1.Implementation study of Evidence-based Nursing Practice Guideline for Enteral Nutrition of Infants with Congenital Heart Disease application
Weijia FU ; Ying GU ; Lihua ZHANG ; Huimei WANG ; Yuxia YANG
Chinese Journal of Practical Nursing 2022;38(36):2811-2818
Objective:To evaluate the effectiveness of Evidence-based Nursing Practice Guideline for Enteral Nutrition of Infants with Congenital Heart Disease application on improving the nutritional status of infants with congenital heart disease (CHD) in the target population, and to explore the effective strategies of evidence implementation in the process of dissemination, implementation and integration into clinical practice. Methods:This was an implementation study. Promoting Action on Research Implementation in Health Services Integrated Framework (i-PARIHS) was used as a theoretical model. Infants with CHD who received cardiac surgery from the heart ICU of Children ′s Hospital of Fudan University from January 2019 to February 2020 were selected as the study subjects. January to June 2019 and September to February 2020 were the pre and post implementation phase respectively. For medical staff, communication strategy, implementation process strategy, integration strategy and capacity-building strategy were used to advance the implementation process. According to the implementation strategy of children, the 26 best practice recommendations in the guide were translated into operable nursing processes and enteral nutrition programs, which were implemented in four stages: admission to the hospital, pre operation, post operation cardiac care room, post operation ward recovery, and pre discharge. Implementation Results Variable Assessment Form was used to evaluate effectiveness of the implementation strategies; hospitalization weight and upper arm circumference, serum albumin and pre-albumin before discharge were used to evaluate effectiveness of the interventions. Results:Scores of eight aspects of Implementation Results Variable Assessment reached more than 75% of the total score. Pre-albumin of post-implementation was (166.53 ± 42.57) g/L, which was statistically significantly higher than (148.41 ± 30.66) g/L before discharge ( t=-3.21, P<0.01); the weight loss of pre-implementation was 0.00 (0.41) kg, while the weight change of post-implementation was -0.10 (0.40) kg, the difference was statistically significant ( Z=-2.90, P<0.01). Conclusions:The strategies of diffusing, implementing, integrating the CHD enteral nutrition protocol based on guide could improve the implementation results and the nutrition status of infants with CHD.
2.The effects of correcting tape on extensor synergy gait in hemiplegic patients
Sheng WANG ; Chuan GUO ; Chen GONG ; Weijia CHEN ; Yuchen WANG ; Zhaohua GU
Chinese Journal of Physical Medicine and Rehabilitation 2018;40(10):740-744
Objective To observe the effect of a walking correcting tape on the kinematics and temporal-spatial indicators of gait after a stroke. Methods Thirty hemiplegic stroke survivors were randomly divided into a control group ( n=15) and a correcting tape group ( n=15) . In addition to their routine rehabilitation program, the control group received 30 minutes of walking training five times a week for 3 weeks with any necessary oral guidance and posture correction. The correcting tape group performed the same walking training assisted by a self-made walking correcting tape. Before and after the treatment, the kinematics and temporal-spatial indicators of both groups were quantified using three-dimensional gait analysis. Results After the treatment, the peak angles of hip and knee flex-ion were significantly higher in the taped group than in the control group and in the taped group before the treatment ( P≤0.05) . After the treatment, the walking speeds, stride frequencies and stride lengths of both groups were signifi-cantly better than before the treatment, but those of the former group were all significantly better than the latter ( P≤0.05 for both) . Conclusions Correcting tape can improve the peak angles of hip and knee flexion of hemiplegic legs and improve the walking capacity of stroke patients.
3.Construction of a training evaluation index system of sterility concept for nursing interns in the operating room based on Kirkpatrick model
Lan LIN ; Yan LI ; Weijia GU ; Lin LIN
Chinese Journal of Medical Education Research 2021;20(8):977-981
Objective:Based on the Kirkpatrick model, construct an evaluation index system for the teaching effect of aseptic concept for interns in operating room.Methods:Based on the Kirkpatrick model as the theoretical framework, combined with literature review and group discussion, the first draft of the indicator system was drawn up, and the expert consultation questionnaire was compiled. 30 experts with nursing teaching experience from several tertiary hospitals and medical undergraduate colleges in Chengdu were selected for research. Delphi conducts 2 rounds of consultation with experts. The collected data were input by Excel, and analyzed by SPSS 23.0.Results:The positive coefficients of the two rounds of consulting experts were l00.00% and 93.33%; the expert authority coefficients were both>0.7; the overall coordination coefficient of expert opinions Kendall's W was 0.321 and 0.427, respectively, with statistical significance ( P<0.05). The final result index system for training nurses in operating room aseptic concept includes 4 first-level indicators, 11 second-level indicators, and 45 third-level indicators. Conclusion:The construction method of aseptic concept assessment index system for nursing students in operating room is scientific and reasonable, and the content is set appropriately, which can provide a basis for the evaluation of aseptic concept training for nursing students in operating room.
4.Advance in Rhythmic Auditory Stimulation to Improve Walking Function in Patients with Hemiplegia after Stroke (review)
Weijia GU ; Xiaoming YU ; Leichao LIANG ; Yan XU ; Xubo WU ; Shangjun HUANG
Chinese Journal of Rehabilitation Theory and Practice 2018;24(12):1408-1412
Through providing rhythmic stimulation to movement center, rhythmic auditory stimulation (RAS) may encourage hemiplegic patients to adjust movement pattern and external rhythm in time to improve the walking function after stroke. As an emerging intervention to treat the hemiplegic patients after stroke, RAS could effectively improve temporospatial gait parameters (gait velocity, stride length, cadence, and symmetry, etc.), joint movement pattern (angle of pelvis anterior tilt, and peak angle of knee flexion in mid-swing, etc.) and balance, which may be related to rhythmic entrainment movement system and the theory of auditory-movement synchronization. Simultaneously, frequency and dosage of RAS and the patient's lesions all have effect on the outcome of intervention.