(physical pain,physiological function,emotional function,social function),and nursing satisfaction(very satisfied,basically satisfied,satisfied,dissatisfied)were compared between the two groups of patients.Results:The incidence of complications in the experimental group(4,9.76%)was significantly lower than that in the control group(29,70.73%);the SAS scores and SDS scores of the patients in the experimental group after intervention were both lower than those in the control group;the quality of life score(physical pain,physiological function,emotional function,and social function)was all higher than those of the control group;the post-intervention nursing satisfaction of the experimental group(40,97.57%)was also significantly higher than that of the control group(29,73.17%);and the listed differences were statistically significant(P<0.01).Conclusion:For patients with hemodialysis ventricular arteriovenous fistula failure,comprehensive nursing intervention can reduce the incidence of complications,relieve anxiety and stress,improve quality of life and nursing satisfaction,and achieve better preventive effects.
文摘AIM:To quantify cumulative effective dose of intensive care unit(ICU)patients attributable to diagnostic imaging.METHODS:This was a prospective,interdisciplinary study conducted in the ICU of a large tertiary referral and level 1 trauma center.Demographic and clinical data including age,gender,date of ICU admission,primary reason for ICU admission,APACHE Ⅱ score,length of stay,number of days intubated,date of death or discharge,and re-admission data was collected on all patients admitted over a 1-year period.The overall radiation exposure was quantified by the cumulative effective radiation dose(CED)in millisieverts(mS v)and calculated using reference effective doses published by the United Kingdom National Radiation Protection Board.Pediatric patients were selected for subgroupanalysis.RESULTS:A total of 2737 studies were performedin 421 patients.The total CED was 1704 m Sv with a median CED of 1.5 mS v(IQR 0.04-6.6 mS v).Total CED in pediatric patients was 74.6 mS v with a median CED of 0.07 mS v(IQR 0.01-4.7 mS v).Chest radiography was the most commonly performed examination accounting for 83% of all studies but only 2.7% of total CED.Computed tomography(CT)accounted for 16% of all studies performed and contributed 97% of total CED.Trauma patients received a statistically significant higher dose [median CED 7.7 mS v(IQR 3.5-13.8 mS v)] than medical [median CED 1.4 m Sv(IQR 0.05-5.4 m Sv)] and surgical [median CED 1.6 mS v(IQR 0.04-7.5 mS v)] patients.Length of stay in ICU [OR = 1.12(95%CI:1.079-1.157)] was identified as an independent predictor of receiving a CED greater than 15 mS v.CONCLUSION:Trauma patients and patients with extended ICU admission times are at increased risk of higher CEDs.CED should be minimized where feasible,especially in young patients.
基金Key Research Project of Scientific and Educational Innovation in the Institute of Educational Science,Chinese Academy of Management Sciences(Grant No:KJCX5406).
文摘Objective:In general hospitals,pharmaceutical care was carried out to reduce the incidence of adverse drug reactions(ADR),and this effect was significant.It can significantly reduce the incidence of adverse drug reactions and improve the safety of drug therapy.The Joint Surgery Department and the Department of Neurology of Changle County People's Hospital in Shandong province were investigated for the effect of pharmaceutical care on reducing adverse drug reactions.Methods:120 patients were selected from the Department of Joint Surgery and Neurology,Changle County People's Hospital,Shandong Province from May 2015 to May 2020.According to the random table method,the patients were divided into experimental group(60 cases)and control group(60 cases).Control group:routine drug therapy.Experimental group:pharmaceutical care treatment was carried out jointly,and the incidence of adverse reactions was compared between the two groups.Results:The incidence of adverse reactions in experimental group was lower than that in control group.Conclusion:In general hospitals,pharmaceutical care is effective in reducing adverse drug reactions,which can significantly reduce the incidence of adverse drug reactions.At the same time,this improves the safety of drug treatment,which is worthy of clinical promotion.
文摘目的分析总结门诊输注左氧氟沙星注射剂治疗中患者出现不良反应的特点、相关影响因素,试探讨相关预见性护理措施并评价护理效果。方法选取我院门诊2022年6月~2023年6月一年间输注左氧氟沙星注射剂246例。采用随机数表法将246例患者分为对照组和干预组,每组123例,对照组给予常规护理,干预组给予预见性护理,比较两组患者不良反应(Adverse drug Reaction,ADR)发生率,经分组护理后,246例患者中其中出现ADR 68例。分析ADR病例的年龄、性别、基础疾病类型、不良反应发生时间、既往用药过敏史、产生ADR时用药次数等特点,总结影响ADR的相关因素。结果6K干预组患者的ADR发生率显著低于对照组(P<0.05);68例ADR中,年龄偏大、具有用药过敏史、不良反应发生时间更早、首次用药即产生ADR、受累器官为中枢神经系统的患者的比率显著更高(P<0.05)。结论年龄偏大、具有用药过敏史、不良反应发生时间更早、首次用药出现ADR的患者在输注左氧氟沙星后更容易出现ADR,针对上述影响因素制定相关预见性护理措施,可有效减少ADR事件,有临床应用价值。
文摘Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factors associated with worse hearing function.Methods We conducted a single-centre retrospective study,and included adult patients admitted to the intensive care unit(ICU)of Kurashiki Central Hospital between January 2014 and September 2019,who had regular pure tone audiometry performed before and after ICU admission.Correlations between changes in PTA threshold and patient characteristics,were evaluated.The included ears were classified as those with worse hearing(>10 dB increase in the PTA threshold)and those without worse hearing,and the baseline characteristics were compared.Results During the study period,125 ears of 71 patients(male:female ratio,35:36;mean age,72.5±12.3 years)met the eligibility criteria.Age,sex,and the use of furosemide were not correlated with changes in PTA threshold.Univariate analysis showed that ears with worse hearing were associated with a lower serum platelet count than ears without worse hearing(153±85×10^(9)/L vs.206±85×10^(9)/L,respectively;P=0.010),and the rate of planned ICU admission(elective surgery)was higher in the worse hearing group(57.1% vs.28.8%,respectively;p=0.011).Conclusions Age,sex,and the use of furosemide did not have adversely affect hearing function.Low serum platelet count and planned admission appear to be risk factors for worse hearing.
文摘In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.