介入专科护士核心能力评价指标的初步构建

目的初步构建介入专科护士核心能力评价指标,旨在为介入专科护士的培养、考核、评价与管理提供参考。方法采用德尔菲法对18名专家进行2轮函询,并确定介入专科护士核心能力指标及权重。结果2轮函询专家的积极性分别为100%、88.89%;专家的权威系数为0.90;一、二、三级指标的协调系数分别为0.357、0.401、0.436(均P0.01)。最终确立的评价指标包括理论知识能力、实践操作能力、批判性思维能力、人际交往能力、护理临床管理能力、科研学习能力、指导能力7项一级指标,23项二级指标,56项三级指标。结论介入专科护士核心能力评价指标的专家意见集中,可信度高,可为介入专科护士的培养、考核、评价与管理提供参考。     

《中国介入影像与治疗学》杂志2011年稿约

《中国介入影像与治疗学》杂志是经国家新闻出版总署批准、由中国科学院主管、中国科学院声学研究所主办、中国工程院医药卫生工程学部协办的国家级学术核心期刊。主要刊载有关血管介入、非血管介入、肿瘤介入、神经介入、心脏介入、介入超声、介入器材和药物的研发与应用、介入疗法的综合临床效果评估以及相关交叉学科等方面的最新研究成果。栏目设有专家述评、基础与实验研究、临床研究、综述、     

肿瘤介入病房护理风险预案的制定及实施效果评价

目的 探讨护理风险预案的制定与实施在肿瘤介入病房中的作用.方法 总结肿瘤介入病房2008年3月至2009年12月的临床管理经验,结合文献资料分析,制定适合肿瘤介入病房的护理风险预案并实施,并比较实施前后护理质量综合考评、患者满意度、不良事件发生率,评价实施效果.结果 护理风险预案实施后,肿瘤介入病房护理质量综合考评在全院55个护理单元排名从(28.3±3.0)名上升至(5.9±1.2)名;患者满意率从(93.2±1.0)％上升至(98.5±0.4)％;不良事件发生率下降.结论 制定与实施护理风险预案,是肿瘤介入病房安全规范化管理的有效方法.     

新型冠状病毒感染流行期间胰腺疾病手术时机选择及围手术期处理优化措施思考

随着新型冠状病毒的进一步变异和国家疫情防控宏观策略的调整，我国疫情防控进入了新阶段，疫情防控重心从“防感染”转向“保健康，防重症”。目前，对于新型冠状病毒感染是否会影响胰腺手术的结局以及围手术期管理，尚存在争议。基于此问题，国内10家胰腺外科手术大容量中心专家共同讨论了关于新型冠状病毒感染流行期间胰腺疾病手术时机选择及围手术期处理优化措施，并初步达成了一定的共识。胰腺外科医生务必要认识到新型冠状病毒感染对围手术期安全造成的潜在风险，并通过正确选择手术时机、优化围手术期管理、建立新的胰腺肿瘤随访体系等措施，以应对疫情冲击带来的挑战，确保围手术期的安全性。     

《中国介入影像与治疗学》杂志2010年稿约

《中国介入影像与治疗学》杂志是经国家新闻出版总署批准、由中国科学院主管、中国科学院声学研究所主办、中国工程院医药卫生工程学部协办的国家级学术核心期刊。主要刊载有关血管介入、非血管介入、肿瘤介入、神经介入、心脏介入、介入超声、介入器材和药物的研发与应用、介入疗法的综合临床效果评估以及相关交叉学科等方面的最新研究成果。栏目设有专家述评、基础与实验研究、临床研究、综述、方法技术学、规范化探讨、研究快报、经验交流、短篇报道、会议纪要等。     

《中国介入影像与治疗学》杂志稿约

<正>《中国介入影像与治疗学》杂志是经国家新闻出版广电总局审批、国内外公开发行的国家级学术核心期刊,由中国科学院主管、中国科学院声学研究所主办。主要刊载有关血管介入、非血管介入、肿瘤介入、神经介入、心脏介入、介入超声、介入器材和药物的研发与应用、介入疗法的综合临床效果评估以及相关交叉学科等方面的最新研究成果。栏目设置包括专家述评、基础与实验研究、临床研究、综述、方法技术学、规范化探讨、继续教育、经验交流、个案报道等。     

《中国介入影像与治疗学》杂志稿约

<正>《中国介入影像与治疗学》杂志是经国家新闻出版广电总局审批、国内外公开发行的国家级学术核心期刊,由中国科学院主管、中国科学院声学研究所主办。主要刊载有关血管介入、非血管介入、肿瘤介入、神经介入、心脏介入、介入超声、介入器材和药物的研发与应用、介入疗法的综合临床效果评估以及相关交叉学科等方面的最新研究成果。栏目设置包括专家述评、基础与实验研究、临床研究、综述、方法技术学、规范化探讨、继续教育、经验交流、短篇报道等。     

《中国介入影像与治疗学》杂志2013年稿约

《中国介入影像与治疗学》杂志是经国家新闻出版总署批准、由中国科学院主管、中国科学院声学研究所主办、中国工程院医药卫生工程学部协办的国家级学术核心期刊。主要刊载有关血管介入、非血管介入、肿瘤介入、神经介入、心脏介入、介入超声、介入器材和药物的研发与应用、介入疗法的综合临床效果评估以及相关交叉学科等方面的最新研究成果。栏目设有专家述评、基础与实验研究、临床研究、综述、方法技术学、规范化探讨、继续教育、研究快报、经验交流、短篇报道、会议纪要等。     

经皮穿刺冷热多模态消融治疗肺部恶性肿瘤操作规范专家共识

随着现代医学技术的进步,肿瘤治疗方式越来越多样。冷冻消融治疗疗效确切、并发症少、手术创伤小、患者恢复快,已得到临床广泛认可。深低温冷冻和高强度加热多模态治疗模式打破了进口产品长期垄断的局面,获得临床专家一致肯定。国内从事恶性肿瘤消融治疗的介入放射学、内科学及外科学专家就冷热多模态消融治疗肺恶性肿瘤操作规范进行了充分深入讨论后达成本专家共识。     

《中国介入影像与治疗学》杂志稿约

《中国介入影像与治疗学》杂志是经国家新闻出版总署批准、由中国科学院主管的国家级学术期刊。主要刊载有关血管介入、非血管介入、肿瘤介入、神经介入、心脏介入、介入超声、介入器材和药物的研发与应用、介入疗法的综合临床效果评估以及相关交叉学科等方面的最新研究成果。栏目设有专家述评、基础与实验研究、临床研究、综述、方法技术学、规范化探讨、研究快报、短篇报道、会议纪要、读者来信等。1投稿要求1.1总体要求文稿应具有科学性、先进性、创新性和可读性,力求重点突出,论点明确,资料详实,数据可靠,结构严谨,写作规范,表达准确,文…     

Experience and suggestion of medical practices for burns during the outbreak of COVID-19

COVID-19 is spreading almost all over the world at present, which is caused by the 2019 novel coronavirus (2019-nCoV). It was an epidemic firstly in Hubei province of China. The Chinese government has formally set COVID-19 in the statutory notification and control system for infectious diseases according to the Law of the People’s Republic of China on the Prevention and Treatment of Infectious Diseases. China currently is still struggling to respond to COVID-19 though intensive actions with progress made. The Burn Department of our hospital is one of sections with the highest infectious risk of COVID-19. Based on our own experience and the guidelines on the diagnosis and treatment of COVID-19 (7th Version) with other regulations and literature, we describe our experience with suggestions for medical practices for burn units during the COVID-19 outbreak. We hope these experiences and suggestions benefit our international colleagues during the pandemic of the COVID-19.     

Surge in testicular torsion in pediatric patients during the COVID-19 pandemic

BackgroundTesticular torsion is a pediatric surgical emergency, and prompt diagnosis and treatment is imperative. During the COVID-19 pandemic, pediatric patients with symptoms of testicular torsion may be reluctant to seek medical care which increases the likelihood of delayed presentation and the need for an orchiectomy. This observational study sought to determine whether there was a higher number of testicular torsion cases during COVID-19.MethodsAs the first patient with COVID-19 was admitted to our facility on March 6, 2020, we identified male children ages 1–18 years with testicular torsion between March 1-December 31, 2020 (during COVID-19) compared to the same time period between 2015 and 2019 (prior to COVID-19). All patients were evaluated at our Institution's Emergency Department by a pediatric urologist.ResultsThere were 38 cases of testicular torsion between March 1-December 31, 2020 compared to 15.8 cases on average during the same 10-month period between 2015 and 2019 (a total of 79 cases). There was a statistically significant increase in testicular torsion cases during the COVID-19 pandemic compared to equivalent time periods in 2015–2019 (38 vs. 15.8, p = 0.05). Patients with testicular torsion during the COVID-19 pandemic were younger, had a longer duration of symptoms, and had a higher number of orchiectomies (although not statistically significant).ConclusionDuring the COVID-19 pandemic, an escalation in testicular torsion cases was observed. Timely assessment, diagnosis, and surgery are crucial to prevent testicular loss and potential infertility in the future. Further evaluation is needed to elucidate the surge in testicular torsion and possible mechanisms.     

Hip fracture care during the 2020 COVID-19 first-wave: a review of the outcomes of hip fracture patients at a Scottish Major Trauma Centre

Background and Purpose of the StudyThis study reviewed whether the response to the Coronavirus (COVID-19) pandemic affected the care for hip fracture patients at a major trauma centre in Scotland during the first-wave lock-down period.MethodsAll patients referred to Orthopaedics with a hip fracture in a major trauma centre in Scotland were captured between 14 th March and 28 th May (11 weeks) in 2020 and 2019. Patients were identified using electronic patient records. The primary outcomes are time to theatre, length of admission and 30-day mortality. Secondary outcomes are COVID-19 prevalence, duration of surgery, proportion of patients to theatre within 36 hours and COVID-19 positive 30-day mortality from time of surgery. 225 patients were included: 108 from 2019 and 117 from 2020.The main findings30-day mortality was 3.7% (n=4) in 2019 and 8.5% (n=10) in 2020 (p=0.142). There was no statistical difference with time to theatre (p=0.150) nor duration of theatre (p=0.450). Duration of admission was reduced from 12 days to 6.5 days (p=<0.005). 4 patients tested positive for COVID-19 during admission, one 5 days after discharge, all underwent surgical management. 30-day mortality for COVID-19 positive patients during admission was 40%. COVID-19 prevalence of patients that were tested (n=89) was 5.62%.ConclusionsThis study has shown the care of hip fracture patients has been maintained during the COVID-19 pandemic. There is no statistically significant change in mortality, time to theatre, and duration of surgery, however, the patient’s admission duration was significantly less than the 2019 cohort.     

Impact of COVID-19 on Patient Trends and Outcome: Results from a Tertiary Care Burn and Plastic Unit in Northern India

Background  Burn and trauma injuries need emergency care and resuscitation, which required uninterrupted delivery of inpatient care services during the coronavirus disease 2019 (COVID-19) pandemic. Burn patients are physiologically immunocompromised, increasing the risk of COVID-19 infection in them. This study analyzes the impact of COVID-19 pandemic on patient trends in a burn and plastic unit and assesses the effect of COVID-19 infection in burns. Methods  This single-center, retrospective observational case–control study was conducted in the Department of Burns, Plastic and Maxillofacial Surgery of a tertiary care hospital in New Delhi, India. Patient data was collected from April 1, 2019 to August 10, 2019 and from April 1, 2020 to August 10, 2020. All data of burns and trauma patients collected was analyzed and compared. Results  There were total 350 admissions during COVID time period and 562 admissions during non-COVID time period. The admission rate, type of burn injury, and death rate did not vary significantly during the two time periods. Thermal burn was the most common type of burn injury. There were total 18 cases diagnosed to be COVID-19 positive during the pandemic. There were two deaths among COVID-19 positive burn cases. Conclusion  This study finds no difference in patient patterns during COVID and non-COVID time period. Amongst burn patients, no increased risk of COVID-19 infection is seen with larger body surface area of burns. No increase in mortality is seen in burn patients infected with COVID-19.     

Worsening Arthroplasty Utilization With Widening Racial Variance During the COVID-19 Pandemic

BackgroundElective arthroplasty surgery in the United States came to a near-complete halt in the spring of 2019 as a response to the COVID-19 pandemic. Racial disparity has been a long-term concern in healthcare with increased focus during the pandemic. The purpose of this study is to evaluate the effects of COVID-19 and race on arthroplasty utilization trends during the pandemic.MethodsWe used 2019 and 2020 Center for Medicare and Medicaid Service fee-for-service claims data to compare arthroplasty volumes prior to and during the COVID-19 pandemic. We compared overall arthroplasty utilization rates between 2019 and 2020 and then sought to determine the effect of race and COVID-19, both independently and combined.ResultsThere was a decrease in primary total knee arthroplasty (?28%), primary total hip arthroplasty (?14%), primary total hip arthroplasty for fracture (?2%), and revision arthroplasty (?14%) utilization between 2019 and 2020. The highest decrease in overall arthroplasty utilization was in the Hispanic population (34% decrease vs 19% decrease in the White population). We found that a non-White patient was 39.9% (P < .001) less likely to receive a total joint arthroplasty prior to COVID-19. The COVID-19 pandemic further exacerbated the pre-existing racial differences in arthroplasty utilization by decreasing the probability of receiving a total joint arthroplasty for non-White patient by another 12.9% (P < .001).ConclusionWe found an overall decreased utilization rate of arthroplasty during the COVID-19 pandemic with further decrease noted in all non-White populations. This raises significant concern for worsening racial disparity in arthroplasty caused by the ongoing pandemic.     

Surgical complications in COVID-19 patients in the setting of moderate to severe disease

The coronavirus disease 2019 (COVID-19) pandemic has had a considerable impact on the work of physicians and surgeons. The connection between the patient and the surgeon cannot be replaced by telemedicine. For example, the surgical staff faces more serious difficulties compared to non-surgical specialists during the COVID-19 pandemic. The primary concerns include the safest solutions for protecting healthcare staff and patients and the ability to provide adequate surgical care. Additionally, the adverse effects of any surgery delays and the financial consequences complicate the picture. Therefore, patients' admission during the COVID-19 pandemic should be taken into consideration, as well as preoperative measures. The COVID-19 situation brings particular risk to patients during surgery, where preoperative morbidity and mortality rise in either asymptomatic or symptomatic COVID-19 patients. This review discusses the recent factors associated with surgical complications, mortality rates, outcomes, and experience in COVID-19 surgical patients.     

Initial Effects of COVID-19 on Patients with ESKD

BackgroundReports from around the world have indicated a fatality rate of patients with coronavirus disease 2019 (COVID-19) in the range of 20%–30% among patients with ESKD. Population-level effects of COVID-19 on patients with ESKD in the United States are uncertain.MethodsWe identified patients with ESKD from Centers for Medicare and Medicaid Services data during epidemiologic weeks 3–27 of 2017–2020 and corresponding weeks of 2017–2019, stratifying them by kidney replacement therapy. Outcomes comprised hospitalization for COVID-19, all-cause death, and hospitalization for reasons other than COVID-19. We estimated adjusted relative rates (ARRs) of death and non–COVID-19 hospitalization during epidemiologic weeks 13–27 of 2020 (March 22 to July 4) versus corresponding weeks in 2017–2019.ResultsAmong patients on dialysis, the rate of COVID-19 hospitalization peaked between March 22 and April 25 2020. Non-Hispanic Black race and Hispanic ethnicity associated with higher rates of COVID-19 hospitalization, whereas peritoneal dialysis was associated with lower rates. During weeks 13–27, ARRs of death in 2020 versus 2017–2019 were 1.17 (95% confidence interval [95% CI], 1.16 to 1.19) and 1.30 (95% CI, 1.24 to 1.36) among patients undergoing dialysis or with a functioning transplant, respectively. Excess mortality was higher among non-Hispanic Black, Hispanic, and Asian patients. Among patients on dialysis, the rate of non–COVID-19 hospitalization during weeks 13–27 in 2020 was 17% lower versus hospitalization rates for corresponding weeks in 2017–2019.ConclusionsDuring the first half of 2020, the clinical outcomes of patients with ESKD were greatly affected by COVID-19, and racial and ethnic disparities were apparent. These findings should be considered in prioritizing administration of COVID-19 vaccination.     

Effects of the COVID-19 pandemic on the outcome and mortality of patients with diabetic foot ulcer

The outbreak of the coronavirus disease 2019 (COVID-19) led to events that significantly impaired the treatment and management of patients with chronic diabetes. Therefore, elective treatments at hospitals were cancelled and patients with chronic ailments were instructed to stay at home and minimise the time spent in public areas. The second was due to COVID-19-induced anxiety that deterred many patients from seeking care and adhering to periodic out-patient visits. In this study, we examined the short-term effects of the COVID-19 pandemic on patients with chronic diabetes who suffered from contaminated diabetic ulcers. We conducted a retrospective study with patients who had undergone amputations following diabetic ulcers during 2019-2020. The research group included diabetic amputees during the COVID-19 outbreak period ranging from March 2020 to December 2020. The control group included diabetic amputees from the corresponding period in 2019. Using the Wagner Scale, we measured the difference in the severity of ulcers upon the patient's initial admission. Additionally, we examined patient survival rates based on the size of amputations, by specifically focusing on the period between 1- and 6-months post-surgery. The results failed to suggest a clear and statistically significant worsening trend in the condition of patients in the research and control groups. Due to public lockdowns, transportation restrictions, scarcity of healthcare staff, and reduced adherence to exposure anxiety, patients with diabetic foot ulcers received inferior medical care during the COVID-19 pandemic. However, this study could not find a statistically significant difference in the mortality and major amputation rates in patients with diabetic ulcer before and during the pandemic. The health system should incorporate the existing institutional and technological recommendations to facilitate care and follow-up of patients with diabetic foot ulcers during the current and future pandemics.     

Optimize the management of urological tube-related emergencies during the coronavirus disease 2019 (COVID-19) pandemic

BackgroundTo introduce and determine the value of optimized strategies for the management of urological tube-related emergencies with increased incidence, complexity and operational risk during the global spread of coronavirus disease 2019 (COVID-19).MethodsAll emergent urological patients at Tongji Hospital, Wuhan, during the period of January 23 (the beginning of lockdown in Wuhan) to March 23, 2020, and the corresponding period in 2019 were recruited to form this study’s COVID-19 group and control group, respectively. Tongji Hospital has the most concentrated and strongest Chinese medical teams to treat the largest number of severe COVID-19 patients. Patients in the control group were routinely treated, while patients in the COVID-19 group were managed following the optimized principles and strategies. The case incidence for each type of tube-related emergency was recorded. Baseline characteristics and management outcomes (surgery time, secondary complex operation rate, readmission rate, COVID-19 infection rate) were analyzed and compared across the control and COVID-19 periods.ResultsThe total emergent urological patients during the COVID-19 period was 42, whereas during the control period, it was 124. The incidence of tube-related emergencies increased from 53% to 88% (P<0.001) during the COVID-19 period. In particular, the incidence of nephrostomy tube-related (31% vs. 15%, P=0.027) and single-J stent-related problems (19% vs. 6%, P=0.009) increased significantly. The mean surgery times across the two periods were comparable. The number of secondary complex operations increased from 12 (18%) to 14 (38%) (P=0.028) during the COVID 19-period. The number of 2-week postoperative readmission decreased from 10 (15%) to 1 (3%) (P=0.049). No participants contracted during the COVID-19 period.ConclusionsUrological tube-related emergencies have been found to have a higher incidence and require more complicated and dangerous operations during the COVID-19 pandemic. However, the optimized management strategies introduced in this study are efficient, and safe for both urologists and patients.     

Health care disparities during the COVID-19 pandemic

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, is a pandemic with more than 32 million cases and more than 500,000 deaths nationwide. With the significant health consequences seen secondary to COVID-19, health care disparities have been further exacerbated. Mechanisms that have been proposed to account for the increased disparity seen during the COVID-19 pandemic are multifactorial. This review of the literature outlines the unique barriers to health and disparities that are associated with vulnerable communities who have been most impacted by the COVID-19 pandemic in the United States.