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。

Team STEPPS模型在“ICU-病房”肺部延伸护理中的应用效果评价

目的:评价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)构建的"ICU-病房"肺部延伸护理模式的应用效果。方法:回顾性选取2016年1-12月符合纳入标准的术后患者为对照组(98例),给予常规护理。纳入2017年1-12月符合纳入标准的术后患者为实验组(135例),运用基于Team STEPPS模型构建的"ICU-病房"肺部延伸护理模式。结果:实验组患者非计划重返ICU率、因肺部原因重返ICU率均低于对照组,患者对护理工作满意度评分高于对照组,差异均有统计学意义(P<0.05)。结论:运用基于Team STEPPS模型构建的"ICU-病房"肺部延伸护理模式可降低患者重返ICU率,提高患者满意度。

基于Team STEPPS模型构建呼吸道管理小组在老年机械通气中应用价值

目的观察基于Team STEPPS模型构建呼吸道管理小组在老年机械通气患者中的应用价值。方法采用便利整群抽样,选取ICU收治的34例老年机械通气患者为对照组,进行常规护理干预;选取ICU收治的37例老年机械通气患者为实验组,开展基于Team STEPPS模型构建呼吸道管理小组干预。记录两组24 h及48 h内非计划重返重症监护室(ICU)的发生率、因呼吸原因重返ICU率;检测评估两组患者离开ICU前及离室后的血氧饱和度和动脉血氧分压;评估记录两组的护理满意度。结果干预后,实验组24 h及48 h内非计划重返ICU发生率、因呼吸原因重返ICU发生率均显著低于对照组(P<0.05);离室后,两组SaO 2、PaO 2值较干预前升高,且观察组高于对照组(P<0.05);观察组总满意率高于对照组(P<0.05)。结论基于Team STEPPS模型构建呼吸道管理小组可有效减少老年机械通气患者非计划重返ICU和因呼吸原因重返ICU的发生,患者血气指标改善、预后提高,护理满意度高。

Team STEPPS模型在预防导尿管相关性尿路感染管理中的应用实践

目的:探讨Team STEPPS模型应用于预防导尿管相关性尿路感染(CAUTI)管理中的实践效果。方法:基于Team STEPPS模型构建预防CAUTI管理模式,建立基于证据的多部门协作系统及CAUTI预防管理方案,比较该模式实施前后干预措施落实情况、标本送检率、标本采集不合格率、CAUTI监测情况。结果:各季度干预措施落实总体呈上升趋势,标本送检率由41.95%上升为72.90%,标本采集不合格率由11.37%下降至4.24%,CAUTI发生率由3.27‰下降至2.89‰。结论:基于Team STEPPS模型构建预防CAUTI管理模式对预防CAUTI管理有效,可一定程度降低CAUTI发生率,提升预防措施的落实。

Team STEPPS模型联合早期多元化活动护理在行机械通气ICU患者中的应用效果

目的探讨改善医疗质量和患者安全的团队策略与工具训练(Team STEPPS)模型联合早期多元化活动护理对行机械通气治疗的重症监护室(ICU)患者的应用效果。方法选取2019年12月至2022年4月于北京航天总医院ICU行机械通气治疗的90例患者为研究对象,将2019年12月至2021年2月收治的45例患者设为对照组,2021年3月至2022年4月收治的45例患者设为观察组。对照组患者采取常规护理,观察组患者采取Team STEPPS模型联合早期多元化活动护理。比较2组患者的治疗时间、呼吸功能、英国医学研究委员会肌力评定法(MRC)评分和并发症发生情况。结果观察组的机械通气时间、ICU入住时间及总住院时间均短于对照组(P均<0.05)。与入ICU第1天相比,2组在入ICU第3天的氧合指数、经皮动脉血氧饱和度均提高,呼吸频率均减慢(P均<0.05);与入ICU第3天相比,2组在入ICU第5天的上述指标水平均更优(P均<0.05);观察组在入ICU第3天及第5天的上述指标水平均优于同期对照组(P均<0.05)。与入ICU第1天相比,2组在入ICU第7天的MRC评分均提高(P均<0.05);与入ICU第7天相比,2组在出ICU时的MRC评分均提高(P均<0.05);观察组在入ICU第7天及出ICU时的MRC评分均高于同期对照组(P均<0.05)。观察组的并发症总发生率低于对照组(P<0.05)。结论Team STEPPS模型联合早期多元化活动护理有助于缩短患者的治疗时间,改善其血气指标水平和肌肉活动度,降低并发症发生率。

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。

基于STEPPS原则的网络社区口碑营销特点分析——以小红书为例

本文基于乔纳·伯杰提出的STEPPS原则,从传播学的视角出发,以网络社区小红书为例,分别从社交货币(Social Currency)、诱因(Triggers)、情绪(Emotion)、公共性(Public)、实用价值(Practical Value)、故事(Stories)六个方面分析网络社区口碑营销的特点,为增强网络社区中产品、思想和行为的传播效果提供思路及一定的借鉴意义。

Team STEPPS模型在产后抑郁产妇延伸护理中的应用效果

目的探讨Team STEPPS模型在产后抑郁产妇延伸护理中的应用效果。方法选择2017年2月至2019年8月铜川市耀州区人民医院收治的产后抑郁产妇112例,根据随机数字表法分为模型组56例,对照组56例。对照组给予常规护理,模型组给予基于Team STEPPS模型的延伸护理,两组的护理观察时间为3个月。结果护理期间模型组的复诊、饮食、服药、运动等依从性分别为96.4%、100.0%、94.6%和96.4%,显著高于对照组的75.0%、83.9%、76.8%和66.1%(P<0.05);两组护理后的症状管理、心理与社会适应等评分均显著高于护理前(P<0.05),且以对照组为参照,模型组明显更高(P<0.05);两组护理后的抑郁评分均显著低于护理前(P<0.05),且以对照组为参照,模型组明显更低(P<0.05);护理后以对照组为参照,模型组的生命质量评分明显更低(P<0.05)。结论Team STEPPS模型在产后抑郁产妇延伸护理中的应用能提高产妇的依从性与自我护理能力,缓解产妇的心理障碍,提高产妇的生活质量。

TeamSTEPPS模式应用于内镜手术室护理安全管理

对内镜手术室护理安全管理中应用team stepps模式的安全管理效果进行探究。方法:样本数量为100例,样本选取时间为2019年到2021年。按照护理管理方式的不同,将100例患者分为采用常规护理安全管理的对照组,以及采用常规护理安全管理联合team stepps模式护理干预的观察组,将两组护理人员干预前后的情况进行观察。结果:比较两组的SAQ评分,干预前无明显差异(P>0.05),干预后两组的SAQ评分存在显著差异,观察组的SAQ评分显著高于对照组,数据对比差异显著(P<0.05)。对比两组护理满意度干预前无明显差异(P>0.05),干预后两组护理满意度差异显著,观察组显著高于对照组,差异有显著性(P<0.05)。结论:在内镜手术室护理安全管理中应用team steps模式,可以使医护人员的安全意识和安全态度有所提升,从而在护理工作中对护理行为进行规范,改善内镜手术室的安全管理质量,使患者对护理满意度有所提升,该安全管理模式适合在临床中大力推广应用。

基于STEPPS模型下的太极拳场馆口碑传播方法研究

随着人们健身意识的不断加强和体育产业相关政策的推出,体育健身休闲产业逐渐走入大众视野,而作为体育健身休闲产业诸多业态之一的太极拳场馆,为了在新的环境中取得更大的市场份额,也亟待优化自身的发展模式。在太极拳场馆现阶段的宣传模式中口碑传播起到了十分重要的作用。本研究以STEPPS模型对口碑传播从社交货币、诱因、情绪、公共性、实用价值和故事6个方面进行分析,旨在为太极拳场馆的口碑传播方式提供合理的分析和建议,从而改善太极拳场馆的经营现状为太极拳产业的发展起到积极作用。

Team STEPPS模型在血透室护理管理中预防感染的效果

目的:探讨Team STEPPS模型在血透室护理管理中预防感染的效果。方法:选取2018年在血透室就诊的78例患者和在职护士30名进行研究,根据护理管理方法的不同分为对照组和观察组,每组39例患者和15名护士。对照组实施常规护理管理,观察组在对照组的基础上引入Team STEPPS模型。评价两组护士团队协作和安全氛围、管理感知、工作满意、压力感知及工作条件得分;记录两组护理管理期间医院感染发生率。结果:观察组护士团队协作和安全氛围、管理感知、工作满意、压力感知及工作条件得分明显高于对照组(P<0.05);观察组的感染率为2.56%,明显低于对照组的17.95%(χ2=5.014,P=0.025)。结论:Team STEPPS模型用于血透室的护理管理,能够提高护士团队的合作能力,增强安全意识,预防医院感染的发生,保障患者安全。

骨折患者术后深静脉血栓的护理研究进展

骨折患者术后深静脉血栓一般是下肢深静脉血栓,其发生多与患者基础疾病、手术时间过长、麻醉方法使用不当、术中静脉壁创伤、患者凝血功能异常等多种因素有关.随着现代护理观念的进步,当前"以疾病为中心"的护理模式已变为"以人的健康为中心"的护理模式.本文概述了骨折患者术后深静脉血栓形成的机制,总结骨折患者术后深静脉血栓的护理研究进展,如常规护理、基于Caprini量表的预警性护理、延续护理、Team STEPPS模型护理、中医特色护理、品管圈活动护理,以促进持续改善患者预后.

Responses of plant diversity and soil microorganism diversity to nitrogen addition in the desert steppe,China

Nitrogen(N)deposition is a significant aspect of global change and poses a threat to terrestrial biodiversity.The impact of plant-soil microbe relationships to N deposition has recently attracted considerable attention.Soil microorganisms have been proven to provide nutrients for specific plant growth,especially in nutrient-poor desert steppe ecosystems.However,the effects of N deposition on plant-soil microbial community interactions in such ecosystems remain poorly understood.To investigate these effects,we conducted a 6-year N-addition field experiment in a Stipa breviflora Griseb.desert steppe in Inner Mongolia Autonomous Region,China.Four N treatment levels(N0,N30,N50,and N100,corresponding to 0,30,50,and 100 kg N/(hm2•a),respectively)were applied to simulate atmospheric N deposition.The results showed that N deposition did not significantly affect the aboveground biomass of desert steppe plants.N deposition did not significantly reduce the alfa-diversity of plant and microbial communities in the desert steppe,and low and mediate N additions(N30 and N50)had a promoting effect on them.The variation pattern of plant Shannon index was consistent with that of the soil bacterial Chao1 index.N deposition significantly affected the beta-diversity of plants and soil bacteria,but did not significantly affect fungal communities.In conclusion,N deposition led to co-evolution between desert steppe plants and soil bacterial communities,while fungal communities exhibited strong stability and did not undergo significant changes.These findings help clarify atmospheric N deposition effects on the ecological health and function of the desert steppe.

Effects of long-term fencing on soil microbial community structure and function in the desert steppe,China

One of the goals of grazing management in the desert steppe is to improve its ecosystem.However,relatively little is known about soil microbe communities in the desert steppe ecosystem under grazing management.In this study,we investigated the diversity and aboveground biomass of Caragana korshinskii Kom.shrub communities in long-term fencing and grazing areas,combined with an analysis of soil physical-chemical properties and genomics,with the aim of understanding how fence management affects plant-soil-microbial inter-relationships in the desert steppe,China.The results showed that fence management(exclosure)increased plant diversity and aboveground biomass in C.korshinskii shrub area and effectively enhanced soil organic carbon(233.94%),available nitrogen(87.77%),and available phosphorus(53.67%)contents.As well,the Shannon indices of soil bacteria and fungi were greater in the fenced plot.Plant-soil changes profoundly affected the alpha-and beta-diversity of soil bacteria.Fence management also altered the soil microbial community structure,significantly increasing the relative abundances of Acidobacteriota(5.31%-8.99%),Chloroflexi(3.99%-5.58%),and Glomeromycota(1.37%-3.28%).The soil bacterial-fungal co-occurrence networks under fence management had higher complexity and connectivity.Based on functional predictions,fence management significantly increased the relative abundance of bacteria with nitrification and nitrate reduction functions and decreased the relative abundance of bacteria with nitrate and nitrite respiration functions.The relative abundances of ecologically functional fungi with arbuscular mycorrhizal fungi,ectomycorrhizal fungi,and saprotrophs also significantly increased under fence management.In addition,the differential functional groups of bacteria and fungi were closely related to plant-soil changes.The results of this study have significant positive implications for the ecological restoration and reconstruction of dry desert steppe and similar areas.

Benefits and ecological restoration implications of hanging grass fences in Mongolian desert steppe

Tumbleweeds participate in a common seasonal biological process in temperate grasslands,creating hanging grass fences during the grass-withering season that result in distinct ecological phenomena.In this study,we addressed the urgent need to understand and restore the degraded desert steppe in Central Mongolia,particularly considering the observed vegetation edge effects around hanging grass fences.Using field surveys conducted in 2019 and 2021 in the severely degraded desert steppe of Central Mongolia,we assessed vegetation parameters and soil physical and chemical properties influenced by hanging grass fences and identified the key environmental factors affecting vegetation changes.The results indicate that the edge effects of hanging grass fences led to changes in species distributions,resulting in significant differences in species composition between the desert steppe's interior and edge areas.Vegetation parameters and soil physical and chemical properties exhibited nonlinear responses to the edge effects of hanging grass fences,with changes in vegetation coverage,aboveground biomass,and soil sand content peaking at 26.5,16.5,and 6.5 m on the leeward side of hanging grass fences,respectively.In the absence of sand dune formation,the accumulation of soil organic carbon and available potassium were identified as crucial factors driving species composition and increasing vegetation coverage.Changes in species composition and plant density were primarily influenced by soil sand content,electrical conductivity,and sand accumulation thickness.These findings suggest that hanging grass fences have the potential to alter vegetation habitats,promote vegetation growth,and control soil erosion in the degraded desert steppe of Central Mongolia.Therefore,in the degraded desert steppe,the restoration potential of hanging grass fences during the enclosure process should be fully considered.

Effects of Typical Soil and Stratification Thickness on Water Infiltration Characteristics in Central Ningxia

In order to compare the influence of different soil types and stratification on water infiltration capacity,two main types of soil in the desert steppe,sierozem(S)and aeolian sandy soil(A),were selected,and infiltration simulation tests were conducted on homogeneous soil and layered soil(layer thickness 5,10,and 20 cm),respectively.The results show that during the whole experiment,there was a small difference between S5A95(aeolian sandy soil 95 cm thick was covered with sierozem 5 cm thick)and S10A90(aeolian sandy soil 90 cm thick was covered with sierozem 10 cm thick)in the wetting front process,infiltration rate and cumulative infiltration,but there was a significant difference between S5A95 and S20A80(aeolian sandy soil 80 cm thick was covered with sierozem 20 cm thick).In the initial infiltration stage,there was no significant difference between A5S95(sierozem 95 cm thick was covered with aeolian sandy soil 5 cm thick)and A10S90(sierozem 90 cm thick was covered with aeolian sandy soil 10 cm thick).However,with the increase of infiltration time,the wetting front process,A5S95,A10S90 and A20S80 had significant differences in terms of wetting front process,infiltration rate and cumulative infiltration.The infiltration capacity of A was significantly higher than that of S.Combined with linear R 2 value and model parameters,the three infiltration models were comprehensively compared,and the fitting process and results of the general empirical model for the infiltration process of homogeneous soil and layered soil showed good results.Three models were used to simulate the water infiltration process of layered soil with different textures,and the order of the effect is as follows:general empirical model>Kostiakov model>Philip model.Soil type and layer thickness had a great influence on water infiltration process.When sierozem was covered with aeolian sandy soil 20 cm thick,the infiltration capacity was the best.As aeolian sandy soil was covered with sierozem 10 cm thick,the infiltration effect was the worst.Therefore,once coarse graying occurs on the surface of sierozem(the thickness of sand is more than 20 cm)or when the content of fine particles overlying aeolian sandy soil(the thickness of silt and clay soil is more than 10 cm)during ecological restoration is high,the soil hydrological characteristics will change significantly,which may lead to changes in vegetation types and even ecosystem structure.

基于循证构建肠造口患者护理团队核心要素指标体系

目的基于循证构建肠造口患者护理团队核心要素指标体系。方法以Team STEPPS模型为概念框架,采用文献检索法、专家小组讨论、德尔斐专家函询法,筛选指标建立肠造口患者护理团队核心要素指标体系。结果2轮专家函询问卷有效回收率均为100%,专家权威程度系数为0.890,专家意见的协调系数为0.421。最终确定的核心要素指标体系包括一级指标2项,二级指标7项,三级指标44项。结论肠造口患者护理团队核心要素指标体系内容较全面,科学可靠,具有一定实用性,可为临床实践提供参考。

Studies on Transferrin and Posttremsferr Polymorphism and Their Relationship with Performances in Red Steppe

[Objective] The aim of this study was to investigate the correlation between blood protein polymorphism of red steppe and its performance.[Method]Two blood protein polymorphic loci were detected in transferring(Tf)and posttremsferr(Ptf)from thirteen red steppes and eighteen hybrid of limousin and red steppe by polyacrylamide gel electrophoresis.[Result]Tf and Ptf were controlled by three and two alleles respectively.[Conclusion]The variance analysis of blood protein polymorphic loci and its performance indicates that two protein loci have a positive or negative correlation with some traits of red steppe and the improved limousin cattle population.

Detecting Vegetation Fractional Coverage of Typical Steppe in Northern China Based on Multi-scale Remotely Sensed Data

One of the study objectives of global change is land use/cover change (LUCC) by using multiscale remotely sensed data on global and regional scale. In this paper, field sample, digital camera, Landsat-ETM+ (ETM+, Enhanced Thematic Mapper) image and the National Oceanic and Atmospheric Administration/the advanced very high resolution radiometer (NOAA/AVHRR) image were integrated to detect, simulate and analyze the vegetation fractional coverage of typical steppe in northern China. The results show: (1) Vegetation fractional coverage measured by digital camera is more precise than results measured by other methods. It can be used to validate other measuring results. (2) Vegetation fractional coverage measured by 1 m 2 field sample change fluctuantly for different observers and for different sample areas. In this experiment, the coverage is generally high compared with the result measured by digital camera, and the average absolute error is 9.92%, but two groups measure results, correlation coefficient r(2) = 0.89. (3) Three kinds of methods using remotely sensed data were adopted to simulate the vegetation fractional coverage. Average absolute errors of the vegetation fractional coverage, measured by ETM+ and NOAA, are respectively 7.03% and 7.83% compared with the result measured by digital camera. When NOAA pixel was decomposed by ETM+ pixels after geometrical registry, the average absolute errors measured by this method is 5.68% compared with the digital camera result. Correction coefficients of three results with digital camera result r(2) are respectively 0.78, 0.61 and 0.76. (4) The result of statistic model established by NOAA-NDVI (NDVI, Normalized Difference Vegetation Index) and the vegetation fractional coverage measured by digital camera show lower precision (r(2) = 0.65) than the result of statistic model established by ETM+-NDVI and digital camera coverage then converted to NOAA image (r(2) = 0.80). Pixel decomposability method improves the precision of measuring the vegetation fractional coverage on a large scale. This is a significant practice on scaling by using remotely sensed data. Integrated application of multi-scale remotely sensed data in earth observation will be an important approach to promoting measuring precision of ecological parameters.

Spatial-temporal Evolvement Characteristics of Climate Productivity for the Plants on Inner Mongolia Desert Steppe

Thornthwaite Memorial model and other statistic methods were used to calculate the climate-productivity of plants with the meteorological data from 1961 to 2007 at 9 stations distributed on Inner Mongolia desert steppe.The spatial and temporal variation characteristics of climate-productivity were analyzed by using the methods of the tendency rate of the climate trend,accumulative anomaly,and spatial difference and so on.The results showed that the climate-productivity kept linear increased trend over Inner Mongolia desert steppe in recent 47 years,but not significant.In spatial distribution,the climate-productivity reduced with the increased latitude.The climate-productivity in southwest part of Inner Mongolia desert steppe was growing while that in the southeast was reducing.The variation rate of the climate-productivity increased from the northwest part to the southeast part of Inner Mongolia desert steppe.In recent 47 years,the climate-productivity in southeast Jurh underwent the greatest decreasing extent,and the region was the sensitive area of the climate-productivity variation.