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25 November 2024, Volume 31 Issue 22
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Journal of Nursing. 2024, 31(22): 12-16. https://doi.org/10.16460/j.issn1008-9969.2024.22.012Objective To construct a whole-process smart transfusion management model based on blood bank forward, to move the blood bank toward the departments of blood use, to realize the whole-process smart management of blood, and to explore the clinical effect of this model. Methods Smart blood cabinet and “the Internet of Things” refrigerated boxes with constant temperature were developed. A whole-process smart transfusion information management system was applied in hematology department. Clinical practice of this model was evaluated through measuring the time the blood withdrawn from the cold chain before transfusion, the qualified rate of transfusion nursing records, the time consumed per single blood bag transfusion and the proportion of transfusions during day shifts. Results After the blood bank was moved forward, the time the blood withdrawn from the cold chain before transfusion was shortened from (25.11±3.20 )min to (6.08±2.57) min (t=155.991, P<0.001); the qualified rate of blood transfusion nursing records increased from 84.94% to 97.22%（χ2=503.096, P<0.001); the time consumed per single blood bag transfusion was shortened from (19.39±3.27) min to (2.05±1.07) min(t=170.680, P<0.001), and the proportion of transfusions during day shifts increased from 54.90% to 85.07%（χ2=168.540, P<0.001). Conclusion The whole-process smart transfusion management model based on blood bank forward has improved blood management, quality of blood transfusion and safety of blood transfusion. It has also optimized clinical workflow and improved nurse work efficiency.
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Journal of Nursing. 2024, 31(22): 17-21. https://doi.org/10.16460/j.issn1008-9969.2024.22.017Objective To investigate the establishment and implementation effects of a nursing research outpatient clinic. Methods A nursing research outpatient clinic was established in July 2023, and qualified members were selected for the outpatient team. We improved the organization and management of the nursing research outpatient clinic, clarified work processes and service scope, and provided targeted research services for clinical nursing staff, including research proposal submission, study design, and paper writing. The effectiveness of the nursing research outpatient clinic was evaluated based on the number of outpatient visits, research output, nursing staff's research capabilities, and satisfaction with the research environment. Results Since the operation of the nursing research outpatient clinic, there were 294 outpatient visits. The research capabilities of nursing staff were improved, and satisfaction with the research environment had significantly increased, with statistical significance (P<0.05). Conclusion The establishment of nursing research outpatient clinic aims to guide nursing staff in applying for research projects, conducting studies, applying for patents, and writing and publishing papers, enhancing the research capabilities of nursing staff and their satisfaction with research environment. This initiative provides reference and inspiration for promoting the development of research outpatient clinics in China and improving the clinical research level of hospitals.
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Journal of Nursing. 2024, 31(22): 35-40. https://doi.org/10.16460/j.issn1008-9969.2024.22.035Objective To develop review indicators for perioperative voice rehabilitation in patients with vocal cord organic dysphonia, to analyze the obstacle factors, and to provide reference for the transformation of clinical evidence. Methods Guided by the knowledge to action framework (KTA) model, according to steps of knowledge application including identifying problems, establishing evidence-based groups and expert teams and introducing knowledge into clinical situation, review indicators and review methods were identified and formulated through consultation and discussion. According to the results of the baseline review, based on the OMRU model, the barriers to introducing evidence into clinical practice were analyzed by brainstorming method. Results A total of 15 pieces of best evidence were included, and 13 review indicators and review methods were identified and formulated. A total of 8 barriers including 2 in evidence reform, 3 in potential adopter and 3 in practice environment were summarized. Conclusion The development of review indicators in this study is scientific and feasible, and the assessment of obstacles was scientific and novel. The research may provide reference for evidence transformation.
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Journal of Nursing. 2024, 31(22): 41-47. https://doi.org/10.16460/j.issn1008-9969.2024.22.041Objective To evaluate the guidelines related to hypoglycemia management in adults with diabetes and provide reference for clinical practice. Methods Domestic and international databases, guidelines and websites of relevant societies were searched. Two researchers independently extracted data, and three researchers used Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) to evaluate the quality of clinical practice guidelines and summarize and analyze the recommended opinions. Results A total of 17 guidelines were included, including 10 clinical practice guidelines and 7 expert consensuses. The overall quality evaluation of the guidelines was relatively high. Seven opinions were extracted regarding the classification of hypoglycemia, the management of hypoglycemia in conscious, unconscious or unresponsive patients, the management of hypoglycemia after blood glucose recovery, the management of hypoglycemia in enteral nutrition recipients and insulin pump wearers and the prevention of hypoglycemia. Conclusion The included guidelines are generally of high quality, which can provide evidence-based support for the clinical practice of hypoglycemia management for adults with diabetes in China. However, a strict localization of foreign guidelines is required before being applied to the clinical environment in China.
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Journal of Nursing. 2024, 31(22): 48-53. https://doi.org/10.16460/j.issn1008-9969.2024.22.048Objective To perform a scoping review on the application of fracture liaison service (FLS) in patients with osteoporotic hip fracture and to provide reference for FLS's clinical application and future research. Methods We searched literature in CNKI, Wanfang Data, VIP, CBM, Chinese Medical Journal Full Text Database, PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and JBI databases from the inception to November 30, 2023. The following information was retrieved and extracted for the analysis: author, publication year, nation, study type, sample size, intervention, length of intervention, and outcome indicator. Results Totally 33 articles were collected. The framework of the interventions was mainly established by the establishment of FLS team, patient identification and validation, risk factor evaluation and intervention, pharmaceutical and non-pharmacological treatment, and health follow-up. A total of 27 outcome indicators were extracted and categorized into 4 aspects: effectiveness outcome indicators, subjective outcome indicators, safety outcome indicators, and hospital-related outcome indicators. Conclusion In patients with osteoporotic hip fracture, FLS has a favorable impact on prognosis improvement and re-fracture prevention. In future research, an appropriate FLS program for patients with osteoporotic hip fracture should be created, and the interventions, outcome indicators, and evaluation tools should be standardized.
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Journal of Nursing. 2024, 31(22): 61-66. https://doi.org/10.16460/j.issn1008-9969.2024.22.061Objective To construction a symptom management theory-based self-management intervention scheme for patients with neurogenic bladder (NGB), and to provide reference for the self-management of patients with NGB. Methods Through literature review, a self-management intervention scheme for patients with NGB based on symptom management theory was developed, and 15 experts were invited to carry out 2 rounds of Delphi expert consultation for further revision of the scheme. Results The expert enthusiasm of the two rounds of correspondence was 100%, and the expert authority coefficient (Cr) 0.852. The final scheme consisted of 3 first-level, 16 second-level, and 37 third-level indicators. The importance score of each item was 4.20~4.93; the coefficient of variation 0.052~0.207, and the expert Kendall harmony coefficient(W) 0.118 (P<0.001). Conclusion The self-management intervention scheme for patients with NGB based on symptom management theory is reliable and scientific, and can provide reference for patients' self-management in clinical practice.
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Journal of Nursing. 2024, 31(22): 67-72. https://doi.org/10.16460/j.issn1008-9969.2024.22.067Objective To establish a four-level nurse-led early mobilization program for patients after open heart surgery. Methods We systematically searched CNKI, Wanfang Data, VIP, PubMed, Medline, Cochrane Library for literature on early rehabilitation of patients after open heart surgery and formed a pool of entries for the four-level nurse-led early mobilization program. A panel of experts modified the pool of entries to form the first draft of the program through group meeting, and 2 rounds of expert consultation with Delphi method was conducted to form the final draft of the program. Results The recovery rate of 2 rounds of consultation was 100% and 93%; expert authority coefficient 0.900 and 0.930; and Kendall's W 0.127 and 0.230, respectively, showing statistical significance (P<0.001). The coefficient of variation of the 2 rounds of consultation ranged from 0 to 0.180, and the importance score from 4.230 to 5.000. The final four-level nurse-led early program for patients after open heart surgery consisted of 3 first-level, 8 second-level, and 27 third-level indexes. Conclusion The four-level nurse-led early mobilization program for patients after open heart surgery in this study is scientific and feasible, and can provide guidance for clinical medical workers.
