Objective Based on the acquirable and optimized evidences at present, to explore the challenge and countermeasures for the development of nursing discipline in China, and to provide suggestions for promoting the construction of nursing discipline, platform, and talent team. Methods The study materials were searched in the following electronic databases including PubMed, EMbase, Web of Science, CNKI, VIP and CBM, as well as in the official websites of World Health Organization (WHO), International Council of Nurses (ICN), World Bank, the Ministry of Health (MOH) and the Ministry of Education (MOE) of China, and the domestic universities, colleges or technical secondary schools. Then the statistical analysis was conducted using SPSS 13.0 and Microsoft Excel software. Results a) By 2012, there were 855 nursing schools, 38 212 nursing undergraduates enrolled in universities, and 130 837 nursing students enrolled in junior colleges and senior vocational schools; b) The doctor-to-nurse ratio was 1 to 0.9 in 2010. The actual demand for doctors was 2.6 million, and there were still lack of 346 000 nurses; c) The age of nurses younger than 35 years old accounted for 50%. Those with primary professional title accounted for 64% to 69%, while less than 2.5% with advanced professional title; d) The training cost for a doctor and nurse/midwife in China only accounted for 2/5 of that in India and 1/5 to 1/4 in the sub-Sahara Africa; and e) To date, only 30.1% of disaster nursing studies in China provided research data, 30.6% were clinical experience and 38.3% were review. Conclusion Education and health systems need to be extensively reformed. It is necessary to train nursing students with core competencies using transformative learning. It is necessary to update textbooks and teaching methods, and funding should be appropriately increased. Nursing should cooperate with other disciplines, and apply evidence-based nursing methods to improve the quality of healthcare services and patient satisfaction.
Objective To provide evidence-based therapeutic schedule for an adult patient with Lumber Isthmic Spondylolisthesis grading II. Methods Based on fully assessing the patient’s conditions, the clinical problems were put forward according to PICO principles. Such database as The Cochrane Library (2005 to April 2011), DARE (April 2011), CENTRAL (April 2011), MEDLINE (April 2011), EMbase and CBM were searched to collect high quality clinical evidence, and then we told a patient information about treatment plans. The plan was chosen by the patient for she knew her conditions and the plans. Results We included 1 meta-analysis, 3 randomized controlled trials, 5 systematic reviews and 1 prospective study on the natural course of isthmic spondylolisthesis were included. Literature evidence indicated that the prognosis of isthmic spondylolisthesis was good. Surgery should be selected when there was neither no remission of symptom, nor progression of lumber olisthy with conservative treatment. The long-term effect of surgery may be good, but it cannot change the natural course of the disease. Based on literature evidence, the patient chose the conservative treatment. After one year’s treatment the patient recovered, her sciatica relieved, and CT showed no progression of lumber olisthy. Conclusion Patient with low grand isthmic spondylolisthesis chose conservative treatment may achieves good effects, whereas on the process of the treatment, regular follow-up to monitor the progression of lumber olisthy should be conducted.
Within 4 weeks after Lushan earthquake, 400 person-times were rescued in the West China Hospital of Sichuan University. There were 325 hospitalized victims, 238 surgeries including 202 orthopedic surgeries, 28 critical victims, and 1 severe victim. In order to avoid and reduce the complications, minimize disability, and recover in the early stage, a set of early rehabilitation nursing process was established by the department of rehabilitation of the West China Hospital since the 28th hour after the earthquake: set up the emergency teams for early rehabilitation nursing, and clarify the responsibilities of each team; select the technicians of early rehabilitation nursing, and perform scientific management; build the information platform for early rehabilitation nursing, and make information unobstructed; strengthen the cooperation with professional and social organizations. This nursing mode helps the victims get rehabilitation care and treatment timely and efficiently. Up to the 4 weeks after earthquake, 178 person-times recover, accounted for 44.5%; and the records of 69 victims in Wenjiang branch of the hospital show zero death after orthopedic surgery.
Objective To systematically evaluate the effect of occupational protection education towards needle stick injuries among nursing students in China. Methods A computerized literature searching was carried out from October 2002 to October 2012 in following databases: PubMed, CNKI, WanFang Data and VIP, so as to collect all controlled studies about the effects of preventing needle stick injuries between students who had occupational protection education and those who had not. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.0 software was used for meta-analysis. Results A total of 10 studies involving 2 197 nursing students were included. Ten studies indicated that protection education could reduce the incidence of needle stick injuries by 33%; 3 studies indicated that protection education could increase the awareness rate of protective knowledge by 52%; and 4 studies indicated that protection education could increase the correct treatment rate after injuries by 61%. Conclusion Occupational protection education before internship is effective to prevent needle stick injuries among nursing students. However, because of the limitation of this study, more high quality studies are needed to further confirm its effectiveness and to provide targeted advices for formulating preventive measures.
Objective To formulate an evidence-based nursing strategy of turning over for a patient with the risk of pressure ulcer. Methods The personalized clinical questions were put forward based on the PICO and patient’s condition, and the following databases such as NGC, The Cochrane Library of DARE, CDSR, CCTR, MEDLINE, PubMed and CBM were searched to collect the best clinical evidences of turning over for preventing pressure ulcer. Results One clinical guideline, one systematic review and three randomized controlled trials were included finally. According to the retrieval outcomes, patient’s clinical condition, and patients and their family members’ willingness, a reasonable nursing plan of turning over was formulated: lie on the visco-elastic foam decompression bed, turn over every 4 hours, and combine supine position with alternation of left-oblique 30° position and right-oblique 30° position. During hospitalization, the grade-I pressure ulcer in size of 4×6 cm2 on patient’s sacrococcygeal region was clear, dry and not broken, and the other part of body with pigmentation had no occurrence of pressure ulcer. Conclusion Evidence-based approaches are helpful to provide patient with a nursing plan that meets the needs of both scientificalness and individualization.
Objective To explore the application and effects of Seminar case teaching method in teaching surgical nursing. Methods Nursing students of the Yiyang Junior Medical College were divided into two groups (140 students/group). Seminar case teaching was applied in the trial group, while traditional teaching method (classroom teaching or instruction) was applied in the control group. The two groups used the same materials, and were taught by the same teacher team during the same course. After the courses, surgical knowledge and skills were evaluated using theory exams and operation tests (tools included communication ability scale as well as the California Critical Thinking Dispositions Inventory Scale for students’ ability and quality levels, and an anonymous questionnaire for teaching satisfaction) were analyzed between the two groups. Results The scores of the trial group were higher than those of the control group in theory exams and operation tests, with a significant difference (Plt;0.01). The before-after score differences of communication skills and critical thinking ability of the trial group were also higher than those of the control group, with a significant difference (Plt;0.01). The result of the anonymous questionnaire showed that, the students in the trial group had better satisfaction about Seminar case teaching method. Conclusion Seminar case teaching method applied in surgical nursing teaching is feasible and effective, which is better than traditional teaching method in improving knowledge, ability, and quality of nursing students.
Objective To formulate a rational adjuvant therapeutic evidence-based nursing plan for a patient with grade II red and swelling type phlebitis. Methods According to the condition of the patient and using the PICO principle, we put forward clinical problems. Then we comprehensively searched the National Guideline Clearinghouse (NGC), ACP Journal Club, The Cochrane Library, DARE, PubMed, MEDLINE, CNKI and Google Scholar from 2000 to 2012. Relevant clinical guidelines, evidence summaries, systematic reviews/ meta-analyses, randomized controlled trials (RCTs), and high quality reviews on adjuvant therapy of grade II red and swelling type phlebitis were collected and their authenticity, importance and applicability were evaluated. Results One systematic review, four meta-analyses, five RCTs, and one review were totally included. According to current evidence as well as the patient’s clinical conditions and preference, a comprehensive and effective adjuvant therapeutic and nursing programme was given to the patient. For grade II red and swelling type phlebitis with blisters and severe pain, paretic infusion should be immediately stopped on the lesion-side limb, and venous indwelling needle should be extracted. Then, mucopolysaccharide polysulfate cream should be applied on the skin impaired by vein inflammation, and the local area should be gently massaged for 3 min, twice daily (once in the morning and evening, respectively). After four-day treatment and nursing care, the patient with phlebitis had already recovered. Conclusion Evidence-based medicine approaches could help us develop comprehensive therapeutic plans for patients which promote recovery of patients with phlebitis, alleviate pain, improve health, and increasepatients’ quality of life.
Objective A systematic review was conducted based on the domestically published literature for improving the quality of oral nursing care.Methods The terms "oral nursing care", "oral hygiene care", "mouth care" were used to search related studies in Chinese databases (up to April 30, 2004) along with handsearching additional studies. Four authors screened and selected the studies, appraised the methodological quality and extracted data from these selected studies. The results were presented by description or Meta-analysis. Results A total of 28 studies were identified, of which 6 were excluded. The methodological quality varied among the studies, 7 scored as B, 15 as C (11 randomized controlled trials, 4 quasi-randomized trials). A total of 2 372 patients were observed including some were critically ill, or intubated, or receiving radiotherapy or chemotherapy or undergoing surgical operations.Six authors of RCT replied and four of them provided more information on methods of randomization. Data analysis revealed that traditional oral nursing procedure was suitable for the severely sick patients who could not take self-care. Brushing and gargling were suitable for conscious patients who could use their hands. Tea and toothpaste were safe, economical and convenient oral nursing agents. Oral pH was a useful index for the selection of oral nursing agents and mouthwashes. A gargle containing sodium bicarbonate was used in the acidic oral environment and reduced fungal infection. The mouthwash with tea polyphenols had good effect for oral health, and might be as the first choice for prophylaxis of stomatitis induced by radiotherapy and/or chemotherapy. Some mouthwashes developed by Chinese herbs improved oral health efficiently. Some disinfectants with good safety and low toxicity might be used as supplementary agents in oral nursing care. Conclusions Oral nursing care procedures have improved the efficiency of oral care. But the conclusion should be verified by more, well designed randomized controlled trials involving a collaborative multidiscipliary health care professionals. Oral nursing care practice needs to be evidence based.