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find Author "冯梅" 13 results
  • 自制开启预防呼吸机相关性肺炎之门的钥匙量角器

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  • Application of Discharge Planning Model in Respiratory Department

    ObjectiveTo explore the application of discharge planning model in Respiratory Department. MethodWe developed discharge planning model in the Respiratory Department and performed standardized management on inpatients by assessing, planning, implementing and following up the whole process. A total of 716 discharged patients before the implementation of the planning model (January to March 2014) were designated as the control group, and 739 discharged patients after the model implementation (April to June 2014) were regarded as the observation group. Then, we compared such indexes as the rate of discharge planning, average length of hospital stay, retention rate of discharged patients, the number of new hospital admissions and medical orders during the time of weak nurse strength, and inpatient satisfaction before and after the model implementation. ResultsAfter implementation of discharge planning model, all observed indicators were significantly better in the observation group (P<0.05). ConclusionsImplementation of discharge planning model can effectively promote physician-nurse cooperation, plan health guidance for discharged patients, make them be ready to return to society and family, improve patients' satisfaction, and achieve the aim of patient-oriented high quality care. Meanwhile, it also can shorten the average length of hospital stay, reduce orders during the time of weak strength. It can not only ensure the ward medical indexes, but is helpful to manage nursing schedule.

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  • Effect of quality control circle in reducing ventilator-associated pneumonia in Pediatric Intensive Care Unit

    Objective To investigate the effect of quality control circle in reducing ventilator-associated pneumonia in Pediatric Intensive Care Unit (PICU). Methods A total of 1 249 child patients who underwent mechanical ventilation between January and December 2013 were chosen as the control group, and they accepted routine management. Another 1 208 child patients treated between January and December 2014 were selected as the observation group, and quality control circle was adopted. The compliance of ventilator care bundles, the duration of mechanical ventilation, the length of PICU stay and the incidence of ventilator-associated pneumonia were compared between the two groups. Results Compared with the control group, compliance of ventilator care bundles was higher in the observation group (P<0.01), the duration of mechanical ventilation was shorter [(6.9±2.4) daysvs. (4.6±2.2) days], the length of PICU stay was shorter [(9.2±3.1) daysvs. (7.7±2.4) days], and the incidence of ventilator-associated pneumonia was lower (22.4‰vs. 9.1‰) (P<0.05). Conclusion Application of quality control circle can significantly promote the compliance of ventilator care bundles, and decrease the duration of mechanical ventilation, the length of PICU stay and the incidence of ventilator-associated pneumonia.

    Release date:2017-01-18 08:50 Export PDF Favorites Scan
  • The Psychological States and Their Influencing Factors in the Parents of Congenital Defect Neonates Admitted to Intensive Care Unit

    ObjectiveTo investigate the psychological states and their influencing factors in parents of congenital defect neonates admitted to Intensive Care Unit (ICU). MethodsThe self-designed general information questionnaire was used to collect the demographic data, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the states of anxiety and depression of the parents of congenital defect neonates admitted to ICU between June 1 and November 29, 2013. ResultsA total of 152 parents were included in this investigation. The average score of SAS was 39.45±8.53. The average score of SDS was 43.28±10.76. Univariate analysis found that parents with lower educational level, poorer family income, positive family history and countryside residence might have higher score of SAS, while parents with Han nationality, poorer family income and family history would have higher score of SDS. Multivariate analysis discovered that living condition and family history were related to anxiety status. However, depression state was influenced by nationality, family income and family history. ConclusionA considerable number of parents of congenital defect neonates admitted to ICU have anxiety or depression. And nationality, family income, family history and living condition are the major risk factors.

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  • Practice of closed-loop group nursing model in the makeshift intensive care unit for coronavirus disease 2019

    ObjectiveTo explore the effect of closed-loop group nursing model on the makeshift intensive care unit (ICU) in a hospital specialized for coronavirus disease 2019 (COVID-19).MethodsSeveral fever wards had been shifted into ICUs and ran by the first medical team from Sichuan Province from January 30th to March 19th, 2020. Closed-loop group nursing model was utilized. The nursing model activated the nurses in management by empowerment and nursing group establishment. To ensure standard of care, measures were carried out in this model, namely, improving the physical work environment, nurse training, optimizing composition of nursing manpower, fine and standardized management of medical resources, “double-chain” medical supply system, “3S” management on first aid kit, protecting patient safety and dignity, and developing emergency nursing workforce deployment plan.ResultsThe implementation of closed-loop group nursing model showed good results in treating severe to critically ill COVID-19 patients regardless of shortages in nursing workforce and facilities. The rescue work was carried out successfully in the makeshift ICUs. All the nurses showed great teamwork and were really involved in the management of the wards. ConclusionsAs the current ICUs were not adequate for the increasing number of critically ill patients during the epidemic, it was unavoidable to transform other wards into ICUs. Closed-loop group nursing model was utilized to break the hierarchy. As a result, all nurses were empowered to participate in nursing management and their potential was fully inspired. Furthermore, this working model presented a clear working framework in multidisciplinary teamwork in a limited time, which also provided patients with dignity and safety.

    Release date:2020-10-26 03:00 Export PDF Favorites Scan
  • Predictive value of STAMP in Health Information System in children with critical congenital heart disease

    ObjectiveTo analyze the perdictive value of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for malnutrition or postoperative complications in children with critical congenital heart disease (CHD).MethodsA total of 875 children with critical CHD who were hospitalized in West China Hospital, Sichuan University form August 2019 to February 2021, including 442 males and 433 females with a median age of 30 (12, 48) months, were assessed by STAMP in Health Information System. Clinical data of postoperative complications were collected.Results(1) Based on World Health Organization Z-score as gold standard, 24.5% had malnutrition risk, and 34.3% were diagnosed with malnutrition. According to STAMP, the children were with medium malnutrition risk of 37.9% and high malnutrition risk of 62.1%. There was a statistical difference of incidence rate of malnutrition and detection rate of STAMP malnutrition risk in gender, age, ICU stay or length of mechanical ventilation (P<0.05); (2) with the optimal cut-off point of 5.5 in STAMP for malnutrition, the sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) were 68.3%, 84.3%, 48.1%, 88.3% and 0.82, respectively; (3) 12.0% of the children were with postoperative complications; (4) with the optimal cut-off point of 5.5 in STAMP for postoperative complications, the sensitivity, specificity, positive predictive value, negative predictive value and AUC were 83.8%, 73.1%, 18.8%, 99.1% and 0.85, respectively.ConclusionChildren with critical CHD have a higher incidence of malnutrition risk and postoperative complications. STAMP has a good perdictive value for malnutrition or postoperative complications, however, the sensitivity and specificity of STAMP are affected by the gold standard or the cut-off point.

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  • Association between preoperative anemia and postoperative infection and death in children with acyanotic congenital heart disease undergoing elective cardiac surgery: A retrospective cohort study

    Objective To analyze the relationship between preoperative anemia and postoperative infection and death in children with acyanotic congenital heart disease (CHD) after elective cardiac surgery. Methods Medical records and follow-up data of 3 859 children with acyanotic CHD who underwent elective cardiac surgery in our hospital from 2011 to 2018 were retrospectively collected, including 2 081 males and 1 778 females with a median age of 32.2 (13.7, 61.5) months. The relationship between preoperative anemia and postoperative infection and death within 90 days was analyzed by univariate and multivariate regression analyses. Results Preoperative anemia was found in 325 (8.4%) patients. There were 716 (18.6%) patients of postoperative infection, including 281 (7.3%) patients of confirmed infection and 435 (11.3%) patients of suspected infection. Forty-six (1.2%) patients died within 90 days after the operation. Univariate analysis showed that age, infection history within 3 months before admission, degree of pulmonary hypertension, the risk adjustment in congenital heart surgery-1 (RACHS-1) score, cardiopulmonary bypass (CPB), disease diagnosis, chromosome abnormality, preoperative left ventricular ejection fraction (LVEF)<55% and preoperative anemia were associated with postoperative infection. Age, degree of pulmonary hypertension, RACHS-1 score, CPB, disease diagnosis and preoperative LVEF<55% were associated with postoperative death within 90 days. Logistic regression analysis showed that preoperative anemia was significantly associated with confirmed postoperative infection [OR=1.82, 95%CI (1.18, 2.82), P=0.007], suspected infection [OR=1.60, 95%CI (1.11, 2.30), P=0.012] and total infection [OR=1.64, 95%CI (1.20, 2.24), P=0.002]. The results of modified Poisson regression analysis showed that there was no significant association between preoperative anemia and death within 90 days after the surgery [RR=1.59, 95%CI (0.69, 3.69), P=0.276]. Conclusion Preoperative anemia may be a risk factor for infection after elective cardiac surgery in children with acyanotic congenital heart disease.

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  • 教育干预对提高小儿重症监护室医护人员手卫生依从性的影响

    目的分析小儿重症监护室(ICU)内对医护人员进行手卫生教育培训的效果,并探讨医护人员手卫生依从性及影响因素,提出管理对策。 方法通过加强手卫生培训,选择2013年10月-2014年3月小儿ICU医护人员77名,对其手卫生进行干预,比较干预措施前后医护人员对手卫生知识掌握情况及手卫生执行率。由感染控制护士床旁隐蔽观察手卫生依从性情况,并将结果进行统计学分析。 结果对医护人员进行教育干预后,医护人员手卫生执行率提高了35.89%,手卫生相关知识考试合格率提高了41.56%。 结论对医护人员进行常规教育培训、再教育和手卫生依从性监测应作为医院感染预防策略的一部分。

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  • 新型冠状病毒肺炎隔离病房患者嗅觉减退原因的多因素分析

    目的探讨住院新型冠状病毒肺炎(简称新冠肺炎)患者嗅觉减退情况及原因。方法对新冠肺炎定点收治医院隔离病房的患者展开问卷调查,了解患者年龄、性别、文化程度、患病时间、既往嗅觉灵敏程度、本次患病有无上呼吸道症状(鼻塞、流涕及打喷嚏等)、既往感冒史及感冒时有无嗅觉减退;通过主观判断法,使用家庭常见的白醋,重新单独包装后让患者闻嗅,判断患者嗅觉是否减退或丧失。采用多因素的二分类 Logistic 回归分析新冠肺炎患者嗅觉减退的可能原因。结果共调查 79 例患者,其中 14 例(17.72%)发生不同持续时间的嗅觉减退。二分类 Logistic 回归分析结果显示,新冠肺炎患者嗅觉减退或丧失与患者年龄、文化程度、基础疾病、治疗药物、上呼吸道症状无明显关联(P>0.05)。女性患者较男性患者更容易发生嗅觉减退(P=0.038);患病时间越长,越容易发生嗅觉减退(P=0.033);不吸氧患者较吸氧患者更容易出现嗅觉减退(P=0.048)。结论新冠肺炎患者在患病期间可以出现程度不同的嗅觉减退。多因素分析提示嗅觉减退与患者性别、患病时长以及吸氧与否有一定关系。

    Release date:2020-07-24 07:00 Export PDF Favorites Scan
  • Construction of the rating scale for key techniques using the inhaler device for patients with chronic airway disorder based on the Delphi-AHP method

    Objective we want to construct a rating scale for the key technique using the inhaler device for patients with chronic airway disorder and to provide a reference tool for the scientific evaluation of patients’ techniques in the use of inhaler devices. MethodsThrough literature review and Delphi expert consultation, the items of the rating scale were determined, and the weights and assignments of the items were determined through the analytic hierarchy process. The resulting evaluation form was used for clinical assessment of patients, and the differentiation of each item was tested by the critical ratio method.ResultsAfter the two rounds of consultation, the positive coefficients of experts were 95.24% and 100%, the expert authority coefficients were 0.988 and 0.990, and the Kendall-W coefficients were 0.371 (P<0.001) and 0.654 (P<0.001), respectively. The final form, consisting of 10 operational items for evaluating key inhaler techniques for patients with chronic airway disorder, was finalized. The results of the hierarchical analysis showed that the consistency ratio CR was 0.088<0.10, which satisfied the consistency test. The top 5 key operational steps were medication preparation, exhalation, holding the mouthpiece, inhalation, and breathholding. Used for clinical patient assessment showed better discrimination of items (t ≥ 3, P<0.05).ConclusionThe rating scale for the technique using the inhaler device for chronic airway disorder constructed in this study is scientifically reliable, convenient, and practical, which can be used as an objective evaluation tool to assess patients’ skill in inhaler device use.

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