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Teamwork combined with risk management in pediatric nursing

Chinese Journal of Practical Nursing.2017;33(4):290-293. doi:10.3760/cma.j.issn.1672-7088.2017.04.012

Objective To study the effect of teamwork combined with risk management in pediatric nursing. Methods A total of 188 pediatric patients were selected as the research objects of this study from February 2013 to December 2014. Among them 92 pediatric patients admitted to the hospital from February to December 2013 were set as the control group,who adopted the traditional routine nursing management mode;another 96 pediatric patients admitted to hospital fromJanuary 2014 to December 2014 were set as the observation group,who accepted teamwork combined with risk management nursing mode. Quality of care,nursing complaints,risk events,team total score and satisfaction index of two group were compared. Results The therapeutic nursing, psychological nursing, health education, nursing quality of life scored 98.02 ± 2.61, 97.27 ± 2.46, 97.16 ± 3.18, 98.21 ± 3.08 in the observation group, which were significantly higher than those of the control group (84.28 ± 1.92, 86.09 ± 1.87, 82.64 ± 2.17, 85.58 ± 2.29) with significant difference (t=6.891-9.426, P<0.01). The risk events ratio, nursing complaints ratios were 2.08% (2/96), 2.08% (2/96) in the observation group, which were lower than those of the control group 10.87% (10/92), 13.04% (12/92), and the difference was statistically significant (χ2=6.069,8.187, P<0.05). The total score of team cooperation was 3.86 ± 1.09 in the observation group, and 2.67 ± 1.05 in the control group (t=2.410,P<0.01). The satisfaction degree in the observation group was 51.04% (49/96), which was significantly higher than the control group, 44.57%(41/92),with significant difference (χ2=7.221,P<0.05). Conclusions Applying teamwork combined with risk management nursing mode to pediatrics may improve teamwork and the quality of nursing management and nursing quality,reduce risk events and nursing complaints, ease the poor mental symptoms of families, and improve satisfaction.

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Initially identification of core interventions to pediatric nursing based on Nursing Interventions Classification

Jiwen SUN ; Jianhua LOU ; Nanping SHEN

Chinese Journal of Practical Nursing.2017;33(4):284-289. doi:10.3760/cma.j.issn.1672-7088.2017.04.011

Objective To identify the core interventions preliminarily performed by pediatric nurses for hospitalized children. Methods Based on Nursing Interventions Classification (NIC), the data of survey related to the factors of representation and frequency derived from the definition of Core Nursing Interventions were collected from 59 pediatric senior nurses above the 3rd clinical ladder, working in one of Shanghai university affiliated and tertiary children hospitals. The data was analyzed by L type of Metric Diagram. The intervention with product of two factors above 12 was selected as the core intervention. Results A total of 109 interventions were selected as core interventions on pediatric nursing from 497 interventions of NIC. The top 3 domains in quantity of interventions were physiological complex domain (36 items), physiological basic domain (26 items) and health system domain (19 items). The domain with the highest score (16.79 ± 3.42) was safety domain, followed by physiological complex domain (16.19 ± 2.98), while domain with the lowest score (13.62±2.05) was family domain. Conclusions The initial and systematic pediatric nursing core interventions were identified based on NIC and definition of core intervention. Part of core interventions reflects the characteristics of pediatric nursing practice, but more is requested to reflect the pediatric-specific care related to family-center and age-appropriated concepts. Some of inefficient interventions remind nursing administers further reflect thinking, especially on human resource management.

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Comparison of curative effect of silver-coated dressing and general aseptic dressing in the wound healing of abdominal operation

Lei SUN ; Ying ZHANG ; Huanqin LEI ; Xiaolong BAI ; Yanpei ZHAO ; Lin MA

Chinese Journal of Practical Nursing.2017;33(4):276-278. doi:10.3760/cma.j.issn.1672-7088.2017.04.009

Objective To compare the effect of silver-coated dressing and general aseptic dressing on the wound healing of abdominal operation. Methods A total of 94 patients from the general surgery department of Second Affiliated Hospital of Xi'an Jiaotong University who underwent abdominal operation were divided into two groups by double blind method, 49 cases in silver-coated dressing group, and 45 cases in general aseptic dressing group. The wound healing of the two groups were observed after wound dressing change, and the wound dressing change times, the healing time, the degree of pain, the positive rate of bacterial culture and the incidence rate of scar healing were observed in the two groups. Results The patients in silver-coated dressing and general aseptic dressing group had no significant differences in gender, age, length of incision, type of incision and poor wound healing type (all P>0.05);after two wound dressings change treatment, the wound dressing change times and incision healing timeof the silver-coated dressing group was (6.52 ± 1.52) times and (16.34 ± 5.96) days, which were less than those of the general aseptic dressing group, which were (8.74 ± 2.35) times and (23.32 ± 8.32) days; and the pain severity (NRS) scored 4.13 ± 1.01, which was lower than that of general aseptic dressing group (6.54 ± 0.95), with significant difference between two groups (t=5.482, 4.704, 11.890, P < 0.05). The bacterial culture positive rates of the silver-coated dressing group was 60.00% (21/35), which was higher than that of the general aseptic dressing group, 23.33%(7/30), the difference was statistically significant (P<0.01);at the same time, the scar healing cases was 4 in the silver-coated dressing group, which was less than 11 cases in the general aseptic dressing group. The difference was statistically significant (P < 0.05). Conclusions The silver-coated wound dressing method is better than the general aseptic wound dressing, and has obvious advantages in the treatment of abdominal poor healing incision. The silver-coated wound dressing can promote the healing of incision, reduce scar healing, shorten the hospitalization time, reduce the suffering of patients.

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The effect evaluation of fast track surgery nursingon percutaneous lumbar diskectomy

Guoping LI ; Chenglian WANG ; Fang YIN

Chinese Journal of Practical Nursing.2017;33(4):272-275. doi:10.3760/cma.j.issn.1672-7088.2017.04.008

Objective To evaluate the effect of fast track surgery nursing on percutaneous lumbar diskectomy. Methods A total of 126 patients were randomly divided into the control group and the experimental group,the control group received traditional nursing plan, the experimental group was given fast track surgery nursing plan. The nursing effect was observed. Results Postoperative anal exhaust time, feeding time, walking time, length of hospital stay ofthe experimental group were (1.61±0.71) days, (2.01±0.71) days, (4.70±2.12) days, (12.72±2.07) days, whichwere significantly shorter than those of the control group, which were (3.37±0.93) days, (2.27±0.63) days, (8.40±3.21) days, (15.81±2.14) days, the difference between two groups were statistically significant (t=4.012-6.068, P<0.05). The incidence of complications was 11.1%(7/63) in the experimental group, which was lowercompared with the control group, 23.8% (15/63), the difference between two groups was statistically significant(χ2=6.639, P < 0.05). Curative effect of the experimental group was 90.4% (57/63), which was significantly higher than that of the control group, 85.7% (54/63), the difference between two groups was not statistically significant (χ2=1.460,P>0.05). The Rdand Morris Questionnaire score of the experimental group was 21.67±3.48, which was higher than that of the control group(14.43 ± 2.01), the difference between two groups was statistically significant(χ2=6.077, P <0.05). Conclusion Fast track surgery nursing can promote the patient's postoperative rehabilitation ,reduce the postoperative complications, shorten the length of hospital stay and improve the quality of life.

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The study of the subthreshold depression and their quality of life for long-term survivors after breast cancer surgery

Liming LYU ; Hui GAO ; Haiying CHENG

Chinese Journal of Practical Nursing.2017;33(4):259-264. doi:10.3760/cma.j.issn.1672-7088.2017.04.005

Objective To investigate the subthreshold depression for long-term survivors after breast cancer surgery and its effect on their quality of life (QOL). Methods The self-made general questionnaire, Centre for Epidemiological Studies Depression Scale (CES- D), Hamihon Rating Scale for Depression and Functional Assessment of Cancer Therapy- Breast were used to investigate the subthreshold depression and its effect on their QOL for 210 long-term survivors after breast cancer surgery. The difference in general conditions and score of QOL between the subthreshold depression and non-subthreshold depression groups was also compared. Results The subthreshold depression with incidence rate of 46.67%(98/210) was observed for the log-term survivors after breast cancer surgery in this study. The results indicated that the age (≤50) (OR=5.627, 2.662,P<0.01), marriage (unmarried, divorced or widowed) (OR=5.087, P<0.01), employment (unemployed, sick leave or retired) (OR=2.077,P<0.05) and low income (<3000 RMB/month) (OR=3.375,P<0.01) were the key factors that led to the occurrence of subthreshold depression. The score of QOL for the subthreshold depression group were lower than those of the non-subthreshold depression group (t=-6.653--2.926,P<0.01), and had a significantly negative correlation with score of depression and QOL (β=-0.362--0.132). Conclusions A high incidence rate of subthreshold depression for long-term survivors after breast cancer surgery was observed. The incidence rate of subthreshold depression increased for the patients with younger age, low income,unmarried or unemployment. Due to their low QOL, attentions should be paid to the early detection and early prevention for the long-term survivors with subthreshold depression after breast cancer surgery.

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Application of process quality monitoring for the control of hospital infection in ICU

Jing ZHAO ; Wenli LI

Chinese Journal of Practical Nursing.2017;33(4):254-258. doi:10.3760/cma.j.issn.1672-7088.2017.04.004

Objective To explore the effect of process quality monitoring for hospital infection control of ICU. Methods A total of 265 critically ill patients admitted to ICU were chosen as the control group from April 1, 2014 to March 31, 2015, who were strictly enforced three cluster strategies to prevent catheter related blood stream infection (CRBSI), catheter-associated urinary tract infection (CAUTI) and ventilator–associated pneumonia (VAP) with periodical data monitoring in ICU. Another 292 critically ill patients admitted to ICU were chosen as the observation group from April 1, 2015 to March 31,2016, who were added 3 measures of process quality monitoring on the basis of implementation method of the control group. The incidence of CRBSI, CAUTI and VAP time were compared between two groups. Results There was statistically significant difference on the incidence rate of the CRBSI between the two groups (χ2=4.504, P=0.034), which was respectively 1.79%(5/280) and 5.10%(13/255). There was statistically significant difference in the incidence rate of CAUTI between the two groups (χ2=5.708, P=0.017), which was respectively 3.48% (10/287) and 8.27% (21/254). There was statistically significant difference on the incidence rate of VAP between the two groups (χ2=8.291, P=0.004), which was respectively 3.48% (10/287) and 8.27% (21/254). Mean time of mechanical ventilation in the observation group and the control group was respectively (2.14±1.40) days and (3.37±2.01) days, there was no significant difference (P=0.073). Mean time of ICU stay in the observation group and the control group was respectively (6.04±1.04) days and (11.92±1.90) days, there was statistical significance (t=-1.840, P=0.024). Number of qualified central venous catheter maintenance, perineum clean and oral care had negative relevance with number of patients with CRBSI, CAUTI and VAP, correlation coefficient in the observation group was respectively-0.701,-0.618,-0.677, there was statistical significance (P<0.05). Conclusions The implementation of quality monitoring can reduce the number of patients with CRBSI, CAUTI and VAP, which suggests wide application in ICU.

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Reliability and validity of the Chinese version of Safety Attitudes Questionnaire

Feng ZHANG ; Xiang LI ; Shuhua CHENG ; Changying CHEN

Chinese Journal of Practical Nursing.2017;33(4):250-254. doi:10.3760/cma.j.issn.1672-7088.2017.04.003

Objective To translate the English version of Safety Attitudes Questionnaire (SAQ) into Chinese,and to test the reliability and validity of the Chinese version of SAQ. Methods The SAQ was developed into Chinese version through translation, back-translation and cross-culture adaption. The reliability and validity of the Chinese version of SAQ were tested in 823 first-line nurse managers in Henan. Results The scale content validity index was 0.90 of the Chinese SAQ, and the item content validity index ranged from 0.83 to 0.96. The correlations between the items and the full scale, the dimensions and the full scale separately ranged from 0.32 to 0.64 and 0.50 to 0.81 (P<0.01). The confirmatory factor analysis resulted in a good model fit for the six dimensions and the full construct, the goodness-of-fit index was 0.96, Tucker-Lewis index was 0.93, comparative fit index was 0.95, and root mean square error of approximation was 0.06. The Cronbach alpha coefficient for the scale was 0.913 and for the six dimensions were 0.565, 0.655, 0.825, 0.804, 0.880, 0.725 separately, the test-retest reliability coefficient was 0.934. Conclusions The Chinese version of SAQ is a valid and reliable tool to assess the safety culture of first-line nurse managers in Chinese hospitals.

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Analysis of grounded theory literature in nursing in China

Jiayin RUAN ; Yunxian ZHOU

Chinese Journal of Practical Nursing.2017;33(5):396-400. doi:10.3760/cma.j.issn.1672-7088.2017.05.020

Objective To analyze the major issues existing in grounded theory literature in nursing in China so as to improve nursing personnel's understanding of grounded theory and promote its application in nursing research. Methods Grounded theory literature in nursing were retrieved from Wangfang, CNKI and VIP Databases from January 2000 to April 2016. Articles which using grounded theory as a research method were included. Two researchers analyzed the main issues of these articles, explained misunderstanding and inappropriate research practice in depth based on grounded theory evaluation criteria, personal experiences and relevant knowledge, and some suggestions were offered accordingly. Results Twenty articles were included. The major pitfalls of these articles were methodology (11 articles, accounting for 55.0%), sampling (14 articles, accounting for 70.0%) and saturation (9 articles, accounting for 45.0%), data analysis (9 articles, accounting for 45.0%) and conceptualization (9 articles, accounting for 45.0%). Conclusions Although grounded theory has been used in many fields in nursing in China, it is still in the initial stage, and some misunderstanding appeared. It is necessary to strengthen the learning of grounded theory knowledge and practical exploration, increase the learning paths in future so as to improve the research quality and promote the development of nursing research.

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A research progress of psychological problems and influential factors of senile dementia caregivers

Zeping LIU ; Qimeng YE

Chinese Journal of Practical Nursing.2017;33(5):392-395. doi:10.3760/cma.j.issn.1672-7088.2017.05.019

With the decline in cognitive ability, loss of ability to live, the demand of care for the Alzheimer's patients gradually increased. Caregivers tended to bear a greater physical and mental burden. In this study, we found that the caregivers of senile dementia were prone to psychological problems such as depression and anxiety, which may be related to the caregiver's age and caregiving time, and the positive intervention can relieve the psychological problems of the caregivers. This article aims to provide a theoretical basis for nursing workers to explore more effective nursing measures, so as to improve the quality of life of dementia patients and caregivers.

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Effect of feedback closed-loop management system on patient satisfaction

Jianshu LIANG ; Huijuan DIAN ; Ran ZHANG

Chinese Journal of Practical Nursing.2017;33(5):388-391. doi:10.3760/cma.j.issn.1672-7088.2017.05.018

Objective To apply the feedback closed-loop management systemin the telephone follow-up service for discharged patients to increase patient satisfaction and improve the quality of nursing. Methods From January 2015,telephone return visit to discharged patients were analyzed, a summary of dissatisfaction events, analyze the causes every month. Then,the improvement measures for nursing quality were put forward and the effects were evaluated to form a closed-loop management system. Results After the application of feedback closed-loop management system,there was a significant difference in patients' satisfaction with nursing service between the first half (with the incidence of 91.77%,3657/3985) and the second half (with the incidence of 95.76%,3610/3770) of 2015 (χ2=52.22, P < 0.01). Of the 9 items of dissatisfaction recorded in the questionnaire, significant difference was observed in 8 items, as service attitude, hospitalizing education, personal care, question answering, nurse's operation, health education, respect, clean environment and the discharge instructions. The incidence of each item was 2.11%(84/3985), 0.23%(9/3985), 0.35%(14/3985), 0.33%(13/3985), 0.30%(12/3985), 2.99%(119/3985), 0.33%(13/3985), 0.58%(23/3985), 2.58%(103/3985) in the first half of 2015 respectively, compared to 1.09%(41/3770), 0.05%(2/3770), 0.05%(2/3770), 0.08%(3/3770), 0.21%(8/3770), 0.64%(24/3770), 0.85%(32/3770), 0.21%(8/3770), 1.25%(47/3770) in the second half of 2015 respectively (χ2=4.084-59.088,P<0.01 or 0.05). However, no significant difference was observed in the nurse operational between the first half (0.30%) and the second half (0.21%) in 2015 (χ2=0.596, P>0.05). Conclusions Feedback closed-loop management systemic a scientific management theory. It can increase patient satisfaction with nursing service,improve the quality of nursing,and make quality management more scientific and effective .

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