Frontiers of Nursing最新文献

Objective

To assess the outcome of the application of active learning during practicum among nursing students using clinical assessment and evaluation scores as a measurement.

Methods

Nursing students were instructed on the basics of active learning prior to the initiation of their clinical experience. The participants were divided into 5 groups of nursing students (n = 56) across three levels (years 2–4) in a public academic institute of a bachelor degree program in Macao. Final clinical evaluation was averaged and compared between groups with and without intervention.

Results

These nursing students were given higher appraisals in verbal and written comments than previous students without intervention. The groups with the invention achieved higher clinical assessment and evaluation scores on average than comparable groups without the active learning intervention. One group of sophomore nursing students (year 2) did not receive as high of evaluations as the other groups, receiving an average score of above 80.

Conclusions

Nursing students must engage in active learning to demonstrate that they are willing to gain knowledge of theory, nursing skills and communication skills during the clinical practicum.

Catheter fracture is a rare but serious complication of a peripherally inserted central catheter (PICC). An adolescent patient was sent to Tianjin Medical University General Hospital (Tianjin, China) because the PICC was fractured when removed by a nurse. Chest X-ray showed that the PICC fragment slid into the right pulmonary artery. Through emergency surgery, the remainder of the PICC was successfully retrieved by an interventional operation percutaneously via the right femoral vein. PICC fracture is less common and always without significant discomfort if not found timely, and it may lead to serious complications, such as pulmonary embolism, and even death. Thus, nurses, patients and their family members should pay enough attention to the daily maintenance of PICC and have a deep understanding of the reasons associated with PICC fracture as well as how to prevent it. Interventional operation is minimally invasive, which is a good choice for the removal of intravascular foreign bodies, leading to fewer complications and a good prognosis.

Objective

To observe changes in RBC count, changes, RBC morphology, and serum potassium during compressed transfusion of WBC-removal whole blood.

Methods

Prepared human WBC-removal whole blood and connected transfusion apparatus with different sizes of intravenous detaining needles (18G, 20G, 22G and 24G). Observed RBC count and serum potassium concentration under different pressures (100 mmHg, 200 mmHg, and 300 mmHg) as blood flowed out of the pinhead end of the intravenous detaining needle. Samples obtained with the 20G needle were smeared on glass slides, and RBC morphologic changes were observed under an oil immersion lens.

Results

RBC count and serum potassium changed slightly under different pressures with different sizes of intravenous detaining needles as blood flowed through the transfusion apparatus. In addition, the observation of blood samples under a common light microscope revealed that coarse-prick, oblong, and spindle cell counts in the visual fields increased gradually as the pressure increased. Additionally, a portion of cells had undergone splintering.

Conclusions

While applying 18G, 20G, 22G and 24G intravenous detaining needles for blood transfusion under less than 300 mmHg of pressure, no significant RBC count change was found in blood samples in the short term. However, there were significant RBC morphologic changes. The results could offer more basis to ensure the clinical safety of patients undergoing blood transfusion.

Objective

The associations between social support and burnout were explored in ICU nurses of Shanghai.

Methods

We performed a cross-sectional study of 356 ICU nurses by applying random cluster sampling. Data were collected using self-reported questionnaires under the instruction of trained investigators. Data on emotional exhaustion, depersonalisation and feelings of low personal accomplishment etc. were collected, calculated and analyzed.

Results

The participants had a mean age of 26.96 years (SD 4.07). The mean value (M) and standard deviation (SD) of emotional exhaustion was M = 31.85, SD = 8.38, those of depersonalisation was M = 11.69, SD = 5.54 and those of feelings of low personal accomplishment was M = 19.79, SD = 7.02. The high degree of emotional exhaustion (EE), depersonalisation (DP), and lack of personal accomplishment (PA) were revealed to be 76.4%, 39.6%, and 94.9%, respectively. The major influencing factors of emotional exhaustion included support from co-workers(R = 0.343, T = 1.98, P = 0.049), taking leave (R = −1.182, t = −3.747, P = 0.001), requisition of work (R = −1.41, t = −2.369, P = 0.018), and supervisor support (R = −0.524, t = −3.926, P = 0.001). The major influencing factors of depersonalisation were support from the supervisor (R = −0.333, t = −4.146, P = 0.001), age (R = −0.89, t = −2.272, P = 0.024) and requisition of work (R = −0.148, t = −2.124, P = 0.034). There was a positive co-relationship between personal accomplishment and supervisor support.

Conclusions

Supervisor support, age, and requisition of work were the major influencing factors of depersonalisation. In addition, supervisor support plays an important role in low personal accomplishment. Further research should focus on supervisor support, co-worker support, time on leave, and requisition of work associated with emotional exhaustion.

Objective

To investigate the necessity and importance of enhancing the sterilization management of acupuncture needles.

Method

Traditionally, acupuncture needles were cleaned manually without thermal disinfection, which often caused needle-stick injuries. To solve the problems, a special cleaning case for acupuncture needles was designed and built to help achieve optimization of the processing flow if the case is used correctly in the process of recycling, cleaning, and package checking.

Result

Closed treatment of acupuncture needles reduced the percentage of needle-stick injuries to zero, and centralized management raised patients' satisfaction rate from 93% to 98%.

Conclusion

Effective sterilization of acupuncture needles is a precondition for the safe treatment of patients. Optimization of the processing flow can ensure the safety of medical personnel and patients; safety is stipulated by relevant regulations concerning sterilization and disinfection standards.

Objective

To study factors influencing nurses' job burnout and their subjective well-being and to explore the relationships between these two phenomena.

Methods

A total of 250 nurses from three hospitals in Shandong were evaluated with the Maslach Burnout Inventory and a subjective well-being scale.

Results

Nursing staff showed significantly different levels of job burnout (P < 0.05) according to the following characteristics: age, marital status, educational background, technical title, years of nursing experience, monthly income, manning quotas and parental status. Level of burnout is higher for nursing staff who are under the age of 30 years, are unmarried, had secondary education, had unofficial manning quota status, are childless, hold a primary title and whose years of nursing experience are less than five years. Statistical significance was found for life satisfaction (P < 0.05) with differences in age; marital status; technical title; years of nursing experience; monthly income; manning quota status; and parental status in positive emotion, negative emotion and degree. There is a significant negative correlation between every dimension of job burnout and life satisfaction and positive emotions for subjective well-being. Every component of job burnout was significantly positively correlated with negative emotions. (P < 0.05).

Conclusion

Age, marital status, educational background, technical title, years of nursing experience, monthly income, manning quotas and parental status have different influences on occupation burnout and subjective well-being. Dimensions of occupation burnout have functions of predicting subjective well-being.

This paper reviews the causes of knee osteoarthritis, traditional Chinese and Western medicine therapies and nursing research progress and indicates that traditional Chinese and Western medicine have gradually recognized the cause of knee osteoarthritis. Knee osteoarthritis has been treated with various treatments and nursing care planning, and the combination of traditional Chinese and Western medicine has constantly been improved. Nurses should instruct the discharged patient to correctly treat their disease, adopt the health education, and, via the establishment of a healthy lifestyle, insist on a functional exercise to relieve the pain, delay disease progression, and improve quality of life.

Objective

Ventilator associated pneumonia (VAP) has been shown to be associated with significant morbidity and mortality (Chastre and Fagon, 2002; Klompas, 2007) among mechanically ventilated patients in the intensive care unit (ICU), with the incidence ranging from 9% to 27%; crude mortality ranges from 25% to 50% (Rello, Ollendorf, Oster, et al., 2002; Tablan, Anderson, Besser, Bridges, Hajjeh, 2003). A meta-analysis of published studies was undertaken to combine information regarding the effect of subglottic secretion drainage (SSD) on the incidence of ventilated associated pneumonia in adult ICU patients.

Methods

Reports of studies on SSD were identified by searching the PUBMED, EMBASE, and COCHRANCE LIBRARY databases (December 30, 2010). Randomized trials of SSD compared to usual care in adult mechanically ventilated ICU patients were included in this meta-analysis.

Results

Ten RCTs with 2314 patients were identified. SSD significantly reduced the incidence of VAP (relative risk [RR] = 0.52, 95% confidence interval [CI]: 0.42–0.64, p < 0.00001). When SSD was compared with the control groups, the overall RR for ICU mortality was 1.00 (95% CI, 0.84–1.19) and for hospital mortality was 0.95 (95% CI, 0.80–1.13). Overall, the subglottic drainage effect on the days of mechanical ventilation was −1.52 days (95% CI, −2.94 to −0.11) and on the ICU length of stay (LOS) was −0.81days (95% CI, −2.33 to –0.7).

Conclusions

In this meta-analysis, when an endotracheal tube (ETT) with SSD was compared with an ETT without SSD, there was a highly significant reduction in the VAP rate of approximately 50%. Time on mechanical ventilation (MV) and the ICU LOS may be reduced, but no reduction in ICU or hospital mortality has been observed in published trials.

Objective

To investigate the risk factors related to the development of pressure sores in critically ill surgical patients and to establish a basis for the formulation of effective precautions.

Methods

A questionnaire regarding the factors for pressure sores in critically ill surgical patients was created using a case control study with reference to the pertinent literature. After being examined and validated by experts, the questionnaire was used to collect data about critically ill surgical patients in a grade A tertiary hospital. Among the 47 patients enrolled into the study, the 14 who developed nosocomial pressure sores were allocated to the pressure sore group, and the remaining 33 patients who met the inclusion criteria and did not exhibit pressure sores were allocated to the control group. Univariate and multivariate logistic regression analyses were employed to examine the differences in 22 indicators between the two groups in an attempt to identify the risk factors for pressure sores.

Results

According to the univariate analyses, the maximum value of lactic acid in the arterial blood, the number of days of norepinephrine use, the number of days of mechanical ventilation, the number of days of blood purification, and the number of days of bowel incontinence were statistically greater in the pressure sore group than in the control group (p < 0.05). The multivariate logistic regression analysis revealed that the number of days of norepinephrine use and the level of lactic acid in the arterial blood were high risk-factors for pressure sores (p < 0.05).

Conclusions

The best method for preventing and control pressure sores in surgical critically ill patients is to strongly emphasize the duration of the critical status and to give special attention to patients in a continuous state of shock. The adoption of measures specific to high-risk patient groups and risk factors, including the active control of primary diseases and the application of decompression measures during the treatment of the patients, are helpful for improving the quality of care in the prevention and control of pressure sores in critically ill patients.

Objective

This review aimed to examine the outcomes and influencing factors of telecare management of type 2 diabetes, to provide some advice for medical staff and to inform decision makers to promote the development of telecare in specific areas.

Sources of information

The reference articles were mainly selected from the CNKI, Wanfang Database, PubMed, Science Direct and other resources. Following a systematic, comprehensive search of databases, a total of 1062 qualitative, quantitative or mixed studies were initially selected; after careful review and screening, 45 studies were coded and analysed.

Inclusion criteria

The articles were selected using the words “diabetic”, “type 2 diabetes”, “telecare, telenursing, remote care or telemedicine”, “outcomes or effect” and “influencing factors”. Type 2 diabetic who were intervened by electronic equipment are included. The patients who just have type1 diabetes are excluded, and those who were treated without using electronic equipment also are excluded.

Results

Telecare produces positive results with a variety of outcomes, such as an improvement in the overall status of patients with type 2 diabetes, making full use of the medical staff resources and promoting the popularity of the hospital remotely; however, the factors which may prevent the development of telecare are various.

Conclusions

Telecare has a positive effect in all aspects. With the development of technology and gradual changes in the people's concept of e-health, telecare may have a brilliant future and may play a more important role in promoting human health.