ObjectiveTo investigate the best time interval for replacement of urine collection bags for patients with indwelling catheter. Methods90 patients in brain surgery department with indwelling catheter were randomly divided into group A,B,C,group A replaced urine collection bags every 3 days,group B replaced urine collection bags every 7 days,group C replaced urine collection bags every 14 days.Urine samples were gathered in three groups of patients for bacterial culture on the admission day,the 5th,the 8th,the 11th and the 14th day respectively,and the positive rates of bacterial culture were compared.ResultsThe positive rates of urinary bacterial culture in three groups were not significantly different by statistical analysis. ConclusionsReplacement time of urine collection bags for patients with indwelling catheter may be extended to 14 days,and may be synchronization with the replacement time of urine catheters.This can reduce bacterial ascending infection,decrease nosocomial infection rate,save health care costs,reduce the labor intensity of the nursing staff,improve the social and economic benefits.

Objective:To explore the application of 4C teaching combined with case simulation teaching in the practice teaching of respiratory and critical care medicine nursing students.Methods:Eighty nursing practice students from 2019 to 2021 in the Department of Respiratory and Critical Care Medicine of Beijing Chaoyang Hospital Affiliated to Capital Medical University were selected as the research objects, and they were randomized into control group ( n=40) and observation group ( n=40). The control group adopted traditional teaching, and the observation group adopted 4C teaching combined with case simulation teaching. The nursing comprehensive ability and self-directed learning ability of the two groups of nursing students were compared, and the evaluation of teaching methods between the two groups was assessed. SPSS 22.0 was used for Chi-square test and t-test. Results:The scores of theoretical knowledge, ward management, prevention and control of hospital infection, basic nursing, standardized writing of nursing documents, and critical care of nursing students in the observation group were higher than those in the control group ( P<0.05); the scores and total scores of learning awareness, learning behavior, learning strategies, interpersonal relationships, and learning evaluation in the observation group were higher than those in the control group ( P<0.05). The observation group believed that their teaching method was better than the control group in terms of mobilizing learning initiative, improving basic nursing practices, promoting clinical communication skills, improving the ability to analyze and solve problems, enhancing the concept of humanistic care, helping to understand and master knowledge, and improving the overall quality ( P<0.05). Conclusion:The 4C teaching combined with case simulation teaching can improve the comprehensive nursing ability and self-directed learning ability of nursing students in department of respiratory and critical care medicine, and the nursing students have a high opinion of the teaching method.

Objective:To explore the medical costs and influencing factors of patients diagnosed with Brucellosis in Datong of Shanxi province.Methods:Information on demographics, medical visits, and costs of patients diagnosed with Brucellosis between January 1, 2017, and December 31, 2019, were collected. Health care utilization and medical costs were analyzed from different genders, age groups, underlying diseases, clinical stages, and comorbidities.Results:A total of 2 289 patients (1 715 outpatient and 574 inpatient cases) were included in the analysis. 72.0% (1 649/2 289) were male, with an average age of (49.6±15.5) years; age between 45-59 years was the dominant group (36.2%,829/2 289). The mean age of inpatients (51.4±16.0) was higher than that of outpatients (49.0±15.2)( Z=-4.01, P<0.001). The average number of outpatient visits per outpatient was (1.6±1.5) times. The duration of hospitalization was (14.6±9.9) and (20.8±11.4) days for patients with central nervous system complications and (16.6±9.5) days for vascular system complications. Of the inpatients, 51.0% (293/574) had underlying diseases, and 30.3% (174/574) had endocrine and metabolic diseases. 54.0% (310/574) of inpatients were diagnosed with acute Brucellosis, and 46.0% (264/574) were diagnosed with chronic Brucellosis. A total of 64.3% (369/574) of inpatients had complications, 30.3% (174/574) of digestive system complications, followed by skeletal system complications (29.1%, 167/574). Among outpatients, age significantly affected medical costs ( P<0.001). For inpatients, age and complications and treatment effect were influential factors ( P<0.05). Patients with the combined skeletal system and central nervous system complications had significantly higher medical costs ( P<0.001). Conclusions:The medical costs for outpatient cases of Brucellosis were moderate. However, the economic burden was higher for inpatients, especially those with skeletal and neurological complications. Early detection, diagnosis, and treatment of cases were essential to avoid chronic Brucellosis and its complications and reduce medical costs.