Objective To investigate the effect of a real-time compliance dashboard to help reduce ventilator-associated pneumonia ( VAP) with ventilator bundle. Methods 240 patients who were admitted into the intensive care unit ( ICU) of Shougang Hospital of Peking University and had received mechanical ventilation ( MV) for over 48 hours, between January 2010 and November 2011, were studied prospectively. The patients were divided into two groups by random number table, ie. a dashboard group ( n = 120) with implementation of a real-time compliance dashboard to help reduce VAP with ventilator bundle, and a control group ( n=120) with implementation of usually routine order to help reduce VAP with ventilator bundle. The success rate of ventilator bundle implementation, incidence of VAP, duration of MV, duration within ICU, mortality within 28 days, cost within ICU were compared between two groups. Results Compared with the control group, the success rate of ventilator bundle implementation obviously increased ( 81.6% vs. 52.5%) , incidence of VAP ( 14. 5/1000 days of MV vs. 36.2 /1000 days of MV) , duration of MV [ 5( 4,7) days vs. 8( 6,11) days] , duration within ICU [ 8( 6,12) days vs. 13( 8,16) days] , mortality of 28 days ( 12.6% vs. 28.6% ) , and cost within ICU ( 36,437 vs. 58,942) in the dashboard group obviously reduced ( Plt;0.05) . Conclusions Implementation of a real time compliance dashboard to help reduce VAP with ventilator bundle can obviously improve medical personnel compliance and reduce incidence of VAP, duration of MV, duration within ICU, mortality and cost in ICU than those of routine medical order to help reduce VAP with ventilator bundle.
Objective To investigate the factors influencing the medication adherence among patients with diabetes signing family doctor service contract in Beijing urban areas, and provide the basis for improving the level of medication adherence. Methods A total of 320 patients with diabetes from four community health service centers in Beijing urban areas were selected to answer the questionnaires using convenient sampling from June to September 2015. Univariate analysis and binary logistic regression were used for the influencing factors analysis. Results A total of 320 questionnaires were distributed, and 317 valid questionnaires were recovered, in which the rate of high medication adherence was 54.6%. The results of logistic regression showed that the main impact factors on medication adherence were age [odds ratio (OR)=1.918, P=0.011)], degree of education (OR=2.462, P=0.008), knowledge related to diabetes (OR=1.773, P=0.027), adopting of family doctor service or not (OR=2.521, P=0.029) and social function status (P=0.003). Conclusions The family doctor service team should implement the practice of the family doctor service to ensure that the contracted residents can make full use of the family doctor services; and strengthen the follow-up and interventions for patients less aged or with low degree of education. For those with poor social function, more attention should be paid to their self-health management behavior to improve the level of patients’ compliance. As a result, the levels of blood glucose will be well controlled to reduce possibilities of complications and improve their health status and quality of life.
ObjectiveTo compare the investigation results of compliance and accuracy of hand hygiene in medical staff achieved by Hospital Infection Management Department and Department Infection Management Teams, and analyze the reasons for differences of the results and take measures to improve the investigation ability of hand hygiene in hospitals. MethodsWe statistically analyzed the results of compliance and accuracy of hand hygiene from January to December 2013 investigated by the infection management department and 25 infection management teams. Both the hospital and departments used "WHO Standard Observation Form". Single-blind method was used to observe the implementation of hand hygiene in medical staff. ResultsThe hospital infection management department investigation showed that hand hygiene compliance and accuracy were 64.97% and 87.78%, respectively, while the investigation by infection management teams showed that hand hygiene compliance and accuracy were 90.54% and 93.37%, respectively. The differences between the investigation results of two-level organizations were statistically significant (χ2=286.2, P<0.001; χ2=532.6, P<0.001). ConclusionWe should take measures to enforce the training of hand hygiene implementation and the observation method, and improve the guidance and assessment, promote investigators' working responsibility and observation ability, so that the survey data can accurately reflect the actual situation to urge medical staff to form good hand hygiene habits.
ObjectiveTo explore the effect of family-school-hospital application in continuous nursing care for children with epilepsy. Methods120 children with epilepsy admitted to Children's Hospital Affiliated to Jiangnan University from January 2021 to October 2022 were randomly divided into two groups, each with 60 cases. The control group received routine care, while the experimental group received family-school-hospital continuous care. Compare the awareness of epilepsy knowledge, disease control effectiveness, medication compliance, negative emotions, physical and mental status, and quality of life before and after nursing between the families of two groups of children with epilepsy. ResultsAfter 2 months of nursing care, the scores of family members' knowledge of epilepsy in the experimental group were higher than the control group (P<0.05). The effect of disease control in the experimental group was better the control group (P<0.05). The drug compliance of the experimental group was higher than the control group (P<0.05). The quality of life score in the intervention group was higher than the control group (P<0.05). ConclusionThe application of family-school-hospital in the continuous care of children with epilepsy can improve their family members' awareness of epilepsy knowledge, effectively control the disease, improve medication compliance, improve negative emotions and physical and mental conditions, and thus improve the quality of life of children.
ObjectiveTo explore the current status of treatment adherence in patients with chronic kidney disease without dialysis and to analyze its influencing factors.MethodsThe patients who visited the Outpatient Department of Nephrology of West China Hospital of Sichuan University from September to December 2020 were taken as the research objects. Self-designed general information questionnaire, treatment adherence questionnaire, physician-patient communication satisfaction, health information seeking behavior questionnaire, and physician-patient concordance questionnaire were used to investigate, and path analysis was used to explore the influencing factors of treatment adherence.ResultsA total of 203 valid questionnaires were obtained. Treatment adherence score was (21.69±2.42) points, self-reported health status was (2.48±0.91) points, physician-patient concordance was (20.39±2.70) points, physician-patient communication satisfaction was (67.73±5.52) points, and health information seeking behavior was (13.17±2.65) points. Health information seeking behavior (r=0.214, P=0.002), physicians-patient concordance (r=0.494, P<0.001), physician-patient communication satisfaction (r=0.229, P=0.001) were positively correlated with treatment adherence. Self-reported health status was negatively correlated with treatment adherence (r=−0.225, P=0.001). Path analysis showed that physicians-patient concordance was the most influencing factor of treatment adherence (total effect=0.474).ConclusionHealth information-seeking behavior and physicians-patient concordance are important factors affecting treatment adherence in chronic kidney disease patients without dialysis. In order to improve treatment adherence of chronic kidney disease patients, healthcare providers can provide various ways to provide information, which can help make more disease-related health knowledge available to patients. Moreover, healthcare workers should also further explore ways to improve the concordance related to reaching agreement between doctors and patients on medical and treatment options.
ObjectiveTo investigate the medical knowledge and treatment compliance of parents of asthma children in Gaoming District, Foshan City. MethodOne hundred consecutive parents of asthma children who sought pediatric service in Gaoming People's Hospital from January to December in 2012 were surveyed by the use of Knowledge-Belief-Behavior Questionnaire developed by Capital Research Center of Pediatrics. ResultsNinety-five of the one hundred questionnaires provided useful data for analysis. Among these parents, 63.18% understood the nature of asthma being hyperactive inflammatory disease of the airways; 78.91% believed it to be controllable by regular treatment; only 21.05% of asthma children under parental guidance received inhaled corticosteroids on a regular basis; 14.74% considered their children fit for physical exercises when stabilized; 22.10% chose inhaled β2 agonists as "relievers" during attacks; 61.05% were concerned about the side effects on growth of inhaled corticosteroids and 48.42% discontinued its use against physician's instruction; 82.11% of asthma children had not been evaluated by Asthma Control Questionnaire. ConclusionsParents of asthma children in Gaoming District, Foshan City have weak links in the understanding of this condition. Though most believe it to be controllable under regular treatment, the overall compliance is unsatisfactory. Therefore, knowledge of asthma should be propagated at various public fronts in order to better improve the treatment compliance and consequently the disease control, of asthma children.
ObjectiveTo retrospectively collect data on patients with stable chronic obstructive pulmonary disease (COPD), and explore the current status of medication adherence and its main influencing factors in China.MethodsAccording to the principle of convenience, 293 patients with COPD were enrolled in 16 tertiary hospitals located in Nanjing, Hefei, Wuhu, Xuzhou, and Chuzhou. The status quo and influencing factors of medication adherence in COPD patients were identified and analyzed by using the 8-item Morisky Drug Compliance Scale, Beliefs about Medicines Questionnaire, Hospital Anxiety and Depression Scale, General Self-Efficacy Scale, and modified British Medical Research Council. The analysis was based on the framework provided by the WHO’s "five-dimensional determinants" and the mathematical relationship was demonstrated through sequential logistic regression analysis. ResultsThe medication adherence of the target population is 11.95%. A higher socio-economic status [odds ratio (OR) 0.30, 95% confidential interval (CI) 0.10 - 0.91], patients’ general beliefs about the medication utility (OR 0.29, 95%CI 0.17 - 0.50) and overuse (OR 0.30, 95%CI 0.16 - 0.55) were associated with a lower chance of being adherent in patients with COPD. While disease severity (OR 2.01, 95%CI 1.11 - 3.64) and types of drug use (OR 1.91, 95%CI 1.07 - 3.41) presented opposite results. ConclusionsMedication adherence in domestic patients with COPD is not satisfactory at the present stage. Effective ways to improve patients’ medication adherence and quality of life could be proposed from the national, living environment and individual three dimensions.
Objective To explore the compliance improvement of rehabilitation exercise for patients after spine surgery. Methods Forty-nine in-patients who underwent spinal surgery between June 1st and July 14th 2016 were selected as the control group and 50 in-patients who underwent spinal surgery between July 15th and August 30th 2016 were selected as the trial group. The control group received conventional nursing for rehabilitation exercise, and the tiral group adopted a series of quality improvement measures for rehabilitation exercise. The compliance of functional exercise, the accuracy of patients’ exercise and the satisfaction with health education of the patients were compared between the two groups. Results The functional exercise compliance in the trial group (complete compliance in 45 cases, partial compliance in 4 cases, non-compliance in 1 case) was higher than that in the control group (complete compliance in 9 cases, partial compliance in 34 cases, non-compliance in 6 cases) with a statistical difference (Z=–6.910, P<0.001). The functional exercise accuracy rate of patients was higher in the trial group [84.00%(168/200)] than that in the control group [53.06% (104/196)] with a statistical difference (χ2=44.060, P<0.001). The patients’ satisfaction with health education in the trial group (4.64±0.49) was higher than that in the control group (4.20±0.89) with a statistical difference (t=3.084, P=0.003). Conclusion The implementation of nursing quality improvement intervention can improve the compliance and accuracy rate of rehabilitation functional exercise of patients undergoing spinal surgery, and improve the satisfaction of patients, which is worth promoting.