Objective To make a reasonable evidence-based nursing scheme for the oxygen non-humidified of continuing nasal cannula oxygen therapy. Method Adopting the JBI clinical evidence application system, make sure the evidence baseline investigated before application, used during clinical application, and reviewed after application. Based on the now available best evidence, making examination standard and apply it to clinical care. During the application of evidence, 81 continuing low-flow (oxygen flow≤4L/min) nasal cannula oxygen patients were taken. Making assessment on the experiment group(oxygen non-humidified) and control group (oxygen humidified) in three aspects: the comfort level and effect of oxygen therapy, and humidification bottles contamination. Results During the application of evidence, the difference between experiment group and control group shows no statistical significance (P>0.05);the experiment group in oxygen therapy operating time was (162.93±40.18) s, the control group operating time was (258.60 ± 56.97) s, the difference of two groups in shows statistical significance (t=8.752, P<0.01). Conclusion The continuing low-flow (oxygen flow≤4L/min) nasal cannula oxygen therapy do not need humidification. And the clinical application of this best evidence standardizes the clinical nurses oxygen nursing behavior, reduces the nursing cost and enhances the quality of clinical nursing.

Objective: To study the effect of using modified prone position to reduce the occurrence of pressure injury in patients with prone position ventilation. Method: Totally 64 patients with prone position ventilation from February 2014 to February 2018 were selected in the Department of Intensive Care of the Drum Tower Hospital, Medical College of Nanjing University. Twenty-six patients with prone position ventilation From February 2014 to February 2016 were selected as the control group. The patients in the control group were in a horizontal prone position, with soft pillows under both sides of the shoulders and hips along the longitudinal axis of the patient (vertical axis), and gel pads under chests; Thirty-eight patients with prone position ventilation from March 2016 to February 2018 were selected as the experimental group. The patients in the experimental group were positioned on turnover sliding cloth, soft pillows were placed under the sliding cloth, on one side along the vertical axis (vertical axis) of the patients, and the soft pillows were repositioned to other side of the patients every 4 hours, i.e. the patients were turned over in the prone position. The incidence of pressure injury, the number of occurrences (each site marked as 1) and the incidence of other related complications were compared between the two groups. Results: The incidence of pressure injury in the experimental group was 10.53% (4/38) and 46.15% (12/26), in the control group. The median and quartile of the number of pressure injuries in the experimental group were 0 (0,0), and 0 (0,2) in the control group. Statistical analysis was performed using the rank sum test. The difference was statistically significant (F=10.287,11.469, P<0.05). Among other related complications, the unplanned extubation rate was 0.38%(1/26) in the control group and 0 in the experimental group. No aspiration occurred in both groups. Conclusions The use of a modified prone position can reduce the incidence of pressure injuries and reduce the incidence of other related complications, by reducing the duration of skin pressure and decreasing the friction and shear force. It is worthy of popularization and application in clinical practice.

Objective To investigate the prevention effect of chlorhexidine gluconate (CHG) gel dressings combined with chlorhexidine wipe bath on femoral venous central line-associated bloodstream infections (CLABSI) in continue renal replacement therapy (CRRT). Methods A total of 593 cases of patients with femoral venous catheter who receipted CRRT were divided into the experimental group and the control group. 282 cases of patients who hospitalized in ICU from January 2016 to December 2016 were assigned into the control group and received 3M transparent dressings and whole-body warm water bathing.Those hospitalized in ICU from January 2017 to November 2017 were assigned into the experimental group including 311cases and received 3M CHG gel dressingscombined with 2％chlorhexidine wipe bathing. Incidence of CLABSI were compared between the two groups. Results 4 cases of patients occurred CLABSI in the experimental group and 12 cases occurred CLABSI in the control group, the difference between groups was statistically significant(χ2=3.900,P<0.05). In the experimental group, 311 cases were retained for 3219 catheter-days, and 282 cases in the control group were retained for 2249 catheter-days. Compared with transparent dressings and whole-body warm water bathing, chlorhexidine gluconate gel decreasescombined with 2％ chlorhexidine wipe bath could reduce the morbidity of CLABSIs from 5.3‰(12/2249) to 1.2‰(4/3219). The on onsite time of CLABSI in the experimental group was (12.5 ± 8.23) days, which in the control group was (10.50 ± 6.46) days, the differenceare not statistically significant (t=0.504,P>0.05). Conclusions CHG gel dressings combined with chlorhexidine wipe bathing would be more effective to prevent CLABSI in CRRT.