Objective This study aims to explore the application effectiveness of the PDCA cycle method in preventing and reducing internal errors in the intravenous drug dispensing center(PIVAS).Methods Internal error data from our hospital's PIVAS in 2020 and 2021 were collected.The data from 2020 represented the pre-implementation of the PDCA cycle,while the data from 2021 represented the post-implementation period.The changes in internal errors and error rates before and after imple-mentation were compared.Results After implementing the PDCA cycle management measures,the annual error rate decreased from 0.887％o in 2020 to 0.681‰ in 2021,a decrease of 23.22％.Conclusion The PDCA cycle method can effectively reduce the occurrence of internal errors,improve work accuracy,and ensure the safety of clinical drug use in PIVAS.

Objective This study aims to explore the application effectiveness of the PDCA cycle method in preventing and reducing internal errors in the intravenous drug dispensing center(PIVAS).Methods Internal error data from our hospital's PIVAS in 2020 and 2021 were collected.The data from 2020 represented the pre-implementation of the PDCA cycle,while the data from 2021 represented the post-implementation period.The changes in internal errors and error rates before and after imple-mentation were compared.Results After implementing the PDCA cycle management measures,the annual error rate decreased from 0.887％o in 2020 to 0.681‰ in 2021,a decrease of 23.22％.Conclusion The PDCA cycle method can effectively reduce the occurrence of internal errors,improve work accuracy,and ensure the safety of clinical drug use in PIVAS.

Objective To investigate the effect of tiopronin on renal function during anti-tuberculosis liver protection therapy.Methods Clinical data of patients with initially treated sensitive tuberculosis treated in our hos-pital from September 2019 to September 2022 and whose anti-tuberculosis regimen was only isoniazid,rifampicin,pyrazinamide and ethambutol were retrospectively analyzed.The patients were divided into study group and control group according to whether tiopronin was used.The baseline data,blood creatinine(Scr),blood urea nitrogen(BUN),urine protein,creatinine clearance,drug combination and related adverse reactions of the two groups were compared.Results Patients obtained based on inclusion and exclusion criteria were divided into a study group(n=102)(antitubercular drugs+tiopronin)and a control group(n=105)(antitubercular drugs+glutathione).There were no statistically significant differences(P＞0.05)in ALT,AST,DBIL,and TBIL levels between the two groups before treatment,at Middle and late treatment.At the later stage of treatment,serum Scr,BUN,creatinine clearance and urinary protein showed statistical differences between the study group and the control group(P＜0.05).The abnormal rate of indicators and the incidence of adverse reactions in the study group were higher than those in the control group at the later stage of treatment(P＜0.05).Conclusion For patients undergoing tuberculosis treatment,the efficacy of tiopronin and glutathione in protecting the liver is comparable.However,in terms of renal function,long-term use of tiopronin is associated with more pronounced damage.Due to the relatively low cost of tiopronin,for families with heavy economic burdens,short-term use of the drug can ensure safety,while long-term use requires close monitoring of renal function changes and timely adjustments to medication.

Objective:To study the risk factors of venous thromboembolism(VTE)and the predictive value of the improved VTE score model to identify the risk of VTE in gynecological surgery patients.Methods:From Janu-ary 1,2020 to December 31,2022,41 patients with VTE after gynecological surgery were selected as the VTE group,and a total of 164 patients with adjacent gynecological surgeries during the same period were selected as the non-VTE group with a ratio of 1 :4.Univariate and multivariate Logistic regression analysis were used to ana-lyze the risk factors of VTE after gynecological surgery,and a modified VTE risk factor rapid assessment model(referred to as the improved VTE score model)was constructed.The receiver operating characteristic(ROC)curve was used to study the predictive value for VTE for in gynecological surgery,and compared with the Caprini score model(Caprini table for short).Results:①Multivatiate Logistic regression analysis showed that there were independent risk factors for postoperative VTE in gynecology surgery(OR＞1,P＜0.05),including age≥60 years,BMI≥28 kg/m2,malignant tumors,surgery time＞3 hours,history of thrombosis,and the increased D-di-mer difference before and after surgery.②The Area under Curve(AUC)of ROC was 0.963 in the improved VTE score model with a Youden index 81.10％,sensitivity 87.80％and specificity 93.29％.The AUC of the Caprini score model was 0.888 with Youden index 63.41％,sensitivity 73.17％and specificity 90.24％.The improved VTE score model the Caprini score model identified 92.68％and 85.37％of VTE patients as high-risk or ex-tremely high-risk,respectively,but the difference was not statistically significant(P＜0.05).Conclusions:More attention should be paid to the six independent risk factors for postoperative VTE in gynecology surgery.The two score models showed a similar identified level.However,the improved VTE score model is more simple and easier to operate,has better practicality,and has certain clinical promotion value.

Objective:To explore the effect of comfort nursing intervention in hospice care for advanced cancer patients at home, and to provide reference for hospice care for advanced cancer patients at home.Methods:A randomized controlled trial was conducted. A total of 105 patients with advanced cancer who were treated in the Cancer Hospital Affiliated to Harbin Medical University from January to February 2023 were selected as the research objects. According to the random number table, they were divided into control group of 53 cases and intervention group of 52 cases. The control group received routine nursing methods, while the intervention group received comfort nursing interventions on this basis. The intervention lasted for 4 weeks. The changes in palliative care outcomes, quality of life and death anxiety were compared between the two groups before and after intervention.Results:Totally 105 cases were included, 53 cases in the control group and 52 cases in the intervention group. In the control group, there were 25 males, 28 females, aged (58.96 ± 10.71) years old; in the intervention group, there were 22 males, 30 females, aged (59.82 ± 10.53) years old. Before intervention, there was no statistically significant difference in palliative care outcomes, quality of life and cancer death anxiety scores between the two groups of patients (all P>0.05). After intervention, the total score of palliative care outcomes in the intervention group was (13.34 ± 5.88) points, significantly lower than (16.15 ± 5.72) points in the control group, with a statistically significant difference ( t = 2.48, P<0.05). The overall health status score of quality of life was (68.55 ± 9.34) points in the intervention group, higher than (63.01 ± 9.28) points in the control group ( t = 3.05, P<0.05). The total score of cancer death anxiety was (8.85 ± 2.72) points, significantly lower than (10.59 ± 3.14) points of the control group, with a statistically significant difference ( t = 3.04, P<0.05). Conclusions:The application of comfort nursing mode in home based hospice care can improve the quality of hospice care for advanced cancer patients, reduce their level of death anxiety, and is of great significance for improving the quality of life of advanced cancer patients.

Objective To investigate the effect of tiopronin on renal function during anti-tuberculosis liver protection therapy.Methods Clinical data of patients with initially treated sensitive tuberculosis treated in our hos-pital from September 2019 to September 2022 and whose anti-tuberculosis regimen was only isoniazid,rifampicin,pyrazinamide and ethambutol were retrospectively analyzed.The patients were divided into study group and control group according to whether tiopronin was used.The baseline data,blood creatinine(Scr),blood urea nitrogen(BUN),urine protein,creatinine clearance,drug combination and related adverse reactions of the two groups were compared.Results Patients obtained based on inclusion and exclusion criteria were divided into a study group(n=102)(antitubercular drugs+tiopronin)and a control group(n=105)(antitubercular drugs+glutathione).There were no statistically significant differences(P＞0.05)in ALT,AST,DBIL,and TBIL levels between the two groups before treatment,at Middle and late treatment.At the later stage of treatment,serum Scr,BUN,creatinine clearance and urinary protein showed statistical differences between the study group and the control group(P＜0.05).The abnormal rate of indicators and the incidence of adverse reactions in the study group were higher than those in the control group at the later stage of treatment(P＜0.05).Conclusion For patients undergoing tuberculosis treatment,the efficacy of tiopronin and glutathione in protecting the liver is comparable.However,in terms of renal function,long-term use of tiopronin is associated with more pronounced damage.Due to the relatively low cost of tiopronin,for families with heavy economic burdens,short-term use of the drug can ensure safety,while long-term use requires close monitoring of renal function changes and timely adjustments to medication.

Objective:To explore the chain mediating effect of self-efficacy and positive coping styles between nurses′ adversity quotient on work engagement, so as to provide a theoretical reference for nursing managers to promote work engagement.Methods:A convenience sampling method was used to select 512 nurses from four tertiary hospitals in Shaanxi Province, and a cross-sectional study was conducted on them using the general information questionnaire, Adversity Response Profile, General Self-Efficacy Scale, Simplified Coping Style Questionnaire and Utrecht Work Engagement Scale-9.Results:The total scores of nurses' adversity response profile, self-efficacy, positive coping style and work engagement were 132.00(120.00, 139.00), 27.00(23.00, 29.00), 24.00(20.00, 25.00), 27.00(25.00, 35.00) points. Nurses' work engagement was significantly positively correlated with adversity quotient, self-efficacy and positive coping styles( r values were 0.523-0.614, all P<0.01). The independent mediation of self-efficacy or positive coping styles and the chain mediation of both accounted for 23.6%,40.9% and 15.9% of the total effect respectively. Conclusions:Nurses′ adversity quotient not only directly affected work engagemnet, but also indirectly affected work engagement through self-efficacy and positive coping style. The research suggested that managers should pay attention to the improvement of nurses′ self-efficacy and positive coping style, so as to promote nurses′ work engagement.

Objective To investigate the change of infusion particles and PH value of rifampicin for injection under dif-ferent configuration and application conditions,and to provide the best configuration method and the best infusion quality control strategy for rifampicin for injection.Methods The particle number and PH value of rifampin for injection were investigated and measured under different configuration and application conditions,and the factors affecting the formation of particles were ana-lyzed.Results The stable pH value of Rifampicin for injection was 7.2-8.1,and the number of particles was the least in the light filtering and 5%glucose 500 mL,and the number of particles was the least in 1～4 h after the configuration.Conclusion The optimal infusion quality control strategy is to filter rifampicin for injection by blocking light,500 mL of solute 5%glucose,1～4 h after configuration,and use of disposable precision filter infusion set.

Objective: To investigate the relationship between ultrasound derived ratio of femoral vein to femoral artery diameter and hemodynamics in patients with heart failure. Methods: This was a case-control study. A total of 61 patients with heart failure and 49 patients with non-heart failure hospitalized in the Department of Critical Care Medicine from September 2017 to September 2018 were included in this study. Doppler ultrasound was used to measure the femoral artery and vein diameter. After deep inhalation, the femoral vein diameter was measured again, and the ratio of femoral vein and artery diameter was calculated. The central venous pressure (CVP) and mean pulmonary wedge pressure (mPAWP) were also measured. Pearson correlation analysis was used to explore the correlation between the ratio of femoral vein diameter to femoral artery diameter and CVP and mPAWP, and linear regression equation was established. Results: The overall CVP and mPAWP levels were significantly higher, and the femoral vein diameter after deep inhalation was bigger in heart failure patients than in non-heart failure patients(all P<0.001). The femoral vein diameter/femoral artery diameter ratio was positively correlated with CVP (r=0.76, P<0.001), and positively correlated with mPAWP (r=0.40, P<0.001) in heart failure group. The linear regression equation established by the femoral vein/femoral artery diameter ratio and CVP in the heart failure group showed that the inner diameter of the femoral vein/the inner diameter of the femoral artery ratio≥1.3 corresponded CVP≥15.518 cmH₂O(1 cmH₂O=0.098 kPa) in heart failure patients. Conclusions In patients with heart failure, the inner diameter of the femoral vein/femoral artery ratio is positively correlated with CVP and mPAWP. The ratio of inner diameter of the femoral vein/femoral artery can be used to assess the volumetric load of patients with heart failure and to guide the clinical treatment of heart failure patients.

Objective To discuss effect of mechanical oiling and manual oiling in rust protection of coupling surgical instruments.Methods A total of 68 surgical instruments were divided into observation group and control group,with 34 surgical instruments in each group.The control group was treated with mechanical oiling,and the observation group used manual oiling,cleaning qualified rate,the rust rate after 3 months,lubricant amount and the average cost per month were observed.Results The qualified rate of surgical instruments by visual inspection in the control group was 99.09％,and was 98.77％ by magnifier,and the observation group were 99.23％ and 98.89％,respectively,but there was no significant difference between the two groups (P ＞ 0.05).Rust rate after 3 months was 8.94％ in the control group,and was 1.40％ in the observation group,there was significant difference between two groups (P ＜ 0.05).Lubricating oil amount and total cost of two groups in the control group were (28 800.00 ±618.96)mL,(12 180.00±256.78) RMB,and were (5 600.00 ±489.71) mL,(2 216.00 ± 189.93) RMB,respectively,in the observation group,and there was significant difference between two groups (P ＜ 0.05).Conclusion Compared with mechanical oiling,manual oiling has better lubrication effect and can significantly reduce cost and corrosion of equipment,improve the maintenance effect,and ensure the quality of disinfection equipment.