持续质量改进(CQI)在小儿静脉留置针穿刺护理管理中的应用

研究分析持续质量改进(CQI)在小儿静脉留置针穿刺护理管理中的应用。选用自2014年1月至2015年12月来我院诊治的小儿患者400例为研究对照,按照护理方式不同分为对照组和研究组,各200例。对照组采用常规护理,研究组采用持续质量改进(CQI)护理,对比两组患者静脉留置针穿刺成功率、家长和护士满意度以及并发症发生状况。进行持续质量改进(CQI)后研究组的家长满意度及护士满意度明显高于对照组,差异有统计学意义(P0.05),持续质量改进护理管理在小儿静脉留置针穿刺中可以提高穿刺成功率以及家长和护士对护理结果满意度,并发症较低,效果显著。     

静脉穿刺成败因素的探讨

静脉穿刺贯穿于整个护理活动中,也是基础护理操作的重要内容.穿刺的成败常成为患者评价护理质量及影响护患关系的重要因素.通过在实习期间不断实践静脉穿刺,小组讨论,与临床护士交流,查阅文献等方式,总结影响静脉穿刺成败的因素,主要有护士因素、患者因素以及环境因素,其中护士因素为主要因素.护理人员应积极掌握这些因素,提高穿刺技术,减轻患者痛苦,保证能及时、准确地用药及治疗,达到关爱患者,共享生命健康.     

减轻静脉穿刺疼痛的临床研究进展

<正>静脉穿刺是护士常用的基础护理技术操作,穿刺成功与无痛是患者和护士关注的焦点。而患者常常惧怕穿刺疼痛不能很好地配合治疗,这为及时采取正常治疗方式设置了障碍,并成为护患纠纷的潜在因素。因此,减轻周围静脉穿刺的疼痛,并使操作更趋于完善、规范,一直是护理同仁研究和探讨的问题。现将减轻静脉穿刺疼痛的研究进展综述如下。     

护理实践教学中护生静脉穿刺失败原因分析及对策

静脉穿刺常用于输液(血)、静脉注射、静脉抽血,是护士必备的基本功,因此它是基础护理实验教学的重点内容,静脉穿刺成功与否直接影响到患者的诊治,有时危及到患者的生命。为提高在校护生静脉穿刺成功率,从而改进实践教学方法,帮助护生实现真人模拟穿刺成功,增强护生自信心,为其将来从事临床护理工作打下坚实的基础。     

静脉输液无痛技术的探讨

静脉输液是临床治疗、抢救用药最常用的基础护理操作技术之一，穿刺的成功与否、有无疼痛是患者和护士共同关注的焦点。在临床实践中，我们改进了传统的静脉输液操作方法，减轻了患者的疼痛，提高了穿刺成功率。     

患者接受实习护生静脉穿刺操作的原因分析

目的:探讨患者愿意接受实习护生静脉穿刺操作的原因,以提高实习护生带教的针对性。方法:自制调查表对225名接受实习护生首次静脉穿刺的患者及87名接受实习护生二次静脉穿刺的患者进行调查,并分析调查结果。结果:患者愿意接受实习护生静脉穿刺的前三位的原因是护患沟通好、护士的基础护理好、带教老师的认可。当首次穿刺失败后患者愿意接受实习护生二次静脉穿刺的前三位的原因主要有,护士真诚的道歉及沟通、带教老师的沟通、愿意给护生第二次机会。结论:提高实习护生的沟通能力、重视基础护理操作及增加带教老师对护生的认可度是提高患者对实习护生静脉穿刺接受率的重要因素。     

两种不同握拳方法对末梢静脉充盈的影响

静脉输液是临床治疗的重要手段之一,静脉穿刺是护士必须掌握的一项基础护理操作,手背浅静脉穿刺是静脉输液最常见的部位.传统的输液方法是选好静脉、扎好止血带,嘱患者握拳使静脉充盈,消毒局部皮肤,然后进行穿刺[1].我们通过在临床实践中观察比较发现,在嘱患者握拳时握拳的松紧度及方法对静脉充盈的影响较大,正确的握拳方法可以使静脉迅速充盈,提高穿刺成功率,减轻患者痛苦,现报道如下.     

双止血带结扎法对静脉充盈不良患者手背静脉输液效果的研究

目的 探讨双止血带结扎法对静脉充盈不良患者手背静脉穿刺输液静脉穿刺成功率及减少护士劳力的影响.方法 将200例静脉血管充盈不良住院患者静脉输液采用单、双止血带结扎法进行对比研究,采用查随机数字表方法 分为实验组和对照组,实验组采用双止血带结扎法,对照组采用传统的单止血带结扎法.结果 实验组静脉穿刺成功率明显高于对照组(P<0.05)并减轻了护士的劳力.结论 双止血带结扎法对静脉血管充盈不良患者穿刺输液能明显提高静脉穿刺成功率、减少护士的劳力及提高护理工作的效率.     

细节护理在儿科静脉穿刺中的应用

目的:探讨细节护理在儿科静脉穿刺中的应用效果。方法:将683例儿科住院患儿,按照治疗先后随机分为对照组和试验组。对照组给予常规护理,实验组实施细节护理,并对两组患儿输液结束后情况(静脉穿刺成功率、护理差错率及患者满意度等)进行比较分析。结果:试验组实施细节护理后,提高了护士静脉穿刺成功率和患者满意度,护理差错率明显降低,与对照组比较,差异有统计学意义(P<0.05)。结论:细节护理在儿科静脉穿刺中应用价值较高,可以提升患者满意度和护理质量,值得在临床中进一步推广与使用。     

两种手背静脉穿刺的临床应用

静脉输液是临床护理工作中不可缺少的一项护理操作，手背静脉是患者最容易接受也是护士静脉输液最常采用的穿刺部位之一。手背静脉具有暴露部位最少，活动限制最小等优点。为了减少患者痛苦，提高护士静脉穿刺的成功率，我们对60例患者进行了400次静脉输液，对采用两种静脉穿刺方法进行比较分析，现将结果报告如下。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.