Objective
To explore the compliance improvement of rehabilitation exercise for patients after spine surgery.
Methods
Forty-nine in-patients who underwent spinal surgery between June 1st and July 14th 2016 were selected as the control group and 50 in-patients who underwent spinal surgery between July 15th and August 30th 2016 were selected as the trial group. The control group received conventional nursing for rehabilitation exercise, and the tiral group adopted a series of quality improvement measures for rehabilitation exercise. The compliance of functional exercise, the accuracy of patients’ exercise and the satisfaction with health education of the patients were compared between the two groups.
Results
The functional exercise compliance in the trial group (complete compliance in 45 cases, partial compliance in 4 cases, non-compliance in 1 case) was higher than that in the control group (complete compliance in 9 cases, partial compliance in 34 cases, non-compliance in 6 cases) with a statistical difference (Z=–6.910, P<0.001). The functional exercise accuracy rate of patients was higher in the trial group [84.00%(168/200)] than that in the control group [53.06% (104/196)] with a statistical difference (χ2=44.060, P<0.001). The patients’ satisfaction with health education in the trial group (4.64±0.49) was higher than that in the control group (4.20±0.89) with a statistical difference (t=3.084, P=0.003).
Conclusion
The implementation of nursing quality improvement intervention can improve the compliance and accuracy rate of rehabilitation functional exercise of patients undergoing spinal surgery, and improve the satisfaction of patients, which is worth promoting.
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.
ObjectivesTo explore the characteristics of Chinese methodological studies on patient compliance in clinical trials so as to provide reference for clinical trial of patient compliance in future.MethodsCNKI, VIP, CBM and WanFang Data databases were electronically searched to collect methodological studies on patient compliance in clinical trials published in Chinese language from January 2000 to December 2018. Two reviewers independently screened literature, extracted data and then, qualitative analysis of document characteristics was then performed.ResultsA total of 84 articles were included, in which 68 were studies on Western medicine and 16 were studies on traditional Chinese medicine (TCM). The results showed that: the quantity of studies on patient compliance increased along with time. However, those in TCM field did not increase. All included studies summarized their strategies to improve patient compliance, however key information for quality evaluation were missing.ConclusionsThere is still a lack of research on how to improve patients’ compliance in clinical trials to ensure the reliability of the results. Existing studies have not systematically and comprehensively explored the influencing factors of patients’ compliance. Clinical trials researchers in China have not focused sufficiently to patients’ compliance and lack the proper methodology to frame studies.
ObjectiveTo analyze the status quo, problems and weak points of cleaning compliance in the Intensive Care Unit (ICU), and assess the intervention effects by evaluating the object surface cleaning quality in the ICU.
MethodsBetween September 1st and December 1st, 2014, fluorescence marker was used to mark the surfaces of medical instruments and objects in the ward which were supposed to be cleaned by the nursing and cleaning staff. The assessment of cleaning compliance was performed through observing the residual fluorescence. Then, targeted intervention was carried out for situations with a low cleaning compliance.
ResultsBefore the intervention, the thorough cleaning rates of medical instruments in the Comprehensive ICU, Neurological ICU (NICU), and Chest ICU were respectively 43.3%, 31.4%, and 23.8%, and the thorough surface cleaning rates for those units in order were 67.1%, 60.5%, and 48.4%, respectively. After the first intervention, the cleaning rate of medical instruments in the Comprehensive ICU was 47.1%, which had no significant change (P=0.345), but the rate in the NICU and Chest ICU reached respectively 65.3% and 35.1%, which was significantly improved (P<0.05). The object surface cleaning rates were 73.3% and 58.1% in the Comprehensive ICU and Chest ICU after the first intervention, and there was no significant difference compared with those before the intervention (P>0.05), but the object surface cleaning rate in the NICU was significantly improved to 85.5% (P<0.05). After the second intervention, the medical equipment cleaning rates were 66.9%, 83.3%, and 57.4%, respectively for those three units, and compared with those before intervention, all the three were significantly improved (P<0.05). The object surface cleaning rates for NICU and Chest ICU were significantly raised to 85.6% and 84.2% (P<0.05), while it was 65.7% in the Comprehensive ICU and was not significantly improved (P=0.767).
ConclusionObservation and supervision through a feedback system can raise the cleaning compliance, which is helpful in controlling and preventing nosocomial infection.
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.
Objective
To understand the effect of World Health Organization(WHO) multimodal hand hygiene improvement strategy on hand hygiene compliance among acupuncturists.
Methods
All the acupuncturists in departments (Department of Acupuncture, Department of Encephalopathy, Department of Orthopedics and Traumatology) with acupuncture programs in Xi’an Hospital of TCM were chosen in this study between September 2015 and August 2016. Based on the WHO multimodal hand hygiene improvement strategy, comprehensive measures were regulated among acupuncturists. Hand hygiene compliance and accuracy, and hand hygiene knowledge score were compared before and after the strategy intervention. Then, the effects of key strategies were evaluated.
Results
Overall hand hygiene compliance rate, accuracy and knowledge scores increased from 51.07%, 19.86% and 81.90±2.86 before intervention to 72.34%, 51.70%, and 98.62±2.92 after intervention (P<0.05). Hand hygiene compliance rates also increased in various occasions such as before contacting the patient, after contacting the patient, before acupuncture treatment, and before acupuncture needle manipulation (P<0.05).
Conclusion
Hand hygiene compliance in acupuncturists can be significantly improved by the implementation of WHO multimodal hand hygiene improvement strategy.
Objective To collect and analyze the qualitative studies on patients’ compliance with hypertension management in the community, and to summarize the factors influencing the compliance from the view of patients. Methods Eleven electronic databases and search strategies and words were determined through discussion by experts and the review group. After the selection and critical appraisal of the retrieved studies were performed by two reviewers independently, meta-summary was employed for the results of qualitative studies. Results Five studies were included. The results showed some factors had great impact on the compliance of patients, including patients’ knowledge of hypertension and its treatment, doctor-patient relationship, patients’ financial status, social support, designing of treatment plans, and patients’ individual conditions. Conclusion To improve doctors’ technical competence, building good doctor-patient relationship, strengthening patients’ individualized health education, formulating the proper treatment plan, and making good use of the social support system would promote the compliance with hypertension management in the community.
Objective To investigate the effect of a real-time compliance dashboard to help reduce ventilator-associated pneumonia ( VAP) with ventilator bundle. Methods 240 patients who were admitted into the intensive care unit ( ICU) of Shougang Hospital of Peking University and had received mechanical ventilation ( MV) for over 48 hours, between January 2010 and November 2011, were studied prospectively. The patients were divided into two groups by random number table, ie. a dashboard group ( n = 120) with implementation of a real-time compliance dashboard to help reduce VAP with ventilator bundle, and a control group ( n=120) with implementation of usually routine order to help reduce VAP with ventilator bundle. The success rate of ventilator bundle implementation, incidence of VAP, duration of MV, duration within ICU, mortality within 28 days, cost within ICU were compared between two groups. Results Compared with the control group, the success rate of ventilator bundle implementation obviously increased ( 81.6% vs. 52.5%) , incidence of VAP ( 14. 5/1000 days of MV vs. 36.2 /1000 days of MV) , duration of MV [ 5( 4,7) days vs. 8( 6,11) days] , duration within ICU [ 8( 6,12) days vs. 13( 8,16) days] , mortality of 28 days ( 12.6% vs. 28.6% ) , and cost within ICU ( 36,437 vs. 58,942) in the dashboard group obviously reduced ( Plt;0.05) . Conclusions Implementation of a real time compliance dashboard to help reduce VAP with ventilator bundle can obviously improve medical personnel compliance and reduce incidence of VAP, duration of MV, duration within ICU, mortality and cost in ICU than those of routine medical order to help reduce VAP with ventilator bundle.
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.
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.
