Table of Content

10 February 2023, Volume 4 Issue 2 Previous Issue    Next Issue

Research Paper

Select

Intervention effect of transitional nursing program on migration stress of liver transplant patients' family members GUO Zhongxian, GOU Yuli, SHA Liyan, JIANG Jing, JU Weiwei 2023, 4 (2):  101-105.  doi: 10.3761/j.issn.2096-7446.2023.02.001 Abstract ( )   PDF (801KB) ( )   Save Objective To investigate the effect of transitional nursing program on migration stress and care ability of liver transplant patients' family members. Methods Using non-concurrent control experimental method,57 liver transplant patients from April 2021 to May 2022 were selected as the study subjects in a tertiary Class A hospital of Dalian. They were randomly divided into observation group（n=27） and control group（n=30） according to the order of admission. The control group adopted routine nursing mode,and the observation group adopted transitional care program based on the ABC-X model. Family Relocation Stress Scale（FRSS） and Family Caregiver Task Inventory（FCTI） were used to evaluate the intervention effect before and after intervention. Results After intervention,the FRSS score of the observation group（30.17±7.29） was lower than that of the control group（32.40±4.88）,and the difference was statistically significant（t=9.816,P<0.001）. The FCTI score of the observation group（22.66±2.91）was lower than that of the control group（30.00±2.91）,and the difference was statistically significant（t=9.459,P<0.001）. Conclusion The transitional nursing program based on ABC-X model can reduce the migration stress level of family members of liver transplant patients and improve their care ability. References | Related Articles | Metrics

Special Planning-Nutrition Support Nursing in Critically Ill Patients

Select

Meta-analysis of the effects of volume based feeding on nutrition intake of ICU patients YU Haitao, CAI Li, CHEN Lu, LI Zehui, WU Yunlian 2023, 4 (2):  106-111.  doi: 10.3761/j.issn.2096-7446.2023.02.002 Abstract ( )   PDF (986KB) ( )   Save Objective To systematically evaluate the effects of volume based and rate based feeding on the nutrition intake of intensive care patients. Methods Cochrane Library,PubMed,Web of Science,CNKI,Wanfang Database,China Biomedical Database and VIP were searched for randomized controlled trials and quasi-experimental studies related to the effects of volume-based and rate-based feeding on compliance rate of nutrition in critically ill patients from the database's inception to August 2022. After literature screening,data extraction and the risk of bias were evaluated independently by two researchers,meta-analysis was performed using RevMan 5.3 software. Results A total of 5 randomized controlled trials and 4 quasi-experimental studies were included,including 718 patients. Meta-analysis showed that compared with rate-based feeding,volume-based feeding scheme can improve the compliance rate of energy intake[MD=16.58,95%CI（11.15,20.01）,P<0.001] and protein intake compliance rate in intensive care patients,but the differences in the incidence of diarrhea[OR=1.07,95%CI（0.72,1.58）,P=0.75],the inci-dence of vomiting/reflux[OR=0.77,95%CI（0.48,1.26）,P=0.30],ICU hospitalization length[MD=-0.11,95%CI（-0.15,0.94）,P=0.84] and other aspects were not statistically significant between the two groups. Conclusion Compared with the traditional enteral nutrition scheme,volume based feeding could significantly improve the nutritional intake of critical patients,but did not increase the incidence of complications of enteral feeding,and could effectively ensure the nutritional supply of patients. References | Related Articles | Metrics

Select

Evidence summary of enteral nutrition management in patients with prone position ventilation ZHANG Li, YANG Tingting, SHI Liping, WANG Gang, PAN Yueshuai, LIN Hui 2023, 4 (2):  112-118.  doi: 10.3761/j.issn.2096-7446.2023.02.003 Abstract ( )   PDF (1019KB) ( )   Save Objective To retrieve,evaluate and summarize the evidence related to enteral nutrition management for patients with prone position ventilation,so as to provide evidence for clinical nursing. Methods We searched the National Institute for Health and Care Excellence（NICE）,Registered Nurses' Association of Ontario（RNAO）,Scottish Intercollegiate Guidelines Network（SIGN）,CNKI,Wanfang,CBM,China Medical Journal Network,UpToDate,Cochrane Library,PubMed,European Society for Parenteral and Enteral Nutrition,American Society for Parenteral and Enteral Nutrition,Society of Critical Care Medicine and other websites for all the evidence related to enteral nutrition management of patients with prone position ventilation. Two researchers evaluated the quality of the included literature and extracted evidence from the literature that met the quality standards. Results A total of 20 articles were included. We summarized 23 best evidences in 7 aspects of enteral nutrition including timing,route selection,preparation,selection of nutrient solution,feeding speed,tolerance and anti-aspiration management. Conclusion The best evidence for enteral nutrition management in prone position ventilation patients summarized in this study can provide evidence for the clinical practice. It is recommended that when applying evidence in clinical application,nurses should assess the specific medical environment,the promotion and obstacle factors of applying evidence,and then carry out targeted evidence application,scientifically carry out enteral nutrition management for patients with prone position ventilation. References | Related Articles | Metrics

Select

Nutritional support in patients with acute mesenteric ischemia: a scoping review XIANG Bo, LIU Liping, HUANG Ping 2023, 4 (2):  119-124.  doi: 10.3761/j.issn.2096-7446.2023.02.004 Abstract ( )   PDF (914KB) ( )   Save Objective To perform a scoping review on nutritional support in patients with acute mesenteric ischemia,describe the mode,approach,time,formula and outcome evaluation index of nutritional support in order to provide reference for clinical work and later research. Methods A literature search was performed in the CNKI,CBM,VIP,Wanfang,Cochrane Library,PubMed,Elsevier databases to identify relevant studies following the framework of scoping review which was proposed by Arksey et al. and refined by Levac et al. The time was from the establishment of the database to October 2022. The included literature was screened,summarized and analyzed. Results A total of 10 articles were included,including 4 in Chinese and 6 in English,published from 1974 to 2020. The methods and approaches of nutritional support,parenteral nutrition formula,enteral nutrition initiation time and evaluation indexes,enteral nutrition formula and outcome evaluation indexes were analyzed and summarized. Conclusion Nutritional support improves the clinical outcome of patients with acute mesenteric ischemia,but there is a lack of research on nutrition screening,early enteral nutrition support and nutritional follow-up after discharge. In the future,more studies need to be carried out to explore the application of nutritional support in patients with acute mesenteric ischemia to form norms and guidelines. References | Related Articles | Metrics

Select

Research progress of preoperative enteral nutrition in neonates with critical congenital heart disease LI Minmin, WANG Yingying, LI Qianqian, DONG Chunhui 2023, 4 (2):  125-129.  doi: 10.3761/j.issn.2096-7446.2023.02.005 Abstract ( )   PDF (932KB) ( )   Save Enteral nutrition is a nutritional support method that provides nutrients and other nutrients through the gastrointestinal tract. Preoperative enteral nutrition is crucial to improve the short-term and long-term prognosis of newborns with critical congenital heart disease. However,the management of enteral nutrition before surgery in neonates with congenital heart disease varies widely around the world. This article reviews preoperative enteral nutrition in newborns with congenital heart disease from the overview of enteral nutrition,influencing factors of enteral nutrition,evaluation of enteral nutrition,implementation of enteral nutrition and problem handling,and puts forward the improvement direction of future clinical practice in order to provide reference for the management of preoperative enteral nutrition in newborns with congenital heart disease in China. References | Related Articles | Metrics

Select

Sequential nutritional care for ICU patients with nutritional support complicated with refeeding syndrome WANG Haiyan, LONG Xingxia, WU Wenying, ZENG Fei, TANG Jiaying, YAO Meiqi, FENG Xiuqin 2023, 4 (2):  129-131.  doi: 10.3761/j.issn.2096-7446.2023.02.006 Abstract ( )   PDF (598KB) ( )   Save To summarize the nursing experience of 89 ICU patients complicated with refeeding syndrome. Nursing points included formulation of nutritional support programs based on nutritional assessment,implementation of sequential nutritional support,correction of electrolyte imbalance mainly due to hypophosphatemia. All 89 patients were successfully cured and discharged from hospital. References | Related Articles | Metrics

Select

Nutritional support care of a child with megacystis microcolon intestinal hypoperistalsis syndrome LI Mei, CHEN Xiaofei 2023, 4 (2):  132-135.  doi: 10.3761/j.issn.2096-7446.2023.02.007 Abstract ( )   PDF (809KB) ( )   Save To summarize nutritional support care of a child with megacystis microcolon intestinal hypoperistalsis syndrome. In terms of the serious intestinal digestion and absorption disorder,it was easy to cause malnutrition and intestinal failure,and it was dependent on parenteral nutrition,nutritional support was the difficulty of the nursing. Dynamical evaluation of nutritional status was adopted to provide a basis for formulating nutritional treatment plans. Reasonable nutritional support method was selected,and parenteral nutrition and enteral nutrition support were provided. Symptomatic supportive care was provided to avoid serious complications. And long-term follow-up mechanisms were established to carry out health education and improve disease prognosis. After 45 days of standardized treatment and care,the child's condition was controlled,with increased weight. After stabilization,he was discharged from the hospital and continued to be followed up regularly. References | Related Articles | Metrics

Guideline and Standard

Select

Interpretation for nursing standard of high flow nasal cannula oxygen for adults QI Xiaojiu, WU Xinjuan, GAO Yanhong, ZHANG Zhixia, LAN Meijuan, GUO Shuming, ZHANG Huizhi, XIANYU Yunyan, LIU Yu, CAO Qing, ZHANG Hongjun, HUANG Zheng, DONG Fan, TANG Li’an, ZHANG Su 2023, 4 (2):  136-139.  doi: 10.3761/j.issn.2096-7446.2023.02.008 Abstract ( )   PDF (704KB) ( )   Save High flow nasal cannula oxygen therapy has been widely used in China due to its ability to maintain the normal function of airway mucous,reduce physiological dead space,provide high-flow warm and humidified gas and provide certain ventilation support. At present,there is no clear guidance document for nursing staff in China. Beijing Hospital and other 11 hospitals have formulated the “Nursing Standard for High Flow Nasal Cannula Oxygen in Adults（T/CRHA 015-2023）”,a group standard of the Chinese Research Hospital Association,which provides the basic requirements,assessment,operation and infection control methods for caring adult patients with nasal high flow oxygen therapy. The present article is interpreting some items concerning the each part of standard to help the users understand the standard and promote the normative practice of high flow nasal cannula oxygen therapy. References | Related Articles | Metrics

Emergency Care Research

Select

Nursing care of a patient with massive hemoptysis after lung transplantation undergoing rigid bronchoscopy under extracorporeal membrane oxygenation ZHANG Shuai, LIN Yan, GAO Chunhua, CHU Junqing, DONG Zhenyuan 2023, 4 (2):  140-143.  doi: 10.3761/j.issn.2096-7446.2023.02.009 Abstract ( )   PDF (682KB) ( )   Save To summarize the emergency nursing experience of a patient with massive hemoptysis after lung transplantation undergoing rigid bronchoscopy assisted by extracorporeal membrane oxygenation. For patients with massive hemoptysis without symptoms,a comprehensive emergency plan was adopted,including safe and quick transport,extracorporeal membrane oxygenation care,bedside rigid bronchoscopy management,and monitoring of patient bleeding and thrombosis. After 12 days of active treatment and care,the patient recovered and was discharged from the hospital. References | Related Articles | Metrics

Select

Emergency nursing of a patient with thrombocytopenia syndrome caused by novel bunya virus infection ZHANG Guowen, WANG Sa, LIN Wenfeng, SUN Liqin, CHENG Baozhen, WU Zuojia, CHEN Fang 2023, 4 (2):  143-146.  doi: 10.3761/j.issn.2096-7446.2023.02.010 Abstract ( )   PDF (719KB) ( )   Save This case study summarized the emergency nursing experience of a patient with fever combined with thrombocytopenia syndrome caused by novel bunyavirus infection. The nurses traced the history in detail for the unknown cause of the disease,and rapidly improved virological examination to diagnose suspected pathogens. Emergency platelets transfusion,prevention and monitoring of bleeding complications,stop of all possible transmission routes and comprehensive measures to prevent cross infection were taken. After 21 hours of multidisciplinary emergency treatment and precise nursing,the patient was successfully transferred to ICU for further treatment and later transferred to the other hospital for rehabilitation. References | Related Articles | Metrics

Select

Nursing care of a child with anterior mediastinal lymphoma supported with extracorporeal membrane oxygenation and continuous blood purification XIE Wangfang, LOU Xiaofang, ZHU Jihua, XU Bin 2023, 4 (2):  147-150.  doi: 10.3761/j.issn.2096-7446.2023.02.011 Abstract ( )   PDF (723KB) ( )   Save This paper summarized the rescue and the nursing care of a case of anterior mediastinal lymphoma complicated with severe airway obstruction and superior vena cava compression. Key nursing pointes included early identification of dyspnea caused by local compression of mediastinal lymphoma,effective intervention of extracorporeal membrane oxygenation. During the operation of extracorporeal membrane oxygenation combined with continuous blood purification,the patient was closely observed,symptoms of airway obstruction were dynamically evaluated,and pressure of superior vena cava was continuously monitored. We timely observed and effectively treated hypotension,bleeding and other complications,tumor lysis syndrome such as hyperkalemia and hypocalcemia. After careful treatment and nursing,the extracorporeal membrane lung machine was successfully evacuated after 12 days of operation. The patient's condition recovered steadily on the 20th day of admission and was transferred to hematology department for further specialized treatment. References | Related Articles | Metrics

Critical Care Research

Select

Nursing of prone position ventilation for acute respiratory distress syndrome after liver transplantation: a case report LU Haifei, FENG Xiuqin, WANG Lizhu, ZHANG Liu, QIAN Yanying 2023, 4 (2):  151-153.  doi: 10.3761/j.issn.2096-7446.2023.02.012 Abstract ( )   PDF (534KB) ( )   Save To summarize the nursing of individualized prone ventilation in a critically ill patient with postoperative respiratory distress after split liver transplantation. In this case,the postoperative liver section was prone to bleeding and it had a high risk of abdominal compression under the prone position,a modified prone position ventilation scheme was implemented with adequate assessment and effective immobilization of the patient's abdominal wound. And continuous and dynamic monitoring of intra-abdominal pressure,adjustment of position and enteral nutrition strategy guided by intra-abdominal pressure,strengthening of observation and care for abdominal drainage tube during prone position were adopted. The lung function of the patient improved significantly after four times of prone position ventilation within 5 days after the operation and no adverse events such as hemorrhage and displacement of liver occurred. The tracheal intubation was successfully removed on the 5th day after the operation urgery,and the patient recovered and was discharged from the hospital on the 39th day. References | Related Articles | Metrics

Select

Perioperative nursing of a pregnancy patient with Ⅵ mucopolysaccharidoses GU Huimin, XU Xiaowen, SHU Limei, ZHANG Yue, WU Tianxia 2023, 4 (2):  154-157.  doi: 10.3761/j.issn.2096-7446.2023.02.013 Abstract ( )   PDF (712KB) ( )   Save To summarize the perioperative nursing experience of a pregnancy patient with Ⅵ mucopolysaccharidoses. In view of the problems of emotional anxiety,worry about fetal outcome,short stature,abnormal spine development,large tongue,small thoracic size,intercostal diaphragm impaired movements,limited muscle strength and cardiac function grade Ⅱ in this patient,key points of nursing included preoperative psychological supportive care,comfort improvement guidance,activity safety management,heart failure dynamic protection,maternal and fetal multidisciplinary monitoring,postoperative fluid precision balance,close airway monitoring,complication prevention,maternal and infant intimacy building measures. After careful treatment and nursing,the patient was discharged on the sixth day after cesarean section. The newborn was discharged from the Neonatal Department on the 43rd day after birth. Both of the maternal and fetal outcome were well. References | Related Articles | Metrics

Quality and Safety

Select

The practice of optimized rescue and nursing management plan for esophagogastric variceal bleeding LÜ Minfang, ZHU Yinghua, ZHANG Shuangyan, WEI Wei 2023, 4 (2):  158-162.  doi: 10.3761/j.issn.2096-7446.2023.02.014 Abstract ( )   PDF (849KB) ( )   Save Objective To carry out the practice of optimized rescue and nursing management plan for patients with esophagogastric variceal bleeding in liver cirrhosis. Methods A multidisciplinary rescue and nursing team was established,the problems in the rescue process was analyzed,and the measures was optimized from emergency condition assessment and nursing,volume resuscitation,emergency drug hemostasis,endoscopic hemostasis,emergency transport,and quality control was carried out and the management plan was practiced in the emergency department. Results Hemostasis was successful in all 15 patients. The length of hospital stay was （7.73±3.13） days,which was significantly shorter than that of patients with esophagogastric variceal bleeding in liver cirrhosis reported in the literature（12.5±2.5） days. Conclusion Optimizing the rescue and nursing management plan for patients with esophagogastric variceal bleeding in liver cirrhosis can shorten the hospital stay length of patients. References | Related Articles | Metrics

Select

Investigation and intervention of a suspected outbreak of carbapenem-resistant Acinetobacter baumannii infection in an pediatric intensive care unit PENG Hanling, ZHANG Zhiqin, SU Chunmei 2023, 4 (2):  163-166.  doi: 10.3761/j.issn.2096-7446.2023.02.015 Abstract ( )   PDF (680KB) ( )   Save Objective To investigate the epidemiological features of a suspected healthcare-associated infection outbreak of carbapenem-resistant Acinetobacter baumannii（CRAB） in Pediatric Intensive Care Unit（PICU）,and facilitate the prevention and control of hospital associated infection effectively. Methods Subjects infected with CRAB in PICU from May 20th 2021 to June 6th 2021 were investigated epidemiologically and environmental hygiene was monitored. Risk factors were analyzed and corresponding preventive control methods were taken. Results CRAB was detected in 6 cases with 4 cases being identified as colonization and 2 cases as nosocomial infection. The qualified rate of bacterial count on the surfaces of objects was 44.44%（16/36）. Univariate analysis revealed that coma,endotracheal intubation,bronchoscopy and conventional sputum suction were relevant risk factors. There were no new infected cases occurred in PICU after a series control methods were taken since June 7th 2021. Conclusion This CRAB HAI may be spread transversely through environmental surfaces and hands of medical staffs in the process of sputum suction with bronchoscopy. Cleaning and disinfection of the surfaces of objects and hand hygiene management in PICU are vital for preventing hospital infection. References | Related Articles | Metrics

Evidence Synthesis and Practice

Select

The research hotspots of critical care nursing in recent 5 years based on PubMed database NI Qiqi, ZHUANG Yiyu 2023, 4 (2):  167-172.  doi: 10.3761/j.issn.2096-7446.2023.02.016 Abstract ( )   PDF (919KB) ( )   Save Objective To analyze the research hotspot of critical care nursing abroad in recent 5 years，in order to provide reference for critical care nursing research in China. Methods PubMed database was searched for articles related to critical care nursing from 2017 to 2022. Bicomb software was used for word frequency analysis，and gCLUTO software was used for cluster analysis. Results A total of 1 263 articles related to critical care nursing were included，the number of publications reached the highest level from 2018 to 2020，and showed a downward trend in the past two years. Forty-four high-frequency keywords were extracted，and the cumulative percentage of occurrence frequency was 55.50%. Four research hotspots of critical care were summarized by cluster analysis，which were humanistic care of critical care nursing，working environment of critical care，clinical nursing practice of critical care and nursing of special critical diseases. Conclusion In recent years，the research objects and contents extended and deepened. The research objects included ICU nurses，patients and their families. The research contents involved humanistic care，clinical practice and working environment，focused on clinical difficulties such as surrogate decision-making，auxiliary communication and hospice care of ICU patients. In the future，we still need to summarize the hotspots of critical care nursing research in order to provide ideas for further exploring the depth and breadth of critical care nursing research. References | Related Articles | Metrics

Select

Summary of best evidence for hyperglycemia management in patients with ischemic stroke LIAO Zongfeng, YI Qiaoli, MAO Liye, LI Ling 2023, 4 (2):  172-178.  doi: 10.3761/j.issn.2096-7446.2023.02.017 Abstract ( )   PDF (881KB) ( )   Save Objective To summarize the best evidence of hyperglycemia management in ischemic stroke patients for formulating a scientific and reasonable hyperglycemia management scheme. Methods According PIPOST model to construct evidence-based questions, we systematically searched PubMed, Web of Science,Cochrane Library, UpToDate,BMJ Best Practice, GIN, RANO, NICE, SIGN, ACP, CNKI, Wanfang Data,Medlive.cn on the evidence related to hyperglycemia management in ischemic stroke patients,including guidelines,best clinical practice information manuals,evidence summaries,expert consensuses,systematic reviews,and standards. The search time limit was from the establishment of databases to November 2022. Two trained researchers evaluated the quality of the literature,and extracted the evidence. Results A total of 12 articles were included,including 7 guidelines,2 systematic reviews,2 expert consensuses,1 evidence summary. The best evidence included 26 recommendations in 6 aspects,namely admission assessment and management,in-hospital blood glucose monitoring and management,goals of blood glucose control,discharge guidance,non-pharmacological intervention and pharmacological intervention. Conclusion This study summarized the best evidence of hyperglycemia glucose management in ischemic stroke patients,and provided evidence-based references for clinical practice of clinical medical staff. References | Related Articles | Metrics

Review

Select

Research progress of thirst symptom management in critically ill patients ZHU Xiuli, DING Juan, CHEN Yang, MAO Shifang 2023, 4 (2):  179-183.  doi: 10.3761/j.issn.2096-7446.2023.02.018 Abstract ( )   PDF (762KB) ( )   Save The thirst symptom management is a thirsty nursing implementation framework composed of symptom management theory combined with nursing interventions,and a method to provide high quality nursing for thirst of critically ill patients. This article reviews the pathogenesis of thirst in critically ill patients,risk factors and symptom management strategies. Symptom management strategies mainly include 6W2H,palliative care and safety management interventions. Symptom management strategy can provide systematic thirst nursing for critically ill patients,but its hierarchical nursing strategy and evaluation index need to be further improved. References | Related Articles | Metrics

Select

Research progress on dynamic assessment and real-time monitoring of optimal sedation levels in critically ill children WANG Xinzhi, LOU Xiaofang 2023, 4 (2):  184-188.  doi: 10.3761/j.issn.2096-7446.2023.02.019 Abstract ( )   PDF (770KB) ( )   Save Dynamic assessment and real-time monitoring of sedation levels is a necessary part of achieving optimal sedation levels in critically ill children. This article reviews the selection of sedation assessment tools for critically ill children,the range of optimal sedation levels,the timing and frequency of sedation assessment,and the use of sedative medications,and the monitoring of physiologic status during sedation. Dynamic assessment and real-time monitoring of the child's sedation status and physiological indicators can enable the children to achieve optimal sedation levels more rapidly and safely,but uniform standards and regulations need to be further established and improved. References | Related Articles | Metrics

Nursing Technology Research

Select

Design and application of gastric lavage system with the function of purification warming and water storage LI Linfei, CHEN Junxi, CHEN Mei, GOU Xianjuan, SHEN Yi, ZHAO Yi 2023, 4 (2):  189-192.  doi: 10.3761/j.issn.2096-7446.2023.02.020 Abstract ( )   PDF (790KB) ( )   Save Objective To independently design a gastric lavage system with the function of purification warming and water storage,and explore its application effect in the treatment of patients with acute poisoning. Methods The gastric lavage system included purifier,water heater,water storage bucket,thermostat and booster pump. 154 cases of acute poisoning patients treated with gastric lavage in the emergency department of a tertiary class A general hospital in Zunyi City from November 2020 to March 2022 were selected as the research objects,77 cases in the experimental group and 77 cases in the control group. The experimental group received gastric lavage system with the function of purification warming and water storage,while the control group received traditional gastric lavage water supply. Compare the differences between the two groups in time of water intake,total gastric lavage time,total emergency treatment time,and rescue success rate. Results During the clinical application,the time of water taking was （2.88±0.71） min,the total time of gastric lavage was （18.49±1.74） min,and the total time of emergency treatment was （119.11±44.47） min in the experimental group. The time of water taking was （9.04±1.67） min,the total time of gastric lavage was （29.88±2.50） min,and the total time of emergency treatment was （137.54±60.16） min in the control group. The differences between the two groups were statistically significant（P<0.05）. The rescue success rate of the experimental group was 98.70%,and that of the control group was 97.40%. Conclusion The application of purification warming and water storage gastric lavage system in the treatment of patients with acute poisoning can significantly shorten the time of water intake for gastric lavage,the total time for gastric lavage and the total time for emergency treatment,and improve the success rate of rescue. References | Related Articles | Metrics