Objective To investigate the status of knowledge, attitude and practice (KAP) of Standard Practice for Intravenous Nursing among nurses. Methods A total of 140 nurses were recruited and investigated with a self-designed questionnaire on March 16th, 2016. Results A total of 140 questionnaires were collected and 137 valid questionnaires were finally analyzed. Nurses’ KAP scores of Standard Practice for Intravenous Nursing were good. Hospital level, hospital characteristics, position and whether the nurses were specialized in intravenous nursing were influencing factors of the scores (P<0.05). Conclusions The general situation of KAP of Standard Practice for Intravenous Nursing is good, but nurses' knowledge on intravenous treatment is rather weak. Nurses should pay more attention to the knowledge of Standard Practice for Intravenous Nursing. Targeted education should be provided for nurses to promote the formation of positive attitude and healthy behaviors of clinical intravenous nursing practice.
Objective To investigate the status quo of implementation ofIntravenous Practice Standard in a tertiary A hospital in Sichuan. Methods At 09:00-11:30 am, on March 16th, 2016, a questionnaire designed by intravenous team (IV Team) was used to conduct the investigation in all the inpatiets according to inclusion and exclusion criteria. The SPSS 17.0 software was used to perform all statistical analysis. Results The intravenous infusion rate in the hospital was 76.87%, while the rate in Emergency Department peaked up to 96.11%. Indwelling needle was the most common used device for intravenous therapy in clinical practice, which was used in 77.91% of the inpatients, and steel needle, peripherally inserted central catheter (PICC), central venous catheter, and implantable venous access port were also widely used. Peripheral intravenous catheter was used in 2 990 inpatients, and 78.12% of the puncture sites met the standard; PICC was used in 397 inpatients, and 90.17% of the puncture sites met the standard. The incidence of intravenous infusion related-complications was 15.08%, the incidence of drug exosmosis / exudation was 10.06%, and the incidence of catheter-related blood stream infection (CRBSI) was 2.89%. Conclusions On the whole, the intravenous infusion rate in this hospital accords with the national average level, but the rate in some departments should be controlled. The selection of device for intravenous therapy is reasonable, but the selection of intravenous site should be more standardized. The incidence of intravenous infusion related-complications is low, but the prevention and control of drug exosmosis / exudation and CRBSI should be reinforced. Health care organizations should pay more attention to enforce the Intravenous Practice Standard into practice to promote clinical medical service.
Objective To explore how to integrate the various sources of information in designing an evidence-based nursing care plan for preventing gastrointestinal hemorrhage (GIH) after pancreaticoduodenectomy (PD). Method Papers and references about prevention of GIH after PD were searched between September and October 2015, and an evidence-based nursing care plan was drawn up and implemented from November 2015 to January 2016. Results A total of 79 papers were found and of which 17 were aviliable. Thirty-nine patients were cared on the basis of the effective project, of whom one was dignosed with GIH on the 3rd postoperative day and the rate of post-PD hemorrhage was 2.6%. All patients were diacharged on the 6th or 7th postoperative day. Conclusion Exploring evidences under the guidance of scientific method and applying them to clinical nursing can prevent post-PD hemorrhage and improve life quality of patients.
ObjectiveTo systematically review the efficacy of enteral nutrition combined with parenteral nutrition (EN+PN) and enteral nutrition alone (EN) in gastric cancer patients undergoing gastrectomy. MethodsPubMed, EMbase, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of EN+PN and EN in gastric cancer patients undergoing gastrectomy from inception to September 25th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 23 RCTs were included. The results of meta-analysis showed that compared to EN group, EN+PN group had a shorter hospital stay (MD=−1.75, 95%CI −2.45 to −1.05, P<0.000 1) and a lower risk of postoperative complications (RR=0.55, 95%CI 0.46 to 0.66, P<0.000 1). However, there was no statistical difference in the first exhaust time between the two groups. ConclusionThe current evidence shows that EN+PN may contribute to reducing the incidence of postoperative complications and shortening the length of hospital stay in gastric cancer patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
Objective To analyze the research status of immunonutrition in China based on Chinese databases, and to provide a reference for clinical practice and future research. Methods Literatures about the application of immunonutrition in nutrition support were searched in China National Knowledge Infrastructure, SinoMed, Chongqing VIP and Wanfang databases using bibliometrics methods. The retrieval time was up to August 2022, and the document characteristics such as the number of publications, the institutions and the citation frequency and other features were analyzed. Results A total of 725 literatures were included, with the highest number of literatures issued in 2015 and 2020, both 62. The areas with the most published literatures were Jiangsu (10.6%) and Guangdong (8.4%). The institutions with the most published literatures were General Hospital of Eastern Theater Command (4.8%) and West China Hospital of Sichuan University (3.9%). There were 78 dissertations and 647 journal articles in total. The most published journal was Parenteral & Enteral Nutrition (6.5%). The top three citations were all reviews. The degree of cooperation was 2.7, and the co-authorship rate was 70.1%. A total of 121 articles reported the supporting funds and projects. The research types included 499 original studies (68.8%) and 226 secondary studies (31.2%). The analysis of the subjects showed that immunonutrition was mostly applied to gastrointestinal diseases, especially gastrointestinal cancer patients, accounting for 42.5%. Nutritional support was divided into enteral nutrition and parenteral nutrition. Enteral nutrition was adopted in most literatures, accounting for 88.4%. Conclusions The research content of immunonutrition in Chinese database in China is relatively simple. Most of them focus on the comparison between immunonutrition and general nutrition support. The selection of immune nutrients and the application of immunonutrition in critically ill patients such as sepsis need further research.
ObjectiveTo analyze the clinical effects and hospitalization costs of the enhanced recovery after surgery (ERAS) mode for patients underwent radical resection of hepatocellular carcinoma (HCC). MethodThe clinicopathologic data of adult patients who underwent radical resection of HCC in the West China Hospital of Sichuan University from January 2017 to December 2019 were collected retrospectively. ResultsA total of 1 082 patients were collected according to inclusion and exclusion criteria in this study, including 469 patients in the ERAS mode group and 613 patients in the traditional mode group. There were no significant differences in baseline data such as gender, age, body mass index, preoperative complications, operation type, and medical group between the two groups (P>0.05). Compared with the traditional mode group, the total hospitalization cost, medical service fee, examination fee, bed fee, and cooling and heating fee in the ERAS mode group were lower (P<0.05), the average total hospitalization time was shortened by about 1.2 d (P<0.01), the preoperative hospitalization time was shortened by about 0.3 d (P=0.03), and the postoperative hospitalization time was shortened by about 0.8 d (P<0.01) in the EARS mode group. There were no significant differences in the incidences of specific complications and total complications between the two groups (P>0.05). ConclusionERAS for patients with HCC might play a role in improving rehabilitation efficiency and reducing hospitalization costs.
Objective To analyze the progress of evaluation indexes for enhanced recovery after surgery (ERAS) model at home and abroad, and to propose suggestions for constructing systematic evaluation model of ERAS. Methods Atfirst checked the Chinese and English databases, including Medline, Embase, Sciencedirect, ACP Journal Club, BioMed Central, the Cochrane Central Register of Controlled Trials (CENTRAL), Science Citation Index Expanded, Cochrane Library, NHS Economic Evaluation Database, CNKI, VIP, and Wanfang databases (retrieval time was from January 1997 to December 2017), and then filtered the literatures, excluded duplicate documents, a total of 1 020 English literatures and 786 Chinese literatures were enrolled eventually to make an review. Results The literatures showed that, at present, there was no comprehensive and systematic evaluation index system about ERAS at home and abroad. The existing evaluation indexes mainly included the following deficiencies: localization and fragmentation of evaluation indicators, lack of evaluation indicators of ERAS organizational framework and process management, as well as lack of standardized operational definition of evaluation indicators. Conclusions The evaluation indexes of ERAS at home and abroad do not constitute a systematic evaluation index system according to scientific principles, which will restrict the standardization of accelerated surgical rehabilitation in our country. To establish a multidimensional and comprehensive quality evaluation index system based on multi-evaluation of hospital, patient, social, and medical management institutions, which covers ERAS organizational structure, process management, and clinical outcomes, is a necessary condition for the development of ERAS model.
ObjectiveTo research and summarize the best evidences of probiotic-riched early enteral nutrition for postoperative liver transplantation, and provide references for precise and individual clinical nutrition and probiotics usage management in patients with liver transplantation.MethodsThe scientific problem was established according to the PIPOST. The British Medical Journal Best Practice, Cochrane Library, Jonna Briggs Institute, Guidelines International Network, National Guideline Clearinghouse, etc. were used to search the papers or relative data recordings. The evidence evaluation and summary were carried out based on the previous documents.ResultsOne evidence summary, 2 systematic reviews, and 5 randomized controlled studies were included. Based on the specific questions, 6 dimensions (24 evidences) were extracted and summarized: the early enteral nutrition was used within postoperative 24 h, starting with 20 mL/h, but not more than 125 mL/h, essential nutrients would be fine and tube feeding would be converted to oral feeding as soon as possible; Lactobacillus 20 mg and Bifidobacterium 15 mg were suggested, 3 times/d, probiotic-riched early enteral nutrition for postoperative liver transplantation should be lasted for at least 14 d.ConclusionsEvidence-based medicine is used to collect the best evidence of probiotic-riched early enteral nutrition for postoperative liver transplantation, there are few studies on early enteral nutrition after liver transplantation in China. Application of the best evidence needs to be analyzed and constructed according to current situation of liver transplantation in China.
Alzheimer’s disease (AD) is a chronic central neurodegenerative disease. The pathological features of AD are the extracellular deposition of senile plaques formed by amyloid-β oligomers (AβOs) and the intracellular accumulation of neurofibrillary tangles formed by hyperphosphorylated tau protein. In this paper, an in vitro pathological model of AD based on neuronal network chip and its real-time dynamic analysis were presented. The hippocampal neuronal network was cultured on the microelectrode array (MEA) chip and induced by AβOs as an AD model in vitro to simultaneously record two firing patterns from the interneurons and pyramidal neurons. The spatial firing patterns mapping and cross-correlation between channels were performed to validate the degeneration of neuronal network connectivity. This biosensor enabled the detection of the AβOs toxicity responses, and the identification of connectivity and interactions between neuronal networks, which can be a novel technique in the research of AD pathological model in vitro.
During the coronavirus disease 2019 (COVID-19) epidemics, universities take responsibility for the health of their students and epidemic control. Our urgent recommendation focuses on four key questions of emergency management in universities following rigorous evidence-based approaches and provides timely suggestions to university managers, academic faculties and student affairs managers. We recommend universities during the COVID-19 epidemics should: 1) suspend offline lectures; 2) provide proper health education on the disease; 3) encourage face masks, however oppose using N95 masks on the campus; 4) encourage hand hygiene and provide sanitizing products on the campus.