Use of multiple nursing interventions (cluster nursing) in ABO hemolytic disease of neonates and evaluation of its effect

Effect of Cluster Nursing on Recovery Effect and Hospitalization Time of Patients with Acute Cerebral Infarction After Thrombectomy

OBJECTIVE

To explore the effects of cluster nursing on self-care ability, length of hospital stay, complications and neurological function of patients with mechanical thrombectomy of large vessel occlusion in acute cerebral infarction.

METHODS

A total of 83 patients with acute cerebral infarction who underwent thrombolectomy in a tertiary hospital in Anhui Province from June 2019 to March 2021 were randomly divided into observation group and control group. The observation group was treated with cluster nursing intervention mode, and the control group was treated with routine nursing mode. Barthel index scores and National Institute of Health Stroke Scale (NIHSS) scores were compared between the two groups at admission and at 1 week, 1 month and 3 months of nursing intervention. The length of stay and incidence of complications were compared between the two groups.

RESULTS

There was no significant difference in baseline data, Barthel index and NIHSS score between the two groups at admission (P>0.05). The Barthel index at 1 week, 1 month and 3 months after operation in the observation group was significantly higher than that in the control group (P<0.05), while the NIHSS score, incidence of complications and length of hospital stay were significantly lower than those of the control group (P<0.05).

CONCLUSION

Cluster nursing can improve the neurological function, improve the self-care ability, reduce the incidence of complications, shorten the hospitalization period, improve the prognosis and promote the recovery of patients with acute cerebral infarction thrombolysis.

The Significance of Implementing Bilevel Positive Airway Pressure under Cluster Nursing in Improving the Survival Possibility of Patients with Severe Pulmonary Infection Complicated by Respiratory Failure

Objective. To explore the significance of bilevel positive airway pressure (BIPAP) under cluster nursing in improving the survival probability of patients with severe pulmonary infection (SPI) complicated by respiratory failure (RF). Methods. This research included 153 SPI patients complicated by RF ( $\text{SPI}+\text{RF}$ ) admitted between January 2020 and March 2022, including 55 cases in group A who were treated with BIPAP under cluster care during hospitalization, 47 cases in group B receiving invasive continuous mechanical ventilation during hospitalization, and 51 cases in group C treated with BIPAP under routine care during hospitalization. The three cohorts were compared regarding pre- and posttreatment serum inflammatory factors (IFs), blood gas (BG) parameters, heart rate (HR), and respiratory rate (RR). Besides, the cumulative time of ventilator use, successful ventilator weaning rate, mortality, and incidence of adverse events were counted. Finally, patients were scored for their psychological state using the Hamilton Anxiety/Depression Scale (HAMA/HAMD). Results. The posttreatment TNF-α, IL-6, PCT, WBC, and PaCO2 reduced statistically in all the three groups, with the lowest levels found in group A and the highest in group B ( $P<0.05$ ); while PaO2 and SpO2 increased, with the highest values found in group A and the lowest in group B ( $P<0.05$ ). Among the three groups, group A had the shortest duration of ventilator use, the highest successful weaning rate, and the lowest incidence of adverse events ( $P<0.05$ ). Besides, HAMA and HAMD scores were the lowest in group A among the three groups, while those in group B were higher compared with group C ( $P<0.05$ ). Conclusion. The implementation of BIPAP under cluster nursing can effectively reduce inflammatory responses of $\text{SPI}+\text{RF}$ patients, improve their vital signs, and enhance their psychological state, which has extremely high clinical application value.

Continuing Care Bundle in Elderly Patients with Rectal Cancer after Radical Resection with Permanent Stoma

Objective. A continuing care bundle can achieve a better outcome than a single implementation after discharge. This study aims to investigate the effect of this intervention in elderly patients with rectal cancer after radical resection with a permanent stoma. Methods. Elderly patients diagnosed with rectal cancer underwent radical resection with permanent stoma, they were divided into the control group (n = 42) and bundle group (n = 42). The control group received the conventional care, and the bundle group received the continuing care bundle in addition to the conventional care. At 1- and 3-month after discharge, self-efficacy, self-care knowledge, ability to change stoma appliances, negative emotions, quality of life, and patient satisfaction were observed. Results. The increased levels of self-efficacy, self-care knowledge, and ability to change stoma appliances were displayed in the bundle group after discharge as compared with that in the control group, along with the enhanced score of SF-36 subscales, including physical function (PF), role physical (RP), global health (GH) and vitality (V), social function (SF), and mental health (MH). Furthermore, patients showed alleviated depression and anxiety after the continuing care bundle as compared to those after conventional care. Besides, the bundle groups had higher patient satisfaction than the control group. Conclusions. Continuing care bundle can serve as an effectiveness intervention in elderly rectal cancer patients after radical resection with permanent stoma via increasing self-efficacy and self-care knowledge, enhancing the ability to change stoma appliance, reliving the negative emotion, and improving quality of life and patient satisfaction.

Application Effect of Cluster-Based Care in Patients with Hypertensive Disorders of Pregnancy and Osteoarthritis

Objective

To explore the application effect of cluster-based care in patients with hypertensive disorders of pregnancy and osteoarthritis.

Methods

The clinical data of 60 patients with hypertensive disorders of pregnancy and osteoarthritis in our hospital were retrospectively analyzed, among which those receiving routine care from January 2020 to December 2020 were grouped into the control group (30 patients), and those receiving cluster-based care from January 2021 to January 2022 were grouped into the research group (30 patients). Psychological status, care satisfaction, and pregnancy outcomes were compared between the two groups.

Results

After intervention, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores in the research group were lower than those in the control group (P < 0.05). There was no statistical significance in the difference of the modes of delivery between the two groups (χ 2 = 1.763, P > 0.05). Patients in the research group had a lower incidence of perinatal complications than those in the control group (χ 2 = 5.689, P < 0.05). And the satisfaction rate of care in the research group (93.33% vs 70%) was higher than that in the control group (χ 2 = 4.238, P < 0.05).

Conclusion

Cluster-based care can reduce patients' negative mood, increase their satisfaction, and improve the maternal and infant outcomes. This type of care offers better quality care measures for patients with pregnancy hypertension and osteoarthritis, and has a wide clinical application prospect.

Effect of Cluster Nursing Based on Risk Management Strategy on Urinary Tract Infection in Patients With Severe Craniocerebral Injury

Objective

To observe the effect of cluster nursing based on risk management strategy in the management of urinary tract infection in patients with severe craniocerebral injury.

Methods

A total of 116 patients with severe craniocerebral injury who were admitted to our hospital from March 2019 to March 2021 were included. They were divided into the control group (58 patients) and the observation group (58 patients). The control group received routine nursing care and the observation group received cluster nursing based on risk management strategy. The incidence of catheter-associated urinary tract infection (CAUTI), the results of bacterial culture on the surface of the urinary catheter, the incidence of nursing risk events, the duration of placing the urinary catheter, the length of hospital stay, and hospital costs as well as the patient satisfaction score were compared between the two groups. The knowledge, attitude, and practice scale for prevention of catheter infection and the competence evaluation scale of nurses were used to evaluate the sense-control ability and core competence of the interveners.

Results

The total incidence of CAUTI in the observation group was (6.90%) lower than that in the control group (20.69%) (p < 0.05). The bacterial culture results on the catheter surface of patients in the observation group before and after 6 and 12 h of catheter cleaning were better than those of patients in the control group (p < 0.05). The duration of indwelling urinary catheter, hospitalization time, and hospitalization expenses of patients in the observation group were lower than those of patients in the control group (p < 0.05). The incidence rate of nursing risk events in the observation group was (1.72%) lower than that in the control group (11.86%) (p < 0.05). The overall satisfaction score of patients and the control and core ability scores of nursing staff in the observation group were higher than those in the control group (p < 0.05).

Conclusion

Cluster nursing based on risk management strategy can effectively reduce the incidence of nursing risk events and the probability of UTI in patients with severe craniocerebral injury, shorten the duration of indwelling urinary catheter and hospitalization.

Study on effects of care bundles on patients with severe pneumonia complicated with respiratory failure

OBJECTIVE

This study was designed to determine the effects of care bundles on patients with severe pneumonia complicated with respiratory failure and to discuss the adverse reaction rate in prognosis.

METHODS

A total of 64 patients with both severe pneumonia and respiratory failure admitted to the intensive care unit (ICU) of our hospital from January 2019 to December 2020 were enrolled as research objects. These patients were equally divided into a control group and an experimental group in a random manner. The experimental group was given care bundles, while the control group was given conventional nursing. Then the nursing effect, adverse reactions, and nursing satisfaction of the two groups were compared and analyzed.

RESULTS

The experimental group experienced shorter mechanical ventilation time and hospital stay than the control group. After nursing, both groups got apparent improvements on the levels of partial pressure of carbon dioxide (PaCO₂), partial pressure of oxygen (PaO₂), and oxygen saturation, with better improvements in the experimental group than those in the control group. In terms of the incidence of ventilator-associated pneumonia (VAP), chest ultrasound imaging, and nursing satisfaction, the experimental group garnered more positive results than the control group (all P<0.05).

CONCLUSIONS

Care bundles can greatly improve the nursing effect on patients with severe pneumonia complicated with respiratory failure. Compared with conventional nursing, it can contribute to considerably shorter mechanical ventilation time and hospital stay, optimal blood gas indexes and oxygen saturation, substantially lower incidence of ventilator-related diseases, and better prognostic recovery effect.

Effect of care bundles in the nursing of severe pneumonia

OBJECTIVE

To explore the effect of care bundles and analyze the influence of different angles of turning over on the sputum excretion of mechanically ventilated patients with severe pneumonia.

METHODS

120 patients with severe pneumonia in our hospital from October 2016 to October 2019 were equally randomized into four groups, each with 30, according to the date of admission. The control group was given conventional nursing and placed in a position of left 30°-half lying-right 30°; the group A was given comprehensive care bundles and placed in a position of left 30°-half lying-right 30°; the group B was given comprehensive care bundles and placed in a position of left 45°-half lying-right 45°, and the group C was given comprehensive care bundles and placed in a position of 60° left-half lying-60° right. The respiratory rates and oxygenation indexes of patients in the three groups (group A, B, C) in lateral position at 2 h and 6 h respectively before and after mechanical ventilation were compared. And we compared the nursing efficiency and satisfaction.

RESULTS

The control group showed lower nursing efficiency and satisfaction compared with the group A (P<0.05). The group B and C showed higher oxygenation index after six hours of ventilation compared with group A (P<0.05). After two hours of mechanical ventilation, the group B and C showed lower respiratory rate and higher oxygenation index compared with the group A, and the respiratory rate and oxygenation index of the group B were closest to the normal range (P<0.05).

CONCLUSION

The sputum excretion effect of mechanically ventilated patients with severe pneumonia was the best if they were placed in a position of left 45°-half lying-right 45° and given comprehensive care bundles.