目的 对烧伤层流病房多重耐药菌感染的相关因素进行分析，通过护理干预来预防和减少烧伤病房多重耐药菌感染的发生。 方法 回顾性分析2011年1月－12月收治的629例烧伤患者，其中发生多重耐药菌感染74例，感染率为11.8%。 结果 感染部位：创面分泌物培养感染占70.2%，痰液标本培养感染占9.4%，血液标本培养感染占16.2%，其他占4.2%。感染病原菌：以金黄色葡萄球菌为主，占77.0%；鲍曼不动杆菌占4.2%，铜绿假单胞菌占10.8%，肺炎克雷伯菌占6.7%，真菌感染占1.3%。 结论 对发生医院内多重耐药菌感染的原因进行分析并及时采取相应的护理干预措施，及可行的医院感染管理控制措施，对烧伤患者预后有重要的意义，可有效降低院内感染率的发生。
ObjectiveTo evaluate the effect of bundle strategies on the prevention and control of multidrug-resistant organisms (MDROs) in intensive care unit (ICU), in order to effectively prevent and control the severe situation of multiple drug-resistant bacteria in ICU.MethodsWe selected patients who admitted into the ICU from January 2016 to December 2017 as study subjects, and monitored 6 types of MDROs. Basic information was surveyed and collected from January to December 2016 (before intervention), while bundle strategies on MDROs were implemented from January to December 2017 (after intervention), including issusing isolation orders, hanging isolation marks, wearing isolation clothes, using medical articles exclusively, cleaning and disinfecting environment, implementing hand hygiene, etc. Then we compared the MDRO detection rate, nosocomial infection rate, MDRO nosocomial infection rate, and compliance rates of interventions between the two periods.ResultsThe MDRO detection rate before intervention was 77.10%, and that after intervention was 49.12%, the difference between the two periods was statistically significant (χ2=69.834, P<0.001). The nosocomial infection rate of ICU decreased from 23.51% before intervention to 15.23% after intervention, the MDRO nosocomial infection rate decreased from 13.70% before intervention to 5.84% after intervention, and the differences between the two periods were statistically significant (χ2=8.594, P=0.003; χ2=13.722, P<0.001). The compliance rates of doctor’s isolation orders, hanging isolation marks, wearing isolation clothes, using medical articles exclusively, cleaning and disinfecting environment, and hand hygiene, as well as the correct rate of hand hygiene after intervention (92.12%, 93.55%, 81.77%, 84.24%, 82.90%, 77.39%, and 96.37%) were significantly higher than those before intervention (31.94%, 52.00%, 23.43%, 48.18%, 67.16%, 59.46%, and 88.64%), and the differences were all statistically significant (P<0.001).ConclusionThe implementation of the above bundle strategies on the prevention and control of MDROs can decrease the MDRO detection rate and MDRO nosocomial infection rate.
ObjectiveTo explore the corresponding intervention measures to reduce maternal mortality rate by analyzing the causes and problems of maternal deaths. MethodsA retrospective analysis was conducted to analyze all cases of maternal mortality from January 2005 to June 2013 in West China Second University Hospital. ResultsAmong the 14 cases of maternal deaths, the main diseases of the patients were pregnancy complicated with heart disease, hypertensive disorders, obstetric hemorrhage, amniotic fluid embolism and ectopic pregnancy. Four cases got prescriptive prenatal care during pregnancy, accounting for 28.6% (4/14), while 10 cases did not, accounting for 71.4% (10/14). Six patients died in prenatal period which accounted for 42.9% (6/14), while 8 died in postnatal period which accounted for 57.1% (6/14) and 5 died within 24 hours which accounted for 62.5% (5/8). Seven underwent cesarean section and 6 fetuses survived. Two went through trial of labor and no fetus survived. There was no ordered postmortem. ConclusionIntensifying education of prenatal care during pregnancy, improving quality of obstetrical service and diathesis of healthcare professionals, strengthening the supervision of high-risk pregnancy and timely choosing the time and manner of delivery are the main measures to decrease the maternal mortality.
摘要:目的:减少胎膜早破患者产科并发症的发生。方法:将我院于2005年1月至2006年12月收治的217例胎膜早破的患者设为对照组，将2007年1月~2008年12月收治的248例胎膜早破的患者设为观察组。对照组采用教科书上传统的方法进行护理,观察组正确地判断胎膜早破,胎儿宫内状况评估,产前选择正确的卧位,加强对产前、产时、产后规范的监护,积极预防感染等措施。结果:积极的医疗处理有效地减少了产后出血,胎儿宫内窘迫,切口感染的发生。结论:对胎膜早破的患者,尽早地采取正确、有效的护理干预措施,能减少产科并发症的发生,保障母儿的健康。Abstract: Objective: To reduce maternal obstetrics complications of premature rupture of membranes occurred. Methods: From in January 2005 to December 2006, treated 217 cases of premature rupture of membranes in pregnant women as control group, from January 2007 to December 2008 treated 248 cases of premature rupture of membranes as observation group. The control group used the traditional textbook approach to care. The observation group to determine the correct premature rupture of membranes, fetal assessment, pregnant women to choose the correct prelying, strengthen the preproduction, the postnatal care norms positive measures such as the prevention of infection. Results:The suitable medication and nursing procedure could effectively reduce postpartum hemorrhage, fetal distress, the occurrence of incision infection. Conclusion: The maternal premature rupture of membranes, as soon as possible to take the correct and effective nursing interventions can reduce the incidence of obstetric complications to protect the health of mothers and infants.
Objective To systematic review the international interventions on mental health of involuntary migrants, and evaluate the effects of different interventions. Methods We searched 10 international electronic databases and 3 grey literature databases to November 2008. Websites of relevant organizations and Google were searched for any missing information. Research papers that reported describing or evaluating any interventions on preventing and treating mental health problems of involuntary migrants were included. Two reviewers independently screened, appraised and extracted the data, disagreements were resolved by discussion. Implemented interventions were summarized and analyzed by qualitative synthesis method. As there was heterogeneity in the type of interventions, study design, and outcomes, the study results were not pooled statistically in meta analysis. Results Of the 35 studies included in the analysis, 16 studies aimed to describe intervention strategies, while 19 studies were to evaluate effectiveness of interventions. The targeted population were mainly refugees and asylum seekers caused by the war, violence and other tortures, while only one study targeted at reservoir migrants. All the psychological interventions were divided into prevention intervention and treatment intervention. The main interventions include: integrated psychological intervention, group treatment, cognitive behavior therapy, testimony, narrative exposure therapy, supportive counseling service, family support and therapy, etc. Of which, integrated psychological interventions are the most common intervention. Most of the studies evaluating effectiveness are observational studies, while only six are controlled trials. The results of most evaluation studies show that the implemented psychological interventions have positive impact on mental health of involuntary migrants. Conclusions There are limited intervention studies on mental health of involuntary migrants, and evaluation studies are lack of rigorous design. More research especially preventive intervention study is required. High-quality trials with large sample and rigorous design are needed to evaluate the most effective psycho-interventions for different groups of involuntary migrants.
ObjectiveTo explore the influence of nursing interruption event intervention on the incidence of nursing risk events. MethodsIn January 2012, we carried out intervention on nursing interruption events. And general situation questionnaire was used on December 30th, 2011 (control group) and December 30th, 2012 (intervention group) respectively to investigate 190 clinical nurses. ResultsThe occurrence of the interruption events was positively correlated with the incidence of nursing risk events. Effective intervention significantly reduced the incidence of risk events (P<0.05). ConclusionEffective prevention of adverse outcomes caused by interruption events reduces the risk of nursing, improves the quality of care, and ensures the safety of the patient.
ObjectiveTo systematically interpret the updated risk of bias in non-randomized studies of interventions version 2 (ROBINS-I V2) in 2024, summarizing its key improvements, operational procedures, and clinical application value. MethodsThrough literature review and case studies, the improvements of ROBINS-I V2 were compared with the 2016 version, including the expansion of bias domains, refinement of signaling questions, and optimization of decision flowcharts. A retrospective study in stomatology was used to demonstrate the practical application of the tool. ResultsThe ROBINS-I V2 tool has restructured the hierarchy and refined the definitions of bias domains, optimized the evaluation processes across seven risk-of-bias dimensions, and minimized subjective judgment errors through standardized decision flowcharts. ConclusionROBINS-I V2 significantly improves the rigor of bias assessment in non-randomized intervention studies through its scientific design and standardized workflow. It is recommended for evidence quality grading and decision-making support in clinical research.
In recent years, an increasing amount of systematic reviews have been published; however, few reviews adequately considered and reported details of interventions, which not only limited the usability of systematic reviews but also wasted resource. In order to improve reporting of intervention details in systematic reviews, BMJ recently published recommendations. This paper interprets the recommendations to improve usability of systematic reviews.
Objective To systematically review the psychological resilience intervention in China, so as to evaluate its effectiveness. Methods Studies published as of October 2012 were searched in CBM, VIP, CNKI and WanFang Data. The randomized controlled trials (RCTs) and controlled before-and-after trials (CBAs) about psychological resilience intervention were included. Two reviewers independently performed screening, quality assessment and data extraction, and then reached a consensus after cross-check and discussion. Qualitative synthesis was adopted instead of meta-analysis for the existed significant deviations in outcomes of included studies. Results A total of 8 studies including 3 RCTs and 5 CBAs were included for the analysis. All the studies referred to the objects of students, including 6 for college students, 1 for secondary school students and 1 for left behind students in rural junior school. All 8 studies evaluated the effectiveness of group psychological guidance, 1 of which also compared the outcomes of psychological lectures. All the included trials suggested that group psychological guidance and psychological lectures might significantly improve the psychological resilience of subjects. Conclusion Current studies on psychological resilience intervention are limited, the measure has been taken seems relatively single, which mainly focuses on students and lacks of high-quality research design. It suggests take more diverse psychological resilience interventions for different population, and evaluate both short-term and long-term effectiveness by performing large sample, strictly designed and high-quality trials.
针刺平行随机对照试验通常没有准确报告试验组和对照组的干预方法.为促进标准化,国际上有经验的针刺医师和研究者组成的小组制定了一些原则,即针刺临床对照试验中干预措施报告的标准(缩写为STRICTA).在征求意见过程中,一些期刊编辑协助对此标准进行了修改,使之与随机对照试验报告的标准(CON-SORT)格式一致,作为该指南对针剌研究报告的延伸.参与此事的杂志编辑已确定要发表该标准,建议其作者群按照此标准准备论文,并将邀请更多杂志采用该标准.目的是使针剌对照试验的干预措施充分报告,从而有利于对这些研究的严格评价、分析及这些措施的推广.