Objective To assess and compare the predicted abilities of PRE- DELIRIC and E-PRE-DELIRIC two delirium prediction models in ICU patients. Methods From January 2017 to April 2017, 265 critically ill patients who met the inclusion criteria were included in this study. The clinical data of all the included patients, respectively calculated the scores with both PRE-DELIRIC and E-PRE-DELIRIC rating software were collected. Forecasting performance of two different models of discrimination and calibration were assessed. 2 medical staff assessed 20 patients with the Chinese version PRE-DELIRIC and E-PRE-DELIRIC,while the intraclass correlation coefficients were accumulated to evaluate the inter-rater reliability. Results The average scores of PRE-DELIRIC were46.41 ± 14.05in delirium group and20.08 ± 9.96 in patients without delirium, the difference between scores was statistically significant (t=14.34, P<0.05). The average scores of E-PRE-DELIRIC were36.23±13.34in delirium group and14.45±9.56 in patients without delirium, the difference between scores was statistically significant (t=14.59, P<0.05). The AUROCC and its 95％CI of the PRE-DELIRIC and E-PRE-DELIRIC for prediction of delirium were 0.928(0.891-0.965) and 0.904(0.861-0.947) respectively in all patients. Discrimination was generally good for two models. The PRE-DELIRIC and E-PRE-DELIRIC sensitivity were 0.841, 0.812, specificity was 0.939, 0.913, the threshold values of PRE-DELIRIC model was 36.5％and E-PRE-DELIRIC model was 30.5％. The Youden′s index of PRE–DELIRIC model was 0.779, which better than 0.725 of E-PRE-PREDIRIC model. Conclusions The PRE-DELIRIC and E-PRE-DELIRIC models both have high accuracy in predicting delirium of patients in intensive care unit. PRE-DELIRIC does better performance than E-PRE-DELIRIC, but has imitation in terms of time. E-PRE-DELIRIC model can be used in ICU patients who develop delirium within 24 h following admission.

Objective:To explore the clinicaleffect of radial arterial puncture cannulationunder ultrasonic guidance in patients with critical diseases.Methods:From December 2016 to May 2017,120 patients under critical conditions in Department of Intensive Care Unit,Xiangya Hospital,Central South University,who received arterial cannulation,were randomly divided into 2 groups:a control group (traditional blind puncture method) and an observation group (ultrasound-guided radial arterial cannulation) (60 cases in each group).The success ratio of radial arterial puncture cannulation by one time,total success ratio of radial arterial puncture cannulation,numbers of puncture,the rate of complications and the time of consumption were compared between the 2 groups.Results:There was no statistically significant difference in the total success ratio of radial arterial puncture cannulationin the 2 groups (P＞0.05).The success ratio radial arterial puncture cannulation by one time was significantly greater in the observation group than that in the control group (P＜0.05);the numbers of puncture,the rate of complications and the time of consumption in the observation group were lower than those in the control group,with statistically significant (all P＜0.05).Conclusion:The application of ultrasound-guided radial arterial puncturecannulation can improve the success ratio of radial arterial puncturecannulation by one time,decrease the numbers of puncture,reduce the incidence of complications and save operation time.

Objective: To study the application effect of graded nursing intervention for ICU patients combined with the Pre-Deliric prediction model. Methods: A total of 288 ICU patients were elected and divided into the control group (141 cases from May 2017 to October 2017) and the intervention group (147 cases from November 2017 to April 2018) according to hospitalization time. The control group received conventional delirium prevention measures. The intervention group was assessed within 24 h following admission with Pre-Deliric prediction model to screen the risk of delirium, and then they received grading prevention care based on the assessment results of delirium risks. The data of this study were collected by Numeric Rating Scale, Critical-Care Pain Observation Tool, Richmond Agitation and Sedation Scale, Confusion Assessment Method for the ICU. The incidence and duration of delirium, 28d survival rate, ICU length of stay of the two groups were statistically analyzed. Results: Compared with the control group, we detected that the incidence of delirium in the intervention group was significantly lower (χ²=5.043, P<0.05), 21.7%(32/147) vs. 35.5%(50/141). Compared with the control group, we found that the duration of delirium in the intervention group was significantly shorter,(1.68±1.24) vs.(2.82±1.60)d, the ICU length of stay in the intervention group were significantly shorter than the control group(t=4.45, P<0.01), (3.42±3.02)d vs (6.21±4.56)d. There was no significant difference in the 28-day ICU survival rate between the two groups (P>0.05). Conclusions the risk assessment and grading nursing care combined with Pre-Deliric prediction model could effectively prevent the occurrence and shorten the duration of delirium, and also shorten the ICU length of stay.It was significant for improve the quality of nursing.

Objective: To explore the effect of nursing scheduling software combined with mobile phone APP in the nursing manpower arrangement in intensive care unit. Methods: The nursing scheduling software and mobile phone APP were applied to management resources of 82 nurses in ICU, substituted for traditional manual way. The work efficiency, nursing quality and nurse satisfaction were compared before and after implementing in intensive care unit. Results: After implementation of nursing scheduling software combined with mobile phone APP, the average time of scheduling was reduced from (6.49±0.62) h to (4.29±0.44) h, the difference was statistically significant (t=19.97, P<0.01). The nursing quality score was improved from (97.54±1.19) points to (95.16±1.29) points, the difference was statistically significant (t=-4.70, P<0.01). The nurses′ satisfaction about scheduling was improved from 73.2%(60/82) to 96.3%(79/82), the difference was statistically significant (χ²=17.04, P<0.01). Conclusions The mode of nursing scheduling software combined with mobile phone APP in intensive care unit has a good effect, which can improve the scheduling efficiency, the job satisfaction of nursing staff and the quality of nursing,and promote the nursing information management.