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

Engine remaining useful life prediction based on trajectory similarity

The traditional remaining useful life prediction methods need to study the mechanism failure of equipment and the vibration signals can easily be submerged by the noise in the actual operation, in order to solve these problems, the methods of Trajectory similarity based prediction (TSBP) and condition monitoring based on lubricant information are proposed in this paper. The gradient model of lubricant data information which is processed by principal component analysis (PCA) is used to monitor equipment status. Additionally, degradation trajectory abstraction procedure and similarity evaluation procedure are studied in detail. Finally, the both studies are combined for the research of engine remaining useful life prediction and case study proves the simplicity and effectiveness of this method

Application of EMD-WVD and particle filter for gearbox fault feature extraction and remaining useful life prediction

Fault feature extraction and remaining useful life (RUL) prediction are important to condition based maintenance (CBM). In order to realize the fault feature extraction of gearbox vibration signal presenting nonlinear and non-Gaussian, the integration of empirical mode decomposition (EMD) and Wigner-Ville distribution (WVD) are proposed in this paper. Taking the kurtosis as standard, the WVD is applied to some IMFs with larger kurtosis to calculate the time-frequency distribution, with an effective suppress on mode mixing and the cross-term interference. Afterwards, particle filter (PF) with the state space model based on Wiener process is proposed to predict the RUL of gearbox considering degradation feature, gearbox teeth wear and nonlinear and non-Gaussian system. The gearbox life cycle test shows that the EMD-WVD method can extract the valued characteristics of vibration signal accurately, and the particle filter can provide an effective way to predict the RUL of gearbox

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

The experience of China-educated nurses working in Australia : a symbolic interactionist perspective

Transnational nurse migration is a growing phenomenon. However, relatively little is known about the experiences of immigrant nurses and particularly about non-English speaking background nurses who work in more economically developed countries. Informed by a symbolic interactionist framework, this research explored the experience of China-educated nurses working in the Australian health care system. Using a modified constructivist grounded theory method, the main source of data were 46 face to face in-depth interviews with 28 China-educated nurses in two major cities in Australia. The key findings of this research are fourfold. First, the core category developed in this study is reconciling different realities, which inserts a theoretical understanding beyond the concepts of acculturation, assimilation, and integration. Second, in contrast to the dominant discourse which reduces the experience of immigrant nurses to language and culture, this research concludes that it was not just about language and nor was it simply about culture. Third, rather than focus on the negative aspects of difference as in the immigration literature and in the practice of nursing, this research points to the importance of recognising the social value of difference. Finally, the prevailing view that the experience of immigrant nurses is largely negative belies its complexities. This research concludes that it is naïve to define the experience as either good or bad. Rather, ambivalence was the essential feature of the experience and a more appropriate theoretical concept. This research produced a theoretical understanding of the experience of China-educated nurses working in Australia. The findings may not only inform Chinese nurses who wish to immigrate but also contribute to the implementation of more effective support services for immigrant nurses in Australian health care organisations

The experience of China-educated nurses working in Australia: a symbolic interactionist perspective.

Transnational nurse migration is a growing phenomenon. This study explored the experiences of China-educated nurses working in Australia.Using a constructivist grounded theory method, 46 in-depth interviews were conducted with 28 China-educated nurses in two major cities in Australia.The core category emerged was "reconciling different realities". Three phases of reconciling were conceptualised: realising, struggling, and reflecting. Realising refers to an awareness of the discrepancies between different realities. Struggling reflects the dilemma of the "middle position" and how being situated as "the other" is experienced. Reflecting is the process of making sense of the experience and rationalising the gains and losses associated with immigration.This study produced a theoretical understanding of the experience of China-educated nurses working in Australia. The findings not only inform Chinese nurses who wish to migrate but contribute to the implementation of more effective support services for immigrant nurses

The overall experience of China-educated nurses working in Australia.

<p>The overall experience of China-educated nurses working in Australia.</p

Factors influencing the healthcare transition in Chinese adolescents with inflammatory bowel disease: a multi-perspective qualitative study

Abstract Background The development and implementation of the transition from pediatric to adult healthcare systems for adolescents with inflammatory bowel disease (IBD) should consider stakeholders’ perceptions. This study aimed to explore the factors influencing the transition of Chinese adolescents with IBD from the perspectives of patients, parents, and healthcare providers. Methods A descriptive qualitative research was conducted. Purposive sampling was used to recruit 36 participants, including 13 patients, 13 parents, and 10 providers, from a tertiary pediatric IBD center, a tertiary adult IBD center, and the China Crohn’s & Colitis Foundation in Zhejiang Province, China. Individual semi-structured interviews were used to collect data on facilitators and barriers to the transition process. Conventional content analysis was used to analyze the interview transcripts. Results Nine primary themes were identified. Patients with young age, prolonged disease duration, severe disease, academic pressures such as the Gaokao, low level of disease acceptance, limited transition consciousness, low self-efficacy, poor transition communication, and inadequate medical transition system serve as barriers. While patients with the mentality of guilt towards their parents; parents with low education levels and intensive work schedules, high levels of disease acceptance, and situations of parent-child separation; stakeholders with high transition consciousness, high transition self-efficacy, and effective transition communication act as facilitators. Furthermore, community support and hospital guide services were also contributing factors during the transition. Conclusions This study offers comprehensive insights into the factors affecting the transition of Chinese adolescent IBD patients. The process is continuously influenced by stakeholders, community, and healthcare environments and policies. Identifying these factors provides healthcare providers with a reference for developing and implementing targeted transition interventions

Analysis of laboratory repeat critical values at a large tertiary teaching hospital in China.

CONTEXT: As a patient safety measure, laboratories are required to have a critical values policy by regulatory agencies. Unfortunately, little information is available on repeat critical values for the same analyte(s) on the same patient. OBJECTIVE: To investigate the occurrence and distribution of repeat critical values and the relationship between the frequency of such values and patient outcome to provide information for hospitals on improving reporting policies. METHODS: Eleven laboratory critical value lists, including chemistry and hematology analytes, were selected from a tertiary hospital in China in the year 2010. The distribution and interval time for each repeat critical value were calculated. Serum potassium and platelet count were used as examples to illustrate the relationship between the frequency of the repeat critical values and patient outcome. RESULTS: All test items on the critical value list were prone to the occurrence of repeat critical values. On average, each patient who experienced critical values had 2.10 occurrences. The median interval time for each repeat critical value varied, with most being longer than 8 hours. For those patients who had repeat critical values of serum potassium and platelet count, along with the increased frequency, the patients had a longer hospital stay and a generally worse outcome. CONCLUSIONS: Patient can have a number of repeat critical values and the frequency of these values is closely related to patient outcome. A careful evaluation is warranted if a laboratory chooses to adopt a policy of not reporting each repeat critical value

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