scholarly journals Observations on the Application of Nursing Risk Management in the Care of Critically Ill Patients in the Respiratory Unit

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Yannan Sun
Keyword(s):  
Risk Management ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Treatment Satisfaction ◽  
Clinical Symptoms ◽  
Statistical Significance ◽  
Management Model ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference

 Objective: Investigate the effectiveness of nursing risk management in the care of critically ill patients in the respiratory unit. Methods: Among the critically ill respiratory patients admitted to our hospital between May 2019 and April 2020, 78 patients were randomly selected and divided into an observation group and a control group, each consisting of 39 patients. In the observation group, a nursing risk management model was implemented, i.e., patients' clinical symptoms were observed at any time to monitor their treatment satisfaction and the effectiveness of their care and routine care was implemented for the control group. Results: The heart rate, respiratory rate, and pH of patients in the observation group were more stable than those in the control group, and their respiratory status was better, with differences in data. There was also significant statistical significance (P<0.05). The incidence of patient-provider disputes, unplanned extubation, and unplanned events were lower in the observation group compared to the control group, and their data difference was statistically significant (P<0.05). The treatment satisfaction as well as the total effective rate of patients in the observation group was also much higher than that of the control group, and there was also a statistically significant difference in the data (P<0.05). Conclusion: The nursing risk management model has a significant therapeutic effect in the care of critically ill respiratory patients. Therefore, it is worth popularizing to use in the clinical nursing of respiratory critical patients.

scholarly journals The effects of gastrointestinal function on the incidence of ventilator-associated pneumonia in critically ill patients

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 556-561
Author(s):  
Yuanqiang Lin ◽  
Zhixia Sun ◽  
Hui Wang ◽  
Meihan Liu
Keyword(s):  
Gastric Juice ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Ph Value ◽  
Serum Levels ◽  
Control Group ◽  
Gastrointestinal Function ◽  
Ventilator Associated Pneumonia ◽  
Observation Group ◽  
Gastric Feeding

AbstractObjectiveTo investigate the effect of gastrointestinal function on the incidence of ventilator-associated pneumonia (VAP) in critically ill patients.MethodsFrom August 2012 to June 2016, 160 critically ill patients in the ICU (Intensive Care Unit) of our hospital were selected as the research group; patients were divided equally into an observation group and a control group, 80 patients in each group, based on the random draw envelope principle. The control group was given a nasogastric tube for gastric feeding, the observation group was given a dual lumen gastrointestinal enteral device for gastric feeding; the two groups’ enteral nutrition observation time was 7d; any changes in patient condition and prognosis were recorded.ResultsThe pH value of gastric juice in the control group and the observation group was 6.13±1.38 and 4.01±1.83, respectively: the pH for the observation group was significantly lower than that of the control group (t=4.982, P<0.05). The incidence of VAP in the observation group and the control group was 2.5% and 12.5%, respectively: the VAP for the observation group was significantly lower than that of the control group (P<0.05). The serum levels of pre-albumin and albumin after feeding in the two groups were significantly higher than before feeding (P<0.05); the serum levels of pre-albumin and albumin in the observation group after feeding were significantly higher than those in the control group (P<0.05). The mechanical ventilation time and ICU length of stay in the observation group were 9.12±2.13 days and 12.76±1.98 days, respectively, significantly lower than those of the control group of 10.56±2.89 days and 16.33±2.11 days (P<0.05).ConclusionObstacles to gastrointestinal function in critically ill ICU patients are common; enteral gastric feeding by dual lumen gastrointestinal for can improve the patient’s nutritional status, promote and maintain the normal pH value of gastric juice, thereby reducing the incidence of VAP through rehabilitation of patients.

scholarly journals Impact of ascorbic acid in reducing the incidence of vancomycin associated nephrotoxicity in critically ill patients: A preliminary randomized controlled trial

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 929
Author(s):  
Nouran Hesham El-Sherazy ◽  
Naglaa Samir Bazan ◽  
Sara Mahmoud Shaheen ◽  
Nagwa A. Sabri
Keyword(s):  
Ascorbic Acid ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Statistical Significance ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Control Group ◽  
Control Groups ◽  
The Absolute ◽  
And Control

Background Antioxidants show nephroprotective effect against vancomycin associated nephrotoxicity (VAN) in animals. This study aimed to assess the ascorbic acid nephro-protective role against VAN clinically. Methods Forty-one critically ill patients were randomly assigned to one of two groups: intervention group (vancomycin IV plus ascorbic acid, n=21) or control group (vancomycin IV only, n=20). Primary outcomes were the incidence of VAN and the absolute change in creatinine parameters, while mortality rate was the secondary outcome. Nephrotoxicity was defined as an increase in serum creatinine (S.cr) by at least 0.5 mg/dL or 50% of baseline for at least two successive measurements. This study is registered at Clinicaltrials.gov (NCT03921099), April 2019. Results Mean absolute S.cr increase was significant when compared between both groups, P-value = 0.036, where S.cr increased by 0.05(0.12) and 0.34(0.55) mg/dL in the intervention and control groups, respectively. Mean absolute Cr.cl decline was significant when compared between both groups, P-value = 0.04, where Cr.cl was decreased by 5.9(17.8) and 22.3(30.4) ml/min in the intervention and control groups, respectively. Incidence of VAN was 1/21(4.7%) versus 5/20(25%) in the intervention and control groups, respectively (RR: 0.19; CI: 0.024–1.49; P-value = 0.093). Mortality was higher in the control group; however, it was not statistically significant, P-value = 0.141. Conclusion Co-administration of ascorbic acid with vancomycin preserved renal function and reduced the absolute risk of VAN by 20.3%, however, the reduction in VAN incidence didn’t reach statistical significance level. Further large multicenter prospective trials are recommended.

scholarly journals Physical methods for the treatment of fever in critically ill patients: a randomized controlled trial

2016 ◽  
Vol 50 (5) ◽  
pp. 823-830 ◽  
Author(s):  
Patrícia de Oliveira Salgado ◽  
Ludmila Christiane Rosa da Silva ◽  
Priscila Marinho Aleixo Silva ◽  
Tânia Couto Machado Chianca
Keyword(s):  
Body Temperature ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Tympanic Temperature ◽  
Control Group ◽  
Physical Methods ◽  
Group I ◽  
Significant Difference ◽  
Ice Pack

Abstract OBJECTIVE To evaluate the effects of physical methods of reducing body temperature (ice pack and warm compression) in critically ill patients with fever. METHOD A randomized clinical trial involving 102 adult patients with tympanic temperature ≥ 38.3°C of an infectious focus, and randomized into three groups: Intervention I - ice pack associated with antipyretic; Intervention II - warm compress associated with antipyretic; and Control - antipyretic. Tympanic temperature was measured at 15 minute intervals for 3 hours. The effect of the interventions was evaluated through the Mann-Whitney test and Survival Analysis. "Effect size" calculation was carried out. RESULTS Patients in the intervention groups I and II presented greater reduction in body temperature. The group of patients receiving intervention I presented tympanic temperature below 38.3°C at 45 minutes of monitoring, while the value for control group was lower than 38.3°C starting at 60 minutes, and those who received intervention II had values lower than 38.3°C at 75 minutes of monitoring. CONCLUSION No statistically significant difference was found between the interventions, but with the intervention group I patients showed greater reduction in tympanic temperature compared to the other groups. Brazilian Registry of Clinical Trials: RBR-2k3kbq

scholarly journals A NEW MIXED SURGICAL TREATMENT FOR GRADES III AND IV HEMORRHOIDS: MODIFIED SELECTIVE HEMORRHOIDECTOMY COMBINED WITH COMPLETE ANAL EPITHELIAL RETENTION

2021 ◽  
Vol 34 (2) ◽  
Author(s):  
Hua HUANG ◽  
Yunfei GU ◽  
Lijiang JI ◽  
Youran LI ◽  
Shanshan XU ◽  
...  
Keyword(s):  
Anal Canal ◽  
Anal Incontinence ◽  
Treatment Satisfaction ◽  
Operation Time ◽  
Controlled Study ◽  
Anal Stenosis ◽  
Control Group ◽  
Observation Group ◽  
Canal Diameter ◽  
Significant Difference

ABSTRACT Background: Varicose veins appear above and below the dentate line in mixed hemorrhoids, which seriously affects anal function and quality of life. Aim: To propose an improvement in tissue-selecting therapy repair of anal pad combined with complete anal canal epithelial retention comparing with Milligan-Morgan surgery. Methods: A prospective randomized controlled study was designed enrolling 200 patients with grade III and IV hemorrhoids. They were divided into control and observation groups. The control received Milligan-Morgan surgery, and the observation the modified tissue-selecting therapy stapler combined with complete anal canal preservation surgery. All patients were followed for six months to evaluate the treatment differences. Results: In final, control group included 82 and observation 87. The average operation time of the control group was significantly lower than that of the observation, while the bleeding volume was significantly lower in control group. The control group VAS score was 3 (1, 4), and observation 4 (2, 5). There was no significant difference in the incidence of urinary retention, bleeding and wound margin edema after surgery at one month postoperatively. Digital incidence of anal stenosis in the observation group was significantly lower than in control; the same occurred with residual anal margins. The postoperative anal canal diameter was significantly larger than the control group. Wexner anal incontinence score showed that no anal incontinence occurred in both groups, and the control group scored was significantly higher than observation. In final six months follow-up, the observation group did not experience any relapse and four cases were found among controls. The treatment satisfaction of the observation group was better. Conclusions: In grades III and IV hemorrhoids, modified tissue-selecting therapy combined with complete anal canal preservation had better prognosis and treatment satisfaction than Milligan-Morgan procedure, and it is a new surgical method for patients with advanced mixed hemorrhoids.

scholarly journals The Efficacy of Tripterygium Glycosides Combined with LMWH in Treatment of HSPN in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yan Jin ◽  
Yanzheng Wang ◽  
Sai Wang ◽  
Qiongqiong Zhao ◽  
Donghua Zhang ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Clinical Symptoms ◽  
Effective Rate ◽  
Control Group ◽  
Clinical Effects ◽  
Observation Group ◽  
Significant Difference ◽  
Before And After ◽  
Qilu Hospital ◽  
Tripterygium Glycosides

Objective. This study aimed to explore the clinical efficacy and relevant mechanism of Tripterygium glycosides combined with low molecular weight heparin calcium (LMWH) in the treatment of Henoch–Schönlein purpura nephritis (HSPN) in children. Methods. 64 cases of children patients with HSPN treated at Qilu Hospital (Qingdao) from January 2015 to May 2020 were selected and randomly divided into the control group and the observation group and 32 cases in each group. Conventional medical treatment was applied in the two groups, besides which the control group was given LMWH while the observation group was given Tripterygium glycosides based on the control group. The clinical efficacy and the indexes of clinical symptoms of the two groups were compared. Immune globulin level, fibrinogen content (FIB), prothrombin time (PT), platelet level (PLT), and activated partial thromboplastin time (APTT) level of the two groups were compared before and after the treatment. Results. The total effective rate in the observation group was significantly higher than that of the control group, and the recurrence rate in the observation group was lower than that in the control group. After treatment, urine red blood cell count and 24 h urine protein were obviously better than those of the control group. There was no statistically significant difference in PT between the two groups of children before and after treatment. The levels of PLT and FIB in the two groups of patients after treatment were significantly lower than before treatment, and the PLT levels in the observation group were lower than those in the control group. Conclusion. The combination of Tripterygium glycosides and LMWH had good clinical effects in the treatment of children with HSPN, and it could improve the clinical symptoms, the mechanism of which might be related to the increase of PT, a decrease of PLT, and the improvement of coagulation function.

scholarly journals Curative effect of Omeprazole under different treatment courses in treatment of children with PU and HP infection and its influence on inflammatory factors

2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Shaohui Zhang ◽  
Yuan-da Zhang ◽  
Qing-wei Dong ◽  
Fang Gu
Keyword(s):  
Adverse Reactions ◽  
Eradication Rate ◽  
Clinical Symptoms ◽  
Statistical Significance ◽  
Symptom Relief ◽  
Inflammatory Factors ◽  
Controlled Study ◽  
Control Group ◽  
Observation Group ◽  
Curative Effect

Objective: To compare curative effect and safety of omeprazole under different treatment courses in treatment of children with peptic ulcer (PU, diameter ≤1.0cm) and helicobacter pylori (HP) infection and its influence on inflammatory cytokines. Methods: The study was a randomized controlled study and conducted at Baoding children’s hospital from June 2015 to June 2018. In this study 100 PU children with positive HP were chosen and classified into two groups at random. The 58 cases in the observation group were given omeprazole + amoxicillin + clarithromycin, and the antibiotics were not used two weeks later. Then, omeprazole was used to treat for two weeks. 42 cases in the control group were given omeprazole + amoxicillin + clarithromycin for two weeks. Curative effect, HP eradication rate, clinical symptoms, incidence of adverse reactions, level of serum inflammatory cytokine interleukin-6 (IL-6) and level of tumor necrosis factor-a (TNF-a) in two groups were compared. Results: Total effective rate, HP eradication rate and clinical symptom relief of observation group were better than those of control group, and the differences showed statistical significance (P<0.05). The differences of two groups in the incidence of adverse reactions had no statistical significance (P<0.05). Serum IL-6 level and TNF-a level of observation group were significantly lower than those of control group and before the treatment, and the differences had statistical significance (P<0.05). Conclusion: The application of omeprazole in treatment of PU patients with positive HP for four weeks can significantly improve PU cure rate and HP eradication rate, relieve clinical symptoms and reduce inflammatory response, so it deserves to be promoted clinically. doi: https://doi.org/10.12669/pjms.36.7.3048 How to cite this:Zhang S, Zhang Y, Dong Q, Gu F. Curative effect of Omeprazole under different treatment courses in treatment of children with PU and HP infection and its influence on inflammatory factors. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.3048 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.

The Effect of Combination Use of Hemodialysis and Hemoperfusion on Microinflammation in Elderly Patients with Maintenance Hemodialysis

2022 ◽  
pp. 1-8
Author(s):  
Jun Li ◽  
Hui Li ◽  
Wenjiao Deng ◽  
Lixin Meng ◽  
Wenya Gong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Adverse Reactions ◽  
Statistical Significance ◽  
Continuous Treatment ◽  
Maintenance Hemodialysis ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference

<b><i>Background:</i></b> Patients with maintenance hemodialysis (MHD) generally have a microinflammatory state. The aim of this study was to investigate the effects of hemodialysis (HD) combined with hemoperfusion (HP) on microinflammatory state in elderly patients with MHD. <b><i>Methods:</i></b> One hundred and fifty elderly patients with MHD were randomly divided into the control group and the observation group. The control group received simple HD treatment, and the observation group received combined HD + HP treatment on the basis of the control group. After 6 months of continuous treatment, the patients were evaluated to compare the quality of life, inflammation, adverse reactions, and nutritional indicators in the 2 groups before and after treatment. <b><i>Results:</i></b> There was no significant difference in the quality of life between the 2 groups before treatment. After treatment, the scores of psychological aspects, physiological aspects, social aspects, environmental aspects, and independent ability in the observation group were higher than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). There was no statistical significance in the level of inflammation between 2 groups before treatment. After treatment, the levels of hs-CRP, Hcy, IL-6, and TNF-α in the observation group were significantly lower than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). The incidence of dry mouth, skin reaction, neuritis, and subcutaneous tissue fibrosis in the observation group was lower than that in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). There was no statistical significance in nutritional level indexes between 2 groups before treatment (<i>p</i><sub>1</sub> &#x3e; 0.05). After treatment, the levels of hemoglobin, total protein, albumin, and transferrin in the observation group were significantly higher than those in the control group, with statistical significance (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> The clinical effect of HD combined with HP in elderly MHD patients is significant, which can effectively reduce the incidence of adverse reactions and inflammation in the patients and improve the quality of life and nutritional indicators of the patients.

scholarly journals "Heterozygous Treatment" Method to Improve the Biased Status of the Damp-heat Constitution and Symptom Integral: Randomized Controlled Trial

2018 ◽  
Vol 1 (1) ◽  
pp. 33
Author(s):  
Xianbing Hou ◽  
Haizhang Wang ◽  
Yanzhen Huo ◽  
Hui Zhao
Keyword(s):  
Clinical Symptoms ◽  
Controlled Trial ◽  
Treatment Method ◽  
Control Group ◽  
Observation Group ◽  
Randomized Controlled ◽  
Dark Urine ◽  
Significant Difference ◽  
Before And After ◽  
And Control

Objective: To observe the clinical effect of "heterozygous treatment" intervening the damp-heat constitution. Method: 106 cases with damp-heat constitution were randomly divided into the observation group and control group, 53 cases for each group. Lianpu drink was given to the two groups, and the observation group was treated with scraping, acupuncture, cupping, constitution care and popularization of constitution science for "heterozygous treatment" based on the control group. 70 days later, "constitution classification and determination table of traditional Chinese medicine" was used to determine, and statistics was applied to analyze the change of the symptoms of the two groups before and after the intervention. Results: in the observation group, compared to before the intervention, symptoms like dirty and oily complexion, yellow greasy tongue, bitter taste, dullness and scanty dark urine were significantly improved (P < 0.05), and improvement of the above symptoms was greater than the control group (P < 0.05) .Conclusion: There is no significant difference between the two groups (P > 0.05). Conclusion: the "heterozygous treatment" method can significantly improve the clinical symptoms of people with damp-heat constitution, with a better role in regulating.

The clinical application of an innovative tracheotomy fixation belt in critically ill patients

2021 ◽  
pp. 1-5
Author(s):  
Gui-Li Zhang ◽  
Ping Hao ◽  
Zhi-Jing Shi ◽  
Lei Xu ◽  
Yun-Mei Shi ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Fixation Method ◽  
Control Group ◽  
Observation Group ◽  
Skin Damage ◽  
Tracheotomy Tube ◽  
Skin Injury ◽  
The Difference ◽  
And Control

BACKGROUND: Tracheotomy is one of the first-aid measures for rescuing critically ill patients. OBJECTIVE: This study was designed to observe the clinical effect of using an innovative tracheotomy fixation belt in critically ill patients and to explore the feasibility of using this fixation method. METHODS: Eighty critically ill patients requiring a tracheotomy in Putuo District Central Hospital of Shanghai were enrolled in this study and divided into the observation group and control group (n= 40, each). In the control group, fixation was performed with conventional cotton twill tape, while in the observation group the fixation was carried out using a tracheotomy fixation belt. The differences in neck skin injury, the occurrence of eczema, and the rate of detachment of the tracheotomy tube in the two groups were compared. RESULTS: The rate of neck skin injury was 7.5% lower in the observation group than in the control group (30%), and the difference was statistically significant (p< 0.05). The incidence of skin eczema was 5% lower in the observation group than in the control group (22.5%), and the difference was statistically significant (p< 0.05). The detachment rate of the tracheotomy tube was 5% lower in the observation group than in the control group (20%), and the difference was statistically significant (p< 0.05). CONCLUSION: The use of an innovative tracheotomy fixation belt can effectively reduce skin damage to the patient’s neck, the incidence of eczema, and the incidence of detachment of the tracheotomy tube.

The Impact of Operating Room Detailed Nursing Based on Risk Management on Surgical Patient Satisfaction and Intraoperative Risk Control

2021 ◽  
Vol 7 (5) ◽  
pp. 1605-1612
Author(s):  
Caixia Li ◽  
Yubing Zhang ◽  
Xingliang Yang ◽  
Qibiao Ge
Keyword(s):  
Quality Of Life ◽  
Risk Management ◽  
Patient Satisfaction ◽  
Operating Room ◽  
Statistical Significance ◽  
Control Group ◽  
Observation Group ◽  
Room Nursing ◽  
Nursing Quality

Background The operating room has always been a key clinical inspection high-risk department. The “;Detailed Rules for the Implementation of Evaluation Standards for Tertiary General Hospitals” issued by the Ministry of Health in 2011 emphasized the establishment of operating room quality and safety indicators, which can be evaluated regularly, and continuous improvement is required. The nursing level of nurses in the room is directly related to the overall nursing quality of the hospital. Objective To observe the impact of detailed nursing in operating room based on risk management on surgical patient satisfaction and intraoperative risk control. Methods A retrospective selection of 130 patients who were treated in the operating room of our hospital from January 2018 to March 2020 was retrospectively selected. Among them, 65 patients used conventional operating room nursing procedures, and the other 65 patients used risk management-based operating room detailed nursing procedures. The intraoperative rescue, secondary intubation, incidence of > 3 h in room, nursing error rate, postoperative general situation (recovery time of bowel sounds, first exhaust time, ambulation time, postoperative complication rate) and satisfaction were compared between the two groups. Visual analogue scale (VAS) score was used to evaluate the degree of postoperative pain. Nursing quality score and health survey short form (SF-36) were used to evaluate nursing quality and quality of life. Results: Intraoperative rescue (0.00%), secondary intubation (0.00%), in-room> 3h incidence (1.54%) and nursing error rate (0.00%) in the observation group were compared with those in the control group, which were not statistically significant (P >0.05). The recovery time of bowel sounds in the observation group was (41.71 ±3.46) h, the time to first exhaust (59.47±5.23) h, and the time to get out of bed (54.36±4.78) d were shorter than those in the control group. The postoperative complication rate (3.08%) was lower than that of the control group, which had statistical significance (P<0.05). The VAS scores of the observation group at 6h, 12h, and 24h after surgery were lower than those of the control group, and the satisfaction level of the observation group (93.85%) was higher than that of the control group, which had statistical significance (P<0.05). Observation group’s nursing quality score (nursing skills, environmental management, nursing quality monitoring, disinfection and isolation, nursing document management), quality of life score (physical function, social support, pain, mental health, social function, mood, mental state, general health) All were higher than the control group, which had statistical significance (P<0.05). Conclusion: The application of operation room detail nursing based on risk management in surgery can reduce postoperative pain, promote the recovery of gastrointestinal function, improve patient satisfaction and quality of life, and effectively control intraoperative risks.

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