1.Research progress on ICU delirium assessment instrument at home and abroad
Lingyu DAI ; Hongle ZHAO ; Meng LYU ; Yanmei SHI ; Shuxiang ZHANG
Chinese Journal of Modern Nursing 2019;25(13):1713-1716
Delirium is an acute cognitive impairment syndrome. The incidence of delirium in intensive care unit (ICU) is higher than that in general wards which is an independent risk factor of clinical outcomes of ICU patients. At present, there is no unified standards in assessment instrument for ICU delirium in China which has influences on early diagnosis and assessment by medical staff and makes the incidence of ICU delirium high. This paper reviewed the research progress of assessment instrument for ICU delirium at home and abroad so as to provide a basis for assessment of ICU patients with delirium in China.
2.Effect of early enteral nutrition support on nutritional status and infection complications in patients with severe craniocerebral injury: a Meta-analysis
Yanmei SHI ; Quancheng ZHANG ; Hongle ZHAO ; Meng LYU ; Lingyu DAI ; Shuxiang ZHANG
Chinese Journal of Modern Nursing 2019;25(29):3765-3770
Objective? To evaluate the impacts of early enteral nutrition (EEN) support and delayed enteral nutrition(DEN) support in the nutritional status and infection complications in patients with severe traumatic brain injury. Methods? The articles of randomized controlled trials about EEN support and DEN support on the nutritional status and infection complications in patients with severe traumatic brain injury were searched in CBMdisc, CNKI, Wanfang Data, VIP, Cochrane Library, Web of Science, PubMed, EMbase from 1990 to 2017. The quality evaluation method in Cochrane-Handbook5.0 handbook was adopted to evaluate the quality of articles and test the heterogeneity of the included articles. Fixed-effect model or random-effect model were used to merge the effects. Results? A total of 10 randomized controlled trials were included. Meta-analysis results proved that, compared with DEN support, EEN support can increase the level of serum total protein, albumin and peripheral lymphocyte count (Z=10.20, 4.23, 5.24;P<0.01) and reduce the incidence of pulmonary infection and craniocerebral infection in patients with craniocerebral injury (Z=4.12, 2.15; P<0.05), but it has no effect on the incidence of upper gastrointestinal hemorrhage in patients with craniocerebral injury (Z=0.82, P=0.41). Conclusions? Compared with DEN support (within 48 hours of admission), EEN support (48 hours after admission) can effectively improve serum total protein and albumin, improve nutritional status, increase peripheral lymphocyte count, increase patient resistance and reduce the occurrence of cranial infection and pulmonary infection. Therefore, patients with severe craniocerebral injury should receive EEN support if there is no contraindication.
3.Construction of structured education course for patients with neurogenic bladder during rehabilitation period
Heli ZHANG ; Xianjing HU ; Hongle DAI ; Shuyu HAN ; Yongmei LUO ; Rongmei GENG ; Baohua LI
Chinese Journal of Modern Nursing 2024;30(25):3416-3423
Objective:To construct a structured education course for patients with neurogenic bladder during the rehabilitation period.Methods:This study consisted three stages of current situation survey, literature search, and expert consultation. From February 2022 to February 2023, a current survey was conducted on the self-management needs of 62 patients with neurogenic bladder. In April 2023, a literature search was conducted to summarize the best evidence on nursing and management of neurogenic bladder, and form the initial version of course indicators and content. From April to May 2023, 14 experts were selected for consultation, and the Delphi method was used to demonstrate the course indicators and content, and to construct the final draft of the course.Results:A total of 62 patients with neurogenic bladder were included, they have requirements for water management, bladder function training, and dietary requirements, etc. A total of 2 053 articles were retrieved, and 14 articles were ultimately included, including eight guidelines, four evidence summaries, one expert consensus, and one systematic review. The expert authority coefficients for the two rounds of expert consultation were 0.93 and 0.92, respectively. The Kendall coordination coefficient of various indicators in the second round of expert consultation was 0.227 to 0.288 ( P<0.01). After two rounds of expert consultation, a structured education course for patients with neurogenic bladder during the rehabilitation period was finally developed, including six primary indicators, 21 secondary indicators, and 30 tertiary indicators. Conclusions:The structured education course for patients with neurogenic bladder during the rehabilitation period, based on current situation survey, high-quality evidence, and expert consultation, is comprehensive in content and reasonably designed, which can provide supportive assistance for future nursing health education and management for patients with neurogenic bladder.