【摘要】目的对一线临床科室参与汶川地震抗震救灾的外援护士和本土护士的社会支持系统进行调查研究。方法随机抽取抗震救灾一线科室(ICU、骨科、急诊)外援护士及本土护士各175名,设为外援组和本土组,采用对地震的自我认知问卷及社会支持评定量表(SSRS)进行测评。结果两组护士对地震相关知识的知晓情况、响应抗震救灾的行为表现、地震对专业的影响等方面无明显差异(Pgt;0.05);两组护士的社会支持总分均低于国内常模 (Plt;0.01),除外援组主观支持维度得分与国内常模无显著差异(Pgt;0.05)外,两组的社会支持其它各维度得分均低于国内常模,外援组的社会支持总分及主观支持、客观支持得分均高于本土组(Plt;0.01),两组对支持的利用度无明显差异(Pgt;0.05)。结论为抗震救灾一线科室护士提供积极的社会支持是保证心理健康的重要措施。【Abstract】ObjectiveTo evaluate the difference of psychological state between local and nonlocal nurses during the Wenchuan Earthquake. Methods A total of 175 local nurses and 175 nonlocal nurses were randomly selected and investigated by SSRS and the earthquake questionnaire. Results There were no significant differences in their knowledge about the earthquake, professional identity and action (Pgt;0.05). The total and the three dimensions scores of SSRS of the two groups were lower than those of the domestic norms (Plt;0.01) except the subjective support dimensions. The total scores, objective support and subjective support dimensions scores of nonlocal group were higher than that in the local group (Plt;0.01). In coping style questionaire, there were significant differences in solving problems and retreat factor(Plt;0.01)and no significant differences in remorse, salvation and illusion(Pgt;0.05). Conclusion The earthquake affected mental health of the nurses and their psychological state need to be much concerned,especially the nonlocal ones.
Objective To survey the knowledge of hand hygiene among nurses and to identify factors influencing the performance of hand hygiene.Methods A questionnaire of hand hygiene developed according to the Guideline for Hand Hygiene in Health Care Settings was used to investigate nurses’ knowledge about hand hygiene.Results The average score for nurses’ knowledge about hand hygiene was 18.59±2.19 out of a possible maximum score of 21. Knowledge about hand hygiene among nurses varied significantly in different departments (P=0.004). The main self-reported factors influencing the performance of hand hygiene were irritation and dryness caused by hand-washing agents (73.44%) and busy workload (65.53%).Conclusions Nurses generally have good knowledge about hand hygiene but are less aware of some hand hygiene indications. Effective measures are needed to improve compliance with hand hygiene among nurses.
ObjectiveTo explore the psychological pressure in Intensive Care Unit (ICU) nurses and the sources of their pressure. MethodWe investigated the ICU nurses in West China Hospital with a self-designed psychological pressure questionnaire from March to September 2013. ResultsThe total stress level of ICU nurses was 2.89±0.86. The top five sources were low salaries and welfare benefits (3.37±0.61), high frequency of night work (3.31±0.88), wide need of knowledge (3.22±0.41), heavy workload (3.20±0.80) and chronic fatigue syndrome (3.19±0.75). ConclusionsGreat psychological pressure exists in ICU nurses. We urgently need effective approaches to relieve the stress of ICU nurses in order to improve the efficiency and quality of nursing service.
Objective To evaluate the effect of physician-nurse-pharmacist collaboration on cardiovascular disease risk factors in diabetes patients. Methods Randomized controlled trails (RCTs) on collaboration among physicians, nurses and pharmacists for reducing cardiovascular disease risk factors in diabetes patients were collected from Cochrane Central Register of Controlled Trials, Medline (Ovid SP), Embase, China Knowledge Resource Integrated Database, VIP and WanFang. We screened the retrieved studies according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analysis with the Cochrane Collaboration’s Revman 5.3.0 software. Results Seven RCTs were included. The results of meta-analysis showed that the change in glycosylated hemoglobin A1c, systolic blood pressure, diastolic blood pressure and low density lipoprotein-cholesterol were significantly reduced in the collaboration group than in usual care group [SMD=–0.39, 95%CI (–0.56, –0.21),P<0.000 1;SMD=–0.30, 95%CI (–0.43, –0.18),P<0.000 01;SMD=–0.37, 95%CI (–0.64, –0.11),P=0.006;SMD=–0.11, 95%CI (–0.16, –0.06),P<0.000 1]. Conclusions Collaboration among physicians, nurses and pharmacists is effective for reducing cardiovascular disease risk factors in diabetes patients. But its long-term efficacy still needs to be confirmed by performing higher quality, large sample RCTs with long-term follow-up.
To improve nursing interventions for patients with epilepsy and intellectual impairment. Epilepsy, as one of the common chronic neurological diseases, often coexists with intellectual impairment. This article reviews the treatment methods and related nursing measures for epilepsy patients with intellectual impairment, and proposes the application of comprehensive nursing concepts in clinical practice. The nursing of patients with epilepsy and intellectual impairment faces multiple challenges. Nursing activities provide personalized care needs, emphasize patient education, simplify medication treatment plans, and promote collaborative relationships between patients, nursing staff, and healthcare providers. Through evidence-based intervention, interdisciplinary collaboration, and innovative nursing models, nursing plays a crucial role in improving patient treatment outcomes and enhancing their quality of life.
Objective To explore the application effects of nursing quality control mode based on nurse satisfaction. Methods A total of 226 nurses in 12 nursing units were selected from December 2013 to June in 2014 as the study subjects. Then, we compared the nurse satisfaction, patient satisfaction, and the effect of nursing quality control before and after the implementation of quality control mode in which nurses participated actively. Results After a half-year practice of nursing quality mode, all the investigation items of the project were significantly different from those before the mode application (P>0.05), except Q1, Q2, Q8, and Q10 in the nurse satisfaction questionnaire, q1, q2, q3, q4, and q14 in the patient satisfaction questionnaire, and quality of emergency management in the nursing quality control section. Conclusion Application of nursing quality control mode can fully mobilize the enthusiasm of nurses, improve nurse satisfaction and the effect of nursing quality management, which has a high value of application in clinical nursing management.
ObjectiveTo understand the status of the nurse facial skin damage because of regular exposure to a variety of environmental damage factors, in order to cause enough attention and find the solution. MethodsBetween January 2013 and June 2014, we used a self-made questionnaire to survey 122 operating room nurses from grade three first-rate hospitals by random sampling on the facial skin damage status. Then, we analyzed the risk factors of operating room nurses facial skin damage and put forward such countermeasures as improving working environment, increasing service facilities, reducing pollution and biological, chemical, psychological factors, and selecting and using surgical masks properly and promoting facial skin protective measures. ResultsThe survey showed that 93.3% of all the investigated operating room nurses had facial skin problems which mainly was rough dry skin (99.2%); 76.7% of the nurses thought that it was related to the nature of work, and 72.5% of them considered that metal fatigue was the main influence factor. ConclusionWe should strengthen the nurses’ own protection consciousness, enact all kinds of protective measures, strictly implement the system of protection and take effective protective measures as to reduce the operating room nurses facial skin damage.
ObjectiveTo systematically review the effects of nursing-implemented sedation protocol on outcomes of mechanical ventilation and sedation in mechanically ventilated ICU patients. MethodsWe searched EMbase (Ovid), The Joanna Briggs Institute EBP Database (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL, Ovid), MEDLINE (Ovid), Web of Knowledge, CINAHL, CBM, CNKI, WanFang Data and VIP to collect studies on nursing-implemented sedation protocol up to January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 11 studies involving 2118 patients (1 037 were in the intervention group, and 1 081 were in the control group) were included. The results of meta-analysis showed that nursing-implemented sedation protocol could reduce the total dosage of midazolam (MD=-163.82, 95%CI -309.81 to -17.84, P=0.03), the daily dosage of midazolam (MD=-37.22, 95%CI -61.14 to -13.29, P<0.01), and the incidence rate of VAP (RR=0.53, 95%CI 0.34 to 0.81, P<0.01). However, nursing-implemented sedation protocol had no effects on the length of mechanical ventilation, the length of ICU stay, and self-extubation. ConclusionCompared with the usual sedation management, nursing-implemented sedation protocol can reduce the dosage of midazolam and the incidence rate of VAP. But no statistical significances are found in the length of mechanical ventilation, the length of ICU and the incidence rate of self-extubation.
Objective To explore the nurses’ cognition of busyness in intensive care unit (ICU), summarize the main busy scenes, and provide strategies for solving problems of busyness. Methods Nurses in three ICU departments of Shanghai Oriental Hospital were selected by purpose sampling method from September 2020 to January 2021. Face-to-face semi-structured in-depth interviews were conducted with nurses. The interview data were analyzed and thematically refined using the method of Colaizzi data analysis. Results A total of 10 nurses were interviewed, including 8 general nurses and 2 head nurses, all of whom were women. The cognition of busyness covered three elements: explosively increased workload, time pressure, and overwhelming information from multiple sources. Busy scenes included four themes: large amount of patients, critical conditions of patients, unstable conditions of patients, and frequent service transfer among different medical divisions. Conclusions According to the three elements of nurses’ cognition of busyness and scenes of it, nursing managers can put forward corresponding solutions. This can retain or attract more nurses to work in ICU and provide better services for patients.
ObjectiveTo evaluate the influence of personalized nursing intervention on the negative emotions after occupational exposure for nurses in the Emergency Department, in order to provide effective nursing intervention methods for relieving nurses' negative emotions after occupational exposure. MethodsTwenty nurses with occupational exposure between January and September 2013 were chosen to be the control group, and another 20 nurses with occupational exposure between October 2013 and October 2014 were designated as the personalized nursing group. The level of depression and anxiety was compared between the two groups by using the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) on the exposure day and 5 weeks after the exposure. ResultsBefore intervention, SDS score of the control group was 0.65±0.04 and of the personalized nursing group was 0.63±0.05, and there was no statistically significant difference between the two groups (t=0.59, P=0.44); SAS score of the control group was 51.98±6.77 and of the personalized nursing group was 50.73±10.03, and there was no statistically significant difference between the two groups (t=0.37, P=0.70). After the intervention, personalized nursing group had lower scores of SDS and SAS than the control group. SDS score was 0.64±0.11 in the control group and 0.50±0.09 in the personalized nursing group with a significant difference (t=5.11, P < 0.01); SAS score was 49.53±9.49 in the control group and 42.66±9.53 in the personalized nursing group, and the difference was statistically significant (t=4.10, P < 0.01). ConclusionThe personalized nursing intervention can effectively alleviate negative emotions after occupational exposure for nurses in the Emergency Department.