ObjectiveTo construct a scientific, standardized, and consistent nursing service quality evaluation system for hemodialysis centers, and to provide scientific basis for the evaluation, improvement, and promotion of nursing service quality in hemodialysis centers.MethodsFrom October to December 2018, based on the Servqual model, combined with the particularity of hemodialysis center and relevant national policies and regulations, the indexes of nursing service quality were determined by Delphi method and precedence chart method, and the nursing service quality evaluation scale of hemodialysis center was established.ResultsThe established nursing service quality evaluation system for hemodialysis center was consisted of 7 items of first-level, 15 items of second-level, and 38 items of third-level. The effective recovery rate of expert letters was 93.75%, and the expert authority coefficient was 0.914. The Kendall coordination coefficients for the three levels of indicators were 0.570, 0.583, and 0.496 (P<0.01), and the variation coefficients for each level of indicators were between 0.000 and 0.179. Among the first-level indicators, the largest weight was security, and the smallest weight was effectiveness.ConclusionsThe evaluation system of nursing service quality for hemodialysis centers is scientific, reliable, and feasible. In view of the particularity of nursing service in hemodialysis centers, clear evaluation criteria are put forward, which can evaluate the service quality more comprehensively, scientifically, objectively, and directly, and improve and enhance the service level of hemodialysis centers according to the evaluation system.
Objective To explore the application effect of " dual-channel teaching” of the rain classroom platform in airway obstruction teaching. Methods A total of 228 nursing undergraduate students in Grade 2015 were selected as the research subjects by the method of cluster random sampling. Class B (n=115) was randomly selected as the control group and Class A (n=113) was selected as the experimental group. Class B adopted the traditional practical teaching mode, and Class A was integrated with the rain classroom platform on this basis. After the end of the course, the learning situation of the experimental group students were understood through the rain classroom background data, the teaching effects of the two groups were evaluated by the students’ theoretical scores and applied case test scores, and the experimental group student’s evaluation of the rain class was understood by questionnaire survey. Results There were 105 nursing students (92.92%) completing pre-school preparation tasks, 103 (91.15%) participating in the class answering, and 113 (100.00%) completing the after-school exercises. The theoretical scores and applied case assessment scores of the experimental group students were 79.44±6.25 and 83.24±3.64, respectively, and those of the control group students were 68.50±7.96 and 70.59±5.51, respectively, the differences between the two groups were statistically significant (P<0.05). In the experimental group, 92 nursing students (81.42%) liked the rain classroom platform teaching. Conclusion The rain classroom platform teaching can bring about the ecological transformation of the open speech in classroom, and comprehensively improve the overall quality and comprehensive ability of students, which is worthy of promotion and application in teaching.
Objective To investigate the prognostic value of troponin I ( cTNI) , brain natriuretic peptide ( BNP) and D-dimer in acute pulmonary embolism ( APE) .Methods The plasma levels of cTNI, BNP, and D-dimer were measured in 98 consecutive patients with APE at the time of admission. The relationship between these parameters and mortality were evaluated. Results APE was diagnosed in 98 consecutive patients during January 2009 to December 2010, in which 49 were males and 49 were females. 14 ( 14. 3% ) patients died at the end of follow-up. The patients with positive cTNI tests had more rapid heart rates, higher rate of syncope, cardiogenic shock and mortality than the patients with normal serumcTNI. However the age and blood pressure were lower in the patients with abnormal serum cTNI ( P lt; 0. 05) . A receiver-operating characteristic curve analysis identified BNP≥226. 5 ng/L was the best cut-off value ( AUC 0. 829, 95% CI 0. 715-0. 942) with the negative predictive value of 97. 1% for death. The mortality of the patients whose serum D-dimer level ranging from 500 to 2499 ng/mL, 2500 to 4999 ng/mL, and ≥5000 ng/mL was 7. 8% , 12% , and 41. 2% , respectively ( P = 0. 009) . Upon multivariate analysis, cardiogenic shock ( OR=2. 931, 95% CI 0. 828-12. 521, P =0.000) , cTNI≥0. 3 ng/mL ( OR=1. 441, 95% CI 0. 712-4. 098, P = 0. 0043) , BNP gt; 226. 5 ng/L ( OR = 1. 750, 95% CI 0. 690-6. 452, P = 0. 011) and D-dimer≥5000 ng/mL( OR = 1. 275, 95% CI 0. 762-2. 801, P = 0. 034) were independent predictors of death. Conclusions Combined monitoring of cTNI, BNP or D-dimer levels is helpful for prognosis prediction and treatment decision for APE patients.