Objective:To deeply study and explore the cognitive and barrier factors of clinical nurses' nutrition management in patients with pressure injury (PI), and provide evidence for developing quantifiable standardized management model and strengthening individualized nutrition management.Methods:A semi-structured in-depth interview was conducted with 11 nurses. The NVivo10.0 software and Colaizzi's 7-step analysis of phenomenological data were used to analyze interview data.Results:The study summarized four themes that hindered nutrition management: subjective judgment bias; education training lags behind and radiates one-sided; lack of policy and configuration; conflict between workload, roles and perceptions.Conclusions:There are many obstacles to the implementation of nutrition management in patients with PI. An objective, feasible and standardized nutrition management plan should be established, support should be provided by policy, configuration and information system, and relevant knowledge training and multi-team cooperation should be strengthened to improve patient life.

Objective To observe the application effect of nurses-dominated rehabilitation management mode in acute stroke patients.Methods A total of 86 patients with acute ischemic stroke (AIS) in the department of neurology were selected for the study and were randomly divided into observation group (n =43) and control group (n =43) according to the order of admission.All patients were given routine treatment and nursing,and the control group was given the routine rehabilitation training for self-choice after in a stable condition,and the observation group was followed by a multidisciplinary team consultation to carry out the early comprehensive rehabilitation training.The activities of daily living in the two groups,nerve function,nutrition risk condition were compared before intervention and at 14d after intervention,and the related complications within 1 month after intervention were analyzed between the two groups.Results At 7 d after intervention,the MBI score and nutritional adequacy rate of the observation group were significantly higher than intervention before and were significantly higher than that of the control group (P ＜ 0.05).The NIHSS score and nutritional risk rate of the observation group were significantly lower than intervention before and were significantly lower than that of the control group (P ＜ 0.05).At 14 d and 1 month after intervention,the MBI score and nutritional adequacy rate of the two groups were significantly higher than intervention before,and those in the observation group were significantly higher than that of the control group at the same time period (P ＜ 0.05).The NIHSS score and nutritional risk rate of the two groups were significantly lower than intervention before,and the observation group were lower than the control group at the same time period (P ＜0.05).The incidence rates of post-stroke depression,brain-induced spasm,swallowing dysfunction and shoulder-hand syndrome were significantly lower in the observation group than that in the control group within 1 month after intervention (P ＜ 0.05).Conclusion Nurses-dominated ASU rehabilitation management mode can effectively improve the rehabilitation effect of patients.

Objective To observe the application effect of nurses-dominated rehabilitation management mode in acute stroke patients.Methods A total of 86 patients with acute ischemic stroke (AIS) in the department of neurology were selected for the study and were randomly divided into observation group (n =43) and control group (n =43) according to the order of admission.All patients were given routine treatment and nursing,and the control group was given the routine rehabilitation training for self-choice after in a stable condition,and the observation group was followed by a multidisciplinary team consultation to carry out the early comprehensive rehabilitation training.The activities of daily living in the two groups,nerve function,nutrition risk condition were compared before intervention and at 14d after intervention,and the related complications within 1 month after intervention were analyzed between the two groups.Results At 7 d after intervention,the MBI score and nutritional adequacy rate of the observation group were significantly higher than intervention before and were significantly higher than that of the control group (P ＜ 0.05).The NIHSS score and nutritional risk rate of the observation group were significantly lower than intervention before and were significantly lower than that of the control group (P ＜ 0.05).At 14 d and 1 month after intervention,the MBI score and nutritional adequacy rate of the two groups were significantly higher than intervention before,and those in the observation group were significantly higher than that of the control group at the same time period (P ＜ 0.05).The NIHSS score and nutritional risk rate of the two groups were significantly lower than intervention before,and the observation group were lower than the control group at the same time period (P ＜0.05).The incidence rates of post-stroke depression,brain-induced spasm,swallowing dysfunction and shoulder-hand syndrome were significantly lower in the observation group than that in the control group within 1 month after intervention (P ＜ 0.05).Conclusion Nurses-dominated ASU rehabilitation management mode can effectively improve the rehabilitation effect of patients.

Objective:To explore the Application value of hospital-community-family integrated service in nursing management of children with bronchial asthma.Methods:From December 2018 to February 2019 in Haikou Hospital Affiliated to Xiangya Medical College of Central South University, 90 children with asthma were selected and divided into control group (45 cases) and observation group (45 cases) according to random digital table method. The patients in the control group received routine hospitalization diagnosis and health education, while the patients in the observation group received integrated management services of family type medical care. Six months after the intervention, the clinical efficacy, the number of acute attacks, psychological state, quality of life, length of stay and cost of the two groups were compared.Results:The total effective rate of the observation group (95.56%, 43/45) was significantly higher than that of the control group (82.22%, 37/45), the difference was statistically significant ( χ2 value was 4.050, P<0.05). The times of acute attack, the times of readmission, the time of hospitalization and the expenses of the children in the observation group were (7.36±2.19) times, (4.22±1.78) times, (13.89±4.32) d, (3 023.83±219.76) yuan respectively, which were significantly lower than those in the control group (12.03±3.98) times, (7.03±2.43) times, (21.73±5.32) d, (5 032.33±324.23) yuan, and the difference was statistically significant ( t values were 6.258-34.381, P<0.01). The scores of Self-rating Anxiety Scale (31.23±4.84) and Self-rating Depression Scale (37.62±2.61) in the observation group were significantly lower than those in the control group (36.11±2.72, (43.27 ± 2.94), the difference was statistically significant( t values were 5.896, 9.641, P < 0.01). The scores of symptom (6.50±1.63), emotion and activity(6.33±1.02), quality of life (6.54±0.98) in the observation group were significantly higher than those in the control group (5.77±1.55, 5.45±0.98, 5.78±0.67), the differences were statistically significant ( t values were - 2.177, - 4.173, - 4.295, P < 0.05 or 0.01). Conclusions:The application of hospital-community-family integrated care service in the nursing management of children with bronchial diseases can effectively improve the clinical therapeutic effect, reduce the number of acute episodes and hospitalization time, improve the psychological status and quality of life of children, which is worthy of wide clinical promotion.

Objective To investigate and analyze the prevalence of pressure ulcer and other skin injuries, and the implementation of pressure ulcer prevention measures among inpatients in Class ⅢGrade A hospitals in Hainan province. To provide basis for fomulating bundle of care model to prevent and intervent pressure ulcer, and establishing early warning management model on nosocomial pressure ulcer in ClassⅢGrade A hospitals in Hainan province. Methods A cross-sectional survey was conducted on inpatients from 7 ClassⅢGrade A hospitals in Hainan province. A investigation was performed by a self-designed inpatients'questionnaire and qualified tools on pressure ulcer and other skin injuries. Statistical analysis of data using by SPSS19.0 software. Results The content validity index of the self-designed inpatients'questionnaire and qualified tools on pressure ulcer and other skin injuries was 0.91, Cronbach α coefficient was 0.93. The prevalence of pressure sores was 2.28% (165/7 248), of which 66.06% (109/ 165) was family involvement, 30.30% (50/165) was hospital acquired, 3.03% (5/165) was community involvement,and 0.61% (1/165) was both from family and hospital acquired. Medical instrument related pressure ulcer accounted for 18.18%(30/165) of the total number of pressure ulcer. The most common site of pressure ulcer was the sacrococcygeal region, accounting for 47.94% (93/194). The proportion of pressure ulcer in stageⅡwas the highest (35.57% , 69/194). 52.01% (647/1 244) of patients at risk of pressure ulcer did not use the anti-pressure devices,and 81.40% (1 013/1 244) of patients' main compression sites were not covered by dressings.35.50%(442/1 244) of patients did not according to plans or regularly turn over, only 56.19% (699/1 244) patients turned over every 2 hours. 61.57% (442/1 244) patients who have pressure ulcer did not have anti-pressure ulcer signs. Among other skin injuries: the prevalence of incontinence related dermatitis was 0.88%(64/7 248), and the prevalence of avulsion skin injury was 0.37%(27/7 248). Conclusions The incidence of acquired pressure ulcer in ClassⅢGrade A hospitals in our province is slightly higher than other domestic investigation results. The reasons may be that anti-pressure devices in hospital configuration are not enough, lack of the tailored bundle of prevention measures of pressure ulcer, and failure to establish an effective early warning management model on pressure ulcer etc. So prevention and treatment of pressure ulcer should have a further standard management. Instrument related pressure ulcer and incontinence related dermatitis should also attract the attention of clinical nurses and managers.