Application of Continuous Improvement of Pre-Examination Process Based on Evidence-Based Nursing Concept in Acute Chest Pain of Adults.

To explore the impacts of optimizing emergency nursing care process on success rate of rescue and incidence of adverse reactions in patients with acute chest pain. A total of 90 emergency patients with acute chest pain, admitted between January 2022 and December 2023, were selected as study participants. Patients were randomly assigned to either the control group or the observation group using a random number table method. The control group received routine care, while the observation group underwent an optimized emergency nursing care process. Comparisons between the two groups were made for the following outcomes: rescue and hospitalization time, rescue success rate, pain intensity, incidence of adverse reactions, mental status, and nursing satisfaction. Compared with the control group, the rescue and hospitalization time of the observation group were shorter (p < 0.01). Compared with the control group, the rescue success rate of the observation group was higher (82.22% vs. 97.78%; p = 0.013). The visual analogue score (VAS) scores of the observation group at 30 min, 60 min, 120 min and 240 min after rescue were lower than those of the control group (p < 0.01). Compared with the control group, the incidence of adverse reactions of the observation group was lower (20.00% vs. 4.44%; p = 0.024). Compared with the control group, the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores of the observation group were lower after nursing (p < 0.01). Compared with the control group, the nursing satisfaction score of the observation group was higher (p < 0.01). The optimized emergency nursing care process for patients with acute chest pain is associated with relief of pain, a decrease in the occurrence of negative psychology and adverse reactions, as well as an effective improvement in the success rate of rescue.

Objective To explore the effect of integrated nursing process based on process reorganization in the improvement of success rate of emergency treatment for patients with multiple traumas. Methods 60 patients with multiple traumas treated at our department from June, 2015 to June, 2016 were selected as a control group, and 62 from July, 2016 to June, 2017 an observation group. The control group was received with emergency nursing routine care, and the observation group were treated with integrated nursing process based on process reorganization. The consultation time, the time from diagnosis to special treatment, the time for establishment of infusion channel, the time for recovery of blood pressure, the treatment success rate, the incidence of accidents, patient satisfaction, and nursing disputes was compared between two groups. Results The consultation time, the time from diagnosis to special treatment, the time for establishment of infusion channel, and emergency operation time were shorter, the treatment success rate and patient satisfaction were higher, and the incidences of accidents and nursing disputes were lower in the observation group than in the control group (all P<0.05). Conclusion Integrated nursing process based on process reorganization for patients with multiple traumas can effectively shorten treatment time and increase treatment success rate and satisfaction. Key words: Process reorganization; Nursing process; Emergency multiple traumas; Rescue success rate; Satisfaction

Objective To investigate the effect of grading and triage of acute stroke (AS) in emergency department. Methods Sixty-seven patients with AS admitted to the emergency department of Luoding People's Hospital from January, 2017 to October, 2018 and taking a emergency grading and triage mode were selected as an observation group, and sixty-seven patients not take the emergency grading and triage mode as a control group. The time from admission to diagnosis, the treatment success rate, and the family members’ satisfaction rate were compared between these two groups. Results The waiting time, treatment waiting time, and emergency treatment time were significantly shorter in the observation group than in the control group (t=21.047 3, 10.213 5, and 8.976 9, all P<0.05). The success rate was 100.00% in the observation group, and was 85.07% in the control group (χ2=10.806 5, P<0.05). The missed diagnosis rate and the incidence of medical disputes were significantly lower in the observation group than in the control group (χ2=6.900 2 and 6.916 1, both P<0.05). The satisfaction was 98.51% in the observation group, and was 86.57% in the control group (χ2=6.916 1, P=0.000 0). Conclusion Grading and triage of AS in emergency department can significantly shorten the patients' rescue time, effectively improve the patients' success rate and satisfaction, and reduce the incidence of medical disputes. Key words: Acute stroke; Emergency treatment; Emergency grading and triage; Patient satisfaction

Objective To investigate the effects of glutamine on intestinal functions of dogs following abdominal open injury coupled with seawater immersion.Methods Following open abdominal injury,30 adult dogs were randomly divided into 3 groups:the seawater immersion group(the control group),the routine treatment group(the conventional group)and the glutamine treatment group(the observation group),each consisting of 10 animals.Blood pressure,heart rate,respiration,abdominal circumference,bowel sound were monitored both before and after injury.Blood samples were collected for the detection of endotoxin,D-lactate,diamine oxidase(DAO),tumor necrosis factor alpha(TNF-a),interleukin-1(IL-1 and lactulose/mannitol(L/M)ratio.After 24 hours,small intestine tissues were taken for pathological detection and measurement of intestinal mucosal thickness and villous height.Results When compared with the conventional group,no statistically significant differences could be seen in mean artery pressure(MAP),heart rate,respiration,bowel sound and abdominal circumference for the observation group(P＞0.05).When compared with the conventional group and the observation group,significant differences could be noted in MAP and bowel sound for the control group(P＜0.05).And statistical significance could also be noted for heart rate,respiration and abdominal circumference at hours 12 and 24 respectively following injury(P＞0.05).Endotoxin:when compared with the conventional and observation groups,statistical significance could also be noted in endotoxin for the control group at hours 12 and 24 following injury(P＞0.05),and statistical significance could also be noticed for the observation group at hour 24,when compared with the control and conventional groups(P＞0.05).D-lactate:there were statistically significant differences for the conventional group,when comparisons were made between the 3 groups at hour 12 following injury(P＜0.05),however,no statistical significance could be noted between the observation group and the control group(P＞0.05).Statistical significance was observed for the conventional group,when compared with the control and observation groups(P＜0.05).And no statistical significance was noted,when a comparison was made between the observation and control groups(P＜0.05).DAO:when compared with the control and conventional groups,statistical significance could be noted for the observation group at hours 8 and 24 respectively following injury(P＜0.05).TNF-α:when compared with observation and conventional groups,there was statistical significance for the observation group at hours 12 and 24 respectively following injury(P＜0.05).IL-1:when compared with the control[(7.40±2.71)ng/L]and the conventional groups[(8.71±3.13)ng/L],statistical significance could be observed for the observation group at hour 12 following injury(P＜0.05),however no statistical significance could be noted,when a comparison was made between the observation and control groups.At hour 24 following injury,when compared with the control[(9.91±3.18)ng/L]and conventional groups[(10.12±2.25)ng/L],statistical significance could be noticed for the observation group(P＜0.05).Urine L/M ratio:statistical significance would be noticed for the observation group,when compared with the control and conventional groups(P＜0.05).Pathological results:only mild edema could be seen in the intestinal mucosal cells of the animals in the observation group under optical microscope,which was obviously lighter,when compared with the observation and control groups.And there were statistical differences in intestinal mucosal thickness and villous height,when compared with the conventional group(P＜0.05),however,no statistical differences could be noted,when a comparison was made between the control and conventional groups(P＞0.05).Conclusions Glutamine seems to have definitive therapeutic effects on intestinal dysfunction induced by abdominal injury coupled with seawater immersion. Key words: Seawater immersion; Open abdominal injury; Intestinal function; Glutamine; Therapeutic effect

This study evaluates the efficacy of a Delphi-method-based nursing plan for critically ill emergency patients. A total of 80 critically ill patients admitted to the emergency department between January 2021 and January 2023 were included in the study, divided into 2 groups: the control group (n = 40) receiving routine emergency care, and the observation group (n = 40) receiving a nursing plan based on the Delphi method. The Delphi process involved the formation of an expert panel, followed by multiple rounds of anonymous feedback. After reviewing and refining the initial nursing criteria, the experts reached a consensus on key care indicators and interventions. The final plan emphasized personalized care, risk assessment during transport, in-hospital care, and psychological support. The observation group received care based on this plan. The transfer time, rescue success rate, rescue time, and hospitalization duration were compared, along with the incidence of complications, self-rating anxiety scale and self-rating depression scale scores, and nursing satisfaction. The transfer time, rescue time, and hospitalization duration were significantly shorter in the observation group compared to the control group (P < .05). The rescue success rate was significantly higher in the observation group (P < .05). The incidence of complications was 7.5% in the observation group, significantly lower than the 32.5% observed in the control group (P < .05). After nursing care, both groups showed significant reductions in self-rating anxiety scale and self-rating depression scale scores; however, the post-intervention scores in the observation group were significantly lower than those in the control group (P < .05). Nursing satisfaction in the observation group was 95%, significantly higher than the 80% in the control group (P < .05). The nursing plan for emergency critically ill patients constructed based on the Delphi method can help improve the success rate of rescue, reduce the risk of complications, enhance patients' psychological well-being and satisfaction with care, demonstrating significant clinical implications.

Objective To observe the clinical effects of pre-hospital emergency treatment combined with interventional therapy on patients with acute myocardial infarction, and to provide a reliable basis for the selection of treatment methods. Methods The clinical data from 600 patients with acute myocardial infarction admitted to General Hospital of Tongmei Group from March 2017 to March 2019 were retrospectively analyzed. And the patients were grouped by treatment methods. All patients were given emergency treatment before admission. A total of 317 patients with interventional therapy were included in the observation group, and 283 patients with conventional treatment were included in the control group. The absolute value of the difference in the heart rate, respiration, blood pressure, blood oxygen saturation and other indicators before emergency treatment and during transportation were observed and compared between the two groups. The number of defibrillation and hospital stay were compared between the two groups. The success rate of rescue, incidence of complications and rate of sudden death in the two groups were calculated. Results During delivery and before emergency treatment, the absolute differences of heart rate, respiration, blood pressure and other indicators of the observation group were superior to those of the control group, and the absolute difference of blood oxygen saturation was lower than that of the control group, however, the number of defibrillation and hospitalization time were less than those in the control group, with statistically significant differences (P< 0.05). The success rate of rescue in the observation group was 95.90%(304/317), significantly higher than the 81.98%(232/283) in the control group (P< 0.05), and the incidence of complications and sudden death rate were statistically lower than those in the control group (P< 0.05). Conclusions Pre-hospital emergency treatment combined with interventional therapy in patients with acute myocardial infarction can effectively improve clinical symptoms in a short period of time, which is beneficial to reducing the number of defibrillation, shortening the length of hospital stay, improving the success rate of rescue, and reducing the risk of related complications and sudden death. Key words: Acute myocardial infarction; Pre-hospital emergency treatment; Interventional therapy; Success rate of rescue; Clinical curative effect

To explore the effect of comprehensive nursing based on risk prevention in perioperative nursing of intracranial aneurysm. A total of 156 patients who suffered from intracranial aneurysm were admitted in neurosurgery department from the hospital between January 2018 and January 2019. Patients were randomly divided into observation group (n=78, patients were given comprehensive nursing based on risk prevention) and control group (n=78, patients were given routine nursing). The following parameters, such as postoperative hospital stay, rescue success rate, Glasgow coma scale (GCS) after being awake, anxiety degree and nursing effect (incidence of complications, incidence of infection and patient satisfaction) were compared between the two groups. The postoperative hospital stay, rescue success rate and GCS after intervention in the observation group were significantly better than those in the control group (P<.05). The degree of anxiety in the observation group after intervention was superior to that in the control group (P<.05), similar results were obtained in terms of the nursing effect in the observation group compared with the control group (P<.05). Comprehensive nursing was associated with the shortness of hospitalisation time of patients, improved rescue rate, reduced occurrence of complications and infection, and improved satisfaction of patients. Thus, comprehensive nursing was regarded to exert protective effect with a promising future for clinical practice.

Objective: To explore the application effect of an artificial intelligence (AI)-assisted diagnostic system in the clinical diagnosis and treatment of digestive system tumors (including gastric cancer, colorectal cancer, liver cancer, etc.), providing evidence-based support for improving the efficiency and accuracy of diagnosis and treatment of digestive system tumors. Methods: A total of 200 patients with digestive system tumors admitted to our hospital from January 2022 to December 2024 were selected and divided into an observation group (n = 100, receiving AI-assisted diagnosis combined with conventional diagnosis and treatment) and a control group (n = 100, receiving conventional diagnosis and treatment) according to the random number table method. The differences in diagnostic and treatment indicators between the two groups were compared. Results: The diagnostic time in the observation group was 18.25 ± 3.68 minutes, significantly shorter than that in the control group (35.72 ± 5.14 minutes) (t = 25.36, P &lt; 0.001). The missed diagnosis rate and misdiagnosis rate in the observation group were 2.00% (2/100) and 1.00% (1/100), respectively, significantly lower than those in the control group [8.00% (8/100) and 7.00% (7/100), respectively] (χ2 = 4.01, 5.03, both P &lt; 0.05). Conclusion: The AI-assisted diagnostic system can significantly improve the diagnostic accuracy of digestive system tumors, shorten the diagnostic and treatment time, and reduce the missed diagnosis and misdiagnosis rates, demonstrating high application value in the clinical diagnosis and treatment of digestive system tumors.

BACKGROUND Disorders of consciousness are critical emergencies requiring timely intervention to improve outcomes. Process reengineering using checklists can enhance efficiency in clinical settings. AIM To evaluate whether checklist-based process reengineering in the Emergency Department reduces emergency stay duration and hospitalization time, and improves rescue success rate, prognosis, and satisfaction among patients with disorders of consciousness. METHODS From January 2021 to December 2023, our hospital admitted 400 emergency consciousness disorders patients using purposive sampling. The first 200, undergoing rescue without the checklist-based process, formed the control group. The next 200, post-implementation, constituted the observation group. We collected data on emergency stay duration, rescue success rate, hospitalization duration, and patient satisfaction for analysis. Patient prognosis in both groups was compared. RESULTS The observation group showed significantly shorter emergency stay duration, time to recovery, and overall hospitalization duration (intensive care unit, general ward, total) compared to the control group (P &lt; 0.05). The observation group had a higher rescue success rate (P &lt; 0.05) and better recovery rate (P &lt; 0.05) than the control group. Both medical staff and patients’ family members reported higher satisfaction with the emergency rescue model after checklist-based process reengineering compared to the conventional emergency rescue model (P &lt; 0.05). CONCLUSION Emergency process reengineering based on checklists can effectively reduce the emergency stay duration for patients with consciousness disorders, improve rescue success rates, enhance patient prognosis, and increase overall medical and patient satisfaction.

Objective To explore the application effects of emergency nursing procedure in clinical nursing of patients with acute cerebral infarction. Methods A total of 70 patients with acute cerebral infarction, admitted from January 2013 to January 2014 in Emergency Department in Hubei Provincial Hospital of Integrated Chinese & Western Medicine, were selected as research objects and randomly divided into observation group and control group, each with 35 cases. Patients in the observation group were treated by emergency nursing procedure, while patients in the control group were given routine nursing care. Emergency care effects, neurological function and mental state after treatment in two groups were observed. Results Rescue time, lethality rate and disability rate in the observation group were significantly lower than that in the control group, but the success rate of rescue and nursing satisfaction were significantly higher than that of control group, while success rate of rescue and satisfaction of nursing in the observation group were significantly higher than that in the control group (P 0.05); after the treatment, CSS scores and NIHSS scores of patients in both groups declined significantly, while MMSE scores rose significantly (P<0.05). Nevertheless, improvement degree in the observation group were more apparent compared with that of the control group (P<0.05). Conclusions Application of emergency nursing procedure in patients with acute cerebral infarction can significantly shorten rescue time and improve neurological function and mental state after treatment, which make it worth popularizing further in clinic. Key words: Nursing; Cerebral infarction, acute; Emergency nursing procedure

Objective To explore the clinical value of predictive nursing procedure for patients with orthopedic trauma. Methods 130 patients with orthopedic trauma were randomly divided into the observation group(72 cases)and the control group(58 patients).The control group was given conventional orthopedic care.The observation group was given predictive nursing procedure.The effective rescue time,hospital stay,hospital costs,complications,success rate of rescue and satisfaction degree with nursing for the two groups were taken for statistics. Results The effective rescue time and hospitalization time of the observation group were significantly shorter than the control group.The hospital costs reduced significantly.The complications in the observation group were significantly less than the control group,while the success rate of rescue was significantly higher.The satisfaction degree of the observation group was significantly higher than the control group. Conclusions The predictive nursing for patients with orthopedic trauma can improve treatment effect and reduce complications and hospital costs,which is worthy of promotion. Key words: Predictive nursing; Orthopedics; Trauma

Objective To investigate the effects of different pre-hospital treatments on the prognosis of patients with acute respiratory failure. Methods 100 patients with respiratory failure admitted into our hospital from April, 2015 to March, 2017 were enrolled in this study. They were divided into an observation group and a control group using random number method, 50 cases for each group. The observation groups took comprehensive pre-hospital treatment, and the control group routine pre-hospital treatment. The ventilator treatment time and hospital stay were compared between these two groups. The SGRQ scores (SGRQ) between the two groups before and after admission were analyzed. The rescue success rates and mortalities in both groups were calculated. Results The ventilator treatment time and hospital stay were shorter in the observation group than in the control group (both P<0.05). The SGRQ score was lower at the time of admission than before the intervention in the observation group, and was lower in the observation group than in the control group at the time of admission (P<0.05). The rescue success rate was 90.0% in the observation group, and was 50.0% in the control group (χ2=12.769, P<0.05). Conclusion Effective pre-hospital first aid for patients with acute respiratory failure can shorten the time of ventilator use and hospitalization time, improve their quality of life, and reduce the mortality. Key words: Pre-hospital treatment; Acute respiratory failure; Hospital stay; Mortality

We aimed to investigate the clinical effect of low molecular weight heparin (LMWH) combined with magnesium sulfate in patients with severe pre-eclampsia (PE). A total of 70 patients with severe PE admitted in Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, China from Jun 2020 to May 2021 were enrolled and randomized into observation and control groups. The control group was treated with magnesium sulfate only, and the observation group was treated with small-dose LMWH combined with magnesium sulfate. The clinical effects and artery blood flow index were analyzed. The observation group had higher coagulation function than that in the control group. RI, S/D, and PI in the observation group after treatment were lower than those in the control group, with statistically significant differences (P <0.05). In serum and placental tissues, both kininase expression and TGF-1 levels of the observation group were higher than those of the control group, with lower PAPP-A, VCAM-1 and E selectin levels than those in the control group. Small-dose LMWH combined with magnesium sulfate can promote the expression of endogenous kallikrein, weaken the infiltration of cytotrophoblast, and improve the maternal blood clotting state in patients with severe PE. It also improves placental microblood flow and effectively prolong pregnancy, promotes fetal growth, and improves the clinical effects.

Objective To investigate the effect of low-dose aspirin combined with vitamin E on the incidence of intrauterine growth restriction and hemorheological indexes of pregnant women in patients with gestational hypertension. Method 134 elderly patients with chronic urticaria treated in our hospital from November 2017 to November 2020 were studied. According to the treatment methods, they were randomly divided into observation and control groups. There were 67 patients in the observation group, aged 20-37 years, with an average of (25.7 ± 2.75) years. There were 67 patients in the control group, aged 21-35 years, with an average of (26.3 ± 3.17) years. No significant difference was observed between the two groups (P > 0.05). Results The number of cases with postpartum hemorrhage and intrauterine growth restriction in the observation group was less than that in the control group. The total incidence rate was lower than that in the control group. There were significant differences in the above results (P < 0.05). The number of patients with preterm birth in the observation group was less than that in the control group, but there was no significant difference in the results (P > 0.05). The head circumference, abdominal circumference, biparietal diameter, and femoral length diameter in the control and observation groups increased significantly after treatment (P < 0.05). Compared with the control group, the head circumference, abdominal circumference, biparietal diameter, and femoral diameter in the observation group increased more after treatment, and the results were statistically poor (P < 0.05). The systolic blood pressure, diastolic blood pressure, and mean arterial pressure in the control and observation groups decreased significantly after treatment, and the results were statistically different (P < 0.05). Compared with the control group, the systolic blood pressure, diastolic blood pressure, and mean arterial pressure in the observation group decreased more after treatment. The results were statistically different (P < 0.05). The plasma viscosity levels, whole blood high shear viscosity, and whole blood low shear viscosity in the control and observation groups decreased significantly after treatment, and the results were statistically different (P < 0.05). Compared with the control group, plasma viscosity levels, whole blood high shear viscosity, and whole blood low shear viscosity in the observation group decreased more after treatment, and the results were statistically different (P < 0.05). The control and observation groups' fetal systolic/diastolic pressure and pulsatile index decreased significantly after treatment, and the results were statistically different (P < 0.05). Compared with the control group, the fetal systolic/diastolic blood pressure and pulsatile index in the observation group decreased more after treatment, and the results were statistically poor (P < 0.05). Conclusion Low-dose aspirin combined with vitamin E is effective in treating intrauterine growth restriction in patients with gestational hypertension. It can effectively control the blood pressure and blood flow of patients and newborns and improve pregnancy outcomes without increasing the incidence of adverse reactions. It is worthy of clinical promotion.

The intensive care unit (ICU) is a specialized hospital department. Awake patients in the ICU frequently encounter adverse psychological states, such as anxiety and fear, often accompanied by poor sleep quality. This situation has garnered significant attention within the medical community. To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU patients. One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control (n = 60) and observation (n = 60) groups. Patients in the control group were cared for using the conventional nursing model, while patients in the observation group were cared for using the prospective nursing model. Sleep improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index (PSQI). The PSQI, Generalized Anxiety Disorder 7-item (GAD-7) scale, Self-Depression Scale (SDS), and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care models. Patient satisfaction in the observation group was significantly higher than in the control group. The GAD-7 and SDS scores in the observation group were significantly lower than those in the control group, and the total effective rate of sleep improvement in the observation group was significantly higher than in the control group. After treatment, the PSQI scores of the two groups significantly decreased (P < 0.05). The decrease in the observation group was more significant than that in the control group, and the difference between the two groups was statistically significant. Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU, which is worthy of clinical application.