Objective:To explore the influence of health education based on Information-Motivation-Behavior Skills (IMB) model on the self-management of fistula in patients with autogenous arteriovenous fistula (AVF) plasty.Methods:A total of 112 patients undergoing AVF plasty from October 2020 to October 2021 were selected and divided into 2 equal group by the random number table method. The control group used usual care and health education. The observation group implemented a health education intervention based on the IMB model .Repeated-measures ANOVA were used to compare the difference of self-efficacy, self-management ability of AVF between before, 4, 8, and 12 weeks after intervention.Results:Before the intervention, there were no significant differences between the two groups about the scores of AVF scale and the general self-efficacy scale (all P>0.05). After 4 weeks, 8 weeks and 12 weeks of intervention, the total scores of Self-management ability of AVF were (56.27 ± 6.12), (64.51 ± 4.40) and (73.53 ± 3.60), which were significant higher than those of in the control group (49.38 ± 4.50), (57.93 ± 6.70) and (59.36 ± 5.28)( t=6.73, 6.06, 16.44, all P<0.05). Conclusion:Health education based on IMB model can improve the self-management ability and self-efficacy of patients undergoing AVF plasty with a more long-term impact on patients.

Objective To investigate the effect of implementing dynamic post management in the emergency day ward, which has plenty of urgent, time-concentrated work every day.Methods In January 2015, the Cangzhou Central Hospital Nursing Department passed the plan that set a process for the dynamic post qualification requirements, screening test, the system training, quality control, performance evaluation, salary allocation in day ward and our nursing department created a perfect dynamic post management system. From December 2014 (before implementation) to December 2015 (after implementation), the effects were investigated from the patients' waiting time, the degree of satisfaction, the human cost, and the stability of the nursing team. Results After the implementation of the dynamic post management in the emergency day ward, the patients' waiting time decreased from (19.23±2.73)min to (10.14±1.18)min (t=93.09,P<0.01)and the degree of satisfaction increased from 85.45%(171/200) to 95.50%(191/200)with the differences of statistical significance (χ2=11.631,P<0.01). A total of 50 qualified nurses obtained qualification via admittance examination. We had arranged 820 classes and accumulatively worked 2300 hours, which had saved at least 10 of nursing personnel.Conclusions Dynamic nursing station is beneficial to the reasonable allocation of human resources and the stability of the nursing team.

Objective To detect the application effect of position management process in patients with lateral position in the Department of Neurosurgery.Methods We recruited 506 patients undergoing elective neurosurgery posed lateral position from August 2015 to May 2016 in Cangzhou Central Hospital and divided them into control group and experimental group by their surgery date, with 253 cases in each group. The patients received routine method for position arrangement while patient in experimental group underwent position management process. The rate of ulcer and length of position arrangement were compared between two groups. Results The length of moving patients to the end of position arrangement required (11±4.25) min averagely in experimental group and (15±3.86)min in control group, and there was statistical significance between two groups (t=11.077,P<0.01). The ulcer happened 2 cases in experimental group and 7 cases in control group (P>0.05).Conclusions For patients with lateral position applied position management process in Department of Neurosurgery, it can improve work efficacy, reduce the complications of perioperative circulatory system, ulcer happened.

Lateral position is a common surgical position in neurosurgery, it is also a susceptible position for pressure ulcers. The reasons not only consist of the common causes of general surgery, but also consist of unique factors due to its special position. The technique and rationality of body position placement is significant for the prevention of pressure ulcers. This article reviews the causes and preventive measures of pressure ulcers with lateral position in neurosurgery operation after consulting extensive literature. We will expound and analyze the way of body position placement, placement techniques of every part, selection of material for various body positions, and precautions of position nursing in perioperative period of lateral position surgery, etc. We hope to provide references for the prevention and management of pressure ulcers in neurosurgery operation with lateral position.

Objective To construct training course for specialized wound nurses based on Delphi method. Methods Firstly, the consultation list on context of training course for specialized wound nurses was designed by self between January 2015 to May 2015. The expert consultation involving eleven clinical nurse specialists, ten nursing managers, four nursing teachers from fifteen cities of provinces was performed via three rounds to determine the content of training course for specialized wound nurses. Results The content determined of training course for specialized wound nurses included three indicators in level one ( course components) involving professional attitude, knowledge and skills, 14 indicators in level two ( course name) involving medical ethics value of wound nursing, history of wound nursing, importance of specialized wound nurses and so on, 58 indicators in level three ( course context) involving personal and family burden caused by chronic wounds, development situation of wound nursing in China, working pattern of specialized wound nurses, professional development requirements and so on. Conclusions The context of training course for specialized wound nurses is determined from three dimensions including professional attitude, knowledge and skills. Besides, this study provides suggestions and theoretical support for the training of specialized wound nurses.

Objective To investigate the application and effect of bundle nursing intervention combining with ventilator pipeline disinfection in the prevention of ventilator-associated pneumonia (VAP). Methods A total of 100 cases who had not received bundle nursing intervention combining with ventilator pipeline disinfection in ICU ward,Cangzhou Central Hospital between February 2012 to January 2014 were treated as control group,while another 100 cases who had received bundle nursing intervention combining with ventilator pipeline disinfection in the same ward from February 2014 to January 2016 were treated as observation group. Incidence of VAP,length of mechanical ventilation time and ICU stay of two groups were compared. Results In different models of nursing care,incidence rate of VAP of the observation group and the control group were 9.0% and 24.0%(χ2=3.52,P < 0.05);length of mechanical ventilation time and ICU stay of the observation group were (4.62±2.10) d and (7.30±1.30) d which were shorter than those of the control group (t=2.40,19.30;P < 0.05). Conclusions Bundle nursing intervention combining with ventilator pipeline disinfection could lower the incidence of VAP,shorten the duration of mechanical ventilation time,ICU stay and improve patients' satisfication which is worthy of application in clinic.

Patients with connective tissue diseases and vasculitis often develop refractory skin ulcers in various parts of the body due to abnormal autoimmune reactions, and the skin ulcers caused by different types of diseases have strong heterogeneity. In 2020, The Journal of Dermatology published the Japanese " Guidelines for the management of connective tissue disease/vasculitis-associated skin ulcers", which is an updated version of its 2016 edition, to guide clinical management of related diseases in a more scientific and standard way. By interpreting the guidelines, this paper aims to help domestic clinicians clarify the diagnosis and treatment objectives of connective tissue disease and vasculitis-associated skin ulcers, accelerate skin wound healing, and improve healing quality.

Objective? To explore the effects of new orthopedic high-waist shoes on preventing foot drop deformity among spinal cord injury patients with lower limb paralysis. Methods? From April 2016 to January 2018, we selected a total of 44 spinal cord injury patients with paralysis. All of the patients were divided into experimental group and control group according to the order of admission and random number sampling approaches. Patients of experimental group wore new orthopedic high-waist shoes from the first day after admission, while patients of control group used the square soft pillow in foot. We compared the incidence of foot drop deformity among patients two weeks after admission. Results? The incidences of foot drop deformity, pressure injury on foot as well as strephenopodia of patients in experimental group and control group were 18.2% vs. 40.9%, 4.5% vs. 18.2% as well as 27.3% vs. 59.1% respectively with statistical differences (P＜0.05). Conclusions? Early use of new orthopedic high-waist shoes can effectively prevent foot drop, protect function of ankle joint and promote the rehabilitation of neuromuscular function in limb among spinal cord injury patients with paralysis.

Objective:To explore the relationship between disease uncertainty, coping style, and self-perceived burden (SPB) in patients with lower extremity deep vein thrombosis (DVT) .Methods:Totally 280 patients with lower extremity DVT who were hospitalized in the Department of Vascular Surgery of three ClassⅢ Grade A hospitals in Cangzhou from September 2020 to April 2021 were selected by convenience sampling and investigated with the general information questionnaire, Medical Coping Style Questionnaire, Self-Perceived Burden Scale (SPBS) , Medical Coping Modes Questionnaire (MCMQ) , and Mishel's Uncertainty in Illness Scale (MUIS-A) . Pearson correlation was used to analyze the correlation between variables. A total of 280 questionnaires were distributed in this study, and 262 valid questionnaires were recovered, with an effective recovery rate of 93.6%.Results:The SPB score of the 262 patients with lower extremity DVT was (28.83±7.43) ; disease uncertainty, avoidance, and yielding were positively correlated with the patients' SPB ( r=0.651, 0.477, 0.469; P<0.01) , while facing was negatively correlated with SPB ( r=-0.485, P<0.01) . The path analysis revealed that avoidance and yielding played a partial mediating effect between disease uncertainty and SPB, accounting for 14.6% of the total path effect. Conclusions:Disease uncertainty can indirectly affect SPB in patients with lower extremity DVT through avoidance and yielding. Clinical medical staff should formulate targeted intervention and health guidance strategies to improve patients' disease cognition and coping ability, and reduce their SPB.

Objective:To explore the effect of intelligent rehabilitation device on lower limb function rehabilitation in stroke patients with hemiplegia.Methods:Using convenience sampling, 186 stroke hemiplegic patients admitted to the Department of Neurology and Surgery of Brain Hospital, Cangzhou Central Hospital from July 2021 to July 2022 were selected as the study subject. The patients were divided into a control group, a strengthening group, and an intelligent rehabilitation group, with 62 patients in each group using the random number table. The control group received routine rehabilitation for 40 minutes per day, 5 days per week, for a total of 4 weeks. On the basis of the control group, the strengthening group received an additional 30 minutes of routine rehabilitation training every day. The intelligent rehabilitation group received an additional 30 minutes of intelligent rehabilitation device exercise per day on top of the control group. The Fugl-Meyer Assessment Lower Extremity (FMA-L), Berg Balance Scale (BBS) scores, and Functional Ambulation Category (FAC) grading of three groups of patients before and after intervention were compared.Results:Sixty patients in each group completed the study. The FMA-L and BBS scores of the three groups of patients after intervention were higher than those before intervention, and the FAC grading was better than that that before intervention, with statistical differences ( P<0.05). After intervention, the FAM-L and BBS scores of the intelligent rehabilitation group were higher than those of the control group and the strengthening group, and the FAC grading was better than that of the control group and the strengthening group, and the differences were statistically significant ( P<0.05) . Conclusions:The intelligent rehabilitation device can improve the lower limb function of stroke patients with hemiplegia, and is worthy of clinical promotion and practice.