Objective To explore the preventive effect of early bowel intervention on the gastrointestinal dysfunction in patients with invasive mechanical ventilation.Methods Sixty patients with invasive mechanical ventilation were equally randomly divided into the observation group and the control group.patlents in the control group were treated by conventional nursing care,while Patients in the observation group were given the early bowel intervention including abdominal massage and stimulation of rectum.The two groups were compared in terms of gastrointestinal dysfunction.Result The rate of gastrointestinal dysfunction in the observation group was significantly lower than that of the control group(P<0.05).Conclusion The early bowel intervention may effectively promote intestinal peristalsis,protect the intestinal digestion, absorption of nutrients and mucosal barrier function and prevent gastrointestinal dysfunction in patients with invasive mechanical ventilation during enteral nutrition.

Objective To explore the effect of early systematic intestinal stimulation on patients with mechanical ventilation .Methods Ninety-four patients with mechanical ventilation were chosen and divided into the control group and the observation group according to the random number table , each with 47 cases.The control group received the routine nursing , and the observation group received the early systematic intestinal stimulation.The score of APACHEⅡscale, the days of mechanical ventilation , the incidence rate of multiple organ dysfunction syndrome ( MODS ) , the days of hospitalization in ICU and the mortality were compared between two groups .Results No difference was found in the score of APACHEⅡ scale before the intervention between two groups (P>0.05).The score of APACHEⅡscale was (14.60 ±7.95) in the observation group after the intervention, and was lower than (18.38 ±8.24) in the control group and (19.57 ±2.64) before the intervention, and the differences were statistically significant (t=-2.268,-4.841, respectively;P<0.05). The scores of APACHEⅡ scale were respectively (19.47 ±2.28), (15.34 ±1.63) in the control group exclude the death cases before and after the intervention , and the difference was statistically significant ( t=-13.077,P<0.01).The days of mechanical ventilation was (7.66 ±6.89) d in the observation group, and was lower than (11.96 ±8.19) d in the control group, and the difference was statistically significant (t =-2.753,P<0.01).No differences were found in the incidence rate of MODS , the days of hospitalization in ICU and the mortality between two groups (P >0.05).Conclusions The preventive implement of early systematic intestinal stimulation on patients with mechanical ventilation can improve the condition of patients , and shorten the duration of mechanical ventilation .

Objective To discuss the effect of the complete nursing order and guidelines on improving the nursing quality in ICU .Methods The nursing quality , patients ’ satisfaction and the hierarchical training examination scores before and after using the improved nursing order guidelines were compared , from 2012 to 2013 .Totals of 177 patients in 2012 were treated with conventional nursing order system , and 183 patients in 2013 were treated with the improved nursing order guidelines .Results In 2012, totals of 177 patients with 3 566 times nursing observation were included , and 183 patients, with 3 634 times nursing observation were included in 2013.In 2013, oral care failure rate was 0.28%, which was significantly lower than 1.18% in 2012, with a significant difference(χ2 =20.45, P=0.00).In 2013, the bed elevation unqualified rate was 0.33%, which was significantly lower than 1.54% in 2012, with a significant difference (χ2 =28.69,P=0.00).In 2013, the artificial airway ballonet pressure implementation rate was 99.56%,which was significantly higher than 98. 65%in 2012, with a significant difference (χ2 =16.76,P=0.00).In 2013, the patients’ satisfaction scores was (98.08 ±0.67), which was significantly higher than (94.58 ±2.47) in 2012, with a significant difference (t=4.91,P =0.00).The nurse training assessment scores was (89.33 ±9.64) in 2013, which was significantly higher than ( 82.17 ±4.04 ), with a significant difference ( t =2.62, P =0.02 ). Conclusions Nursing order guidelines applied in ICU bedside can promote the improvement of the nursing quality, ensure the safety of nursing care , and let patients receive continuous and homogeneous care .Improved nursing order guidelines not only effectively improve the whole nursing level of ICU , but also provide diversified platform for nurse training at all levels .