Application of Intelligent Nursing Information System in Emergency Nursing Management

This paper is combined with the intelligent nursing information system to build the emergency nursing platform architecture, from the system emergency procedures, system functionality, network environment deployment, and database design aspects of the discussion. Based on hospital information security, the nursing monitoring system of the intelligent nursing information system is constructed to realize network communication, which is clear and intuitive. The intelligent information system is applied to safety control, medical order information, condition information, and information inquiry, which can save working time and complete the rapid transmission and accurate execution of medical order, making the network communication of medical care more quick and convenient and maximizing the overall efficiency. Based on the disordered phenomenon of registration triage, the Relief algorithm is used to classify the aetiology and triage, and the combination of medical advice, information query, and IT technology is optimized, so as to eliminate the phenomenon of round diagnosis, insert number, and improve the medical environment of waiting for diagnosis, taking medicine, examination, and testing. Finally, through the testing of system information security, information traceability, and rapid information query, the problems in nursing management have been basically solved.

Natalya Nikolaevna Kholodkovskaya: at the origins of bibliographic work at the Military Medical Academy

The purpose of this publication is to comprehensively and fully disclose the contribution of the scientist bibliographer Natalya Nikolaevna Kholodkovskaya to the work of the bibliographic department of the fundamental library of the Military Medical Academy. The preparation of the materials for this article is timed to coincide with two significant dates: in 2021, the bibliography department of the library of the Military Medical Academy will celebrate 90 years and the 130th anniversary of the birth of N.N. Kholodkovskaya. The article is devoted to the pages of the biography of N.N. Kholodkovskaya, her professional development and major achievements in the field of bibliographic activity. In the choice of the profession of Natalya Nikolaevna, the influence of her father, the famous professor, the outstanding zoologist and the original lyric poet Nikolai Aleksandrovich Kholodkovsky, can be traced. For 45 years from 1921 to 1966 N.N. Kholodkovskaya worked in the fundamental library of the academy, in different years she held the positions of a scientific bibliographer, head of the department, and from December 2, 1938 to September 1939, she headed the library. With the name of N.N. Kholodkovskaya connected the creation of the bibliography department, the first head of which she became. During the Great Patriotic War N.N. Kholodkovskaya was in besieged Leningrad and helped preserve the richest library fund. The main directions of the work of the bibliography department under the leadership of N.N. Kholodkovskaya were: preparation of bibliographic lists of literature, execution of written or oral address, clarifying, factual information on various topics; deep bibliographic development of large planning topics; development of the reference and bibliographic apparatus, replenishment of the auxiliary reference fund; preparation of written and oral translations, preparation of abstracts of articles on military medicine from foreign journals and books. The translations were regularly published in the Military Medical Journal. N.N. Kholodkovskaya compiled a number of valuable indexes that have not lost their significance. Among them: Bibliographic index of Russian literature on military medicine, Materials for the history of the Military Medical Order of Lenin of the Academy S.M. Kirov, The effect of penetrating radiation on the body, Sleep therapy and others. The current profile bibliographic information of the structural divisions of the Academy and individual specialists was at a high level in accordance with their scientific and educational needs and requests. The scientific novelty of the article lies in the fact that this is the first attempt at scientific understanding of the work of the bibliography department of the library of the Military Medical Academy, in attracting previously unpublished documents, memoirs of contemporaries. As a result of the preparation of the publication, materials were found and analyzed that give a more complete picture of the personality and professional merits of N.N. Kholodkovskaya; about its role in the creation and development of the bibliography department, in the confirmation of the principles and methods of bibliographic work, which are adhered to in the department to this day (17 figs, bibliography: 26 refs).

Effectiveness, safety and implementation results of the strategies aimed at the safe prescription of medications in university hospitals in adult patients. Systematic review

Introduction: A broad range of practices aimed at improving the effectives and safety of this process have been documented over the past few years. Objective: to establish the effectiveness, safety and results of the implementation of these strategies in adult patients in university hospitals. Methodology: A review of systematic reviews was conducted, in addition to a database search in the Cochrane Library of Systematic Reviews, Embase, Epistemonikos, LILACS and gray literature. Any strategy aimed at reducing prescription-associated risks was included as intervention. This review followed the protocol registered in the International Prospective Registry of Systematic Reviews (PROSPERO): CRD42020165143. Results: 7,637 studies were identified, upon deleting duplicate references. After excluding records based on titles and abstracts, 111 full texts were assessed for eligibility. Fifteen studies were included in the review. Several interventions grouped into 5 strategies addressed to the prescription process were identified; the use of computerized medical order entry systems (CPOE), whether integrated or not with computerized decision support systems (CDSS), was the most effective approach. Conclusions: The beneficial effects of the interventions intended to the prescription process in terms of efficacy were identified; however, safety and implementation results were not thoroughly assessed. The heterogeneity of the studies and the low quality of the reviews, preclude a meta-analysis.

Optimization of Clinical Nursing Management System Based on Data Mining

The clinical nursing work based on the establishment and improvement of the clinical nursing system breaks through the traditional nursing work model, which has achieved the advantages of full traceability, practical operation, comprehensive analysis, and individual error correction of nursing work, and greatly improves the nursing quality and work efficiency of nurses. With the advent of the era of big data, how to organically combine data mining technology with nursing information to optimize the nursing information system, apply big data to clinical nursing work through nursing information system, and provide patients with more efficient, high-quality, and safe nursing services is a problem that needs urgent consideration in today’s era. Therefore, this research is based on the framework of the hospital’s existing clinical care system, using data mining technology to improve the Bayesian algorithm and data preprocessing, optimizes the design of functional modules in the clinical nursing management system, and optimizes the patient information management, medical order management, medical order execution management, basic information and expense management, nursing execution process management, system and data management, barcode management, physical sign management, WAP information management, and other subsystems in the clinical nursing information management system. Experiments have proved that the use of a data mining-based clinical care management system can simplify user operations and improve users’ application of software. The application system of nursing methods based on data mining technology more completely integrates nursing information management business, makes nursing information management initially “digital,” and can improve the quality of hospital care to a large extent.

Reasons for adherence and abandonment of physical activity

Background: The practice of physical activity appropriate to individual conditions and with proper education, brings physical, psychological and social benefits. Objectives: To investigate the main reasons for the adherence and the abandonment of the practice of physical activity. Method: The present work consists of a review study of a propositional type (reflection journal writing) on the reasons of adherence and abandonment to the practice of physical activity. Results: The results showed that among the reasons cited for adherence to physical exercise are the search for: health, aesthetics/physical appearance, socialization, medical order, improvement of physical fitness and quality of life, leisure, well-being, control of corporal weight, competition, pleasure and satisfaction in the practice of exercise, among others. On the other hand, among the reasons for abandonment are: lack of time, laziness, gym distant from the home or work, high cost, influence of the family or media, and work routine. Conclusion: Through the findings, it can be concluded that there is a need for attention by physical education professionals, in addition to the use of efficient strategies to motivate students, with the purpose of getting them to adhere the practice of physical activity and, with that, less people will give up the regular practice of systematized physical activities.

Job preferences for medical and nursing students to work in rural Guizhou Province, China: a discrete choice experiment

Background Maldistribution of health workers between urban and rural areas has been a critical difficulty in China. The shortage of health workers in disadvantaged areas reduces access to essential health services delivery, and adversely affects the population health. Policies on attracting health workers to locate in rural areas are needed to be explored. In order to identify the appropriate incentives, we conducted a discrete choice experiment to determine how specific job attributes might be valued by final year students in medical university in Guizhou Province, China. Methods Attributes of potential job were developed through literature review, in-depth semi-structured interviews and pretest. Salary, education opportunity, transportation, job location, workload, essential equipment, medical order, and identification ('bianzhi') were included. The questionnaire was formulated through a fractional factorial experiment design using %MktRuns macros of SAS 9.4. All medical and nursing students in the final year at Guizhou Medical University were invited to participate in the study. Mixed logit model was used to estimate stated preferences of attributes. Willingness to pay and uptake rates for a defined job were also calculated based on the mixed logit estimates. Results The final sample comprised 787 respondents, including 388 medical students and 399 nursing students. Attributes were statistically significant (with the exception of once every two years for education opportunity) and had expected signs. The results indicate that physical conflict between doctors and patients and identification ('bianzhi') were two of the most important non-monetary job characteristics for both medical and nursing students. And nursing students placed more value on identification ('bianzhi'). Policy simulation suggests that as for the individual incentive respondents were most sensitive to salary increasing. Incentive packages effects were stronger for students from rural background. Conclusions Strategies on medical order, identification ('bianzhi') and salary should be considered to attract final year medical and nursing students to work in rural areas. In addition, specific recruitment policy design tailored for subgroups should be taken into account.

Studies on the efficacy of pyrotinib in the treatment of HER-2 positive advanced solid tumors.

e15639 Background: To explore the efficacy and safety of pyrotinib in the treatment of HER-2 positive advanced solid tumors patients. Methods: Patients with HER-2 positive advanced solid tumors in oncology department of our hospital from October 2018 to Janurary 2020 were collected. All the patients were given oral pyrotinib 400mg once a day in a 28-day cycle. The clinicopathological characteristics, treatment history, and curative effect were collected, and the adverse reactions related to the treatment were recorded. Results: 13 patients with HER-2 positive advanced solid tumors were enrolled, including 11 patients with metastatic breast cancer, 3 patients with metastatic colon cancer, 3 patients with gastric cancer. Among them, 10 patients were evaluated for efficacy and(or) side effect, of which 3 patients were excluded because they were not taken pyrotinib according to the medical order or they had no complete follow up data. The total mPFS was 5.63 months (95%CI: 2.533-5.467), partial remission (PR) were 3 cases(30%), stead diease(SD) were 6 cases(60%), progress diease was 1 case(10%). The overall response rate (ORR) and the disease control rate (DCR) were 23.1%, 69.2%, respectively. 2 patients received first-line treatment and 11 patients received second-or-further-line treatment. 11 cases of trastuzumab were changed to anti-HER-2 after treatment failure, of which 2 cases were treated with pirotinib after trastuzumab and lapatinib failed treatment. 12 cases with HER-2 overexpression and 1 case with HER-2 amplification. The incidence of pyrotinib side effects was 100%, which occurred in the first cycle of treatment and was common in grade 1 and 2. The common symptoms were diarrhea (100%), hand and foot skin reaction (38%), rash (8%), etc. Grade 3 to 4 adverse events occurred in 1 patient (8%) received pyrotinib plus capecitabine. 1 patient reduced pyrotinib dosage because of diarrhea. Nevertheless, diarrhea did not lead to discontinuation. Conclusions: The treatment of HER-2 positive advanced solid tumors with pyrotinib have good exact affect, and the toxicity could be controlled.

593 Ambient Room Temperature in a Burn Intensive Care Unit - A Quality Improvement Project

Introduction In patients with burns > 20% TBSA, hypermetabolism, evaporative water loss, infection risk and discomfort are all amplified by exposure to cold ambient temperatures. Post-operative patient hypothermia is also detrimental. It is essential to not only maintain a warm patient room temperature, but also to be able to rapidly increase room temperature in the burn ICU. The purpose of this study was to measure typical patient room temperatures in a burn ICU at an adult regional ABA-verified burn center, and to evaluate our ability to intervene and raise room temperature. Methods The ambient temperatures of nine patient rooms were recorded from 14 June to 14 August, 2019. Temperature was measured every minute by a wall-mounted smart sensor placed at standardized positions away from windows or electronic equipment. All devices were tested prior to use, with temperature and humidity accurate and standardized to < 0.2oC and 2% respectively at 18-25oC. Data was transmitted to a mobile smartphone. On 15 August 2019 all room temperatures were manually adjusted to ‘maximum’. This was identified as a sound change initiative, and replicated a potential medical order to increase the ambient temperature should a hypothermic patient be imminently returning from the operating room or resuscitation area after admission. Results Over the baseline observation period (Figure 1) the mean ± SD room temperature was 23.3 ± 1oC. Temperatures deviated below a mean of 22oC during 166 hours per room (11.5%, range 3–362). Following the intervention on 15 August (Figure 2), ambient temperature increased minimally in 6/9 rooms and only by 2–3°C in two rooms (mean rise of 1.03oC; range -0.88oC to 3.26oC). Conclusions The burn ICU rooms are relatively cold and our ability to raise ambient temperature quickly is limited. Further QI change ideas include: 1) a facility engineering assessment 2) set alarms on the smart sensors to alert staff when room temperature falls below a designated threshold. Applicability of Research to Practice This project has identified an important future QI initiative to maintain warm ambient patient room temperatures in the burn ICU.

NURSE IN THE POLISH HEALTH CARE SYSTEM

Nurses are the largest group of Polish medical staff. There are currently approximately 230,000 nurses employed in Poland. There is a statutory profession for many years. Nurses provide health services on the basis of a medical order or on their own. As a result of changes in the law, the scope of their professional competences has been increasing for several years, including to independently administer medicines and issue prescriptions. The purpose of the article is to present and analyze legal norms determining the status of a nurse in the Polish health care system. In addition, the definition of the statutory principles of cooperation between doctors and nurses. The analysis shows that changes in law in recent years have significantly influenced the increase in the role of nurses in the health care system and they are also relevant to the practice of the medical profession.