ObjectiveTo systematically review the predictors of enteral nutrition feeding intolerance in critically ill patients. MethodsThe PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang Data, VIP and CBM databases were searched to collect relevant observational studies from the inception to 6 August, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. ResultsA total of 18 studies were included, including 28 847 patients. The results of the meta-analysis showed that gender, age, severity of illness, hypo-albuminemia, length of stay, postpyloric feeding, mechanical ventilation and mechanical ventilation time, use of prokinetics, use of sedation drugs, use of vasoactive drugs and use of antibiotics were predictors of enteral nutrition feeding intolerance in critically ill patients, among which postpyloric feeding (OR=0.46, 95%CI 0.29 to 0.71, P<0.01) was a protective factor. ConclusionAccording to the influencing factors, the medical staff can formulate a targeted enteral nutrition program at the time of admission to the ICU to reduce the occurrence of feeding intolerance. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
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.
ObjectiveTo investigate the influence of evidence-based nursing intervention on the treatment effect and quality of life in patients with peritoneal dialysis.
MethodSixty-four patients who underwent peritoneal dialysis between January 2013 and December 2014 in our hospital were randomly divided into control group (n=32) and intervention group (n=32) . The control group received routine nursing and the intervention group received evidencebased nursing intervention. Urea clearance index (KT/V), serum albumin and hemoglobin levels were detected for both groups of patients before and after nursing intervention. Generic Quality of Life Inventory (GQOLI)-74 scale was used to assess patients' quality of life.
ResultsAfter nursing intervention, KT/V, serum albumin and hemoglobin levels in the intervention group were significantly higher than those in the control group (P<0.05) . The scores of such items as physical function, psychological function, social function and overall evaluation in the GQOLI-74 scale in the intervention group were significantly higher than those in the control group (P<0.05) .
ConclusionsEvidence-based nursing intervention can effectively improve the treatment effect and quality of life in patients with peritoneal dialysis, which is worthy of clinical popularization and application.
ObjectiveTo systematically review the diagnostic value of common screening questionnaires for chronic obstructive pulmonary disease (COPD). MethodsThe Cochrane Library, Web of Science, PubMed, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect diagnostic studies on the effectiveness of COPD screening questionnaires from inception to January 31 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies,then network meta-analysis was performed by using Meta-disc 1.4 and Stata 15.0 software. ResultsA total of 28 studies involving 4 screening questionnaires were included. The results of the network meta-analysis showed that, sensitivity sorting was CDQ17 > LFQ > COPD-PS4 > CDQ20 > COPD-SQ > COPD-PS5, the specificity sorting was COPD-SQ > COPD-PS5 > CDQ20 > CDQ17 > COPD-PS4 > LFQ. Subgroup analysis showed the sensitivity of CDQ17 and specificity of CDQ20 were the highest in China, the sensitivity of LFQ and specificity of COPD-PS5 were the highest in foreign countries. ConclusionCurrent evidence suggests that CDQ and LFQ have high sensitivity but poor specificity, while COPD-SQ and COPD-PS have strong specificity but poor sensitivity. In China, CDQ is recommended for screening of COPD patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To explore the characteristics of articles related to Evidence-based Nursing (EBN) and to identify the problems and difficulties encountered by clinical nurses when they were engaged in evidence-based practice in China.Methods We searched for articles published in 6 nursing journals in China from 2000 to early 2006, and classified, investigated and analyzed the retrieved articles. Results Research on EBN has been changing from explaining theories and methods to applying research results in nursing practice. Among articles on clinical application, 90.9% did not describe the methods and search strategy used; 63.6% did not specify the sources of the evidence applied in practice; 93.9% did not describe the methodological quality of the evidence; only 6.1% used the results of systematic reviews or randomized trials to guide clinical practice; and 72.7% did not use effective evaluation methods to identify the nursing outcomes after applying evidences in clinical practice. Conclusions The quality of EBN related articles needs to improve further. Nurses should learn more about the knowledge and skills associated with EBN so as to improve the quality of nursing practice and of academic articles on EBN
ObjectiveTo investigate the effect of evidence-based nursing course in undergraduate nursing students' critical thinking ability.
MethodsA prospective cohort study design was performed in students from two nursing undergraduate classes, who elected evidence-based nursing course as an observation group and students lacked of the course as a control group. The Chinese Version of Critical Thinking Disposition Inventory (CTDI-CV) was used to test critical thinking ability at the beginning and the end of the semester. The scores of CTDI-CV and rank of scores were compared between the two groups using t test and rank sum test.
ResultsA total of 88 students were included, of which 41 students were in the observation group and 47 students were in the control group. Compared to the control group, the observation group demonstrated significantly more improvement in the total scores (MD=22.29, 95%CI 13.477 to 31.114), the search for truth (MD=2.81, 95%CI 0.211 to 5.410), open-minded (MD=3.37, 95%CI 1.280 to 5.471), analysis capabilities (MD=3.41, 95%CI 1.351 to 5.481), systematicity (MD=3.39, 95%CI 1.447 to 5.336), confidence critical thinking (MD=2.83, 95%CI 0.512 to 5.152), curiosity (MD=4.53, 95%CI 2.273 to 6.786) and cognitive maturity (MD=1.93, 95%CI -0.502 to 4.377). The level of total scores, the search for truth, analysis capabilities, systematicty, confidence critical thinking, and curiosity in the observation group were significantly improved.
ConclusionEvidence-based nursing course learning can improve the undergraduate nursing students' critical thinking skill.
Objective To formulate an evidence-based adjuvant therapeutic plan for a patient with large area pressure ulcers. Methods Based on an adequate assessment of the patient’s condition and using the principle of PICO, we searched The Cochrane Library (Issue 1, 2008), DARE (Issue 3, 2008), CCRT (Issue 1, 2008), MEDLINE (1980~ March 2008) and Chinese Journal Full-text Database CNKI (1979~2008) for the best available clinical evidence on adjuvant therapy of large area pressure ulcers with infrared rays, nutrition support and some special overlays. Results Two systematic reviews and three randomized controlled trials were included. According to the current evidence, as well as the patient’s clinical condition and preference, a comprehensive therapeutic plan was given to the patient. And in the next three months with the therapeutic plan, the patient’s large area pressure ulcers had already recovered. Conclusion Evidence based approaches can help us develop the best comprehensive therapeutic plan for the patient and will help improve the therapeutic results for patients with large area pressure ulcers.
