Nursing Care Research Articles

Glymphatic system dysfunction and risk of clinical milestones in patients with Parkinson disease.

Glymphatic dysfunction may play a significant role in the development of neurodegenerative diseases. We aimed to evaluate the association between glymphatic dysfunction and the risk of malignant event/clinical milestones in Parkinson disease (PD). This study included 236 patients from August 2014 to December 2020. Diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index was calculated as an approximate measure of glymphatic function. The primary outcomes were four clinical milestones including recurrent falls, wheelchair dependence, dementia, and placement in residential or nursing home care. The associations of DTI-ALPS with the risk of clinical milestones were examined using multivariate Cox proportional hazards regression models. Then, logistic regression was repeated using clinical variables and DTI-ALPS index individually and in combination of the two to explore the ability to distinguish patients who reached clinical milestones within a 5-year period. A total of 175 PD patients with baseline DTI-ALPS index and follow-up clinical assessments were included. A lower DTI-ALPS was independently associated with increased risk of recurrent falls, wheelchair dependence, and dementia. Additionally, in 103 patients monitored over 5 years, a logistic regression model combining clinical variables and DTI-ALPS index showed better performance for predicting wheelchair dependence within 5 years than a model using clinical variables or DTI-ALPS index alone. Glymphatic dysfunction, as measured by the DTI-ALPS index, was associated with increased risk of clinical milestones in patients with PD. This finding implies that therapy targeting the glymphatic system may serve as a viable strategy for slowing down the progression of PD.

Development of a risk predication model for critical care needs in patients with intracerebral hemorrhage: a retrospective cohort.

It is very important to provide the correct nursing care for patients with intracerebral hemorrhage (ICH), but the level of critical care needs in patients with intracerebral hemorrhage is not clear. The purpose of this study is to establish a risk model based on the epidemiological and clinical characteristics of ICH patients, to help identify the critical care needs of ICH patients. The clinical data of ICH patients from January 2018 to September 2023 were analyzed retrospectively. The full cohort was used to derive the clinical prediction model and the model was internally validated with bootstrapping. Discrimination and calibration were assessed using the area under curve (AUC) and the Hosmer-Lemeshow tests, respectively. 611 patients with ICH were included for model development. 61.21% (374/611) ICH patients had received critical care interventions. The influencing factors included in the model were Glasgow Coma Scale (GCS) score, intraventricular hemorrhage, past blood pressure control, systolic blood pressure on admission and bleeding volume. The model's goodness-of-fit was evaluated, which yielded a high area under the curve (AUC) value of 0.943, indicating a good fit. For the purpose of model validation, a cohort of 260 patients with ICH was utilized. The model demonstrated a Youden's index of 0.750, with a sensitivity of 90.56% and a specificity of 78.22%. GCS, systolic blood pressure, intraventricular hemorrhage, bleeding volume and past blood pressure control are the main factors affecting the critical care needs of patients with ICH. This study has deduced a clinical predictive model with good discrimination and calibration to provide scoring criteria for clinical health care providers to accurately evaluate and identify the critical care needs of ICH patients, to improve the rational integration and allocation of medical resources.

Nurses' perceptions of caring behaviors at referral hospitals in Ethiopia: A mixed-methods approach.

Caring plays a vital role in nursing and serves as an indicator of quality. Nurse caring behaviors are directed towards patients' safety and wellbeing. Nurses' perceptions of caring behaviors are affected by different factors. Understanding the factors linked to how nurses perceive caring behaviors is crucial for enhancing the quality of care. The aim of this study was to examine the factors associated with nurses' perceptions of caring behaviors and gain a more comprehensive understanding. A multicenter sequential explanatory mixed-methods study was conducted among medical-surgical nurses at three referral hospitals in the Amhara region, Ethiopia. Quantitative data were collected using a pretested self-administered survey package including the Amharic version of the Caring Behaviors Inventory-16. Qualitative interviews using semi-structured, open-ended questions were conducted after the survey to complement and clarify the quantitative results, facilitating integrate through a connecting approach. A multiple linear regression model was used to examine the relationship between nurses' perceptions of caring behaviors and associated factors. The qualitative data was examined to find meaningful patterns using codebook thematic analysis. This method was deductive and followed the guidelines by Braun and Clarke, building on the findings from the quantitative results. The overall mean of nurses' perceptions of caring behaviors was 4.75. The multiple linear regression analysis showed that female sex (b = 0.300, P = 0.004), age (b = 0.028, P = 0.001), nurse staffing (b=-0.115, P = 0.001), work-related stress (b = 0.298, P = 0.003), and job satisfaction (b=-0.254, P = 0.016) were associated with nurses' perceptions of caring behaviors. The codebook thematic analysis generated three themes, caring is universal and fundamental in nursing, impediments to provision of comprehensive care, and perception of the work conditions. The findings of the qualitative data complemented the results of the quantitative data. Discrepancies between nurses' expectations and the actual working environment may create uncertainty in care provision and impact quality-of-care. Strategies to harmonize the nurses' working environment should consider work-related factors.

The effect of baby touch on premature infants

Objective: Premature infants require special attention during nursing. This study aimed to explore the effects of baby touch on the growth, immunity, sleep and communication in premature infants. Methods: This was a retrospective study. A total of 64 premature infants with a gestational age of 30-36 weeks were selected at Maternity & Child Care Center of Qinhuangdao from June 2022 to May 2023, and randomly divided into experimental group and control group. The control group received routine comprehensive nursing care for newborns, while the experimental group was additionally treated with touch intervention using the international standard touch method. The effects of the three months touch on the growth and development, immunological function, sleep quality, and emotional communication of the premature infants were observed. Results: No statistically significant differences were found in gender, gestational age, birth weight, birth length, or head circumference at birth between the two groups (p> 0.05). In the third month, the increases in body weight, body length and head circumference were significantly more obvious, the immunological function indicators including CD3+, CD4+, CD8+, IgG, IgA and IgM were all significantly higher, the sleep time and sleep quality were both significantly superior, and the interaction time and intimacy with parents were significantly superior in the experimental group compared with the control group, with statistically significant differences (p< 0.05). Conclusion: Baby touch can promote growth and development, strengthen immunological function, improve sleep quality and enhance the emotional communication abilities of premature infants, and help them better adapt to the environment and grow. doi: https://doi.org/10.12669/pjms.40.10.9275 How to cite this: Du Q, Zhu H, Guo M, Yang Q, Yang H, Ma Y. The effect of baby touch on premature infants. Pak J Med Sci. 2024;40(10):2256-2260. doi: https://doi.org/10.12669/pjms.40.10.9275 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Impact of medical adhesives on persistent fluid extravasation at needle injection sites in patients with severe edema: a randomized controlled trial.

To investigate the efficacy of medical glue in halting fluid extravasation at needle insertion sites in patients with severe edema. Sixty patients with severe edema were recruited between June 2022 and June 2023 and randomly allocated into either the control group or the experimental group, with 30 cases in each. In the experimental group, after intramuscular injection, medical glue was administered at the needle insertion site, and covered with gauze dressing upon curing, and subsequently subjected to pressure bandaging. Patients were instructed to limit their activity. Meanwhile, the control group received conventional nursing procedures involving pressure bandaging and activity restriction. The effectiveness of nursing interventions in halting exudation, duration of hospitalization, duration of exudation, nursing expenses, skin complications (infection, rash, abrasion, abnormal sensation, etc.), and patient satisfaction with nursing care were monitored. Comparison between the two groups revealed statistically significant differences in several aspects: the success rate of halting exudation, duration of exudation, total skin complication rate, and overall satisfaction [83.3% vs. 20.0%, (2.20 ± 2.76) days vs. (7.33 ± 3.28) days, 6.67% vs. 33.33%, 80.00% vs. 36.67%, P < 0.05]. However, there were no statistically significant differences in hospitalization time and nursing expenses [(14.50 ± 5.17) days vs. (14.00 ± 3.95) days, (537.53 ± 264.19) yuan vs. (661.97 ± 305.55) yuan, P > 0.05]. Medical glue demonstrates effectiveness in halting fluid extravasation at needle insertion sites among patients experiencing severe edema. Additionally, it reduces the duration of exudation, diminishes skin complications resulting from exudation, and significantly enhances patient satisfaction with nursing care. Given these benefits, its clinical adoption and application are highly recommended.

The Effect of Mindfulness-Based Stress Reduction on Pediatric Oncology Nurses' Stress Level, and Pediatric Oncology Patients' Psychosocial Symptoms and Care Satisfaction: A Prospective Non-Randomized Trial.

Studies investigating the effects of relaxation practices on nurses and patient outcomes are limited. This study aimed to evaluate the impact of Mindfulness-Based Stress Reduction (MBSR) on pediatric oncology nurses' stress levels, as well as the psychosocial symptoms and care satisfaction of pediatric oncology patients. A non-randomized prospective study with a pretest-posttest design was conducted, involving 112 children and 8 pediatric oncology nurses between November 2021 and August 2022. The study was conducted in 3 stages. First, the children's nursing care satisfaction and psychosocial symptoms were evaluated during the first 3 months before the MBSR intervention. Second, the nurses participated in the MBSR program for 2 months. Third, the children's nursing care satisfaction and psychosocial symptoms were assessed again 3 months after the MBSR intervention. The results showed that children who received nursing care post-MBSR had lower scores in the Psychosocial, Hopelessness, and Communication Difficulty subscales compared to those who received care pre-MBSR. Additionally, these children had higher scores in Evaluation of Quality of Care from the Children's Point of View, Psychosocial, Physical, and Information subscales. There was a significant reduction in the stress levels of nurses between the pre-MBSR and post-MBSR assessments. MBSR is an effective method for reducing pediatric oncology nurses' perceived stress levels and should be utilized to support both pediatric oncology nurses and patients in enhancing their psychosocial functioning.

CUIDADOS DE ENFERMAGEM NA PREVENÇÃO DE INFECÇÕES HOSPITALARES: ESTRATÉGIAS E PROTOCOLOS

Objective: The study aimed to analyze the strategies and protocols adopted by nursing professionals in order to evaluate their effectiveness and propose improvements. Method: A bibliographic methodology was used, reviewing the current literature on hand hygiene protocols, use of Personal Protective Equipment (PPE), and prevention of infections associated with invasive devices. Results: The results indicated that the fundamental protocols are effective in reducing infections, but highlighted the need for continuous training and the potential use of monitoring technologies to improve adherence and evaluation of practices. The study objectives were achieved, recommending regular updating of protocols, intensification of training, and the integration of new technologies to improve strategies for preventing hospital infections. Conclusion: This article investigated nursing care in the prevention of hospital infections. The justification for the study lies in the importance of optimizing infection prevention, a continuous challenge in hospital settings that impacts patient safety and health costs. Keywords: Hospital infections. Nursing care. Prevention. Control strategies.

CUIDADOS DE ENFERMAGEM NA PREVENÇÃO DE INFECÇÕES HOSPITALARES: ESTRATÉGIAS E PROTOCOLOS

Objective: The study aimed to analyze the strategies and protocols adopted by nursing professionals in order to evaluate their effectiveness and propose improvements. Method: A bibliographic methodology was used, reviewing the current literature on hand hygiene protocols, use of Personal Protective Equipment (PPE), and prevention of infections associated with invasive devices. Results: The results indicated that the fundamental protocols are effective in reducing infections, but highlighted the need for continuous training and the potential use of monitoring technologies to improve adherence and evaluation of practices. The study objectives were achieved, recommending regular updating of protocols, intensification of training, and the integration of new technologies to improve strategies for preventing hospital infections. Conclusion: This article investigated nursing care in the prevention of hospital infections. The justification for the study lies in the importance of optimizing infection prevention, a continuous challenge in hospital settings that impacts patient safety and health costs. Keywords: Hospital infections. Nursing care. Prevention. Control strategies.

Rainbow within and beyond: A qualitative study on the experiences of lesbian, gay, bisexual, and transgender staff nurses in the Philippine hospital settings.

An individual's sexual orientation plays a fundamental role in their self-identity, relationships, and health. Years have shown both progressive and regressive responses to the LGBT community's social acceptance, particularly observable in various areas. Yet existing literature overlooks the Filipino healthcare settings, particularly with lesbian, gay, bisexual, and transgender (LGBT) staff nurses. Exploring their perspectives and experiences, whether challenges or successes, is crucial for gaining insights into occupational matters, workplace dynamics, and policy development. The research aimed to explore the lived experiences of LGBT staff nurses in the hospital settings. Husserl's Transcendental Phenomenology research design was utilized in this study. Participants included LGBT staff nurses with at least a year of experience at any hospital department. Individualized unstructured interviews were conducted with three participants interviewed face-to-face and five through online video conferencing platforms from March to April 2024. All interviews were transcribed, coded, themed, and analyzed using Colaizzi's approach. Data saturation was achieved with eight participants. Seven themes emerged, including: Recognizing Gender Stereotypes, Optimizing Nursing Care, Yearning for Acceptance, Generating Meaningful Relationships, Battling Heteronormative Gender Norms, Inspiring Potentials beyond Gender and Profession, and Valuing the Progress of LGBT Inclusivity. The study revealed that LGBT staff nurses had multifaceted experiences with patients, colleagues, and superiors in the hospital settings as their workplace. They faced gender stereotyping and battled against limits on expression but fought to defend their authentic identities. They built relationships with colleagues and strived to be defined beyond societal perceptions. As they yearn for amplified LGBT acceptance in the workplace and society, they expressed gratitude for progress towards acceptance of the LGBT community.

Exploring nulliparous women's perceptions of pelvic organ prolapse treatments: A qualitative study for enhancing nursing care in Romania.

There remains a significant gap in understanding what nulliparous (NP) women desire in terms of treatment for pelvic organ prolapse (POP) before pregnancy and childbirth. This study aimed to assess the perceptions of young NP women without POP regarding various POP treatments and identify their preferred treatment options to enhance quality in nursing practice. This study employed a qualitative descriptive design involving thirteen young NP women at the Faculty of Medicine, Ovidius University from Constanța, Romania. Age, body mass index (BMI), comorbidities, previous surgical interventions, and smoking status were evaluated. Participants underwent a semi-structured interview from January to February 2024, during which their perceptions of different POP treatments were explored. The interviews were audio-recorded and transcribed verbatim and were analyzed using content analysis. The mean age of the NP women without POP was 24.23 years, with 61.53% having a BMI of 30 or greater and 69.23% reporting previous surgical interventions. Four dominant themes emerged: 1) the Internet as a source of information about treatments for POP; 2) insufficient knowledge about POP symptoms; 3) the preference for supervised PFM training; and 4) choosing the surgical treatments by vaginal route, although wishing to preserve the uterus. The findings indicated that young NP women's perceptions of POP treatments were primarily influenced by online information. The preferred treatment for POP among young NP women was conservative, with a strong emphasis on supervised PFM training. This study provides valuable insights into nursing practice by highlighting NP women's perceptions and preferences for PFM training as a treatment for POP, potentially contributing to delaying the onset of this condition in their lives.

Efficacy of wooden toy training in alleviating cognitive decline in elderly individuals with cognitive impairment: A cluster randomized controlled study.

With the increasing global aging population, the health and welfare of elderly individuals, especially individuals with prevalent mild cognitive impairment (MCI) living in nursing homes, have become critical concerns. These concerns highlight the urgency of developing effective interventions to address the cognitive and psychological needs of elderly individuals, ensuring their well-being and alleviating the burden on their caregivers. This study investigates the impact of wooden toy training on mitigating cognitive decline in elderly individuals with cognitive impairment. It evaluates how this training influences cognitive functions and psychological well-being, exploring whether it can slow or reverse the progression of cognitive decline. This outcome will be assessed in a randomized controlled trial, in which changes in cognitive ability and psychological health indicators among the participants will be measured. A two-arm, open-label, cluster-randomized controlled trial. The study was conducted in two nursing homes, which served as both the recruitment sites for participants and the intervention locations. These nursing homes were selected for their ability to facilitate the intervention and for their representative demographic characteristics of the elderly population. The settings provided a controlled environment that was conducive to implementing the wooden toy training program and observing its effects on the participants. A total of 76 elderly participants with mild cognitive impairment but functional independence were recruited. Participants were randomized into an intervention group and a control group. The intervention group engaged in an 8-week wooden toy training program, whereas those in the control cohort received customary nursing care. Standardized cognitive and psychological well-being measures were used to assess improvements in cognitive performance and mental health. Significant improvements were observed in the cognitive functions of the intervention group from a baseline score of M = 13.11 to M = 16.29 postintervention (95% CI [-4.44, -1.93]), along with reductions in depressive symptoms from a baseline score of M = 8.63 to M = 7.18 (95% CI [0.38, 2.51]). Additionally, engagement in activities with wooden toys significantly satisfied their need for competence, increasing from a baseline of M = 16.29 to M = 20 postintervention (95% CI [-5.92, -1.51]), and relatedness, which improved from a baseline of M = 20.32 to M = 22.95 (95% CI [-4.73, -0.53]). This study underscores the potential of a wooden toy intervention in nursing homes that combines cognitive challenges with traditional cultural elements to improve cognitive functions in elderly individuals with mild cognitive impairment. Our findings suggest a novel method of promoting the cognitive and psychological health of nursing home residents through emotional comfort and social interaction.

ASSISTÊNCIA DE ENFERMAGEM NA SAÚDE MENTAL DOS PORTADORES DE LINFANGIOLEIOMIOMATOSE

The importance of providing quality and knowledgeable care, and recognizing the impact generated on the mental health of patients with a rare disease, such as Lymphangioleiomyomatosis or LAM, advocating nursing care as essential. Objective: to highlight and inform the need for nursing care in the mental health of patients with LAM. Method: this is a bibliographic review, based on articles selected from the databases: Scientific Electronic Library (SciELO), Brazilian Society of Pulmonology and Tisiology, Google Scholar and the Ministry of Health. The inclusion criteria were articles that were published in the year 2020 to 2024, except for some cases where it was necessary to search for slightly older articles for a more complete research. Results: the nursing team, because it is on the front line of care and has a greater bond with patients, becomes responsible for providing proper care to people who have a rare disease, such as LAM, as this generates psychological illness. Knowing the subject, studying it and providing adequate assistance, thus reducing the impacts generated by this disease. Thus, providing guidance regarding the concept of LAM, the symptoms that may arise, how to reduce them, respecting the entire process and providing the emotional support they need. Conclusion: the presence of a nurse is necessary to provide the appropriate assistance to these patients. It is extremely important to have knowledge of LAM and its harms to the mental health of patients, enabling this professional to be able to provide the best possible care to a patient with a rare disease.

Stuart Stress Adaptation and Nola Pender's Model on Mental Nursing Care of Patients Schizophrenia: Case Study

To describe the application of the Stuart Stress Adaptation and Nola Pender Models in mental nursing care for a patient with schizophrenia and risk of violent behavior. This research method used case studies. The sample is one patient with schizophrenia. Data collection is done through direct observation, interviews, and patient medical records. The results showed that the client showed a major nursing problem in the form of risk of violent behavior. Predisposing factors included passive childhood experiences and socio-cultural issues, while precipitation included feeling disrespected by the husband's family. Nursing interventions provided to the patient included logotherapy, forgiveness therapy, and psychoeducation to the family. Family psychoeducation forms a supportive system in the client's recovery process. The results of this study indicate that there is a reduction in symptoms of violent behavior in schizophrenia patients. The importance of integrating the Stuart Stress Adaptation and Nola Pender Model in the psychiatric nursing care of patients with paranoid schizophrenia.

Organizational innovations related to Primary Care Access Points (GAP) for unattached patients in Quebec: a multi-case qualitative study

BackgroundBeing attached to a primary care (PC) provider is at the core of a strong primary health care system. Centralized waiting lists (CWL) for unattached patients have been implemented in eight provinces of Canada to support the attachment process. In Quebec, the Ministry of Health mandated the implementation of Primary Care Access Points (GAP) across the province to help unattached patients navigate the health system while awaiting attachment through the CWL. Several local health territories developed complementary innovations to the GAP to respond to local population needs. This paper aims to describe five organizational innovations implemented locally.MethodsThis multi-case qualitative study was conducted in four local health territories in the province of Quebec. Fifty-two semi-structured interviews with healthcare managers, nurses, physicians, other health professionals and administrative staff were conducted between April 2023 and April 2024. An interview guide was developed based on existing frameworks on the implementation of innovations and the evaluation of the GAP. Thematic analysis was conducted using NVivo software. Inductive and deductive approaches were used to develop relevant codes and themes. Logic models were built to describe the organizational innovations.ResultsFive organizational innovations are described. First, a multidisciplinary clinic aimed at responding to patients with mental health issues was implemented. Second, a nurse clinic was implemented to provide temporary care for patients with unstable chronic illnesses. The third innovation is a mobile proximity clinic where unattached GAP patients are first evaluated by a paramedic before receiving care from a nurse. Fourth, a pharmacist trajectory was implemented to increase engagement of community pharmacists to respond to GAP patients. The last innovation is a decentralized GAP offering in-person nursing care to unattached GAP patients.ConclusionsDescriptions of these five innovations are key to inform other territories and provinces on ways to improve access for unattached patients while they are waiting to be attached. The introduction of the GAP and the organizational innovations, suggests a transition where access to PC services does not rely solely on attachment status.

Introduction and Systematic Review of the Good Nursing Care Scale.

To provide an introduction to the Good Nursing Care Scale (GNCS) and systematically review the application of the scale in health research. Systematic review. Empirical studies published in English or Finnish in peer-reviewed journals or as a summary of a PhD thesis where the scale was used for data collection amongst patients were included. Analysis was made by using descriptive statistics, narrative analysis, and evaluation of psychometric properties. PubMed, CINAHL, Cochrane, and Scopus in October 2023. A total of 26 full-text studies and summaries of PhD theses were included in the review. The GNCS has been developed systematically, and the theoretical structure has remained stable. The studies indicate a high level of patient-centered quality of nursing care. Validity and reliability evaluation and reporting were systematic in the studies and mainly indicate sufficient level. Variations between countries are not large, supporting the international use of the GNCS. Patient-centered quality of nursing care is predominantly at high levels. However, systematic evaluation is needed to provide longitudinal data. For that purpose, the GNCS is one potential instrument. Support for the use of existing, tested instruments is encouraged to provide critical ideas for the future needs of nurse practitioners, managers, teachers and researchers. This paper impacts researchers interested in systematic evaluation of the patient-centered quality of nursing care and for practitioners taking care of patients. For researchers, it introduces a relevant instrument, the GNCS, for analysing the quality or for comparing the quality with other instruments. For practitioners, it produces evidence of the usability of the GNCS. PRISMA guided the systematic review, and the COSMIN guideline was used for quality appraisal of included studies. No Patient or Public contribution.

Effect of nursing care based on goal-oriented mind mapping model on the prognosis of patients with severe brain injury.

The objective of this study was to observe the effect of nursing care based on goal-oriented mind-mapping on the prognosis of patients with severe brain injury. Clinical data of 116 patients with severe brain injury admitted to Qinghe County Central Hospital between March 2021 and August 2023 were retrospectively analyzed. Based on the nursing mode the patients received, they were divided into an Observation group (n = 58, patients received nursing based on the goal-oriented mind mapping mode) and a Control group (n = 58, patients received routine care). Data on length of hospital stay, complications, functional recovery, cerebral oxygen metabolism, and quality of life scores of the 2 groups were collected and analyzed. The length of hospital stay of the Observation group was shorter than that of the Control group (P < .05). The total incidence of complications in the Observation group was lower than that in the Control group (P < .05). After intervention, neurological function, cerebral oxygen metabolism indicators, and quality of life of the 2 groups improved significantly compared with those before the intervention; furthermore, the neurological function and cerebral oxygen metabolism indexes of the Observation group were better than those of the Control group (P < .05). The nursing care based on goal-oriented mind-mapping model for patients with severe brain injury can effectively shorten the length of hospital stay, reduce the occurrence of prognostic complications, and improve the recovery of neurological and limb motor functions, and ultimately achieve the goal of improving the quality of life.

Effectiveness of accelerated rehabilitation surgical nursing on perioperative outcomes in patients with calcaneal fractures.

This study aims to evaluate the impact of accelerated rehabilitation nursing on perioperative outcomes in patients with calcaneal fractures. A total of 101 patients with calcaneal fractures admitted from December 2020 to December 2022 were included in this study. Patients were randomly assigned to an observation group (OG) of 51 patients receiving accelerated rehabilitation surgical nursing and a control group (CG) of 50 patients receiving conventional surgical nursing. Outcomes assessed included patient satisfaction, visual analog scale (VAS) scores before and after surgery, swelling reduction time, and complication rates. The satisfaction rate in the OG was 96.07%, significantly higher than the 80.00% observed in the CG. Post-operative VAS scores at day 4 and 6 were significantly lower in the OG compared to the CG. Swelling reduction time was shorter in the OG (152.56 ± 25.22 hours) compared to the CG (170.76 ± 22.51 hours). Additionally, the complication rate in the OG was significantly lower at 7.84% compared to 24.00% in the CG (P < .05).the implementation of accelerated rehabilitation nursing significantly shortened the average length of hospital stay for patients in the observation group. In contrast, patients in the control group, who received conventional nursing care, had a relatively longer hospital stay. In the perioperative treatment of calcaneal fractures, accelerated rehabilitation surgical nursing can significantly improve patient satisfaction, reduce pain, shorten the time for swelling to subside, and lower the incidence of complications. Additionally, it can shorten the hospital stay for patients, demonstrating its efficacy and potential for broader clinical application.

Effect of Nurse-Assisted Early Warning Intervention for Prevention of Venous Thromboembolism Following Cesarean Delivery

Abstract Objective The aim of the study is to assess the role of a nurse-assisted early warning intervention in improving prophylaxis against obstetric venous thromboembolism (VTE) and preventing VTE following cesarean delivery (CD). Methods A prospective cohort study conducted between January 1, 2020, and December 30, 2022, enrolled pregnant women who underwent CD in the obstetric unit of Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital. The patients were assigned to a control group (routine nursing care) or the intervention group (nurse-assisted early warning intervention) depending on whether or not the nurse-assisted early warning intervention had been implemented. The χ 2 test and Student’s t test were used for statistical analysis. The primary outcome was the incidence of systemic VTE following CD, and secondary outcomes were the rates of mechanical or pharmacologic prophylaxis receipts for VTE and the frequency and severity of adverse events related to pharmacologic prophylaxis. Results A total of 27,074 cases were enrolled. The incidence of symptomatic VTE following CD was significantly lower in the intervention group (0.29 per 1000 deliveries) than in the control group (2.4 per 1000 deliveries) (P &lt; 0.001). Significantly more cases received mechanical and pharmacological VTE prophylaxis in the intervention group than in the control group (respectively, 19.8% vs. 12.6% receiving mechanical prophylaxis and 0.9% vs. 0.2% receiving pharmacological prophylaxis). No cases of life-threatening bleeding occurred in either group. Conclusion The application of nurse-assisted early warning intervention may be an effective method for preventing VTE following CD.

Experimental study on radiational characteristics and nursing care of a novel radioisotope 188Re memory alloy esophageal stent.

Radioactive esophageal stent, known for inhibiting tumor growth and delaying restenosis in malignant esophageal tumors, presents challenges due to potent radiation, leading to side effects. This study aims to support the clinical use of 188Re radioactive esophageal stent. The 188Re stent with 128MBq initial activity was placed in a biomimetic esophageal membrane. Radiation absorption doses were measured by thermoluminescence and calculated using mathematical software. Under simulated positioning, the stent was implanted in the esophagus of an experimental pig, followed by the feeding of Kangfuxin solution and nursing care (KFX-RT). Non-implanted and implanted-only pigs served as normal (CR) and experimental (RT) controls. Blood samples collected on days 7 and 21 were analyzed for inflammatory factors (TGF-β1, TNF-α, IL-6) using enzyme-linked immunosorbent assay. Esophageal tissue cells were assessed for deoxyribonucleic acid index (DI) and subdiploid content through flow cytometry. Absorbed doses at 0.5mm and 5mm reference points were 223.91cGy and 20.55cGy, respectively, with 92.64% absorbed within a 1mm thickness. Radiation dose significantly decreased at 6.5mm, with only 4.72% absorbed at depths ≥6.5mm. On days 7 and 21, levels of inflammatory factors, DI and subdiploid content were significantly increased in the KFX-RT and RT groups compared to the CR group, while all levels in the KFX-RT group were significantly lower than in the RT group. The 188Re esophageal stent exhibits high radiation absorption in superficial tissues and low absorption in deeper tissues. Kangfuxin solution combined with nursing care alleviates radiation-induced inflammatory damage.

Application of Nursing Project Management in Increasing the Utilization of GCS in Patients at High Risk for DVT

&amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: To investigate the effect of nursing program improvements on improving the utilization rate of gradient compression stockings in patients at high risk of deep vein thrombosis. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: To set up a special project improvement group, determine the topic of special project improvement, set 40 patients with postoperative Caprin score &amp;gt;5 before the implementation of special project improvement activities, i.e., from January to May 2022 in our hospital, as the control group, and 40 patients with postoperative Caprin score &amp;gt;5 after the implementation of special project improvement activities, i.e., from July to November 2022 in our hospital as the experimental group, and count the number of patients using gradient compression stockings to prevent deep vein thrombosis, and investigate the effect of using gradient compression stockings in improving the utilization rate of patients with high risk of deep vein thrombosis. The number of patients using gradient compression stockings to prevent deep vein thrombosis, the survey of patients&amp;apos; knowledge about deep vein thrombosis and satisfaction with care, and the comparison of the differences between the two groups before and after the project improvement. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: The use rate of gradient compression stockings in the experimental group was 82.5% higher than that of gradient compression stockings in the control group, which was 15%, with statistically significant differences (p &amp;lt; 0.05); the experimental group&amp;apos;s knowledge of DVT was higher than that of the control group, with statistically significant differences (p &amp;lt; 0.05); and the experimental group&amp;apos;s satisfaction with nursing care increased from 91.73 points to 98.75 points, with statistically significant differences (p &amp;lt; 0.05). &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: Project management can effectively increase the utilization rate of gradient compression stockings for high-risk patients with deep vein thrombosis and improve patients&amp;apos; knowledge of deep vein thrombosis and satisfaction with nursing care.