Objective To know the present situation of hand hygiene compliance in medical staff and analyze problems in the management of hand hygiene and related influencing factors, in order to take effective control measures and gradually improve hand hygiene compliance in medical staff. Methods Between January and October 2014 and between January and October 2015, 8-10 healthcare workers respectively from Department of Internal Medicine, Department of Surgery and Department of Rehabilitation were selected to be observed. The healthcare workers between January and October 2014 before the application of plan-do-check-action (PDCA) cycle were regarded as the control group, and hand hygiene observation was performed in October 2014; the healthcare workers between January and October 2015 were regarded as the observation group (after PDCA application), and hand hygiene observation was carried out in October 2015. Under the PDCA cycle, we set up hand hygiene management working group to investigate the hand hygiene work before PDCA cycle was applied. Hand hygiene knowledge survey was carried out. Fishbone diagram was used to find out the causes of poor hand hygiene compliance. Based on these factors, improvement plans of hand hygiene were regulated and implemented. Then, continuous improvement was promoted according to PDCA cycle management process. Results After PDCA implementation, healthcare workers’ hand hygiene compliance (79.67%), correct handwashing rate (94.97%), and hand hygiene compliance before contacting the patients (85.96%), before sterile operation (68.14%), after contacting the patients (78.02%), after contacting patients’ blood or body fluid (85.96%), and after contacting patients’ surroundings (79.14%) were all significantly higher than those before the PDCA implementation (46.39%, 69.62%, 38.42%, 23.20%, 49.14%, 53.78% and 48.39%) (P<0.05). After the implementation of PDCA cycle, the amount of disinfectants consumed per day and the amount of hand sanitizer was 10.13 mL, significantly more than that before PDCA implementation (2.8 mL). The hospital was equipped with full hygiene equipment. Conclusion Applying PDCA cycle for continuous improvement of hand hygiene work can promote the hand hygiene compliance for medical staff.
Objective To investigate the compliance of ketogenic diet in children with refractory epilepsy and its correlation with the curative effect, and to provide support and basis for the implementation and improvement of the long-term management of ketogenic diet in this patient population. MethodsA total of 106 children and their families who were followed up on ketogenic diet in the Department of Pediatrics of Fudan University from March 2019 to January 2022 in the Department of Ketogenic Multidisciplinary Treatment (MDT) were selected by convenience sampling method. General data questionnaire and ketogenic compliance questionnaire were used for investigation and follow-up. ResultsThe mean compliance of ketogenic diet in refractory epilepsy children was (13.27±3.68). The compliance scores of ketogenic children with different therapeutic effects and cognitive functions were significantly different. The compliance score was significantly correlated with the therapeutic effect and cognitive level, that is, the higher the therapeutic effect of ketogenic diet in children with higher compliance score, the better the cognitive improvement. ConclusionThe compliance of ketogenic diet in children with refractory epilepsy needs to be further improved. Improving the compliance of ketogenic diet is of great significance for the efficacy of ketogenic diet. Medical staff should actively develop the corresponding intervention program and follow-up management mode to further improve the treatment compliance of children's families, improve the treatment effect and improve the quality of life of children's families.
Objective To evaluate which is better method zymogen or low temperature frozen in removing vascular endothelial cell so as to lay a foundation for creating a kind of brace which is not to be rejected and the same as own blood vessel. Methods Fresh and not damaged umbilical blood vessel was collected from natural labour women, human umbilical blood vessel was remove carefully from normal foetus, then was put into disinfectant at 37℃ for 24 hours. They were divided into 3 groups:normal group(NG),zymogen group(ZG) and low temperature frozen group(LG). ZG: 0.1% collagenⅡ enzyme was addedin umbilical blood vessel and closed the both sides and the vascular endothelialcell was removed in 37℃ water. LG:Umbilical blood vessel was put into liquidnitrogen for 24 hours after frozened step by step, and then it was put into 37℃ water for 30-60 s and the vascular endothelial cells were washed away by normal saline. NG:Umbilical blood vessel was kept into 4℃ Kerb’s liquid. The bacteria were culturedin each group. The samples were stained by HE,elastic fiber and collagen fiberwere observed by light and scanning electron microscope. The difference of compliance was compared. Human leukocyte antigen ABC(HLA-ABC) and HLA-DR were observed by immunohistochemical method and the expression of antigen of umbilical blood vessel was analysed. Results In LG, umbilical vascular endothelial cells were removed completely; artery showed vertical smooth muscle and vein showed elastic membrane. InZG, umbilical vascular endothelial cells were removed completely after 20 minutes;artery showed vertical smooth muscle cells and vein showed lower endothelial layer. The vascular compliance in LG was higher than that in NG, and the latter was also higher than that in ZG,but showing no significant differences (Pgt;0.05). The compliance of umbilical vein was 2-3 times as much asthat of umbilical artery.The expression of HLA-ABC and HLA-DR in LG andZG were lower than that in NG, showing significant differences (Plt;0.01). Conclusion Low temperature frozen methodand zymogen method(0.1% collagen Ⅱ enzyme for 20 min) can remove vascular endothelial cells of human umbilical blood vessel completely.Low temperature frozenmethod was better than zymogen method.
ObjectiveTo compare the investigation results of compliance and accuracy of hand hygiene in medical staff achieved by Hospital Infection Management Department and Department Infection Management Teams, and analyze the reasons for differences of the results and take measures to improve the investigation ability of hand hygiene in hospitals. MethodsWe statistically analyzed the results of compliance and accuracy of hand hygiene from January to December 2013 investigated by the infection management department and 25 infection management teams. Both the hospital and departments used "WHO Standard Observation Form". Single-blind method was used to observe the implementation of hand hygiene in medical staff. ResultsThe hospital infection management department investigation showed that hand hygiene compliance and accuracy were 64.97% and 87.78%, respectively, while the investigation by infection management teams showed that hand hygiene compliance and accuracy were 90.54% and 93.37%, respectively. The differences between the investigation results of two-level organizations were statistically significant (χ2=286.2, P<0.001; χ2=532.6, P<0.001). ConclusionWe should take measures to enforce the training of hand hygiene implementation and the observation method, and improve the guidance and assessment, promote investigators' working responsibility and observation ability, so that the survey data can accurately reflect the actual situation to urge medical staff to form good hand hygiene habits.
Objective To evaluate the influence on the estimation of respiratory mechanics with dynamic signal analysis approach during noninvasive positive pressure ventilation (NPPV) under different inspiratory effort conditions. Methods The Respironics V60 ventilator was connected to a ASL5000 lung simulator, which simulate lung mechanics in healthy adults with body weight from 65 to 70 kg, and patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress (ARDS). Each lung models was subjected to 4 different muscle pressures (Pmus): 0, 5.0, 10.0, and 15.0 cm H2O. Inspiratory pressure support level was adjusted to maintain tidal volume (VT) achieving 7.0 mL/kg outputted by ventilator respectively. Positive end expiratory pressure was set at 5.0 cm H2O and back-up rate was 10 beats per minute. Measurements were conducted at system leaks with 25 to 28 L/min. The respiratory system compliance (Crs), inspiratory and expiratory resistance (Rinsp and Rexp) were estimated by special equations, which was derived from the exhaled VT, flow rate and airway pressure. Results The driving pressure (DP) was decreased with Pmus increasing, and was 1.0 cm H2O after Pmus exceeding 10.0 cm H2O and the VT was larger than 7.0 mL/kg in normal adult model. The estimated value of Crs was affected by the changes of Pmus in all three lung models. The significant underestimation of Raw and the overestimation of Crs were observed when Pmus level exceed 10.0 cm H2O. The measured errors of Crs and Rexp were within 10% in COPD and ARDS model when Pmus was at 5.0 cm H2O. The underestimation of Rinsp was always existed in all Pmus level (P<0.01). Conclusions Using dynamic signal analysis approach, the real-time estimation of respiratory mechanics (Crs and Raw) is no need to interrupt the spontaneous breathing during NPPV. Excessive effort will increase the patient’s inspiratory workload, which is not benefit to accurate estimation of respiratory mechanics.
OBJECTIVE: To explore the relationship between the properties of compliance and the change of structure of components in anastomosed arteries. METHODS: The arterial pressure and diameter of femoral arteries of dogs were measured in vivo before and after arterial anastomosis in different time intervals to deduce the arterial compliance. The anastomosed arteries were removed and evaluated through light microscopic examination and various staining methods, the relative contents of elastin, collagen and smooth muscles were measured through image analysis system. RESULTS: The compliance of arteries was gradually decreased after anastomosis with peak-time on the 14th day. The content of elastin at different time had no significant difference, while the content of collagen increased gradually, the ratio of them was increased. CONCLUSION: The property of compliance of anastomosed arteries is closely related to the contents of the structural components.
ObjectiveTo investigate the practice effect of WeChat on the treatment compliance of patients with hyperlipidaemia in general out-patient department. MethodsFrom June 2012 to May 2013, 178 patients with hyperlipidaemia who could use WeChat software were selected. The patients were randomly divided into the control group (87 patients) and experimental group (91 patients). All the patients were treatment with routine nursing intervention. The experimental group was giving nursing intervention based on WeChat. After 180 days, the compliance score and serum lipid level of the patient were tested and analyzed. ResultsThe score in experimental group on the treatment compliance were as follows:diet:6.57±0.78, take medicine:8.64±1.13, exercise:5.11±0.97, and return visit:5.75±0.74; the percentage effective control of lipid level was 93.4%. The score of the control group on the treatment compliance were as follows diet:4.63±1.23, take medicine:6.91±0.73, exercise:3.98±0.54, and return visit:4.86±0.39; the percentage effective control of lipid level was 57.5%. The difference in the results between two groups is significant (P<0.05). ConclusionApplying WeChat software on nursing intervention for patients with hyperlipidaemia may increase the treatment compliance and enhance the control of serum lipid level.
This study was performed on canine femoral veins which were interpositionally implanted into the femoral arteries and the investigation was in terms of zero-stress state, compliance and hemodynamic assessment. The results revealed that the vein grafts had the similar characteristics of compliance with the normal veins. Using Doppler ultrasonography to monitor the blood flow velocity through the vein grafts, the hemodynamic parameters such as pulsatility index (PI) and blood flow volume were evaluated consecutively within one month after the operations .No significant differences were found between these parameters at different time points. It was suggested that autogenous vein graft had an adaptive course when operating in an arterial hemodynamic circumstances and It’s mechanical changes did not bear upon the hemodynamics through the vein graft.
ObjectiveTo investigate the efficacy of follow-up continuous nursing intervention on the self-management ability and medication compliance of patients undergoing maintenance hemodialysis. MethodsBetween June and December 2013, 157 maintenance hemodialysis patients were randomly divided into control group (n=76) and study group (n=81). The control group was given conventional nursing, while the study group received continuous nursing intervention program as well as conventional nursing. Six months later, the self-management ability and medication compliance of the patients were assessed by using self-made Patient Self-management Scale and Morisky Medication Compliance Scale. ResultsSix months later, self-management ability in patients of the study group was significantly better than that in the control group (P<0.05). Medication compliance rate in the study group reached a highest of 45.7%, while it was only 18.4% in the control group, and the difference between the two groups was significant (χ2=13.283, P<0.001). ConclusionFollow-up continuous nursing intervention can obviously improve maintenance hemodialysis patients' ability of self management and compliance behavior, so as to improve the quality of life of these patients.
ObjectiveTo explore the influence factors of therapeutic compliance and emotional expression of first-degree relatives in acute schizophrenic patients with psychotic symptoms. MethodsThe Brief Psychiatric Rating Scale (BPRS) was used to measure the severity of psychotic symptoms in sixty schizophrenic patients from June to September 2014 in West China Hospital and the Toronto Alexithymia Scale (TAS) was used to survey the emotional expression in their family members. The homemade treatment adherence scale was used to survey the treatment adherence in patients for one week. ResultsThere was a poor therapeutic compliance in nineteen patients with acute schizophrenia (32%) and the other 41(68%) had good therapeutic compliance; the relatives of schizophrenic patients had high TAS scores (male: 67.61±10.03; female: 69.68±11.46) than the normal models did (P ＜ 0.05) . The differences between the patients with different therapeutic compliance in BPRS total score, reactivator, hostile and suspicion factor (P ＜ 0.05) . The therapeutic compliance was related to the severity of the psychotic symptoms (P ＜ 0.05) . Conclusions There is a bad emotional expression in the relatives of acute schizophrenic patients. The psychotic symptoms can influence the therapeutic compliance. The milder the psychotic symptoms, the better the therapeutic dependence.