Table of Content

10 December 2023, Volume 4 Issue 12 Previous Issue    Next Issue

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Design and application of intra-hospital transport work instruction sheet for patients supported by extracorporeal membrane oxygenation CHU Junqing, LIN Yan, GAO Chunhua, REN Yayu, ZHANG Shuai, LI Xingjie, QIAO Wenbo 2023, 4 (12):  1061-1067.  doi: 10.3761/j.issn.2096-7446.2023.12.001 Abstract ( 161 )   Save Objective Design an intra-hospital transport work instruction sheet for patients supported by extracorporeal membrane oxygenation（ECMO） and evaluate its effect in clinical practice. Methods The hospital transport work instruction sheet of adult ECMO patients was designed by literature review，group discussion，expert meeting and so on. From January to December 2020，84 adult ECMO in-hospital transport patients in ICU ward of a tertiary class A hospital in Zhejiang Province were selected as the experimental group，was used intra-hospital transpor work instruction sheet. From January 2018 to December 2019，45 adult patients with ECMO intra-hospital transport were selected as the control group，and routine transport care was adopted. The incidence of transport- related adverse events and duration of in-hospital transport were compared between the two groups. Results The incidence rate of adverse events related to condition change，technology and movement，and transport time in experimental group were lower than those in control group（P<0.01）. Conclusion The use of intra-hospital transport work instruction sheet in adult ECMO patients can shorten the time of intra-hospital transport，reduce the incidence of transport-related adverse events，improve transport efficiency and ensure transport safety. Related Articles | Metrics

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Construction and validation of a nomogram risk prediction model for subsyndromal delirium in mechanically ventilated patients GU Tiantian, CHEN Junxi, YANG Yang, XIAO Xu, LI Jiao, ZHANG Yongmei 2023, 4 (12):  1068-1074.  doi: 10.3761/j.issn.2096-7446.2023.12.002 Abstract ( 106 )   Save Objective To analyze the risk factors for the occurrence of subsyndromal delirium in mechanically ventilated patients and construct a nomogram risk prediction model to predict the occurrence of subsyndromal delirium. Methods Convenience sampling was used to select 434 mechanically ventilated patients admitted to the ICU of a tertiary hospital in Guizhou Province from July 2021 to June 2022，who were categorized into the subdelirium syndrome group （n=136） and the non-subdelirium syndrome group （n=298） using the ICU Patient Ambi- guity of Consciousness Assessment Scale. We explored the independent risk factors for the occurrence of subde- lirium syndrome through univariate and multifactorial logistic regression analyses，established a risk prediction model，developed a nomogram，and validated the model both internally and externally. Results Multifactorial logistic regression analysis revealed that age（OR=1.029），acute physiological and chronic health status score（OR=1.267）， whether restrained（OR=1.029），intensive care pain score（OR=2.487），Richards-Campbell sleep scale score（OR=1.150）， Richmond agitation-sedation score（OR=1.500） were independent risk factors for the development of subdelirium. The consistency index of the nomogram model for the occurrence of subdelirium in mechanically ventilated patients in the ICU was 0.956，with a sensitivity of 86.2% and a specificity of 94.1%. Conclusion The risk prediction model construc- ted in this study can effectively predict the occurrence of subdelirium syndrome in mechanically ventilated patients， which provides a reference for clinical medical personnel to scientifically predict the occurrence of subdelirium. Related Articles | Metrics

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Analysis on the status and latent profile analysis of mental workload of emergency department nurses in the process of responding to major public health emergencies SHI Aili, CHENG Lingling, ZHANG Mengfei, YAO Jiaping, LUO Liying 2023, 4 (12):  1075-1081.  doi: 10.3761/j.issn.2096-7446.2023.12.003 Abstract ( 108 )   Save Objective To investigate the current situation of mental workload of nurses in emergency department in the process of dealing with major public health emergencies，and to analyze the latent potential profile and explore its influencing factors. Methods From December 2022 to January 2023，the emergency department nurses in 9 general hospitals （5 tertiary hospitals and 4 secondary hospitals） in Zhejiang Province were selected by convenience sampling method，and the survey instruments included self-designed general information questionnaire， NASA task load index scale，psychological capital questionnaire，and general health questionnaire. Results 466 questionnaires were distributed and 456 were returned with an effective rate of 97.85% . In the process ofresponding to majo r public health emergencies，the total score of 456 emergency department nurses’ mental workload was （91.25±11.75），the total score of Psychological Capital Questionnaire was （100.08±13.89），and the total score of General Health Questionnaire was （2.34±2.90），and the latent profile analysis classified them into 4 catego- ries，which were named according to the category characteristics as C1 low load feeling and high self-evaluation （10.1% ），C2 high load feeling and high self-evaluation （24.1% ），C3 medium load feeling and medium self- evaluation（37.2%），C4 high load feeling and low self-evaluation （28.5%）. Ordered multi-categorical Logistic regression showed that age，years of work，education，hospital grade，mental health，and psychological capital were factors influencing the psychological load of emergency department nurses in coping with major public health emergencies. Conclusion The Mental workload of emergency department nurses in response to major public health emergencies is at a high level，and the psychological health of the high load feeling and low self-evaluation group is at high risk and should be a major concern. Psychological capital is negatively correlated with psychological load. This suggests that nursing managers should develop targeted interventions to improve their psychological capital，so as to reduce the high psychological load of emergency department nurses in response to major public health events. Related Articles | Metrics

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The correlation analysis of organizational silence and structural authorization among emergency department nurses in tertiary Grade A hospitals WANG Ye, PEGN Fei, GUI Li, DONG Lan, LÜ Jun, FENG Xia, QIAO Anhua 2023, 4 (12):  1082-1086.  doi: 10.3761/j.issn.2096-7446.2023.12.004 Abstract ( 69 )   Save Objective To understand the current situation of organizational silence and structural authorization a- mong emergency department nurses in tertiary Grade A hospitals，and to explore the correlation between the two factors. Methods The nurses from the emergency departments of 5 tertiary hospitals in Shanghai were selected as the research subjects by convenient sampling from January to February of 2023. A survey was conducted using the Employee Silence Questionnaire and the Work Efficiency Condition Scale，and a correlation analysis was conducted. Results The results showed that 138 nurses in the emergency department had a score of （36.72±12.56） for or- ganizational silence. Among the three dimensions，the score of tacit silence was （3.33±1.23），indifference silence was （3.06±1.19），defense silence was （2.80±1.20），and structural authorization was （61.03±13.73）. There was a negative correlation between organizational silence and structural authorization （P<0.01）. Conclusion Nurses in the emergency department of tertiary Grade A hospitals have moderate level of organizational silence，which is negative- ly correlated with structural authorization. The lower the level of structural authorization，the heavier the degree of organizational silence. This suggests that managers can reduce or even eliminate organizational silence among emer- gency department nurses by enhancing structural authorization. Related Articles | Metrics

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A qualitative study of post-traumatic growth experiences of emergency department nurses going through public health events of infectious diseases XIONG Wenyan, CHU Zhe, ZHANG Chunyan, WANG Wei, FAN Hongquan 2023, 4 (12):  1087-1093.  doi: 10.3761/j.issn.2096-7446.2023.12.005 Abstract ( 56 )   Save Objective To study the psychological state，the psychological journey and post-traumatic growth experience of emergency department nurses going through public health events of infectious diseases，of nurses，so as to provide guidance for psychological interventions and subsequent training for emergency department nurses. Methods Using a rooting theory research approach，in-depth interviews were conducted with emergency department nurses involved in COVID-19 frontline ambulance work between December 2022 to January 2023 while the researcher conducted full participant observation to observe the work status or emotions of nurses，teamwork and cooperation，and handling various unexpected situations. The data was analyzed using Strauss and Corbin’s rooting theory. Results The stress response of emergency department nurses when faced with a public health event of an infectious disease was divided into four phases：stress，fatigue，debugging and growth，forming four categories，13 sub- categories and 20 codes. Conclusion The psychological reaction of nurses in emergency department when they face public health events of infectious diseases is a one-way dynamic change process. Stable social support and the responsibility and protection of managers are the important driving forces for nurses to change from stress fatigue to debugging growth. Good professional quality，high resilience of psychological traits and reflection sublimation are the internal factors that promote growth. It is suggested that department managers should make emergency response when dealing with public health events of infectious diseases，improve procedures and systems，create a positive department atmosphere，carry out specialized training，consolidate professional knowledge and skill reserves，and pay special attention to the shaping of necessary psychological qualities. Related Articles | Metrics

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Qualitative study on the experience of occupational fatigue among nurses in emergency departments from the perspective of effort-reward XIONG Siqi, LI Jie, PANG Yunzhen, LI Si, HUANG Ying 2023, 4 (12):  1094-1098.  doi: 10.3761/j.issn.2096-7446.2023.12.006 Abstract ( 53 )   Save Objective To explore the occupational fatigue of nurses in emergency departments based on the effort-reward imbalance system，analyze its risk factors，and provide reference for exploring effective risk management strategies for fatigue in emergency department. Methods The interview outline was constructed under the guidance of the three factors of the effort-reward imbalance model，namely intrinsic drive，extrinsic effort and extrinsic reward. The semi-structured interview method was adopted to conduct in-depth interviews with 12 emergency department nurses from two tertiary class A hospitals in Kunming from August to October 2022，and the collected data were analyzed using Colaizzi’s 7-step analysis method for phenomenological data. Results The extracted topic included three dimensions and a total of 6 factors. There are two internal driving factors：efficient team cooperation and rapid improvement of personal ability. There are three external factors：intense work load，conflicting experience with patients，and excessive training input. And it has an extrinsic reward，meaningful recognition. Conclusion The study found that efficient teamwork，rapid improvement of personal ability and meaningful recognition can promote the continuous work of emergency department nurses，but high intensity of workload，conflict experience with patients， and excessive training investment will aggravate the occupational fatigue experience of emergency department nurses. It is necessary to identify the occupational fatigue of nurses in time and understand the influencing factors， so as to adopt targeted pre-control strategies to promote the physical and mental health of nurses，increase the empathy，and reduce the brain drain of emergency department. Related Articles | Metrics

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A grounded theory research on the trauma recovery process of the second victim in ICU nurse clinical alert-related adverse events GUAN Ruixin, ZHAO Xiaoshuang, SUN Hairui, ZHANG Dan, ZHANG Jiping, ZHANG Baorong 2023, 4 (12):  1099-1105.  doi: 10.3761/j.issn.2096-7446.2023.12.007 Abstract ( 93 )   Save Objective To understand the ICU nurses’ trauma recovery process as the second victims of clinical alert-related adverse events. Methods Based on programmed grounded theory，semi-structured interviews，data analysis，and model construction were conducted with 21 nurses. Results The trauma recovery process of ICU nurses as the second victims of adverse events related to clinical alerts includes five stages院evaluation，storming， recovery，control，and duration. The trauma recovery time of ICU nurses varies against different severity of adverse events. Conclusion the process of trauma recovery is affected by alert recurrence and work control ability. Administrators should combine the resuscitation model and take comprehensive measures，including improving stress management system and enhancing work control ability，as well as updating manpower allocation and talent training mechanism，to improve the current situation of ICU nurses’ as second victims. Related Articles | Metrics

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Translation and psychometric test of the Chinese version of the Stressor Scale for Emergency Nurses ZHANG Mengjie, LI Ke, ZHANG Jianxia, LI Ning, YU Miao, YANG Zhennan 2023, 4 (12):  1105-1111.  doi: 10.3761/j.issn.2096-7446.2023.12.008 Abstract ( 95 )   Save Objective To translate and test the reliability and validity of the Chinese version of the Stressor Scale for Emergency Nurses （SSEN）. Methods The Brislin translation method was used to translate the SSEN scale literally，back-translate and cross-culturally adjust to the Chinese version of the SSEN. Thirty emergency nurses were selected for pre-survey，after modifying the survey results，the reliability and validity of the Chinese version of SSEN was tested among 317 emergency nurses by convenient sampling in several tertiary general hospitals in in Beijing. Results The Chinese version of SSEN includes life and death situation，patients’ andfamilies’ actions and reactions，technical and formal support，conflicts，total 4 dimensions，24 items. The Scale-Content Validity Index（S-CVI） was 0.94，and Item-Content Validity Index（I-CVI） was 0.83 to 1.00. Four common factors were extracted by exploratory factor analysis，and the cumulative variance contribution rate was 76.730%. The Cronbach’s α for the total scale was 0.960，and the split-half reliability was 0.840. Conclusion The Chinese version of SSEN has acceptable reliability and validity，It can be used to measure the pressure source of emergency nurses， effectively evaluate the pressure state of emergency nurses，and provide a basis for nursing managers to intervene. Related Articles | Metrics

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Nursing care of a trauma patient undergoing exploratory laparotomy within the trauma recovery unit under resuscitation balloon occlusion DING Youya, WANG Sa, YAN Danping, WANG Yuwei 2023, 4 (12):  1112-1115.  doi: 10.3761/j.issn.2096-7446.2023.12.009 Abstract ( 95 )   Save To summarize the emergency nursing experience of a patient with traumatic hemorrhagic shock who underwent exploratory laparotomy within the trauma recovery unit under resuscitation balloon occlusion. In response to issues such as the inability to maintain vital signs，rapid progression of the condition，the need to shorten preoperative preparation time and reduce transport risks in patients with traumatic hemorrhagic shock，exploratory laparotomy with resuscitation balloon occlusion was performed in the emergency trauma recovery unit. After symptomatic treatment and nursing，the patient’s vital signs tended to be stable，and was transferred to the intensive care unit for further treatment for 15 days before being transferred to the local hospital for rehabilitation. After discharge，the patient was followed up for 3 months and recovered well. Related Articles | Metrics

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Nursing care for a pregnant woman had a successful full-term delivery after uterine rupture repair surgery HU Xiaoli, LI Yacen, SHU Limei, DING Qi, LI Baohua 2023, 4 (12):  1115-1118.  doi: 10.3761/j.issn.2096-7446.2023.12.010 Abstract ( 59 )   Save To summarize the nursing experience of a patient with incomplete uterine rupture complicated by deep vein thrombosis after repair surgery and successful pregnancy to full term delivery. Regarding the difficulty and complicated deep vein thrombosis in this case of extending pregnancy to full-term after uterine rupture repair surgery，we adopted a multidisciplinary team cooperation，and vigilant monitor，uterine contraction suppression， modified ankle pump exercises，early ambulation，prevention of pulmonary embolism，continuous care. Both maternal and neonatal outcomes were good. The aim is to provide nursing experience for future care and prevention of complications in such cases. Related Articles | Metrics

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Nursing care of a child with anti N-methyl-D-aspartate receptor encephalitis accompanied by toxic epidermal necrolysis YAN Chunli, ZHANG Yi, Pang Lili, ZHANG Huan, Wang Xiuling 2023, 4 (12):  1119-1122.  doi: 10.3761/j.issn.2096-7446.2023.12.011 Abstract ( 58 )   Save To summarize the nursing experience of a child with anti N-methyl-D-aspartate receptor encephalitis with toxic epidermal necrolysis. Early identification of condition changes，full monitoring of suspected allergenic drugs，personalized skin and mucosal care based on the evolution process of the skin lesion and the characteristics of the disease，precise control of wound infection，implementation of procedural pain strategies，maintenance of venous pathways and fluid management under the condition of mucosal barrier damage，active provision of children’s medical assistance services，and elimination of negative emotions were taken. After 56 days of treatment and care， the child’s condition improved and was discharged from the hospital. He is now recovering well. Related Articles | Metrics

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Nursing care on hepatic artery thrombosis after liver transplantation in a patient with familial hypercholesterolemia ZHU Li, LU Fangyan, WANG Fang, FU Laijian, WANG Yan 2023, 4 (12):  1122-1125.  doi: 10.3761/j.issn.2096-7446.2023.12.012 Abstract ( 50 )   Save To summarize the first aid and nursing experience on early hepatic artery thrombosis of domino liver transplantation for a child with familial hypercholesterolemia. In order to solve the problems of atypical early clinical symptoms of hepatic artery thrombosis，easy occurrence of bleeding and infection during thrombolytic therapy，we adopted measures such as early identification of hepatic artery thrombosis，special management of catheter contact thrombolytic therapy，precise anticoagulation management，continuous low negative pressure abdominal irrigation，individualized nutrition management and skin management of xanthoma. After active treatment and meticulous care，the child was stable and discharged from the hospital and followed up for more than 4 months，with a good prognosis. Related Articles | Metrics

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Perioperative nursing of a premature infant with omphalocele，exstrophy of the bladder，imperforate anus and spinal defect complex ZHOU Huiyun, LUO Feixiang, SHEN Fei, ZHAO Yijun, ZHU Jihua 2023, 4 (12):  1126-1129.  Abstract ( 45 )   Save The perioperative nursing experience of a premature infant with omphalocele，exstrophy of the bladder， imperforate anus and spinal defect complex（OEIS） was summarized. Nursing key points：preoperative nursing of ev- ersion cloacal mucosa；nursing after first stage anal anoplasty to avoid anal stenosis and incision infection；nursing care after second stage surgery，including management of drainage tube under plaster fixation of human position af- ter bladder exstrophy repair，observation of intraperitoneal high pressure，prevention of cast syndrome，stepwise pain management，postoperative skin management and incision care to promote postoperative recovery；discharge guidance and transitional care to improve the discharge readiness and home care capabilities of infant’s family. The infant recovered well and was discharged on the 49th day of admission. Related Articles | Metrics

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Qualitative study on ICU nurses’ perception and experience of patient-family centered care model ZHOU Jiyun, FANG Xiaojie, WEI Yulian, SONG Qing, GAO Sufang 2023, 4 (12):  1130-1134.  Abstract ( 53 )   Save Objective To investigate the cognition and real work experience of ICU nurses on patient-family centered care mode，and to provide reference for optimizing ICU care mode and better meeting the needs of patients and their families. Methods With the method of objective sampling，15 ICU nurses from a tertiary class A hospital in Zibo City，Shandong Province were selected for semi-structured in-depth interviews. Colaizzi 7-step analysis was used to analyze the interview data. Results Three themes were identified：ICU nurses’ attitudes towards the implementation of patient and family centered care （approval；skeptical or negative）；work experience of clinical nurses in ICU under patient and family centered care model （reduced work pressure；conducive to the construction of a good nurse-patient relationship；caused weak safety consciousness among nurses；higher requirements for ICU nurses）；practical difficulties （lack of professional training；incomplete standards and system processes；insufficient multidisciplinary cooperation）. Conclusion The attitude of ICU nurses towards the implementation of the patient-family-centered care model varies from person to person and shows multiple work experiences，which still needs to be improved continuously in clinical practice. It is suggested that ICU nurses should change the conservative concept of care and strengthen professional training. At the same time，more professional norms and standards should be issued for patient-family centered care model，and interdisciplinary cooperation should be promoted to pay attention to and promote the development of patient-family centered care model. Related Articles | Metrics

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Systematic review of risk prediction models for central venous catheter occlusion LIU Ting, PAN Xiaoyan, LI Fang, WANG Min, DENG Tingting, PI Haiyan 2023, 4 (12):  1135-1141.  Abstract ( 114 )   Save Objective To systematically evaluate the risk prediction models of central venous catheter blockage. Methods The Cochrane Library，CINAHL，Embase，PubMed，Web of Science，Wanfang，VIP，Chinese Biomedical Literature Database（CBM） and CNKI were searched for the researches on the risk prediction models of central venous catheter blockage. The retrieval period was from the establishment of the database to June 9，2023.Two investigators independently screened the literature and extracted the data，and evaluated the quality. Results A total of seven studies on the risk prediction model for central venous catheter occlusion were included，and the area under the ROC curve ranged from 0.660 to 0.820. The predictors with the highest frequency were thrombus history，body massindex，D-dimer level，blood flow velocity，and catheter tip position. The risk of bias assessment showed that the included studies had high risk of bias，six studies had good applicability and the remaining one study had poor applicability，mainly due to insufficient sample size，no blinding method reported and no proper missing data handling. Conclusion The existing risk prediction models of central venous catheter blockage had high risk of bias. In the future，we should focus on the methodological details of the study design and the standardization of reporting，and multi-center and large sample studies should be carried out to further optimize and validate the model and improve the model performance. Related Articles | Metrics

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Research progress on risk prediction models for 30-day readmission of patients with chronic obstructive pulmonary disease LIU Xiaoling, ZHAO Hua, LU Wenyan, ZHANG Dan, ZHANG Xuemeng, HUANG Jing 2023, 4 (12):  1142-1146.  doi: 10.3761/j.issn.2096-7446.2023.12.016 Abstract ( 148 )   Save 30-day readmission refers to patients being readmitted to the hospital within 30 days after discharge. The high readmission rate among chronic obstructive pulmonary disease（COPD） patients poses a significant public health challenge. The risk prediction models can quickly screen out the high risk population of readmission and provide the basis for early prevention. This article reviews the basic characteristics，construction methods，and predictive performance of risk prediction models for COPD patients readmitted within 30 days，providing references for clinical healthcare professionals in preventing 30-day readmission among COPD patients. However，further improvements are needed in the selection of predictive factors and the evaluation and application of the models. Related Articles | Metrics