Methods To explore the level of delirium knowledge of geriatric nurses in Sichuan province and analyze the factors, so as to provide the basis for systematic and targeted knowledge training on delirium and clinical management. Methods Using the self-designed “the Questionnaire of Elderly Delirium Knowledge”, geriatric nurses from 22 hospitals in Sichuan province were investigated through a convenient sampling method from September 2018 to February 2019. Results A total of 475 geriatric nurses were investigated. The average delirium knowledge score of the 475 geriatric nurses was 69.51±12.42. Multiple linear regression analysis showed that the main factors affecting the score of delirium-related knowledge were the education of nurses (P=0.037), technical title (P<0.001), years of working in the geriatric department (P=0.001), and the level of working hospital (P=0.001). Conclusions The level of delirium knowledge of geriatric nurses is low and can not meet the needs of clinical work. Nursing managers should carry out delirium knowledge training according to the different characteristics of nurses.
Objective To assess the current status of medical waste management and classification disposal in hospitals across Hubei Province, providing a scientific basis for optimizing medical waste disposal strategies and promoting waste minimization, harmless treatment, and resource utilization. Methods A random sample survey was conducted on medical and health institutions in Hubei Province between January 8 and January 17, 2025. The self-made survey questionnaire was used to survey and analyze the medical waste management and classification disposal in medical and health institutions. Results A total of 257 medical and health institutions were surveyed. Among them, there were 93 tertiary hospitals (36.19%), 75 secondary hospitals (29.18%), 77 primary hospitals (29.96%), and 12 non-graded medical institutions (4.67%). The overall compliance rate for medical waste management and training exceeded 90%. In terms of medical waste supervision sections, compliance rates in primary hospitals and non-graded hospitals were 77.92% (60/77) and 58.33% (7/12), respectively. The compliance rate for medical waste classification and disposal was above 90%, with a 100% (221/221) compliance rate for the disposal of placentas from normal deliveries. However, the standardized disposal rates for “fetal tissues from pregnancies under 16 weeks or weighing less than 500 grams”, “amputation and other human tissues (or organs)” and “dead fetus” were 81.45% (180/221), 44.65% (96/215), and 79.64% (176/221), respectively. Additionally, 87.16% (224/257) of healthcare institutions classified single-use soft infusion bottles (bags) as recyclable waste, but significant variations were observed in the disposal of uncontaminated waste (e.g., empty disinfectant bottles, empty dialysis fluid barrels, oxygen humidifier bottles, and orthopedic casting materials). Furthermore, 99.61% (256/257) of hospitals provided protective equipment for medical waste handlers, 91.83% (236/257) conducted regular health examination to them, and 97.28% (250/257) had established needle stab reporting systems and related training programs. Conclusions Medical waste management and classification in hospitals across Hubei Province are largely standardized. However, the certain categories of medical waste still require stricter regulation and oversight.
ObjectiveTo investigate the use of anti-hypertensive drugs among hypertension patients in examination medical center. MethodThis was a cross-sectional survey. Data of 3 000 cases of medical examination center health records from December 2012 to December 2013 were sampled, and 1 310 patients with hypertension were screened for analysis of medication. ResultsIn the 1 310 hypertension patients, 959 used antihypertensive drugs before, among whom 423 (44.11%) accepted only one anti-hypertensive drug and 536 (55.89%) accepted compound anti-hypertensive drugs or combined medicine. In patients of the previous kind, calcium channel blocker classes of antihypertensive drugs were used the most (n=244, 25.44%). Among the second kind of patients, 359 (37.43%) were treated with a two-compound drug or a combination of two drugs, and most of them used the combination of calcium channel blocker with angiotensin receptor blocker or calcium channel blocker with angiotensin converting enzyme inhibitor. ConclusionsThe current using of anti-hypertensive drug is in accordance with the recommendation of anti-hypertensive treatment guidelines in some way, but there are still some gaps between real clinical practice and guidelines.
Objective To analyze the nurses' current view and perceptions of enhanced recovery after surgery (ERAS) by a questionnaire and to promote the clinical application of ERAS. Methods We conducted a questionnaire study for nurses who attended the First West China Forum on Chest ERAS in Chengdu during September 26-27, 2016 and 259 questionnaires were collected for descriptive analysis. Results (1) The application status of ERAS: There were 13.5% responders whose hospital took a wait-an-see attitude, while the others' hospital took different actions for ERAS; 85.7% of nurses believed that ERAS in all surgeries should be used; 58.7% of nurses believed that the concept of ERAS was more in theory than in the practice; 40.2% of nurses thought that all patients were suitable for the application of ERAS; (2) 81.9% of nurses believed that the evaluation criteria of ERAS should be a combination of the average hospital stay, patients’ comprehensive feelings and social satisfaction; (3) 70.7% of nurses thought that the combination of subjects integration, surgery orientation and surgeon-nurse teamwork was the best model of ERAS; 44.8% of nurses thought the hospital administration was the best way to promote ERAS applications; (4) 69.1% of responders believed that immature plan, no consensus and norms and insecurity for doctors were the reasons for poor compliance of ERAS; 79.5% of nurses thought that the ERAS meeting should include the publicity of norms and consensus, analysis and implementation of projects and the status and progress of ERAS. Conclusion ERAS concept has been recognized by most nurses. Multidisciplinary collaboration and hospital promotion is the best way to achieve clinical applications.
Objective To investigate the diabetic knowledge of primary hospital doctors and diabetes patients, and to explore the way to improve the capability of primary hospitals in preventing and treating diabetes. Methods Between January 2013 and June 2014, we set questionnaires to learn the profiles of diabetes knowledge of 328 internal and general medicine doctors including 43 chronic disease management workers from fifteen township hospitals and two community health centers, 152 doctors from village clinics, and 575 diabetes patients in Xindu District of Chengdu City. We made questionnaires for doctors and patients respectively to investigate their knowledge on diabetes and blood sugar control in the patients. Finally, we made plans to train doctors in primary hospitals according to the results of the investigation. Results For township hospitals, 328 questionnaires were given out with 319 retrieved, and the valid retrieval rate was 97.3%; 152 questionnaires were given out to village doctors and 149 were retrieved, with a valid retrieval rate of 98.0%; and we gave out 575 questionnaires to the diabetes patients and retrieved 539, with a valid retrieval rate of 93.7%. Primary hospitals were insufficient in their drug varieties. Among doctors in township hospitals, 7.8% had bachelor’s degree, 53.6% had received post-secondary education, and 38.6% had received secondary vocational education. Most of the village doctors had not received any professional medical education, among whom, 89.9% had a certificate of village doctors and 10.1% had a certificate of assistant doctors. The diabetes questionnaire score of primary hospital doctors was low, while the score of chronic disease management workers was relatively higher (P<0.05). For diabetes patients, medical investment was inadequate, treatment rate was low, common sense of diabetes was insufficient, and glycosylated hemoglobin control rate was only 13.5%. Conclusions Diabetes patients in primary hospitals have a poor disease control, which is probably associated with the insufficient publicity and education from doctors. It is necessary to train primary hospital doctors at all levels. In order to get the best therapeutic effect, we advocate that diabetes should be managed by doctors of chronic disease management, although they should receive systematic training for a long time.
Objective To investigate the status of health condition and activities of daily living of “50630” retired cadres in Mianzhu, and analyze the related factors affecting their activities of daily living. Methods According to the registration information of Mianzhu administration of elderly cadres in Sichuan, the method of cluster sampling was adopted in March 2019 to select retired cadres who participated in work between October 1st, 1949 and June 30th, 1950 in urban and rural areas respectively. The survey and analysis were carried out using the self-designed general condition questionnaire, Berg balance scale, Hoffer walking ability rating scale, and modified Barthel Index, to understand the activities of daily living ability of retired cadres and analyze the relevant factors affecting their self-care ability of daily life. Results A total of 64 “50630” retired cadres were investigated, with an average age of (86.39±3.37) years. 64.06% of the patients with poor balance function needed wheelchair, 10.94% could not walk, and 56.25% were heavily dependent on activities of daily living. Age (r=−0.421, P=0.001) and underlying diseases (r=−0.060, P=0.032) were negatively correlated with activities of daily living. Balance ability (r=0.658, P<0.001), walking ability (r=0.393, P=0.001), spouse status (r=0.669, P<0.001), care status (r=0.830, P<0.001), place of residence (r=0.706, P<0.001) were positively correlated with activities of daily living. Education level (r=0.096, P=0.380) and gender (r=0.122, P=0.265) had no correlation with activities of daily living. Multiple linear regression analysis showed that the main influencing factors of daily living activities of “50630” retired cadres in Mianzhu were balance function, walking ability, spouse or not and type of care. Conclusions There are many related factors affecting the activities of daily living of “50630” retired cadres, which can be intervened according to basic diseases, balance function and walking ability. Through multi-disciplinary and multi-sectoral cooperation, integrating community health service resources, providing all-round health care services, formulating personalized rehabilitation measures, and organizing community group activities, it is possible to improve their social participation, psychological status, and ability of daily living activities, and reduce the disability, so as to further improve the quality of life of veteran cadres.
ObjectiveBased on the off-label drug use (OLDU) record application of alprostadil injection (Lipo-PGE1) which was the only one rejected in the Guangdong General Hospital in 2013, we retrospectively investigated all the background information of inpatients' OLDU of Lipo-PGE1 in 2012, so as to provide references for intervention of OLDU and effect evaluation. MethodsAccording to OLDU in dose record application of clinical departments, we summarized medical orders about inpatients' use of Lipo-PGE1 during hospitalization in 2012 and analyzed OLDU situation according to drug labels. Then, we summarized situation of drug use in all departments, analyzed OLDU incidence in dose, calculated prescribed daily dose (PDD) and drug use density (DUD) in each department to evaluate the degree of OLDU in dose. Resultsa) A total of 106 576 medical orders involving 8 620 case-times were analyzed. According to the data of cases, medical orders and drug use amount, the OLDU incidences were 34.43%, 25.16% and 41.37%, respectively. Lipo-PGE1 was used in every clinical department in this hospital and OLDU occurred in 69.44% departments (25/36). b) According to the number of medical orders, there were 6 departments with the OLDU incidence in dose > 50% and 5 departments with the OLDU incidence in dose during 50% to 20%. c) The average of PDD of the whole hospital was 12.77 μg. A total of 25 departments' PDDs were off-label, and 10 departments' PDDs were above the average level of the whole hospital. The ICU's PDD was the highest, with 2.35 times more than label dose. d) The PDD in each department was not directly proportional to DUD, which indicated the degree of OLDU in dose was not directly proportional to use intensity. This may be caused by different disease burdens in departments. ConclusionLipo-PGE1 is widely used in the Guangdong General Hospital where OLDU in dose occurs commonly. Since PDD and DUD reflect different contents, the two indicators should be combined to monitor OLDU.
ObjectiveTo evaluate the applicability of SF-36 scale on assessment of quality of life in patient with breast cancer. MethodsThree hundreds and seventy-one patients with breast cancer in Department of Breast of First Affiliated Hospital of Xinjiang Medical University from June 2011 to January 2014 were treated and then surveyed with SF-36 scale, evaluating the feasibility, reliability, validity, ceiling effect, and floor effect. Results①The feasibility evaluation:Completion time of SF-36 scale was (12.1±3.2) min, finishing rate was 100%. ②The reliability evaluation:All the split-half reliability coefficients and the Cronbach's α were all above 0.8. All the internal consistency coefficients were all above 0.6. ③The validity analysis:All the Pearson coefficients were all above 0.7. Tow principal component were extracted by factor analysis, which accounted for 63.22% of total variance. After the maximum variance rotation, two common factors were generated, which was almost the same with the theory structure assumption of scale. ④Ceiling effect and floor effect:There was remarkable ceiling effect on bodily pain, which was 77.35%; there was obvious floor effect on role physical and mental health, which was 20.32% and 24.88%, respectively. ConclusionThe SF-36 scale is an useful scale for the evaluation of the quality of life among the patients with breast cancer, but individual items need to be further perfected according to the actual situation.
ObjectiveTo explore the quality of life (QOL) of rural cognitive function impaired elderly in Guangyuan city and analysis the influencing factors, in order to provide evidence for improving the QOL of rural cognitive function impaired elderly. MethodsBy stratified cluster sampling method, Mini-Mental State Examination (MMSE) was adopted in the cognitive function impaired screening in Guangyuan rural area of Sichuan province in 2012, then we used SF-12 questionnaire to evaluate the QOL of those rural elderly (more than 60 years old) whose cognitive function was impaired. ResultsA total of 270 rural cognitive function impaired elderly were selected from 735 old people. The results of QOL assessment showed that:the mean of physical component summary (PCS) was 37.93±11.55, and the mean of mental component summary (MCS) was 44.07±13.14. Gender, age, education levels, economic situation of the selfassessment, chronic disease, being engaging in physical labour and daily life care were correlated with the score of QOL. ConclusionIn order to improve their QOL, we should help the elderly with cognitive function impaired and focus on prevention and individual treatment; their special difficulties should be fully considered when making the policy of health care and social security.
Objective We conducted a questionnaire study who attended the First West China Forum on Chest Enhanced Recovery after Surgery (ERAS) in order to analyze whether it can improve the knowledge of ERAS and how to organize an effective meeting. Methods We analyzed 188 questionnaires from the representatives of the First West China Forum on Chest ERAS after the meeting which included two parts: one was the personal basic information and institution of respondents, and the other was the opinion of the content setting and suggestion for the next forum. Results A percentage of 97.7% of participants believed that this forum contributed to improving their understanding of ERAS and 65.3% of them will put the concept of ERAS into practice after the meeting. The exchange of experience and project communication of ERAS were the most useful agendas approved by representatives while expert lectures should be more appropriate (18.1%). Arrangement for topic discussion and enough time for discussion were supported by 93.1% and 98.9% of the representatives respectively. Multi-center project discussion (80.9%) and interactive sessions especially WeChat interaction (74.0%) should be added on ERAS forum. Conclusion Reasonable agenda settings are beneficial to improve the understanding and compliance of application of ERAS.