Table of Content

20 October 2021, Volume 18 Issue 10 Previous Issue    Next Issue

Special Planning——Linking Evidence to Action

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Improving evidence-based thinking for nursing students HU Yan,ZHOU Ying-feng,XING Wei-jie,ZHU Zheng,CHEN Yu,GU Ying,ZHANG Xiao-ju,YANG Zhong-fang 2021, 18 (10):  869-874.  doi: 10.3761/j.issn.1672-9234.2021.10.001 Abstract ( 396 )   HTML ( 1 )   PDF (1087KB) ( 18 )   Save Figures and Tables | References | Related Articles | Metrics This paper analyzed concept of evidence-based thinking,introduced evidence-based thinking map,and addressed the significance of improving evidence-based thinking for nursing students. Strategies and approaches to improve evidence-based thinking were addressed,which include integrating evidence-based thinking in nursing curriculum,organizing journal club,conducting case analysis and ward round driven by evidence-based thinking,and developing evidence implementation project based on clinical problems. It is emphasized that evidence-based thinking is the key to improve scientific literacy of nursing profession.

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Developing students’ evidence-based nursing ability relying on an Evidence-based Nursing Research Center：practice and reflections HAO Yu-fang,ZHOU Fen,LI Xiao-hua,YUE Shu-jin,LI Xue-jing,ZHANG Xiao-yan 2021, 18 (10):  875-878.  doi: 10.3761/j.issn.1672-9234.2021.10.002 Abstract ( 205 )   HTML ( 0 )   PDF (676KB) ( 9 )   Save References | Related Articles | Metrics The development of nursing discipline needs a large number of high-quality nursing talents with the ability of evidence-based nursing practice. Carrying out evidence-based nursing education is essential for cultivating the ability of evidence-based nursing practice and facilitating the development of nursing discipline. Relying on the Evidence-based Nursing Research Center,School of Nursing,Beijing University of Chinese Medicine nursing teachers disseminate best practice evidence in teaching activities to promote the reform of evidence-based nursing education. In recent years,we have carried out a large number of activities in the first classroom,the second classroom,and clinical practice. Those activities have achieved fruitful achievements,which promoted nursing students’ evidence-based practice competence. Based on years of practical experience in the reform of evidence-based nursing education,this paper introduces reform strategies of evidence-based nursing education.

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Problems and countermeasures in evidence implementation in clinical nursing practice JIANG Yan,CHEN Zhong-lan,WANG Cong,LIU Shan-shan,YANG Zhi-bo,CHEN Yu-zhen,GUO Juan,WANG Ying-li 2021, 18 (10):  879-882.  doi: 10.3761/j.issn.1672-9234.2021.10.003 Abstract ( 205 )   HTML ( 0 )   PDF (677KB) ( 7 )   Save References | Related Articles | Metrics Knowledge translation is a hotspot in global health care,and there is a gap between evidence and clinical nursing practice. How to promote evidence translation into clinical nursing practice,standardize nursing behavior,and promote the high-quality development of public hospitals were urgent problems to be solved. This article gathered evidence,practitioners,environment and evaluation in the translation of nursing evidence,analyzed the problems in the translation of clinical nursing evidence,and discussed improvement measures. We aimed to provide references for scientific,high-quality,and efficient evidence-based nursing practice.

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Developing high-quality search strategy in evidence synthesis WANG Zhi-wen,LENG Min-min,SUN Yue 2021, 18 (10):  883-887.  doi: 10.3761/j.issn.1672-9234.2021.10.004 Abstract ( 322 )   HTML ( 1 )   PDF (705KB) ( 20 )   Save Figures and Tables | References | Related Articles | Metrics To build a bridge between evidence and practice and provide practitioners with more concentrated evidence,different types of evidence synthesis researches such as systematic reviews,overview of systematic reviews and evidence summary have gradually emerged. Search strategy is not only a necessary step but also one of the key quality indicators in evidence synthesis researches. Problems in search strategy are common including untransparent search strategy,single search resources,and inappropriate search terms. This paper used examples from four aspects including identifying the types of literature,choosing comprehensive and appropriate search resources,determining appropriate search terms,and presenting transparent search strategies to provide references for improving the quality of evidence.

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Strategies to improve evidence-based practice ability of nurses ZHOU Chun-lan,WU Yan-ni,ZHAO Hui-hui,CHEN Li-ling,SONG Hui-juan,WU Jin-yan,WANG Yan-fang,OU Jie-xia,LIU Ying 2021, 18 (10):  888-892.  doi: 10.3761/j.issn.1672-9234.2021.10.005 Abstract ( 275 )   HTML ( 2 )   PDF (700KB) ( 13 )   Save References | Related Articles | Metrics Evidence-based practice is one of the core abilities of nurses. Cultivating and improving the evidence-based competence of nurses is the developmental trend of nursing education. However,there are still huge challenges in the implementation and use of evidence-based practice among nurses,and nurses’ evidence-based practice ability needs to be further improved. The purpose of this article is to summarize and report of the evidence-based training experience of nurses in Nanfang Hospital of Southern Medical University,and to propose strategies for training nurses’ evidence-based practice ability. Hopefully we can provide a reference for conducting evidence-based training for nurses.

Nursing Education

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The effects of peer tutoring on students’ performance in the course of Midwifery Technology in a higher vocational college ZOU Yan,WU Xin-gang 2021, 18 (10):  893-896.  doi: 10.3761/j.issn.1672-9234.2021.10.006 Abstract ( 190 )   HTML ( 0 )   PDF (495KB) ( 6 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate the effects of peer tutoring on students’ performance in the course of Midwifery Technology in a higher vocational college. Methods One hundred year 2 midwifery students in a higher vocational college were chosen by convenience sampling. Fifty students were assigned to the experimental group,and another 50 students were assigned to the control group. Peer tutoring method was used in the experimental group. Students were divided into small cooperative teams according to their advantages. The top ten students were appointed as team leaders. Before class,the teacher gave them learning materials and assigned the learning tasks to them. The team leaders guided discussion among the students and students helped each other to complete the learning tasks. In class,students presented their learning results and teachers gave their feedback,comments and summary. After class,the team leaders pushed the members to complete their homework. Students in the control group were taught by conventional teaching method. Teachers provided learning resources and tasks before class and students completed them independently. In class,teachers taught theoretical knowledge and demonstrated the skills. Students practiced in groups after the demonstration. After class,the students did their homework by themselves and the teacher corrected it. The learning effects were evaluated through examination and questionnaire survey. Results The theoretical examination scores and skill scores of students in the experimental group were significantly higher than those in the control group（P<0.05）. Meanwhile,students’ scores of interpersonal communication,organizational coordination,team cooperation,self-regulated learning and learning efficiency in the experimental group were significantly higher than those in the control group（P<0.05）. Conclusion Peer tutoring method effectively promotes the teaching quality of the Midwifery Technology course for students in the higher vocational colleges.

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Research management system and developmental strategies of academic personnel of Kiang Wu Nursing College of Macau LOK Ka In,VAN Iat Kio,ZHU Ming-xia,LEONG Sok Man 2021, 18 (10):  897-899.  doi: 10.3761/j.issn.1672-9234.2021.10.007 Abstract ( 235 )   HTML ( 0 )   PDF (436KB) ( 2 )   Save References | Related Articles | Metrics This article introduces the research management system of Kiang Wu Nursing College of Macau,including the composition of the college’s teaching and research team,research project management system,research quality assurance mechanism. This article lists the development strategies to promote the growth of the academic ability of the teaching and research team,and to build nursing majors which can provide reference of teaching and research team to improve research level for similar colleges.

Clinical Teaching

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Comparison of the clinical evaluation results of undergraduate nursing interns with different learning styles LÜ Fang-fang,ZHENG Jing,YANG Hong-mei,KONG Dong 2021, 18 (10):  900-903.  doi: 10.3761/j.issn.1672-9234.2021.10.008 Abstract ( 204 )   HTML ( 0 )   PDF (487KB) ( 1 )   Save Figures and Tables | References | Related Articles | Metrics Objective To understand the types of learning styles of undergraduate nursing interns,and compare the differences in the clinical evaluation results of students with different learning styles,so as to provide references for teaching hospitals to formulate clinical practice teaching strategies. Methods A total of 293 undergraduate nursing students were investigated with general information questionnaire and Kolb’s Learning Styles Inventory,and the theoretical and skill examination were used to evaluate the clinical performance of nursing students. Results The distribution of the learning styles of undergraduate nursing interns were converging（46.1%）,assimilating（23.2%）,diverging（17.1%） and accommodating（13.7%）. There was a significant difference in the average score of clinical evaluation with different learning styles（F=43.21,P<0.001）. Students with diverging learning style had the lowest clinical evaluation score（87.94±3.76）. Conclusion The converging and assimilating style is the dominant style among nursing undergraduates. Nursing students have different types of learning style. The clinical performance of students with converging and accommodating is better than students with diverging and accommodating. Therefore various teaching methods should be incorporated to enhance learning outcomes,and then we may improve the clinical teaching effects of nursing students.

Continuing Education

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A survey of clinical competence of head nurses MA Gui-juan,LU Yue,LIU Ze-yang,ZHU Yong-jian,LI Ming-zi 2021, 18 (10):  904-909.  doi: 10.3761/j.issn.1672-9234.2021.10.009 Abstract ( 185 )   HTML ( 0 )   PDF (796KB) ( 2 )   Save Figures and Tables | References | Related Articles | Metrics Objective To understand the clinical competence of the head nurses,to provide basis for improving the clinical nursing ability of head nurses. Methods The clinical competence of 82 head nurses in general hospitals were evaluated by KOMET competence development and assessment in technical and vocational education and training. Besides,the competence level of head nurses was compared based on different characteristics. Results Among all head nurses,62（75.6%） nurses had expert level,18（22.0%） had proficient level,and 2（2.4%） had competent level. Among the 8 dimensions,the intuitiveness,work process orientation,function,persistence,social acceptance dimension and family,social and cultural environment were at high levels,while the economic and the creative dimension were at low levels. Head nurses with different educational backgrounds,professional titles,and the hospital classification level had different clinical competence level（P<0.05）. Conclusion In general,the clinical competence of the head nurses was at a high level,but it was still relatively weak on the economy and creative ability.It was recommended to strengthen the training of cost awareness,efficiency awareness and creative ability of head nurses.

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Caring for ICU dying patients and coping with patient death：the perspectives from senior nurses CHANG Ming-ming,QU Qing-rong,ZHANG Zhong-ling,LI Hui-dong,LI Ting 2021, 18 (10):  910-914.  doi: 10.3761/j.issn.1672-9234.2021.10.010 Abstract ( 216 )   HTML ( 0 )   PDF (708KB) ( 1 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore ICU senior nurses’ experience on caring for ICU dying patients and coping with patient death. Methods A qualitative descriptive study was adopted. A semi-structured interview was utilised to explore the views and perspectives of 11 senior nurses,who were from ICU department,a tertiary hospital,in Zhengzhou City,Henan Province. These participants were purposively sampled. Colaizzi analysis was conducted to analyse the qualitative data. Results Four main themes emerged from the qualitative data,including being experienced in coping with death,lacking of skill on end-of-life and death communication,experience of job burnout and strong sense of professional value. Conclusion Senior nurses from ICU were able to take care of dying patients and deal with patient death,but they had end-of-life communication needs and had a sense of professional exhaustion.

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Reliability and validity of the Reflection Evaluation for Learners’ Enhanced Competencies Tool PAN Jing-jing,ZHAO Lin,PENG Ji-na,ZHANG Jing-yi,CHEN Xiao-fang 2021, 18 (10):  915-919.  doi: 10.3761/j.issn.1672-9234.2021.10.011 Abstract ( 199 )   HTML ( 0 )   PDF (612KB) ( 4 )   Save Figures and Tables | References | Related Articles | Metrics Objective To translate the Reflection Evaluation for Learners’ Enhanced Competencies Tool（REFLECT） into Chinese and to test its reliability and validity. Methods The REFLECT was translated forward and backward after which cultural adaptation was completed. Then the Chinese version（C-REFLECT）was reviewed by six experts with relevant expertise to test its content validity. Fifty diaries from the new graduate nurses were evaluated by three individuals using the C-REFLECT to verify its reliability. Results Statistical significance was shown between the high score group and the low score group evaluated by the C-REFLECT（t=4.210~9.121,P<0.001）. The commonality scores ranged from 0.318 to 0.718 while factor loadings were from 0.564 to 0.847. Content validity coefficients were from 0.83 to 1. Cronbach’s α coefficient was 0.833 and test-retest reliability was 0.618（P<0.01）.Interrater reliability among three individuals was 0.681（P<0.05）. Conclusion The C-REFLECT was valid and reliable as an analytical tool for reflective diary evaluation. It can be used to assess the reflection ability of new nurses. Besides,it can provide reference for reflection training and individual feedbacks.

Clinical Practice

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The training workshop on swallowing and ingestion skills for caregivers of patients with dysphagia after stroke GAO Yan,FAN Ling,JIANG Li,ZHAO Hui,WANG Hui-min,GAO Xue-mei,YANG Liu 2021, 18 (10):  920-924.  doi: 10.3761/j.issn.1672-9234.2021.10.012 Abstract ( 169 )   HTML ( 0 )   PDF (612KB) ( 2 )   Save Figures and Tables | References | Related Articles | Metrics Objective To investigate the effects of a training workshop for caregivers of patients with dysphagia after stroke. Methods A total of 176 patients with deglutition disorder after stroke and their direct caregires in the neurological rehabilitation unit of a rehabilitation center in a tertiary hospital in Shenyang from January to December 2020 were selected and divided into the control group and the experimental group according to their admission date. Caregivers in the control group received regular health education while caregivers in the experimental group received training workshop on swallowing and feeding skills. Before and after the intervention,the caregivers in the two groups were assessed the knowledge of dysphagia. Besides,the swallowing function scores of patients in the two groups were assessed at admission,1 month and 3 months after discharge. Results After three months,the caregivers’ knowledge score of dysphagia management in the experimental group was 22.67±3.45,and it was 18.14±2.29 in the control group. There was a statistically significant difference between the two groups（t=10.326,P=0.001）. The generalized estimating equation showed that the scores of swallowing function of patients in the two groups 1 month after discharge and 3 months after discharge were higher than those at admission（P<0.05）. The swallowing function scores of patients in the experimental group 1 month and 3 months after discharge were higher than those of patients in the control group（P<0.05）. Conclusion Workshop training on caregivers of patients with dysphagia after stroke can improve caregivers’ swallowing and care skills,and thereby improve the swallowing function of patients.

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Development and effects evaluation of a standardized procedure of prevention and treatment of diaper dermatitis in infants after liver transplantation in ICU LU Fang-yan,JIA Xue-zheng,DAI Yan-hong,WANG Yan,TANG Sa-xiao,WANG Hua-fen 2021, 18 (10):  925-929.  doi: 10.3761/j.issn.1672-9234.2021.10.013 Abstract ( 171 )   HTML ( 0 )   PDF (718KB) ( 3 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the effects of a standardized procedure of prevention and treatment of diaper dermatitis in infants after liver transplantation in ICU. Methods Through systematic literature review,quality evaluation,evidence summary,and expert discussion,the standardized procedure of prevention and treatment of diaper dermatitis in infants after liver transplantation in ICU was developed. The procedure included assessment of high risk factors,assessment of dermatitis severity,graded prevention and treatment,and report. A non-synchronous controlled study was conducted. The infants who underwent liver transplantation from June to December 2020 were included. Among them,75 cases were allocated to the experimental group from September to December 2020 and received standardized procedure. Another 57 cases in the control group from June to August 2020 received routine nursing care. We compared the incidence and severity and healing time of diaper dermatitis between the two groups. Results The incidence of diaper dermatitis of two groups were not statistically significant（χ2=1.235,P=0.266）. The dermatitis severity was reduced（Z=2.378,P=0.017）and the healing time was significantly shorter than that of the control group（Z=2.852,P=0.004）. Conclusion The standardized procedure can effectively improve the effects on pre-vention and treatment of diaper dermatitis,standardize the behavior of nursing staff and improve the quality of care.

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The effects of a guided breathing training on postoperative rehabilitation of older patients with lung cancer ZHOU Ting,LIU Yao 2021, 18 (10):  930-934.  doi: 10.3761/j.issn.1672-9234.2021.10.014 Abstract ( 215 )   HTML ( 0 )   PDF (778KB) ( 4 )   Save Figures and Tables | References | Related Articles | Metrics Objective To explore the effects of guided breathing training on the rehabilitation of older patients with lung cancer after thoracoscopic lobectomy. Methods A total of 78 older patients with lung cancer after thoracoscopic lobectomy were randomly assigned into the experimental group（40 cases） and the control group（38 cases）. Patients in the experimental group received guided breathing training,including intercostal muscle mobilization,rib mobilization,thoracic induction and abdominal breathing induction. Patients in the control group received routine pulmonary rehabilitation treatment. The pulmonary function before and 28 days after the operation,surgical complications,chest tube retention time and hospital stay were compared between the two groups. Results On the 28th day after operation,the peak expiratory velocity of the patients in the experimental group was（305±62） L/min while it was（223±42） L/min of patients in the control group（t=6.773,P<0.001）. The forced expiratory volume in one second in the experimental group was（1.8±0.4） L and it was（1.6±0.3） L of patients in the control group（t=2.799,P=0.006）. The combined incidence of postoperative pneumonia and atelectasis was lower in the experimental group（20.0%）than in the control group（44.7%）（χ2=11.744,P=0.001）. The length of indwelling chest tube in the experimental group was（80±31） h,and it was（97±36） h for patients in the control group（t=2.193,P=0.031）. The days of postoperative hospitalization in the experimental group were（4.2±1.5） d which were less than that of patients（5.1±1.4） d in the control group（t=2.764,P=0.007）. Conclusion Guided breathing training can improve lung function,reduce the incidence of atelectasis of pneumonia,shorten the time of retaining chest tube and hospital stay for elderly patients with lung cancer after thoracoscopic lobectomy.

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Evidence summary for prevention of pressure ulcer in patients with prone position ventilation PENG Cao,CHEN Xiu-wen,REN Hua,YAN Bin,HUANG You-xi 2021, 18 (10):  935-941.  doi: 10.3761/j.issn.1672-9234.2021.10.015 Abstract ( 400 )   HTML ( 1 )   PDF (882KB) ( 8 )   Save Figures and Tables | References | Related Articles | Metrics Objective To summarize the best evidence of prevention of pressure ulcer in patients with prone position ventilation. Methods We systematically searched for evidence in UpToDate,National Institute for Health and Care Excellence,British Medical Journal Best Practice,Wound,Ostomy and Continence Nurses Society,Cochrane Library,PubMed,CNKI,etc. Guidelines,systematic evaluation,expert consensus and evidence summary were all collected. Results A total of 10 articles were included,including 5 guidelines,2 systematic evaluations,1 expert consensus,and 2 evidence summary. The best evidence included risk assessment,skin and tissue assessment,repositioning,skin protection,prevention of pressure injury related to medical devices,supervision and training with a total of 30 items. Conclusion Medical staff should select the best tailored evidence according to the evidence level. Besides,they should also standardize the management of patients with prone ventilation,reduce the occurrence of related pressure ulcer,and improve the quality of care.

Review

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A review of serious games in nursing education MA Deng-hui,ZHANG Jun,SHI Yu-xin,ZHANG Guai 2021, 18 (10):  942-945.  doi: 10.3761/j.issn.1672-9234.2021.10.016 Abstract ( 282 )   HTML ( 0 )   PDF (527KB) ( 4 )   Save References | Related Articles | Metrics As a new nursing teaching method,serious games have continuously attracted the attention of nursing educators. This article outlined the concept,characteristics and types of serious games and summarized the application advantages of serious game in nursing education. We hoped to provide reference for the application of serious games in nursing education.

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Anticoagulant medication adherence in patients after mechanical valve replacement：a review ZHENG Xiao-yuan,LIU Jia-xin,TANG Jing,HUANG Zhuo-er,LIU Li-juan,CONG Li 2021, 18 (10):  946-950.  doi: 10.3761/j.issn.1672-9234.2021.10.017 Abstract ( 170 )   HTML ( 0 )   PDF (620KB) ( 1 )   Save References | Related Articles | Metrics The rational use of anticoagulant drugs is important for preventing complications after mechanical valve replacement,and medication compliance is one of the main indicators to evaluate the degree of patient compliance with the prescribed medication. This paper reviewed the assessment tools,influencing factors of medication adherence in patients after mechanical valve replacement to provide reference. It is recommended to rationally adjust the dosing regimen,strengthen individualized health education,standardize the offline follow-up system and process,establish a complete social support system,actively develop intelligent auxiliary software,and scientifically carry out continuous nursing so as to provide reference for home rehabilitation treatment,continuation care and related research.

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Research progress of exercise rehabilitation therapy for patients with liver cirrhosis LIN Hong,LU Li-fen 2021, 18 (10):  951-955.  doi: 10.3761/j.issn.1672-9234.2021.10.018 Abstract ( 229 )   HTML ( 0 )   PDF (679KB) ( 3 )   Save References | Related Articles | Metrics Exercise rehabilitation therapy is an important mean of chronic disease management. Studies have shown that exercise rehabilitation therapy can improve the activity tolerance and muscle quality,reduce weakness. hepatic venous pressure gradient and portal vein width and improve the health-related quality of life in cirrhosis patients. This article introduces the current research progress of exercise rehabilitation therapy for patients with liver cirrhosis,regarding the exercise prescription,target population,safety,rehabilitation mechanism,and assessment indicators. The rehabilitation therapy of liver cirrhosis is still in its infancy. It is necessary to further accumulate evidence-based evidence and establish an evidence-based practice programs to benefit more patients with liver cirrhosis.

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A review of related factors and prevention and treatment of primary catheter allotopia LIN Qin,WANG Tong-yu,XIA Kai-ping,LI Xu-ying,YUAN Zhong 2021, 18 (10):  956-960.  doi: 10.3761/j.issn.1672-9234.2021.10.019 Abstract ( 191 )   HTML ( 0 )   PDF (652KB) ( 3 )   Save References | Related Articles | Metrics This paper reviewed the relevant factors,prevention measures and treatments of primary catheter allotopia. The causes of primary catheter allotopia were analyzed. Method of correcting the catheter position was pointed out. Several suggestions were proposed including choosing the best insertion route,choosing the visual catheterization method to promote accurate positioning, rational selection of catheter delivery skills, and strengthening the training of venous therapy specialty nurses to improve their catheterization experience.