Background Core competencies of intensive care unit (ICU) nurses were defined as the essential capability to influence patient safety and interdisciplinary collaboration; however, there has been no research conducted that relates to core competencies of ICU nurses at Chinese tertiary‐A hospitals in Shanghai. Aims and objectives To investigate the current state of core competencies and the factors that influence this key capability in ICU nurses in Chinese tertiary‐A hospitals. Design This was a multicentre, cross‐sectional study. Methods A convenient sampling method was used to investigate 451 ICU nurses at five tertiary‐A hospitals in Shanghai. Data were collected using self‐administered questionnaires. Results The core competencies of ICU nurses were above average, and the scores of seven dimensions, ranked from first to last, were medical ethics, clinical practice, nurse–nurse co‐operation, assessment and decision‐making, personal and professional development, teaching and research and nurse–physician co‐operation. Multivariate linear regression analysis showed that the factors exerting an influence on the core competencies of ICU nurses were title, role incumbent and ICU department. Conclusion This study showed an above‐average level of core competencies among ICU nurses in tertiary‐A hospitals in Shanghai; however, competencies related to nurse–physician co‐operation and the translation of research into practice were underdeveloped. Relevance to clinical practice Nursing managers should implement targeted interventions to improve nurse–physician co‐operation and translate research into practice competencies, such as high‐fidelity simulation, inter‐professional education, scientific research training and innovative skills tutorials. Moreover, this study demonstrated the influencing factors that can be used to improve core competences of ICU nurses.
Background Noma is a rare disease, which is characterized by rapid progression and a high rate of mortality; however, relatively few cases of noma infection accompanied by septic shock in children have been described. Further, most health care professionals have no knowledge of this disease or of its clinical significance. Case presentation Herein, we present a case report of a six-year-old male patient who was diagnosed with noma infection at a Chinese pediatric medical intensive care unit (PMICU), at which time, it was discovered that he had septic shock. Following treatment by continuous renal replacement therapy (CRRT) for septic shock arising from noma, the patient was in generally good condition, and the local wound was seen to be essentially healed five weeks post-admission. Conclusion Noma is an opportunistic infectious disease condition. Treatment of the acute phase of noma predominantly focuses on controlling the infection and improving systemic conditions. In addition, CRRT could be considered as a treatment option for cases that present with noma accompanied by septic shock.
Objective: The primary objective of this study was to investigate the prevalence of intensive care unit (ICU) pediatric delirium in Shanghai, China. Secondary objectives were to determine the association of hypoxia and infection with ICU pediatric delirium, and the impact between different age. Design: Prospective single-center observational study. Setting: Two pediatric intensive care unit (PICU) within a tertiary-A general hospital. Patients: Patients age between 1 month to 7 years in PICU who stayed at least 1 day were included. Convenance sampling was used. Interventions: None. Measurements and Main Results: Pediatric patients (n=639) were screened twice a day for the prevalence of ICU pediatric delirium by Cornell Assessment of Pediatric Delirium, 300 (46.95%) of them had infection and 213 (33.33%) had hypoxia in PICU. Children who suffered hypoxia remained more than three times likely to be delirious during their hospitalization compared with children who were not hypoxia, after controlling other covariates, the odds of pediatric delirium for subjects with hypoxia was 3.26 times (95% CI, 1.98-5.38) the odds without hypoxia. Also, the odds of pediatric delirium for subjects with infection was 2.55 times (95% CI, 1.58-4.11) the odds without infection adjusting for other covariates. After subgrouping by age, the occurrence of ICU pediatric delirium with infection for children younger than two years old was 5.37 times (95% CI, 3.09-9.33) compared with patients who were never infection, while that for the children equal to or older than two years old was no statistically significant relationship. Conclusions: The prevalence of ICU pediatric delirium was 31.30%, while there is an independent association of infection and hypoxia with ICU pediatric delirium. Furthermore, children younger than two years old took more risks on pediatric delirium when they were infected in this study, while there was no relationship between infection and pediatric delirium who aged 2 years or older.
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