同伴教育在产科新护士规范化培训中的应用

[目的]探讨同伴教育在产科新护士规范化培训中的应用效果。[方法]将2012年4月—2012年9月进入产科的新护士15人设为对照组,将2013年4月—2013年9月进入产科的新护士15人设为观察组,对照组采用传统的培训方法进行培训,观察组在传统的培训基础上采用同伴教育法进行培训,比较两组护士在知识、技能、综合能力方面的得分。[结果]观察组护士的知识、技能、综合能力均高于对照组,差异有统计学意义(P <0.05)。[结论]同伴教育培训有助于提高产科新护士规范化培训的效果。     

综合培训在塞拉利昂埃博拉出血热护理人员穿脱防护装具中的应用

目的探讨综合培训在塞拉利昂中塞友好医院埃博拉出血热护理人员穿脱防护装具中的应用效果。方法便利抽样法选取2014年9月中塞友好医院塞拉利昂籍(以下简称塞方)护理人员47名为研究对象,采用综合培训的方法对其进行穿脱防护装具的培训。受训者先接受1周的实践培训;第2周的培训内容根据前1周的培训效果设定,将容易出错且对防护效果至关重要的步骤加强培训。2周培训结束后,以穿脱防护装具过程中关键步骤的不合格率对培训效果进行评价。结果培训前塞方护士在穿脱防护装具的关键步骤中的不合格率均较高,培训后关键步骤的不合格率明显下降,差异有统计学意义(P0.05)。结论塞方护士传染病防护知识掌握水平和技能水平均非常差,综合培训可取得较好的效果,值得推广。     

同伴教育在急诊科护士规范化培训中的应用

目的：探讨同伴教育在急诊科新护士规范化培训中的应用效果。方法：将2010年9月至2011年3月进入急诊科的新护士28人设为对照组,2011年9月至2012年3月进人急诊科的新护士31人设为实验组,对照组接受传统培训方法,实验组在传统培训的基础上接受同伴教育干预。比较两组护士在知识、技能、奖惩以及综合能力等方面的得分。结果：实验组护士的知识、技能、综合能力的得分和受表彰的例数均高于对照组,投诉发生率较对照组低,差异有统计学意义（P〈0．05）。结论：同伴教育有助于提高新护士规范化培训的效果。     

同伴教育在心内科实习护生规范化培训中的应用

[目的]探讨同伴教育在心内科实习护生规范化培训中的应用效果。[方法]将2013年7月—2013年10月进入心内科实习护生107人设为对照组,2013年11月—2014年2月进入心内科的实习护生105人设为试验组。对照组接受传统培训方法,试验组在传统培训的基础上接受同伴教育干预,比较两组护生理论和操作成绩。[结果]试验组护生的理论、技能操作的成绩均高于对照组,差异有统计学意义(P0.05)。[结论]同伴教育有助于提高心内科实习护生规范化培训的效果。     

基于行动研究的任务驱动教学方法在心肺复苏技能培训中的应用

目的探讨基于行动研究的任务驱动教学方法在心肺复苏(cardiopulmonary resuscitation,CPR)技能培训中的应用效果。方法将2011年本院新招收的80名护士设为对照组,采用传统的培训方法;2012年新招收的80名护士设为实验组,采用基于行动研究的任务驱动教学方法。比较两组护士CPR理论和操作考核成绩及教学效果的差异。结果实验组护士CPR理论和操作考核成绩及对教学方法满意率均高于对照组(P0.05)。结论基于行动研究的任务驱动教学方法,不但可提高护士CPR理论和操作考核成绩,同时也提高了教学效果,是行之有效的培训方法。     

构思-设计-实现-运作教学模式在眼科手术室临床带教中的应用

目的探讨在眼科手术室实习护士临床带教中运用构思-设计-实现-运作(CDIO)教学模式的效果。方法2019年1月至2019年9月选取该院眼科实习护士69名,随机分为对照组(34例)和观察组(35例),对照组采用传统教学,观察组采用CDIO教学模式,课程结束后比较两组自主学习能力、培训效果和护生对教学方法的满意率。结果观察组在护生技能操作及理论考试等方面的成绩均比对照组高,差异有统计学意义(P<0.05)。观察组护生学习合作能力、自主学习能力、自我管理、学习动机及信息素质等方面的评分均高于对照组,差异有统计学意义(P<0.05)。观察组护生对教学形式、教学技能、教学态度、课堂气氛、师生交流、见习安排等方面满意率高于对照组,差异有统计学意义(P<0.05)。结论CDIO教学模式可提高眼科手术室实习护士自主学习能力,从而提高护生培训效果及其对教学的满意率,对提升眼科临床教学成效有着较佳的促进效果。     

双主体互动教学模式在低年资护士培训中的应用

目的 探讨双主体互动教学模式在低年资护士培训中的效果。方法 选取2012年1月—2014年12月从事临床护理工作且工作时间≤3年的210名护士设为对照组;2015年1月—2017年12月工作时间≤3年的213名护士设为观察组,对照组采用传统带教方法进行培训,观察组采用双主体互动教学模式,比较2组护士理论考核及技能操作考核成绩、自主学习能力、评判性思维能力。结果 观察组理论和技能操作成绩均高于对照组(t=17.733,P＜0.001;t=11.650,P＜0.001)、自主学习能力和评判性思维能力均优于对照组(P＜0.001)。结论 双主体互动教学模式在低年资护士培训中具有良好的效果,能提高低年资护士的学习兴趣,提高培训效果,促进低年资护士综合能力的提高。     

阶梯式层级教学模式对新执业护士专业知识及岗位胜任力的影响

[目的]探讨阶梯式层级教学模式对新执业护士专业知识及岗位胜任力的影响。[方法]将2016年新入职的30名护士设为对照组,采取常规性岗前培训;将2017年新入职的32名护士设为观察组,采用阶梯式层级教学模式进行岗前培训,比较两组护士培训效果及岗位胜任能力。[结果]观察组护士基础理论、专科理论、基础操作、床边实践得分高于对照组(P0.05)。观察组新执业护士理论知识、健康教育能力、护理观察能力、专业技术水平、应急能力、规避纠纷能力、医院感染防护能力评分高于对照组(P0.05)。[结论]阶梯式层级教学模式能有效提高新执业护士专业知识及岗位胜任能力,确保护理安全。     

医护患共同参与情景模拟教学在护理应急预案演练中的应用

目的探讨医护患共同参与情景模拟教学在护理应急预案演练中的应用效果。方法 2014年9月至2016年9月,选取某院内科系统工作的、需进行护理应急预案演练培训的N0、N1级护士189名为研究对象。按随机数字表法将其分为观察组、对照组。观察组采用医-护-患共同参与的情景模拟教学培训,对照组采用由培训护士扮演医、护、患三种角色的情景模拟教学进行培训,培训期为1个月。培训结束后对两组护士进行理论考试、操作考核及培训方法满意度调查,以评价培训效果。结果培训后,观察组、对照组理论考试分别为(91.5±5.5)、(80.5±4.5)分;操作考核分别(93.5±3.5)分、(85.5±3.5)分;对培训方法的满意率分别为91.1%、52.3%,差异均有统计学意义(均P0.05)。结论医护患共同参与的情景模拟教学较培训护士扮演医护患三种角色的情景模拟教学培训效果更好,护士对该培训方法的满意度更高,值得推广。     

跨学科综合教程结合微信群反馈在呼吸内科护理教学中的运用

目的探讨评价跨学科综合教程结合微信群反馈在呼吸内科护理教学中的运用效果。方法2015年9月-2016年6月选取该院46名护士接受呼吸内科的护理教学培训,采用常规方法教学,设为对照组。2016年9月-2017年6月选取46名护士接受呼吸内科的护理教学培训,采用跨学科综合教程结合微信群反馈教学,设为实验组。对比两组实习成绩以及护生对实习的评价。结果实验组出科测试合计评分、日常考评、总分分别为(66.0±8.9)分、(18.5±1.3)分、(84.5±9.4)分高于实验组(61.4±9.3)分、(16.8±1.4)分、(78.2±8.4)分,差异均有统计学意义(均P<0.05)。实验组实习护士对教学内容、师生互动满意度均优于对照组,差异有统计学意义(P<0.05),实验组教学质量、教学模式、教师能力与对照组差异无统计学意义。结论在呼吸内科护理教学中的运用跨学科综合教程结合微信群反馈,可以提升教学的质量。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.