Objective To compare the advantages between SmartCare weaning and protocoldirected weaning in COPD patients regarding five aspects including comfort degree of COPD patients in weaning stage, workload of medical staff, weaning success rate, weaning time, and complications associated with mechanical ventilation. Methods COPD patients who’s planning to receive ventilation weaning were randomly divided into a SmartCare weaning group ( SC group) and a protocol-directed weaning group ( SBT group) . The comfort degree of patients and workload of medical staff were assessed by the visual analogue scale ( VAS) as the weaning plan started. 0 was for the most discomfort and maximal workload, and 10 was for the most comfort and minimal workload. Data fromthe following aspects had been recorded: times of blood gas analysis, weaning success rate, weaning time, self-extubation rate, the rate of re-intubation within 48 hours, and ventilator-associated pneumonia ( VAP) incidences. Results 40 patients were selected and divided into the SC group ( n =19) and the SBT group ( n =21) . There was no significant difference in the enrolled age and APACHEⅡ between two groups. The VAS scores was higher in the SC group than that in the SBT group in the first three days ( Plt;0.01) . The weaning time was shorter in the SBT group than that in the SBT group [ ( 4.7 ±2.7) days vs. ( 5.5 ±3.2) days] , without significant difference between two groups ( P gt;0.05) . There were no differences in times of blood gas analysis, weaning success rate, weaning time, self-extubation rate, the rate of re-intubation within 48 hours, and ventilator-associated pneumonia ( VAP) incidences between two groups ( P gt; 0.05) .Conclusion As compared with protocol-directed weaning, SmartCare weaning can increase comfort degree of patients and reduce the workload of medical staff with similar weaning success rate, weaning time, and complications associated with mechanical ventilation.
ObjectiveTo explore the effect of comfort care on patients undergoing CT enhanced scan. MethodsSixty patients undergoing CT enhanced scan were enrolled in June 2013, who were randomly divided into general care group (n=30) and comfort care group (n=30). General care group was given the routine care, while patients in the comfort care group accepted comfort care as well as routine care. The success rate of examination and excellent or good imaging rate between the two groups were compared. ResultsIn the general care group, the scan was successful in 21 patients and failed in 9, with a successful scan rate of 70.0% (21/30), and the excellent and good imaging rate was 71.4%. For the comfort care group, the scan examination succeeded in 29 patients and failed in 1 with a success rate of 96.7% (29/30), and the excellent and good imaging rate was 96.6% (28/29). The success rate in the two groups had statistical significance (χ2=7.680, P=0.006), and the excellent and good imaging rate was also significantly different (χ2=7.607, P=0.022). ConclusionComfort care for patients undergoing CT enhanced scan has a good effect in alleviating psychological stress, ensuring comfort and safety, and improving the success rate and excellent and good rate of imaging quality, which reflects its real value of nursing service in CT Department.
ObjectiveTo compare the differences in preventing subcutaneous effusion, skin flap necrosis, and patient comfort between simple negative pressure drainage and negative pressure drainage combined with chest compression bandaging after radical mastectomy for breast cancer. MethodsOne hundred and ninety-six patients underwent radical mastectomy for breast cancer from January 2010 to December 2012 in this hospital were collected.The simple negative pressure drainage (SNPD group, n=84) and negative pressure drainage combined with chest compression bandaging (NPD+CB group, n=112) after radical mastectomy for breast cancer were used to prevent postoperative subcutaneous effusion.The postoperative complications, postoperative 3 d drainage volume, and patient comfort were compared in two groups. ResultsOne hundred and ninety-six patients with breast cancer were females.The differences of general clinical data were not statistically significant in two groups (P > 0.05).The differences of chest wall mean extubation time, axillary mean extubation time, postoperative 3 d mean drainage volume, and incidences of subcutaneous effusion and skin flap necrosis were not statistically significant in two groups (P > 0.05).The rate of comfort satisfactory in the SNPD group was significantly higher than that in the NPD+CB group [76.2%(16/84) versus 22.3%(25/112), P < 0.001].The chemotherapy was not affected after operation in two groups. ConclusionsComparing with negative pressure drainage combined with chest compression bandaging, simple negative pressure drainage do not increase postoperative subcutaneous effusion and skin flap necrosis, but it greatly improves the patients satisfactory rate.
ObjectiveTo determine if comfort level was associated with chest tube size(16F or 28F) among lung cancer patients with video-assisted thoracoscopic surgery (VATS) lobectomy. MethodsWe performed VATS lobectomy for 163 patients with lung cancer in our hospital between February and May 2014. There were 70 males 93 females. The patients were allocated into two groups including a 28F group and a 16F group. There were 75 patients at age of 53.18±14.73 years with insertion of one chest drain of 28F in the 28F group. And there were 88 patients at age of 56.62±12.62 years with insertion of one chest drain of 16F in the 16F group. Heart rate and variation of pulse, breathing rate and variation of breathing rate, pain scores, comfort level, and activities daily living (ADL) of the two groups were compared. ResultsThere was no significant difference in the patient characteristics and operation data between the two groups. There were statistical differences in variation of heart rates on the 1st day, 2nd day, and 3rd day after operation between the 16Fgroup and the 28F group (9.67±3.33 times/min vs.18.54±5.33 times/min, P=0.037; 7.89±2.88 times/min vs. 19.01±4.67 times/min, P=0.045; 7.67±3.01 times/min vs. 20.88±5.34 times/min, P=0.021). The percentage patients of mild pain in the 16F group (77.65%) was higher than that in the 28F group (49.78%, P=0.023) with a statistical difference. The independent ambulation and comfort level in the 16F group(67.05%, 67.05%) were significant higher than those in the 28F group (45.78%,55.11%, P=0.023, P=0.026). ConclusionOur findings suggest that drainage via a small-bore chest tube provides meaningful postoperative comfort level in the patients with VATS lobectomy.
ObjectiveTo evaluate the effect of postoperative no indwelling urethral catheters in lung operation. MethodsIn this prospective cohort study, we recruited 100 patients who were scheduled for pulmonary lobectomy under general anesthesia in a single institution of Thoracic Surgery Department in West China Hospital between April and December 2014. These patients were divided into two groups including a no indwelled urethral catheter group (NIUC, 50 patients) and an indwelled urethral catheter group (IUC, 50 patients). The clinical effect was compared between the two groups. ResultsThere was no statistical difference in incidence of postoperative urinary retention or urinary tract infection between the two groups (P=0.433, 0.050). However, the comfort degrees(0 degree) of patients in the NICU group was significantly higher than that of the ICU group with a statistical difference (P=0.002). While postoperative hospitalization time in the NICU group (P=0.023) was shorter than that in the ICU group (P=0.004). Prostatic hyperplasia was the high risk factor for the lung postoperative urinary retention (P=0.056). ConclusionPostoperative no indwelling urethral catheters in lung operation has the benefit of improving the comfort degrees of inpatients and increasing the postoperation urinary retention.
Assisting immobile individuals with regular repositioning to adjust pressure distribution on key prominences such as the back and buttocks is the most effective measure for preventing pressure ulcers. However, compared to active self-repositioning, passive assisted repositioning results in distinct variations in force distribution on different body parts. This incongruity can affect the comfort of repositioning and potentially lead to a risk of secondary injury, for certain trauma or critically ill patients. Therefore, it is of considerable practical importance to study the passive turning comfort and the optimal turning strategy. Initially, in this study, the load-bearing characteristics of various joints during passive repositioning were examined, and a wedge-shaped airbag configuration was proposed. The airbags coupled layout on the mattress was equivalently represented as a spring-damping system, with essential model parameters determined using experimental techniques. Subsequently, different assisted repositioning strategies were devised by adjusting force application positions and sequences. A human-mattress force-coupled simulation model was developed based on rigid human body structure and equivalent flexible springs. This model provided the force distribution across the primary pressure points on the human body. Finally, assisted repositioning experiments were conducted with 15 participants. The passive repositioning effectiveness and pressure redistribution was validated based on the simulation results, experimental data, and questionnaire responses. Furthermore, the mechanical factors influencing comfort during passive assisted repositioning were elucidated, providing a theoretical foundation for subsequent mattress design and optimization of repositioning strategies.