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 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.
【摘要】 目的 调查手术室工作多层面满意度，分析影响其满意度的因素，提出干预措施。 方法 采用自行设计调查表对手术医生、手术患者或家属、病区护士、手术室护生进行手术室工作满意度调查分析。 结果 2009年4季度各层面满意度gt;95%，比1季度满意度提高了9.51%，与1季度相比有统计学意义（Plt;0.05）。且护理人员素质、手术室管理、人文服务等都有不同程度的提高。 结论 对手术室满意度进行多层面定期调查和不定期抽查，全方位地分析不同层面影响满意度的因素，采取有效的干预措施，达到持续质量改进。【Abstract】 Objective To investigate the multidimensional satisfaction in the operating room’s work and to analyse various factors and intervention measures. Methods The multidimensional satisfaction in the operating room’s work of surgeon, surgical patients, family members, ward nurses, and practical nurses were investigated and anlyzed by self-designed questionnaire. Results In 2009, various satisfaction rate of the fourth quarter is 95%, compare with the the first quarter, the satisfaction rate of the fourth quarter increased 9.51%, the difference was statistically significant(Plt;0.05). The paramedic’s quality, management of operating room, quality of nurse, human services have got different increase. Conclusion To conduct the multidimensional periodic surveys and occasional spot checks about satisfaction rate of the operating room, and to analyze roundly the different levels factors of affecting the satisfaction rate can take effective interventions to achieve continuous improvement of the nurse quality.
目的 探讨心理干预措施对改善妇科恶性肿瘤患者的生命质量的作用及有效性。 方法 对2008年11月－2010年11月收治的87例妇科恶性肿瘤患者，随机分为试验组与对照组，试验组43例，实施心理干预及常规治疗；对照组44例，采取常规治疗；并对两组患者入院后及出院前生存质量、心理状况以问卷调查方式进行资料收集，用以比较、评价心理干预对改善妇科恶性肿瘤患者生命质量的作用及效果。 结果 妇科恶性肿瘤患者抑郁发生率为56.3%（49/87），焦虑发生率为62.1%（54/87）； 心理干预后两组患者组间各指标比较，试验组患者的总体健康状况、生存质量、角色功能、情绪功能、认知功能得分比对照组增高（P＜0.05）；试验组患者疲倦、恶心呕吐、失眠、食欲下降、便秘症状、抑郁、焦虑得分比对照组得分下降（P＜0.05）。 结论 心理干预可改变妇科肿瘤患者的负性心理倾向，缓解抑郁、焦虑等情绪，减轻化疗药物所引起的系列副作用，能有效提高其生活质量。
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.
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。
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 know the status quo of multidrug-resistant organism (MDRO) infection in primary general hospitals, analyze the differences among various intervention measures, and put forward guiding principles for MDRO infection control in primary general hospitals. Methods We investigated all patients (n=51 612) admitted into the hospital between January 2013 and December 2015, and found out 6 types of MDRO. Pre-interventional investigation was carried out between January 2013 and June 2014 (before intervention) during which no intervention measures were taken; Intervention was carried out between July 2014 and December 2015 (after intervention). All departments in the hospital (6 groups) were matched with intervention measures (6 groups) randomly. Then, we compared the MDRO detection rate, nosocomial infection case rate and intervention compliance rate among the groups. Results We detected altogether 611 MDRO cases (without duplication) out of the 51 612 cases. The total detection rate of MDRO was 1.18%. The detection rate of MDRO before and after intervention was 1.37% and 1.01%, respectively. The difference between the two was of statistical significance (P<0.05). After the intervention, the detection rate in groups 1, 5 and 6 was significantly lower than before (P<0.05); the differences in detection rate among groups 2, 3, and 4 were not significant (P> 0.05). Nosocomial infection rate decreased from 0.28% before intervention to 0.14% after intervention (P<0.05). After the intervention, MDRO nosocomial infection case rate of groups 1, 5 and 6 was significantly lower than before (P<0.05); the rate was lower in groups 3 and 4 than before without any significance (P>0.05); no MDRO cases were detected in group 2 and comparison was meaningless. The knowledge rates of medical workers and of nursing staff increased from 52.97% and 20.00% before intervention to 78.76% and 66.34% after intervention, respectively (χ2=30.670, 38.604;P<0.05). The compliance to all kinds of protection measures improved significantly (P<0.05) except compliances to equipment of hand antiseptic agent and patient transfer order (P> 0.05). Conclusion Promoting the compliance rate to hand hygiene and environmental cleaning and disinfection, primary general hospitals can decrease the detection rate and nosocomial infection case rate of MDRO.