Objective To explore the therapeutic effect of dermlin and the combination of dermlin and pressure dressing in elderly patients with pressure ulcer.Methods From January 2011 to August 2016, a total of 120 hospitalized elderly patients with pressure ulcers in First Affiliated Hospital of PLA General Hosptial were chosen as research objects. Patients with blister diameter less than 5 mm were defined as small blister group, and patients with blister diameter equal to or more than 5 mm were defined as big blister group. Each group containing 60 patients was divided into the observation group and the control group. In the small blister group, there were 30 cases in the control group with 41 blisters and 30 cases in the observation group with 37 blisters. Blisters in small blister groups were not pumped, of which the control group was treated by iodine while the observation group was treated by dermlin. In the big blister group, there were 30 cases in the control group with 42 blisters and 30 cases in the observation group with 41 blisters. Blisters in big blister groups were pumped, of which the control group was firstly treated by iodine and then applied with pressure dressing, while the observation group was firstly treated by dermlin and then applied with pressure dressing. The evaluation standard of therapeutic effect contained recovery, efficiency, improvement and non-effect. All the groups' healing situations were observed and recorded within 7 days.Results In the small blister group, the effective rates were 100.0% in the observation group and 97.6% in the control group. The therapeutic effects in the observation group were statistically significant better than the control group (Z=-2.347,P=0.019). The therapeutic time in the observation group was significantly shorter than the control group (P<0.01). In the big blister group, the effective rates were 97.5% in the observation group and 92.9% in the control group. The therapeutic effects in the observation group were statistically significant better than the control group (Z=-3.495,P<0.001). The therapeutic time in the observation group was significantly shorter than the control group (P<0.01).Conclusions Both dermlin and the combination of dermlin and pressure dressing could significantly enhance the healing of elderly patients' pressure ulcers and reduce the healing time.

Objective To investigate the application effects of tannic acid ointment on the prevention of incontinence dermatitis among elderly bedridden patients. Methods Eighty elderly bedridden patients with fecal incontinence and intact skin, were randomly divided into observation group and control group. The patients of control group received the routine nursing method while the patients of observation group were prophylactically treated by smearing tannic acid ointment on the basis of routine nursing. The number and time of the cases occurring incontinence-associated dermatitis in both two groups were observed. Results Eight cases of incontinence dermatitis in the observation group occurred while thirty cases occurred in the control group ( P<0. 01). The incontinence dermatitis occurred later in the observation group compared with control group (P<0. 01). Conclusions The tannic acid ointment can not only significantly reduce the incidence of incontinence dermatitis but also can delay the occurrence time of incontinence dermatitis among the bedridden patients with fecal incontinence.

Objective To explore the effect of refined communication in the improvement of health education for elderly hospitalized patients.Methods A total of 465 hospitalized patients from January to June in 2015 were assigned to the control group and 485 of hospitalized patients from July to December in 2015 were assigned to the observation group. Patients in control group received the routine nursing method; for the observation group, besides the routine nursing method, refined communication group was established, and refined communication measures were worked out, as well as the communication expressions, they were implemented and carried out in every clinical link and operation. Then, mastery degree of health education ( including hospital guidance, the guidance for taking drugs and diet and guidance of examination) in two groups was evaluated 7 days after being admitted to the hospital, as well as the patient satisfaction ( including ward management, service attitude and nursing process) before hospital discharge. Results The mastery scores of healthy education for the observation group were (15.10±3.32), (47.71±8.30) and (14.49±3.62), while the scores in the control group were (13.25±3.30),(40.97±7.30) and (12.36±3.35)(P<0.01). As for the patient satisfaction when patients leaving hospital, the scores of the observation group were (14.93±3.20),(14.91± 3.75) and (56. 92±1.99), while that of the control group were (12.74±3.48),(12.08±3.96) and (43.54± 9.07) . These two groups showed significant difference ( P<0. 01 ) . Conclusions Refined communication standardizes the nursing behavior of nurses, enhances the hospitalized patients′ mastery degree of healthy education and patient satisfaction, improves the subjectivity of nurses and promotes the harmony of the relationship between patients and doctors.

Objective To investigate the effect of quality circle control ( QCC ) management in the prevention of accidental prolapse of gastric tube in patients with cerebral -vascular disease .Methods First, we set up the quality control circle , identified the theme , analyzed the current situation and drew the Pareto diagram and fishbone diagram to find out the three main causes .Then we set up the goals and developed strategies .At last we confirmed and standardized the results , modified and formulated the tube management system . Results After applying the QCC management , the extubation rate significantly reduced from 27.5%(55/200) to 5.0%(10/200) (χ2 =27.05,P<0.01), with an achievement rate of 115%and progress rate of 81%.The responsibility, self-confidence, initiative, problem solving ability, team cohesion, communicate and coordinated ability, happiness and quality control means had improved after the application of QCC management . Conclusions The application of QCC management can effectively solve the accidental prolapse of gastric tube in patients with cerebral-vascular disease and improve the nursing quality and the comprehensive quality , and increase the cohesion of the department .

Objective:To investigate the effect of comprehensive nursing management measures on reducing unplanned extubation of gastric tube in patients with Alzheimer's disease.Methods:By convenience sampling method, 102 elderly patients with Alzheimer's disease indwelling gastric tube diagnosed in the Fourth Department of Health Care of the Second Medical Center of PLA General Hospital from August 2016 to August 2018 were selected as the observation group, and 118 elderly patients with Alzheimer's disease indwelling gastric tube from July 2014 to July 2016 were selected as the control group. Caregivers of the patients in both groups of were included, 102 in the observation group and 118 in the control group.The control group received routine nursing, fixed the gastric tube with ordinary adhesive tape, and restrained with ordinary wrist restraint belt.The observation group was treated with comprehensive nursing intervention. 3M elastic tape was used to fix the gastric tube, and hand table tennis racket type restraint was used; Use the gastric tube inspection signature form to urge nurses to inspect and sign; Health education document of standard indwelling gastric tube was established; Strengthen the training of nurses and improve their comprehensive ability. The unplanned extubation rate and gastric tube management satisfaction of the two groups were compared.Results:There were 15 cases of unplanned extubation in the control group and 4 cases in the observation group. The difference between the two groups was statistically significant (χ 2=4.301, P=0.038) . There was no statistically significant difference in satisfaction with indwelling process between the two groups ( P>0.05) . The scores of fixed restraint method and management process in the observation group were higher than those in the control group ( P<0.05) . The difference was statistically significant ( P<0.05) . Conclusions:Through improving the methods of fixation and restraint and improving the comprehensive nursing ability, the application of comprehensive nursing intervention can effectively prevent unplanned extubation of patients with Alzheimer's disease indwelling gastric tube, reduce the incidence of unplanned extubation, and improve the satisfaction of caregivers to the management of patients with Alzheimer's disease indwelling gastric tube.

Objective:To understand the incidence of mild cognitive impairment (MCI) of elderly patients with subjective memory impairment and analyze its influencing factors.Methods:A total of 322 patients with subjective memory impairment in elderly frail cognitive management clinic in General Hospital of Chinese PLA were selected by the convenient sampling method. According to the 2018 Diagnostic Criteria for Diagnosis and Treatment of Dementia and Cognitive Impairment in China, the subjects were divided into the MCI group and the non-MCI group. Demographic data, physiological factors, psychological factors, lifestyle and nutritional status of patients were collected using self-designed questionnaires. The Barthel Index Rating Scale was used to assess activity of daily living, 9-item Patient Health Questionnaire (PHQ-9) was used to assess depression and Generalized Anxiety Disorder Questionnaire (GAD-7) was used to to assess anxiety. The Pittsburgh Sleep Quality Index was used to assess sleep disturbances and Mini Nutritional Assessment Short Form (MNA-SF) was used to assess nutritional status. Univariate analysis and multivariate binary logistic regression analysis were used to explore the influencing factors of MCI in patients. Results:Among the 322 elderly patients with subjective memory impairment, 173 (53.73%) had MCI and 149 (46.27%) were non-MCI patients. Binomial Logistic regression analysis showed that reading habits, housework, social interaction, anxiety, age, depression, and sleep disturbance were the influencing factors of MCI in the elderly with subjective memory impairment ( P<0.05) . Conclusions:The incidence of MCI in elderly patients with subjective memory impairment is relatively high. The cognitive management clinic should comprehensively evaluate and analyze the influencing factors of such patients and assist patients to establish a healthy lifestyle according to their personal conditions, so as to improve their cognitive status.