AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection.METHODS: In the  ...AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection.METHODS: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo.RESULTS: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P < 0.001]. FC to select patients for colonoscopy could reduce cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented.CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated.展开更多
Unrestrained anti-microbial resistance (AMR) among bacterial pathogens has made the management and treatment of post-operative wound infections difficult. This study assessed the current AMR patterns of bacterial isol...Unrestrained anti-microbial resistance (AMR) among bacterial pathogens has made the management and treatment of post-operative wound infections difficult. This study assessed the current AMR patterns of bacterial isolates in post-operative wound infections in a tertiary care hospital in Kathmandu,Nepal. Pus swabs collected from post-operative wound infections and submitted for culture and sensitivity were included in this study. Isolation and identification of the organism was done by standard microbiological methods. Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method and result was interpreted as per National Committee for Clinical Laboratory Standards (NCCLS) guide lines. Of the 120 pus swabs processed for culture, 96 showed bacterial growth. Staphylococcus aureus 36 (37.5%) was the predominant gram positive isolate and Escherichia coli 24 (25%) was the major gram negative isolate .The infection was most prevalent in the age group 20-40 years. All S. aureus isolates were sensitive to aminoglycosides and vancomycin. Out of 36 S. aureus, 15 (41.66%) isolates were methicillin resistant S. aureus (MRSA). Staphylococcus epidermidis showed high resistance (50%-100%) to all antibiotics but were sensitive to vancomycin. All gram negative isolates showed high resistance against cephalexin (75%-100%) and ceftriaxone (25%-100%). Overall multi-drug resistant isolates were 66.7%. A high level of AMR was observed in gram negative bacterial isolates. Rational use of antibiotics and a regular monitoring of AMR patterns in post-operative wound infections are essential and mandatory to avert further emergence and spread of anti-microbial resistance among bacterial pathogens.展开更多
Background: Postoperative wound healing has been a problem which causes high mortality in the developing world;postoperative wound has been reported to cause devastating consequences and a measurable mortality. There ...Background: Postoperative wound healing has been a problem which causes high mortality in the developing world;postoperative wound has been reported to cause devastating consequences and a measurable mortality. There is a limited number of published studies in Tanzania investigating Nursing practice on post-operative wound care in surgical wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania. This study assesses nursing practice on postoperative wound care by nurses in surgical wards at Muhimbili National Hospital. Methods: A cross-sectional study of surgical nurses was carried out through the use of randomly selected surgical wards at Muhimbili National Hospital in Tanzania from September 2011 to July 2013. A multistage cluster sampling technique was used to obtain a suitable number of study participants. Data collection was done using a checklist from a convenient sample of 71 nurses in selected surgical wards. Results: The result indicates that a big number of the participants were female (76.5%) and those of the age group 25 to 34 years were 40.8%. Participants exceeding a half of the selected sample reported to have poor post-operative wound care practice (57.7%). In comparison, male participants scored higher, and had better practice than their female counterparts, however, there was no considerable difference in the scores (P = 0.803). During set-up and preparation phase, the washing of hands before starting and after the completion of procedure was taken into consideration by less than half of the participants (49.3%). All participants did not ensure the environment is clean and take into account the patient’s privacy through the use of screen or even closing the room. The report shows that nurses take into consideration putting on clean gloves during the removal of the old dressing (99%), the use of sterile gloves during wound dressing was taken into consideration by most of the nurses (63%). Good practice was noted in applying dressing solution as recommended (85%), dry sterile dressing was applied by (90%), arrangement and setting up of dressing forceps and other items that may be needed in order of their application using forceps (20%), usage of forceps to dip gauze into antiseptic solution (35%) and cleaning of the wound cleaning from least contaminated to most contaminated area was only adhered to by (34%). Post-operative counseling and giving to the patient not to temper with the wound was done by a representation of only 15% of nurses. All the nurses did not do the documentation of the changes observed on the wound nor did they report on the patients comfort and the date and time after the procedure wound changes, reported patient comfort, and recorded date or time after the procedure. Conclusion: Majority of the nurses in surgical wards do not follow the postoperative wound care checklist provided by MNH although they know its importance. Assessment of the wound and documentation continues to be a problem in the nursing profession in Tanzania. Nurses are reasonably knowledgeable about the principal of wound dressing;however, lack of knowledge on some of the key principles of wound dressing is worth noting. Almost half of the nurses do not wash hands before and after the procedures, they don’t use single gauze in one direction only, not cleaning from least contaminated to most contaminated area, which can lead to wound contamination.展开更多
BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment...BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment efficacy and increasing morbidity.AIM To investigate the risk factors associated with post-operative infection in HCC patients undergoing D-TACE,and to provide evidence for clinical prevention and targeted intervention strategies.METHODS Clinical data of 77 primary HCC patients who underwent D-TACE in our hospital from January 2022 to December 2023 were retrospectively analyzed.Patient demographics,laboratory test results,tumor characteristics,and surgery-related parameters were collected.Univariate and multivariate logistic regression analyses were performed to identify risk factors for post-operative infection.RESULTS Post-operative infection occurred in 20 cases(25.97%)among the 77 patients.Univariate analysis showed that age≥65 years,Child-Pugh grade B,tumor diameter≥5 cm,operation time≥120 minutes,preoperative albumin<35 g/L,and comorbid diabetes were significantly associated with post-operative infection(P<0.05).Multivariate logistic regression analysis identified Child-Pugh grade B(OR=2.851,95%CI:1.426-5.698),operation time≥120 minutes(OR=2.367,95%CI:1.238-4.523),and preoperative albumin<35 g/L(OR=2.156,95%CI:1.147-4.052)as independent risk factors for post-operative infection.CONCLUSION Liver function status,operation time,and preoperative albumin level are significant factors affecting post-operative infection in HCC patients undergoing D-TACE.For high-risk patients,enhanced perioperative management,appropriate timing of surgery,and active improvement of nutritional status should be implemented to reduce the risk of post-operative infection.展开更多
Introduction: Post-operative (post-op) complete atrio-ventricular heart block (CAVB) occurs after 1% - 4% of pediatric cardiac operations. Current practice dictates implantation of permanent pacemaker (PPM) when post-...Introduction: Post-operative (post-op) complete atrio-ventricular heart block (CAVB) occurs after 1% - 4% of pediatric cardiac operations. Current practice dictates implantation of permanent pacemaker (PPM) when post-op CAVB persists >9 days. We propose that earlier PPM implantation may be the most cost-effective methodology since patient costs increase with extended length of stay (LOS). Methods: Data on the probabilities of persistent post-op CAVB were extracted from published reports. No individual patient data were utilized during this study. This was utilized to create a decision-making model and a total cost analysis on post-op day 0 - 10 to determine the most cost-efficient day to implant a PPM. Cost variables included estimates of daily cardiac ICU care, cost of PPM implantation, LOS, cost related to possible superficial or deep infection based on published prevalence rates (2.3% and 4.9%, respectively) and need for explant due to deep infection or recovery of native conduction. The model assumes 5-day minimum LOS and 1 day increase in LOS with PPM implantation. Cost data were obtained from relevant billing codes and manufacturer list prices for PPM and leads. A secondary analysis evaluated probability of unnecessary PPMs implanted and excess costs. Results: Post-op day (POD) 4 is the lowest total cost of PPM implantation for post-op CAVB, even when accounting for possible risk of either superficial or deep infection. A one-way sensitivity analysis accounting for variability of cardiac ICU care costs between centers ranging from $3000 - $9000 per day consistently replicates POD 4 as the most cost-effective day for PPM implantation. Implant on POD 4 results in a 26% chance of unnecessary implantation. Conclusions: The most cost-efficient day for PPM implantation for post-op CAVB is post-op day 4, which results in a minimum total cost savings of $17,422 per patient. Added costs due to risk of superficial or deep infection are marginal due to low prevalence of post-operative infection in this population.展开更多
目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随...目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随机数字表法分为对照组和观察组,各46例。对照组患者接受常规护理,观察组患者接受Guided Care护理模式,两组均持续护理2 m。比较两组心理状态、治疗依从性、生活质量以及护理满意度。结果:护理后,观察组抑郁-焦虑-压力量表(Depression Anxiety Stress Scales,DASS)各项评分均较对照组低,Morisky改良版服药依从性量表(Morisky Medication Adherence Scale,MMAS-8)评分、(The Mos 36-item Short Form Health Survey,SF-36)评分及护理满意度均高于对照组(P<0.05)。结论:Guided Care护理模式能够有效改善不孕症患者接受IVF-ET治疗期间的焦虑、抑郁情绪,增强其治疗依从性,对于顺利妊娠具有积极意义,从而获得更高的护理满意度。展开更多
A case of imported severe falciparum malaria with spontaneous splenic rupture was reported in this paper.The patient,an African migrant worker,developed hemolytic anemia,sepsis,thrombocytopenia,coagulation dysfunction...A case of imported severe falciparum malaria with spontaneous splenic rupture was reported in this paper.The patient,an African migrant worker,developed hemolytic anemia,sepsis,thrombocytopenia,coagulation dysfunction,liver failure,renal insufficiency,electrolyte disturbance and other clinical manifestations after returning to the local area.Plasmodium falciparum was found by peripheral blood smearscopy and was diagnosed as severe falciparum malaria.After standardized anti-malaria treatment,plasma exchange+cytokine adsorption therapy,the establishment of“forewarning-forewarning-prevention-emergency”predictive nursing management model,the establishment of an integrated nursing team,the division of medical care is clear,professional knowledge is complementary,after three months of regular follow-up,the patient has no malaria recurrence,no refire,the function of all organs returned to normal.展开更多
With the accelerating aging process of China’s population,the demand for community elderly care services has shown diversified and personalized characteristics.However,problems such as insufficient total care service...With the accelerating aging process of China’s population,the demand for community elderly care services has shown diversified and personalized characteristics.However,problems such as insufficient total care service resources,uneven distribution,and prominent supply-demand contradictions have seriously affected service quality.Big data technology,with core advantages including data collection,analysis and mining,and accurate prediction,provides a new solution for the allocation of community elderly care service resources.This paper systematically studies the application value of big data technology in the allocation of community elderly care service resources from three aspects:resource allocation efficiency,service accuracy,and management intelligence.Combined with practical needs,it proposes optimal allocation strategies such as building a big data analysis platform and accurately grasping the elderly’s care needs,striving to provide operable path references for the construction of community elderly care service systems,promoting the early realization of the elderly care service goal of“adequate support and proper care for the elderly”,and boosting the high-quality development of China’s elderly care service industry.展开更多
Objectives This study aimed to evaluate the effectiveness of the stepped self-care program on the self-care,self-efficacy,and quality of life of stroke survivors.Methods This quasi-experimental study allocated 110 str...Objectives This study aimed to evaluate the effectiveness of the stepped self-care program on the self-care,self-efficacy,and quality of life of stroke survivors.Methods This quasi-experimental study allocated 110 stroke survivors from two neurology wards into an intervention group(n=55)who received the stepped self-care program and a control group(n=55)who received usual care from June to December 2023.The Self-Care of Stroke Inventory,Stroke Self-Efficacy Questionnaire,and the short version of the Stroke Specific Quality of Life Scale were administered at baseline(T0),immediately post-intervention(T_(1)),and at 1-month(T_(2))and 3-month(T_(3))follow-ups.Data were analyzed using repeated measures analyses of variance,and generalized estimating equations.Results A total of 48 participants in the intervention group and 50 participants in the control group completed the study.No statistically significant differences were observed at T0 in any of the measured indicators(all P>0.05).The study showed significant group,time,and group×time interaction effects across the assessed outcomes(all P<0.05).Follow-up between-group comparisons at T_(1),T_(2),and T_(3) indicated that the intervention group had significantly higher scores in self-care maintenance,self-care monitoring,self-care management,self-efficacy,and quality of life than the control group(all P<0.001).Conclusions The stepped self-care program significantly improved self-care behaviors,self-efficacy,and quality of life among stroke survivors.These findings support the broader implementation of this approach in post-discharge home self-care.展开更多
Background:Continuous care for children with enterostomy and their families has been gaining popularity in China.Objective:To evaluate the feasibility of continuous care for children with enterostomy and their familie...Background:Continuous care for children with enterostomy and their families has been gaining popularity in China.Objective:To evaluate the feasibility of continuous care for children with enterostomy and their families in China.Methods:The PubMed,Web of Science,Embase,Cochrane Library,EBSCO,CNKI,CBM,VIP,and WanFang were searched for clinical trials until December 30,2025.Two reviewers independently searched articles,evaluated quality and extracted data.This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA).Results:33 studies involving 2774 participants were included.The meta-analysis showed that continuous care strategy can significantly reduce the incidence of complications in children with enterostomy(OR=0.20,95%CI=0.16-0.26,p<0.001,I2=0%),effectively improve the family caregiver ability for enterostomy(MD=-10.34,95%CI=-13.82 to-6.85,p<0.001,I2=99%),shorten the time for family members to replace stoma bags(MD=-13.57,95%CI=-19.66 to-7.49,p<0.001,I2=100%),and alleviate negative emotions such as anxiety(SMD=-1.80,95%CI=-2.36 to-1.23,p<0.001,I2=92%)and depression(SMD=-1.54,95%CI=-2.04 to-1.04,p<0.001,I2=89%)in the families of the affected children.Conclusions:Continuous care can reduce complications of enterostomy in children,improve the family caregiver ability for enterostomy and alleviate negative emotions of family members such as anxiety and depression.展开更多
Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching t...Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching the construction of an emergency care system based on the concept of“linkage”,delving into its theoretical foundations,exploring innovative construction models,and analyzing practical cases.The study indicates that an emergency care system under the“linkage”concept can effectively integrate resources and enhance efficiency,providing new insights for improving the construction of the emergency care system.It aims to promote the development of the emergency care system towards a more scientific,efficient,and collaborative direction.展开更多
Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant...Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant’s eight-step concept analysis approach was utilized to identify and define the attributes,antecedents,and consequences of reflective supervision in the ICU.An extensive literature search was conducted across various databases,including Google Scholar,CINAHL,PubMed.Articles published from 2005 to 2025 were identified.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 statement to indicate the included articles and extract related data based on relevance.Results Forty articles were included in the analysis.The identified attributes included the supervisor-supervisee relationship,effective communication,teamwork,collaborations,reflection,competencies,feedback,continuous support,and autonomous choice.The identified antecedents included participation,supportive supervision,flexibility,open-door policy,training,and motivation.Consequences impacting the success of reflective supervision were identified as promotion of resiliency,autonomy,work-life balance,self-awareness,increased self-esteem,professional development,critical thinking,increased job satisfaction,and enhanced commitment.Conclusions Reflective supervision is a complex professional self-care strategy that enhances ICU practice,by promoting nurses’well-being,self-awareness,therapeutic skills,and professional development.展开更多
This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementi...This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementing refined volume management,anticoagulation management,and ventilator management during extracorporeal membrane oxygenation;providing personalized nutritional support for the child;and strengthening the prevention and management of complications.After active treatment and nursing care,the child recovered well and was successfully transferred out of the intensive care unit.展开更多
Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 20...Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.展开更多
In recent years,with the accelerating aging process of the population,China has entered an aging society,and the number of elderly patients with chronic diseases has been increasing.The traditional medical and elderly...In recent years,with the accelerating aging process of the population,China has entered an aging society,and the number of elderly patients with chronic diseases has been increasing.The traditional medical and elderly care service models can no longer fully meet their needs.The integrated medical and elderly care model has emerged as the times require.It organically combines medical resources with elderly care resources to provide comprehensive and continuous health management services for the elderly,becoming an important approach to solving the problems of chronic disease management among the elderly.In this regard,this paper first elaborates on the role of integrated medical and elderly care in the management of chronic diseases among the elderly,and then puts forward application strategies of integrated medical and elderly care in the management of chronic diseases among the elderly,in order to provide certain reference for relevant researchers.展开更多
Take care of your hair to help it stay clean,strong and healthy.Wash your hair when it gets dirty,but not too often.For most people,that means every two to three days.People with oily hair wash it every one to two day...Take care of your hair to help it stay clean,strong and healthy.Wash your hair when it gets dirty,but not too often.For most people,that means every two to three days.People with oily hair wash it every one to two days.Use a brush or comb to keep your hair neat and smooth.It's also important to be gentle so you don't pull or break your hair.Never go to bed with wet hair.It can break easily when you sleep.Dry it before bed!展开更多
Hebei Province has incorporated targeted assistance services for people with disabilities into livelihood projects,upgrading the quality and efficiency of support services for disadvantaged groups.THE living and nursi...Hebei Province has incorporated targeted assistance services for people with disabilities into livelihood projects,upgrading the quality and efficiency of support services for disadvantaged groups.THE living and nursing allowances provided by the Chinese government for people with disabilities who are unable to work are not only important components of China’s social security system which provide for the needs of its disabled,but also show China’s ability to guarantee the basic living standard and social fairness and justice for this group of people.展开更多
Highlights By conjugating the same anti-N monoclonal antibody(mAb4-mAb1)with colloidal gold or fluorescent microspheres,this study developed two rapid point-of-care antigen immunochromatographic strips for the detecti...Highlights By conjugating the same anti-N monoclonal antibody(mAb4-mAb1)with colloidal gold or fluorescent microspheres,this study developed two rapid point-of-care antigen immunochromatographic strips for the detection of porcine deltacoronavirus.The fluorescent microsphere-based lateral flow test strip demonstrated a sensitivity of 10^(1.7)TCID_(50)/0.1 mL,which is fourfold higher than that of the colloidal gold-based assay.Porcine deltacoronavirus(PDCoV)is a recently identified enteric coronavirus that causes an acute infectious disease in piglets,leading to diarrhea,vomiting,dehydration,and mortality(Hu et al.2015).展开更多
文摘AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection.METHODS: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo.RESULTS: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P < 0.001]. FC to select patients for colonoscopy could reduce cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented.CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated.
文摘Unrestrained anti-microbial resistance (AMR) among bacterial pathogens has made the management and treatment of post-operative wound infections difficult. This study assessed the current AMR patterns of bacterial isolates in post-operative wound infections in a tertiary care hospital in Kathmandu,Nepal. Pus swabs collected from post-operative wound infections and submitted for culture and sensitivity were included in this study. Isolation and identification of the organism was done by standard microbiological methods. Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method and result was interpreted as per National Committee for Clinical Laboratory Standards (NCCLS) guide lines. Of the 120 pus swabs processed for culture, 96 showed bacterial growth. Staphylococcus aureus 36 (37.5%) was the predominant gram positive isolate and Escherichia coli 24 (25%) was the major gram negative isolate .The infection was most prevalent in the age group 20-40 years. All S. aureus isolates were sensitive to aminoglycosides and vancomycin. Out of 36 S. aureus, 15 (41.66%) isolates were methicillin resistant S. aureus (MRSA). Staphylococcus epidermidis showed high resistance (50%-100%) to all antibiotics but were sensitive to vancomycin. All gram negative isolates showed high resistance against cephalexin (75%-100%) and ceftriaxone (25%-100%). Overall multi-drug resistant isolates were 66.7%. A high level of AMR was observed in gram negative bacterial isolates. Rational use of antibiotics and a regular monitoring of AMR patterns in post-operative wound infections are essential and mandatory to avert further emergence and spread of anti-microbial resistance among bacterial pathogens.
文摘Background: Postoperative wound healing has been a problem which causes high mortality in the developing world;postoperative wound has been reported to cause devastating consequences and a measurable mortality. There is a limited number of published studies in Tanzania investigating Nursing practice on post-operative wound care in surgical wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania. This study assesses nursing practice on postoperative wound care by nurses in surgical wards at Muhimbili National Hospital. Methods: A cross-sectional study of surgical nurses was carried out through the use of randomly selected surgical wards at Muhimbili National Hospital in Tanzania from September 2011 to July 2013. A multistage cluster sampling technique was used to obtain a suitable number of study participants. Data collection was done using a checklist from a convenient sample of 71 nurses in selected surgical wards. Results: The result indicates that a big number of the participants were female (76.5%) and those of the age group 25 to 34 years were 40.8%. Participants exceeding a half of the selected sample reported to have poor post-operative wound care practice (57.7%). In comparison, male participants scored higher, and had better practice than their female counterparts, however, there was no considerable difference in the scores (P = 0.803). During set-up and preparation phase, the washing of hands before starting and after the completion of procedure was taken into consideration by less than half of the participants (49.3%). All participants did not ensure the environment is clean and take into account the patient’s privacy through the use of screen or even closing the room. The report shows that nurses take into consideration putting on clean gloves during the removal of the old dressing (99%), the use of sterile gloves during wound dressing was taken into consideration by most of the nurses (63%). Good practice was noted in applying dressing solution as recommended (85%), dry sterile dressing was applied by (90%), arrangement and setting up of dressing forceps and other items that may be needed in order of their application using forceps (20%), usage of forceps to dip gauze into antiseptic solution (35%) and cleaning of the wound cleaning from least contaminated to most contaminated area was only adhered to by (34%). Post-operative counseling and giving to the patient not to temper with the wound was done by a representation of only 15% of nurses. All the nurses did not do the documentation of the changes observed on the wound nor did they report on the patients comfort and the date and time after the procedure wound changes, reported patient comfort, and recorded date or time after the procedure. Conclusion: Majority of the nurses in surgical wards do not follow the postoperative wound care checklist provided by MNH although they know its importance. Assessment of the wound and documentation continues to be a problem in the nursing profession in Tanzania. Nurses are reasonably knowledgeable about the principal of wound dressing;however, lack of knowledge on some of the key principles of wound dressing is worth noting. Almost half of the nurses do not wash hands before and after the procedures, they don’t use single gauze in one direction only, not cleaning from least contaminated to most contaminated area, which can lead to wound contamination.
文摘BACKGROUND Post-operative infection is a common and serious complication following drugeluting trans arterial chemo embolization(D-TACE)in patients with hepatocellular carcinoma(HCC),potentially compromising treatment efficacy and increasing morbidity.AIM To investigate the risk factors associated with post-operative infection in HCC patients undergoing D-TACE,and to provide evidence for clinical prevention and targeted intervention strategies.METHODS Clinical data of 77 primary HCC patients who underwent D-TACE in our hospital from January 2022 to December 2023 were retrospectively analyzed.Patient demographics,laboratory test results,tumor characteristics,and surgery-related parameters were collected.Univariate and multivariate logistic regression analyses were performed to identify risk factors for post-operative infection.RESULTS Post-operative infection occurred in 20 cases(25.97%)among the 77 patients.Univariate analysis showed that age≥65 years,Child-Pugh grade B,tumor diameter≥5 cm,operation time≥120 minutes,preoperative albumin<35 g/L,and comorbid diabetes were significantly associated with post-operative infection(P<0.05).Multivariate logistic regression analysis identified Child-Pugh grade B(OR=2.851,95%CI:1.426-5.698),operation time≥120 minutes(OR=2.367,95%CI:1.238-4.523),and preoperative albumin<35 g/L(OR=2.156,95%CI:1.147-4.052)as independent risk factors for post-operative infection.CONCLUSION Liver function status,operation time,and preoperative albumin level are significant factors affecting post-operative infection in HCC patients undergoing D-TACE.For high-risk patients,enhanced perioperative management,appropriate timing of surgery,and active improvement of nutritional status should be implemented to reduce the risk of post-operative infection.
文摘Introduction: Post-operative (post-op) complete atrio-ventricular heart block (CAVB) occurs after 1% - 4% of pediatric cardiac operations. Current practice dictates implantation of permanent pacemaker (PPM) when post-op CAVB persists >9 days. We propose that earlier PPM implantation may be the most cost-effective methodology since patient costs increase with extended length of stay (LOS). Methods: Data on the probabilities of persistent post-op CAVB were extracted from published reports. No individual patient data were utilized during this study. This was utilized to create a decision-making model and a total cost analysis on post-op day 0 - 10 to determine the most cost-efficient day to implant a PPM. Cost variables included estimates of daily cardiac ICU care, cost of PPM implantation, LOS, cost related to possible superficial or deep infection based on published prevalence rates (2.3% and 4.9%, respectively) and need for explant due to deep infection or recovery of native conduction. The model assumes 5-day minimum LOS and 1 day increase in LOS with PPM implantation. Cost data were obtained from relevant billing codes and manufacturer list prices for PPM and leads. A secondary analysis evaluated probability of unnecessary PPMs implanted and excess costs. Results: Post-op day (POD) 4 is the lowest total cost of PPM implantation for post-op CAVB, even when accounting for possible risk of either superficial or deep infection. A one-way sensitivity analysis accounting for variability of cardiac ICU care costs between centers ranging from $3000 - $9000 per day consistently replicates POD 4 as the most cost-effective day for PPM implantation. Implant on POD 4 results in a 26% chance of unnecessary implantation. Conclusions: The most cost-efficient day for PPM implantation for post-op CAVB is post-op day 4, which results in a minimum total cost savings of $17,422 per patient. Added costs due to risk of superficial or deep infection are marginal due to low prevalence of post-operative infection in this population.
文摘目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随机数字表法分为对照组和观察组,各46例。对照组患者接受常规护理,观察组患者接受Guided Care护理模式,两组均持续护理2 m。比较两组心理状态、治疗依从性、生活质量以及护理满意度。结果:护理后,观察组抑郁-焦虑-压力量表(Depression Anxiety Stress Scales,DASS)各项评分均较对照组低,Morisky改良版服药依从性量表(Morisky Medication Adherence Scale,MMAS-8)评分、(The Mos 36-item Short Form Health Survey,SF-36)评分及护理满意度均高于对照组(P<0.05)。结论:Guided Care护理模式能够有效改善不孕症患者接受IVF-ET治疗期间的焦虑、抑郁情绪,增强其治疗依从性,对于顺利妊娠具有积极意义,从而获得更高的护理满意度。
基金“Artificial Liver Special Fund”of Beijing Gan Dan Xiang Zhao Public Welfare Foundation(Project No.:iGandanF-1082024-RGG055)。
文摘A case of imported severe falciparum malaria with spontaneous splenic rupture was reported in this paper.The patient,an African migrant worker,developed hemolytic anemia,sepsis,thrombocytopenia,coagulation dysfunction,liver failure,renal insufficiency,electrolyte disturbance and other clinical manifestations after returning to the local area.Plasmodium falciparum was found by peripheral blood smearscopy and was diagnosed as severe falciparum malaria.After standardized anti-malaria treatment,plasma exchange+cytokine adsorption therapy,the establishment of“forewarning-forewarning-prevention-emergency”predictive nursing management model,the establishment of an integrated nursing team,the division of medical care is clear,professional knowledge is complementary,after three months of regular follow-up,the patient has no malaria recurrence,no refire,the function of all organs returned to normal.
文摘With the accelerating aging process of China’s population,the demand for community elderly care services has shown diversified and personalized characteristics.However,problems such as insufficient total care service resources,uneven distribution,and prominent supply-demand contradictions have seriously affected service quality.Big data technology,with core advantages including data collection,analysis and mining,and accurate prediction,provides a new solution for the allocation of community elderly care service resources.This paper systematically studies the application value of big data technology in the allocation of community elderly care service resources from three aspects:resource allocation efficiency,service accuracy,and management intelligence.Combined with practical needs,it proposes optimal allocation strategies such as building a big data analysis platform and accurately grasping the elderly’s care needs,striving to provide operable path references for the construction of community elderly care service systems,promoting the early realization of the elderly care service goal of“adequate support and proper care for the elderly”,and boosting the high-quality development of China’s elderly care service industry.
基金The National Natural Science Foundation of China[72174184]provided policy and financialsupport for this research.
文摘Objectives This study aimed to evaluate the effectiveness of the stepped self-care program on the self-care,self-efficacy,and quality of life of stroke survivors.Methods This quasi-experimental study allocated 110 stroke survivors from two neurology wards into an intervention group(n=55)who received the stepped self-care program and a control group(n=55)who received usual care from June to December 2023.The Self-Care of Stroke Inventory,Stroke Self-Efficacy Questionnaire,and the short version of the Stroke Specific Quality of Life Scale were administered at baseline(T0),immediately post-intervention(T_(1)),and at 1-month(T_(2))and 3-month(T_(3))follow-ups.Data were analyzed using repeated measures analyses of variance,and generalized estimating equations.Results A total of 48 participants in the intervention group and 50 participants in the control group completed the study.No statistically significant differences were observed at T0 in any of the measured indicators(all P>0.05).The study showed significant group,time,and group×time interaction effects across the assessed outcomes(all P<0.05).Follow-up between-group comparisons at T_(1),T_(2),and T_(3) indicated that the intervention group had significantly higher scores in self-care maintenance,self-care monitoring,self-care management,self-efficacy,and quality of life than the control group(all P<0.001).Conclusions The stepped self-care program significantly improved self-care behaviors,self-efficacy,and quality of life among stroke survivors.These findings support the broader implementation of this approach in post-discharge home self-care.
文摘Background:Continuous care for children with enterostomy and their families has been gaining popularity in China.Objective:To evaluate the feasibility of continuous care for children with enterostomy and their families in China.Methods:The PubMed,Web of Science,Embase,Cochrane Library,EBSCO,CNKI,CBM,VIP,and WanFang were searched for clinical trials until December 30,2025.Two reviewers independently searched articles,evaluated quality and extracted data.This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA).Results:33 studies involving 2774 participants were included.The meta-analysis showed that continuous care strategy can significantly reduce the incidence of complications in children with enterostomy(OR=0.20,95%CI=0.16-0.26,p<0.001,I2=0%),effectively improve the family caregiver ability for enterostomy(MD=-10.34,95%CI=-13.82 to-6.85,p<0.001,I2=99%),shorten the time for family members to replace stoma bags(MD=-13.57,95%CI=-19.66 to-7.49,p<0.001,I2=100%),and alleviate negative emotions such as anxiety(SMD=-1.80,95%CI=-2.36 to-1.23,p<0.001,I2=92%)and depression(SMD=-1.54,95%CI=-2.04 to-1.04,p<0.001,I2=89%)in the families of the affected children.Conclusions:Continuous care can reduce complications of enterostomy in children,improve the family caregiver ability for enterostomy and alleviate negative emotions of family members such as anxiety and depression.
文摘Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching the construction of an emergency care system based on the concept of“linkage”,delving into its theoretical foundations,exploring innovative construction models,and analyzing practical cases.The study indicates that an emergency care system under the“linkage”concept can effectively integrate resources and enhance efficiency,providing new insights for improving the construction of the emergency care system.It aims to promote the development of the emergency care system towards a more scientific,efficient,and collaborative direction.
文摘Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant’s eight-step concept analysis approach was utilized to identify and define the attributes,antecedents,and consequences of reflective supervision in the ICU.An extensive literature search was conducted across various databases,including Google Scholar,CINAHL,PubMed.Articles published from 2005 to 2025 were identified.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 statement to indicate the included articles and extract related data based on relevance.Results Forty articles were included in the analysis.The identified attributes included the supervisor-supervisee relationship,effective communication,teamwork,collaborations,reflection,competencies,feedback,continuous support,and autonomous choice.The identified antecedents included participation,supportive supervision,flexibility,open-door policy,training,and motivation.Consequences impacting the success of reflective supervision were identified as promotion of resiliency,autonomy,work-life balance,self-awareness,increased self-esteem,professional development,critical thinking,increased job satisfaction,and enhanced commitment.Conclusions Reflective supervision is a complex professional self-care strategy that enhances ICU practice,by promoting nurses’well-being,self-awareness,therapeutic skills,and professional development.
文摘This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementing refined volume management,anticoagulation management,and ventilator management during extracorporeal membrane oxygenation;providing personalized nutritional support for the child;and strengthening the prevention and management of complications.After active treatment and nursing care,the child recovered well and was successfully transferred out of the intensive care unit.
基金Construction of Standardized Protective Nursing Plan for Hydrofluoric Acid Operation in Stomatology and Re search on Injury Prevention Effect(Project No.:FZ2025101)。
文摘Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.
文摘In recent years,with the accelerating aging process of the population,China has entered an aging society,and the number of elderly patients with chronic diseases has been increasing.The traditional medical and elderly care service models can no longer fully meet their needs.The integrated medical and elderly care model has emerged as the times require.It organically combines medical resources with elderly care resources to provide comprehensive and continuous health management services for the elderly,becoming an important approach to solving the problems of chronic disease management among the elderly.In this regard,this paper first elaborates on the role of integrated medical and elderly care in the management of chronic diseases among the elderly,and then puts forward application strategies of integrated medical and elderly care in the management of chronic diseases among the elderly,in order to provide certain reference for relevant researchers.
文摘Take care of your hair to help it stay clean,strong and healthy.Wash your hair when it gets dirty,but not too often.For most people,that means every two to three days.People with oily hair wash it every one to two days.Use a brush or comb to keep your hair neat and smooth.It's also important to be gentle so you don't pull or break your hair.Never go to bed with wet hair.It can break easily when you sleep.Dry it before bed!
文摘Hebei Province has incorporated targeted assistance services for people with disabilities into livelihood projects,upgrading the quality and efficiency of support services for disadvantaged groups.THE living and nursing allowances provided by the Chinese government for people with disabilities who are unable to work are not only important components of China’s social security system which provide for the needs of its disabled,but also show China’s ability to guarantee the basic living standard and social fairness and justice for this group of people.
基金financially supported by the National Key Research and Development Program of China(2021YFF0703600)。
文摘Highlights By conjugating the same anti-N monoclonal antibody(mAb4-mAb1)with colloidal gold or fluorescent microspheres,this study developed two rapid point-of-care antigen immunochromatographic strips for the detection of porcine deltacoronavirus.The fluorescent microsphere-based lateral flow test strip demonstrated a sensitivity of 10^(1.7)TCID_(50)/0.1 mL,which is fourfold higher than that of the colloidal gold-based assay.Porcine deltacoronavirus(PDCoV)is a recently identified enteric coronavirus that causes an acute infectious disease in piglets,leading to diarrhea,vomiting,dehydration,and mortality(Hu et al.2015).
