Analysis of clinical application effects and challenges of early warning system for the high-risk obstetric women of China: A scoping review.

BACKGROUND: Obstetric critical illness is an important factor that leads to an increase in maternal mortality. Early warning assessment can effectively reduce maternal and neonatal mortality and morbidity. However, there are multiple early warning systems, and the effect and applicability of each system in China still need to be explored. OBJECTIVES: To elaborate on the application, effectiveness and challenges of the existing early warning systems for high-risk obstetric women in China and to provide a reference for clinical practice. DESIGN: A scoping review guided by the Arksey and O'Malley framework and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping review (PRISMA-ScR) guidelines. ELIGIBILITY CRITERIA: We included original studies related to early warning and excluded those that were guidelines, consensus and reviews. The included studies were published in Chinese or English by Chinese scholars as of June 2021. DATA SOURCES: CNKI, Wanfang, VIP, Cochrane, CINAHL, Embase, PubMed and Web of Science databases were searched systematically, and the reference sections of the included papers were snowballed. RESULTS: In total, 598 articles were identified. These articles were further refined using keyword searches and exclusion criteria, and 17 articles met the inclusion criteria. We extracted data related to each study's population, methods and results. Early warning tools, outcome indices, effects and challenges are discussed. CONCLUSIONS: Although all studies have shown that early warning systems have good application effects, the use of early warning systems in China is still limited, with poor regional management and poor sensitivity for specific obstetric women. Future research needs to develop more targeted early warning tools for high-risk obstetric women and address the current challenges in clinical applications.

Career adaptability of newly graduated nurses at an obstetrics and gynaecology hospital in China: A qualitative study.

AIM: The aim of this study was to gain insight into factors affecting career adaptability of newly graduated nurses and ways to improve them. BACKGROUND: Newly graduated nurses face an important transition from student to professional. Unfortunately, the nurse turnover rate is high due to maladaptation. Factors influencing career adaptability and improvement methods have not been clearly addressed. METHODS: Using a descriptive qualitative study with thematic analysis, 15 newly graduated nurses from a tertiary obstetrics and gynaecology teaching hospital in China were interviewed. RESULTS: Six themes affecting career adaptability were found: personality, self-confidence, occupational care focus, work-related stress, basic professional competency and gap between reality and expectations. Four themes improving career adaptability were identified: strong social support, self-adjustment, self-development and career preparation. Eight subthemes were also identified. CONCLUSIONS: Individual, family and work factors were among those affecting career adaptability among newly graduated nurses. Newly graduated nurses would improve their career adaptability through self-adjustment and social support. Helping them to promote these factors and measures is conducive to improving their career adaptability and reducing staff turnover. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should be aware of the key factors affecting career adaptability among newly graduated nurses and design targeted improvement programmes.

Propofol attenuates hepatic ischemia/reperfusion injury in an in vivo rabbit model.

BACKGROUND: Propofol has been demonstrated to improve hepatic perfusion in a rabbit model; however, the effects of propofol on hepatic ischemia/reperfusion injury are unknown. The aim of the present study was to determine whether propofol has a hepatoprotective effect using an in vivo ischemia/reperfusion model in rabbits. METHODS: A total of 48 rabbits were randomly assigned to two groups: a propofol group (0.6 mg · kg(-1) · min(-1)) or a control group (10% intralipid, 0.6 mg · kg(-1) · min(-1)). Each group was then further divided into three subgroups of 8 rabbits according to the duration (10, 30, and 60 min) of propofol infusion before an ischemic episode was induced by cross-clamping the left hepatic artery and hepatic portal vein. Hepatic ischemia was maintained for 30 min, and the rabbits were monitored for 60 min after reperfusion. Liver enzyme leakage and histopathologic examination were used to evaluate the extent of hepatic ischemia/reperfusion injury. RESULTS: The serum enzyme levels were the same in all groups before the ischemic episode. After the induction of ischemia/reperfusion, the liver enzymes were significantly increased in all rabbits compared with baseline values (P < 0.05). Propofol significantly decreased the leakage of liver enzymes and markedly reduced lesions in histologic examination of the liver compared with the control group (P < 0.05). However, no significant difference was found in serum enzyme levels among the three subgroups in the propofol group. CONCLUSIONS: Propofol reduced hepatic ischemia/reperfusion injury in an in vivo rabbit model; however, the duration of propofol infusion before the ischemic insult did not influence its hepatoprotective effects or the extent of hepatic injury.