1.Qualitative research on changes of psychological resilience of nurses rushing to ICU in Wuhan under COVID-19 epidemics
Dan SHI ; Lijuan ZHOU ; Min ZHOU ; Li ZOU ; Guoqin FENG ; Zhenqing REN
Chinese Journal of Modern Nursing 2020;26(32):4516-4520
Objective:To understand changes in psychological resilience of nurses rushing to ICU in Wuhan under COVID-19 epidemics, and provide a theoretical basis for the psychological adjustment and psychological intervention of nurses in public health emergencies.Methods:Using phenomenological research method, the first batch of nurses from Nursing Department of Taizhou People's Hospital to assist Wuhan medical team in February 2020 were selected as the research objects based on Richardson psychological resilience model by the purposive sampling method. The diaries of 9 nurses who assisted Wuhan ICU were used as the original data, and the data collection time was based on the principle of data saturation. The data reached saturation after 18 days of rushing to Wuhan. A total of 9 nurses all completed the diary writing, with a total of approximately 28 452 words. The Colaizzi method was used to analyze the data and extract the topic.Results:A total of 3 first-level themes and 8 second-level themes were extracted, namely the stress period (intrusive thoughts, physical challenges, psychological distress) , buffer zone (psychological capital mobilization, team resilience stimulation, comprehension of social support) and restructuring period (balance restoration, self-transcendence) .Conclusions:Psychological resilience is not a constant psychological feature, but a constantly changing process in the game of destruction and reorganization. The psychological resilience of nurses rushing to ICU in Wuhan is in a dynamic process of stress-buffer zone-reorganization period, while enhancing team resilience and external support is conducive to the healthy development of the balance of psychological resilience of nurses who rushed to wuhan.
2.Optimal proportion between peripherally inserted central catheter vein and catheter among hematologic tumor patients
Xiaomei QI ; Xinhong DING ; Guoqin REN ; Hongxia HUA ; Qi CAO
Chinese Journal of Modern Nursing 2019;25(6):720-722
bjective? To explore the proportion between peripherally inserted central catheter (PICC) vein and catheter on hemorrhage and plugging among hematologic tumor patients. Methods? From February 2016 to February 2018, we selected 105 patients of department of hematology in Wuxi Second People's Hospital of Nanjing Medical University as subjects. Before PICC, vein diameter was measured with the portable color doppler ultrasound system to obtain the proportion between catheterization vein and catheter diameter. Among 105 PICC catheterization cases of hematologic tumor patients, proportions between catheterization vein and catheter diameter were divided into three groups including <2,2 to 3,>3,35 cases in each group. We observed the incidences of hemorrhage and plugging at different proportions of catheterization. Results? There was no statistical difference in the amount of bleeding of hematologic tumor patients among three groups after catheter (P>0.05). There was a statistical difference in the incidence of plugging (P<0.05). Conclusions? The incidence of hemorrhage and plugging of hematologic tumor patients after PICC cannot be ignored. The proportion between catheterization vein and catheter diameter has no obvious effect on hemorrhage after catheter, but it can affect the incidence of catheter plugging. Therefore, we should apply visual assessment instrument to exactly measure the internal diameter of vein and select appropriate catheter to reduce the complications after catheterization.
3.Effect of companion support on oral medication compliance and anxiety in tumor patients
Hongxia HUA ; Guoqin REN ; Huifen LU
Chinese Journal of Modern Nursing 2017;23(9):1227-1230
Objective To investigate the effects of companion support on oral medication compliance and anxiety in tumor patients.Methods A total of 78 cases of tumor patients with pain were randomly divided into intervention group (n=39) and control group (n=39) and investigated using randomized controlled study. Patients in control group received routine analgesic care, while patients in intervention group received additional 3-month companion support intervention. Treatment compliance and anxiety of patients were compared between two groups.Results After the intervention, patients′ treatment and medication compliance including number of oral medication, medication time, dosage, adherence to continuous medication in intervention group were better than patients in control group. The differences were statistically significant (t=6.366, 2.646, 3.552, 2.588, 3.551;P<0.05). The scores of anxiety of the patients in intervention group were significantly lower than that in control group (t=-2.542,P<0.05).Conclusions Companion support intervention can increase oral medication compliance and improve the anxiety of tumor patients.
4.Application status and prospects of SBAR communication mode in national medical facilities
Xiaomei TU ; Guoqin REN ; Dajiang XIAO ; Ying JIANG
Chinese Journal of Modern Nursing 2017;23(27):3441-3445
Medical security is the core of hospital management at home and abroad. To ensure patient safety, it is the responsibility of the medical staff. However, the effective communications of physicians and nurses and among nurses are patient's safety guarantee. Situation-background-assessment-recommendation (SBAR) communication mode in clinical communication has much positive effect in aspects of validation, gradually become important communication mode. From the origin and framework of SBAR communication mode, this article summarize from carrying out the form and the enlightenment to today's management, in order to provide theoretical reference for clinical application.
5.Implementation of SBAR communication mode in handover of postoperative patients from operating room to intensive care unit
Ping YU ; Guoqin REN ; Jingjing ZHANG ; Yan ZHANG
Chinese Journal of Modern Nursing 2017;23(27):3446-3449
Objective To explore the effect of situation-background-assessment-recommendation (SBAR) communication mode in handover of postoperative patients from operating room (OR) to intensive care unit(ICU).Methods From March 2015 to June 2015, 32 postoperative patients form OR to ICU were recruited in compared group where traditional handover was used. Forty-four patients were then recruited in intervention group since October 2015 to June 2016 where SBAR handover mode was implemented. In intervention group, SBAR handover mode and SBAR handover sheet was build based on previous research as well as training was done for handover nurses. The quality of handover prior to and after the implementation of SBAR handover mode was compared. The degree of recalled information of handover and the proportion of incident reports due to communication errors, as well as the duration of handover were calculated.Results The quality of handover improved from (64.20±2.09) to (71.13±3.10) after the implementation of SBAR handover mode(t=10.15, P<0.01). The degree of recalled information of handover increased from 88.25% to 94.55% for handover nurses (χ2=6.73,P<0.01)while the duration of handover shorted from (18.97±2.12)min to (13.34±2.47)min (t=10.41, P<0.01).Conclusions SBAR handover mode is able to improve the quality and timeliness of handover which can further ensure the accuracy and integrity of handover information and worth popularizing.
6.Application of SBAR communication mode on safety management in emergency department
Jingjing ZHANG ; Ping YU ; Guoqin REN
Chinese Journal of Modern Nursing 2017;23(27):3450-3453
Objective To explore the application of SBAR communication culture in emergency department,so as to promote the effective communication between doctors and nurses and ensure the safety of patients.Methods From July 2015 to June 2016,by setting up an emergency SBAR studio, training, implementation and monitoring of the SBAR communication model for medical staff were carried out, and compared the effect of SBAR communication mode before and after the implementation of the medical cooperative attitude scale,the safety attitude scale and the self-made communication satisfaction scale, and counted the incidence of adverse events caused by communication barriers.Results After the SBAR communication mode,the attitude of nursing cooperation (52.06±4.52) score, and the satisfaction of medical staff (65.62±3.84) were significantly improved compared with before (t=10.905, 6.676;P<0.05),due to communication barriers caused by adverse events and hidden trouble from the previous 50% to decline after the development of the 14.29% (χ2=4.453,P<0.05).Conclusions SBAR communication mode improves the standardization, accuracy and effectiveness of information in emergency medical communication, and has a significant effect on improving the team cooperation and promoting the safety of patients.
7.Impacts of SBAR communication mode on satisfaction among physicians, nurses and patients
Guoqin REN ; Lihua YI ; Yan ZHANG ; Haiying LIU
Chinese Journal of Modern Nursing 2017;23(27):3453-3456
Objective To analyze the changes of the three-party satisfaction (physicians, nurses and patients) after the implementation of situation-background-assessment-recommendation (SBAR) communication mode.Methods The SBAR work group was established in one hospital and implemented SBAR communication based the question direction in Department of Neurosurgery, Neurology, Intensive Care Unit, Orthopedics, EICU and Cardiology Department of one hospital. The comparison of the differences in satisfaction and the incidence of adverse medical care events were carried out among the doctors, nurses and patients before and after the implementation of the SBAR communication model.Results After the implementation of SBAR communication mode, the satisfactions in doctors, nurses and patients were 94.0%, 96.0% and 98.2%, that all were better than traditional communication before the implementation (Z=1.700,2.000,2.974;P<0.05). The medical incidence of adverse events declined from 0.38% to 0.13% (χ2=6.276,P<0.05).Conclusions SBAR communication mode plays an important role in continuously improving the quality of medical care, promoting effective communication and ensuring the safety of patients, and deserves clinical application.
8.Application of SBAR communication mode in the transfer and the handover of surgical patients in the department of surgery
Xiaoxu RONG ; Guoqin REN ; Yuanting ZHOU
Chinese Journal of Modern Nursing 2017;23(27):3457-3460
Objective To explore the application and the effect of the situation-background-assessment-recommendation (SBAR) communication mode in the transfer and the handover of surgical patients. Methods One hundred patients who had orthopedic surgeries from June 2015 to December 2015 were included into the control group. They were managed with the traditional method for the surgical transfer and handover. One hundred patients who had orthopedic surgeries from January 2016 to June 2016 were included into the research group. They were managed with the SBAR communication mode for the surgical transfer and handover. The success rate of the surgical transfer and handover, the satisfaction of medical workers, the incidence of adverse events and the average time of the surgical transfer and handover in the patients in the 2 groups were compared. Results In the surgical transfer and handover, the incidence of adverse events such as falling down from bed, the pipeline disconnection, the fluid extravasation, the disease exacerbation in the research group was 2.0%, which was significantly less compared to the control group (20.0%)(χ2=2.020,P<0.05). The average time of the surgical transfer and handover in the research group was (8.5±5.5)min, which was significantly shorter compared to the control group (11.7±8.5)min(t=3.025,P<0.05).Conclusions The application of the SBAR communication mode in the transfer and handover in surgical departments can effectively reduce adverse events and shorten the time of the surgical transfer and handover. It also improves the efficiency of the surgical transfer and handover, ensures patients' safety and promotes the satisfaction.
9.Application effect of elaborative SBAR communication mode in hospital surgical teams
Liting WEN ; Xueping HU ; Guoqin REN ; Lihua YI
Chinese Journal of Modern Nursing 2017;23(27):3461-3464
Objective To investigate the implementation effect of the situation-background-assessment-recommendation (SBAR) communication mode in hospital surgical teams from the elaborate perspective. Methods Since 2015, the surgical teams of Wuxi No.2 People's Hospital, Affiliated to Nanjing Medical University combined the elaborate management with the SBAR communication mode. The elaborate SBAR report mode was established in the surgeries. Security check reports were carried out in the surgeries. The quality of the nurses' shifting of duty, the incidence of adverse events and the satisfaction of patients after the implementation of the mode were compared to before the implementation.Results The time of the nurses' shifting of duty was shortened from (13.1±4.5)min to(7.4±2.1)min significantly (t=10.737,P<0.01). The incidence of adverse events due to poor communication decreased from 50% to 13.33% significantly (χ2=4.950,P<0.05). The patients' satisfaction on the work of operating rooms increased from 84.44% to 95.74% significantly (χ2=6.652, P<0.05).Conclusions The implementation of the hospital surgical team SBAR communication mode in operating rooms from the elaborate perspective effectively upgrades the meaning of specialist care, optimizes the service procedure and reduces the incidence of adverse events due to poor communication, which guarantees the safety of surgical patients.
10.Application effect of SBAR communication mode in the intensive care unit in the department of neurosurgery
Yan ZHANG ; Guoqin REN ; Haiping PAN ; Shidi ZHAO
Chinese Journal of Modern Nursing 2017;23(27):3464-3467
Objective To evaluate the application effect of the situation-background-assessment-recommendation(SBAR) communication mode in the intensive care unit in the department of neurosurgery (NSICU).Methods From January 2015, the SBAR communication mode was carried out in the shifting of duty for the nurses in the intensive care unit in the department of neurosurgery. The SBAR communication standard of patients' condition was initiated in the communication between nurses and doctors. The implementation effect of the mode was evaluated by the comparisons of the time of the nurses' shifting of duty, the incidence of adverse events, the average hospital stay of patients, the satisfaction of patients between before the implementation (the year of 2014) and after the implementation(the year of 2015).Results After implementing the SBAR communication mode, the incidence of pressure sores decreased from 2.64% to 0.39% significantly (χ2=4.252, P<0.05). The incidence of extubation decreased from 1.76% to 0% significantly (χ2=4.531,P<0.05). The satisfaction of patients increased from 91.4% to 97.7% significantly (χ2=4.714,P<0.05). The handover time of the nurses was shortened from (8.7±2.1)min every time to(6.1±1.9)min every time significantly (t=2.045, P<0.05). The average hospital stay in the NSICU was shortened from (13.2±2.5)day to(10.5±2.1)day significantly (t=2.057,P<0.05).Conclusions The implementation of the SBAR communication mode is helpful to standardize the shifting of duty and the communication process of doctors and nurses, ensure the safety of patients and improve the satisfaction, which is worth promotion and reference.

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