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AIMS: To compare the risk of phlebitis between midline catheters and peripherally inserted central catheters in infusion therapy with a meta-analysis. DESIGN: This was a systematic literature review and meta-analysis. DATA SOURCES: Web of Science, PubMed, Scopus, Embase, Cochrane Library, ProQuest, CNKI, WanFang, VIP and SinoMed were searched from inception to May 2020. REVIEW METHODS: All studies comparing the risk of phlebitis between midline catheters and peripherally inserted central catheters were included. According to the inclusion and exclusion criteria, two authors independently assessed the literature and extracted the data. Meta-analyses were conducted to generate estimates of phlebitis risk in patients with midline catheters verse peripherally inserted central catheters, and publication bias was evaluated with RevMan 5.3. RESULTS: A total of seven studies were collected, involving 1377 participants. The incidence of phlebitis with midline catheters and peripherally inserted central catheters was 1.52% and 3.41%. Meta-analysis showed that the incidence of phlebitis has no significant difference between midline catheters and peripherally inserted central catheters. The sensitivity analysis shows that the results from this meta-analysis are fair in overall studies. All studies have no significant publication bias. CONCLUSION: This study provides the first systematic assessment of the risk of phlebitis between midline catheters and peripherally inserted central catheters. The incidence of phlebitis has no significant difference between them. There are many factors to consider when choosing vascular access devices.
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Cateterismo Venoso Central , Cateterismo Periférico , Flebite , Cateterismo Venoso Central/efeitos adversos , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/métodos , Catéteres , Cateteres de Demora/efeitos adversos , Humanos , Flebite/epidemiologia , Flebite/etiologiaRESUMO
AIM: To investigate the relationship among emotional intelligence (EI), resilience and academic procrastination (AP), and provide suggestions for the development of targeted intervention strategies and lowering of AP level of nursing undergraduates. DESIGN: A cross-sectional study. METHODS: Three provincial universities offering nursing courses in China were investigated in this study. A convenience sample of 256 nursing undergraduates from May 2021 to September 2021 were recruited, with a response rate of 91.4%. Data were collected using face-to-face interviews. The survey tools included the General Information Questionnaire, Academic Procrastination Scale, Emotional Intelligence Scale and Resilience Scale. IBM SPSS v19.0 and Amos 22.0 were used for data analysis. RESULTS: The AP of sampled nursing undergraduates was at the middle level (54.4 ± 21.5). The AP of nursing undergraduates was negatively correlated with EI and resilience. Moreover, the analysis on the mediating role of resilience via structural equation model showed a good fit, with χ2/df = 2.34, RMSEA = 0.07, CFI = 0.99, GFI = 0.95, TLI = 0.98. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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Procrastinação , Resiliência Psicológica , Humanos , Estudos Transversais , Projetos de Pesquisa , Inteligência EmocionalRESUMO
Background: The symptoms of Dysphoric Milk Ejection Reflex (D-MER) occur just before milk release, last no more than a few minutes, and then subside spontaneously, which are characterized by a sudden and transient feeling of dysphoria, depression, sadness, or other negative emotions. These emotions may adversely affect the mother's lactation behavior and mental health, negatively influence the mother-child relationship, and even result in self-harm or suicidal tendencies in lactating women. Case Presentation: We reported two cases of breastfeeding mothers with D-MER who experienced unpleasant emotions during lactation. Severely affected by D-MER symptoms, the mother in the first case chose to wean prematurely after struggling for 6 months, and her symptoms disappeared after weaning. With the help of professional guidance, the mother with D-MER in the second case actively adjusted and persisted in breastfeeding until her daughter was 18 months old, after that her symptoms vanished. Discussion: Awareness and knowledge of D-MER are insufficient among the public and health care professionals. D-MER is not a psychological disorder but a physiological issue caused by hormones, which is different from postpartum depression. The severity of D-MER symptoms can be evaluated by the assessment tool of the D-MER spectrum. Lactating women can relieve their symptoms through self-regulation, lifestyle changes, and professional guidance and treatments. Conclusions: The two cases studies about Chinese women with D-MER will enrich the knowledge of D-MER, and it might suggest some directions to health care workers for exploring scientific guidance and treatments for lactating women. Because the literature and published empirical studies about D-MER are scarce, further researches on the theory and interventions of D-MER are necessary.
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Lactação , Ejeção Láctea , Feminino , Humanos , Lactente , Ejeção Láctea/fisiologia , Lactação/fisiologia , Aleitamento Materno/psicologia , Mães/psicologia , Reflexo/fisiologiaRESUMO
BACKGROUND: Both midline catheters (MCs) and peripherally inserted central catheters (PICCs) can cause venous thromboembolism (VTE), but the prevalence associated with each is controversial. OBJECTIVE: To compare the risk of VTE between MCs and PICCs with a systematic review and meta-analysis. METHODS: The Web of Science Core Collection, PubMed, Scopus, Embase, the Cochrane Library and ProQuest were searched from inception to January 2020. All studies comparing the risk of VTE between MCs and PICCs were included. Selected studies were assessed for methodological quality using the Downs and Black checklist. Two authors independently assessed the literature and extracted the data. Any different opinion was resolved through third-party consensus. Meta-analyses were conducted to generate estimates of VTE risk in patients with MCs versus PICCs, and publication bias was evaluated with RevMan 5.3. RESULTS: A total of 86 studies were identified. Twelve studies were recruited, involving 40,871 patients. The prevalence of VTE with MCs and PICCs was 3.97% (310/7806) and 2.29% (758/33065), respectively. Meta-analysis showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.53, 95% CI: 1.33-1.76, p < .00001). Subgroup analyses by age showed that the prevalence of VTE with MCs was higher than that with PICCs in the adult group (RR=1.75, 95% CI: 1.38-2.22, p < .00001), and higher than that with PICCs in the other subgroups (RR=1.42, 95% CI: 1.19-1.69, p = .0001). Subgroup analyses by nation showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.50, 95% CI: 1.30-1.73, p < .00001) in US subgroup and higher than that with PICCs (RR=2.87, 95% CI: 1.24-6.65, p = .01) in the other nations. The sensitivity analysis shows that the results from this meta-analysis are robust and all studies have no significant publication bias. CONCLUSIONS: This study provides the first systematic assessment of the risk of VTE between MCs and PICCs. MCs are associated with a higher risk of VTE than PICCs in all patients and adults. The findings of this study have several important implications for future practice. However, the risk of VTE between MCs and PICCs in children is unclear.
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Cateterismo Venoso Central , Cateterismo Periférico , Tromboembolia Venosa , Adulto , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/métodos , Cateterismo Periférico/efeitos adversos , Catéteres/efeitos adversos , Criança , Humanos , Prevalência , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etiologiaRESUMO
OBJECTIVE: The primary purpose of this study was to explore the safety of peripheral intravenous catheter (PIVC) replacement every 96 h compared to that of clinically indicated catheter removal. METHODS: A prospective, single-blind, randomized controlled trial was conducted. A random number table method was used. Six hundred patients treated with PIVC intravenous infusion in 10 nursing units of a hospital from September to October 2019 were selected. Sixty were collected from each nursing unit, including 30 in the clinically indicated replacement group and 30 in the routine replacement group. The incidence of phlebitis, catheter-related infection (CRI), occlusion, infiltration, and any form of infusion therapy failure were compared between the two groups. SPSS 23.0 software was used. RESULTS: The dwelling times of PIVC in the clinically indicated replacement group and routine replacement group were significantly different (hours) (83.62 ± 50.08, 69.75 ± 25.54, t = 3.021, p = 0.003). The incidence of any form of infusion therapy failure (RR = 4.448, 95% CI: 3.158-6.265, p < 0.001), phlebitis (RR = 2.416, 95% CI: 1.595-3.660, p < 0.001), occlusion (RR = 6.610, 95% CI: 3.062-14.268, p < 0.001), infiltration (RR = 2.607, 95% CI: 1.130-6.016, p = 0.020), accidental dislodgement (RR = 2.027, 95% CI: 1.868-2.200, p = 0.013), and pain at the insertion site (RR = 2.521, 95% CI: 1.742-3.649, p < 0.001) was higher in the clinically indicated replacement group than that in the routine replacement group. The overall survival curve of PIVC was drawn with Kaplan-Meier survival analysis. The median survival time of intravenous infusion was 59.58 h; the cumulative survival rates of 48 h, 72 h, and 96 h were 77.00%, 51.33%, and 20.33%, respectively. CONCLUSION: Replacement of PIVC every 96 h is safer than clinically indicated.
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Cateterismo Periférico , Flebite , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/métodos , Catéteres/efeitos adversos , Humanos , Flebite/epidemiologia , Flebite/etiologia , Estudos Prospectivos , Método Simples-CegoRESUMO
OBJECTIVE: To study the association between sleep duration and the incidence of type 2 diabetes mellitus (T2DM) and to provide a theoretical basis for the prevention of T2DM through a meta-analysis. METHODS: PubMed, Web of Science, Scopus, Embase, Cochrane Library, ProQuest, CNKI, Wanfang, VIP, and SINOMED were searched from their inception until May 2020. All cohort studies on the relationship between sleep duration and T2DM in adults were included. According to the inclusion and exclusion criteria, two authors independently assessed the literature and extracted the data. Metaregression and publication bias were evaluated, and sensitivity and meta-analyses were conducted with RevMan 5.3. RESULTS: A total of 17 studies were collected, involving 737002 adults. The incidence of T2DM was 4.73% in short sleep duration (SSD) (t ≤ 6 h), 4.39% in normal sleep duration (NSD) (6 h < t < 9 h), and 4.99% in long sleep duration (LSD) (t ≥ 9 h). The meta-analysis demonstrated that SSD increased the risk of T2DM compared with NSD (RR = 1.22, 95% CI: 1.15-1.29, P < 0.001), LSD increased the risk of T2DM compared with NSD (RR = 1.26, 95% CI: 1.15-1.39, P < 0.001), and the risk of T2DM has no significant difference between SSD and LSD (RR = 0.97, 95% CI: 0.89-1.05, P = 0.41). The sensitivity of each study was robust and the publication bias was weak. CONCLUSION: SSD or LSD can increase the risk of T2DM.
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Diabetes Mellitus Tipo 2/epidemiologia , Sono , Estudos de Coortes , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Feminino , Humanos , Masculino , Fatores de TempoRESUMO
OBJECTIVE: Based on the concept of total quality management, the practice of managing needle-stick and sharps injuries was analyzed to improve nursing quality. METHODS: Using total quality management, an improvement plan was completed. Standard operating procedures for infusion therapy and monitoring of the circulatory system were made to reduce the utilization of winged metal needles and the frequency of needle-stick injuries. From 2015 to 2018, four cross-sectional surveys were conducted on the use of winged metal needles, peripheral intravenous catheters, central venous catheters, peripherally inserted central catheters, and implantable venous access ports and the status of needle-stick and sharps injuries in our hospital during the 4 years. RESULTS: Four cross-sectional surveys showed that the percentage of winged metal needle utilization decreased significantly from 13% to 0.5%, and that of peripheral intravenous catheters increased from 77% to 87%. Zero tolerance of winged metal needles increased from 33 to 60 nursing units, an improvement rate of 81.82%. The number of needle-stick injuries decreased from 71 to 21, a decrease of 70.42%. Needle-stick injuries occurred mainly during waste disposal (34.71%) and needle withdrawal (18.18%) and when recapping needles (9.92%). CONCLUSION: Based on total quality management, the implementation of zero tolerance of winged metal needles is much better. The use of winged metal needles and the incidence of needle-stick injuries are reduced. Total quality management is of great clinical value in preventing needle-stick injuries.
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Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Serviço Hospitalar de Enfermagem/normas , Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Centros de Atenção Terciária , Gestão da Qualidade Total/normas , China/epidemiologia , Estudos Transversais , Pesquisas sobre Atenção à Saúde , Humanos , Ferimentos Penetrantes Produzidos por Agulha/diagnóstico , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Both midline catheters (MCs) and peripherally inserted central catheters (PICCs) can cause catheter-related bloodstream infection (CRBSI), but the prevalence associated with each is not clear. OBJECTIVE: To compare the risk of CRBSI between MCs and PICCs with a meta-analysis. METHODS: The Web of Science Core Collection, PubMed, Scopus, Embase, The Cochrane Library and ProQuest were searched. All studies comparing the risk of CRBSI between MCs and PICCs were included. Selected studies were assessed for methodological quality using the Downs and Black checklist. Two authors independently assessed the literature and extracted the data. A fixed effects model was used to generate estimates of CRBSI risk in patients with MCs versus PICCs. Publication bias was evaluated, and meta-analyses were conducted with RevMan 5.3. RESULTS: A total of 167 studies were identified. Ten studies were collected, involving 33,322 patients. The prevalence of CRBSI with MCs and PICCs was 0.58% (40/6,900) and 0.48% (127/26,422), respectively. Meta-analysis showed that the prevalence of CRBSI was not significantly different between MCs and PICCs (RR = 0.77, 95% CI: 0.50-1.17, p = .22). While the result showed that the prevalence of CRBSI with MCs was lower than that with PICCs (RR = 0.55, 95% CI: 0.33-0.92, p = .02) after poor-quality studies were removed. The sensitivity analysis shows that the results from this meta-analysis are fair in overall studies and non-poor-quality studies. All studies have no significant publication bias. CONCLUSIONS: This study provides the first systematic assessment of the risk of CRBSI between MCs and PICCs and provides evidence for the selection of appropriate vascular access devices for intravenous infusion therapy in nursing. The prevalence of CRBSI was not significantly different between them.