Table of Content

10 May 2022, Volume 3 Issue 3 Previous Issue    Next Issue

Research Paper

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The application of shareable clinical decision support systems in the care of patients with heart failure WANG Juan, XU Dongni, PENG Jianjun, YANG Li, ZHAO Xueli, LIANG Xuejiao 2022, 3 (3):  197-202.  doi: 10.3761/j.issn.2096-7446.2022.03.001 Abstract ( )   PDF (1035KB) ( )   Save Objective To explore the application value of shareable clinical decision support systems（CDSS） in the care of patients with heart failure. Methods 106 patients with chronic heart failure who were admitted to a tertiary grade A hospital in Beijing from March 2019 to March 2021 were selected as the study subjects by convenience sampling method. They were divided into experimental group（from March 2020 to March 2021） and control group（from March 2019 to February 2020） according to the time of admission,with 53 cases in each group. The experimental group received nursing intervention based on shareable CDSS,and the control group received routine nursing. After 6 months of intervention,cardiac function,treatment compliance,self-care ability,quality of life of the two groups were compared. Results After intervention,left ventricular ejection fraction,stroke volume and 6-minute walking distance of experimental group were higher/longer than those of control group,and left ventricular end-diastolic diameter was smaller than that of control group（all P<0.05）. The total treatment compliance rate in experimental group was higher than that in control group（90.57% vs 75.47%）（χ2=4.283,P<0.05）. After intervention,the Exercise of Self-Care Agency Scale（ESCA） scores and the Minnesota Living Heart Failure Questionnaire（MLHFQ） scores of experimental group were significantly higher than those of control group（P<0.05）. Conclusion Applying shareable CDSS to the nursing of patients with heart failure is beneficial to improve cardiac function,treatment compliance and self-care ability of the patients,thereby improving quality of life. References | Related Articles | Metrics

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Analysis of risk factors of delayed discharge among lung cancer patients after day surgery HE Hong, TUO Wangyang, YUAN Huadi, HAN Nafei, JIN Yaojuan 2022, 3 (3):  203-207.  doi: 10.3761/j.issn.2096-7446.2022.03.002 Abstract ( )   PDF (907KB) ( )   Save Objective To analyze the risk factors of delayed discharge among lung cancer patients undergoing day surgery to provide reference for reducing the delayed discharge of patients. Methods The data of lung cancer patients who accepted the day surgery were retrospectively collected during April 1st 2020 to November 30th 2021. The patients were divided into two groups,normal discharge group（stayed less than 48 h） and delayed discharge group（stayed over 48 h）. Univariate analysis and logistic regression were used to analyze the risk factor of delayed discharge. Results 1 363 patients were collected,223 patients were delayed and the incidence of delayed discharge was 16.4%. Univariate analysis showed that age,the local resident,the surgery type,surgery length,amount of bleeding,nausea and vomiting,anticoagulant therapy,mechanical prophylaxis were different between delayed discharge patients and normal discharge patients（P<0.05）. Logistic regression showed that age[OR=1.020,95%CI（1.007,1.036）],surgery length[OR=1.014,95%CI（1.010,1.017）],nausea and vomiting[OR=1.567,95%CI（1.052,2.332）] were independent risk factors（P<0.05）. Anticoagulant therapy[OR=0.113,95%CI（0.081,0.158）],mechanical prophylaxis[OR=0.504,95%CI（0.270,0.943）] were protective factors（P<0.05）. Conclusion It suggests that nurses need to focus on these risk factors for lung cancer patients who undergo day surgery,enhance their risk assessment and education during perioperative period,actively understand their intraoperative situation,and give an early individual intervention to reduce their risk of delayed discharge. References | Related Articles | Metrics

Special Planning—Emergency Nursing of Cardiovascular and Cere?brovascular Diseases

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Nursing care of an elderly patient with acute myocardial infarction and non-occlusive ischemic bowel disease YANG Lin, LIU Ning, SHAN Xiaoyan, LI Shuang, WANG Zheng 2022, 3 (3):  208-211.  doi: 10.3761/j.issn.2096-7446.2022.03.003 Abstract ( )   PDF (997KB) ( )   Save The nursing experience of an elderly patient with acute myocardial infarction complicated with non-occlusive ischemic bowel disease was summarized. Small angle turning over was used instead of the traditional turning method during the period of abdominal distension,which can prevent the pressure injury,relieve the symptoms of abdominal distension and ensure the hemodynamic stability of the patient. Stool volume was recorded accurately during diarrhea period to provide a basis for patient volume management. During bleeding period,nasal feeding and enema was used to apply local hemostatic drugs in the gastrointestinal tract,and the suction tube was used instead of anal canal for enema. In the process of accelerated rehabilitation,the whole-body movement drove the local function. By giving targeted care measures,the patient had a good prognosis and was discharged after 3 months. References | Related Articles | Metrics

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Nursing care of a patient with acute type A aortic coarctation complicated by multiorgan malperfusion syndrome SUN Lijun, ZHENG Weiliang, WANG Ziqiang, WU Chuang 2022, 3 (3):  211-214.  doi: 10.3761/j.issn.2096-7446.2022.03.004 Abstract ( )   PDF (795KB) ( )   Save To summarize the nursing experience of a patient with type A aortic dissection complicated with multiorgan malperfusion syndrome. Such patients usually have complex conditions,severe postoperative complications and difficult care. Main points of nursing included observation of signs and symptoms of malperfusion and comprehensive preoperative evaluation,close monitoring of postoperative hemodynamic changes and maintenance of effective perfusion,formation of a multidisciplinary management team to provide patients with precision organ support for malperfusion organs,preventing the related complications postoperatively and out-of-hospital follow-up management. The patient was transferred from ICU to general ward on the 25th day and discharged on the 30th day after operation. References | Related Articles | Metrics

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Emergency care of sudden myocardial infarction during intravenous thrombolysis in a patient with acute ischemic stroke CHEN Yanqin, YANG Hongyan, CHEN Yuanyuan, WEI Hui 2022, 3 (3):  215-217.  doi: 10.3761/j.issn.2096-7446.2022.03.005 Abstract ( )   PDF (646KB) ( )   Save To report intrahospital emergency care of sudden myocardial infarction during intravenous thrombolysis in a patient with acute ischemic stroke. Hospital emergency care plan was adopted in order to solve the problems such as atypical chest pain symptoms,rapid progress and urgent need for percutaneous coronary intervention. The plan included rapid identification of myocardial infarction,effective shortening of preoperative preparation time,safe and fast intrahospital transport,and etc. After 20 days of treatment and care,the patient was discharged from hospital in a stable condition. He was in good condition during 3 months follow-up after discharge. References | Related Articles | Metrics

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Nursing care of a child with Hutchinson-Gilford progeria syndrome complicated with stroke LI Dongyan, JIANG Meidan, ZHAO Ying, ZHANG Lingxia, WANG Jingjing 2022, 3 (3):  218-220.  doi: 10.3761/j.issn.2096-7446.2022.03.006 Abstract ( )   PDF (743KB) ( )   Save This paper summarized the nursing experience of a child with Hutchinson-Gilford progeria syndrome complicated with stroke. Key points of nursing included the start of emergency process to carry out symptom monitoring and first aid treatment; the implementation of rehabilitation doctor led medical care and early rehabilitation intervention with parents' participation; early nasal feeding,regular evaluation of swallowing function,reasonable transition of food properties and correct feeding methods to effectively prevent asphyxia and ensure adequate nutritional needs; adaptive disease prevention and continuous nursing to provide humanistic care for children. After the above care,the child was discharged 17 days after admission. The patient was followed up for 4 months and recovered well. References | Related Articles | Metrics

Emergency Care Research

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Nursing care of a patient with neurofibroma complicated with rupture of pseudoaneurysm of neck and shoulder YU Jingjing, WANG Yuwei, WANG Sa, ZHANG Yukun 2022, 3 (3):  221-223.  doi: 10.3761/j.issn.2096-7446.2022.03.007 Abstract ( )   PDF (561KB) ( )   Save To summarize the nursing experience of a patient with neurofibroma complicated with a ruptured pseudoaneurysm of the neck and shoulder. In view of the increasing neck and shoulder hematoma, rapid disease progress and short preoperative preparation time in this patient,we adopted deep sedation combined with analgesia to establish an advanced airway,opened dual venous access,cooperated within the emergency team,and initiated intra-hospital critical care patient transfer process,implemented good postoperative care. After 13 days of active treatment and meticulous care,the patient successfully recovered and was discharged from the hospital. References | Related Articles | Metrics

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Nursing care of a patient with organophosphorus poisoning after cardiac arrest resuscitation XING Zhuangjie, DU Yifeng, WANG Qin, MA Chengyan 2022, 3 (3):  224-227.  doi: 10.3761/j.issn.2096-7446.2022.03.008 Abstract ( )   PDF (677KB) ( )   Save To report the nursing experience of a patient with organophosphorus poisoning after cardiac arrest resuscitation. For the patient with organophosphorus poisoning who have sudden cardiac arrest during the rescue process,we should grasp the opportunity and adopt the combined treatment of extracorporeal membrane oxygenation （ECMO） and continuous renal replacement therapy（CRRT） in time. In the process of interhospital transfer,attention should be paid to the close cooperation between hospitals and between doctors and nurses to ensure the safety of the transfer. During the treatment process,nurses should ensure the operation and proper fixation of the pipeline,and do anticoagulation care to reduce and control the occurrence of related complications. After timely and efficient treatment and care,the patient was successfully weaned from the machine after 5 days. After 15 days of hospitalization,the patient was transferred to a higher-level hospital for further treatment. References | Related Articles | Metrics

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Nursing of a patient with continued pregnancy delivery after repair of mid-trimester scar uterine rupture GU Huimin, ZHANG Yue, WU Suxian 2022, 3 (3):  228-231.  doi: 10.3761/j.issn.2096-7446.2022.03.009 Abstract ( )   PDF (735KB) ( )   Save To summarize the nursing experience of a patient who continued pregnancy to 34 weeks after repair of mid-trimester scar uterine rupture. For a patient with a strong intention to continue pregnancy with uterine rupture in the second trimester of pregnancy,we need to complete difficult uterine scar repair surgery,and postoperative pregnancy may be complicated with uterine rupture,premature rupture of fetal membranes,venous thrombosis and premature birth. The case was rare and high risk. Nurses needed to identify early symptoms of uterine rupture,provide professional psychological counseling and special medication monitoring according to the progress of the condition. At the same time multidisciplinary collaboration was needed for surgical cooperation and control of maternal complications. After careful treatment and care,the patient extended her pregnancy from 24+2 weeks to 34+3 weeks and successfully delivered a male infant. The maternal and newborn outcome were good and they were discharged 6 d after caesarean section. References | Related Articles | Metrics

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Early identification and nursing care of testicular torsion in adolescents ZHENG Zhihui, ZHU Jihua, ZOU Yao 2022, 3 (3):  232-234.  doi: 10.3761/j.issn.2096-7446.2022.03.010 Abstract ( )   PDF (540KB) ( )   Save Testicular torsion is the most common urological emergency in adolescents and children. Failure to deal with it in time will lead to testicular necrosis and seriously affect their health. Early recognition,timely diagnosis and early intervention are the key to avoid orchiectomy. This research reviewed clinical features and nursing experience of 100 cases with testicular torsion. The formulation of standardized diagnosis and treatment process can effectively shorten the time from visiting the hospital to the operation. Meanwhile,we need to strengthen the popular science education for young children and their parents,and training for the primary medical personnel,striving for the golden time of treatment together to reduce the occurrence of testicular necrosis. References | Related Articles | Metrics

Critical Care Research

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Symptom management in a patient suffering from acquired thrombophilia and multiple skin lesions LONG Yanfang, LI Li, YANG Li, ZHANG Weiru, ZHOU Jianhui 2022, 3 (3):  235-238.  doi: 10.3761/j.issn.2096-7446.2022.03.011 Abstract ( )   PDF (682KB) ( )   Save Experiences in symptom management of a patient with acquired thrombophilia and multiple skin lesions were summarized. In response to the patient's recurrent thrombosis and multiple skin lesions that had been prolonged and progressive,the EEMMA（evaluation,explanation,management,monitoring and attention to detail） model was adopted for symptom management. Multiple causes of recurrent thrombosis and skin lesions were assessed,including the primary disease,insufficient anticoagulation,and the complications of deep vein thrombosis. Following the evaluation results,the primary disease was treated; the anticoagulants were adjusted,and the effects and adverse reactions of anticoagulation were monitored; the occurrence of pulmonary embolism was warned early; the wound center was invited to deal with complex skin lesions. The patient and her family were encouraged to participate in medical care decision-making,thus improving their compliance with care. After meticulous treatment and care for 23 days,the patient's hemoglobin,D-dimer and other indicators tended to be normal,the thrombosis stopped progressing,and the skin lesions were effectively controlled before discharge. References | Related Articles | Metrics

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Nursing of multiple replacement of oxygenators in a patient with multiple injuries and treated by extracorporeal membrane oxygenation JIANG Xiaochun, HUANG Xiaoxia 2022, 3 (3):  239-242.  doi: 10.3761/j.issn.2096-7446.2022.03.012 Abstract ( )   PDF (634KB) ( )   Save The nursing experience of a patient with extracorporeal membrane pulmonary oxygenation after severe multiple injury splenectomy with acute respiratory distress syndrome was reported. In view of the complex and critical condition of the patient,the membrane lungs were replaced for many times during the extracorporeal membrane lung oxygenation treatment,the prevention and care of bleeding and thrombosis complications were needed,and personalized nursing measures such as anticoagulant care,nutritional support,physical rehabilitation and psychological rehabilitation were formulated.After 88 d of treatment and care,the patient recovered and was discharged. References | Related Articles | Metrics

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Multidisciplinary collaborative care for lung transplant patients complicated with bronchial anastomotic stenosis XU Xiaoyan, LÜ Zhanghong 2022, 3 (3):  243-246.  doi: 10.3761/j.issn.2096-7446.2022.03.013 Abstract ( )   PDF (732KB) ( )   Save The experience of multidisciplinary collaborative care in four lung transplant patients complicated with bronchial anastomotic stenosis was summarized. In response to the problems that bronchoscopy has many critical and emergent complications,recurrent episodes of hypoxemia,lack of self-symptom monitoring ability,and lack of rehabilitation continuity,we set up multidisciplinary collaborative management team,formulated perioperative safety care plan of bronchoscopy,precisely implemented individualized oxygen therapy strategy,provided self-symptom monitoring and rehabilitation exercise in case management mode. Four patients were treated by bronchoscopy and carefully cared,and followed up for 6 to 12 months. The transplanted lung functioned well,and the patients per-formed 6-minute walk test with more than 300 m,and average score of Karnofsky functional status scale was 90 points. References | Related Articles | Metrics

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Nursing care of a 103-year-old patient with intertrochanteric fracture complicated with pulmonary embolism YANG Zengzhen, BAI Xiaoling, LI Ling, ZHANG Yunfan 2022, 3 (3):  247-249.  doi: 10.3761/j.issn.2096-7446.2022.03.014 Abstract ( )   PDF (586KB) ( )   Save To summarize the nursing experience of artificial femoral head replacement in a super elderly patient with intertrochanteric fracture complicated with pulmonary embolism. For the patient had no obvious symptoms of pulmonary embolism,several basic diseases,and short time for preoperative preparation,we have taken a series of measures,including planning a multidisciplinary diagnosis and nursing scheme,evaluating and intervening the pulmonary embolism,observing the multimodal analgesic effect,postoperative nutritional support and early rehabilitation. After 23 days of treatment and nursing,the patient was discharged. The patient was followed up for 4 months after discharge and recovered well. References | Related Articles | Metrics

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Nursing care of a patient with Clostridium perfringens infection caused by pecking injury of chicken CHEN Hao, JIAN Fuxia 2022, 3 (3):  250-252.  doi: 10.3761/j.issn.2096-7446.2022.03.015 Abstract ( )   PDF (583KB) ( )   Save To summarize the nursing experience of a case of Clostridium perfringens infection caused by pecking injury of chicken. In terms of wound infection,fluid volume balance and rehabilitation,early detection,early reporting,early treatment and continuous monitoring should be carried out; and targeted wound care,goal-directed continuous renal replacement therapy nursing and rehabilitation management and other measures were also implemented. After 28 days of treatment and nursing,the patient's condition was stable and discharged. The patient was followed up for 3 months after discharge and the condition was good. References | Related Articles | Metrics

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Perioperative nursing of 7 infants with pharyngeal hairy polyps SHENG Meijun, QIU Fei, YE Feiya, ZHU Lina, ZHENG Hong, ZHU Jihua 2022, 3 (3):  253-256.  doi: 10.3761/j.issn.2096-7446.2022.03.016 Abstract ( )   PDF (718KB) ( )   Save To summarize the perioperative nursing experience of 7 infants with pharyngeal hairy polyps. In view of hypoxemia,respiratory symptoms,difficulty in feeding and regurgitation,postoperative nursing problems,the key points of nursing included：promptly correcting the hypoxemia by managing nasal high-flow humidifying oxygen therapy; keeping the unobstructed of respiratory tract and implementing airway clearance therapy; development support of infants which included adequate nutritional support,actively preventing reflux and aspiration,practicing infant-driven feeding to improve the nutritional status; preventing and managing complications of pharyngeal incisions,emphasizing oral care and continuous care for discharged children. After intensive care and precise management,all children were cured and discharged at 3~7 days postoperatively. During the follow-up,all the patients obtained high quality rehabilitation effect without recurrence of hairy polyps. References | Related Articles | Metrics

Quality and Safety

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Construction and application of second victim support system for nurses from the perspective of Newman system theory SONG Qingna, HUANG Xia, LENG Min, XU Xiaohua, LU Xueping, JIANG Yan 2022, 3 (3):  257-262.  doi: 10.3761/j.issn.2096-7446.2022.03.017 Abstract ( )   PDF (888KB) ( )   Save Objective To construct the nurse's second victim support system from the perspective of Newman system theory and verify the clinical application effect of the system. Methods The theoretical framework of the nurse's second victim support system was formulated by literature research. The Delphi method was used to implement two rounds of expert letter consultation,and various contents of the support system were improved according to the results of the letter consultation. The system was implemented and covered all nurses of a tertiary hospital in Qingdao for primary prevention,key protection for secondary prevention,and precise assistance for tertiary prevention. Results This study constructed a nurses' second victim support system from the perspective of Newman system theory,which included 3-level prevention programs,5 initiation ports,and 15 interventions. The system had established mental health records for 3,917 nurses for primary prevention since its operation for one year,and about 3,000 nurses participated in psychological relief lectures and benefited from it. Secondary prevention provided online counseling for 112 nurses and offline psychological counseling for 103 nurses. Tertiary prevention provided advanced psychological support to 37 nurses. Conclusion The second victim support system of nurses from the perspective of Newman system theory can improve nurses' psychological capital,assist psychological reconstruction,promote physical and mental health. References | Related Articles | Metrics

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Meta-analysis of the effect of ultrasound-guided technique in radial artery puncture in adults WEN Dan, WANG Yao, XU Rong, LIANG Zhenghua 2022, 3 (3):  263-268.  doi: 10.3761/j.issn.2096-7446.2022.03.018 Abstract ( )   PDF (1282KB) ( )   Save Objective To systematically evaluate the effect of ultrasound-guided technique in radial artery puncture in adults. Methods Randomized controlled trials on ultrasound guided and palpation in adult radial artery puncture were searched in CNKI,Wanfang,VIP,SinoMed,PubMed,CINAHL,Cochrane Library,Web of Science,Embase,and database of clinical trials. RevMan 5.0 software was used for performing a Meta-analysis. Results Totally 11 studies involving 2 284 participants were enrolled. Results of this meta-analysis suggested that ultrasound guided technique can improve the success rate of the first puncture in adult radial artery puncture,[OR=3.89,95%CI（2.52,6.01）,P< 0.001],reduce the average number of puncture[MD=-0.98,95%CI（-1.73,-0.23）,P=0.01],reduce the incidence of hematoma[OR=0.28,95%CI（0.09,0.88）,P=0.03],reduce the number of catheters used[OR=-1.00,95%CI（-1.81,-0.19）,P=0.02]. Conclusion Current evidence indicates that ultrasound-guided radial artery puncture in adults could significantly increase the first success rate,reduce the incidence of hematoma and the number of catheters used. References | Related Articles | Metrics

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A scoping review of moral distress of emergency and critical care nurses LIU Yuanfei, ZHANG Yuping, JIN Jingfen 2022, 3 (3):  269-275.  doi: 10.3761/j.issn.2096-7446.2022.03.019 Abstract ( )   PDF (858KB) ( )   Save Objective To understand the research status of moral distress of emergency and critical care nurses at home and abroad. Methods PubMed,EMBASE,the Cochrane Library,CINAHL,Scopus,China biomedical literature database,CNKI,VIP Chinese journal database and Wanfang database were searched from the establishment of the database to March 2021. Literature screening and data extraction were carried out. Results A total of 35 literatures were included. The results showed that the influencing factors of moral distress of emergency and critical care nurses included general demographic characteristics,personal internal factors,external factors and specific clinical situations. Different intervention strategies were adopted to deal with the moral distress of nurses,including group discussion,salon activities,course lectures,narrative writing and so on. Before and after the intervention,the changes of nurses' moral distress have not been consistent. Conclusion Many factors have an impact on the moral distress of nurses in emergency and critical care. Intervention strategies that combine various forms and are suitable for national conditions and culture should be adopted. References | Related Articles | Metrics

Forum

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The application and challenge of artificial intelligence in critical care CHEN Niu, CHEN Ying, GUO Jin, LI Chunpeng 2022, 3 (3):  276-279.  doi: 10.3761/j.issn.2096-7446.2022.03.020 Abstract ( )   PDF (614KB) ( )   Save Driven by social needs,national policies and digital innovation,the reform of nursing service model has become an inevitable trend. As a kind of information technology,artificial intelligence is a new means to promote the reform of the medical industry. This article introduces the application of artificial intelligence in decision-making assistance,risk early warning,giving assistance to nurses,remoting intensive care. It analyzes the challenges in standardization of data resources,nursing information talents,security risks and ethical challenges,and provides information for promoting the construction of nursing intelligence in critical nursing care. References | Related Articles | Metrics

Review

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Research progress of nursing interventions for sepsis-associated anemia CHEN Ling, HUANG Sufang, XIONG Jie, ZOU Dengxiu, DENG Juan 2022, 3 (3):  280-283.  doi: 10.3761/j.issn.2096-7446.2022.03.021 Abstract ( )   PDF (627KB) ( )   Save Sepsis is a life-threatening organ dysfunction that caused by the host's immune dysregulation response to infection,and is one of the main causes of death in critically ill patients. Sepsis-associated anemia is one of the most common complications. Its occurrence and duration can increase the fatality rate of patients. At present, inflammatory reactions, blood loss, hemodilution, malnutrition, and the use of vasoactive drugs may lead to sepsis associated anemia. This article reviewed the nursing measures for sepsis associated anemia,including anti-infection treatment,blood sample collection and medical nursing,fluid volume monitoring,nutritional intervention. Current studies provide theoretical basis for the nursing management of sepsis related anemia,but the specific cluster management strategy needs to be further established and improved. References | Related Articles | Metrics

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Research progress on influencing factors and implementation strategies of palliative care for stroke patients YUAN Meiling, YANG Haipeng, DAI Yueguang, MI Long, LIU Xia 2022, 3 (3):  284-288.  doi: 10.3761/j.issn.2096-7446.2022.03.022 Abstract ( )   PDF (755KB) ( )   Save With the continuous development of medicine,more and more attention is paid to providing patients with treatment and nursing services aimed at improving the quality of life. Palliative treatment plays an important role in alleviating the pain of stroke patients and improving their quality of life. The necessity,influencing factors and implementation strategies of palliative care for stroke patients were reviewed,including promoting treatment decision-making discussion,improving symptom management,and establishing and improving palliative care policies,in order to provide reference for the implementation of palliative care for stroke patients. References | Related Articles | Metrics