Objective To study the problems of pharmaceutical care in retail pharmacies and provide reference for the standardized development of pharmaceutical care in China.Methods Based on the literature of CNKI database,Paret...Objective To study the problems of pharmaceutical care in retail pharmacies and provide reference for the standardized development of pharmaceutical care in China.Methods Based on the literature of CNKI database,Pareto analysis was used to study the present situation of pharmaceutical care in retail pharmacies.Then the following problems in pharmaceutical care were found such as low personnel professional quality,inadequate attention,imperfect laws and regulations,and lack of standard service process.As to the first three problems,there were more research references.But there was less literature on the standard care process.Results and Conclusion Focusing on the customer demand,taking drug sales process as the basic framework of pharmaceutical care standardized process,and combining with the collaboration,the service process including prescription drugs review and OTC drugs purchase consultation is established.This process elaborates the division of staff services as well as the service standards in pre-sale,on-sale,and after-sale stages.Besides,it also puts forward some advice for the previous three problems,which will ensure the smooth implementation of pharmaceutical care in drugstores.展开更多
Background and Objectives:Study aim was to determine the levels and barriers of the Nutrition Care Process(NCP),a practical method of individualized nutrition support.Methods and Study Design:Delegate of regis-tered d...Background and Objectives:Study aim was to determine the levels and barriers of the Nutrition Care Process(NCP),a practical method of individualized nutrition support.Methods and Study Design:Delegate of regis-tered dietitians(RDs)from acute-care hospitals answered our nationwide web-based questionnaire(April-June,2023)to determine the implementation status of screening,assessment,intervention(including planning),and monitoring(components of the NCP).Results:Of 5,378 institutions contacted,905(16.8%)responded.For Screening,80.0%screened all inpatients:primary personnel in charge were RDs(57.6%);the most used screen-ing tool was Subjective Global Assessment(SGA)(49.2%).For Assessment,66.1%assessed all inpatients:food intake(93.3%)was most evaluated whereas muscle mass and strength(13.0%,8.8%)were least evaluated.For Intervention,43.9%did so within 48h of hospital admission:oral nutritional supplement(92.9%)was the most common RDs intervention and parenteral nutrition(29.9%)was used less.For Monitoring,18.5%of institutions had monitoring frequency of≥3 times/week whilst 23.0%had monitoring less than once a week for severely malnourished patients.Energy and protein intake(93.7%,84.3%)were most monitored and lipid intake(30.1%)was less monitored.Conclusions:Barriers of NCP included inefficient staffing systems and unsuitable tools in Screening,inaccurate patient targeting and lack of important evaluation items in Assessment,delayed timing and incomplete contents in Intervention,and inadequate frequency and lack of important evaluation items in Monitor-ing.An increase in RDs staffing in acute-care general wards,widespread NCP instruction manuals,and education about the tools and evaluation items utilized in nutritional management are possible solutions.展开更多
Introduction: Controlling hypertension across world continues to be challenging. Managing hypertension is not only concerned with lowering blood pressure by using antihypertensive medications;it also aims to minimize ...Introduction: Controlling hypertension across world continues to be challenging. Managing hypertension is not only concerned with lowering blood pressure by using antihypertensive medications;it also aims to minimize its consequences through adopting self-care practices. Compliance with self-care practices among patients with hypertension is considered a multidimensional phenomenon. The phenomenon of hypertension has been studied quantitatively, however;little qualitative studies were conducted to understand the compliance with self-care among patients with hypertension. Aim: To understand the process that patients with hypertension go through to comply with self-care practices. Methods: This study used a qualitative design that followed constructivist grounded theory approach;purposive sampling was used to recruit participants from cardiac clinics;semi structured, in-depth and face-to-face interview was used as a major method for data collection. Findings: Four participants with hypertension participated in this study;the phenomena of self-care was identified as the central phenomena;the start of the disease was identified as a casual condition;beliefs toward hypertension disease, beliefs toward self-care practices, knowledge and awareness regarding hypertension disease and self-care practices were identified as strategies;experiencing self-care practices was identified as consequence and being patients with hypertension in a social context. Conclusions: The process of compliance with self-care has a path of actions and interactions. The process started from the moment of diagnosis where the patients start to think about self-care. The absence of health care context leads to varying level of compliance with self-care among patients with hypertension. This indicated the need for more effective patient and health care provider relationship, education and awareness campaign.展开更多
Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfe...Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfers, particularly in hospitals where intensive care units are located in buildings separate from general wards. Patient transfers comprise several steps: physicians issue orders, relatives are notified, equipment is prepared, and medical staff coordinate. We identified three factors that influence transfer time: preparation time for bed transfer, time required for shift handovers, and time required for between-ward patient movement. Unfamiliarity with transfer routes and long elevator wait times were factors that also influenced transfer time. The following strategies were proposed: develop a standardized material checklist, design key notes for patient transfers, and optimize transfer routes. These strategies reduced transfer times by 40% to 43%. This study demonstrates that by addressing logistical challenges and streamlining relevant procedures, hospitals can enhance safety and quality of care during patient transfers.展开更多
The Pharmaceutical Care(PC)service is a growing sector.The continuous development of the role of the professional pharmacist in the sector of health services within the pharmacy leads to having an active role in the p...The Pharmaceutical Care(PC)service is a growing sector.The continuous development of the role of the professional pharmacist in the sector of health services within the pharmacy leads to having an active role in the primary care.The PC service has been in operation for years in other western countries such as Spain,the United Kingdom and the United States.Several studies have been carried out,which confirm the benefits of the service in reducing morbidity,hospital admissions and the cost of the health care system.This article sets out the concept of PC and the financial benefit to health expenditure.It also analyzes the Drug Therapy Problem(DTP)and the Patient Care Process.To conclude,a patient case is presented to understand the practical implementation of the theory of the PC and to show how the professional pharmacist reports the pharmacotherapeutic case.展开更多
Objective: to study the clinical effect of modified tissue-type plasminogen activator (rt-PA) in acute cerebral infarction and its improvement on patients viability. Methods: 74 patients with acute cerebral infarction...Objective: to study the clinical effect of modified tissue-type plasminogen activator (rt-PA) in acute cerebral infarction and its improvement on patients viability. Methods: 74 patients with acute cerebral infarction who were treated in our hospital from June 2020 to June 2021 were collected and divided into two groups according to the date of admission. The control group (37 cases) received routine first aid and the observation group (37 cases) received first aid by applying the improved first aid nursing process. The first aid time, clinical curative effect, prognosis level and living ability of the two groups were compared. Results: the time of triage, referral, blood collection, CT examination and rescue in the observation group was significantly shortened (P < 0.05). The scores of Glasgow Coma Scale (GCS) and Glasgow (GOS) were higher than those of the control group (GOS), while the scores of National Institutes of Health (NIHSS) were lower than those of the control group (P < 0.05). The results showed that the total therapeutic effect of the treatment group was 91.89%, which was higher than that of the control group 72.97% (p < 0.05). After emergency treatment, simple Fugl-Meyers motor ability assessment (FMA) and daily living ability (ADL) scores were higher than those of the normal population (P<0.05). Conclusion: the application of improved first aid nursing process in the treatment of acute cerebral infarction with rt-PA can shorten the first aid time, improve the curative effect, and help to further promote the recovery of patients ability to live.展开更多
Objective: to analyze the application effect of optimizing emergency nursing process. Methods: the study subjects were emergency chest pain patients, all patients treated in the emergency department of our hospital, a...Objective: to analyze the application effect of optimizing emergency nursing process. Methods: the study subjects were emergency chest pain patients, all patients treated in the emergency department of our hospital, and the patients were admitted from August 2020 to March 2022. The total number of patients admitted during this time period was 100, dividing all the study subjects into two groups, namely, the observation group and the control group. The sample size of 50 cases in both groups was 50 cases, and different emergency care procedures were adopted. The former was the optimized emergency care method, and the latter was the routine method. Finally, the application effect of the two groups was compared and analyzed. Results: after emergency care intervention treatment, the two groups of first aid, evaluation, hospital time comparison, the study confirmed that compared with the control group, the time index of rescue effect and adverse events, the observation group in rescue efficiency more advantage, and the control group has a high incidence of adverse events, the results are statistically significant (P <0.05). Conclusion: in the rescue process of patients with acute chest pain, if the emergency nursing process can be optimized, it will help to shorten the time of first aid, evaluation and hospitalization, improve the chance of rescue success of patients, reduce the chance of adverse events, and help the recovery of patients, which is worth promoting.展开更多
Objective: to evaluate the method and significance of emergency nursing process optimization for stroke patients. Methods: a total of 92 clinical patients admitted to Jintan District People's Hospital of Changzhou...Objective: to evaluate the method and significance of emergency nursing process optimization for stroke patients. Methods: a total of 92 clinical patients admitted to Jintan District People's Hospital of Changzhou City in Jiangsu Province in 2019 were selected as the research object and divided into the conventional group and the research group, each with 46 cases. The mortality rate and disability rate of the patients were observed. Results: the death rate and disability rate of the patients in the research group were lower than those in the conventional group, and the data difference was statistically significant (P < 0.05). Conclusion: the optimization of emergency nursing process for stroke patients can improve the quality of patient care, so it can be popularized.展开更多
Objective: to analyze the clinical effect of emergency nursing procedures in emergency care of acute cerebral infarction. Methods: the data of 130 patients with acute cerebral infarction admitted to our hospital were ...Objective: to analyze the clinical effect of emergency nursing procedures in emergency care of acute cerebral infarction. Methods: the data of 130 patients with acute cerebral infarction admitted to our hospital were retrospectively analyzed, and they were divided into control group and research group according to the order of treatment, the control group adopted the routine emergency nursing process, and the research group adopted the optimized emergency nursing process to compare the nursing effect. Results: compared with the control group, the treatment time of the study group was significantly shortened, the NIHSS score and MMSE score were improved, and the mortality rate was reduced, and the difference between the data was significantly P<0.05. Conclusion: the application of emergency nursing procedures in emergency care for acute cerebral infarction is of great significance to improving the success rate of patient treatment, and can be promoted and applied.展开更多
Objective: to effectively improve the standardized emergency care procedures for patients with ST-segment elevation myocardial infarction. Methods: Seventy-two patients with ST segment elevation myocardial infarction ...Objective: to effectively improve the standardized emergency care procedures for patients with ST-segment elevation myocardial infarction. Methods: Seventy-two patients with ST segment elevation myocardial infarction who were admitted to our hospital from January 2020 to December 2020 were selected as the main subjects of this study. They were divided into the control group/observation group. Among them, the control group received routine emergency care while the observation group received standardized emergency care procedures based on the routine emergency care measures, so as to compare the differences in the care procedures and patient care quality of the two patients during the emergency treatment. The difference was large, and the condition of the observation group was better. Finally, through the analysis of two groups of patients after treatment, and then investigate the family members and patients' satisfaction with care. The clinical results showed that the efficacy of 88.9% in the observation group was significantly superior to 66.7% in the control group, and the difference was statistically significant (P < 0.05). Conclusion: through analyzing the different nursing procedures of patients in two groups, it was found that the standardized emergency nursing procedures shortened the basic treatment time of patients and improved the success rate of rescue, providing a larger space for the treatment of patients, and the families were also satisfied with it.展开更多
Caring has long been recognized as central to nursing and is increasingly posited as a core concept although developing a theoretical description of caring which is adequate in the 21st. century continues to be a diff...Caring has long been recognized as central to nursing and is increasingly posited as a core concept although developing a theoretical description of caring which is adequate in the 21st. century continues to be a difficult task for nursing scholars. Consequently, verifying existing theoretical structures of caring remains an ongoing challenge. The aim of this article is to provide empirical verification of the caring processes of “knowing,” “being with,” “doing for,” “enabling” and “maintaining belief” from Swanson’s Middle Range Caring Theory based on the categorization of nursing actions from a systematic literature review on care. Methods: A systematic literature review was conducted in the fields of nursing sciences, medicine and psychology. Purposeful sampling was carried out covering a period from 2003-2013. The final sample included 25 articles. Results: Major themes of nursing actions included “knowing” which consisted of centering, nurturing, informed understanding, assessment skills, communication and respect for individual differences. “Being with” was characterized by intimate relationship, connecting, presencing, emotional adaptability awareness of self/other and decentering. “Doing for” included competence, knowledge, professional/technical skills, helping actions, anticipatory, multidisciplinary and preserving dignity. “Enabling” was characterized by self care, commitment, complexity of care, appropriate communication, information/education, sharing power, enabling choice and ongoing validation. Finally, “maintaining belief” was characterized by spiritual being, humanistic view, harmonious balance, hope, love, and compassion, meaning, and religious and spiritual orientation. Conclusion: Empirical verification was shown for the caring processes described in Swanson’s Caring Theory grounded in concrete nursing actions.展开更多
The formation of disinfection by-products（DBPs） from the degradation of N,N-diethyl-3-methyl benzoyl amide（DEET） and ibuprofen（IBP） by the ultraviolet irradiation（UV）/chlorine process and subsequent post-chlor...The formation of disinfection by-products（DBPs） from the degradation of N,N-diethyl-3-methyl benzoyl amide（DEET） and ibuprofen（IBP） by the ultraviolet irradiation（UV）/chlorine process and subsequent post-chlorination was investigated and compared with the UV/H_2O_2 process.The pseudo first-order rate constants of the degradation of DEET and IBP by the UV/chlorine process were 2 and 3.1 times higher than those by the UV/H_2O_2 process, respectively, under the tested conditions. This was due to the significant contributions of both reactive chlorine species U（RCS） and hydroxyl radicals（HO） in the UV/chlorine process. Trichloromethane, 1,1,1-trichloro-2-propanone and dichloroacetic acid were the major known DBPs formed after 90% of both DEET and IBP that were degraded by the UV/chlorine process. Their yields increased by over 50%after subsequent 1-day post-chlorination. The detected DBPs after the degradation of DEET and IBP comprised 13.5% and 19.8% of total organic chlorine（TOCl）, respectively, and the proportions increased to 19.8% and 33.9% after subsequent chlorination, respectively. In comparison to the UV/H_2O_2 process accompanied with post-chlorination, the formation of DBPs and TOCl in the UV/chlorine process together with post-chlorination was 5%–63% higher,Ulikely due to the generation of more DBP precursors from the attack of RCS, in addition to HO.展开更多
AIM: To examine the feasibility and validity of electronic generation of quality metrics in the intensive care unit(ICU).METHODS: This minimal risk observational study was performed at an academic tertiary hospital. T...AIM: To examine the feasibility and validity of electronic generation of quality metrics in the intensive care unit(ICU).METHODS: This minimal risk observational study was performed at an academic tertiary hospital. The Critical Care Independent Multidisciplinary Program at Mayo Clinic identified and defined 11 key quality metrics. These metrics were automatically calculated using ICU Data Mart, a near-real time copy of all ICU electronic medical record(EMR) data. The automatic report was compared with data from a comprehensive EMR review by a trained investigator. Data was collected for 93 randomly selected patients admitted to the ICU during April 2012(10% of admitted adult population). This study was approved by the Mayo Clinic Institution Review Board.RESULTS: All types of variables needed for metric calculations were found to be available for manual and electronic abstraction, except information for availability of free beds for patient-specific time-frames. There was 100% agreement between electronic and manual data abstraction for ICU admission source, admission service, and discharge disposition. The agreement between electronic and manual data abstraction of the time of ICU admission and discharge were 99% and 89%. The time of hospital admission and discharge were similar for both the electronically and manually abstracted datasets. The specificity of the electronically-generated report was 93% and 94% for invasive and non-invasive ventilation use in the ICU. One false-positive result for each type of ventilation was present. The specificity for ICU and in-hospital mortality was 100%. Sensitivity was 100% for all metrics.CONCLUSION: Our study demonstrates excellent accuracy of electronically-generated key ICU quality metrics. This validates the feasibility of automatic metric generation.展开更多
This study was conducted to assess quality of postnatal care that midwives provide to women seeking postnatal services in health facilities in Dedza district, the central region ofMalawi. The study design was descript...This study was conducted to assess quality of postnatal care that midwives provide to women seeking postnatal services in health facilities in Dedza district, the central region ofMalawi. The study design was descriptive cross sectional and utilized quantitative data collection and analysis method to determine structural, process and outcome components of postnatal care in two facilities that offer emergency obstetric and neonatal care and five that offer basic emergency obstetric and neonatal care. All 60 midwives who were providing postnatal care during the time of study in the district were interviewed using a structured questionnaire. In addition, the midwives actual practice was observed and compared to a standard checklist on postnatal care practice which was developed by the Malawi Ministry of Health. Data were analyzed using SPSS version 16.0. Results show that structure for providing postnatal counseling services was inappropriate and inadequate. Furthermore, the contents of postnatal services were below reproductive health standards because the clients were neither monitored nor examined physically on discharge. On average, all the seven facilities scored 48% on postnatal services rendered which is far below the recommended 80% according to the Reproductive Health Standards. There is a need to provide basic infrastructure in all the basic emergency obstetric and neonatal care facilities. In addition, refresher training courses for midwives in maternal and neonatal health with emphasis on postnatal care are recommended. There is also a need to restructure the maternal and neonatal health departments in the facilities so that the postnatal care units become stand-alone priority sites to improve the quality of the postnatal care services rendered.展开更多
<strong>Background: </strong>Inflammatory Bowel Disease is a term that covers intestinal diseases, including ulcerative colitis and Crohn’s disease. Due to the condition of chronic and complex disease, th...<strong>Background: </strong>Inflammatory Bowel Disease is a term that covers intestinal diseases, including ulcerative colitis and Crohn’s disease. Due to the condition of chronic and complex disease, the disease requires specialized nursing care and management in the context of a multi-disciplinary approach. As a guarantee of quality nursing care, it is essential to carry out the nursing process. Considering the commitment to assist the patient with Crohn’s disease, the nurse, through the nursing consultation, is able to diagnose the patient’s needs, proceed to the prescription of care and later evaluate the interventions, having the opportunity to develop work aimed at improving the quality of life of these patients. <strong>Objective:</strong> To describe the nursing process in a patient with Crohn’s disease. <strong>Methods:</strong> Exploratory case report study, carried out at the outpatient clinic for inflammatory bowel diseases of a public hospital in the countryside of the state of S<span style="white-space:nowrap;">ã</span>o Paulo, from June 2019 to October 2019. Data collection was performed through anamnesis, physical examination and analysis of medical records. <strong>Results:</strong> Female patient, 34 years old, diagnosed with Crohn’s disease. With the completion of the nursing process, it was possible to identify five nursing diagnoses and the elaboration of interventions and outcomes. The nursing evaluation was continuous and the patient adhered to the proposed interventions. <strong>Final considerations:</strong> The systematization and organization of the work of the nursing team proved to be essential for quality care, with efficiency and effectiveness, guaranteeing the patient comfort, general well-being and good rehabilitation.展开更多
文摘Objective To study the problems of pharmaceutical care in retail pharmacies and provide reference for the standardized development of pharmaceutical care in China.Methods Based on the literature of CNKI database,Pareto analysis was used to study the present situation of pharmaceutical care in retail pharmacies.Then the following problems in pharmaceutical care were found such as low personnel professional quality,inadequate attention,imperfect laws and regulations,and lack of standard service process.As to the first three problems,there were more research references.But there was less literature on the standard care process.Results and Conclusion Focusing on the customer demand,taking drug sales process as the basic framework of pharmaceutical care standardized process,and combining with the collaboration,the service process including prescription drugs review and OTC drugs purchase consultation is established.This process elaborates the division of staff services as well as the service standards in pre-sale,on-sale,and after-sale stages.Besides,it also puts forward some advice for the previous three problems,which will ensure the smooth implementation of pharmaceutical care in drugstores.
基金supported by Otsuka Pharmaceutical Fac-tory,Inc.(Contract date:January 27,2023).
文摘Background and Objectives:Study aim was to determine the levels and barriers of the Nutrition Care Process(NCP),a practical method of individualized nutrition support.Methods and Study Design:Delegate of regis-tered dietitians(RDs)from acute-care hospitals answered our nationwide web-based questionnaire(April-June,2023)to determine the implementation status of screening,assessment,intervention(including planning),and monitoring(components of the NCP).Results:Of 5,378 institutions contacted,905(16.8%)responded.For Screening,80.0%screened all inpatients:primary personnel in charge were RDs(57.6%);the most used screen-ing tool was Subjective Global Assessment(SGA)(49.2%).For Assessment,66.1%assessed all inpatients:food intake(93.3%)was most evaluated whereas muscle mass and strength(13.0%,8.8%)were least evaluated.For Intervention,43.9%did so within 48h of hospital admission:oral nutritional supplement(92.9%)was the most common RDs intervention and parenteral nutrition(29.9%)was used less.For Monitoring,18.5%of institutions had monitoring frequency of≥3 times/week whilst 23.0%had monitoring less than once a week for severely malnourished patients.Energy and protein intake(93.7%,84.3%)were most monitored and lipid intake(30.1%)was less monitored.Conclusions:Barriers of NCP included inefficient staffing systems and unsuitable tools in Screening,inaccurate patient targeting and lack of important evaluation items in Assessment,delayed timing and incomplete contents in Intervention,and inadequate frequency and lack of important evaluation items in Monitor-ing.An increase in RDs staffing in acute-care general wards,widespread NCP instruction manuals,and education about the tools and evaluation items utilized in nutritional management are possible solutions.
文摘Introduction: Controlling hypertension across world continues to be challenging. Managing hypertension is not only concerned with lowering blood pressure by using antihypertensive medications;it also aims to minimize its consequences through adopting self-care practices. Compliance with self-care practices among patients with hypertension is considered a multidimensional phenomenon. The phenomenon of hypertension has been studied quantitatively, however;little qualitative studies were conducted to understand the compliance with self-care among patients with hypertension. Aim: To understand the process that patients with hypertension go through to comply with self-care practices. Methods: This study used a qualitative design that followed constructivist grounded theory approach;purposive sampling was used to recruit participants from cardiac clinics;semi structured, in-depth and face-to-face interview was used as a major method for data collection. Findings: Four participants with hypertension participated in this study;the phenomena of self-care was identified as the central phenomena;the start of the disease was identified as a casual condition;beliefs toward hypertension disease, beliefs toward self-care practices, knowledge and awareness regarding hypertension disease and self-care practices were identified as strategies;experiencing self-care practices was identified as consequence and being patients with hypertension in a social context. Conclusions: The process of compliance with self-care has a path of actions and interactions. The process started from the moment of diagnosis where the patients start to think about self-care. The absence of health care context leads to varying level of compliance with self-care among patients with hypertension. This indicated the need for more effective patient and health care provider relationship, education and awareness campaign.
文摘Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfers, particularly in hospitals where intensive care units are located in buildings separate from general wards. Patient transfers comprise several steps: physicians issue orders, relatives are notified, equipment is prepared, and medical staff coordinate. We identified three factors that influence transfer time: preparation time for bed transfer, time required for shift handovers, and time required for between-ward patient movement. Unfamiliarity with transfer routes and long elevator wait times were factors that also influenced transfer time. The following strategies were proposed: develop a standardized material checklist, design key notes for patient transfers, and optimize transfer routes. These strategies reduced transfer times by 40% to 43%. This study demonstrates that by addressing logistical challenges and streamlining relevant procedures, hospitals can enhance safety and quality of care during patient transfers.
文摘The Pharmaceutical Care(PC)service is a growing sector.The continuous development of the role of the professional pharmacist in the sector of health services within the pharmacy leads to having an active role in the primary care.The PC service has been in operation for years in other western countries such as Spain,the United Kingdom and the United States.Several studies have been carried out,which confirm the benefits of the service in reducing morbidity,hospital admissions and the cost of the health care system.This article sets out the concept of PC and the financial benefit to health expenditure.It also analyzes the Drug Therapy Problem(DTP)and the Patient Care Process.To conclude,a patient case is presented to understand the practical implementation of the theory of the PC and to show how the professional pharmacist reports the pharmacotherapeutic case.
文摘Objective: to study the clinical effect of modified tissue-type plasminogen activator (rt-PA) in acute cerebral infarction and its improvement on patients viability. Methods: 74 patients with acute cerebral infarction who were treated in our hospital from June 2020 to June 2021 were collected and divided into two groups according to the date of admission. The control group (37 cases) received routine first aid and the observation group (37 cases) received first aid by applying the improved first aid nursing process. The first aid time, clinical curative effect, prognosis level and living ability of the two groups were compared. Results: the time of triage, referral, blood collection, CT examination and rescue in the observation group was significantly shortened (P < 0.05). The scores of Glasgow Coma Scale (GCS) and Glasgow (GOS) were higher than those of the control group (GOS), while the scores of National Institutes of Health (NIHSS) were lower than those of the control group (P < 0.05). The results showed that the total therapeutic effect of the treatment group was 91.89%, which was higher than that of the control group 72.97% (p < 0.05). After emergency treatment, simple Fugl-Meyers motor ability assessment (FMA) and daily living ability (ADL) scores were higher than those of the normal population (P<0.05). Conclusion: the application of improved first aid nursing process in the treatment of acute cerebral infarction with rt-PA can shorten the first aid time, improve the curative effect, and help to further promote the recovery of patients ability to live.
文摘Objective: to analyze the application effect of optimizing emergency nursing process. Methods: the study subjects were emergency chest pain patients, all patients treated in the emergency department of our hospital, and the patients were admitted from August 2020 to March 2022. The total number of patients admitted during this time period was 100, dividing all the study subjects into two groups, namely, the observation group and the control group. The sample size of 50 cases in both groups was 50 cases, and different emergency care procedures were adopted. The former was the optimized emergency care method, and the latter was the routine method. Finally, the application effect of the two groups was compared and analyzed. Results: after emergency care intervention treatment, the two groups of first aid, evaluation, hospital time comparison, the study confirmed that compared with the control group, the time index of rescue effect and adverse events, the observation group in rescue efficiency more advantage, and the control group has a high incidence of adverse events, the results are statistically significant (P <0.05). Conclusion: in the rescue process of patients with acute chest pain, if the emergency nursing process can be optimized, it will help to shorten the time of first aid, evaluation and hospitalization, improve the chance of rescue success of patients, reduce the chance of adverse events, and help the recovery of patients, which is worth promoting.
文摘Objective: to evaluate the method and significance of emergency nursing process optimization for stroke patients. Methods: a total of 92 clinical patients admitted to Jintan District People's Hospital of Changzhou City in Jiangsu Province in 2019 were selected as the research object and divided into the conventional group and the research group, each with 46 cases. The mortality rate and disability rate of the patients were observed. Results: the death rate and disability rate of the patients in the research group were lower than those in the conventional group, and the data difference was statistically significant (P < 0.05). Conclusion: the optimization of emergency nursing process for stroke patients can improve the quality of patient care, so it can be popularized.
文摘Objective: to analyze the clinical effect of emergency nursing procedures in emergency care of acute cerebral infarction. Methods: the data of 130 patients with acute cerebral infarction admitted to our hospital were retrospectively analyzed, and they were divided into control group and research group according to the order of treatment, the control group adopted the routine emergency nursing process, and the research group adopted the optimized emergency nursing process to compare the nursing effect. Results: compared with the control group, the treatment time of the study group was significantly shortened, the NIHSS score and MMSE score were improved, and the mortality rate was reduced, and the difference between the data was significantly P<0.05. Conclusion: the application of emergency nursing procedures in emergency care for acute cerebral infarction is of great significance to improving the success rate of patient treatment, and can be promoted and applied.
文摘Objective: to effectively improve the standardized emergency care procedures for patients with ST-segment elevation myocardial infarction. Methods: Seventy-two patients with ST segment elevation myocardial infarction who were admitted to our hospital from January 2020 to December 2020 were selected as the main subjects of this study. They were divided into the control group/observation group. Among them, the control group received routine emergency care while the observation group received standardized emergency care procedures based on the routine emergency care measures, so as to compare the differences in the care procedures and patient care quality of the two patients during the emergency treatment. The difference was large, and the condition of the observation group was better. Finally, through the analysis of two groups of patients after treatment, and then investigate the family members and patients' satisfaction with care. The clinical results showed that the efficacy of 88.9% in the observation group was significantly superior to 66.7% in the control group, and the difference was statistically significant (P < 0.05). Conclusion: through analyzing the different nursing procedures of patients in two groups, it was found that the standardized emergency nursing procedures shortened the basic treatment time of patients and improved the success rate of rescue, providing a larger space for the treatment of patients, and the families were also satisfied with it.
文摘Caring has long been recognized as central to nursing and is increasingly posited as a core concept although developing a theoretical description of caring which is adequate in the 21st. century continues to be a difficult task for nursing scholars. Consequently, verifying existing theoretical structures of caring remains an ongoing challenge. The aim of this article is to provide empirical verification of the caring processes of “knowing,” “being with,” “doing for,” “enabling” and “maintaining belief” from Swanson’s Middle Range Caring Theory based on the categorization of nursing actions from a systematic literature review on care. Methods: A systematic literature review was conducted in the fields of nursing sciences, medicine and psychology. Purposeful sampling was carried out covering a period from 2003-2013. The final sample included 25 articles. Results: Major themes of nursing actions included “knowing” which consisted of centering, nurturing, informed understanding, assessment skills, communication and respect for individual differences. “Being with” was characterized by intimate relationship, connecting, presencing, emotional adaptability awareness of self/other and decentering. “Doing for” included competence, knowledge, professional/technical skills, helping actions, anticipatory, multidisciplinary and preserving dignity. “Enabling” was characterized by self care, commitment, complexity of care, appropriate communication, information/education, sharing power, enabling choice and ongoing validation. Finally, “maintaining belief” was characterized by spiritual being, humanistic view, harmonious balance, hope, love, and compassion, meaning, and religious and spiritual orientation. Conclusion: Empirical verification was shown for the caring processes described in Swanson’s Caring Theory grounded in concrete nursing actions.
基金supported by the Hong Kong Research Grant Council (grant number 16208914)
文摘The formation of disinfection by-products（DBPs） from the degradation of N,N-diethyl-3-methyl benzoyl amide（DEET） and ibuprofen（IBP） by the ultraviolet irradiation（UV）/chlorine process and subsequent post-chlorination was investigated and compared with the UV/H_2O_2 process.The pseudo first-order rate constants of the degradation of DEET and IBP by the UV/chlorine process were 2 and 3.1 times higher than those by the UV/H_2O_2 process, respectively, under the tested conditions. This was due to the significant contributions of both reactive chlorine species U（RCS） and hydroxyl radicals（HO） in the UV/chlorine process. Trichloromethane, 1,1,1-trichloro-2-propanone and dichloroacetic acid were the major known DBPs formed after 90% of both DEET and IBP that were degraded by the UV/chlorine process. Their yields increased by over 50%after subsequent 1-day post-chlorination. The detected DBPs after the degradation of DEET and IBP comprised 13.5% and 19.8% of total organic chlorine（TOCl）, respectively, and the proportions increased to 19.8% and 33.9% after subsequent chlorination, respectively. In comparison to the UV/H_2O_2 process accompanied with post-chlorination, the formation of DBPs and TOCl in the UV/chlorine process together with post-chlorination was 5%–63% higher,Ulikely due to the generation of more DBP precursors from the attack of RCS, in addition to HO.
文摘AIM: To examine the feasibility and validity of electronic generation of quality metrics in the intensive care unit(ICU).METHODS: This minimal risk observational study was performed at an academic tertiary hospital. The Critical Care Independent Multidisciplinary Program at Mayo Clinic identified and defined 11 key quality metrics. These metrics were automatically calculated using ICU Data Mart, a near-real time copy of all ICU electronic medical record(EMR) data. The automatic report was compared with data from a comprehensive EMR review by a trained investigator. Data was collected for 93 randomly selected patients admitted to the ICU during April 2012(10% of admitted adult population). This study was approved by the Mayo Clinic Institution Review Board.RESULTS: All types of variables needed for metric calculations were found to be available for manual and electronic abstraction, except information for availability of free beds for patient-specific time-frames. There was 100% agreement between electronic and manual data abstraction for ICU admission source, admission service, and discharge disposition. The agreement between electronic and manual data abstraction of the time of ICU admission and discharge were 99% and 89%. The time of hospital admission and discharge were similar for both the electronically and manually abstracted datasets. The specificity of the electronically-generated report was 93% and 94% for invasive and non-invasive ventilation use in the ICU. One false-positive result for each type of ventilation was present. The specificity for ICU and in-hospital mortality was 100%. Sensitivity was 100% for all metrics.CONCLUSION: Our study demonstrates excellent accuracy of electronically-generated key ICU quality metrics. This validates the feasibility of automatic metric generation.
文摘This study was conducted to assess quality of postnatal care that midwives provide to women seeking postnatal services in health facilities in Dedza district, the central region ofMalawi. The study design was descriptive cross sectional and utilized quantitative data collection and analysis method to determine structural, process and outcome components of postnatal care in two facilities that offer emergency obstetric and neonatal care and five that offer basic emergency obstetric and neonatal care. All 60 midwives who were providing postnatal care during the time of study in the district were interviewed using a structured questionnaire. In addition, the midwives actual practice was observed and compared to a standard checklist on postnatal care practice which was developed by the Malawi Ministry of Health. Data were analyzed using SPSS version 16.0. Results show that structure for providing postnatal counseling services was inappropriate and inadequate. Furthermore, the contents of postnatal services were below reproductive health standards because the clients were neither monitored nor examined physically on discharge. On average, all the seven facilities scored 48% on postnatal services rendered which is far below the recommended 80% according to the Reproductive Health Standards. There is a need to provide basic infrastructure in all the basic emergency obstetric and neonatal care facilities. In addition, refresher training courses for midwives in maternal and neonatal health with emphasis on postnatal care are recommended. There is also a need to restructure the maternal and neonatal health departments in the facilities so that the postnatal care units become stand-alone priority sites to improve the quality of the postnatal care services rendered.
文摘<strong>Background: </strong>Inflammatory Bowel Disease is a term that covers intestinal diseases, including ulcerative colitis and Crohn’s disease. Due to the condition of chronic and complex disease, the disease requires specialized nursing care and management in the context of a multi-disciplinary approach. As a guarantee of quality nursing care, it is essential to carry out the nursing process. Considering the commitment to assist the patient with Crohn’s disease, the nurse, through the nursing consultation, is able to diagnose the patient’s needs, proceed to the prescription of care and later evaluate the interventions, having the opportunity to develop work aimed at improving the quality of life of these patients. <strong>Objective:</strong> To describe the nursing process in a patient with Crohn’s disease. <strong>Methods:</strong> Exploratory case report study, carried out at the outpatient clinic for inflammatory bowel diseases of a public hospital in the countryside of the state of S<span style="white-space:nowrap;">ã</span>o Paulo, from June 2019 to October 2019. Data collection was performed through anamnesis, physical examination and analysis of medical records. <strong>Results:</strong> Female patient, 34 years old, diagnosed with Crohn’s disease. With the completion of the nursing process, it was possible to identify five nursing diagnoses and the elaboration of interventions and outcomes. The nursing evaluation was continuous and the patient adhered to the proposed interventions. <strong>Final considerations:</strong> The systematization and organization of the work of the nursing team proved to be essential for quality care, with efficiency and effectiveness, guaranteeing the patient comfort, general well-being and good rehabilitation.
