1.Construction of nursing quality standard in bone oncology department
Weiling ZHANG ; Xiaomin HUANG ; Qian WANG ; Sushuang CHEN ; Xiaolin CAI ; Tianwen HUANG ; Yuan GAO
Chinese Journal of Practical Nursing 2024;40(9):701-709
Objective:To establish the standard of nursing quality in bone oncology department, and provide the basis for scientific evaluation of nursing quality in bone oncology department.Methods:On the theoretical basis of Donabedian′s three-dimensional quality model of "structure-process-outcome", and through literature review and semi-structured interview method, the "evaluation index of nursing quality in bone oncology department" was preliminatively formulated from November 2022 to June 2023. The Delphi method was used to select 31 experts from 31 third-level A hospitals and nursing colleges in 27 provinces or municipalities across the country for two rounds of correspondence consultation. The criteria were screened and modified to determine the evaluation criteria of nursing quality in bone tumor specialty.Results:The questionnaire recovery rate of 2 rounds of expert consultation was 100.00%, the authority coefficient of 2 rounds of expert consultation was 0.93, and the coefficient of variation of 1, 2 and 3-grade standards were all less than or equal to 0.25. The Kendall′s coefficient of concordance of the primary standards of the two rounds of expert consultation were both 0.088, in the secondary standards were 0.103 and 0.140, in the tertiary standards were 0.119 and 0.110. Through 2 rounds of expert letter consultation, the evaluation criteria for the quality of care in bone tumor specialties were divided into three levels, including 3 primary standards (structural quality criteria, process quality criteria and outcome quality criteria), 21 secondary standards and 80 tertiary standards.Conclusions:The construction process of nursing quality standard in bone oncology department is scientific and reliable, reflecting specialty characteristics, and can provide scientific basis for the evaluation of nursing quality in bone oncology department and standardize nursing behavior.
2.Development of exercise programs for patients with total hip replacement at different stages
Xiaoling CHEN ; Qiaoli LIU ; Wanlian XIAO ; Zizhen GUI ; Tianwen HUANG
Modern Clinical Nursing 2024;23(9):37-44
Objective To develop exercise programs for patients with total hip replacement at different stages in order to promote postoperative rehabilitation and functional recovery.Methods According to the"6S"evidence pyramid model,using computer,a systematic search was conducted using computer-based top-down methods across BMJ Best Practice,Up To Date,the Joanna Briggs Institute evidence-based practice database(JBI),the Centre for Evidence-Based Healthcare,the National Institute for Health and Care Excellence(NICE)website,the Guidelines International Network(GIN),the National Guideline Clearinghouse(NGC),the Scottish Intercollegiate Guidelines Network(SIGN),Medlive,Cochrane Library,Embase,PubMed,CINAHL,Web of Science,China National Knowledge Infrastructure(CNKI),China Biomedical Literature Service System,Wanfang Data Knowledge Service Platform,and VIP Database,to select literature related to exercise for patients undergoing total hip replacement.Three researchers independently assessed these documents and extracted evidence to preliminarily form exercise programs.The Delphi method was used to further validate the scientific and practical aspects of the exercise programs by two rounds of consultation.Results Specific exercise programs for patients undergoing total hip replacement were developed for the preoperative stage,postoperative 1(within 1 week after operation),postoperative stage 2(2-6 weeks after operation),and postoperative stage 3(7-12 weeks after operation),with toatal 41 items.Conclusion The exercise programs developed in this study are scientifically sound and reasonable.They can provide reference for medical staff and patients in related fields.
3.Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture (version 2024)
Yun HAN ; Feifei JIA ; Qing LU ; Xingling XIAO ; Hua LIN ; Ying YING ; Junqin DING ; Min GUI ; Xiaojing SU ; Yaping CHEN ; Ping ZHANG ; Yun XU ; Tianwen HUANG ; Jiali CHEN ; Yi WANG ; Luo FAN ; Fanghui DONG ; Wenjuan ZHOU ; Wanxia LUO ; Xiaoyan XU ; Chunhua DENG ; Xiaohua CHEN ; Yuliu ZHENG ; Dekun YI ; Lin ZHANG ; Hanli PAN ; Jie CHEN ; Kaipeng ZHUANG ; Yang ZHOU ; Sui WENJIE ; Ning NING ; Songmei WU ; Jinli GUO ; Sanlian HU ; Lunlan LI ; Xiangyan KONG ; Hui YU ; Yifei ZHU ; Xifen YU ; Chen CHEN ; Shuixia LI ; Yuan GAO ; Xiuting LI ; Leling FENG
Chinese Journal of Trauma 2024;40(9):769-780
Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.
4.Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture (version 2023)
Mi SONG ; Dan KONG ; Yuan GAO ; Yaping CHEN ; Xiaohua CHEN ; Yi CUI ; Junqin DING ; Leling FENG ; Lili FENG ; Jinli GUO ; Yun HAN ; Jing HU ; Sanlian HU ; Tianwen HUANG ; Yu JIA ; Yan JIN ; Xiangyan KONG ; Haiyan LI ; Hui LI ; Lunlan LI ; Shuixia LI ; Hua LIN ; Juan LIU ; Xuemei LU ; Ning NING ; Lingli PENG ; Lingyun SHI ; Changli WAN ; Jie WANG ; Qi WANG ; Yi WANG ; Ruifeng XU ; Ying YING ; Ping ZHANG ; Shijun ZHANG ; Wenjuan ZHOU
Chinese Journal of Trauma 2023;39(3):214-222
Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.
5.Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures (version 2023)
Chunhua DENG ; Xiaohua CHEN ; Zhihua YIN ; Yao JIANG ; Xiaoju TAN ; Yaping CHEN ; Junqin DING ; Luo FAN ; Leling FENG ; Yuyun GAN ; Xiaoyan GAO ; Jinli GUO ; Jing HU ; Chen HUANG ; Guiling HUANG ; Tianwen HUANG ; Yingchun HUANG ; Hui JIN ; Yan JIN ; Fangfang LI ; Hui LI ; Hui LIU ; Ping LIU ; Ning NING ; Lingyun SHI ; Guomin SONG ; Yani SUN ; Guangling WANG ; Jie WANG ; Qi WANG ; Xia WANG ; Xiaoyun WANG ; Yi WANG ; Songmei WU ; Jian YANG ; Yumei ZHANG ; Yang ZHOU ; Xiaoyan WANG ; Yuan GAO
Chinese Journal of Trauma 2023;39(5):394-403
Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.
6.Application of cluster nursing mode in perioperative period of elderly patients with hip fracture
Wanlian XIAO ; Na LI ; Xiaoling CHEN ; Zizhen GUI ; Tianwen HUANG
Chinese Journal of Nursing 2023;58(22):2734-2740
Objective To explore the application of cluster nursing mode in perioperative period of elderly patients with hip fracture.Methods A retrospective cohort study design was used.Through convenience sampling method,50 elderly patients admitted to the hospital for hip fractures from January 2018 to December 2019 were selected as the control group.Meanwhile,47 elderly patients admitted to hospital for hip fractures from January 2020 to December 2021 were selected as the experimental group.The experimental group received cluster nursing,while the control group received routine nursing measures.The outcomes compared between the 2 groups included the effective rate of pain intervention,functional exercise compliance,and the incidence of complications.Results The effective rate of pain intervention(χ2=5.922,P=0.015)and functional exercise compliance(χ2=9.685,P= 0.008)in the experimental group were higher than those in the control group.The number of perioperative complications(χ2=7.600,P=0.006)in the experimental group were lower than those in the control group.Conclusion The application of cluster nursing mode in the perioperative period of elderly patients with hip fractures can effectively control pain,improve functional exercise compliance,and reduce complications.
7.Application research on risk management of postoperative delirium in elderly patients with hip fragility fracture based on FMEA theory
Na LI ; Tianwen HUANG ; Xiaoling CHEN ; Xiaojun CHEN ; Ying ZHONG ; Jie NI ; Xueya YU ; Peihui WU
Chinese Journal of Practical Nursing 2022;38(22):1701-1707
Objective:To explore the effect of postoperative delirium risk management in elderly patients with hip fragility fracture based on failure mode and effect analysis (FMEA) theory, and to provide a basis for reducing the incidence of postoperative delirium.Methods:A total of 50 patients admitted to the First Affiliated Hospital of Sun Yat-sen University due to hip fragility fractures from January to December 2019 were selected as the control group, and 50 patients admitted to the First Affiliated Hospital of Sun Yat-sen University for hip fragility fractures from January to December 2020 were selected as the observation group. The control group received routine care, and the observation group implemented risk control intervention measures based on FMEA theory on the basis of the control group. The risk priority number (RPN) value, incidence of delirium, duration of delirium, pain score, satisfaction, and average length of hospital stay were compared between the two groups of patients in each link of failure risk.Results:The RPN values of each link failure risk of the observation group were 100.80 ± 13.39, 103.96 ± 9.96, 103.76 ± 8.04, delirium duration was (36.33 ± 9.07) min, pain scores were 1.86 ± 0.76, 4.16 ± 1.17, average length of stay was (8.98 ± 4.64) days, and incidence of delirium was 6.0% (3/50), the RPN values of each link failure risk of the control group were 274.10 ± 8.48, 291.00 ± 10.10, 287.78 ± 11.64, delirium duration (78.70 ± 20.10) min, pain scores 2.26 ± 1.02, 4.74 ± 1.19, average length of stay was (11.50 ± 7.66) days, and incidence of delirium was 22.0% (11/50). The differences between two groups showed significant differences ( t values were 1.99-93.24, χ2=4.07, P<0.05). The patient satisfaction score of the observation group was 99.36 ± 1.01, which was higher than that of the control group 89.63 ± 2.62, and the difference was statistically significant ( t=24.50, P<0.05). Conclusions:The perioperative implementation of postoperative delirium risk management model based on FMEA theory in elderly patients with hip fractures can reduce the incidence of postoperative delirium, relieve pain, shorten hospital stay, and improve satisfaction degree. It is worthy of clinical promotion.
8.Early-onset Parkinson′s disease caused by 22q11.2 deletion: a case report
Guoen CAI ; Fengxian CHEN ; Raoli HE ; Zhiting CHEN ; Tianwen HUANG ; Jian ZHANG ; Xiaochun CHEN ; Qinyong YE
Chinese Journal of Neurology 2021;54(6):585-589
Many pathogenic genes have been identified in early-onset Parkinson′s disease, but the early-onset Parkinson′s disease with 22q11.2 deletion has not been reported in Chinese. A case of early-onset Parkinson′s disease with 22q11.2 deletion was confirmed by whole-exome sequencing-based copy number variation detection in Fujian Medical University Union Hospital. This article reports its clinical characteristics and discusses its pathogenesis, diagnosis and treatment management.
9.Value of Mismatch Repair Genes Combined with Neutrophil-Lymphocyte Ratio in Predicting Postoperative Recurrence of Colon Cancer
Ping CHEN ; Jianguang LIN ; Yan HUANG ; Yangbin DAI ; Tianwen XU
Cancer Research on Prevention and Treatment 2021;48(4):370-374
Objective To investigate the clinicopathological characteristics of colon cancer patients with different mismatch repair gene (MMR) status and evaluate the value of MMR status combined with preoperative blood neutrophil-lymphocyte ratio (NLR) in predicting postoperative recurrence of colon cancer. Methods We retrospectively analyzed the pathological MMR immunohistochemistry results of 125 colon cancer patients after radical resection. Patients were divided into deficient mismatch repair (dMMR) group (
10.Analysis of role change and function of microsurgery staff in fighting against COVID-19
Jianghai CHEN ; Qingtang ZHU ; Xianghong LOU ; Tianwen HUANG ; Shouzhen CHENG ; Zhenbing CHEN ; Liqiang GU
Chinese Journal of Microsurgery 2020;43(2):123-125
The outbreak of COVID-19 around the world has made more than two millions of confirmed patients and serious shortages of healthcare resources and medical staff in many countries. In the battle of fighting COVID-19 in Wuhan, many microsurgery staff across China were sent to Wuhan and put on duty in the treatment of COVID-19 patients. The purpose of this article is to review the personal experiences of microsurgery staff in fighting against COVID-19 as well as to analyse how to act professionally when facing the challenges and change of roles and meanwhile having to give full play to the professional advantages subject to make contributions to the battle of COVID-19. A reference is hereby provided for the microsurgery staff in dealing with a sudden and major epidemic outbreak in the future.

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