Table of Content

10 May 2024, Volume 5 Issue 5 Previous Issue    Next Issue

Research Paper

Select

Influencing factors of point-of-care lung ultrasound conducted by intensive care nurses：A qualitative study YUE Wenjing, WANG Zihan, JIANG Ying, LIN Jiayi, WANG Qinlu, WANG Fei, JI Shiming, KANG Xiaofeng 2024, 5 (5):  389-394.  doi: 10.3761/j.issn.2096-7446.2024.05.001 Abstract ( )   PDF (1093KB) ( )   Save Objective To explore the facilitators and barriers encountered by intensive care nurses in the implementation of point-of-care lung ultrasound（POC-LUS）. Methods Based on the theoretical framework of normalization process,the descriptive research method was applied,and purposive sampling was used. 10 nurses and physicians from the intensive ultrasound research group were invited for semi-structured interviews from October to December 2023. Content analysis method was performed for data analysis and theme extraction. Results Ten themes related to four categories were identified. Facilitators to intervention included intrinsic identification of implementers,organizational support,development of individual professional roles,accessibility of portable ultrasound equipment,ease of technical mastery,and promotion of precision nursing. Barriers included lack of procedural standards,lack of qualifications,insufficient resource allocation,and lack of economic evaluation of new technologies. Conclusion The implementation of POC-LUS improves the timeliness and accuracy of intensive care. The cross-integration of ultrasound technology and nursing disciplines has become an emerging nursing model. References | Related Articles | Metrics

Select

Analysis of social responsibility status and influencing factors of reserve nurses in disaster assistance WANG Huaqin, YU Qiang, FAN Xiaoyu, LI Yamin 2024, 5 (5):  395-400.  doi: 10.3761/j.issn.2096-7446.2024.05.002 Abstract ( )   PDF (934KB) ( )   Save Objective To investigate the social responsibility of reserve nurses in disaster assistance and analyze its influencing factors. Methods 708 reserve nurses for disaster assistance were investigated by general data questionnaire,nurses‘ social responsibility questionnaire and nurses‘ sense of professional respect scale to explore the current situation of social responsibility of reserve nurses for disaster assistance and analyze the influencing factors by multiple linear regression. Results The score for reserve nurses‘ social responsibility was （111.91±11.36） points,and there was a positive correlation between social responsibility and the total score of professional respect and scores in each dimension（P<0.01）. Multiple regression analysis results indicated that education level,disaster rescue experience,and the total score of professional respect were factors influencing disaster assistance reserve nurses‘ social responsibility（P<0.05）,jointly explaining 49.5% of the total variance. Conclusion The social responsibility score of disaster assistance reserve nurses is at a high level,and nursing managers should formulate targeted training programs to strengthen the social responsibility awareness of disaster assistance reserve nurses and create a strong atmosphere of care,respect and support for nurses,so as to further improve the social responsibility level of disaster assistance reserve nurses. References | Related Articles | Metrics

Select

The status and risk factors analysis of acute skin failure in critically ill elderly patients XU Pei, WU Lingyu, MA Lihua, XU Xiaowen, ZHOU Jinhong 2024, 5 (5):  401-407.  doi: 10.3761/j.issn.2096-7446.2024.05.003 Abstract ( )   PDF (1164KB) ( )   Save Objective To investigate the incidence and risk factors of acute skin failure in critically ill elderly patients. Methods A prospective observational study was carried out in elderly patients admitted to EICU in a tertiary grade A hospital in Suzhou from January 2021 to January 2023,the risk factors of acute skin failure were analyzed by univariate and multivariate Logistic regression. Results 251 elderly patients completed the survey,105 cases had acute skin failure,the incidence was 41.83%. Logistic regression analysis showed that the risk factors of acute skin failure in severe elderly patients included Braden score（OR=0.732）,renal failure（OR=2.881）,heart failure（OR=3.962）,sepsis（OR=2.459）,arterial blood lactic acid level（OR=1.226）,sedation and analgesia（OR=3.135）. Conclusion The incidence of acute skin failure in critically ill elderly patients is high. Low Braden score,renal failure,heart failure,sepsis,and high arterial blood lactic acid level,use of sedatives and analgesics were independent risk factors for acute skin failure in critically ill elderly patients. References | Related Articles | Metrics

Special Planning一Humanistic Nursing Care

Select

The barriers and enablers to implementing humanistic care in ICU：A qualitative study YU Xiaoyan, WANG Huaqin, TANG Li, PAN Si, ZHANG Li, LI Jinxiu 2024, 5 (5):  408-413.  doi: 10.3761/j.issn.2096-7446.2024.05.004 Abstract ( )   PDF (992KB) ( )   Save Objective To explore the experiences of ICU nurses in providing humanistic care for patients and to analyze the barriers and enablers of the practice,aiming to provide a basis for improving the humanistic care quality. Methods A purposive sampling method was used to select 23 ICU nurses from three tertiary Grade A hospitals in Changsha in March and April 2023 for semi-structured in-depth interviews. The data was collected and the themes were refined using abilities,opportunities,motivations,behavioral models,and thematic analysis method. Results The practice of humanistic care by ICU nurses was influenced by three aspects：capability,opportunity and motivation. In terms of capability,the primary barriers were deficiency in humanistic care literacy,knowledge and skills. In terms of opportunity,the high workload and limited implementation of evidence-based humanistic care affected the conditions and opportunities. In terms of motivation,the major constraints were the absence of awareness and the lack of confidence. However,a strong sense of professional responsibility,positive feedback from patients and families,and a good teamwork atmosphere were facilitating factors. Conclusion To promote the process of humanistic care in ICU,it is necessary to pay attention to the needs of nurses for humanistic care concepts,knowledge and skills,to develop and implement humanistic care management norms and evaluation systems,and to create an organizational atmosphere that supports humanistic care practice,so as to improve the clinical practice of humanistic care in ICU. References | Related Articles | Metrics

Select

Analysis of latent profiles and influencing factors of learned helpless among primary caregivers of postoperative patients with type A aortic dissection ZHAO Qing, WU Wenxian, LI Lin, WANG Xueyan 2024, 5 (5):  414-420.  doi: 10.3761/j.issn.2096-7446.2024.05.005 Abstract ( )   PDF (1029KB) ( )   Save Objective To investigate the latent profiles and influencing factors of learned helpless among primary caregivers of postoperative patients with type A aortic dissection. Methods A convenient sampling method was used to select primary caregivers of postoperative patients with type A aortic dissection from January 2022 to June 2023. A survey was conducted by the general data questionarie,Learned Helplessness Scale,Caregiver Preparedness Scale,and Mishel Uncertainty in Illness Scale-Family Member Form. The growth mixture model was used to identify the latent profiles and Logistic regression analysis was used to analyze the prediction factors of latent profiles. Results The learned helplessness scores of the primary caregivers of 350 patients with type A aortic dissection were（50.40±6.28）,which could be divided into three latent profiles：low helplessness and high despair group （12.57%）,high helplessness and low despair group（27.43%）,and high helplessness and high despair group （60.00%）.Logistic regression analysis showed that patient age,length of stay in ICU after surgery,caregiver gender,caregiver education level,caregiver family monthly income,number of caregivers,whether the caregiver was the main decision maker,and disease uncertainty were the influencing factors of learned helplessness latent profiles（P<0.05）. Conclusion There is heterogeneity in the learned helplessness among primary caregivers of postoperative patients with type A aortic dissection. Medical staff can conduct individualized intervention according to influencing factors of different latent profiles to reduce the learned helplessness of caregivers. References | Related Articles | Metrics

Select

Research hotspots and development trend of emergency hospice care：a visual analysis SU Xin, DAI Fumin, WANG Yanping 2024, 5 (5):  421-426.  doi: 10.3761/j.issn.2096-7446.2024.05.006 Abstract ( )   PDF (852KB) ( )   Save Objective Through the visual analysis of the relevant literature,the research hotspots are sorted out to provide reference for the development of emergency hospice care in China. Methods Literature on emergency hospice care included in the Web of Science core collection from January 1,2013 to December 31,2022 were retrieved and selected,and visually analyzed using CiteSpace 6.2.2R software. Results A total of 1 429 related literature were included in the research scope,and the number of literatures was increasing year by year. The number of authors participating in the emergency hospice care study reached 298 and formed a clear core team. The United States was the country with the largest number of publications,indicating its leading position in the field. In addition,institutions of higher education were the major research institutions,and there were close exchanges and cooperation among various institutions. Keyword analysis showed that the words "palliative care","end-of-life care" and "emergency department" represented the hot direction of research. Conclusion In recent years,emergency hospice care has attracted continuous attention,and the international research on emergency hospice care is wide and relatively mature,which can provide reference for the development of emergency hospice care in China. References | Related Articles | Metrics

Select

Accuracy of different screening tools for identifying hospice needs in emergency department patients：a meta-analysis LI Baiyu, GAO Weiwei, ZHANG Zhufeng, LI Keye, DENG Yayin 2024, 5 (5):  427-434.  doi: 10.3761/j.issn.2096-7446.2024.05.007 Abstract ( )   PDF (1031KB) ( )   Save Objective To evaluate the accuracy of commonly used hospice screening tools to identify hospice needs of emergency department patients. Methods We searched CNKI,Wanfang Database,China Biomedical Literature Database,PubMed,Cochrane Library,Embase,CINAHL,and Web of Science for all studies on hospice screening tools applied to emergency department patients from the time of database construction to November 2023,and two researchers independently performed literature screening,data extraction,and literature quality evaluation,and Stata 15.0 software was used to perform meta-analysis of the profile data. Results A total of 20 papers were included,containing 20,122 patients,involving a total of 6 screening tools,of which the most commonly used was the Surprise Questions（SQ;n=9）,followed by the Palliative Care and Rapid Emergency Screening（P-CaRES;n=7） and the Screen for Palliative and End-of-life care needs in the Emergency Department（SPEED;n=2）. 9 studies identified hospice needs by assessing the SQ for predicting patient mortality. Overall,the sensitivity of the SQ for predicting mortality was moderate at 0.72（0.59,0.82） and the specificity was moderate at 0.74（0.62,0.84）.The sensitivity of the SQ for predicting long-term mortality（within 1 year,2 years） was higher at 0.75（0.64,0.84） than the sensitivity of the SQ for predicting short-term mortality（within 1 month,within 3 months） of 0.65（0.35,0.86）. In addition,for emergency admissions or frequent emergency department visits within 1 year,SQ sensitivity was 0.72（0.41,0.90） and specificity was 0.52（0.32,0.72）.P-CaRES predicted mortality with a sensitivity of 0.73（0.57,0.85） and specificity of 0.64（0.48,0.77）. Conclusion The SQ is the most widely used tool for hospice screening in the emergency department,followed by the P-CaRES,and they both have moderate sensitivity and specificity in predicting patient mortality in the next one year,the conclusion that still requires further validation in high-quality,large-sample studies. References | Related Articles | Metrics

Select

Research progress of psychosocial adaptation in patients after permanent pacemaker implantation LI Jing, LUO Xiaoping, PEI Kexi, HUANG Mengge, CHEN Jiaoling, BAO Hanru, HUANG Qian 2024, 5 (5):  435-438.  doi: 10.3761/j.issn.2096-7446.2024.05.008 Abstract ( )   PDF (711KB) ( )   Save Psychosocial adaptation is a process in which individuals constantly adjust themselves to adapt to environmental changes in order to maintain the best state of physical and mental environment. The low level of psychosocial adaptation of patients after pacemaker implantation can lead to serious adverse events such as self-harm and suicide. This paper reviews the concepts,influencing factors and intervention measures of psychosocial adaptation,aiming to provide reference for clinical staff to implement scientific psychological guidance and intervention. References | Related Articles | Metrics

Emergency Care Research

Select

Cardiac rehabilitation nursing care of a patient who suffered a cardiac arrest following acute myocardial infarction and complicated acute heart failure ZHANG Yifei, LI Mei, HUANG Dandan 2024, 5 (5):  439-442.  doi: 10.3761/j.issn.2096-7446.2024.05.009 Abstract ( )   PDF (799KB) ( )   Save This study summarized the experience of cardiac rehabilitation in an elderly patient suffered a cardiac arrest following acute myocardial infarction and complicated acute heart failure,treated with the combined use of extracorporeal membrane oxygenation（ECMO） and intra-aortic balloon pump（IABP） after cardiopulmonary resuscitation（CPR）. Key nursing interventions included assembling multidisciplinary management team to make treat-ment and rehabilitation plan,establishing dedicated nursing team to create the specialized nursing handover sheet,precise fluid management and evaluation of capacity balance from multiple perspectives,a staged cardiac function assessment and individualized cardiac rehabilitation. Under the collaborative efforts,the patient was successfully weaned from ECMO on the 12th day of hospitalization,weaned from IABP on the 14th day,transferred out of the Intensive Care Unit on the 44th day,began ambulating on the 49th day,and was discharged on foot on the 75th day. References | Related Articles | Metrics

Select

Nursing care of a patient with atrial septal defect and pulmonary hypertension complicated with cerebral embolism during pregnancy CAO Xiaoting, LEI Rui, QIAN Hailan, ZHOU Jingjiang, YUAN Jun 2024, 5 (5):  442-445.  doi: 10.3761/j.issn.2096-7446.2024.05.010 Abstract ( )   PDF (783KB) ( )   Save To summarize the nursing experience of a patient with atrial septal defect and pulmonary hypertension complicated with cerebral embolism during pregnancy. In view of the problems caused by cerebral embolism in the patient,such as weakened muscle strength of the right limb,inability to speak and dysphagia,atrial septal defect,and increased pulmonary artery pressure,a multidisciplinary team was established to maintain the nervous system function,implemented strict volume management to prevent heart failure,implemented early rehabilitation to reduce the degree of functional disability and iIndividual psychological nursing to avoid negative emotions. After 23 days of careful treatment and nursing,the patient‘s condition improved and was discharged. References | Related Articles | Metrics

Critical Care Research

Select

The effects of chain management based on the Information-Motivation-Behavioral Skills model on promoting breastfeeding in premature infants DENG Fengliang, FANG Yuqi, YIN Zhuan, XIANG Qiuhong, HUANG Fang, CHEN Dan, ZHANG Liuyi 2024, 5 (5):  446-451.  doi: 10.3761/j.issn.2096-7446.2024.05.011 Abstract ( )   PDF (956KB) ( )   Save Objective To evaluate the effectiveness of chain management based on the Information-Motivation-Behavioral Skills model（IMB） on promoting breastfeeding in preterm infants. Methods We selected 88 mothers of premature infants admitted to a tertiary hospital in Hunan province from January to June 2022 as the study objects,44 cases meeting the inclusion criteria from January to March 2022 as the control group,44 cases from April to June 2022 as the intervention group. The control group received routine breastfeeding support care,and the intervention group received chain management based on IMB model. Maternal breastfeeding knowledge,infant feeding attitude,breastfeeding self-efficacy scores and exclusive breastfeeding rates and readmission rate of preterm infants within 6 months were compared between the two groups. Results The intervention group scored higher breastfeeding knowledge than the control group（t=-4.747,P<0.001）,higher infant feeding attitude than the control group（t=-17.321,P<0.001）,higher breastfeeding self-efficacy than the control group（t=-2.352,P=0.021） after intervention. The rate of exclusive breastfeeding within 1 month of corrected age in the intervention group（95.2%） was higher than that in the control group（73.8%）,with statistically significant difference（χ2=7.372,P=0.007）. The rate of exclusive breastfeeding within 3 months（88.1%） was higher than the control group（69.0%）,with statistically significant difference（χ2=4.525,P=0.033）. The rate of exclusive breastfeeding within 6 months（66.7%） was higher than the control group（40.5%）,with statistically significant difference（χ2=5.791,P=0.016）. The premature infant readmission rate within 6 months in the intervention group（2.3%） was lower than that in the control group （16.7%）（χ2=4.974,P=0.030）. Conclusion IMB model combined with chain management can improve the rate of exclusive breastfeeding within 6 months of corrected age and reduce the readmission rate. References | Related Articles | Metrics

Select

Nursing of early transplant bowel rehabilitation after small bowel transplantation in children with short bowel syndrome WANG Yan, LU Fangyan, WANG Fang, WU Jun 2024, 5 (5):  451-454.  doi: 10.3761/j.issn.2096-7446.2024.05.012 Abstract ( )   PDF (675KB) ( )   Save To summarize the nursing of early transplant bowel rehabilitation after small bowel transplantation in 5 children with short bowel syndrome caused by various causes. In view of the complex small intestine transplantation in children,many postoperative complications,malnutrition,psychological stress,and home management of transplanted enterostomy,a multidisciplinary collaborative team was established to promote transplanted bowel rehabilitation. We did a good job in the prevention and care of early complications of transplanted intestines,implemented phased nutritional support and care for transplanted intestines,stabilized the child‘s emotions to cooperate with the treatment and nursing of transplanted bowel rehabilitation,carried out training and assessment of home management skills for parents of children with transplanted enterostomy. After active treatment and careful nursing,their early transplanted bowel function recovered smoothly after surgery,and they returned to the hospital on time after discharge. The ileostomy restoration was completed as scheduled 3~4 months after the operation,and the follow-up was 4~12 months,and the recovery was good. References | Related Articles | Metrics

Quality and Safety

Select

Construction and management of intelligent nursing pathway for patients with severe heart failure WU Xiaoxiao, LI Ru, JI Shiming, YANG Yang, WU Jie, ZHANG Chen 2024, 5 (5):  455-460.  doi: 10.3761/j.issn.2096-7446.2024.05.013 Abstract ( )   PDF (859KB) ( )   Save Objective To develop the nursing pathway for severe heart failure patients by Delphi method,and realize the intelligence of the pathway. Methods The preliminary nursing pathway was developed based on literature review and the expert consultation questionnaire was formed. 49 experts were selected for two-round consultations. Results The response rate of the two rounds were both 100.0%. The authoritative coefficient was 0.92. The coefficients of variation in the two rounds of consultation were 0.071 and 0.003,and the coordination coefficients were 0.188 and 0.939,respectively. Experts had the consistent opinions to form the nursing pathway for severe heart failure patients. Nursing pathway was embedded in HIS system,all forms and systems were integrated and linked,and it can assist clinical work intelligently. Conclusion The intelligent nursing pathway for patients with severe heart failure is scientific and reliable. It creates a model combining conventional path and each module,which provides a guarantee for the improvement of nursing quality. References | Related Articles | Metrics

Career Development of Nurses

Select

ICU specialized nursing personnel training and practice led by critical care sub-specialty ZHANG Mi, LI Jieqiong, TANG Yipin, HAN Juan, MOU Chunying, MA Jiajia, GAO Ya 2024, 5 (5):  461-465.  doi: 10.3761/j.issn.2096-7446.2024.05.014 Abstract ( )   PDF (736KB) ( )   Save Objective To explore the training and practical effect of ICU specialized nursing talents under the sub-specialty management mode of critical care nursing. Methods Based on the key technologies of critical care nursing,seven nursing sub-specialty groups were set up in the ICU area of the First Affiliated Hospital of Xi ‘an Jiaotong University from January 2015,including critical nutrition,critical skin,critical intravenous therapy,critical airway,critical rehabilitation,critical blood purification,and venous thrombosis prevention and management,and the critical nursing sub-specialty management model was implemented. The implementation effect was evaluated from the training of specialized talents,the improvement of specialized quality and the scientific research output. Results The critical nursing sub-specialty management model has established a hospital- provincial-national specialized nurse ladder growth system and ICU specialized nurse talent pool,which improves the quality of critical nursing and promotes the sustainable development of critical nursing sub-specialty. Conclusion The implementation of critical nursing sub-specialty management model can meet the career development needs of ICU nurses,clarify the career development path,promote the professional training of critical nursing talents,deepen the connotation of critical nursing specialty,improve the level of critical nursing technology,and enhance the professional value of ICU nurses. References | Related Articles | Metrics

Evidence Synthsis Research

Select

Summary of the best evidence for the prevention and management of central venous catheter-related thrombosis in patients undergoing continuous renal replacement therapy LI Lili, HUA Jiali, ZHANG Xinyin, DONG Yongze, SONG Yuying, CHEN Juanying, YAO Huiping 2024, 5 (5):  466-473.  doi: 10.3761/j.issn.2096-7446.2024.05.015 Abstract ( )   PDF (1166KB) ( )   Save Objective To retrieve,evaluate,and integrate the best evidence for the prevention and management of central venous catheter-related thrombosis（CRT） in patients with continuous renal replacement therapy（CRRT）. Methods We searched BMJ Best Practice,UpToDate and Cochrane Library,Australian Joanna Briggs Institute Evidence-Based Health Care Center database,International Guide Network,UK Institute for Health and Care Excellence,Scottish Interuniversity Guide Network,American Kidney Disease Foundation and other professional related websites,PubMed,Embase,CNKI,Wanfang Database,China Biology Medicine disc,Medlive to collect clinical decisions,guidelines,best practices,expert consensus,systematic review,summary of evidence,and original research related to central venous CRT prevention in CRRT patients. The retrieval period was from the establishment of the database to March 2023. Literature selection,quality evaluation and data extraction were conducted by two members of the evidence-based team. Results A total of 12 literatures were included,including 3 clinical decisions,4 guidelines,2 systematic reviews and 3 expert consensuses. 27 best pieces of best evidence were summarized in 8 aspects,including assessment,cannulation and extubation,catheter type,vascular access monitoring methods,tube sealing,anticoagulants,thrombolysis,training and management. Conclusion In the clinical prevention practice of central venous CRT for CRRT patients,ICU medical staff should carefully select the best evidence to enhance treatment efficacy and safety based on the specific clinical context and the patient‘s wishes,so as to maximize the benefits of patients. References | Related Articles | Metrics

Select

Best evidence summary for assessment and classification of inter-hospital transfer in critically ill patients SUN Shangxue, ZHOU Miao, QIAO Anhua, LI Yangyang, WANG Fang, PENG Fei 2024, 5 (5):  473-480.  doi: 10.3761/j.issn.2096-7446.2024.05.016 Abstract ( )   PDF (1074KB) ( )   Save Objective To summarize and integrate the best evidence for assessment and classification of inter-hospital transport in critically ill patients,so as to provide references for clinical practice. Methods Guidelines,evidence summary,systematic review,clinical decision,best practice and expert consensus on the assessment and classification of inter-hospital transport of critically ill patients were systematically searched in professional guideline networks,association networks and databases at home and abroad according to the "6S" model of evidence resources. The retrieval time was from the establishment of the database to January 3,2024. The evidence-based group evaluated the quality of the literature and extracted evidence. Results A total of 11 articles were included,involving 5 guidelines,4 expert consensuses and 2 systematic reviews. Finally,27 pieces of best evidence were summarized from 5 categories,namely personnel,tools,timing,items（disease assessment,transport-related matters assessment,risk assessment,classification）,assessment and classification records. Conclusion This study summarizes the best evidence for the assessment and classification of inter-hospital transport in critically ill patients,so as to provide a basis for clinical development of inter-hospital transport. References | Related Articles | Metrics