1.Risk assessment and management of quality control of tracheal intubation in patients with unplanned extubation
Jin ZHOU ; Jiezhen LIU ; Jieyi ZENG ; Fei FENG ; Cuiping CHEN ; Ying YU
Modern Clinical Nursing 2017;16(3):64-67
Objective To explore the effect of risk assessment tracking management in reducing unplanned extubation in patients with tracheal intubation.Methods From January to December 2015,120 patients with tracheal intubation in ICU were selected as the control group with routine nursing care of indwelling endotracheal intubation.From January to November 2016,120 patients with tracheal intubation were selected as the observation group,where the risk assessment and risk management were done on the basis of routine nursing as in the control group.The two groups were compared in terms of tracheal intubation and unplanned extubation related knowledge,the implementation of the risk assessment,the accuracy in risk assessment and the incidence of unplanned extubation.Result The tracheal intubation and unplanned extubation related knowledge in the observation group was lower than that of the control group (P<0.001),The implementation rate of the risk assessment and the accuracy in risk assessment in the observation group were significantly higher than the control group,and the rate of unplanned extubation in the observation group was significantly lower than in the control group (all P<0.01).Conclusion The implementation on risk assessment and extubation-preventing nursing quality tracing management can enhance the awareness and knowledge of preventing trachea cannula exodus,improve the quality of nursing and reduce the rate of unplanned extubation.
2.Effect of continuing nursing on rehabilitation of BPH patients after TURP
Cimei XIE ; Jiezhen LIU ; Xiaohong FENG ; Shengli MA ; Jianbo HU ; Hong YUAN
Modern Clinical Nursing 2017;16(3):15-19
Objective To explore the effect of continuing nursing on the rehabilitation of patients with benign prostatic hyperplasia (BPH) after transurethral resection of prostate (TURP).Methods Toally 128 BPH patients after TURP in our hospital from May 2015 to May 2016 were evenly divided into control group and observation group by random digit table.The patients in the control group were normally guided at discharge and those in the observation group the continuing nursing was done by telephone,WeChat,QQ or family visits for 6 weeks after discharge besides normal guidance.The two groups were compared in terms of self-care ability,treatment compliance,complications and quality of life.Results After the intervention,the scores on health knowledge,self-care ability,self-care responsibility,self-care concept,self-care skills dimension of the observation group were significantly higher than those of the control group.The treatment compliance was significantly higher than that of the control group and the incidences of complications,including pain,hematuria,urinary intontinerce and retentron and infection,constipation were significantly lower than those of the control group.The scores on quality of life,physical function,role function,cognitive function,emotional function and social function score were significantly higher than those in the control group (all P<0.05).Conclusion The continuing nursing after surgical treatment of benign prostatic hyperplasia patients can be effective in the improvements of patient's self-care ability,establishment of healthy life behavior,reduction of complications,promotion of their rehabilitation and ultimately the improvement of their quality of life.
3.Therapeutic effects of high monounsaturated fatty acid and low carbohydrate formula on blood glucose levels and diarrhea in critically ill neurological patients
Xiaochang HUANG ; Rong LAI ; Qiuliang YANG ; Jiezhen FENG ; Yongjing SU ; Huiyu FENG ; Hongyan ZHOU
Chinese Critical Care Medicine 2024;36(9):980-984
Objective:To investigate the effects of using a high monounsaturated fatty acid (MUFA) and low carbohydrate formula on blood glucose levels and diarrhea treatment effects in critically ill neurological patients.Methods:A self-controlled before-and-after study design was employed, with 13 patients admitted to the neurology intensive care unit (ICU) of the First Affiliated Hospital of Sun Yat-sen University from November to December 2023, who were treated with a high MUFA and low carbohydrate formula [Glucerna enteral nutrition (EN) preparation]. Changes in blood glucose parameters within 7 days before and after the use of Glucerna EN preparation were analyzed, including standard deviation ( SD) of blood glucose, mean blood glucose (MG), median blood glucose, mean amplitude of glycemic excursions (MAGE), largest amplitude of glycemic excursions (LAGE), coefficient of variation ( CV) of blood glucose, the incidence of hyperglycemia (> 7.8 mmol/L) and severe hyperglycemia (> 13.9 mmol/L), and daily insulin dose. Changes in total protein (TP), albumin (ALB), hemoglobin (Hb), C-reactive protein (CRP), and white blood cell count (WBC) were observed before and after intervention. Improvement in diarrhea symptoms, Hart diarrhea score, Bristol Stool classification score, and incontinence dermatitis classification were also analyzed before and after the use of Glucerna EN preparation. Results:A total of 13 critically ill neurological patients were enrolled, among whom 9 patients had a history of hyperglycemia and 8 patients had diarrhea symptoms. After intervention with Glucerna, the patients' SD of blood glucose, MG, median blood glucose, MAGE, LAGE, CV of blood glucose, incidence of hyperglycemia, incidence of severe hyperglycemia, and daily insulin dose were all lower than those before the intervention [ SD of blood glucose (mmol/L): 1.83±1.11 vs. 2.10±1.13, MG (mmol/L): 8.87±2.03 vs. 9.75±1.37, median blood glucose (mmol/L): 9.12±1.67 vs. 10.17±0.48, MAGE (mmol/L): 0.66±0.31 vs. 0.78±0.32, LAGE (mmol/L): 4.95±3.64 vs. 5.58±3.10, CV of blood glucose: 16.00% (11.00%, 28.50%) vs. 18.00% (12.50%, 27.50%), hyperglycemia incidence: 47.31% vs. 74.66%, severe hyperglycemia incidence: 6.08% vs. 6.71%, daily insulin dose (U): 5.25 (0.00, 32.59) vs. 20.76 (0.00, 66.88)], with a significant decrease in daily insulin dose after the intervention ( P < 0.05); TP, ALB, Hb, CRP and WBC showed no significant changes before and after the intervention with Glucerna EN preparation. The improvement time of diarrhea symptoms after intervention was (3.50±1.41) days, and the Hart diarrhea score on the seventh day after intervention (4.88±3.48 vs. 10.00±3.38) and the Bristol Stool classification score on the third and seventh days after intervention (5.87±0.35, 5.50±0.53 vs. 6.50±0.53) were significantly lower than before the intervention (all P < 0.05). Before the intervention with Glucerna EN preparation, the classification of incontinence dermatitis was mainly classified as Grade 2 severity (71.43%); after the intervention, it significantly improved by the seventh day, with Grade 1 being the main classification (57.14%). Conclusion:The high MUFA and low carbohydrate formula has a positive effect on blood glucose control and diarrhea treatment in critically ill neurological patients.