1.Evidence-based practice for dietary management of non-dialysis chronic kidney disease patients
Lulu MO ; Guifen GUAN ; Donglan LING ; Lijun YANG ; Sijie GAO ; Zhiqing LI ; Yunyi ZHAO ; Chang LIU ; Zebin WANG ; Xiaochun LAI
Chinese Journal of Modern Nursing 2025;31(28):3836-3846
Objective:To construct an evidence-based practice program for dietary management of patients with non-dialysis chronic kidney disease (CKD) based on best evidence and to evaluate the effectiveness of its application.Methods:The best evidence for dietary management of non-dialysis CKD patients was summarized. From September to October 2022, following the evidence clinical transformation model of the Fudan University Centre for Evidence-based Nursing, the best evidence was screened and evidence-based practice program were developed, taking into account patients' wishes, expert opinions, and clinical contexts. From November 2022 through March 2023, baseline reviews, analysis of barriers and facilitators were implemented. Between April 2023 and April 2024, evidence-based practice was carried out in the Department of Nephrology of the Second Affiliated Hospital of Guangzhou Medical University to compare the implementation rate of review indicators at the system, practitioner, and patient levels, and practitioners' knowledge before and after the application of evidence.Results:A total of 14 review indicators were developed. The implementation rate of the 12 review indicators and the practitioners' knowledge of the CKD diet were elevated after the evidence-based practice ( P<0.05) . Conclusions:Evidence-based practice program for dietary management of patients with non-dialysis CKD has a positive effect on improving practitioners' knowledge of non-dialysis CKD diets, implementation rate of dietary management behaviors, and patients' dietary behaviors.
2.Evidence-based practice for dietary management of non-dialysis chronic kidney disease patients
Lulu MO ; Guifen GUAN ; Donglan LING ; Lijun YANG ; Sijie GAO ; Zhiqing LI ; Yunyi ZHAO ; Chang LIU ; Zebin WANG ; Xiaochun LAI
Chinese Journal of Modern Nursing 2025;31(28):3836-3846
Objective:To construct an evidence-based practice program for dietary management of patients with non-dialysis chronic kidney disease (CKD) based on best evidence and to evaluate the effectiveness of its application.Methods:The best evidence for dietary management of non-dialysis CKD patients was summarized. From September to October 2022, following the evidence clinical transformation model of the Fudan University Centre for Evidence-based Nursing, the best evidence was screened and evidence-based practice program were developed, taking into account patients' wishes, expert opinions, and clinical contexts. From November 2022 through March 2023, baseline reviews, analysis of barriers and facilitators were implemented. Between April 2023 and April 2024, evidence-based practice was carried out in the Department of Nephrology of the Second Affiliated Hospital of Guangzhou Medical University to compare the implementation rate of review indicators at the system, practitioner, and patient levels, and practitioners' knowledge before and after the application of evidence.Results:A total of 14 review indicators were developed. The implementation rate of the 12 review indicators and the practitioners' knowledge of the CKD diet were elevated after the evidence-based practice ( P<0.05) . Conclusions:Evidence-based practice program for dietary management of patients with non-dialysis CKD has a positive effect on improving practitioners' knowledge of non-dialysis CKD diets, implementation rate of dietary management behaviors, and patients' dietary behaviors.
3.Evidence summary of surgical site infection prevention in adult inpatients based on guidelines and clini-cal decision making
Qingmei LEI ; Lishan OU ; Donglan LING ; Qiuchen CHENG ; Shizhen ZHANG ; Zhaotao WANG ; Hongbo YAN
Modern Hospital 2024;24(2):222-226
Objective To provide evidence-based references for the prevention of surgical site infection(SSI)by sum-marizing the best evidence for the prevention of SSI in adult inpatients.Methods The'6S'evidence resource pyramid model was used to systematically search the related evidence in domestic and foreign databases,guideline websites,and academic socie-ty websites from the inception of the database to September 30,2023.Four researchers evaluated the quality of the included guidelines,and two researchers independently evaluated the quality of other types of literature and rated the level of evidence.Results A total of 12 articles were included,including 6 clinical decision making and 6 clinical guidelines.Thirty best items of the evidence were summarized from 7 aspects:diagnosis,clinical symptoms,influencing factors,patient prevention strategies,preventive strategies for medical staff,intraoperative and postoperative treatment,and consultation and education.Conclusion Clinical staff should develop a standardized management plan for infection prevention based on corresponding evidence to reduce the incidence of SSI instead of taking a single measurement.Moreover,they need to formulate a standardized work process for preventing SSI based on the clinical practice and patients'preference.
4.Risk prediction models of refeeding syndrome in ICU patients:a review of literature
Shuai YANG ; Hongjing YU ; Jiaxin HE ; Xiaodie ZHANG ; Xiaomei YE ; Wei GUO ; Jingda PAN ; Donglan LING
Modern Hospital 2024;24(2):317-319,324
Refeeding syndrome(RFS)has a high incidence among critically ill patients and significantly impacts the re-covery and prognosis of the patients.In this paper,we reviewed the literature on the risk factors and risk prediction models for RFS,finding the risk factors of RFS included patient-related,treatment-related factors and disease-related factors and the risk prediction models encompassed risk stratification model,risk score models and the Logistic regression models.It was concluded from the review that early assessment was crucial to preventing the occurrence of RFS.However,there was still a lack of reliable RFS risk prediction models with good predictive performance.It was found as well that it was crucial for the prevention of RFS to attach importance to nutritional and serological indicators and other factors.It was expected to be a necessity to conduct prospec-tive and multicenter studies to develop a risk prediction model for predicting RFS for ICU patients.Our review provides a refer-ence for early assessment and intervention for critically ill patients with RFS.
5.A concept analysis of reflective practice in nurses
Yanyan DONG ; Jingda PAN ; Jiaxin HE ; Suiyi LIN ; Hongjing YU ; Donglan LING
Chinese Journal of Nursing 2024;59(1):124-128,封3
Objective To clarify and analyze the concept and connotation of the reflective practice in nurses.Methods CNKI,Wanfang,CBM,PubMed,Embase,Scopus,CIHNAL database were searched in relation to reflective practice in nurses.The retrieval period was from the inception to Dec.2022.Walker and Avant's concept analysis method was used to analyze the connotation.Results A total of 43 articles were retrieved.6 attributes of reflective practice in nurses were identified,including active engagement,critical thinking,openness and acceptance,making connections with previous knowledge or experiences,extemal support,dynamic and continuity.Antecedents included internal and extemal drivers.The reflective practice in nurses ultimately had a vital impact on themselves,patients and organizations.In recent years Reflective Practice Questionnaire has been one of the most commonly used data collection tools to measure the reflective practice in nurses.Conclusion The concept attributes of reflective practice in nurses were identified by concept analysis method,which provides references for nursing educators to cultivate reflective practice ability of nurses.In future research,researchers can combine the connotations of reflective practice for nurses to develop specific assessment tools for testing the level of reflective practice of nurses and construct the local reflective practice intervention scheme for nurses,so as to promote the development of reflective practice in nursing field in China.
6.Summary of the best evidence for intracranial hypertension care in adults with severe brain injury
Yiheng CHENG ; Donglan LING ; Chuanhui XU ; Hongjing YU ; Yongyi YE ; Hongbo YAN ; Jinhua LI ; Xiaodie ZHANG ; Huiling GUO
Chinese Journal of Practical Nursing 2023;39(26):2051-2059
Objective:To summarize the best evidence of intracranial hypertension nursing for adult patients with severe brain injury, and to provide reference for clinical nursing practice.Methods:According to the evidence-based methodology, a systematic search of Chinese and English literature on intracranial hypertension nursing of adult patients with severe brain injury was conducted in domestic and foreign databases such as CNKI, Wanfang, PubMed, Cochrane Library and Cinahl Plus and so on, as well as related guide websites and professional association websites from the establishment of database to August 2022. Two researchers independently evaluated literature quality and screened evidence, and then the project team summarized and concluded the evidence.Results:A total of 6 009 articles were obtained through preliminary search, and 33 articles were included after screening, including 13 guidelines, 1 systematic review, 17 expert consensus, 1 evidence summary, and 1 meta-analysis. In total, 33 pieces of best evidence were obtained from 8 dimensions, including intracranial pressure related threshold, assessment and monitoring, respiratory care, circulation care, analgesic and sedative care, temperature care, nutrition care and cerebrospinal fluid care.Conclusions:This study summarizes the evidence-based basis of intracranial hypertension nursing in adult patients with severe brain injury, which provides a basis for the standardized construction of clinical nursing strategies and empirical research.
7.Summary of the best evidence for diet management in patients with chronic kidney disease in stage 3-5 D
Lulu MO ; Guifen GUAN ; Xiaochun LAI ; Xiangjun QIN ; Lijun YANG ; Chang LIU ; Dongxi HONG ; Zebin WANG ; Donglan LING
Chinese Journal of Modern Nursing 2022;28(16):2152-2161
Objective:To summarize the evidence of diet management in patients with chronic kidney disease (CKD) in stage 3-5 D, so as to provide a reference for clinical nursing.Methods:After establishing evidence-based nursing questions, according to the "6S evidence model", the evidence on diet management of patients with CKD in stage 3-5 D was searched by computer, including computer decision support system evidence, guidelines, best evidence summary and systematic review. The search time limit was from the establishment of the database to September 2020. The guideline quality assessment was independently completed by two research nurses and a doctor of nephrology. The quality assessment of non-guideline article was independently completed by two research nurses, and an evidence-based instructor participated in decision-making. The evidence was extracted, evaluated and graded using the Joanna Briggs Institute (JBI) 2014 version of the intervention research evidence pre-grading system.Results:A total of 19 articles that met the requirements were included, including 5 guidelines, 8 systematic reviews, 4 randomized controlled trials, 1 clinical decision, and 1 national standard. A total of 22 pieces of the best evidence on diet management of patients with CKD in stage 3-5 D were summarized from three aspects, namely, diet/nutrition assessment, diet management, teamwork and education.Conclusions:The best evidence of diet management in patients with CKD in stage 3-5 D provides a certain reference for clinical practice, so as to improve the quality of diet management in patients with CKD and the clinical outcomes of patients.
8.Phenomenological study of the effects of traumatic birth events on compassion fatigue among midwives
Yao YANG ; Meiling HUANG ; Yun CHEN ; Jiamei LI ; Aobuli RUKIYAM ; Yulan REN ; Taizhen LUO ; Donglan LING ; Xi SU
Chinese Journal of Practical Nursing 2022;38(33):2587-2593
Objective:To provide theoretical reference for the construction of effective prevention and control strategies. The study deeply investigates the impact of traumatic birth events on compassion fatigue and inner feelings of midwives.Methods:Fifteen midwives from five tertiary hospitals in Guangzhou were interviewed in depth by semi-structured interview method from April to June 2021. Colaizzi analysis and Nvivo12 plus software were used to analyze and integrate the data and extract themes.Results:Three main themes were extracted, including the characteristics of traumatic birth events (high incidence, sudden and dangerous, preventable and controllable); exacerbating compassion fatigue (reducing compassion satisfaction levels; exacerbating burnout; and aggravating traumatic stress responses); and exploring effective coping strategies (time required for adjustment, seeking stress release).Conclusions:As a strong stressor, traumatic birth events aggravate the symptoms of compassion fatigue in midwives. Managers should pay attention to the occupational exposure of traumatic childbirth events, actively guide midwives to make psychological adjustments. In addition, managers can increase social support and strengthen the ideological and political education of midwives, so that they have good stress tolerance and excellent professional psychological quality.
9.Qualitative research on the driving force of health promotion behavior in elderly patients with acute myocardial infarction after PCI
Wanting LI ; Hongjing YU ; Donglan LING ; Qingyun LU ; Xuemei LIU
Chinese Journal of Modern Nursing 2021;27(11):1407-1412
Objective:To explore the driving factors of health promotion behavior in elderly patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI) after discharge, and to provide a basis for improving the health behavior of patients.Methods:This research adopted the method of phenomenological research in qualitative research. From November 2019 to January 2020, purpose sampling was used to select 12 elderly patients with AMI who underwent PCI after follow-up visits in the AMI Outpatient Clinic of a Class Ⅲ Grade A hospital in Guangzhou as the research objects. Semi-structured interview was used to conduct in-depth interviews with patients. The data was analyzed using the Colaizzi 7-step analysis method.Results:A total of two themes were refined: (1) endogenous driving forces, including four sub-themes of positive self-perception of aging, family responsibility perception, expectations for future social development, and health-related sense of control; (2) exogenous driving force, including three sub-themes of social support system, natural and social medical environment, and long-term medical economic costs.Conclusions:The driving forces for health promotion behaviors in elderly patients undergoing AMI after PCI are complex and diverse. Medical and nursing staff should mobilize the endogenous and exogenous driving forces of the patients according to the individual characteristics of elderly patients, urge them to adopt health promotion behaviors and develop a good healthy lifestyle.
10.Best evidence summary of percutaneous pericardial drainage tube nursing
Xuemei LIU ; Yuqin GU ; Hongjing YU ; Wanting LI ; Xiaocui CAO ; Liying YUAN ; Jian SONG ; Yongyan KUANG ; Caiyin ZHOU ; Lin YANG ; Wen LI ; Donglan LING ; Wei GUO
Chinese Journal of Modern Nursing 2021;27(32):4453-4458
Objective:To select the relevant evidence of percutaneous pericardial drainage tube nursing and summarize the best evidence.Methods:Evidence-based questions were established based on PIPOST model. BMJ Best Clinical Practice, China Biology Medicine disc (CBM) , UpTodate, Cochrane Library, Joanna Briggs Institute Evidence-based Health Care Database, China Guide Network, British Guide Network, National Guide Line Clearing House (NGC) , PubMed, EMbase, Evidence-based Medicine (EBM) , Registered Nurses' Association of Ontario (RNAO) , The European Society of Cardiology (ESC) , American Heart Association (AHA) , Chinese Journal Full-text Database and Wanfang Database were conducted computer retrieval. The search time was from the establishment of the database to December 31, 2020. Two researchers respectively evaluated the quality of the included literature and extracted data and summarized and summarized the evidence that met the standards.Results:Finally, 12 articles were included, including 1 evidence summary, 2 systematic reviews, 1 systematic assesment, 2 guidelines, 1 expert consensus and 5 case series studies. Finally, 11 pieces of evidence were formed, including 6 themes such as drainage tube selection, puncture wound nursing, drainage flow control, flushing and sealing of the tube, observation and recording points, extubation indications and care.Conclusions:This study summarizes the best evidence for percutaneous pericardial drainage tube nursing, which provides evidence-based basis for improving the quality of percutaneous pericardial drainage tube care.

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