Nurses’ knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey

Introduction: In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses’ knowledge on phlebotomy to provide reference for improving blood sampling practice in China. Materials and methods: A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge questionnaire was designed based on the Clinical and Laboratory Standards Institute H3-A6 guidelines, combining with the situations in China. Descriptive analysis and binary logistic regression analysis were used to analyze the knowledge level and its influencing factors. Results: A total of 3400 questionnaires were distributed and 3077 valid questionnaires were returned, with an effective return rate of 90.5%. The correct rates of patient identification, hand sanitization, patient assessment, tube mixing time, needle disposing location and tube labelling were greater than 90%. However, the correct rates of order of draw (15.5%), definition of an inversion (22.5%), time to release tourniquet (18.5%) and time to change tube (28.5%) were relatively low. Binary logistic regression analysis showed that the correct rates of the aforementioned four questions were mainly related to the regional distribution of the hospitals (P < 0.001). Conclusions: The knowledge level on phlebotomy among Chinese nurses was found unsatisfactory in some areas. An education program on phlebotomy should be developed for Chinese nurses to improve the consistency among different regions and to enhance nurse’s knowledge level on phlebotomy

Corrigendum to: Nurses’ knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey

This is a correction of Biochemia Medica 2018;28(1):010703. DOI: https://doi.org/10.11613/ BM.2018.01070

Experiences of Chinese patients with Crohn's disease in the self-administration of nasogastric feeding: A descriptive qualitative study.

BACKGROUND:Despite the increasing number of Crohn's disease patients self-administering nasogastric feeding as enteral nutrition support therapy, no studies have reported the experiences of self-administering nasogastric feeding from the perspective of these patients. OBJECTIVES:To explore the initial trigger factors for the self-administration of nasogastric feeding by Crohn's disease patients and to understand the experiences of self-administration of nasogastric feeding, its effects on various aspects of life and work, and relevant challenges and coping mechanisms encountered during this therapy in order to improve the understanding of this group of patients among medical staff and the public. DESIGN:This study adopted a descriptive qualitative method. Crohn's disease patients from several tertiary hospitals in Hangzhou, Zhejiang, were recruited to participate through purposive sampling combined with maximum variation and the snowballing technique. Data were collected using semi-structured interviews and analyzed using the conventional content analysis method. RESULTS:A total of 11 Crohn's disease patients were interviewed. Four themes and eight subthemes emerged from the analysis: rejecting the self-administration of nasogastric feeding (being afraid of inserting the nasogastric tube, having concerns about nasogastric feeding), accepting the reality of nasogastric feeding (health being the most important, followed by having sources of support), nasogastric feeding as a double-edged sword (the disturbances and efficacies of nasogastric feeding), and nasogastric feeding as a part of life (becoming accustomed to tube insertion and taking nasogastric feeding for granted). CONCLUSIONS:Apart from suffering from physical discomfort, diet and body image disturbances, and inconveniences in daily life, Crohn's disease patients who self-administered nasogastric feeding faced many psychological challenges. Many of these patients eventually adjusted to a life with nasogastric feeding, but not everyone achieved this state. Therefore, health care providers, including physicians and nurses, and the general public should collaborate to help these patients adapt to their "new lives" as soon as possible

Demographic and clinical characteristics of the participants.

<p>Demographic and clinical characteristics of the participants.</p

Themes and subthemes of the study.

<p>Themes and subthemes of the study.</p

Graphene-encapsulated sulfur (GES) composites with a core-shell structure as superior cathode materials for lithium-sulfur batteries

Relatively uniform sized graphene-encapsulated sulphur (GES) composites with a core (S)-shell (graphene) structure were synthesized in one pot based on a solution-chemical reaction-deposition method. These novel GES particles were characterized by XRD, Raman spectrometry, SEM, TGA, EDS and TEM. The electrochemical tests showed that the present GES composites exhibit high specific capacity, good discharge capacity retention and superior rate capability when they were employed as cathodes in rechargeable Li-S cells. A high sulphur content (83.3 wt%) was obtained in the GES composites. Stable discharge capacities of about 900, 650, 540 and 480 mA h g(-1) were achieved at 0.75, 2.0, 3.0 and 6.0 C, respectively. The good electrochemical performance is attributed to the high electrical conductivity of the graphene, the reasonable particle size of sulphur particles, and the core-shell structures that have synergistic effects on facilitating good transport of electrons from the poorly conducting sulphur, preserving fast transport of lithium ions to the encapsulated sulphur particles, and alleviating the polysulfide shuttle phenomenon. The present finding may provide a significant contribution to the enhancement of cathodes for the lithium-sulphur battery technology

Investigation of the Effect of Extra Lithium Addition and Postannealing on the Electrochemical Performance of High-Voltage Spinel LiNi0.5Mn1.5O4 Cathode Material

The LiNi0.5Mn1.5O4 (LNMO) spinel is an attractive cathode candidate for next generation lithium-ion batteries as it offers high power and energy density. In this paper, the effects of extra amounts of lithium addition and postannealing process on the physicochemical and electrochemical properties of the spherical LNMO material were investigated. The experimental results show that the amount of lithium and the postannealing process have significant impacts on the Mn3+ content, phase impurity (rock-salt phase) and phase structures (Fd3m and P4(3)32) of the spherical LNMO cathode materials, so as their electrochemical performance. In particular, the phase transition from Fd3m to P4(3)32 and the Mn3+ content of the LNMO spinels were found to be adjusted by lithium additions and the postannealing process. With the presence of Mn3+, the absence of the impurity phase (rock-salt phase) and the cation ordering in the spinels, the electrochemical rate performance and capacity retention of the products could be significantly improved. In a half cell test, LNMO cathode material with 5% of lithium excess (based on theoretical formula calculation) displays a high specific discharge capacity of 123 mAh g(-1) at 2 C rate with excellent capacity retention of 84% after 500 cycles at 55 degrees C. All these findings show the important roles of the synergic effects of Mn3+ content, phase impurity (rock-salt phase) and phase structures (Fd3m and P4(3)32) on the electrochemical performance improvement of LNMO-based cathode materials, which will guide the preparation of LNMO-based cathode material with excellent electrochemical performance

Investigations on the electrochemical decomposition of the electrolyte additive vinylene carbonate in Li metal half cells and lithium ion full cells

In this study, the decomposition of vinylene carbonate (VC) additive and its effect on the aging behavior is investigated in Li metal half cells and lithium ion full cells. Four electrolyte systems, the reference electrolyte with three VC additive amounts, i.e., 1, 5 and 10 vol% are examined with commercial LiNi1/3Mn1/3Co1/3O2 (NMC 111) cathode material and mesophase carbon microbeads (MCMB) anode material. The thickness changes of the cathode electrolyte interphase (CEI) and of the solid electrolyte interphase (SEI) after 5 constant current cycles at 0.1C and 200 constant current/constant voltage (potential) cycles at 1C are investigated for cells containing different amounts of VC. With the help of X-ray photoelectron spectroscopy (XPS) and high-performance liquid chromatography (HPLC), a correlation between CEI thickness change and electrolyte decomposition is figured out. The addition of VC leads to a thin CEI layer and a high capacity retention in a lithium metal half cell. A strong dependence of the performance on the VC concentration is found for half cells that results from the continuous consumption of electrolyte and the electrolyte additive at the Li metal counter electrode. In contrast, for full cells, even 1 vol% of VC helps to form both a stable CEI and SEI, while a larger amount of VC increases the CEI thickness, electric contact loss and the internal resistance

Influence of electrolyte additives on the cathode electrolyte interphase (CEI) formation on LiNi1/3Mn1/3Co1/3O2 in half cells with Li metal counter electrode

Traditional solid electrolyte interphase (SEI) forming additives of vinylene carbonate (VC), fluoroethylene carbonate (FEC) and ethylene sulfite (ES) are studied with respect to their impact on the formation and growth of the cathode electrolyte interphase (CEI) layer. T-half cells are assembled and undergo three different electrochemical investigation plans: after formation (0.1C, 5 cycles) and long term cycling (0.1C, 5 constant current cycles + 1C, 100/150 constant current/voltage cycles), scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and gas chromatography-mass spectrometry (GC-MS) are combined to investigate morphology, CEI composition, CEI thickness and aging products for cells with different electrolyte systems. The obtained results reveal a significant influence of these additives on the CEI composition and CEI growth. With the help of SEM, it is found that large areas of electrolyte decomposition products are formed at the aged electrode surfaces (=after cycling), with the exception when 2 vol% of FEC is added into the reference electrolyte. From XPS measurements, CEI thicknesses are calculated. The reference electrolyte with 2 vol% of FEC shows the thinnest layer after long time aging (0.8 ± 0.2 nm). For the addition of 2 vol% of VC, an incremental growth of the CEI thickness occurs from the 100th to 150th cycle (from 1.0 ± 0.1 nm to 2.9 ± 0.4 nm). By correlating the CEI thickness values with the electrochemical performance, it can be observed that for lithium metal based half cells, the existence of a thinner CEI layer corresponds to a better cycling behavior, with 2 vol% of FEC showing the highest discharge capacity of 114.4 ± 0.2 mAh/g after 150 cycles at 1C. GC-MS shows that both VC and FEC help to prevent fast electrolyte aging