Nursing procedures

  • 文章类型: Journal Article
    目的:我们的目的是对国际护理教科书中包含的手卫生信息和斯洛文尼亚护理教科书中与护理程序相关的等效内容进行彻底比较。
    背景:手卫生习惯对于预防医疗保健相关感染至关重要,每年影响数百万患者。“手部卫生的五个时刻”背后的想法是鼓励评估成功并提高自我效能。
    方法:比较国际护理教科书中的手卫生内容与斯洛文尼亚护理教科书中的内容。
    方法:在2023年3月至2024年3月之间进行了一项研究,以比较国际护理教科书中的手卫生内容。这项研究包括来自美国和英国的教科书,以及斯洛文尼亚(SI)教科书。最后阶段涉及将手卫生绩效实践与世卫组织“手卫生五个时刻”进行比较。
    结果:该研究回顾了三本教科书中的470个护理程序,确定四个常见的:女性留置导尿,小口径饲管插入,灌肠给药和皮下注射。美国教科书的步数最高,而英国的教科书是最低的。不建议在所有护理程序中使用清洁防护手套,仅适用于小口径饲管插入和灌肠给药。美国教科书省略了女性留置导尿管程序的12个步骤,而英国的教科书包括10个步骤。SI教科书省略了8个步骤。
    结论:手卫生对于预防和控制医疗保健感染至关重要。研究发现,在这些护理程序中,手卫生的频率存在差异。世卫组织的“手部卫生五个时刻”指南并未得到普遍接受,在患者接触之前经常观察到卫生不足。未来的研究应该回顾国外的教科书并更新现有的教科书。
    OBJECTIVE: Our aim was to conduct a thorough comparison between the hand hygiene information included in international nursing textbooks and the Slovenian nursing textbook\'s equivalent content as it relates to nursing procedures.
    BACKGROUND: Hand hygiene practices are crucial in preventing healthcare-associated infections, which affect millions of patients annually. The idea behind \"Five Moments for Hand Hygiene\" is to encourage assessing success and boosting self-efficacy.
    METHODS: Comparison of hand hygiene content in international nursing textbooks with the content in a Slovenian nursing textbook.
    METHODS: A study was conducted between March 2023 and March 2024 to compare hand hygiene content in international nursing textbooks. The study included textbooks from the USA and UK, as well as Slovenian (SI) textbooks. The final phase involved comparing hand hygiene performance practices against the WHO Five Moments for Hand Hygiene.
    RESULTS: The study reviewed 470 nursing procedures across three textbooks, identifying four common ones: female indwelling urinary catheterisation, small-bore feeding tube insertion, enema administration and subcutaneous injections. The USA textbook had the highest number of steps, while the UK textbook had the lowest. Clean protective gloves are not recommended for all nursing procedures, only for small-bore feeding tube insertion and enema administration. The US textbook omitted 12 steps for the female indwelling urinary catheter procedure, while the UK textbook included 10 steps. The SI textbook omitted 8 steps.
    CONCLUSIONS: Hand hygiene is crucial for healthcare infections prevention and control. The study found differences in the frequency of hand hygiene in these nursing procedures. WHO\'s Five Moments for Hand Hygiene guidelines are not universally accepted, with inadequate hygiene often observed before patient contact. Future research should review foreign textbooks and update existing ones.
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  • 文章类型: Journal Article
    这项范围界定审查的目的是总结智力残疾护士对改善儿童健康和福祉的贡献的证据,有智力障碍的成年人和老年人,现在和未来。使用系统审查和荟萃分析(用于范围审查)(PRISMA-ScR)过程和JoannaBriggs研究所(JBI)指导的首选报告项目。我们包括54种出版物。我们确定了154项智力残疾护士采取的干预措施。我们将智力残疾护理干预分为三个主题:实现护理程序,增强服务的影响,提高生活质量。研究结果表明,高质量的研究对于确定智力障碍护理干预在整个生命周期中的影响和有效性至关重要。我们建议建立并定期更新可搜索的智力残疾护士干预在线汇编。这将提供更有效地参与循证实践的机会。
    The objective of this scoping review was to summarise evidence on the contribution of intellectual disabilities nurses to improve the health and well-being of children, adults and older people with intellectual disability, now and for the future. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (for Scoping Reviews) (PRISMA-ScR) process and Joanna Briggs Institute (JBI) guidance was used. We included 54 publications. We identified 154 interventions undertaken by intellectual disability nurses. We categorised the intellectual disability nursing interventions into three themes: effectuating nursing procedures, enhancing impact of services, and enhancing quality of life.Findings point to high quality research being essential in determining the impact and effectiveness of intellectual disability nursing interventions across the lifespan. We recommend that a searchable online compendium of intellectual disability nurse interventions be established and regularly updated. This will provide opportunities to engage more effectively in evidence-based practice.
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  • 文章类型: Journal Article
    目的是确定ID护理干预措施及其对ID患者的健康和医疗保健的影响。数据是使用在线调查问卷从230名参与者的自愿响应和滚雪球样本中收集的。专题,描述性统计,并进行了推理统计分析。我们确定了来自7个国家的ID护士可以进行的878项干预措施。我们将干预措施分为五个主题:实施护理程序,增强ID服务的影响,增强主流服务的影响,提高生活质量,加强ID护理实践。研究结果表明,ID护士在改善ID患者的健康和医疗保健体验方面发挥着重要作用。
    The objective was to identify ID nursing interventions and their impact on the health and healthcare of people with IDs. Data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. We identified 878 interventions that could be undertaken by ID nurses from 7 countries. We categorised the interventions into five themes: effectuating nursing procedures, enhancing impact of ID services, enhancing impact of mainstream services, enhancing quality of life, and enhancing ID nursing practice. Findings demonstrate that ID nurses play important roles in improving the health and healthcare experiences of people with IDs.
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  • 文章类型: Journal Article
    这项研究的总体目标是确定智力残疾护理干预措施及其对智力残疾患者健康和保健的影响。这是一个由4部分组成的系列的第3部分。在本文中,我们报告了来自智力残疾护士在线调查的定量问题的结果。这部分研究的目的是评估智力残疾护士对他们所采取的干预措施的理解的信心。定量数据是使用来自7个国家的230名参与者的自愿响应和滚雪球样本的在线调查问卷收集的。专题,描述性统计,并进行了推理统计分析。评估数据表明并表明智力残疾护士对他们可以有效采取的干预措施缺乏明确性。角色缺乏明确性与雇主组织和国家的类型之间似乎存在相关性。护士领导需要开展进一步的工作,以确定并解决这种缺乏明确性的问题。
    The overall objective of this research was to identify intellectual disability nursing interventions and their impact on the health and healthcare of people with intellectual disability. This is part 3 of a 4-part series. In this paper we report the findings from quantitative questions from an online survey of intellectual disability nurses. The objective of this part of the study was to a evaluate intellectual disability nurses\' confidence in their understanding of the interventions they undertook. Quantitative data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants from 7 countries. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. The evaluation data suggest and demonstrate a lack of clarity among intellectual disability nurses of the interventions they can effectively undertake. There appears to be correlations between lack of role clarity and the types of employer organisations and countries. Further work need to be undertaken by nurse leaders ascertain and address this lack of clarity.
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  • 文章类型: Journal Article
    肝脏是结直肠癌和胃癌转移的关键靶器官。治疗结直肠癌和胃癌的挑战之一是肝转移的管理。本研究旨在探讨其疗效,不利影响,胃肠道恶性肿瘤肝转移患者溶瘤病毒注射及应对策略。
    我们前瞻性分析了2021年6月至2022年10月在上海交通大学医学院附属瑞金医院接受治疗的患者。将47例胃肠道癌肝转移患者纳入研究。数据,包括临床表现,成像,肿瘤标志物,术后不良反应,心理干预,饮食指导,并对不良反应管理进行评价。
    所有患者均成功注射溶瘤病毒,未发生药物注射相关死亡。不利影响,比如发烧,疼痛,骨髓抑制,恶心,呕吐,温和,随后解决。在护理程序综合干预的基础上,患者术后不良反应得到有效缓解和治疗。47例患者均无穿刺点感染,侵入性手术引起的疼痛迅速缓解。2个疗程的溶瘤病毒注射后,术后肝脏MRI显示5例部分缓解,30种稳定的疾病,和靶器官中的12种进行性疾病。
    基于护理程序的干预措施可确保重组人腺病毒5型在胃肠道恶性肿瘤肝转移患者中的顺利治疗。这对于临床治疗具有重要意义,可显著减少患者并发症,提高患者生活质量。
    UNASSIGNED: The liver is a key target organ for colorectal and gastric cancer metastasis. One of the challenges in the treatment of colorectal and gastric cancers is the management of liver metastasis. This study aimed to investigate the efficacy, adverse effects, and coping strategies of oncolytic virus injection in patients with liver metastases of gastrointestinal malignancies.
    UNASSIGNED: We prospectively analyzed patients treated at Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine from June 2021 to October 2022. 47 patients with gastrointestinal cancer liver metastasis were included in the study. The data, including clinical manifestations, imaging, tumor markers, postoperative adverse reactions, psychological intervention, dietary guidance, and adverse reaction management were evaluated.
    UNASSIGNED: Oncolytic virus injection was successful in all patients, and no drug injection-related deaths occurred. The adverse effects, such as fever, pain, bone marrow suppression, nausea, and vomiting, were mild and resolved subsequently. Based on the comprehensive intervention of nursing procedures, the postoperative adverse reactions of patients were effectively alleviated and treated. None of the 47 patients had any puncture point infections, and the pain caused by the invasive operation was relieved quickly. After 2 courses of oncolytic virus injection, postoperative liver MRI showed 5 partial remissions, 30 stable diseases, and 12 progressive diseases in target organs.
    UNASSIGNED: Interventions based on nursing procedures can ensure the smooth treatment of recombinant human adenovirus type 5 in patients with liver metastases of gastrointestinal malignant tumors. This is of great importance for clinical treatment and significantly reduces patient complications and improves the patient\'s quality of life.
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  • 文章类型: Journal Article
    这项研究的目的是评估新生儿手术对极早产儿葡萄糖变异性的影响。早产儿(≤32周妊娠和/或出生体重≤1500g)在出生第2天开始连续血糖监测(CGM),监测5天。微创(脚跟棒,静脉穿刺)和非侵入性(尿布变化,父母在场)程序被记录。在每个程序之前和之后30分钟分析CGM数据。主要结果是手术前后的葡萄糖变异系数(CV=SD/平均值);还评估了SD和中位数葡萄糖。我们分析了22例新生儿的496例手术(GA30.5周[29-31];出生体重1300g[950-1476])。每次手术前后血糖中位数没有变化,而CV和SD在脚跟刺后增加(p=0.017和0.030),静脉穿刺(p=0.010和0.030),和尿布变化(p<0.001和<0.001),在父母在场期间没有差异的情况下。
    结论:非侵入性和微创手术在没有平均血糖变化的情况下增加了血糖变异性。
    背景:•微创手术-包括换尿布-可能会增加早产儿的新生儿压力。
    背景:•连续血糖监测提供了新生儿护理过程中新生儿压力的定量测量,表明葡萄糖变异性增加。
    The objective of this study is to assess the effect of neonatal procedures on glucose variability in very preterm infants. Preterm infants (≤ 32 weeks gestation and/or birthweight ≤ 1500 g) were started on continuous glucose monitoring (CGM) on day 2 of birth and monitored for 5 days. Minimally invasive (heel stick, venipunctures) and non-invasive (nappy change, parental presence) procedures were recorded. CGM data were analyzed 30 min before and after each procedure. The primary outcome was the coefficient of glucose variation (CV = SD/mean) before and after the procedure; SD and median glucose were also evaluated. We analyzed 496 procedures in 22 neonates (GA 30.5 weeks [29-31]; birthweight 1300 g [950-1476]). Median glucose did not change before and after each procedure, while CV and SD increased after heel prick (p = 0.017 and 0.030), venipuncture (p = 0.010 and 0.030), and nappy change (p < 0.001 and < 0.001), in the absence of a difference during parental presence.
    CONCLUSIONS: Non-invasive and minimally invasive procedures increase glucose variability in the absence of changes of mean glucose.
    BACKGROUND: • Minimally invasive procedures - including nappy change - may increase neonatal stress in preterm infants.
    BACKGROUND: • Continuous glucose monitoring provides a quantitative measure of neonatal stress during neonatal care procedures demonstrating an increase of glucose variability.
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  • 文章类型: Journal Article
    这项研究的目的是对用于管理晚期痴呆症患者的传统护理技术和自主机器人应用程序进行比较分析。PubMed,科克伦图书馆,EMBASE,并在WILEY数据库中检索有关护理技术应用于晚期痴呆患者治疗的相关文章。搜索词包括:(晚期痴呆症或重度痴呆症)和[人工智能(AI)或机器人或机器人或神经网络或深度学习或自动化程序或自主应用]。此次搜索共识别出2,679篇文章,并选择了298篇文章。最后,本系统综述包括23篇文章,其中8项研究分析了传统护理技术,15项研究分析了自主机器人应用。重要证据被披露,证明用于晚期痴呆症患者的自主机器人应用是可行的,具有成本效益的解决方案,为患者和医疗保健系统带来了极好的好处。
    The purpose of this study was to perform a comparative analysis of traditional nursing techniques and autonomous robotic applications used for managing patients with advanced stages of dementia. PubMed, Cochrane Library, EMBASE, and WILEY databases were searched for relevant articles concerning nursing techniques applied in the treatment of patients with advanced dementia. The search terms included: (advanced dementia OR severe dementia) AND [artificial intelligence (AI) OR robotic OR robots OR neural networks OR deep learning OR automated procedures OR autonomous application]. This search identified a total of 2,679 articles and 298 articles were selected. Finally, 23 articles were included in this systematic review, out of which 8 studies analyzed traditional nursing techniques and 15 studies analyzed autonomous robotic applications. Significant evidence was revealed, demonstrating that autonomous robotic applications used for patients with advanced stages of dementia are a feasible, cost-efficient solution and represent an excellent benefit for patients and the healthcare system.
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  • 文章类型: Journal Article
    背景:在医疗保健中获得有效的知情同意的过程反映了许多方面。照顾患者的医疗保健专业人员必须向他提供所有必要的信息并验证他的理解,考虑到个体特征。护士是这个过程的主要参与者之一。
    目的:本研究评估护士对其在知情同意过程中的作用的看法。
    方法:一项观察性研究,涉及帕多瓦医院13个病房的300名护士,通过在2018年11月至12月期间提交问卷。
    结果:最终样本由206名护士组成,其中27名男性(13.11%)和179名女性(86.89%)。工作经验,平均15年,对于确定有关观点和经验的问题的答案很重要。年龄在确定护士多久向患者的家庭成员提供有关出院后应采取的行动的信息时很重要。病房在提供给病人的护理水平信息和出院后应采取的行动方面具有决定性作用,以及护士职责的定义。
    结论:收集的数据表明,需要采取干预措施,以减少护士难以告知患者的原因。
    BACKGROUND: The process to obtain valid informed consent in healthcare reflects many aspects. Healthcare professionals that take care of the patient must provide him all the necessary information and verify his understanding, considering individual characteristics. Nurses are one of the main participants in this process.
    OBJECTIVE: This study assesses nurses\' perceptions of their role in the informed consent process.
    METHODS: An observational study involving 300 nurses operating in 13 wards of the Padua Hospital, through the submitting of a questionnaire in the period November-December 2018.
    RESULTS: The final sample is made up of 206 nurses-27 males (13.11%) and 179 females (86.89%). Work experience, on average 15 years, is significant in determining the answers to questions about opinions and experiences. Age is significant in determining how often nurses provide information to the patient\'s family members about the actions to be taken after discharge. The ward was decisive in the responses related to information provided to patients on the nursing care level and the actions to be taken after discharge, and the definition of the nurse\'s duties.
    CONCLUSIONS: The data collected show the need for interventions to reduce the causes of difficult that the nurse has in informing patients.
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  • 文章类型: Journal Article
    目的:评价吸痰4种临床护理程序前后气管套囊压力的动态变化,口腔护理,雾化吸入,翻身,从而为临床上调整袖带压力的时间提供参考。
    背景:袖口压力必须保持在25-30cmH2O的范围内,以确保有效通气并防止吸气,同时维持气管血流灌注。
    方法:一项前瞻性观察性研究。
    方法:将56例插管患者的袖带压力调整为28-30cmH2O。使用袖带压力监测器在四个临床护理程序(吸痰,口腔护理,雾化吸入,和翻转)并比较了各个时间点的袖带压力。半定量咳嗽强度评分(SCSS)用于评估吸痰过程中的咳嗽强度以及吸痰过程中咳嗽强度对袖带压力的影响。这项研究遵循STROBE清单进行横断面研究。
    结果:吸痰四种临床护理过程中的袖带压力,雾化吸入,翻身,和口腔护理,所有都暂时增加(p<0.001),20分钟后下降到不同程度(p<0.001)。其中,在吸痰过程中中度或强烈咳嗽状态下,袖带压力最高(78.38±12.13cmH2O),在手术后20分钟下降最大(21.71±4.80cmH2O)。
    结论:吸痰的四种临床护理程序,雾化吸入,翻身,和口腔护理都会引起不同程度的袖带压降。关于是否需要校正袖带压力的决定取决于具体情况。
    结论:在临床实践中,可以根据不同的临床护理程序单独校正袖带压力,提高了袖带压力的合格率,减少了护士的工作量。
    OBJECTIVE: To evaluate the dynamic changes in tracheal cuff pressure before and after four clinical nursing procedures including sputum suction, oral care, atomisation inhalation, and turning over, and thus provide references for the adjustment time of cuff pressure in clinical practice.
    BACKGROUND: Cuff pressure must be kept within the range of 25-30 cmH2 O to ensure effective ventilation and prevent aspiration, while maintaining tracheal blood flow perfusion.
    METHODS: A prospective observational study.
    METHODS: The cuff pressure of 56 intubated patients was adjusted to 28-30 cmH2 O. A cuff pressure monitor was used to continuously monitor cuff pressure changes before and after four clinical nursing procedures (sputum suction, oral care, atomisation inhalation, and turning over) and the cuff pressures at various time points were compared. The semi-quantitative cough strength score (SCSS) was used to evaluate cough strength during sputum suction and the effect of cough strength on cuff pressure during sputum suction. This study followed the STROBE checklist for cross-sectional studies.
    RESULTS: The cuff pressures during the four clinical nursing procedures of sputum suction, atomisation inhalation, turning over, and oral care, all temporarily increased (p < 0.001) and decreased to varying degrees 20 min later (p < 0.001). Among them, the cuff pressure rose the highest under a state of moderate or strong coughing during sputum suction (78.38 ± 12.13 cmH2 O) and dropped the most at 20 min after the procedure (21.71 ± 4.80 cmH2 O).
    CONCLUSIONS: The four clinical nursing procedures of sputum suction, atomisation inhalation, turning over, and oral care can all cause different degrees of cuff pressure drop. The decision on whether the cuff pressure needs to be corrected depends on the specific situation.
    CONCLUSIONS: During clinical practice, the cuff pressure can be individually corrected according to different clinical nursing procedures, which can increase the qualified rate of cuff pressure and reduce the workload of nurses.
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  • 文章类型: Journal Article
    OBJECTIVE: Nurses\' hand temperature may affect patient comfort but has not been investigated. This study aimed to determine female hospital nurses\' hand skin temperature and clarify the effects of measurement site, time, nursing procedures, and environment.
    METHODS: An observational study.
    METHODS: The middle finger, thenar eminence, hypothenar eminence, and medial forearm skin temperature of 29 female hospital nurses was measured at four time points during a day shift and before and after nursing procedures (hand disinfection, hand washing, taking vital signs, hygiene care, and positioning).
    RESULTS: Mean hand skin temperature was in the range of 29-32°C with interpersonal variations. Mean skin temperature at the medial forearm was 31.94-32.35°C (SD 0.87-1.52°C) and at the middle finger, 29.73-31.07°C (SD > 3°C). Time-dependent skin temperature fluctuations were confirmed on the middle finger (p = .022), and thenar (p = .005) and hypothenar eminence (p = .001). There were weak correlations between skin temperature and environmental factors, including ambient temperature (ρ = .194-.266), humidity (ρ = -.309 to -.319), and hospital room wind speed (ρ = .253-.314). The skin temperature dropped significantly after hand disinfection and handwashing at all measurement sites (middle finger: -1.30 and -3.56°C, respectively; thenar eminence: -1.19 and -3.32°C; hypothenar eminence: -0.80 and -3.39°C; medial forearm: -0.21 and -1.60°C).
    CONCLUSIONS: These findings may raise nurses\' awareness of their skin temperature. Moreover, our study highlights the need to develop countermeasures to ensure optimal nurses\' skin temperature and patient comfort.
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