探索中国老年护理之路

为探索适合我国国情的老年护理的模式,应对我国人口老龄化,发展老年护理事业,应用电子数据库方法查阅了PubMed、CINAHL、维谱和万方等数据库参考文献20余篇,探讨了美国老年护理状态,分析了4种主要的以社区为基础、护士为主导的老年护理模式,探索了其在中国应用的途径和前景。认为应对老龄化应发挥护士的作用,改革护理课程设置,同时完善养老保障系统,从而更好地解决中国老龄化这一严峻的社会问题。     

探索中国老年护理之路

为探索适合我国国情的老年护理的模式,应对我国人口老龄化,发展老年护理事业,应用电子数据库方法查阅了PubMed、CINAHL、维谱和万方等数据库参考文献20余篇,探讨了美国老年护理状态,分析了4种主要的以社区为基础、护士为主导的老年护理模式,探索了其在中国应用的途径和前景.认为应对老龄化应发挥护士的作用,改革护理课程设置,同时完善养老保障系统,从而更好地解决中国老龄化这一严峻的社会问题.     

国外老年护理工作对我国老年护理发展的启示

为探索适合我国老年护理的发展模式,应对我国人口快速老龄化的趋势,发展老年护理事业,笔者在查阅了PubMed、维普和万方等中外数据库参考文献30余篇基础上,分析了日本、美国、挪威老年护理社会化进程、发展轨迹,为探索我国老年护理工作发展的途径和前景提供一些参考和借鉴,现综述如下。     

人口老龄化使中国老年护理面临巨大挑战

目的分析人口老龄化的趋势和中国传统的养老方式以及现存的应对老龄化的服务系统。方法应用电子数据库查阅PubMed，CINAHL，维谱和万方等数据库。结果阐述并分析了我国正在弱化的3种养老方式：家庭支持系统被“4-2-1”型家庭结构和“空巢家庭”的存在所破坏；自我照顾方式由于慢性病的高发和经济条件而受到限制；社会支持系统也因为不充足的老年照护设施和不完备的养老保险系统等而不能满足老年护理的社会需要。结论中国面临亟待应对的老年护理的挑战。     

人口老龄化使中国老年护理面临巨大挑战

目的分析人口老龄化的趋势和中国传统的养老方式以及现存的应对老龄化的服务系统。方法应用电子数据库查阅PubMed,CINAHL,维谱和万方等数据库。结果阐述并分析了我国正在弱化的3种养老方式:家庭支持系统被“4-2-1”型家庭结构和“空巢家庭”的存在所破坏;自我照顾方式由于慢性病的高发和经济条件而受到限制;社会支持系统也因为不充足的老年照护设施和不完备的养老保险系统等而不能满足老年护理的社会需要。结论中国面临亟待应对的老年护理的挑战。     

人口老龄化使中国老年护理面临巨大挑战

目的 分析人口老龄化的趋势和中国传统的养老方式以及现存的应对老龄化的服务系统.方法 应用电子数据库查阅PubMed,CINAHL,维谱和万方等数据库.结果 阐述并分析了我国正在弱化的3种养老方式:家庭支持系统被“4-2-1“型家庭结构和“空巢家庭“的存在所破坏;自我照顾方式由于慢性病的高发和经济条件而受到限制;社会支持系统也因为不充足的老年照护设施和不完备的养老保险系统等而不能满足老年护理的社会需要.结论 中国面临亟待应对的老年护理的挑战.     

我国养老服务需求现状及其长期护理服务策略

人口快速老龄化已成为我国重大的社会问题。分析了我国人口老龄化规模大、发展速度快、程度高、超前于经济发展的特点,以及由此带来的长期护理服务需求及问题,包括缺乏长期护理的保障机制、长期护理服务能力不足、社区功能尚不健全。为应对日益严重的老龄化发展趋势,提出了老年长期护理服务的对策,如建立长期护理保障机制、探索适合国情的长期护理服务模式、提高长期护理专业机构的服务能力。     

我国人口老龄化现状与高级护理人才的培养

通过对我国人口老龄化的成因、特点、护理需求及老年护理教育现状进行分析,提出目前我国的老年护理教育要满足老龄化人口的健康需求,改变现行的护理教育模式,以培养高级老年护理人才,积极应对人口老龄化所带来的问题。     

日本老年护理的发展

日本在经历其他国家未曾体验过的速度经历了人口老龄化后，在政府的支持下，老年护理得到了迅速发展。我国也步入老龄化，也在面临迎接中国人口老龄化带给护理界的挑战，借鉴日本的老年护理模式促进中国老年护理的发展。现就日本老年护理的发展介绍如下。日本老年护理模式的转变以第二次世界大战作为分水岭。第二次世界大战前，以家庭为单位进行各项生产活动的日本人过着三世同堂、     

我国人口老龄化现状与高级护理人才的培养

通过对我国人口老龄化的成因、特点、护理需求及老年护理教育现状进行分析,提出目前我国的老年护理教育要满足老龄化人口的健康需求,改变现行的护理教育模式,以培养高级老年护理人才,积极应对人口老龄化所带来的问题.     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

Structure and content in Norwegian nursing care documentation.

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two-fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

提升护理服务综合价值的研究

目的:研究护理综合价值的提升。方法:分析护理价值研究背景,阐述护理价值研究进展结果:提出护理价值研究途径。结论:有利于达成一种共识,使广大护理人员认识护理价值、研究护理价值、开发护理价值,重视护理综合价值研究和提升。 护理服务价值是护理服务劳动产品的价值和服务本身所创造的价值的总和,即使用价值与价值的统一。目前日本、美国、德国和中国都在加强护理价值研究的探索,但仍存在使用价值与价值研究分离问题。因此,我们应不断加强护理综合价值研究,以适应卫生事业改革对护理管理的挑战。本研究主要在分析国内外护理价值研究的基础上,提出综合护理价值研究途径,以达到合理评价护理价值的目的。     

Towards an aesthetics of nursing

Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader approach to aesthetics and proposes a way in which a theoretical approach to nursing aesthetics could be developed. The paper concludes that nursing is a fit object of aesthetic appreciation and that aesthetic quality is a necessary attribute of good nursing practice.     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

我国护理行业的改革与发展

从我国护理行业的现状、卫生体制改革以及基本国情出发 ,着重探讨护理管理、护理教育、护理环境、护理经济与管理体系、护理立法等方面的发展途径     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

Innovations in United States genetics nursing: Practice and research

Aim: Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics‐related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods: The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics‐related health services, research, education, and public policy. Results: Genetics nurses in the US have developed innovative responses to genetics‐related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health‐care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics‐related research; and (vi) participation in high‐level genetics advisory groups. Conclusions: The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses’ organization known as the International Society of Nurses in Genetics (ISONG) has provided this base.     

晨间护理缺陷分析及对策

目的提高晨间护理质量。方法通过向住院病人和护士发放问卷调查及每周不定期检查各病区晨间护理质量,了解晨间护理工作中存在的缺陷,提出整改的措施。结果晨间护理工作中存在的主要缺陷:51.8%的病人认为护士与病人的沟通少,进病房时未向病人问好,整理病房时未向病人解释,口腔清洁率70.3%,头发清洁率45.3%,皮肤清洁率69.5%,病房安静整洁率67.3%,床单位整洁率86.5%,病情关注情况67.9%,健康教育执行情况48.6%,协助生活不能自理的病人进食、入厕、更衣、床上排便等占75.4%,时间安排满意度75.6%,护士认为晨间护理重要的占30%,晨间护理内容知晓率占60.9%,认为工作量大来不及做的占56.7%。结论提高护士对晨间护理的认识,规范晨间护理内容和程序,加强与病人的沟通,提供符合个体化需要的晨间护理,合理安排护理人员、工作重点和时间,持续质量改进,有助于提高晨间护理质量。