BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptom...BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.展开更多
BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for imp...BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.展开更多
Objective: to apply evidence-based care in chronic cholecystitis to analyze the effect on pain and quality of survival. Methods: from September 2020 to August 2021,82 patients with hospitalized chronic cholecystitis w...Objective: to apply evidence-based care in chronic cholecystitis to analyze the effect on pain and quality of survival. Methods: from September 2020 to August 2021,82 patients with hospitalized chronic cholecystitis were randomly selected.T he double chromosphere method is divided into the evidence-based group and the general group, with 40 cases each. The former applies evidence-based care;the latter applies general care. Pain degree and quality of survival were compared between the two groups. Results: the pain rate and severe pain rate were lower than the general group (P <0.05). Before both patients, nursing, physical function, psychological function, social function, material life, and comprehensive score were significantly similar (P> 0.05), which was higher than the general group (P <0.05). Conclusion: using evidence-based care in the care of chronic cholecystitis patients has reduced pain and improved quality of survival.展开更多
Objective: this paper aims to observe the effect of using the evidence-based care mode on the nursing effect, and to support the life improvement of patients with chronic nephritis. Methods: on 10 January 2019 / 30 De...Objective: this paper aims to observe the effect of using the evidence-based care mode on the nursing effect, and to support the life improvement of patients with chronic nephritis. Methods: on 10 January 2019 / 30 December 2020 (start / end), we were randomly selected for a total of 94 patients with chronic nephritis. Groups distinguish: control V group (47 cases used routine care model) and evidence-based M group (47 cases used evidence-based care model).Nursing effect: observe the psychological state, quality of life, follow the doctor's advice behavior, nursing satisfaction. Results: before nursing, evidence-based M (VS), control V (SF-36), evidence-based M (VS) control V and depression (SDS) control V on anxiety (SAS) (P> 0.05);After nursing, evidence-based M (VS) control V had better SF-36, SAS and SDS scores. After nursing, the evidence-based M group showed significantly higher medication compliance, medical compliance behavior, life regularity rate and care service satisfaction compared with the control group V (P <0.05). Conclusion: in patient nursing, the evidence-based nursing intervention mode can be applied to nursing to help patients with chronic nephritis improve their life, psychological status and medication compliance, which can make patients more satisfied with the nursing service and promote their application.展开更多
Objective.To analyze the effect of applying evidence-based care in rehabilitation nursing effect of patients with patellar fractures.Methods.A total of 54 patients with patellar fractures were randomly selected from t...Objective.To analyze the effect of applying evidence-based care in rehabilitation nursing effect of patients with patellar fractures.Methods.A total of 54 patients with patellar fractures were randomly selected from the hospital.The diagnosis and treatment time were from the beginning of July 2018 to end of June 2019.The digital table grouping was adopted to divide patients into two groups with each group consists of 27 patients with this disease.Both groups underwent routine nursing and the experimental group with increased evidence-based care.Results.Compared with the control group,the knee function evaluation,complications and nursing satisfaction of the experimental group were more ideal,and the difference was statistically significant(P<0.05).Conclusion.Evidence-based care in rehabilitation nursing of patients with patellar fracture can obtain ideal nursing effect.展开更多
Objective: The experiment will implement evidence-based nursing for general surgery patients, and make statistical analysis of the actual effect after application. Methods: A total of 120 general surgery patients were...Objective: The experiment will implement evidence-based nursing for general surgery patients, and make statistical analysis of the actual effect after application. Methods: A total of 120 general surgery patients were selected from January 2018 to April 2019, and were divided into 2 groups according to the sequence. Observe the nursing effect. Results: The observation group achieved ideal results in nursing efficiency, patient pain relief, and nursing satisfaction, compared with the control group, the difference was statistically significant (P0.05). Conclusion: the application of the evidence-based nursing in general surgery nursing can effectively promote the patients physical and mental recovery, and is more effective to improve the quality of nursing care of general surgery, to improve the doctor-patient contradiction, improve patient satisfaction with nursing care has obvious effect, but also can make the incidence of postoperative complications in patients with decreased significantly, with strong clinical popularization value.展开更多
With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their qual...With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their quality of life but also exerting negative effects on their physical and mental health and emotions.Therefore,in the clinical care of tumor patients,helping them relieve“cancer pain”and improving the quality and efficiency of medical care services have become important research topics.This paper takes evidence-based nursing as the starting point,analyzes the basic concepts and practical characteristics of evidence-based nursing,and then proposes the application process and effects of evidence-based nursing in cancer pain care for tumor patients.展开更多
Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the esse...Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the essential components in quality assurance and improvement processes.One of the most necessary steps in this process to improve pain management is to analyze the existing situation.This study aimed to determine the compliance of critical care unit(CCU)nurses’care performance in angina management with evidence-based guidelines(EBGs).Methods:In this observational cross-sectional study,69 nurses working in the CCU departments of public hospitals in Bushehr province participated using the full number method,and their performance was observed 207 times.The data collection tool in this study included a demographic profile form and a 29-item checklist of nurses’performance in angina management.The performance of each nurse was evaluated three times in three different shifts.Descriptive and analytical independent t-tests and Spearman and Pearson correlation were used to analyze the data.SPSS 19 software was used to perform statistical tests.The significance level was considered to be<0.05 in all cases.Results:The findings showed that 85.5%of the participants were female and 14.5%were male,with an average age of 33.87±7.14 years.The average score for performing care functions according to the evidence-based pain management guidelines was 71.42±19.31.The highest(73.60±19.45)and lowest(63.51±28.27)average scores were related to the investigation and evaluation area,respectively.The results showed a significant negative correlation between age and care performance(p<0.03;r=−0.265).Conclusions:The results of this study showed that the average performance score of nurses in angina management based on the guidelines was higher than average.Considering that some items had little compliance,the health system planners are recommended to put the annual training methods to obtain and use the latest guidelines for pain management,especially angina,in the education program of nurses.展开更多
Objective:To determine the incidence,risk factors,antibiotic resistance patterns,and outcomes of various nosocomial infections in Intensive Care Unit(ICU)patients.Methods:The present prospective observational study wa...Objective:To determine the incidence,risk factors,antibiotic resistance patterns,and outcomes of various nosocomial infections in Intensive Care Unit(ICU)patients.Methods:The present prospective observational study was conducted in the multidisciplinary ICU of a tertiary care hospital for 6 months.Incidence,risk factors,and outcome parameters were calculated using Mann Whitney U test,Chi-square test,and stepwise univariate and multivariate logistic regression analysis.Results:The overall incidence of nosocomial infections was 23.5%(74/314).Ventilator-associated pneumonia was the most common infection(54.1%,52/96),followed by catheter-related bloodstream infections(22.9%,22/96).Stress ulcer prophylaxis(aOR 7.691,95%CI 2.202-26.860,P=0.001),endotracheal intubation(aOR 3.251,95%CI 1.251-8.420,P=0.015),Foley’s catheter(aOR 11.917,95%CI 1.335-106.410,P=0.027),and ICU stay>7 days(aOR 30.915,95%CI 10.062-94.980,P=0.001)were statistically significant risk factors associated with nosocomial infection in ICU patients.Gram-negative bacteria showed a high degree of resistance to most of antibiotics except colistin and tigecycline.Infected group's mortality was significantly greater than the uninfected group(21.62%vs.5.83%P<0.001)and had considerably longer ICU length of stay[21(12)vs.7(4)days,P<0.001]and duration of mechanical ventilation[20(11)days vs.0(5)days,P<0.001].Conclusions:This study highlights the high incidence rate of ventilator-associated pneumonia,with extensive drug resistance in ICU patients,highlighting the need for an optimized antimicrobial stewardship program to develop effective strategies for the management of nosocomial infections.Multifaceted interventions targeting modifiable risk factors are essential to reduce the occurences of these nosocomial infections in ICU patients.展开更多
Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts in...Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts independently assessed the quality of the guidelines,extracted valuable evidence and recommendations,and initially formed a draft nursing program.Subsequently,an expert panel was organized to conduct a detailed discussion to review the practicality and effectiveness of the recommendations one by one,and the program was finally revised and improved.Results:The protocol covered four stages of patients’admission,preoperative,postoperative,and discharge,involving specific contents such as nutritional assessment,risk screening,dysphagia assessment,nutritional therapy,enteral and parenteral nutritional support,symptom management,and health education.The program included a total of 61 entries,with 33 class A recommendations and 28 class B recommendations.Conclusion:The constructed perioperative nutritional care program for esophageal cancer patients is scientific and practical,and can provide practical guidance for clinical care.展开更多
Objective: To analyze the application value of evidence-based nursing, study its feasibility in the nursing of patients with acute myocardial infarction, observe the nursing satisfaction of patients, negative mood sco...Objective: To analyze the application value of evidence-based nursing, study its feasibility in the nursing of patients with acute myocardial infarction, observe the nursing satisfaction of patients, negative mood score, clinical indicators, in order to help patients achieve the best prognosis, and improve the quality of life of these patients. Methods: The samples were numbered from 1-100, and the time interval was From January 01, 2021 to February 02, 2022. According to the parity value of the numbers, they were divided into two groups, all patients were diagnosed with acute myocardial infarction: study group (n=50: evidence-based nursing);The control group (n=50: conventional nursing) was compared according to the value of each index after nursing. Results: The time of hospitalization, starting exercise and getting out of bed for the first time in study group was shorter than that in control group, P < 0.05;There was a significant difference in satisfaction between the two groups, and the study group was higher than the control group (P < 0.05). Bad mood score: the control group was higher than the study group (P < 0.05). Conclusion: Evidence-based nursing of acute myocardial infarction has high promotion value, low negative mood score of patients after nursing, high satisfaction, short recovery time, and can be actively promoted in clinic.展开更多
Objective: to explore the application value of evidence-based nursing in perioperative care in patients with acute appendicitis. Methods: 58 patients with acute appendicitis from January 2021 to December 2021 were dou...Objective: to explore the application value of evidence-based nursing in perioperative care in patients with acute appendicitis. Methods: 58 patients with acute appendicitis from January 2021 to December 2021 were double-blind and randomized into two groups. The control group was given routine care, and the evidence-based care group performed an evidence-based care intervention. Quality of life and complication rate were compared between the two groups. Results: quality of life was higher than control group, complication rate was lower than control group, P <0.05. Conclusion: evidence-based nursing intervention in acute appendicitis can improve quality of life and reduce complications.展开更多
Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advance...Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage Ⅱ and Ⅲ rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize diseasefree and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers.展开更多
BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing...BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.展开更多
With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a maj...With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a major cause of premature mortality and associated with devastating complications especially if managed poorly. Although diabetes care is improving in England and Wales, recent audit data suggests care remains imperfect with wide geographical variations in quality. Diabetes care is expensive with a sizeable amount of available expenditure used for treating the complications of diabetes. A target driven, long-term, multifactorial intervention in patients with type 2 diabetes has been shown to reduce mortality and morbidity. The alphabet strategy is a novel approach to effective diabetes care provision, aiming to address patient education and empowerment, provide consistent comprehensive care delivered in a timely fashion, and allowing multidisciplinary team work.展开更多
Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods...Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods.The research adopts the method of combining theoretical analysis and practical application,and designs the evidence-based value-added evaluation framework,which includes the core elements of a multi-source heterogeneous data acquisition and processing system,a value-added evaluation agent based on a large model,and an evaluation implementation and application mechanism.Through empirical research verification,the evaluation system has remarkable effects in improving learning participation,promoting ability development,and supporting teaching decision-making,and provides a theoretical reference and practical path for educational evaluation reform in the new era.The research shows that the evidence-based value-added evaluation system based on data-driven can reflect students’actual progress more fairly and objectively by accurately measuring the difference in starting point and development range of students,and provide strong support for the realization of high-quality education development.展开更多
Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-chan...Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-changing needs and expectations of healthcare personnel.This study aimed to assess the needs and expectations of healthcare personnel regarding evidence-based healthcare in China.Methods We conducted a cross-sectional online survey from December 8,2020 to January 15,2021 involving 901 participants across China.Healthcare providers,policy makers,researchers and educators,and full-time postgraduate medical and nursing students working/living in China were eligible to participate.A self-developed questionnaire was used.Results Participants generally agreed that health-related research evidence was beneficial.Evidence-based resources,such as Cochrane resources,were only known or used by about half of the respondents due to difficulties related to availability and accessibility.Various types of resources,topics of evidence,and themes of workshops were of particular interest to most of the participants.Conclusions The dissemination and translation of evidence,provision of more support in evidence availability,offering evidence-based training,and determining the most in-demand research areas have been identified as priority areas of work which could fulfil the needs and expectations of healthcare personnel in China.展开更多
The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses we...The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainly face to the policymakers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines-Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the clinicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grass-root providers.展开更多
Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper ...Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients.Methods: We used a quality improvement project following a multi-phase design.In Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' preferences.In Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention components.Results: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review.In Phase 2,the logic model was developed and includes (1) the inputs (e.g.educational-and environmental support),(2) the ultimate outcomes (e.g.reduction of postoperative complications),(3) the intermediate outcomes (e.g.behavioural changes),and (4) immediate outcomes (e.g.improved knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into account.The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.展开更多
Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideli...Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.展开更多
文摘BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.
文摘BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.
文摘Objective: to apply evidence-based care in chronic cholecystitis to analyze the effect on pain and quality of survival. Methods: from September 2020 to August 2021,82 patients with hospitalized chronic cholecystitis were randomly selected.T he double chromosphere method is divided into the evidence-based group and the general group, with 40 cases each. The former applies evidence-based care;the latter applies general care. Pain degree and quality of survival were compared between the two groups. Results: the pain rate and severe pain rate were lower than the general group (P <0.05). Before both patients, nursing, physical function, psychological function, social function, material life, and comprehensive score were significantly similar (P> 0.05), which was higher than the general group (P <0.05). Conclusion: using evidence-based care in the care of chronic cholecystitis patients has reduced pain and improved quality of survival.
文摘Objective: this paper aims to observe the effect of using the evidence-based care mode on the nursing effect, and to support the life improvement of patients with chronic nephritis. Methods: on 10 January 2019 / 30 December 2020 (start / end), we were randomly selected for a total of 94 patients with chronic nephritis. Groups distinguish: control V group (47 cases used routine care model) and evidence-based M group (47 cases used evidence-based care model).Nursing effect: observe the psychological state, quality of life, follow the doctor's advice behavior, nursing satisfaction. Results: before nursing, evidence-based M (VS), control V (SF-36), evidence-based M (VS) control V and depression (SDS) control V on anxiety (SAS) (P> 0.05);After nursing, evidence-based M (VS) control V had better SF-36, SAS and SDS scores. After nursing, the evidence-based M group showed significantly higher medication compliance, medical compliance behavior, life regularity rate and care service satisfaction compared with the control group V (P <0.05). Conclusion: in patient nursing, the evidence-based nursing intervention mode can be applied to nursing to help patients with chronic nephritis improve their life, psychological status and medication compliance, which can make patients more satisfied with the nursing service and promote their application.
文摘Objective.To analyze the effect of applying evidence-based care in rehabilitation nursing effect of patients with patellar fractures.Methods.A total of 54 patients with patellar fractures were randomly selected from the hospital.The diagnosis and treatment time were from the beginning of July 2018 to end of June 2019.The digital table grouping was adopted to divide patients into two groups with each group consists of 27 patients with this disease.Both groups underwent routine nursing and the experimental group with increased evidence-based care.Results.Compared with the control group,the knee function evaluation,complications and nursing satisfaction of the experimental group were more ideal,and the difference was statistically significant(P<0.05).Conclusion.Evidence-based care in rehabilitation nursing of patients with patellar fracture can obtain ideal nursing effect.
文摘Objective: The experiment will implement evidence-based nursing for general surgery patients, and make statistical analysis of the actual effect after application. Methods: A total of 120 general surgery patients were selected from January 2018 to April 2019, and were divided into 2 groups according to the sequence. Observe the nursing effect. Results: The observation group achieved ideal results in nursing efficiency, patient pain relief, and nursing satisfaction, compared with the control group, the difference was statistically significant (P0.05). Conclusion: the application of the evidence-based nursing in general surgery nursing can effectively promote the patients physical and mental recovery, and is more effective to improve the quality of nursing care of general surgery, to improve the doctor-patient contradiction, improve patient satisfaction with nursing care has obvious effect, but also can make the incidence of postoperative complications in patients with decreased significantly, with strong clinical popularization value.
文摘With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their quality of life but also exerting negative effects on their physical and mental health and emotions.Therefore,in the clinical care of tumor patients,helping them relieve“cancer pain”and improving the quality and efficiency of medical care services have become important research topics.This paper takes evidence-based nursing as the starting point,analyzes the basic concepts and practical characteristics of evidence-based nursing,and then proposes the application process and effects of evidence-based nursing in cancer pain care for tumor patients.
文摘Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the essential components in quality assurance and improvement processes.One of the most necessary steps in this process to improve pain management is to analyze the existing situation.This study aimed to determine the compliance of critical care unit(CCU)nurses’care performance in angina management with evidence-based guidelines(EBGs).Methods:In this observational cross-sectional study,69 nurses working in the CCU departments of public hospitals in Bushehr province participated using the full number method,and their performance was observed 207 times.The data collection tool in this study included a demographic profile form and a 29-item checklist of nurses’performance in angina management.The performance of each nurse was evaluated three times in three different shifts.Descriptive and analytical independent t-tests and Spearman and Pearson correlation were used to analyze the data.SPSS 19 software was used to perform statistical tests.The significance level was considered to be<0.05 in all cases.Results:The findings showed that 85.5%of the participants were female and 14.5%were male,with an average age of 33.87±7.14 years.The average score for performing care functions according to the evidence-based pain management guidelines was 71.42±19.31.The highest(73.60±19.45)and lowest(63.51±28.27)average scores were related to the investigation and evaluation area,respectively.The results showed a significant negative correlation between age and care performance(p<0.03;r=−0.265).Conclusions:The results of this study showed that the average performance score of nurses in angina management based on the guidelines was higher than average.Considering that some items had little compliance,the health system planners are recommended to put the annual training methods to obtain and use the latest guidelines for pain management,especially angina,in the education program of nurses.
文摘Objective:To determine the incidence,risk factors,antibiotic resistance patterns,and outcomes of various nosocomial infections in Intensive Care Unit(ICU)patients.Methods:The present prospective observational study was conducted in the multidisciplinary ICU of a tertiary care hospital for 6 months.Incidence,risk factors,and outcome parameters were calculated using Mann Whitney U test,Chi-square test,and stepwise univariate and multivariate logistic regression analysis.Results:The overall incidence of nosocomial infections was 23.5%(74/314).Ventilator-associated pneumonia was the most common infection(54.1%,52/96),followed by catheter-related bloodstream infections(22.9%,22/96).Stress ulcer prophylaxis(aOR 7.691,95%CI 2.202-26.860,P=0.001),endotracheal intubation(aOR 3.251,95%CI 1.251-8.420,P=0.015),Foley’s catheter(aOR 11.917,95%CI 1.335-106.410,P=0.027),and ICU stay>7 days(aOR 30.915,95%CI 10.062-94.980,P=0.001)were statistically significant risk factors associated with nosocomial infection in ICU patients.Gram-negative bacteria showed a high degree of resistance to most of antibiotics except colistin and tigecycline.Infected group's mortality was significantly greater than the uninfected group(21.62%vs.5.83%P<0.001)and had considerably longer ICU length of stay[21(12)vs.7(4)days,P<0.001]and duration of mechanical ventilation[20(11)days vs.0(5)days,P<0.001].Conclusions:This study highlights the high incidence rate of ventilator-associated pneumonia,with extensive drug resistance in ICU patients,highlighting the need for an optimized antimicrobial stewardship program to develop effective strategies for the management of nosocomial infections.Multifaceted interventions targeting modifiable risk factors are essential to reduce the occurences of these nosocomial infections in ICU patients.
文摘Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts independently assessed the quality of the guidelines,extracted valuable evidence and recommendations,and initially formed a draft nursing program.Subsequently,an expert panel was organized to conduct a detailed discussion to review the practicality and effectiveness of the recommendations one by one,and the program was finally revised and improved.Results:The protocol covered four stages of patients’admission,preoperative,postoperative,and discharge,involving specific contents such as nutritional assessment,risk screening,dysphagia assessment,nutritional therapy,enteral and parenteral nutritional support,symptom management,and health education.The program included a total of 61 entries,with 33 class A recommendations and 28 class B recommendations.Conclusion:The constructed perioperative nutritional care program for esophageal cancer patients is scientific and practical,and can provide practical guidance for clinical care.
文摘Objective: To analyze the application value of evidence-based nursing, study its feasibility in the nursing of patients with acute myocardial infarction, observe the nursing satisfaction of patients, negative mood score, clinical indicators, in order to help patients achieve the best prognosis, and improve the quality of life of these patients. Methods: The samples were numbered from 1-100, and the time interval was From January 01, 2021 to February 02, 2022. According to the parity value of the numbers, they were divided into two groups, all patients were diagnosed with acute myocardial infarction: study group (n=50: evidence-based nursing);The control group (n=50: conventional nursing) was compared according to the value of each index after nursing. Results: The time of hospitalization, starting exercise and getting out of bed for the first time in study group was shorter than that in control group, P < 0.05;There was a significant difference in satisfaction between the two groups, and the study group was higher than the control group (P < 0.05). Bad mood score: the control group was higher than the study group (P < 0.05). Conclusion: Evidence-based nursing of acute myocardial infarction has high promotion value, low negative mood score of patients after nursing, high satisfaction, short recovery time, and can be actively promoted in clinic.
文摘Objective: to explore the application value of evidence-based nursing in perioperative care in patients with acute appendicitis. Methods: 58 patients with acute appendicitis from January 2021 to December 2021 were double-blind and randomized into two groups. The control group was given routine care, and the evidence-based care group performed an evidence-based care intervention. Quality of life and complication rate were compared between the two groups. Results: quality of life was higher than control group, complication rate was lower than control group, P <0.05. Conclusion: evidence-based nursing intervention in acute appendicitis can improve quality of life and reduce complications.
文摘Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage Ⅱ and Ⅲ rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize diseasefree and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers.
文摘BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.
文摘With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a major cause of premature mortality and associated with devastating complications especially if managed poorly. Although diabetes care is improving in England and Wales, recent audit data suggests care remains imperfect with wide geographical variations in quality. Diabetes care is expensive with a sizeable amount of available expenditure used for treating the complications of diabetes. A target driven, long-term, multifactorial intervention in patients with type 2 diabetes has been shown to reduce mortality and morbidity. The alphabet strategy is a novel approach to effective diabetes care provision, aiming to address patient education and empowerment, provide consistent comprehensive care delivered in a timely fashion, and allowing multidisciplinary team work.
基金This paper is the research result of“Research on Innovation of Evidence-Based Teaching Paradigm in Vocational Education under the Background of New Quality Productivity”(2024JXQ176)the Shandong Province Artificial Intelligence Education Research Project(SDDJ202501035),which explores the application of artificial intelligence big models in student value-added evaluation from an evidence-based perspective。
文摘Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods.The research adopts the method of combining theoretical analysis and practical application,and designs the evidence-based value-added evaluation framework,which includes the core elements of a multi-source heterogeneous data acquisition and processing system,a value-added evaluation agent based on a large model,and an evaluation implementation and application mechanism.Through empirical research verification,the evaluation system has remarkable effects in improving learning participation,promoting ability development,and supporting teaching decision-making,and provides a theoretical reference and practical path for educational evaluation reform in the new era.The research shows that the evidence-based value-added evaluation system based on data-driven can reflect students’actual progress more fairly and objectively by accurately measuring the difference in starting point and development range of students,and provide strong support for the realization of high-quality education development.
文摘Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-changing needs and expectations of healthcare personnel.This study aimed to assess the needs and expectations of healthcare personnel regarding evidence-based healthcare in China.Methods We conducted a cross-sectional online survey from December 8,2020 to January 15,2021 involving 901 participants across China.Healthcare providers,policy makers,researchers and educators,and full-time postgraduate medical and nursing students working/living in China were eligible to participate.A self-developed questionnaire was used.Results Participants generally agreed that health-related research evidence was beneficial.Evidence-based resources,such as Cochrane resources,were only known or used by about half of the respondents due to difficulties related to availability and accessibility.Various types of resources,topics of evidence,and themes of workshops were of particular interest to most of the participants.Conclusions The dissemination and translation of evidence,provision of more support in evidence availability,offering evidence-based training,and determining the most in-demand research areas have been identified as priority areas of work which could fulfil the needs and expectations of healthcare personnel in China.
文摘The four cornerstones of guidance in technique service of family planning are established by WHO based on high quality evidences. They have been updated according to the appearing new evidences, and the consensuses were reached by the international experts in this field. The four documents include Medical Eligibility Criteria for Contraceptive Use, Selected Practice Recommendations for Contraceptive Use, Decision-making Tool for Family Planning Clients and Providers and The Global Handbook for Family Planning Providers. The first two documents mainly face to the policymakers and programme managers and were treated as the important references for creating the local guideline. The other two documents were developed for the front-line health-care and family planning providers at different levels, which include plenty of essential technical information to help providers improve their ability in service delivery and counselling. China paid great attention to the introduction and application of WHO guidelines. As soon as the newer editions of these documents were available, the Chinese version would be followed. WHO guidelines have been primarily adapted with the newly issued national guideline, The Clinical Practical Skill Guidelines-Family Planning Part, which was established by China Medical Association. At the same time, the WHO guidelines have been introduced to some of the clinicians and family planning providers at different levels. In the future, more special training courses will be introduced to the township level based on the needs of grass-root providers.
基金This work is supported by an unrestricted innovation research grant of the Amsterdam UMC,location Academic Medical Center in Amsterdam,the Netherlands
文摘Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients.Methods: We used a quality improvement project following a multi-phase design.In Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' preferences.In Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention components.Results: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review.In Phase 2,the logic model was developed and includes (1) the inputs (e.g.educational-and environmental support),(2) the ultimate outcomes (e.g.reduction of postoperative complications),(3) the intermediate outcomes (e.g.behavioural changes),and (4) immediate outcomes (e.g.improved knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into account.The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.
文摘Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.
