Management of central venous catheters in pediatric onco-hematology using 0.9% sodium chloride and positive-pressure-valve needleless connector

PurposeTo describe, in a sample of pediatric onco-hematological patients, the rate of occlusions in unused central venous catheters (CVC) flushed once a week with a 0.9% sodium chloride solution through a positive-pressure-valve needleless connector.MethodRetrospective cohort study. Subjects aged 0–17 years were identified through a manual search in medical and nursing records and were observed for two years or until the occurrence of one of the following events: start or resume of continuous infusion; CVC removal; death. The primary study outcome was the frequency of CVC occlusion (partial or complete).ResultsFifty-one patients were identified (median age 6 years). The median duration of follow-up was 169 days (IQR 111–305). During the follow up period, 14 patients (27%) had one CVC occlusion, in 2 cases (4%) the occlusion was complete, in 12 (23%) partial. All the occlusions were solved without the need for catheter removal. The lumen diameter ≤4.2 vs > 4.2 French showed a statistically significant association with occlusion at multivariate analysis (OR 4.0; 95% CI 1.1–14.7).ConclusionsOur findings are reassuring with respect to the management of the CVC using the adopted protocol. The study provides useful information for patient care, by verifying the performance of the adopted CVC management protocol and by identifying critical areas for nursing care.     

You never know when your last day will come and your trip will be over – Existential expressions from a melanoma diagnosis

AimThe aim of this study was to further explore expressions of existential experiences by patients diagnosed with malignant melanoma (MM).MethodSemi-structured interviews were performed consecutively after diagnosis among 30 patients with MM. The methodological approach was inspired by Gadamer's hermeneutic philosophy.ResultsThe analysis of expressions of existential experiences after having been diagnosed with malignant melanoma revealed that it is an existential process that people go through, beginning with feelings of suddenly becoming groundless at the time of the diagnosis, including being empty and in a vacuum, being in chaos and uncertainty and being confronted with one's own death. Next theme searching for solid ground included striving to understand what lies ahead, striving to find a balance in life – fighting, hoping, going on living and striving to prioritize family. The last theme creating islands of solid ground when living with cancer included understanding what is meaningful in life, living in the moment – seizing the day and keeping watch on the body.ConclusionOn being diagnosed with malignant melanoma, people go through a process where many questions emerge, including an existential turmoil, which health professionals should be aware of to provide these patients with sufficient support.     

奈达铂+紫杉醇化疗联合胸腹两切口食管切除术治疗食管鳞癌40例的疗效

目的 探究奈达铂+紫杉醇新辅助化疗联合胸腹两切口食管中上段鳞癌切除术对食管鳞癌病人疗效的影响.方法 抽签选取2014年2月至2016年3月枣阳市第一人民医院收治的食管鳞癌病人80例,根据治疗方式不同分为观察组与对照组,各40例.两组手术方式相同,对照组直接行胸腹两切口食管中上段鳞癌切除术,观察组在术前采用奈达铂+紫杉醇...     

专科医院手术室实施专科护士分组管理的方法及效果

目的 探讨分析在专科医院手术室护理工作中实施护理专科分组管理的方法及效果。方法 在厦门市妇幼保健院手术室开展护理专科分组管理,对分组前后护理人员在手术物品准备、术中器械传递、医生特殊习惯的掌握、术中配合等方面的配合度及护士专业知识掌握、护士操作技能掌握等方面进行回顾性的对比分析。结果 实施分组管理后,护理人员在术中器械传递、医生特殊习惯的掌握、术中配合等方面的配合度及对专业知识和操作技能的掌握均明显优于实施分组管理前,差异具有统计学意义(P ＜ 0.05)。结论 在专科医院手术室护理工作中实施护理专科分组管理的临床效果显著,该方法不仅能有效提高护理人员在手术物品准备、术中器械传递、医生特殊习惯的掌握、术中配合等方面的配合度,还能提高其对专业理论知识和操作技能的掌握程度,值得在临床上推广应用。