1.Core competence of stroke specialist nurses:current situation and influencing factors of 103 hospitals in Henan Province
Aixia WANG ; Lulu LI ; Gaile LI ; Mengge XIAO ; Xiyue WANG
Modern Clinical Nursing 2024;23(4):1-6
Objective To explore the current situation and influencing factors that affect stroke specialist nurses in Henan Province and provide a reference for targeted interventions.Methods A total of 140 stroke specialist nurses from over 103 general hospitals in Henan Province were selected to participate the study with the convenience sampling method,between March and November 2022.General data questionnaire and the core competence evaluation questionnaire of stroke specialist nurses in Henan Province were employed for the investigation.Influencing factors were analysed by binary Logistic regression.Results A total of 134 specialist nurses responded to the survey.The findings revealed that the total score of core competence in the stroke specialist nurses was 279.5(257.0,306.0).Among the dimensions of core competence,the clinical thinking ability scored the highest at 4.4(4.0,4.9),while professional development ability scored the lowest at 3.7(3.4,4.0).Cluster analysis categorised that the scores<250 were of a low score group(n=26)and those≥250 were of a high score group(n=108).Binary Logistic regression analysis indicated that education level,years working as a stroke specialist nurse,and the working experience in the stoke fast track team of A&E were the factors that influenced the core competence of the stroke specialist nurses in Henan Province(all P<0.05).Conclusions This study has found that the core competence of stroke specialist nurses in Henan Province is at an acceptable level.Education,years working as a stroke specialist nurse and the working experience in the fast track team of A&E are the primary factors which influence core competence.Nursing managers should devise supportive programs to target the influencing factors and to improve the core competence of the stroke specialist nurses.
2.Mediating roles of stress perception between personality traits and negative experience in nurses as second victim
Zhuoqing DENG ; Xiaohong ZHANG ; Fang HE ; Shu ZHANG ; Rongxin DU ; Jiaqi CHEN
Modern Clinical Nursing 2024;23(4):7-14
Objective To investigate the impact of influence of personality traits of nurses as second victim and negative experience of nurses in adverse event and explore the intermediary roles of stress perception in influencing mechanism of negative experience.Methods Between March and April 2023,a convenience sampling method was employed to select 560 nurses from 3 general hospitals in Taiyuan City to conduct the study.The selected nurse all had experienced adverse events within last 3 months.The survey employed a general information questionnaire,Chinese big five personality questionnaire,second victim experience and support scale and Chinese version of stress perception scale.Pearson's correlation analysis was conducted to explore the correlation between the personality traits of nurses as second victim(specifically neuroticism),negative experiences and stress perception.The mediating role of stress perception between the neuroticism of nurses as second victim and negative experiences of nurses was analysed using PROCESS plug-in with the Bootstrap method.Results All of 560 distributed questionnaires were recovered,with a 100.00%of response rate.Personality traits of nurses as second victim were ranked in descending order with rigor,agreeableness,openness,neuroticism and extroversion.Both negative experiences and stress perception had higher scores(40.25±10.64 and 30.25±5.98,respectively).Neurotic personality in nurses as second victim was positively correlated with negative experience(r=0.528,P<0.01)and stress perception(r=0.594,P<0.01).Negative experiences showed a positive correlation with stress perception(r=0.339,P<0.01).Neurotic personality of nurses as second victim had a significant direct impact on negative experiences[β=0.519,95%CI:0.318-0.720].As one of the stress perception dimensions,tension played a partial mediating role between neurotic personality in nurses as second victim and negative experience[β=0.148,95%CI:0.006-0.300],and a mediating effect percentage of 22.70%.Conclusions The neurotic personality of nurses as second victim can directly affect the negative experiences,either independently or in conjunction with tension.Nursing managers and nurses as second victims can reduce the negative experiences in adverse events by addressing higher neurotic personality and alleviating tension.
3.Knowledge,attitude and practice of transitional care in nurses of 41 hospitals in Shaanxi province:a cluster analysis of current status
Gaiping CHENG ; Zhihua YANG ; Jiang ZHAO ; Qin YUE ; Honghong SHEN ; Chunxiu FAN ; Juan XIE
Modern Clinical Nursing 2024;23(4):15-23
Objective To investigate current status in knowledge,attitude and practice(KAP)of transitional care among the nurses in Shaanxi province,identify the influencing factors that hinder the transitional care and carry out training of transitional care for the nurses in different specialties in order to provide a theoretical basis for establishing a transitional care model for discharged patients.Methods A total of 2 288 nurses were selected to participate the survey from 41 hospitals in Shaanxi province by the stratified two-stage random sampling method.A self-designed questionnaire for general information,an obstacle factor scale,and a KAP of transitional care questionnaire were used as the survey instruments.The data acquired from the survey were processed by Cluster analysis to identify potential categories and the influencing factors.Results Totally 2085 nurses finished the study.Total score of KAP of transitional care among the nurses in Shaanxi province was found at(134.96±23.75),which was at a medium level.The scores of knowledge,attitude and practice were 77.24%,80.64%and 76.98%respectively.Cluster analysis showed that all the nurses could be categorised into either a lower scored group(n=1 596,76.5%)or a higher scored group(489,23.5%),with a best potential category number of 2 for the 2 085 nurses who participated the survey.There were statistically significant differences between the groups in terms of care training,telephone follow-up,network platform,outpatient service of nursing experts,family visits,patient club and hospital categories(all P<0.05).Logistic regression analysis on even factors above showed that care training,telephone follow-up,network platform and patient club could significantly affect the potential categorisation of KAP of the nurses in transitional care(all P<0.05).The main factors that hindered the transitional care included insufficient human resources(93.81%),insufficient supply of community services(93.57%)and lack of a standardised flowchart for transitional care(93.09%).Conclusions Levels of KAP about the transitional care are at a medium level among the nurses of 41 hospitals in Shaanxi province,which indicates that the nurses are active in attitude,but the knowledge and practice are required to be further improved and standardised.The results of cluster analysis indicate that it is necessary for nursing managers to carry out targeted trainings in transitional care for the nurses in different categories.This study provides a theoretical basis to establish a diversified transitional care mode for discharged patients in Shaanxi province.
4.Design and application of WeChat based hospital-community-family nursing platform for premature infants
Fanglian FAN ; Yahong DA ; Ying LǙ
Modern Clinical Nursing 2024;23(4):23-30
Objective To develop a WeChat based hospital-community-family nursing platform for premature infants and evaluate its effect on transitional care for premature infants.Methods A hospital-community-family nursing platform for premature infants using the WeChat applet was developed.A total of 96 preterm infants hospitalised in our hospital between January and September 2021 were enrolled and randomly divided into an observation group and a control group using a random number table,with 48 per group.The premature infants in the observation group were offered with transitional care intervention based on the WeChat based nursing platform developed by us,and those in the control group were on routine outpatient clinic visits and telephone follow-ups.The premature infants of the two groups were compared in terms of physical development,neuropsychological development and re-admission rate within the age of one year.Results A total of 46 premature infants in the observation group and 47 in the control group went through the study.After the intervention,the body length,weight and head circumference of the preterm infants in the observation group were all significantly greater than those in the control group,with F-values between the two groups of 5.338(height),4.133(weight)and 3.069(head circumference)(all P<0.05).The total development quotient and the development quotient of each energy area in the observation group were significantly higher than those in the control group,with F-values between the two groups at 29.881(large movement),22.007(fine movement),17.722(adaptability),22.467(language),34.058(social)and 14.331(total developmental quotient)(all P<0.001).The readmission rate of the premature infants in observation group was statistical significant lower than that of the control group(P<0.05).Conclusions The WeChat based hospital-community-family nursing platform is effective in transitional care for premature infants.It can promote physical development and neuropsychological development of premature infants,and reduce the readmission rate..
5.Effect of individualized fall prevention strategies on fall prevention among patients with Parkinson's disease
Na YIN ; Jinju SUN ; Xin LIU ; Zhike YIN
Modern Clinical Nursing 2024;23(4):31-36
Objective To explore the effectiveness of individualized fall prevention strategies in preventing falls among Parkinson's patients.Methods A total of 140 patients with early to mid-stage Parkinson's disease(PD)admitted to our hospital from June 2021 to June 2022 were selected as the study subjects.The patients were randomly divided into a control group and an intervention group using a random number table method,with 70 patients in each group.Both groups received routine and standardised Parkinson's drug treatment.Additionally,the control group received routine fall prevention nursing interventions,while the intervention group received individualized fall prevention plans proposed based on exercise training and health education in addition to the nursing interventions as given in the control group.The two groups were compared in terms of time by timed up and go tests(TUGT)and respective scores by the Modified Fall Effectiveness Energy Scale(MFES),39-item PD questionnaire(PDQ-39),and Berg balance scale(BBS).Results The intervention group presented with significantly shorter TUGT time compared to the control group[(24.90±3.69)s vs.(26.79±3.52)s,P<0.05].When assessed with the MFES and BBS,the intervention group scored significantly higher compared to the control group[(94.90±9.38)vs.(85.38±8.97),P<0.05;[(44.37±3.20)vs.(40.52±3.66),P<0.05,respectively],while,when assessed with the PDQ-39,the intervention group scored significantly lower compared to the control group[(31.13±9.34)vs.(35.25±10.31),P<0.05].Conclusions Individualized fall prevention strategies proposed based on exercise training and health education can improve their effects on preventing falls of Parkinson's patients and enhance their balance-walking ability,thereby improving their quality of life.Therefore,the strategies are worthy of clinical promotion..
6.Effectiveness of a novelly modified disposable vacuum drainage bottle
Huiling LIANG ; Chunxi LIN ; Guoying LIAN ; Tingting ZHENG ; Wenxin SONG
Modern Clinical Nursing 2024;23(4):37-40
Objective The goal of this study was to carry out a trial of a novel disposable vacuum drainage bottle with speed drainage adjustment and a threaded catheter connector,as well as to further explore the effectiveness in drainage.Methods Twenty-seven patients who underwent continuous fluid drainage in the Coronary Care Unit(CCU)of our hospital between February and August 2023 were put on the trial.The patients were randomly assigned into a control group(12 cases,with 76 replacements of traditional vacuum drainage bottles over the catheterisation and an trial group(15 cases,with 83 replacements of the novelly modified disposable vacuum drainage bottle)by a simple random method.Patients in the control group had the drainage catheter connected to a traditional vacuum drainage bottle,while the patients in the trial group had drainage catheter connected to the novelly modified vacuum drainage bottle.The two groups were compared in terms of the number of bottle replacement,incidence of exudation/leakage/detachment,time for bottle replacement,cost of consumables for drainage,and satisfaction of patients and nurses.Results All patients completed the trial.The trial group exhibited a significantly lower incidence rate in exudation/leakage/detachment,shorter time for bottle replacement and lower cost of consumables for bottle replacement in comparison with those in the control group(all P<0.05).Moreover,both patients and nurses in the trial group reported significantly higher satisfaction with the modified disposable bottle than the bottle used in the control group(both P<0.001).Conclusions The novelly modified disposable vacuum drainage bottle overcomes the deficiencies of the traditional bottle,reduces the incidence of exudation/leakage/detachment over the drainage,cut down the cost of bottle replacement,and shorten the time for bottle replacement.The novel and modified disposable vacuum drainage bottle has received great appreciations from the patients and nursing staff.
7.Effectiveness of Guasha therapy with Hufu Tongbian in treating tumor-related insomnia
Shuanju JI ; Yongfu ZHU ; Shuyue MIAO ; Dongwei ZHANG
Modern Clinical Nursing 2024;23(4):41-46
Objective To explore the effectiveness of Guasha therapy with Fufu Tongbian in treating cancer-related insomnia(CRI)and seek a new approach to managing CRI.Methods Sixty patients with CRI who were admitted to the oncology department of our hospital from July 2021 to July 2022 were engaged in the study.The patients were randomly divided equally into two groups by using the PROCPLAN process in SAS software.The patients in the control group were given conventional symptomatic treatment and the patients in the trial group were managed with Guasha therapy with Fufu Tongbian in addition to the conventional symptomatic treatment.The two groups were compared in terms of clinical efficacy as well as scores by the Pittsburgh sleep quality index(PSQI),Hamilton depression scale(HAMD),and Hamilton anxiety scale(HAMA)were compared after 2 courses of treatment.Results All patients had completed the study.The trial group exhibited significantly higher total effective rate and presented significantly lower scores on PSQI,HAMD and HAMA compared to the control group(all P<0.001).Conclusion Guasha therapy with Fufu Tongbian can improve sleep condition of CRI patients and alleviate their depression and anxiety,thus improving sleep quality of CRI patients.
8.Application effect of rehabilitation instruction based on resourcefulness theory on exercise behavior implementation intention in patients with first-episode stroke
Yiping QUAN ; Fangfang ZHAO ; Jun SUN ; Wenjuan GUAN ; Haiying HU ; Hui ZHANG ; Fei XIE ; Yu LIANG ; Xia CHEN
Modern Clinical Nursing 2024;23(4):47-53
Objective To investigate the effect of rehabilitation instruction based on resourceful theory on the execution intention of exercise behaviour in patient with the first-episode stroke.Methods From September 2022 to February 2023,a total of 80 inpatients with first-episode stroke from a general hospital in Anhui Province participated in the study.Patients in Wards Ⅰ and Ⅱ were assigned to an intervention group,while those in Wards Ⅲ and Ⅳ were assigned to a control group,with 40 patients per group.The patients in control group received standard interventions,while those in the intervention group were offered with a rehabilitation instruction based on resourceful theory in addition to the standard interventions.Stroke patient rehabilitation exercise behaviour execution intention questionnaire,resourcefulness scale and modified Barthel were employed for assessments before and after the intervention.Results After the intervention,the intervention group showed significantly higher scores inexecutive intention of exercise behaviour,resourcefulness level and daily living activities compared to those in the control group(all P<0.01).Conclusion Rehabilitation instruction based on the theory of resourcefulness can effectively increase the executive intention of exercise behaviour in the patients with first-episode stroke,improve the resourcefulness thinking levels and enhance the daily living activity of the patients.
9.Nursing care of children on ECMO due to sepsis shock and complicated with fulminant myocarditis:a report of 3 cases
Ruihua DONG ; Yuanqing LIANG ; Jiao LI ; Lanhua BAO ; Bin LI
Modern Clinical Nursing 2024;23(4):54-59
Objective To summarise a clinical experience of nursing care for 3 children who were treated with ECMO for sepsis and complicated with fulminant myocarditis.Methods Clinical data in nursing cares for 3 children treated with ECMO for sepsis and complicated with fulminant myocarditis were collected and analysed,with the spotted difficulties in nursing care and proposed coping strategies.Results The 3 children survived and were transferred out of the(pediatric intensive care unit,PICU)with stable vital signs and haemodynamics after emergency treatment with ECMO and continuous renal replacement therapy(CRRT).Conclusion Children with sepsis leading to myocardial depression and subsequent heart failure require close observation of the changes and consequently specialised cares after having initiated an ECMO in emergency treatment.This includes ensuring proper fixation of the cannulas,managing anticoagulation,monitoring the speed,flow rate and pressure of ECMO,management of body temperature,skin care,sedation and pain,as well as prevention of complications.These nursing care measures would improve the survival rate after the treatment of ECMO.
10.Application and evaluation of the International Guidelines for Clinical Treatment of Pressure Injury based on LSPI quality improvement framework
Fanfan WANG ; Min ZHUANG ; Sanlian HU ; Jun MA ; Yifang SU
Modern Clinical Nursing 2024;23(4):60-66
Objective To analyse the effect on implementation of the International Guidelines for Clinical Treatment of Pressure Injuries within leadership-staff-performance improvement-information technology(LSPI)framework of quality improvement,therefore to provide theoretical insights in promoting the transformation of prevention and treatment practice guidelines to clinical practices.Methods A pre-and post-control study was in this study.A total of 101 005 inpatients admitted to our hospital between July 2019 and June 2020 were assigned to a control group,and the other 110 824 patients who were hospitalised between July 2020 and June 2021 were assigned to a trial group.The two groups were compared in terms of the promptness rate and accuracy of primary risk assessment,response rate of high-risk patients and incidence of pressure injury before and after implementation of the guideline.Results After implementation of the guideline,the promptness rate and the accuracy of primary risk assessment and the rate of preventive measures in high-risk patients increased from 86.73%to 96.25%,93.46%to 98.69%and 94.21%to 98.15%,respectively.The incidence of hospital pressure injury decreased from 0.77‰ to 0.29 ‰.All the differences were statistically significant(all P<0.05).Conclusions Implementation of the International Guidelines for the Clinical Treatment of Pressure Injuries within the LSPI framework of quality improvement can improve the quality of process management in pressure injury and reduce the incidence of pressure injuries.Therefore,it can facilitate the guideline-based code of practice in the clinical practices.

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