1.Overview of systematic reviews of prevention and management of medication errors in adult patients
Zhide MAI ; Mo YI ; Ke LI ; Jianxia ZHANG ; Zhiwen WANG
Chinese Journal of Modern Nursing 2024;30(20):2716-2723
Objective:To overview the systematic reviews of prevention and management measures of medication errors, so as to provide evidence support for clinical decision-making for medical staff.Methods:Cochrane Library, Australia Joanna Briggs Institute Evidence-based Healthcare Center database, CINAHL, PubMed, Embase, CNKI, SinoMed, Wanfang database and VIP database were searched by computer to search for systematic reviews of prevention and management measures of medication errors, and the search period was from establishment of the databases to June 30, 2023. Two researchers with systematic evidence-based training applied A Measure Tool to Assess Systematic Reviews 2 (AMSTAR 2) to evaluate the literature quality, and Grades of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of outcome indicators.Results:Finally, a total of 19 systematic reviews were included. The overall quality evaluation using AMSTAR 2 was relatively low, with one article rated as high-quality, one article rated as low-quality and 17 articles rated as extremely low-quality. According to the evidence quality evaluation results of GRADE system for 55 outcome indicators of 19 systematic reviews, 3 pieces of evidence were medium, 27 pieces of evidence were low and 25 pieces of evidence were extremely low, indicating an overall low quality of evidence.Conclusions:The related researches on prevention and management of medication errors have been carried out extensively, and the computer system is one of the effective measures to reduce medication errors. The effectiveness of measures such as administration process modification, doctor/nurse education and training, double check, pharmacist intervention, automated dispensing cabinet/ automated pump and drug display is still unclear and needs to be further confirmed by large sample size and high-quality studies.
2.Influencing factors of the outcome in patients with asymptomatic intracranial hemorrhage after endovascular therapy for large vessel occlusive stroke in anterior circulation
Jinrui LI ; Jianxia KE ; Xiaoli FU ; Weicheng ZHENG ; Zhu SHI
International Journal of Cerebrovascular Diseases 2024;32(9):654-660
Objective:To investigate the influencing factors of the outcome in patients with asymptomatic intracranial hemorrhage (aICH) after endovascular therapy (EVT) for large vessel occlusive stroke in anterior circulation.Methods:Patients with large vessel occlusive stroke in anterior circulation underwent EVT at Dongguan People's Hospital from January 2019 to January 2023 were included retrospectively. According to the CT re-examination results within 72 hours after EVT and the changes in the National Institutes of Health Stroke Scale (NIHSS) score, the patients were divided into non-ICH group and aICH group. At 90 days after onset, the modified Rankin Scale was used to evaluate functional outcome, >2 points were defined as a poor outcome. Multivariate logistic regression analysis was used to determine the independent correlated factors for outcome. Results:A total of 173 patients who did not experience intracranial hemorrhage (ICH) or experienced aICH after EVT were enrolled, including 121 males (69.9%), median aged 64.0 years. Sixty-four patients (37.0%) developed aICH after EVT, of which 44 (68.8%) were hemorrhagic infarction (HI) and 20 (31.2%) were parenchymal hematoma (PH). The incidence of poor outcome in the ICH group was significantly higher than that in the non-ICH group (42.2% vs. 26.6%; χ2=4.472, P=0.034). In aICH patients with poor collateral circulation, the proportion of patients with poor outcome was significantly higher than in all non-ICH patients (68.7% vs. 26.6%; χ2=11.388, P<0.001), while there was no significant difference in the proportion of patients with poor outcome in the good collateral circulation group compared to all non-ICH patients (23.5% vs. 26.6%; χ2=0.072, P=0.788). In aICH patients, the proportion of PH (68.7% vs. 11.8%; χ2=14.561, P<0.001) and poor outcome (68.7% vs. 23.5%; χ2=7.209, P=0.027) in patients with poor collateral circulation were significantly higher than that of good collateral circulation. Multivariate logistic regression analysis showed that poor collateral circulation (odds ratio [ OR] 3.84; 95% confidence interval [ CI] 1.07-12.76; P=0.039), older age ( OR 1.07, 95% CI 1.02-1.11; P=0.004), unsuccessful recanalization ( OR 6.36, 95% CI 1.74-23.23; P=0.005) , and PH ( OR 6.14, 95% CI 1.83-20.58; P=0.003) were the independent risk factors for poor outcome in patients with aICH. Conclusions:Among patients who developed aICH after EVT, the proportion of patients with poor outcome in the good collateral circulation group is comparable to that in the non-ICH group, but the risks of PH and poor outcome are significantly increased in the poor collateral circulation group. Poor collateral circulation is an independent risk factor for poor outcome in patients with aICH after EVT for large vessel occlusive stroke in anterior circulation.
3.Analysis of the current situation and influencing factors of work engagement of wound therapists
Zhide MAI ; Ke LI ; Miao YU ; Jianxia ZHANG ; Yanming DING
Chinese Journal of Nursing 2023;58(23):2889-2895
Objective To understand the current status and analyze the factors affecting the work engagement of wound therapists,and to provide references for promoting their work engagement.Methods From September 2022 to March 2023,wound therapists who were certificated by European Wound Management Association for more than 3 months were selected as subjects by convenient sampling method.The data was collected by the General Information Questionnaire,Hospitals and Wound Clinics Questionnaire,Areas of Worklife Scale and Specialty Nurse Work Engagement Scale,and the factors influencing the work engagement of wound therapists were analyzed by univariate and multiple liner regression.Results A total of 219 wound therapists were included.The total mean score of areas of worklife was(99.37±13.70);the average score of items was(3.55±0.49);the total mean score of the specialty nurse work engagement was(140.01±16.00);the average score of items was(4.38±0.50).The results of multiple linear regression analysis showed that reward,community,fairness,and values were factors influencing the work engagement of wound therapists(P<0.05).Conclusion The higher average score of each dimension of areas of worklife could predict the higher level of work engagement for wound therapists.Nursing managers should pay more attention to the job-matching degree of specialty nurses and adopt scientific and effective management methods to improve the job-matching,which will help improve the specialty nurses'work engagement and satisfaction and reduce job burnout.
4.Summary of best evidence for clinical use of closed tracheal suction systems devices in adults
Ke LI ; Zhennan YANG ; Shuyu HAN ; Jianxia ZHANG ; Mengjie ZHANG
Chinese Journal of Modern Nursing 2022;28(23):3154-3160
Objective:To search, evaluate and summarize the evidence of the safety and application of closed tracheal suction systems and to provide reference for clinical nursing work.Methods:BMJ Best Practice, UpToDate, Joanna Briggs Institute Evidence-based Health Care Center, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, American Assocition for Respiratory Care, Society of Critical Care Medicine, Medlive, Cochrane Library, PubMed, Embase, CINAHL, CNKI, Wanfang Database, China Biology Medicine disc were searched for related guidelines, system reviews, expert consensus, best practices, etc. The retrieval time was from the database construction to February 28, 2021. Two researchers independently evaluated the quality of the included literature and extracted and summarized the evidence of the literature that met the quality standards.Results:A total of 20 literatures were included, including 3 clinical decisions, 2 guidelines, 11 systematic reviews and 4 expert consensuses. A total of 27 pieces of best evidence were compiled from five aspects, including indications for use, clinical effects, safety, methods of use and replacement.Conclusions:This study summarizes the best evidence on the clinical application of closed sputum suction devices in adults. When applying the evidence, clinical nurses need to select the best evidence in combination with the clinical environment to standardize the clinical application of closed tracheal suction systems.
5.Reproducibility of a portable spirometer based on differential pressure sensor.
Kun ZOU ; Chaomin NI ; Zhijun HE ; Yongliang ZHANG ; Zuchang MA ; Jianxia SONG ; Ke ZHANG
Chinese Journal of Medical Instrumentation 2013;37(1):30-48
OBJECTIVEAssessing the reproducibility of a portable spirometer, including reproducibility of inter-observer and day-today.
METHODSLung ventilation function was performed in 22 healthy volunteers by two observers on the same day and repeated by the first observer after 24h.
RESULTSThe inter-observer and day-to-day intra-class correlation coefficients are all higher than 0.75. There are no significant difference between each other. Bland-Altman chart shows good limits of agreement between inter-observer and day-to-day, only scattered data are outside of the limits of agreement.
CONCLUSIONSThe portable spirometer shows good inter-observer and day-to-day reproducibility, and can be used for testing lung function in clinical.
Adult ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Ambulatory ; instrumentation ; Observer Variation ; Reproducibility of Results ; Spirometry ; instrumentation

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