目的:检索并整合改善结肠镜检查前肠道准备质量及病人耐受性的最佳证据,为临床实践提供参考.方法:使用PIPOST模式确定问题,按照"6S"证据模型检索国内外结肠镜检查前肠道准备质量及病人耐受性的相关文献,对纳入研究的证据进行质量评价和分级.结果:共纳入文献19篇,包括4篇指南、1篇临床决策、5篇证据总结、4篇系统评价、4篇随机对照试验、1篇文献综述,共总结了23条证据,包括结肠镜检查前肠道准备的指导及宣教、饮食准备、导泻剂的方案选择、用药时机、辅助措施、不良反应的处理6个方面.结论:临床医护人员需结合病人偏好及临床实践选择最佳证据,降低肠道准备不耐受发生率,提高肠道准备质量.

目的 构建并验证ICU患者外周动脉导管非计划性拔管的风险预测模型.方法 选择300例(建模组)ICU留置外周动脉导管患者作为研究对象,回顾性收集患者相关资料,采用单因素分析、logistic回归分析筛选非计划性拔管的危险因素,构建风险预测模型.选择117例ICU留置外周动脉导管患者对风险预测模型进行验证.结果 建模组23.00％患者发生非计划性拔管.年龄≥65岁,并存高血压、静脉血栓栓塞症,置入部位为桡动脉及置入导管为静脉留置针是ICU患者外周动脉导管非计划性拔管的高危因素(均P＜0.05).预测模型的ROC曲线下面积为0.888.模型验证结果显示,ROC曲线下面积为0.903,灵敏度为86.2％,特异度为85.2％,约登指数为0.714.结论 构建的ICU患者外周动脉导管非计划性拔管的风险预测模型预测效果良好,可为医护人员及时采取预防性护理措施提供依据.

目的 探讨移动输血闭环信息系统在临床输血全流程管理中的应用效果.方法 将南京医科大学附属苏州医院信息管理系统(HIS)与输血科信息管理系统(BIS)以及移动护理终端(PDA)进行整合,构建输血闭环管理流程,保障临床用血安全.以2021年5月～2022年4月入住我院行输血治疗的患者1 395例为研究对象,其中2021年5月～10月(闭环管理实施前)的632例患者为对照组,2021年11月～2022年4月(闭环管理实施后)的763例患者为观察组.比较闭环管理前后样管血采集双人核对执行率、取血后30 min内输注率、床旁输血双人核对执行率、15 min巡视率、4 h内输注完成率、输血护理文书规范率,评价输血全流程管理改善效果.结果 样管血采集双人核对执行率,观察组为99.48％(759/763),对照组为93.99％(594/632);取血后30 min内输注率,观察组为95.02％(725/763),对照组为91.46％(578/632);床旁输血双人核对执行率,观察组为100％(763/763),对照组为95.73％(605/632);15 min巡视率,观察组为94.36％(720/763),对照组为90.35％(571/632);4 h内输注完成率,观察组为95.81％(731/763),对照组为92.25％(583/632);输血护理文书规范率,观察组为98.03％(748/763),对照组为81.80％(517/632),两组比较差异均有统计学意义(P＜0.05).结论 移动输血闭环信息系统可实现临床输血全过程管理,有效提高了血制品临床输注规范率、输血文书规范率,保障了临床输血安全.

Objective To explore the effect of mobile transfusion closed-loop information system in the whole process management of clinical blood transfusion. Methods The hospital information system (HIS) of Soochow Hospital affiliated to Nanjing Medical University was integrated with the blood information system (BIS) and personal digital assistant (PDA) to build a closed-loop transfusion management process to ensure the safety of clinical blood use. From May 2021 to April 2022, 1 395 patients who were admitted to our hospital for blood transfusion therapy were studied. Among them, 632 patients from May to October 2021 (before the implementation of closed-loop management) were the control group, and 763 patients from November 2021 to April 2022 (after the implementation of closed-loop management) were the observation group. Before and after the implementation of closed-loop management, we compared the implementation rate of double-checking before blood sample collection, rate of transfusion within 30 min after blood issuing, implementation rate of double-checking of bedside transfusion, situation of patrol every 15 minutes, rate of transfusion completed within 4 h, rate of nursing documentation standardization, so as to evaluate the improvement effect of the whole process of transfusion management. Results The implementation rate of double-checking before blood sample collection was 99.48%(759/763) in the observation group and 93.99%(594/632) in the control group; the transfusion rate within 30 min after blood issuing was 95.02%(725/763) in the observation group and 91.46%(578/632) in the control group; the implementation rate of double-checking of bedside transfusion was 100%(763/763) in the observation group and 95.73%(605/632) in the control group; the complete rate of patrol every 15-min was 94.36%(720/763) in the observation group and 90.35%(571/632) in the control group; the completion rate of transfusion within 4 h was 95.81%(731/763) in the observation group and 92.25%(583/632) in the control group; the rate of nursing paperwork standardization was 98.03%(748/763) in the observation group and 81.80%(517/632) in the control group, and the difference between the two groups was statistically significant (P<0.05). Conclusion The mobile transfusion closed-loop information system can realize the whole process management of clinical blood transfusion, effectively improve the standardization of blood transfusion and transfusion documents, and guarantee the safety of clinical blood transfusion.

目的 探讨医护患协同模式在下肢动脉硬化闭塞症患者中的应用效果研究.方法 采用便利抽样法抽取2019年1月—2020年12月就诊于我院血管外科的下肢动脉硬化闭塞症住院患者80例,采用随机数字表法,分为两组各40例,对照组采用传统护理模式,试验组采用医护患协同护理干预方案.通过行走受损问卷、慢性病自我效能量表、自制的锻炼依从性评价表及焦虑自评量表评估两组在入院时及干预12周后的行走能力、自我管理能力和焦虑水平.结果 干预12周后,在行走能力方面,试验组的行走距离、步行速度、行走受损总分方面均优于对照组,两组差异在爬梯能力方面无统计学意义;在自我管理能力方面,试验组的慢性病自我效能评定、锻炼依从性方面均优于对照组;在焦虑水平方面,试验组的焦虑自评得分优于对照组.结论 医护患协同模式的应用,不仅加强了下肢动脉硬化闭塞症患者的行走能力、自我管理能力,缓解了肢体症状,降低了焦虑水平,改善了预后,提高了生活质量,还提升了医护工作质量.