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The Effectiveness of Student-Led Ward Round Training on Knowledge Acquisition, Critical Thinking Ability, and Self-Confidence of Acute Upper Gastrointestinal Bleeding for Nursing Students
Liu N, Zheng Z, Liao J, Li J, Yang Z, Lai X
Advances in medical education and practice. 2023;14:21-30
Abstract
INTRODUCTION Nursing knowledge, critical thinking ability, and self-perceived confidence are imperative to nursing skills in professional nursing practice. Therefore, nurse educators are required to use teaching strategies that will help promote their knowledge, critical thinking, and self-confidence in complex contents such as the nursing of acute upper gastrointestinal bleeding (AUGIB). PURPOSE This study compares the effect of student-led and instructor-led ward-round training methods on knowledge acquisition, critical thinking ability, and self-perceived confidence during AUGIB sessions. METHODS Forty nursing students in the first year of the Emergency Nursing Residency Program were randomly divided into a student-led ward round training group (SG) and an instructor-led ward round training group (IG) with a ratio of 1:1. A knowledge quiz, critical thinking ability test, and self-perceived confidence questionnaire were performed before and after the ward round training to assess both groups of students for their knowledge acquisition, critical thinking ability, and self-perceived confidence improvement. Feedback questionnaires were conducted after the training to evaluate students' perspectives and interests concerning the teaching module. RESULTS The scores of the post-training quiz were significantly higher than that of the pre-training quiz in both the SG (44.10±2.92 vs 31.10±4.27, p<0.001) and IG (32.35±2.21 vs 30.55±2.24, p=0.01). In the post-training quiz, scores achieved by the students from the SG (44.10±2.92) were significantly higher than those achieved by the students from the IG (32.35±2.21, p< 0.001). The level of self-perceived confidence improved significantly after ward round training in the SG (p< 0.001). However, there was no statistically significant difference in the IG with respect to the change from pre- to post-training (p=0.43).The students' critical thinking ability improved significantly in the SG (14.95±2.58 vs 7.10±1.79, p<0.001), while no significant improvement was found in the IG (7.91±2.28 vs 6.52±2.21, p=0.07) after ward round training. CONCLUSION The teaching method of SWRT improves nursing students' knowledge acquisition, critical thinking ability, and self-perceived confidence in AUGIB.
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The impact of ABO blood group on COVID-19 infection risk and mortality: A systematic review and meta-analysis
Liu N, Zhang T, Ma L, Zhang H, Wang H, Wei W, Pei H, Li H
Blood Reviews. 2020;:100785
Abstract
The 2019 coronavirus disease (COVID-19) has become a global pandemic. Several studies report that ABO blood group polymorphism may be related to COVID-19 susceptibility and clinical outcomes; however, the results are controversial. We conducted a systematic review and meta-analysis to investigate whether ABO blood groups are associated with increased COVID-19 morbidity and mortality. A total of 715 articles were retrieved from seven databases. Ten articles were selected for meta-analysis after removal of duplicates and two levels of screenings. Overall, individuals with blood group A [odds ratio (OR) = 1.33, 95% confidence interval (CI) 1.14 to 1.56] and B (OR = 1.06, 95% CI 1.00 to 1.13) had a substantially higher risk of COVID-19, whereas this was not the case for blood group AB (OR = 1.07, 95% CI 0.88 to 1.30). Individuals with blood group O was not prone to develop the disease (OR = 0.71, 95% CI 0.60 to 0.84). Moreover, the risk of COVID-19 was significantly associated with the Rh-positive blood group (OR = 1.22, 95% CI 0.99 to 1.50). A meta-analysis of 5 studies suggested that blood group A was associated with a significantly increased risk of COVID-19 mortality (OR = 1.25, 95% CI 1.02 to 1.52). Mild publication bias was found in the included studies. This systematic review and meta-analysis indicated that blood groups A and B may be risk factors for COVID-19, whereas the blood group O appears to be protective. Blood group A may be related to unfavourable outcomes. Further rigorous and high-quality research evidence is needed to confirm this association.
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Island Sign Predicts Hematoma Expansion and Poor Outcome After Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis
Wei Y, Zhu G, Gao Y, Chang J, Zhang H, Liu N, Tian C, Jiang P, Gao Y
Front Neurol. 2020;11:429
Abstract
Background: Early hematoma expansion (HE) occurs in patients with intracerebral hemorrhage (ICH) within the first few hours from ICH onset. Hematoma expansion has been considered as an independent predictor of poor clinical outcome and mortality after ICH. Island sign (IS) on the non-contrast computed tomography (NCCT) appears to increase the rate of detection of HE. However, there is insufficient evidence to declare that IS is an independent predictor for ICH patients prognosis and classification. Objectives: To investigate whether IS on NCCT could predict HE and functional outcome following ICH. Methods: Major databases were systematically searched, including PubMed, EMBASE, Cochrane library, and the Chinese database (CNKI, VIP, and Wanfang databases). Studies about the associations between IS and HE or IS and clinical outcome were included. The pooled result used the odds ratio (OR) with a 95% confidence interval (CI) as effect size. Heterogeneity and publication bias were assessed. Subgroup analysis and meta-regression were applied to detect potential factors of heterogeneity. Results: Eleven studies with 4,310 patients were included in the final analysis. The average incidence rate of IS and HE were 21.58 and 33%, respectively. The ideal timing for assessing HE was also not uniform or standardized. We separately performed two meta-analyses. First, 10 studies were included to estimate the association between IS and HE. The pooled OR was statistically significant (OR = 7.61, 95% CI = 3.10-18.67, P < 0.001). Second, four studies were included in the meta-analysis, and the pooled result showed that IS had a significantly positive relationship with poor outcome (OR = 3.83, 95% CI = 2.51-5.85, P < 0.001). Conclusions: This meta-analysis showed that NCCT IS is of great importance and value for evaluation of HE and poor outcome in patients with ICH. Future studies should focus on developing consensus guidelines, and more studies with large sample size and longitudinal design are needed to validate the conclusions.
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[Clinical effect of double filtration plasmapheresis combined with glucocorticoid and immunosuppressant in treatment of children with severe Henoch-Schonlein purpura nephritis]
Liu N, Ma ZZ, Yan HF, Li Q, Lyu XQ, Kang WL, Yin ZR
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics. 2019;21(10):955-959
Abstract
OBJECTIVE To study the clinical effect and safety of double filtration plasmapheresis (DFPP) combined with double pulse therapy with methylprednisolone (MP) and cyclophosphamide (CTX) in the treatment of children with severe Henoch-Schonlein purpura nephritis (HSPN). METHODS A total of 60 children with severe HSPN who were admitted to the hospital from January 2014 to March 2018 were enrolled and were randomly divided into an observation group and a control group (n=30 each). In addition to routine treatment, the children in the control group were given MP+CTX pulse therapy. Those in the observation group were given DFPP treatment in addition to the treatment in the control group, with three courses of treatment in total. After three courses of treatment, the two groups were compared in terms of 24-hour urinary protein, urinary microproteins, renal function parameters, adverse reactions, and clinical outcome. RESULTS After three courses of treatment, the observation group had significantly greater reductions in 24-hour urinary protein, urinary albumin, urinary immunoglobulin G, urinary beta2-microglobulin, serum creatinine, and blood urea nitrogen than the control group (P<0.05). After the treatment ended, the observation group had a significantly shorter time to achieve remission than the control group (P<0.05). No serious adverse reactions, such as hemorrhagic cystitis, thrombocytopenia, and hemolysis, were observed, and there was no significant difference in the overall incidence rate of adverse reactions between the two groups (P>0.05). CONCLUSIONS Compared with MP+CTX pulse therapy alone in the treatment of severe HSPN in children, DFPP combined with MP+CTX pulse therapy can further alleviate renal injury and improve clinical outcome and does not increase the incidence rate of adverse reactions.
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Tranexamic acid is beneficial for reducing perioperative blood loss in transurethral resection of the prostate
Meng QQ, Pan N, Xiong JY, Liu N
Experimental and therapeutic medicine. 2019;17(1):943-947
Abstract
The aim of this randomized controlled trial was to evaluate the effect of tranexamic acid (TXA) on postoperative blood loss during transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). A total of 60 patients with BPH and undergoing TURP were randomized into TXA and control groups. Patients were intravenously administered 1 g TXA or placebo (0.9% sodium chloride solution), respectively, after the induction of anesthesia for TURP. Intraoperative and postoperative bladder irrigation volumes and blood loss volumes were compared between the two groups. Coagulation function (measured by prothrombin, activated partial thromboplastin and thrombin time and fibrinogen levels) was measured before the operation and at 4 h post-operation. Complications from thromboembolic events, such as lower-limb and pulmonary embolisms, were also noted. The TXA group had significantly decreased blood loss intraoperatively and at 4 h postoperatively compared with the control group (P<0.05). The 24 h postoperative blood loss and coagulation function of the two groups were not significantly different. No thromboembolic events or other complications occurred in either group. In conclusion, a preoperative single dose of TXA was indicated to reduce perioperative blood loss in TURP without a notable increase in thrombosis risk.