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Interpretation of group standards for skin care of adult incontinence GAO Yanhong, ZHAO Nuo, LIU Chunmei, WANG Ling, ZHOU Yujie, WANG Xia, GUO Tong, WEI Li, ZHANG Su, WANG Zhiwen, ZHANG Zhixia, HUANG Zheng, JI Huiru, GUO Shuli, JIANG Qixia, XU Honglian, HU Hongyang, ZHANG Hongmei, HU Ailing, SUN Hongling, FU Xiaojin, WU Xinjuan Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 620-624.   DOI: 10.3761/j.issn.2096-7446.2023.07.010 Abstract （589）            Knowledge map    The unified and standardized skin care norms and procedures for incontinence patients provide clinical standard guidance for nursing staff，and are also the guiding basis for reducing the incidence of skin complications of patients. In 2022，the Third Medical Center of the General Hospital of the People’s Liberation Army collaborated with 16 hospitals nationwide to write the group standard of the Chinese Research Hospital Association “skin care norms for adult incontinence patient （T/CRHA 016-2023）”，which was released in January 2023. It mainly standardized the overall evaluation of skin care for adult incontinence patients，the selection of nursing products，the standard process and the key points of nursing. This article explained the important parts and items in this standard in detail to facilitate users’ understanding and promote the standardized practice of skin care for patients with clinical incontinence. Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (10): 909-912.   Abstract （437）            Knowledge map    Related Articles | Metrics

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Optimization and effect evaluation of arterial puncture catheterization process for invasive blood pressure monitoring YANG Fei, SUN Qingmei, PAN Jian, SU Wei, LÜ Ying, ZHAO Qun, MA Yingqin, ZHANG Yingying Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (11): 988-992.   DOI: 10.3761/j.issn.2096-7446.2023.11.005 Abstract （408）            Knowledge map    Objective To optimize the invasive blood pressure monitoring arterial cannulation procedure using catheter tip intracavitary electrocardiogram （ECG） positioning technology and to evaluate its effectiveness. Methods From June 2021 to June 2022，60 patients each from a tertiary level A hospital and a secondary level A hospital in Xinjiang Uygur Autonomous Region undergoing invasive blood pressure monitoring were selected. Based on the cannulation method，they were randomly divided into the optimization group（60 patients） and the traditional group（60 patients） by the random number table method. The optimization group optimized the connection process be- tween arterial puncture cannula and pressure transducer，and introduced intracavitary electrogram localization tech- nology at the tip of arterial puncture. The traditional group used penetrating arterial puncture catheterization. The primary evaluation indicators included first-attempt cannulation success rate，post-puncture bruising，puncture bleed- ing，pain score，and patient satisfaction. Results Compared to the traditional group，the first-attempt cannulation suc- cess rate in the optimization group significantly increased（95.0% vs 83.3%，P=0.04）. The post-puncture bruising rate significantly decreased（5.0% vs 28.3%，P=0.01）. The puncture bleeding rate significantly decreased（0 vs 100.0%，P= 0.04）. The proportion of patients with mild pain significantly increased（95.0% vs 75.0%，P=0.02），while the propor- tion with moderate pain significantly decreased （5.0% vs 25.0%，P=0.02）. Patient satisfaction also improved（95.0% vs 75.0%，P=0.01）. Conclusion Optimizing the procedure of arterial cannulation for invasive blood pressure moni- toring can effectively improve the first-attempt puncture success rate，reduce complications，and enhance patient sat- isfaction. It offers a safer and more efficient cannulation method. Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (6): 562-.   Abstract （395）            Knowledge map    Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (11): 1011-.   Abstract （285）            Knowledge map    Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (10): 869-873.   Abstract （276）            Knowledge map    Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (11): 1006-.   Abstract （270）            Knowledge map    Related Articles | Metrics

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A field study of the status and contents of nursing practice in the management of blood glucose in critically ill adults HUANG Miao, GAN Xiuni, ZHANG Chuanlai, ZHOU Wen Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (2): 101-107.   DOI: 10.3761/j.issn.2096-7446.2024.02.001 Abstract （269）            Knowledge map    Objective To understand the status and contents of current nursing practice in the management of blood glucose in critically ill adult patients in China. Methods From September 2021 to April 2022，an 8-month non-participatory observation of glucose management practice in the intensive care units of four tertiary care hospitals in Chongqing was conducted using field research. Quantitative data were collected using the ICU patient glucose management profile form and nursing staff glucose management practice record form. We repeatedly read the field notes and summarized existing nursing practices and existing problems in current blood glucose management nursing practices，further categorized and conducted in-depth analysis of the data. Results All four field observation sites had paper-based insulin infusion protocols，and the mean duration of the use of the protocols was（9±2.92） years，and the contents of the protocols differed across the fields. A total of 60 hyperglycemic patients were observed，and there were no statistically significant differences in the duration of hyperglycemia，the time required to reach target blood glucose level，and the maintenance of the target blood glucose range among patients from different field sites. The main tasks of the 12 nurses in glucose management included insulin infusion and adjustment，glucose monitoring，patient nutrition management，and hypoglycemia treatment. However，there was still a gap with the best evidence on blood glucose monitoring method，insulin use，whether nutritional support should be combined with insulin infusion，etc. Conclusion Nursing staff need to enhance their clinical decision-making skills，and further construct and implement a comprehensive and standardized practice plan for glucose management in critically ill adult patients based on the best evidence. This is a main solution to address current glucose management practice issues in the field sites. Related Articles | Metrics

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Establishment of quality evaluation indicator system of analgesia and sedation care in adult ICUs WANG Li, HE Xuehua, CHEN Xiangping, GONG Xiaoyan, ZHANG Kai, SUN Lei, SHEN Yunxia Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (9): 773-778.   DOI: 10.3761/j.issn.2096-7446.2023.09.001 Abstract （268）            Knowledge map    Objective To construct a quality evaluation indicator system of analgesia and sedation care in adult ICUs，and to provide a reference standard for monitoring and management of nursing quality of analgesia and sedation in adult ICUs. Methods From February to November 2022，the content and weights of quality evaluation indicators of analgesia and sedation care in adult ICUs were determined by using literature review，expert meeting method，Delphi method and analytic hierarchy method based on the three-dimensional “structure-process-outcome” quality model. Results The effective recovery rates of 2 rounds of questionnaires were 100% and 92% ，the authority coefficients were 0.87 and 0.88，the variation coefficients were 0.04～0.32 and 0～0.21，and the Kendall harmony coefficients were 0.245 and 0.260. The final quality evaluation indicator system of analgesia and sedation care in adult ICUs included 3 first-level indicators，11 second-level indicators and 45 third-level indicators. Conclusion The quality evaluation indicator system of analgesia and sedation care in adult ICUs has high Scientificity and reliability，reflects professionalism and specificity，and has a reference value on evaluating the nursing quality of analgesia and sedation in ICU. Related Articles | Metrics

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Study on the application effect of different sealing solutions in the totally implantable venous access portamong tumor patients ZHU Wei, QIN Xiaoying, HUANG Peipei, XIANG Xiaoyan, LU Qi, CHEN Lijiao, CUI Zhiping, ZHANG Ye Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 581-586.   DOI: 10.3761/j.issn.2096-7446.2023.07.001 Abstract （249）            Knowledge map    Objective To compare the application effects of different sealing solutions in totally implantable venous access port among tumor patients. Methods A randomized sampling was used to select 414 patients who were maintained infusion port in outpatient department of a tertiary Grade A hospital in Zhejiang Province from December 2018 to December 2022. They were divided into three groups，A，B，and C，with 138 cases in each group，using a random number table method. Patients were treated with 5 ml 0.9% sodium chloride for positive pressure sealing during intermittent maintenance in group A，and 5 ml heparin（10 U/ml） for positive pressure sealing in group B，and 5ml heparin（100 U/ml） positive pressure sealing in group C. To observe coagulation function and catheter blockage in patients among three groups. Results There were statistically significant differences in prothrombin time and activated partial thrombin time among the three groups（P<0.05）. There was no significant difference in D-dimer quantity and platelet count（P>0.05）. The pair comparison of prothrombin time among the three groups showed that there was no statistical significance between group A and group B（t=-34.409，P>0.05），but there were statistically significant differences between group A and group C（t=-179.308，P<0.001） and between group B and group C（t=-144.899，P<0.001）. The pairwise comparison of activated partial thromboplastin time among the three groups showed that there was no statistical significance between group A and group B（t=1.406，P>0.05）， but there were statistically significant differences between group A and group C（t=-35.493，P<0.05） and between group B and group C（t=-36.899，P<0.05）. Conclusion Among cancer patients with totally implantable access port during intermittent maintenance period，the use of heparin solution（100 U/ml） can prolong prothrombin time andactivated partial thromboplastin time. It is recommended that clinical nursing staff seal the tube with 0.9% sodium chloride or heparin solution（10 U/ml） in outpatient patients undergoing intermittent maintenance. Related Articles | Metrics

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Analysis on current situation and risk factors of unplanned return to the rescue room in patients under observation in emergency department WANG Fang, ZHENG Danli, HUANG Sufang, XIE Yunli, FENG Mei, XIE La, YANG Ying, DENG Juan, XIAO Yaru Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 639-643.   DOI: 10.3761/j.issn.2096-7446.2023.07.015 Abstract （231）            Knowledge map    Objective To analyze the characteristics of emergency observation patients who unplanned return to the rescue room，and explore its risk factors. Methods A retrospective analysis was conducted on 2 735 patients in emergency observation room who were transferred from the rescue room of a tertiary Grade-A general hospital from January 1，2019 to December 31，2021. The rate of unplanned return to the rescue room was statistically analyzed，and the differences of clinical characteristics between the group of unplanned return to the rescue room and the non-return group were compared. The risk factors of unplanned return to the rescue room were analyzed by binary logistic regression. Results A total of 87 patients returned to the rescue room unplanned，the rate of unplanned return was 3.2%. Logistic regression analysis showed that age（OR=1.021），unexplained abdominal pain （OR=2.916），and trauma（OR=0.226） was associated with the unplanned return to the rescue room（P<0.05）. Conclusion Age and unexplained abdominal pain are risk factors for unplanned return to the rescue room. It is suggested to establish a standardized evaluation process for patients who are transferred to the observation room， especially elderly patients and patients with unexplained abdominal pain，so as to predict the risk of condition changes and reduce the incidence of unplanned return to the rescue room. Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (6): 519-.   Abstract （226）            Knowledge map    Related Articles | Metrics

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Development and psychometric testing of a questionnaire measuring knowledge，belief and practice of prone position ventilation for patients with ARDS among ICU medical staf LI Yajun, WU Qiang, ZHANG Jing, CHEN Lianfang, LI Xiuchuan Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 587-593.   DOI: 10.3761/j.issn.2096-7446.2023.07.002 Abstract （203）            Knowledge map    Objective To develop a questionnaire measuring the knowledge，belief，and practice of prone position ventilation for patients with ARDS among ICU medical staff，and to conduct reliability and validity testing. Methods Based on the knowledge，belief，and behavior theory model，an initial questionnaire was formed through literature study，theoretical analysis，expert interviews，Delphi expert consultation，and preliminary surveys. From October to November 2022，426 ICU medical staff from 7 tertiary comprehensive hospitals in Anhui Province were selected as the research subjects for reliability and validity testing. From January to February 2023，another 455 ICU medical staff from 7 tertiary comprehensive hospitals were selected as the survey subjects for confirmatory factor analysis. Results The final questionnaire consisted of three dimensions：knowledge，belief，and behavior，with a total of 41 items. The cumulative variance contribution rate of the three factors in exploratory factor analysis was 65.319%，and all fitting indicators in confirmatory factor analysis were within an acceptable range （χ2/df=2.504，RMSEA=0.058， RMR =0.014，IFI =0.933，CFI =0.933，PGFI =0.740，PNFI =0.846，PCFI =0.883）. Questionnaire Cronbach’s α coefficient was 0.982，the retest reliability was 0.995，and the split half reliability was 0.950. Conclusion This questionnaire has good reliability and validity，and is suitable for investigating the current status of ICU medical staff’s knowledge，belief，and practice of prone ventilation in ARDS patients. Related Articles | Metrics

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Construction and application of a multidisciplinary team approach for extracorporeal cardiopulmonary re- suscitation WU Jiehua, CHEN Hua, XIA Ye, LENG Xiahua, WANG Mengmeng, CHEN Huan, YAN Chengkun Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (11): 983-988.   DOI: 10.3761/j.issn.2096-7446.2023.11.004 Abstract （189）            Knowledge map    Objective To construct a multi-disciplinary team （MDT） approach for extracorporeal cardiopulmonary resuscitation（ECPR） and evaluate its application. Methods An expert group discussion method was used to con- struct a MDT protocol for extracorporeal cardiopulmonary resuscitation. Using a convenience sampling method，35 patients who underwent ECPR from January 2020 to December 2021 were selected as the experimental group，and 32 patients who underwent ECPR from January 2018 to December 2019 were selected as the control group. The experimental group implemented the extracorporeal cardiopulmonary resuscitation MDT protocol on the basis of the conventional process and care，while the control group was given the conventional emergency receiving and nursing care. Compared the time spent on each session，48h return of spontaneous circulation rate，48h survival rate and in- hospital survival rate between the two groups of patients. Results 31 cases were collected in the experimental group and 27 cases in the control group. The time spent in each session was significantly lower in the experimen- tal group than that in the control group after the intervention，and the difference was statistically significant（P<0.001）. The 48h return of spontaneous circulation rate，48h survival rate and in-hospital survival rate were significantly higher than those in the control group，and the differences were statistically significant （P<0.05）. Conclusion The application of the MDT approach for extracorporeal cardiopulmonary resuscitation can shorten the resuscitation time of patients with extracorporeal cardiopulmonary resuscitation，promote medical and nursing cooperation，and improve the resuscitation success rate. Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (6): 543-.   Abstract （181）            Knowledge map    Related Articles | Metrics

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Research progress on risk prediction models of incontinence associated dermatitis in critically ill patients XU Xia, ZHANG Jiajia, DING Zhuyu, ZHANG Yan, XIAO Xueqi Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 660-663.   DOI: 10.3761/j.issn.2096-7446.2023.07.018 Abstract （180）            Knowledge map    Incontinence-associated dermatitis（IAD） is a major skin problem worldwide. Risk prediction model can screen out high risk patients of IAD，so as to identify and intervene early. This paper reviewed the basic situation， construction method and prediction performance of risk prediction model of incontinence-associated dermatitis，so as to provide reference for clinical medical staff to implement skin prevention management. However，risk factors should be comprehensively included，and emphasis should be placed on the application of the model. Related Articles | Metrics

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Application of best evidence for aspiration prevention in patients with mechanical ventilation YAO Huan, FANG Jinyan, FU Rong, ZHONG Lijun, WAGN Xiaoyan, HUANG Ganying Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (9): 785-791.   DOI: 10.3761/j.issn.2096-7446.2023.09.003 Abstract （178）            Knowledge map    Objective To summarize and evaluate the application effects of the best evidence of aspiration pre- vention in adult patients with mechanical ventilation. Methods The best evidence for the prevention of aspiration in patients with mechanical ventilation was developed into an evidence-based practice plan by using the method of evidence-based nursing. After baseline review，obstacle factor analysis，and construction of the best evidence applica- tion strategy，the best evidence was implemented in the emergency intensive care unit of a tertiary hospital in Hangzhou from October 1 to November 20，2022. The incidence of aspiration in patients before and after evidence- based practice，the implementation rate of review indicators，and the scores of emergency intensive care unit nurses on the knowledge questionnaire of aspiration prevention and management in patients with mechanical ventilation were compared. Results Finally，23 evidences were included and 19 review indicators were formed. After evidence- based practice，the incidence of aspiration in patients with mechanical ventilation decreased from 21.43% to 6.67%，and the incidence of ventilator-associated pneumonia （VAP） decreased from 28.57% to 6.67%. Except for indicator 10 and 19，the implementation rate of the other review indicators increased to more than 90%. The score of nurses’ questionnaire on knowledge of aspiration prevention and management in patients with mechanical ventilation increased from （78.04±1.58） points to （91.04±0.98） points，and the difference was statistically significant （t=-11.879，P＜0.001）. Conclusion Applying the best evidence to clinical nursing practice is conducive to reduce the incidence of aspiration in patients with mechanical ventilation，improve the quality of clinical nursing. Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (6): 485-492.   Abstract （172）            Knowledge map    Related Articles | Metrics

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Application of progressive rehabilitation exercise in patients with mechanical ventilation in ICU BIAN Hong, YU Ping, SUN Qin, HE Ping Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (8): 689-694.   DOI: 10.3761/j.issn.2096-7446.2023.08.003 Abstract （171）            Knowledge map    Objective To investigate the effect of progressive rehabilitation exercise in patients with mechanical ventilation in ICU. Methods A total of 80 patients receiving mechanical ventilation treatment in two wards of ICU of a tertiary Grade A hospital in Wuxi of Jiangsu Province from January 2021 to June 2022 were selected for this study. By unit convenience sampling method，they were divided into two groups，with 40 cases in each group. The control group received routine rehabilitation exercise nursing. The experimental group received early rehabilitation exercise through progressive rehabilitation exercise. Grip strength，sleep quality score，mechanical ventilation duration，length of stay in ICU，incidence of ICU acquired weakness （ICU-AW） and adverse events were compared between the two groups. Results Two patients in the experimental group and six patients in the control group withdrew midway，so 38 patients in the experimental group and 34 patients in the control group were retained. The grip strength and sleep quality score of the experimental group were higher than those of the control group， mechanical ventilation duration，ICU stay length and the incidence of ICU-AW of the experimental group were lower than those of the control group （P<0.05）. During the implementation of the study，there were no adverse events caused by rehabilitation training in the experimental group. Conclusion Progressive rehabilitation exercise can increase the grip strength of patients with mechanical ventilation in ICU，promote the recovery of body function， prevent the occurrence of ICU-AW，regulate the sleep quality of patients，and shorten the length of stay in ICU. Related Articles | Metrics

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Research progress on activities of daily living of ICU patients ZHANG Xiying, JIANG Zhixia, ZHANG Fuyan, GAO Lin, YANG Xiaoling, ZHANG Sha, LIU Qilan Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (8): 715-720.   DOI: 10.3761/j.issn.2096-7446.2023.08.008 Abstract （169）            Knowledge map    Activities of daily living（ADL） is a basic ability for individuals to maintain daily life. Patients with severe diseases are usually dependent on ADL. In addition，due to the influence of post- intensive care syndrome，patients may experience long-term deterioration of ADL and continuous influence on the quality of life of patients after transferring out of ICU. This paper reviews the concept of ADL，the status of ADL of critically ill patients，influencing factors and improvement measures，and puts forward the shortcomings and suggestions in current research，aiming to provide reference for improving the ADL of critically ill patients and improving their long-term quality of life. Related Articles | Metrics