ObjectiveTo explore the continuous care demands in liver transplant recipients and the influencing factors. MethodFrom October to December 2013, 235 liver transplant recipients were investigated with self-designed questionnaire to learn their continuous care demands. Factors affecting demands for continuous care were analyzed with single factor Chi square analysis and binary logistic regression analysis. ResultsA total of 130 recipients (55.3%) needed continuous care. Single factor chi-square analysis showed that three factors including complications, re-hospitalization and time to get to the nearest medical organization were significant for continuous care demands (P<0.05). Binary logistic regression analysis showed that the longer the time spent by liver transplant recipients to reach the nearest medical organization was, the more they hoped for continuous care[OR=3.040, 95%CI (1.585, 5.829), P=0.001]; the patients with readmisson within one year after surgery hoped less continuous care[OR=0.515, 95%CI (0.292, 0.907), P=0.022]. ConclusionsAt present, acceptance degree for continuous care in the liver transplant recipients is quite high. In the continuous care research and practice, we should develop new models and tools to shorten the time and distance between nurses and patients so as to meet the individualized care demands of the patients and improve their quality of life.
Objective To explore the application of fast track surgery (FTS) mode through multidisciplinary cooperation for the perioperative period of liver cancer. Methods A total of 188 patients with liver cancer treated between April and December 2014 were randomly divided into two groups: FTS group (n=94) and control group (n=94). The FTS group was treated with multidisciplinary cooperative FTS mode, while the control group was treated with traditional perioperative treatment. The self-care ability of daily life, pain, ambulation time and frequency, anal exhaust time, defecation time, hospital stay, hospitalization expenses and readmission rate were compared between the two groups. Results Compared with the control group, patients in the FTS group had a better ability of self-care one to three days after surgery, more reduced pain 8, 24 and 48 hours after surgery, more frequent ambulation and longer ambulation time three days after surgery, shorter time of defecation and exhaust, shorter hospital stay and lower hospitalization expenses. All the above differences were statistically significant (P<0.05). The readmission rate, self-care ability four to seven days after surgery, pain scores 72 and 96 hours after surgery were not significantly different (P>0.05). Conclusion Multidisciplinary cooperative FTS mode for liver cancer perioperative rehabilitation can improve patients’ self-care ability, promote a speedy recovery, reduce hospitalization costs, save medical resources and improve disciplinary teamwork ability.
ObjectiveTo investigate status of readiness for hospital discharge of patients with liver cancer after radical surgery and to explore its influencing factors.MethodsA cross-sectional survey was conducted, a total of 200 patients with liver cancer after the radical resection who were planned to discharge within 1 to 2 days in this hospital from January to April 2019 were selected as the study subjects. The general informations and informations relevant readiness for hospital discharge of patients were investigated and analyzed by the questionnaire.ResultsIn this study, 200 questionnaires were distributed, of which 195 were recovered, and 184 were valid, the final effective recovery rate was 92% (184/200). The scores of 4 dimensions of readiness for hospital discharge in 184 patients: The own status was 42.55±12.36, disease knowledge was 51.68±17.58, and response ability was 21.05±6.86, social support available was 31.85±7.56, and the total score of readiness for hospital discharge was 147.07±36.25. One hundred and eighty-four (80.4%) of 184 patients were prepared to discharge. The univariate analysis results showed that the readiness for hospital discharge score was related to the gender, monthly income per household, preoperative comorbidities, and time with tube after the operation (P<0.05); Further the multiple regression analysis showed that the monthly income per household and preoperative comorbidities were the important influencing factors for it (P<0.05).ConclusionsAccording to results of this study on readiness for hospital discharge of patients with liver cancer after operation in this hospital, readiness for hospital discharge is better, and gender, monthly income per household, preoperative comorbidities, and time with tube after operation are influence factors for it, of which monthly income per household and preoperative comorbidities are important influencing factors.
Objective To analyze the risk factors associated with fungal infections in adult recipients after living donor liver transplantation (LDLT). Methods Data of 189 recipients from January 2006 to December 2012 who received LDLT at our center were retrospectively analyzed. Cox regression analysis was used to analyze the risk factors for postoperative fungal infections. Results Postoperative fungal infection was found in 12 recipients. The most common infectious site was lung, whereas the most common fungal pathogen was Candida albicans. Multivariate analysis suggested preoperative low albumin level [HR=0.792, 95%CI (0.694, 0.903), P=0.001], massive intraoperative red blood cell transfusion [HR=4.322, 95%CI (1.308, 14.277), P=0.016] and longer postoperative intensive care unit (ICU) stay [HR=3.399, 95%CI (1.004, 11.506), P=0.049] were the independent risk factors for postoperative fungal infections. Conclusions Lung is the most common fungal infection site after LDLT. Preoperative low albumin level, massive intraoperative red blood cell transfusion and longer postoperative ICU contribute to fungal infections after LDLT.
ObjectiveTo analyze the relevant literatures on the use of midline catheters in China, and to provide references for further studies of midline catheters.MethodsAll literatures related to midline catheters from the date of database establishment to February 2019 were searched in the China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), Wan-Fang Database, and China Biomedical Literature Database (CBM). Bibliometric analysis methods were used to analyze the search results.ResultsTotally 47 articles related to midline catheters were recruited and the number of publications increased in recent years. About 44.68% papers were focused on introducing experiences of the operation process, nursing points, prevention and treatment of complications, and about 38.30% papers were observational studies about indwelling time of midline catheters and complications rate.ConclusionsMore and more attention has been paid to the midline catheters, but further studies with large samples and high quality are still needed, in order to provide more evidence for the application and popularization of midline catheters in China, and choose a safe, comfortable, convenient, low-cost and high-benefit intravenous infusion device for patients.
【摘要】 目的 总结血管腔内覆膜支架植入术治疗腹主动脉瘤患者围手术期并发症的预防、观察和临床护理要点。 方法 对2008年1-8月行血管腔内覆膜支架植入术治疗的27例腹主动脉瘤患者的临床资料进行回顾性分析。 结果 27例手术均获成功，术后未发生严重并发症，治疗及护理效果良好。 结论 有效的护理措施是保证治疗成功的重要因素。【Abstract】 Objective To summarize and analyze the prevention, observation and clinical care of perioperative complications in patients with abdominal aortic aneurysm (AAA). Methods We retrospectively analyzed the clinical data of 27 patients with AAA who underwent endovascular covered stent grafting surgery in our hospital from January to August 2008. Results With appropriate treatment and good care, all grafting surgeries were successful without any severe postoperative complications. Conclusion Effective care measures are an important factor to ensure successful treatment.
ObjectiveTo explore the application effect of itinerant strengthening post in ophthalmic day operating room.MethodsIn June 2019 (before the establishment of the itinerant strengthening post) and January 2020 (after the establishment of the itinerant strengthening post), satisfaction of 21 ophthalmic surgeons in the ophthalmic day operation room of the West China Hospital of Sichuan University on intraoperative nursing cooperation, and coping ability scores of operation in key links, satisfaction with scheduling and workload, as well as complaints and accusations received by surgeons of 15 ophthalmological nurses in the ophthalmic day operation room of the West China Hospital of Sichuan University were collected. The total volume of eye day surgeries and the length of the day operating room open in the second half of 2018 and 2019 were retrospectively collected.ResultsAfter the establishment of the itinerant strengthening post, the coping ability score of operation in key links of ophthalmological nurses was improved [(3.28±0.72) vs. (4.67±0.72), P<0.01]. In terms of surgeons’ satisfaction with intraoperative nursing cooperation, with the exception of aseptic operation, the other items were improved (P<0.05). The surgical nurses’ satisfaction with scheduling and workload [(3.30±0.77) vs. (4.47±0.67), P<0.01]; nurses’ complaints and accusations received by surgeons [(3.60±1.18) vs. (2.33±0.82), P<0.01] were improved. The volume of eye day surgery from July to December 2019 increased by 6.58% over the same period in 2018, and the average open time of the operating room increased by 1.88%.ConclusionThe setting up of itinerant strengthening posts in the ophthalmology day operation room is conducive to strengthening the strength and business guidance of the nurses’ key links in the operation room in a timely and effective manner. It can optimize the allocation of human resources in the operating room as much as possible when the existing nursing staff is in short supply, and improve the quality and efficiency of ophthalmic surgery nursing, which is worthy of promotion and application.
Objective To investigate the status quo of implementation ofIntravenous Practice Standard in a tertiary A hospital in Sichuan. Methods At 09:00-11:30 am, on March 16th, 2016, a questionnaire designed by intravenous team (IV Team) was used to conduct the investigation in all the inpatiets according to inclusion and exclusion criteria. The SPSS 17.0 software was used to perform all statistical analysis. Results The intravenous infusion rate in the hospital was 76.87%, while the rate in Emergency Department peaked up to 96.11%. Indwelling needle was the most common used device for intravenous therapy in clinical practice, which was used in 77.91% of the inpatients, and steel needle, peripherally inserted central catheter (PICC), central venous catheter, and implantable venous access port were also widely used. Peripheral intravenous catheter was used in 2 990 inpatients, and 78.12% of the puncture sites met the standard; PICC was used in 397 inpatients, and 90.17% of the puncture sites met the standard. The incidence of intravenous infusion related-complications was 15.08%, the incidence of drug exosmosis / exudation was 10.06%, and the incidence of catheter-related blood stream infection (CRBSI) was 2.89%. Conclusions On the whole, the intravenous infusion rate in this hospital accords with the national average level, but the rate in some departments should be controlled. The selection of device for intravenous therapy is reasonable, but the selection of intravenous site should be more standardized. The incidence of intravenous infusion related-complications is low, but the prevention and control of drug exosmosis / exudation and CRBSI should be reinforced. Health care organizations should pay more attention to enforce the Intravenous Practice Standard into practice to promote clinical medical service.