Construction and evaluation of nursing-sensitive quality indicators for vaginal birth after cesarean: A Delphi study based on Chinese population.

Aim: To develop scientific, systematic and clinically applicable nursing-sensitive quality indicators for vaginal birth after cesarean in obstetrics, which provide a theoretical and clinical basis for monitoring and improving the nursing quality of vaginal birth after cesarean in China. Methods: A modified Delphi-consensus technique was used in this study. Based on literature retrieval published between January 2012 and December 2022 and group discussion, the preliminary nursing-sensitive quality indicators were selected using a structural-process-outcome model. Then a questionnaire was designed on the preliminary indicators. The modified Delphi method was used to conduct two rounds of expert consultation among 26 hospitals in China. The survey data of experts' opinions were collected and analyzed to determine the final nursing-sensitive quality indicators. The importance of indicators, rationality of calculation formula and operability of data collection were analyzed and discussed. Results: A total of 33 nursing-sensitive quality indicators were determined. The indicators were composed of 3-level ones, including 3 first-level indicators (structural, process and outcome indicators), 9 s-level ones and 33 third-level ones. The positive coefficients in the two rounds of expert consultation were 95.56 % and 97.67 %, respectively, and the authoritative coefficients were 0.88 and 0.94. The coefficients of variation ranged from 0.05 to 0.28. Conclusion: The nursing-sensitive quality indicators were successfully developed using the modified Delphi method. The indicators are scientific, systematic and clinically operable, and play an important role in improving the nursing quality for pregnant women with vaginal birth after cesarean.

Advanced superhydrophobic and multifunctional nanocellulose aerogels for oil/water separation: A review.

At present, the research and development of adsorbents for oil/water separation are mostly focused on polymer materials. The third generation of aerogels are made from nanocellulose prepared from abundant and sustainable cellulose. At present, there is concern regarding the use of nanocellulose aerogels (NAs) in oil/water separation. To improve the selective absorbability, the NAs should be hydrophobically modified, and in this review, we summarized the progress made in hydrophobic modification methods. Additionally, the typical materials used for hydrophobic modification of NAs in recent years were reviewed, and then, we discussed the fabrication of nanocellulose composite aerogels (NCAs) with different properties for use in oil/water separation. Moreover, the additional desirable properties of NAs used in oil/water separation processes are systematically discussed according to the different separation requirements, and the conclusions regarding the relationship between the oil adsorption capacity and different NA parameters are summarized. Finally, the outlook for and challenges faced in the construction of efficient NAs for oil/water separation were put forward.

Design and evaluation of maternal early warning system to reduce preventable maternal mortality in pregnancy and puerperium for high-risk women in China.

BACKGROUND: The maternal early warning system is an effective tool to reduce maternal mortality and morbidity. However, there has been limited research on developing a maternal early warning system especially suitable for Chinese high-risk pregnant women. OBJECTIVE: The purpose is to develop a maternal early warning system to reduce preventable maternal mortality in pregnancy and puerperium in high-risk women in China. DESIGN: A cross-sectional survey design. SETTING: The study was conducted in a first-level hospital in China. PARTICIPANTS: A total of 306 pregnant women were selected as the objects who were admitted to give birth from April to June 2021 in xxx. METHODS: A convenience sampling method was used to select 42 experts from 20 hospitals in more than 10 cities in east and west China, which represents the developed and undeveloped cities. The maternal early warning indicators of high-risk pregnancy during pregnancy and after birth were determined via literature research, research group discussion, and the Delphi expert consultation. MEASUREMENTS AND FINDINGS: The final maternal early warning system for high-risk women in pregnancy and puerperium included 8 first-level indicators and 30 second-level indicators. The expert authority coefficients of the two rounds of consultation were 0.92 and 0.94, respectively. The Kendall harmony coefficients were 0.252 and 0.386, respectively (P<0.001). The area under the ROC curve predicted by the early warning system for high-risk pregnancy during childbirth was higher than 0.86, and the best cut-off point was 9.97. It was statistically significant (P<0.001). KEY CONCLUSIONS: The constructed maternal early warning system for high-risk pregnancy in pregnancy and puerperium has comprehensive contents and high reliability, which will help midwives to identify high-risk pregnancies during childbirth. IMPLICATIONS FOR PRACTICE: The results of this study can help to detect deterioration of the patient, predict morbidity in high-risk women and enable timely intervene to prevent possible severe illness.

Development of a risk assessment scale for perinatal venous thromboembolism in Chinese women using a Delphi-AHP approach.

BACKGROUND: The treatment and prevention of perinatal venous thromboembolism (VTE) are challenging because of the potential for both fetal and maternal complications. METHODS: This study developed a rapid assessment scale for VTE and evaluate its validity based on Delphi-AHP (Analytic Hierarchy Process) method in China. The research was conducted by literature retrieval and two rounds of Delphi expert consultation. The item pools of the scale were developed and a questionnaire was designed according to literature retrieval published between 2010 and 2020. A survey was conducted among experts from 25 level A hospitals in China, and data of experts' opinions were collected and analyzed by the Delphi method. RESULTS: A perinatal VTE risk assessment scale was formed, including 5 first-level items, 20 s-level items and 40 third-level items. The response rates in the two rounds of expert consultation were 97.4% and 98.0%, and the authoritative coefficients were 0.89 and 0.92. The coefficients of variation ranged from 0.04 to 0.28. CONCLUSIONS: The scale is significantly valid and reliable with a high authority and coordination degree, and it can be used to assess the risk of perinatal VTE and initiate appropriate thrombophylactic interventions in China.