ABSTRACT
Objective:To explore the impact of nurses' hierarchical management on nurses' professional life quality, nursing quality and nursing risk in emergency department.Methods:A total of 40 nurses who were on duty in the Emergency Department of Tangshan Gongren Hospital from February 2018 to May 2020 were selected for the study. Our hospital performed routine management of emergency department nurses from February 2018 to February 2019. After a 3-month wash-out period, nurses were managed hierarchically from May 2019 to May 2020. According to the practical experience and educational background of nurses, they were divided into 5 levels, namely N0 level assistant nurse ( n=12), N1 level registered nurse ( n=9), N2 level responsible nurse ( n=10), N3 level specialist nurse ( n=5), N4 expert level ( n=4). Before and after the hierarchical management of nurses in the emergency department, the Quality of Nursing Work Life (QNWL) scale was used to evaluate the nurse′s quality of life, and the nursing quality was assessed by the Nursing Service Quality Questionnaire. Analyze the incidence of errors in the nursing process to assess the nursing risk. Results:The scores of work environment, work family balance, social environment, workload score and QNWL total score before the implementation of hierarchical management were 46.33 ± 8.52, 30.01 ± 6.07, 21.45 ± 4.60, 94.52 ± 8.06, 192.31 ± 12.46, respectively. After implementation, the scores were 51.29 ± 4.75,34.62 ± 4.68, 25.89 ± 3.58, 109.43 ± 6.15 and 221.23 ± 10.03, respectively. The scores after implementation were higher than those before ( t value was 3.216-11.435, P<0.05). The scores of human resource allocation, ward management, operating procedures, basic nursing, nurse training, nursing efficiency, nursing record writing, and first-aid goods management were 84.29 ± 9.75, 80.39 ± 12.46, 83.02 ± 5.63, 80.93 ± 9.84, 87.14 ± 6.12, 85.91 ± 8.46, 88.20 ± 6.76 and 83.51 ± 7.18, respectively. After the implementation, the scores were 92.38 ± 4.66, 94.67 ± 3.89, 91.25 ± 6.37, 94.78 ± 3.56, 95.01 ± 3.78, 93.81 ± 4.11, 95.13 ± 3.07, 93.57 ± 4.62, respectively. The scores after implementation were higher than those before ( t value was 4.735-8.371, P<0.05). After the implementation of nurses' hierarchical management, the nursing error rate was 4.44% (8/180), which was significantly lower than 10.00% (18/180) before implementation ( χ2 value was 4.146, P<0.05). Conclusions:The application of hierarchical management of nurses in emergency department can improve nurses' professional life quality, improve nursing quality, and reduce the incidence of nursing errors. It is worthy of popularization and application in emergency department.
ABSTRACT
Objective To evaluate perception and awareness of disease knowledge in patients with chronic obstructive pulmonary disease (COPD) in rural area of Xuzhou City. Methods Perception and awareness of COPD, including its nature, control, medication use, impact on their quality of life, experience of its acute exacerbation, and so on, in 392 patients with COPD were evaluated with self-designed ad hoc questionnaire. Proportion and percentage were used in statistical analysis. Results According to the GLOD standards, 58 of 392 patients with COPD could be classified as stage Ⅰ (14. 8%), 164 as stage Ⅱ (41.8%), 103 as stage Ⅲ (26.3%) and 67 as stage Ⅳ (17.1%), respectively. Only 14 patients (3.6%) had heard COPD, but all of them did not know the definition of COPD and its acute exacerbation. Lung function tests and health education had never been performed for all these patients. One hundred and twenty-six patients (32. 1%) did not understand that smoking is a risk factor for COPD, 343 patients (87. 5%) had never heard that COPD could be prevented and controlled. Only 95 patients (24. 2%) did regular physical exercises. Seventy-six patients (19. 4%) in stable stage did not take theophylline regularly, and none of them took inhalers or nebulizer drugs regularly or temporally, or oxygen therapy and pulmonary rehabilitation at home. During acute exacerbation, 261 patients (66.6%) could take theophyUine or analogous drugs and antibiotics. One hundred and five patients (26. 8%) were admitted to hospital during the past year due to respiratory symptoms. Physical activities were restrained in 224 patients (57.1%), 91 patients (23. 2%) had a little bit feeling of depression sometimes and social communication was impacted in 232 patients (59. 2%). Conclusions Patients with COPD in rural Xuzhan, Jiangsu province were poor in knowledge of COPD, and their treatment during stable stage and acute exacerbation did not meet the standards. COPD had significant impact on their daily life, and education and management for the patients should be strengthened.
ABSTRACT
Objective To know social and demographic characteristics,behavioral characteristics,as well as knowledge-attitude-belief-practice(KABP) and its influential factors of rural community chronic obstructive pulmonary diseases(COPD) patients. Methods Cluster sampling all COPD patients of fangcun and mape township of tongshan county in 2007. A face-to-face interview was performed to investigate the COPD patients in their home,and t test,one-way analysis of variance and multiple linear regression were used to analyze the behavioral characteristics and K.ABE Results The main Patients were old person aged 60-80,with mean of(63 ± 15)years old. The active and passive smoking rate were 49.5% and 35.9%,respectively,and very significance between male and female Patients (X2 = 101. 365,P＜ 0. 05). 62. 9%abstained from smoking mainly owing to having COPD. About 31.9% of the patients had used the firewood and coal to cook for longer than 30 years. 24. 2% often built their body by exercise; however,only 8. 9%participated in convalescence. The mean KABP score of Patients was (38 ± 8). The Patients have lower knowledge to COPD, but give much more concerns to their own diseases. Univariate and multivariate analysis indicated that the main influential factors of COPD patients KABP were education, family attitude, income,sex and the distance between their homes and health stations. Conclusions Community COPD patients have high smoking rate,long firewood and coal cooking history,so active interventions should be took to those risk factors. KABP level of the COPD patients was not good, more health instructions including prevention,treatment and convalescing of COPD need to be gave to COPD patients.
ABSTRACT
OBJECTIVE To investigate the terminal bacterial pollution of hospital central oxygen supply system and the sanitizing effect of MX-1 disinfector. METHODS Timing many spot samples of terminal oxygen supply equipment (oxygen flowmeter, humid bottle, oxygen pipe) were quantified and cultivated through 24 hours continue supply. RESULTS Five cases of timing many spot samples testified that there were no bacteria oxygen pollution in the pipe oxygen supply in the Department of Respiratory Disease, the Second Affiliated Hospital of Dalian Medical University, and that there were no bacteria pollution in the terminal oxygen supply equipments if they were sterilized strictly, but there would be severe bacteria pollution if they were not sterilized strictly. This test found that lid of humid bottle and lapis were the main source of bacteria pollution. Connection with MX-1 disinfector in the terminal can avoid bacteria pollution. CONCLUSIONS Severe bacteria pollution will happen if the oxygen supply equipments aren't sterilized strictly; connection with MX-1 disinfector in the terminal can avoid bacteria pollution and ensure oxygen for cleanliness and safety.
ABSTRACT
BACKGROUND: Lung cancer keeps the first place in malignant tumor death all along. It is quite necessary to clarify the situation and tendency change of residents' lung cancer death for formulating prevention and cure strategy.OBJECTIVE: To investigate the lung cancer death characteristics, death trend and result out potential life loss of the residents in urban areas of Xuzhou.DESIGN: A retrospective descriptive epidemiology study.SETTING: Center for Disease Prevention and Control of Xuzhou.PARTICIPANTS: Totally 3 890 cases died of lung cancer between 1990 and 2003 in the urban areas of Xuzhou city. METHODS: Residents' lung cancer death characteristics and potential life span loss situation with parameters of crude death rate, standardized death rate, age specific death rate and potential life span loss and other indexes of the residents in the urban areas of Xuzhou city in 1990 and 2003were described.MAIN OUTCOME MEASURES: ①Crude death rate of lung cancer;②Potential life span loss; ③Life lost rate.RESULTS: ①During 14 years period , 3 890 cases of lung cancer death happened ,which accounted for 27.43% of total cases of malignant tumor death; ② year average death rate was 28.31/100 thousand, standardized death rate was 24.88/100 thousand, residents' potential life span loss caused by lung cancer death accounted for 24 230 people per year③ life decreasing rate was 1.19/1 000, standardized life decreasing rate was 1.45/1 000, each case of lung cancer death resulted in potential life loss of 6.23 years; males' death rate was higher than females'(x2=575.70,P ＜ 0.01), the ratio of male to female was 2.31:1. Age specific death rate of male and female after 20 years of age increased in an exponential manner.CONCLUSION: Lung cancer is the most serious malignant tumor that threatens the life health of residents in urban areas of Xuzhou city; the potential life span loss caused by lung cancer is very big. The amount of carcinogenic substances exposed in environments is closely related to the occurrence of lung cancer; therefore, prevention and control of lung cancer should be performed actively.