ABSTRACT:Objective To discuss the risk factors of ICU patients with catheter-associate-durinary tract infection (CAUTI)so as to provide scientific basis for effective nursing measures. Methods ICU patients from April 2012 to March 2014 in our hospital were monitored,and in-dwelling catheter chances,indwelling catheter days,maintenance of urinary catheter,perineum nursing,the urine property,urine culture results were observed.Results 92 cases of urinary tract infection occurred in 1421 urinary catheter indwelling patients.Patients in emergency department with indwelling catheter more than 7 days and perineum nursing less than 2 times a day had more risk factors of urinary tract infection (P <0.05).A total of 153 pathogenic bacteria were separated in 92 patients.Among these pathogenic bacteria,23 cases were multiple drug-resistant bacteria. The top three pathogens were 17.65% of klebsiella,15.69% of candidaalbicans and 9.80% of es-cherichia coli.Conclusion Effective nursing strategies are to shorten the urine tube indwelling time,improve the technique of emergency patients with catheter,correctly maintain urine tube,en-sure the drainage device sealability,strengthen the perineum nursing,apply multiple drug-resis-tant bacteria isolation measures so as to prevent catheter-associated urinary tract infection.

ABSTRACT:Objective To discuss the risk factors of ICU patients with catheter-associate-durinary tract infection (CAUTI)so as to provide scientific basis for effective nursing measures. Methods ICU patients from April 2012 to March 2014 in our hospital were monitored,and in-dwelling catheter chances,indwelling catheter days,maintenance of urinary catheter,perineum nursing,the urine property,urine culture results were observed.Results 92 cases of urinary tract infection occurred in 1421 urinary catheter indwelling patients.Patients in emergency department with indwelling catheter more than 7 days and perineum nursing less than 2 times a day had more risk factors of urinary tract infection (P <0.05).A total of 153 pathogenic bacteria were separated in 92 patients.Among these pathogenic bacteria,23 cases were multiple drug-resistant bacteria. The top three pathogens were 17.65% of klebsiella,15.69% of candidaalbicans and 9.80% of es-cherichia coli.Conclusion Effective nursing strategies are to shorten the urine tube indwelling time,improve the technique of emergency patients with catheter,correctly maintain urine tube,en-sure the drainage device sealability,strengthen the perineum nursing,apply multiple drug-resis-tant bacteria isolation measures so as to prevent catheter-associated urinary tract infection.

Objective To explore the influence of non-drug bundle of care on incidence rate of VAP. Methods Prospective analysis was performed on patients with mechanical ventilation in ICU from January 2015 to December 2016. The patients were assessed daily, monitored for target, and divided into infected group and non-infected group according to incidence of VAP. Relationship between incidence of VAP and measures taken in non-drug bundle of care, with all data statistically analyzed by SPSS 19.0 for windows. Results A total of 1 326 cases were collected in this study, with 109 infected cases and 1 217 non-infected cases. It was shown in related single factor analysis that factors influencing incidence of VAP included mode of tracheal intubation (whether with subglottic secretion drainage or not), severity of clinical conditions of the patients (APACHEⅡ score >18 points), time of mechanical ventilation (>7 days), hand sanitation, the patients' compliance to operations like elevation of bed head (>30°), oral care, assessment of tracheotomy cuff pressure, monitoring of gastric residual volume, timely dumping of condensed water, and unobstructed subglottic secretion drainage (P< 0.05). It was shown in Logistic regression analysis that mechanical ventilation time was an independent factor affecting incidence of VAP (OR=30.536, P<0.01). Conclusions According to non-drug bundle of care strategies, daily evaluation should be conducted. Early off-machine and early extubation can reduce incidence of VAP.

Objective To investigate the effect of real-case-based training and examination method in ICU nurses training. Methods A test group of multi-level real-case-based training was established and took the examination of nurses in ICU. The examination included the ability of disease observation and assessment, clinical thinking, application of nursing procedure and so on. The frequency of assessment was divided into three parts:once a month, every three months and every six months. Results After the real-case-based training and examination program, the comprehensive score of ICU nurses at excellent and favorable level were improved. The excellent and favorable rates of the first and the fourth season were 31. 6% and 59. 6%, which had a significant difference (χ2 =9. 161,P<0. 05). The nursing quality of the second half of year was significantly improved. There was no case of pressure sore, unplanned extubation, out for inspection. The compliance of hand washing and bed raise was improved. The incidence of ventilator associated pneumonia, catheter related bloodstream infection and urinary tract infection was decreased. The nurse training examination, education level and learning atmosphere were significantly improved (P <0. 05). Conclusions The real-case-based training and examination model can effectively improve the ICU nurses′ clinical nursing competency, and it also can promote the enthusiasm and the quality of nursing.

ObjectiveTo explore psychological experiences and care needs of elderly patients with chronic obstructive pulmonary disease (COPD) following dysphagia. MethodsFrom April to June, 2024, 13 elderly patients with COPD and dysphagia received treatment in Yixing No. 2 People's Hospital (Yixing Occupational Disease Institute) and Northern Jiangsu People's Hospital were interviewed. Nvivo 11.0 and content analysis were employed to analyze and summarize themes. ResultsTwo main themes were identified. The psychological experiences included fear of eating due to swallowing and choking, swallowing anxiety in social situations, concerns about malnutrition, and emotional loss related to family. The care needs included improvement in swallowing function, adjustment of food texture, assistance with disease adaptation and effective access to health education information. ConclusionHealthcare professionals should thoroughly understand the psychological and needs of elderly patients with COPD-related dysphagia, and comprehensive nursing strategies should be developed and implemented to improve swallowing function and overall quality of life.