护士对出院患者实施电话随访的体会

目的总结护士对出院患者护理电话随访(简称电话随访)的经验体会。方法对出院患者进行电话随访,并随机抽取100例进行问卷调查分析。结果患者依从性、对护士角色的认知及满意度较高。结论护理电话随访有利于提高患者的依从性和满意度、提升护士角色的认同,值得推广。     

电话随访住院患者满意度分析

目的 通过电话随访调查住院患者满意度,以提升医院医疗、护理服务水平.方法 对出院44 067例患者进行电话随访,调查对医师治疗、治疗结果、病房管理、责任护士的责任心及服务态度、护士的主动服务意识、医疗收费和医德医风7个方面的满意度.结果 59岁及以下的患者在医师治疗和病房管理方面满意度高于≥60岁患者,组间比较差异具有统计学意义(P＜0.01或P＜0.05);≤30岁患者在护士的主动服务意识和医疗收费方面,满意度较其他两组低,差异具有统计学意义(P＜0.05).公费医疗患者在医师治疗、护士的主动服务意识方面满意度最高,在病房管理方面满意度最低,差异具有统计学意义(P＜0.05);北京地区医疗保险患者在护士的主动服务意识方面满意度最低,差异具有统计学意义(P＜0.05).结论 电话随访能了解临床实际状况、不同年龄和不同费用类别住院患者满意度,协调医患关系,更好地提高服务质量和患者满意度.     

复方柴胡酊外用治疗小儿外感高热106例临床护理

通过对100例骨折患者实施出院随访，有利于改善护患关系，提高护理工作质量、患者的依从性和满意度，提升患者对护士角色的认同，避免或减少后遗症和并发症的发生。     

眼外伤致伤因素的分析及护理随访研究

目的:通过对新时期眼科医院眼外伤致伤因素的分析及护理随访研究,探讨护理随访工作的重要性、方法以及新理念。方法:分析眼外伤的致伤因素,根据眼外伤的特点,通过对我院开展护理随访工作和十二年的回顾、总结及其提炼,对随访工作产生了一些新的认识和适应新时期的新理念。结果:被调查100%的眼外伤患者认为护理随访中护士的角色功能很重要;100例患者不同程度的遵从了出院时以及护理随访时的健康指导,占总数的98%;100%的患者满意护理随访的形式和内容。结论:护理随访工作具有保护眼睛健康的重要性,是获取得医学信息反馈的最主要方法,是医学科研的重要组成部分,是医院管理的一个重要内容;对医院开展医疗、教学、科研、创收都有十分重要作用。我们要用这些新理念、新方法,更好地为广大眼外伤患者服务,提高眼科医院的知名度、品牌度,对生命负责,对社会回报,从而更加"追求卓越,创造健康,保护眼睛,恢复光明"。     

骨折100例出院随访体会

通过对100例骨折患者实施出院随访,有利于改善护患关系,提高护理工作质量、患者的依从性和满意度,提升患者对护士角色的认同,避免或减少后遗症和并发症的发生。     

导航护理模式在胃癌患者连续性全程管理中的初步探讨与实践

目的：介绍“导航护士”角色在胃癌患者连续性全程管理中的建立与应用,并评估应用效果。方法：以患者需求为导向,针对胃癌患者就医过程中诊疗不连续的主要环节,界定胃癌专病导航护士的角色功能和岗位职责,建立癌症患者连续性全程管理模式,并从患者满意度、医护人员认可度、围术期并发症等方面评估该管理模式的应用效果。结果：本研究建立了胃癌专病导航护士介导的 “门诊-住院-出院”全程管理模式,该模式下,患者治疗依从性明显提高,患者对各类指导满意度明显提高,术后呼吸系统并发症发生率明显降低；医护人员对导航护士具有较高的认可度。结论：导航护士角色的引入和应用推动了胃癌全程管理模式的建立与发展,提高了患者满意度及治疗依从性,未来应进一步推动导航护理工作模式的应用与创新。     

临床护理路径在慢性鼻窦炎患者中的应用

选择2011-2012年在本科接受治疗的慢性鼻窦炎患者112例,将患者随机分为两组,观察组用传统途径护理方式,对照组按制定的临床护理路径进行护理,从患者的住院天数、对护理的满意度、对医疗护理的依从性等方面进行分析对比。结果对照组患者的住院天数明显少于观察组;对照组在护理的满意度、医疗护理的依从性都高于观察组（P〈0.05）。使用临床护理路径对慢性鼻窦炎患者进行护理,不但提高了患者对医疗护理的依从性及对护士的满意度,而且可明显提高护理的质量。     

专科护士电话回访在功能性鼻内镜鼻窦手术后恢复中的应用

目的探讨专科护士电话回访在功能性鼻内镜鼻窦手术患者恢复中的作用。方法将本院收治的100例功能性鼻内镜鼻窦手术患者随机分为观察组与对照组各50例,对照组患者在出院1个月内由医院随访处护士实施常规随访,观察组患者在出院6个月内由指定专科护士进行电话回访。6个月后,比较两组患者治疗效果、遵医行为、随访依从性及对医院随访满意度等情况。结果两组患者在治疗效果、遵医行为、随访依从性、满意度等方面比较,均P<0.05,差异具有统计学意义,观察组优于对照组。结论 对功能性鼻内镜鼻窦手术后患者实施专科护士电话回访,能增强患者遵医行为,提高患者随访依从性,从而提高治愈率。     

电话随访出院患者满意度8597人次调查分析

目的:通过电话随访调查分析出院患者对医疗护理服务的满意度。方法:由专职人员对出院患者进行电话随访,征求患者住院期间对医疗护理服务的意见及建议,将患者的有效随访信息进行汇总分析。结果:电话随访8 597人次,收集各方面意见385件;影响患者满意度的首要因素为服务态度问题,第二位为护士技能操作及疗效和医护服务的及时性。结论:服务态度是影响医院满意度的主要因素,过硬的技术和高度的服务效率是患者对医护人员的期望,与患者多沟通建立良好医患关系是提高满意度的有力措施。     

患者满意度的影响因素与对策探讨

总结了患者满意度的影响因素及医疗行业患者满意度现状，影响因素主要包括医院条件、患者的期望、护士的服务水平等，满意度现状主要包括过重的医疗负担影响患者满意度、护士提供的服务达不到患者的预期、医院尚未建立健全的患者满意度评价体系，认为加强护士的服务意识培训、规范并落实护理质量标准、不断增加方便患者的措施能提高患者满意度。     

Children's views of nursing and medical roles: implications for advanced nursing practice

AIM: Changes in healthcare delivery make it increasingly likely that children accessing ambulatory care will receive their health assessment and management from nurses rather than junior doctors. As part of a larger study exploring the safety and efficacy of nurse-led pre-operative assessment (Rushforth et al 2006) this study aimed to discover children's views of nursing and medical roles. METHOD: Data were collected from 63 children using drawing and writing activity sheets during preadmission events. FINDINGS: Findings suggest that there is a clear demarcation in children's minds between doctors and nurses. In addition to the gender differences, children saw 'caring' as a nursing role and 'curing' as a medical role. However, there has been some change since earlier studies with only three children noting that nurses 'helped doctors' or 'did what doctors tell them' and less than a quarter of the children drawing nurses with hats. CONCLUSION: As with all other patients, children should be fully informed of the status of the practitioner undertaking their care; understanding how they perceive the roles of doctors and nurses will support this information giving.     

医护人员基础护理认知现状的调查分析

目的了解医生、护士基础护理认知现状。方法选取某医院301名医生和502名护士进行基础护理知识、态度的问卷调查。结果护士基础护理知识的掌握优于医生(P0.05),医生基础护理态度优于护士(P0.05);医护人员基础护理知识回答正确率均较低的内容为压疮护理、协助病人穿衣顺序、吸氧浓度、基础护理与生活护理的关系;医生在基础护理定位方面的态度优于护士(P0.05),医护人员在基础护理服务对象和服务提供者方面具有相似的态度(P0.05)。结论医护人员均需加强基础护理知识的学习、应用,理清基础护理与生活护理的关系,在基础护理定位方面仍需统一思想、提高认识。     

Newly qualified doctors’ perceptions of informal learning from nurses: implications for interprofessional education and practice

Abstract

Newly qualified doctors spend much of their time with nurses, but little research has considered informal learning during that formative contact. This article reports findings from a multiple case study that explored what newly qualified doctors felt they learned from nurses in the workplace. Analysis of interviews conducted with UK doctors in their first year of practice identified four overarching themes: attitudes towards working with nurses, learning about roles, professional hierarchies and learning skills. Informal learning was found to contribute to the newly qualified doctors’ knowledge of their own and others’ roles. A dynamic hierarchy was identified: one in which a “pragmatic hierarchy” recognising nurses’ expertise was superseded by a “normative structural hierarchy” that reinforced the notion of medical dominance. Alongside the implicit learning of roles, nurses contributed to the explicit learning of skills and captured doctors’ errors, with implications for patient safety. The findings are discussed in relation to professional socialisation. Issues of power between the professions are also considered. It is concluded that increasing both medical and nursing professions’ awareness of informal workplace learning may improve the efficiency of education in restricted working hours. A culture in which informal learning is embedded may also have benefits for patient safety.     

妇科医护人员对择期手术病人术前禁食禁饮认知状况的调查研究

[目的]了解妇科医护人员对择期手术病人术前禁食禁饮的认知状况。[方法]采用问卷法对妇科37名医护人员进行调查分析。[结果]妇科医护人员对择期手术病人术前禁食禁饮的认知存在差异及不合理性。[结论]医护人员应及时更新禁食禁饮新观念,灵活运用术前禁食禁饮原则,给予择期手术病人术前恰当的饮食指导,增加围手术期的安全性。     

A practical guide to venepuncture and management of complications.

For years many nurses have felt that if they had the ability to perform skills such as venepuncture they would be able to provide a more holistic and efficient service. The culture in which nurses and doctors have traditionally worked has often made it difficult for nurses to become competent at such skills. However, the boundaries of medical and nursing roles have started to change and a culture of shared roles is emerging which has many benefits for patients, medical staff and nursing staff. This article provides a practical guide to venepuncture. It highlights the structure of a vein and the veins that are suitable for venepuncture. It also addresses the prevention and management of potential complications.     

Decision-making for acutely ill nursing home residents: nurses in the middle

Title.  Decision-making for acutely ill nursing home residents: nurses in the middle.
Aim.  This paper is a report of a study to generate a model of nursing behaviours and social processes inherent in decision-making for acutely ill nursing home residents.
Background.  Most research concerning clinical decision-making in nursing homes focuses on the perspectives of doctors. Much less is known about the perspectives and actions of nurses with regard to decision-making, despite the centrality of their roles in nursing homes.
Method.  Grounded theory was used. Data were collected in 2004 in four nursing homes in the United States of America using in-depth, semi-structured interviews, 74 hours of non-participant observation and informal conversational interviews with key nursing staff involved in decision-making.
Findings.  Nurses strive to create a plan of care acceptable to family members and doctors, consistent with wishes of residents and most comfortable for residents. A unifying theme of satisfying all sides emerged as representative of the negotiation strategies used by nurses to address these competing points of view. Four phases in this negotiation occurred: weighing the significance ; notifying the family ; feeling it out ; and playing the middleman . The outcome was either a decision for life-prolongation or for palliative care.
Conclusion.  Decisions for nursing home residents are complex and involve weighing and balancing the interests and preferences of many concerned participants, including residents, families and doctors. This process requires skill in clinical judgment, communication and collaboration.     

干部门诊老年病人焦虑状况的相关性研究

[目的]了解干部门诊老年病人的焦虑状况及其影响因素。[方法]采用Zung焦虑自评量表,对门诊971例老年病人进行问卷调查,分析不同性别、年龄、文化程度、对医护服务满意度及疾病了解程度对病人焦虑水平的影响。[结果]干部门诊就诊的老年病人的焦虑水平高于常模(P<0.05),不同性别、年龄、文化程度、对医护服务满意程度及对疾病了解程度明显影响病人焦虑水平。[结论]干部门诊就诊的老年病人焦虑水平高于正常人,女性、年龄偏大、文化程度越高、对服务满意度越差、对疾病的知识了解越少,焦虑症状越重。     

护士决策分级护理工作流程的研究

[目的]制订护士决策分级护理的工作流程。[方法]应用Delphi法对19名护理专家和15名医疗专家进行护士决策分级护理工作流程的2轮专家咨询。[结果]护士决策分级护理分为准备、评估、决策、调整4个步骤;决策护士通过判断病人病情严重程度及生活自理能力,依据分级标准独立做出级别诊断,并下达在分级护理护嘱单上;某些特定情况护士无法决策护理级别时,与医生进行病情讨论后共同决议。[结论]制订并规范护士决策分级护理的工作流程,体现工作步骤关系并提供操作标准,使护理工作处于最佳运行状态,以提高护理质量。     

医护患对优质护理服务工作评价的调查研究

目的:了解医、护、患三者对优质护理服务工作的评价情况。方法:采用自行设计的调查问卷进行调查,了解优质护理服务试点病房的医生、护士、患者对优质护理服务相关问题的看法与评价及影响优质护理服务深入开展的因素。结果:医、护、患三者对优质护理服务的整体评价较高,对优质护理服务相关问题的看法表现在关于无陪管理、由护士承担基础生活护理等方面有所不同,对影响优质护理服务深入开展的因素评价大体一致,其中,护士认知不够,护理人力不足被认为是主要影响因素,但在收费与护士付出不符条目上,医生、护士、患者评价有统计学差异(P<0.01)。结论:优质护理服务得到绝大部分医、护、患三者的认同与肯定,但要进一步推进优质护理服务的深入开展,更好地落实优质护理服务,需要各级医疗卫生管理部门及相关部门高度关注各种影响与阻碍优质护理服务发展的因素,并采取相应的干预措施。