1.Effect of risk management on junior nurses in operation room
Dan WU ; Qiulian SHI ; Yaoqin LI ; Zhenyu LIU ; Shunhua DENG
Modern Clinical Nursing 2014;(12):38-40
ObjectiveTo explore the role of risk management in reducing the nursing risk of junior nurses in operation room. Method The risk management was implemented among junior nurses in operation room including establishing training groups for risk management,establishing instructor system,classifying nursing risk events and formulating operation room nursing risk monitoring. Result After risk management,the rate of risk events in the junior nurses was lowered as compared to pre-enforcement of the risk management(P<0.001).Conclusions The risk management can improve the risk awareness of junior nurses in operation room and reduce the incidence of nursing risk events.
2.Investigation of posttraumatic stress disorders after accidents in Pearl River Delta *
Lei SHI ; Kexiong ZHOU ; Fangmei YANG ; Xishun ZHANG ; Liguang CHEN ; Qiu GUO ; Qiulian CHEN ; Shu XING ; Yi SONG
Chongqing Medicine 2013;(21):2511-2513
Objective To investigate the incidence and related risk factors of post-traumatic stress disorders (PTSD) after acci-dents in the Pearl River Delta .Methods Inpatients after accidents from April 2009 to February 2010 in seven hospitals of the Pearl River Delta cities ,such as Guangzhou ,Shenzhen and Zhuhai ,were surveyed with PTSD Checklist-Civilian Version (PCL-C) and self-made questionnaire .Results In a total of 554 post traumatic patients ,a prevalence of 28 .5% of PTSD symptoms were found in this region with 7 .8% (marks≥50) of severe degree and 20 .8% (marks :38-49) of mild to moderate degree .In the severe PTSD symptoms group ,the top three items were getting nervous and upset once faced similar situation ,difficulty sleeping or easy to be a-wake ,and the trauma experience caused recurring disturbing memory ,ideas or image .Multivariate analysis showed that female ,una-ble self-care ,incapable of working ,lack help from friends ,multiple injury ,and injury time longer were all associated with the PTSD symptom incidence .Conclusion The prevalence of PTSD symptoms is relatively high in injured patients after accidents in the Pearl River Delta .Early identification and intervention of PTSD symptoms in post-traumatic patients are important for the prevention of PTSD .
3.The influence of duration of intra-abdominal hypertension on the prognosis of critically ill patients
Jianshe SHI ; Jialong ZHENG ; Jiahai CHEN ; Yeqing AI ; Huifang LIU ; Bingquan GUO ; Zhiqiang PAN ; Qiulian CHEN ; Mingzhi CHEN ; Yong YE ; Rongkai LIN ; Chenghua ZHANG ; Yijie CHEN
Chinese Journal of Emergency Medicine 2022;31(4):544-550
Background:In the clinical setting, the effect of intra-abdominal hypertension on the human body is dependent on time, but its role is not yet clear.Objective:To investigate the effect of the duration of intra-abdominal hypertension (IAH) on the prognosis of critically ill patients.Methods:This prospective cohort study enrolled 256 IAH patients who were admitted to the Surgical ICU of 10 Grade A hospitals in Fujian Province from January 2018 to December 2020. The duration of IAH (DIAH) was obtained after monitoring IAP, and ICU length of stay, duration of mechanical ventilation, duration of continuous renal replacement therapy (CRRT) and average daily energy intake from enteral nutrition during ICU stay were observed and recorded. The correlation was analyzed by Spearman rank correlation. The patients were divided into the survival group and the death group according to their survival state at 60 days after enrollment. Thereafter, clinical characteristics between the two groups were compared. Multivariable logistic regression was used to study and validate the relationship between DIAH and 60-day mortality. The receiver operating characteristics (ROC) curve was established to evaluate the predictive abilities of DIAH on the mortality risk.Results:In critically ill patients, DIAH was positively correlated with duration of mechanical ventilation ( r=0.679, P<0.001), duration of CRRT ( r=0.541, P<0.001) and ICU length of stay ( r=0.794, P<0.001), respectively. In addition, there was a negative correlation between DIAH and average daily energy intake from enteral nutrition ( r=-0.669, P<0.001). After multivariable adjustment, DIAH was an independent risk factor for 60-day mortality in critically patients with IAH ( OR=1.05, 95% CI: 1.01-1.12; P = 0.012), and exhibited a linearity change trend relationship with mortality risk. The ROC curve analysis of DIAH showed that the area under ROC curve (AUC) was 0.825 (95% CI: 0.763~0.886, P<0.01). When the cut-off value was 16.5 days, the sensitivity was 78.4% and the specificity was 75.4%. Conclusions:DIAH is an important risk factor for prognosis in critically ill patients. Early identification and rapid intervention for the etiology of IAH should be performed to shorten DIAH.