Table of Content

10 April 2024, Volume 5 Issue 4 Previous Issue    Next Issue

Research Paper

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Emergency nurses' ability of responding to public health emergencies：a multicenter survey LI Fan, LI Shuya, SUN Pengxia, CAI Mengxin, HUA Xiaoxue, LIU Aihui, SHI Yan, ZHU Huadong 2024, 5 (4):  293-297.  doi: 10.3761/j.issn.2096-7446.2024.04.001 Abstract ( )   PDF (790KB) ( )   Save Objective To investigate the experience and capacity of responding to public health emergencies among the emergency nurses,to provide reference for improving the emergency capacity of public health emergen-cies. Methods Using the convenience sampling method,1 603 nurses from 119 medical institutes in 16 provinces and cities were selected from March to April 2023. The general data questionnaire,emergency nurses' emergency capacity to public health emergencies questionnaire was used to investigate. Results The score of capacity responding to public health emergencies of emergency nurses was（208.04±44.45）. The results of multiple linear regression analysis showed that the emergency drill and training experience,rotation in fever department,gender,work department and age were independent predictors of nurses' capacity of public health emergencies（P<0.05）. Conclusion The emergency nurses have medium emergency capacity to public health emergencies. And the managers can carry out continuous and planned training based on the levels and echelon,according to the requirements of emergency response and management at different stages and the requirements of different levels of nurses. References | Related Articles | Metrics

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Study on the assessment and prevention practice status of ICU acquired weakness among ICU nurses in tertiary hospitals LÜ Lulu, ZHANG Xuejing, LI Wenxiong 2024, 5 (4):  298-304.  doi: 10.3761/j.issn.2096-7446.2024.04.002 Abstract ( )   PDF (999KB) ( )   Save Objective To describe the status of the assessment and implementation of prevention strategies for intensive care unit acquired weakness（ICU-AW） among nurses in the tertiary hospitals,analyze the barriers that affected the practice. Methods A self-designed questionnaire was used to investigate 397 ICU nurses of 28 tertiary hospitals in Beijing,Liaoning Province and Hebei Province from November to December 2022 by convenient sampling. Results The clinical ICU-AW assessment was mainly completed by doctors（55.42%）. Muscle strength was the first choice for the evaluation of ICU-AW（65.49%）. 84.13% of nurses reported that there was no standardized strategy or process related to ICU-AW,and the main preventions were analgesia and sedation（65.24%）,early mobilization（62.47%）. The main forms of activity were respiratory function exercise（33.00%） and passive training in bed（33.25%）. The cognitive score of nurses in ICU-AW assessment and prevention strategy was （20.74±8.03）,attitude score was（26.68±4.19） and practice score was（29.79±5.40）. Age,working years,educational background and regional distribution of hospital were the influencing factors of nurses on ICU-AW assessment and prevention practice（P<0.05）. Conclusion Nursing staff's cognition level of ICU-AW is insufficient,assessment methods of ICU-AW are limited,standardized intervention procedures are lacking,and human resources are insufficient. Education and training of ICU-AW should be strengthened,resources allocation should be improved,and standardized assessment and practice procedures should be constructed to promote the clinical implementation of assessment and prevention practices of ICU-AW. References | Related Articles | Metrics

Special Planning-Critical Pediatric Care

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Application of standardized transport process management in pediatric extracorporeal membrane oxygenation rapid response team HUANG Yali, CAI Shuhong, WANG Xielei, ZHENG Yirong 2024, 5 (4):  305-311.  doi: 10.3761/j.issn.2096-7446.2024.04.003 Abstract ( )   PDF (1306KB) ( )   Save Objective A standardized transport process management for pediatric extracorporeal membrane oxygenation（ECMO）-rapid response team（RRT） was constructed and applied,and its application effect was analyzed. Methods ECMO-RRT standardized transport process management was constructed through literature search,expert consultation. We continuously selected 19 patients who applied ECMO treatment in a children hospital in Fujian Province from July 2021 to December 2022 as the study subjects,including 11 cases admitted in January to December 2022 as the experimental group,and 8 cases admitted from July 2021 to December 2021 as the control group. The experimental group was implemented by a ECMO-RRT standardized transport process management,and the control group was implemented by a routine ECMO treatment process. The differences in team preparation time,time of catherterization,first aid technique,professional knowledge,rescue order,cooperative rescue speed and emergency initiative,rescue comprehensive satisfaction,the occurrence of neurological complications and the number of deaths during hospitali were compared between two groups. Results Compared with the control group,the team preparation time（33.10±6.06） minutes,the time of catherterization（47.45±6.73） minutes were significantly shortened,and comprehensive satisfaction in the experimental group increased significantly. The differences were statistically significant（P<0.001）. There were 2 cases of neurological complications in each of the two groups,and 2 cases in the experimental group died during hospitalization. Conclusion The application of the ECMO-RRT standardized transport process management for pediatric ECMO patients can shorten the time of initiation of ECMO treatment and improve the overall satisfaction of team members and has a positive effect on the treatment of critically ill pediatric patients. References | Related Articles | Metrics

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Audit indicators development and obstacle factors analysis for child sedation monitoring management ZHANG Wanying, LU Fangyan, DAI Yanhong, LU Lu, HE Panpan 2024, 5 (4):  312-318.  doi: 10.3761/j.issn.2096-7446.2024.04.004 Abstract ( )   PDF (1216KB) ( )   Save Objective To carry out evidence-based practice of child sedation monitoring,develop audit indicators,comprehensively evaluate the clinical status of child sedation monitoring,analyze obstacles and promoting factors,and formulate action strategies. Methods 14 audit indicators were developed based on the best evidence of child sedation monitoring to conduct a baseline survey on the clinical practice status of sedation level and sedation complications in children. Then we analyzed obstacles and promoting factors based on evidence,potential adopters,and practical environmen. Results The compliance rates for monitoring behaviors such as sedation level,delirium,and withdrawal syndrome were 0~100%,0~13.0%,and 0~43.5%,respectively. The accuracy rates of nurse specific tool use and evaluation frequency among nurses were 0. After analysis,the main obstacles to evidence transformation were poor knowledge,belief,and practice levels of sedation monitoring,inefficient decision-making,lack of systems,processes,and monitoring systems. The main promoting factors were strong leadership,multidisciplinary collaboration,solid evidence-based research foundation,and advanced information technology. Conclusion There is currently a gap between the clinical status and best evidence of pediatric sedation monitoring. We should make full use of promoting factors to overcome obstacles, implement improvements, and promote the clinical transformation of best evidence. References | Related Articles | Metrics

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Nursing care of postoperative complications in patients with corrosive esophageal stenosis undergoing colon transplantation for esophageal replacement surgery ZHU Jiaying, GU Ying, YANG Yuxia, HE Jun, SHEN Weijie, LIU Yuxin, HU Jing 2024, 5 (4):  319-322.  doi: 10.3761/j.issn.2096-7446.2024.04.005 Abstract ( )   PDF (841KB) ( )   Save To summarize the observation and nursing care of postoperative complication in 7 children with corrosive esophageal stenosis undergoing colon transplantation for esophageal replacement surgery. The nursing points included：Establishing an interdisciplinary collaborative team to provide targeted treatment and care based on the different characteristics of postoperative complications;Paying attention to assessment and intervention of postoperative reflux and aspiration;Early identification and rehabilitation care for dysphagia;Implementation and nursing of pulmonary infection and early respiratory function training;Assessment and prevention of cervical anastomotic stenosis and maintenance of the stoma;Personalized health education and follow up. Within two weeks after surgery,4 of the 7 patients experienced reflux,1 had aspiration,1 had dysphagia,and 5 had pulmonary infections. Within 2 months of postoperative follow-up,there were 2 cases of skin infection around the stoma of the gastric/jejunostomy. There were 2 cases of cervical anastomotic stenosis within one year of postoperative follow-up. After meticulous treatment,care,and follow-up,the esophageal function of 7 children with colon replacement esophagectomy recovered well. After（5.83±1.95） days of surgery,parenteral nutrition was stopped and oral feeding gradually resumed. After （43.00±7.51） days of surgery,gastric/jejunostomy was closed. Two children with cervical anastomotic stenosis underwent esophageal dilation surgery,and the postoperative recovery was good. References | Related Articles | Metrics

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Perioperative nursing of children with Berry syndrome XIE Chunlu, TANG Xiaomin, ZHU Jihua, YANG Yi 2024, 5 (4):  323-326.  doi: 10.3761/j.issn.2096-7446.2024.04.006 Abstract ( )   PDF (1252KB) ( )   Save To summarize the perioperative nursing experience of a patient with Berry syndrome. According to the young age and critical condition of the patient,active nutritional support was taken to achieve the required weight for surgery as soon as possible,the stability of circulation was maintained to ensure the continuous opening of the ductus arteriosus,and the strict volume management was used to reduce pulmonary hypertension. After operation,nursing interventions such as nursing of delayed chest closure,respiratory function support,complications management,and discharge health education were taken for the child with complex surgery and critical condition. After careful nursing,the patient was discharged smoothly. After more than 1 month of follow-up after discharge,the patient's cardiac function recovered well. References | Related Articles | Metrics

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A meta-synthesis of qualitative studies on the care experience of parents during the transitional period of pediatric intensive care WU Jingyun, LU Fangyan, WANG Huafen, BAO Ruijie, LI Zhiru, RAO Yuxin 2024, 5 (4):  327-334.  doi: 10.3761/j.issn.2096-7446.2024.04.007 Abstract ( )   PDF (1331KB) ( )   Save Objective To systematically evaluate the qualitative studies on parents' caring experience during the transitional period of pediatric intensive care and to provide references for developing interventions to improve their caring experience. Methods The qualitative studies on parents' caring experience during the transitional period of pediatric intensive care were searched from domestic and international relevant databases. The retrieval time was from the inception to May 12th,2023. The Australia Joanna Briggs Institute Critical Appraisal Tool for qualitative research was used to evaluate the quality of studies. The results were integrated by the method of aggregative integration. Results A total of 10 studies were included,53 findings were extracted,10 new categories were generated and 4 integrated results were formed：mixed dual emotions during transitional period,multiple changes coping with the transitional period of pediatric intensive care,parents' search for a multi-dimensional social support system,and inadequate care information on the transitional period of pediatric intensive care. Conclusion During the transitional period when a child is transferred from intensive care unit to the general ward,the nursing staff should strengthen communication with parents,ease their negative emotions,and meet the needs of parents through multiple ways,to improve the caring ability of parents and ensure a smooth transition for the children and their parents. References | Related Articles | Metrics

Emengency Care Research

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Perioperative nursing care of a patient with sudden rupture of aortic sinus aneurysm into the right atrium at 11 weeks of twin pregnancy WANG Yuan, CHEN Jianhong, SHAO Lewen 2024, 5 (4):  334-337.  doi: 10.3761/j.issn.2096-7446.2024.04.008 Abstract ( )   PDF (718KB) ( )   Save To summarize the perioperative nursing experience of a patient with a sudden aortic sinus aneurysm bursting into the right atrium at 11 weeks of twin gestation. Nursing key points included preoperative cardiac function monitoring of pregnant women,including aneurysm and rupture status monitoring,early warning of right heart failure and sudden death;intraoperative complication monitoring and prevention,postoperative accurate volume management and renal function monitoring,perioperative fetal monitoring,health education and discharge guidance. After 9 days of careful treatment and nursing,the patient recovered and was discharged from the hospital. After 36 weeks of follow-up,the twins were delivered by cesarean section. The mother and the baby were in good condition. References | Related Articles | Metrics

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Perioperative care of twin pregnancy patients with Stanford type A aortic dissection undergoing cesarean section and Sun's surgery CHEN Gong, ZHANG Taotao, NIE Xiaofei, CHENG Li, LUO Xiangyu, GUO Jingjing, WEN Mingjun 2024, 5 (4):  338-340.  doi: 10.3761/j.issn.2096-7446.2024.04.009 Abstract ( )   PDF (572KB) ( )   Save To Summarize the perioperative nursing experience of a twin pregnancy patient with Stanford type A aortic dissection undergoing cesarean section and Sun's surgery. In response to the wide range of dissection tears in the patient,twins in late pregnancy,and high difficulty in nursing,we implemented reasonable preoperative handling,control of heart rate and blood pressure,protection of the fetus to ensure the smooth transition to surgery. We also prevented pressure injuries during surgery and strengthened temperature management,and provided postoperative fine control of circulation and volume,continuous renal replacement therapy to remove water and toxins from the body,prevention of complications,while strengthening nutritional support,implementing obstetric care and personalized psychological support. After 43 days of careful treatment and care,the patient was discharged smoothly and the maternal and infant outcomes were good. References | Related Articles | Metrics

Critical Care Research

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Perinatal whole-process management of a puerpera with Eisenmenger syndrome complicated with severe pulmonary hypertension WANG Zhaohui, ZHENG Huijuan, ZHANG Lili, WANG Qingqing 2024, 5 (4):  341-343.  doi: 10.3761/j.issn.2096-7446.2024.04.010 Abstract ( )   PDF (592KB) ( )   Save To summarize the nursing experience of perinatal whole-process management in a case of Eisenmenger syndrome complicated with severe pulmonary hypertension. Aiming at maternal persistent hypoxemia,cardiac insufficiency and severe pulmonary hypertension,etc.,we used step-by-step oxygen therapy support care with targeted oxygen saturation,monitored and evaluated the condition of the fetus in uterus,focused on managing perinatal volume and pressure balance,identified pulmonary hypertension crisis signs earlier and avoided predisposing factors,prevented serious complications,took personalized discharge health guidance. After 10 days of treatment and nursing,the patient's condition was stable and discharged. After 3 months of follow-up,the mother and baby were in good condition. References | Related Articles | Metrics

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Early rehabilitation nursing for patients with acute severe botulism CHEN Ying, CHEN Yunchao, CAO Shaoyan, XU Cui, Wang Zhi, Feng Boxing, PAN Jing 2024, 5 (4):  344-346.  doi: 10.3761/j.issn.2023-00608.2024.04.011 Abstract ( )   PDF (538KB) ( )   Save To summarize the early rehabilitation nursing experience of two patients with acute severe botulism. For the myasthenic syndrome caused by botulinum toxin poisoning in two cases,the targeted early rehabilitation plan was developed by multi-discipline to ensure safety and feasibility. Dynamic assessment,joint rehabilitation measures,stepped early rehabilitation activities were implemented. We also paid attention to patients' psychological nursing to improve patients' rehabilitation compliance. After comprehensive rehabilitation treatment,two patients were discharged successfully with good prognosis. References | Related Articles | Metrics

Quality and Safety

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The improvement and effects evaluation of a series of tools for inpatient pipeline nursing JIANG Jinhua, REN Hongmei, ZHENG Wangmin, HU Xiuying, LIANG Yue 2024, 5 (4):  347-351.  doi: 10.3761/j.issn.2096-7446.2024.04.012 Abstract ( )   PDF (4203KB) ( )   Save Objective To improve a series of pipeline nursing tools for inpatients and explore its application effects. Methods We improved a series of tools for inpatient pipeline nursing,including improved restraint tools,improved equipment for early activities and equipment for imaging examination in-hospital transport,optimized pipeline fixation,and standardized pipeline identification. Convenience sampling method was used to select inpatients treated in a tertiary class A hospital in Nanping City,Fujian Province from January 2019 to December 2022 as subjects,with 8 977 patients in the experimental group（January to December of 2022） and 7 094 patients in the control group（January to December of 2019） according to admission time of the patients. The experimental group was managed with self-designed pipeline nursing care series tools,and the control group was managed with conventional pipeline nursing tools. The incidence of unplanned extubation was compared between the two groups. Results The incidence of unplanned extubation in experimental group was lower than that in control group and the difference was statistically significant（χ2=13.946,P<0.05）.Among them,the incidence of central venous catheter and tracheal catheter was lower than that of control group（χ2=4.545、15.623,P<0.05）. Conclusion Implementation of the improved inpatient pipeline nursing care series tools reduced the rate of unplanned inpatient extubation and improved the safe management of patient indwelling pipelines. References | Related Articles | Metrics

Career development of nurses

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A qualitative study of the experiences of nurses experiencing missed nursing care events in the ICU LI Chuansheng, CHI Juntao, FANG Xiaoming, LI Wen, LI Xiaohong 2024, 5 (4):  352-358.  doi: 10.3761/j.issn.2096-7446.2024.04.013 Abstract ( )   PDF (1097KB) ( )   Save Objective To understand the real feelings of ICU nurses after experiencing missed nursing care events,in order to provide them with positive and effective countermeasures in a targeted manner. Methods Using the phenomenological research method in qualitative research,we conducted semi-structured interviews with 17 ICU nursing staff experiencing missed nursing care events in a tertiary class A hospital in Yantai City,content analysis was used for data analysis. Results The experiences of 17 nurses experiencing missed nursing care events could be categorized into 4 themes and 15 sub-themes. Theme 1：Causes,human resources,physical resources,patient factors,disruptive events,and the specificity of the ICU;Theme 2：Coping,low willingness to report,avoidance,and reflection;Theme 3：Expectations,improving the system,teamwork,and expectation of understanding and relevant training;Theme 4：Cognition,valuing deficiencies,lack of recognition and promoting growth. Conclusion Measures should be taken in clinical work to eliminate relevant influencing factors for nurses experiencing missed nursing care events. It is recommended to improve the cognitive level of nurses and promote their positive coping by strengthening relevant training and psychological interventions with a view to avoid the occurrence of missed nursing care events. References | Related Articles | Metrics

Evidence Synthesis Research

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Summary of the best evidence for the communication strategy of end-of-life care for emergency nurses HOU Hailong, XIAO Shiqi, LI He, CHENG Xianjuan, DONG Tianjiao, SUN Shanwen 2024, 5 (4):  359-366.  doi: 10.3761/j.issn.2096-7446.2024.04.014 Abstract ( )   PDF (1180KB) ( )   Save Objective To retrieve and summarize the best evidence of communication strategies for emergency department nurses' participation in end-of-life care（EoLC）. Methods We established evidence-based problems. According to the "6S" evidence model,we searched from top to down,including UpToDate,BMJ best clinical practice,British National Institute for Health and Care Excellence（NICE）,Canadian Ontario Registered Nurses Association（RNAO） website,International Guide Network,Australian Joanna Briggs Institute（JBI） Evidence-based Health Care Center Library,Cochrane Library,PubMed,Web of Science,Embase,CINAHL,Wanfang Database,CNKI,VIP Database,CBM,Yimaitong and other databases and websites for relevant literature on the communication strategy of emergency nurses' participation in EoLC which included clinical decision-making system,practice guidelines,evidence summary,consensus,and systematic review. The retrieval time was from the establishment of the database to March 2023.Two researchers who received training in evidence-based medicine used the literature evaluation criteria and evidence grading system of JBI evidence-based health care center to evaluate literature quality and evidence level,and extract,induce and summarize evidence according to the topic. Results 10 articles were finally included,including 2 guidelines,3 clinical decisions,5 systematic evaluations,and 29 pieces of evidence were summarized. Conclusion The formation of best evidence for emergency nurses to participate in the EoLC communication strategy is rigorous and scientific,with a certain clinical practicability. Emergency medical staff need to combine cultural background,clinical situation and patient opinions to provide targeted EoLC services for terminally ill patients. References | Related Articles | Metrics

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Bibliometric and visual analysis of diaphragm dysfunction based on Web of Science CHEN Tianchao, FENG Yueyin, LIU Xinyi, BAI Yunfeng, ZHAO Mingxi, SUN Xiangyu, WU Xinjuan 2024, 5 (4):  367-373.  doi: 10.3761/j.issn.2096-7446.2024.04.015 Abstract ( )   PDF (1454KB) ( )   Save Objective To analyze the research status and research trends of diaphragmatic dysfunction at home and abroad,and to provide a basis for nursing staff to carry out relevant clinical work or further care for critically ill patients. Methods We searched articles related to diaphragmatic dysfunction in the Web of Science core database from its establishment to 11 December 2023,and performed bibliometric analyses by R-bibliometrix and VOS viewer software. Results A total of 1,572 articles related to diaphragmatic dysfunction were published from 1992 to 2023,and the number of articles issued showed an increasing trend. A stable network of partnerships between countries and regions has been formed internationally,and the topics of diaphragmatic dysfunction explored range from the physiological mechanism of muscle weakness to the phenomenon of diaphragmatic dysfunction in critically ill patients. Ultrasound technology for detecting diaphragmatic dysfunction is a recent hot spot of the research. Conclusion Current research in the field of diaphragmatic dysfunction is gradually increasing abroad,with extensive exploration into physiological mechanisms,disease prognosis,interventions,etc. Nursing research in this field in China is still in the infancy period and urgently needs to be explored in depth by nursing researchers,to improve the quality of care for mechanically ventilated patients in a more targeted way,and to improve the related adverse outcomes in critically ill patients. References | Related Articles | Metrics

Review

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The application effects of remote training in peritoneal dialysis patients：a scoping review HE Peipei, YIN Xiaohong, HU Lijun, SUN Miaojuan, YING Shan 2024, 5 (4):  373-379.  doi: 10.3761/j.issn.2096-7446.2024.04.016 Abstract ( )   PDF (1038KB) ( )   Save Objective To review the timing,content,methods and application effects of remote training for peritoneal dialysis patients,aiming to provide a basis for future research directions. Methods Based the scope review guideline of the Joanna Briggs Institute 2020 edition,we systematically searched CNKI,WANFANG,VIP,PubMed,CINAHL,Cochrane Library,Web of Science,Embase and EBSCO,from database inception to July 2023. The included literature was summarized and analyzed. Results 14 articles were included. The carriers of remote training were summarized as telephone,short message,Internet,self-developed software,wechat. The contents of remote training included home dialysis,complications management,nutrition guidance,drug management,rehabilitation guidance,and etc. The forms of remote training included individualized training,regular online delivery training,online Q&A,online case sharing and peer education,and etc. Remote training had positive effect on patients' outcomes. Conclusion The combined application of multiple carriers can improve the training effects of patients with peritoneal dialysis,but the convenience and intelligence of the carriers need to be further improved. The contents and forms of remote training for peritoneal dialysis patients are diverse,but they lack of specificity. The timing,duration and effect indicators of remote training for peritoneal dialysis patients are still uncertain,and can be flexibly adjusted according to patient needs. The short-term remote training for peritoneal dialysis patients is clear,but the long-term effect needs to be further explored. References | Related Articles | Metrics

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Progress in research of ICU nurses involved in the training of subsyndromal delirium CUI Yining, XING Huanmin, LI Liming, XU Xiulu, ZHU Shichao, XIA Ming 2024, 5 (4):  380-384.  doi: 10.3761/j.issn.2096-7446.2024.04.017 Abstract ( )   PDF (758KB) ( )   Save Subsyndromal delirium refers to a mental state between a normal state and delirium,which generally shows one or more symptoms of delirium and does not fully meet the diagnostic criteria for delirium. This paper reviews the theoretical model,main contents,training effects,forms and influencing factors of subsyndromal delirium training for ICU nurses,aiming at providing reference for more comprehensive and standardized training for ICU nurses. References | Related Articles | Metrics