品管圈在规范ICU床边护理交接班中的应用效果评价

目的：探讨品管圈活动在规范重症加强护理病房(ICU)床边护理交接班方面应用的效果。方法成立品管圈，确定主题，对主题展开原因分析，针对原因拟定对策并实施。观察分析品管圈活动前后床边护理交接班存在的问题。结果品管圈活动开展前后床边护理交接班存在问题发生率比较，差异有统计学意义(P<0.01)。结论开展品管圈活动有利于护理管理者发现问题所在，群策群力，解决关键问题，提高床边护理交接班质量。     

规范床边交接班制度的实施与效果

规范床边交接班制度,首先,转变观念,提高床边交接班重要性的认识,并分析旧的床边交接班模式的不足,在此基础上制定新的床边交接班的形式、程序、规范标准,并组织落实。规范床边交接班制度后,护士工作的主动性提高,工作重点突出;护理措施落实到位,杜绝和减少护理缺陷;突出专科护理质量,促进专科的发展,并满足了患者的知情权,提高患者的满意度。     

护理交接单在ICU护理交接班中的应用效果观察

目的 观察护理交接单在ICU护理交接班中的应用效果.方法 设计护理交接单并应用到ICU护理交接班中,进行患者病情掌握率的考核,实地护理质量检查,对比实施护理交接单前后病情掌握评分和护理质量评分.结果 实施后护士对患者病情掌握评分和护理质量评分均高于实施前,差异均有统计学意义（P＜0.05）.结论 护理交接单的应用,使ICU有了统一规范的交接班,提高了交接班的效果,减少了护理缺陷.     

品管圈在减少ICU护士交接班相关不良事件发生率中的应用

目的 探讨品管圈活动在减少ICU护士交接班相关不良事件发生率中的应用效果.方法 成立品管圈,确立“减少ICU护士交接班相关不良事件发生率”为主题,通过现状把握、原因分析、目标设定、制定对策、组织实施、效果确认与标准化等程序,开展品管圈活动,比较活动前后护士交接班相关不良事件发生率.结果 开展品管圈活动后,护士交接班相关不良事件发生率由10.6％降至3.5％,目标达成率为103％,进步率为67％,不同原因引起的交接班相关不良事件发生率比较差异有统计学意义(P＜0.05).结论 开展品管圈活动能够有效减少ICU护士交接班相关不良事件发生率,提高护理质量,确保护理安全.     

护士长晨会交接班点评在儿科病房的应用

目的 探讨护士长晨会交接班点评在儿科病房的应用效果.方法 在儿科病房,每天护士晨会交班后,由护士长进行点评,点评交班护士的质量,并对护士进行提问.结果 护士长晨会交接班点评应用后,护理交接班质量、护士对患儿病情的掌握及医生对护理工作满意度评分均有显著提高（P＜ 0.05）.结论 在儿科病房,护士长晨会交接班点评的应用,可以提高护理交接班质量和护士对患儿病情的掌握,提高了护士的专科护理水平和医生对护理工作满意度.     

探讨规范床头交接班对护理质量的影响

目的了解规范床头交接班对护理质量的影响。方法每天晨会后,下午下班前,护士长带领全科当班护士一起进行床头交接班,并规范床头交接班时护士的仪表、语言、行为、交接班内容等项目,使交接班不流于形式。将规范床头交接班前后的护理质量进行综合评价。结果采取护士长带领全体当班护士规范床头交接班后的护理质量全面提高。结论规范床头交接班是一种行之有效的护理质量管理方法。     

ABC患者评估流程在ICU床旁交接班中的应用

交接班是日夜班工作的衔接,交接班质量的好坏,直接影响当天的医疗护理质量和医疗护理安全。本文通过对ICU中653例规范交接班流程患者应用ABC患者评估流程,在接班过程中的患者评估环节取得良好效果,防止护理并发症,提高护理工作质量,保证了ICU护理工作的安全性、连续性和准确性。     

规范床边交接班流程的护理体会

目的探讨规范护理交接班在提高护理工作质量的价值和意义,以帮助临床护士掌握护理程序和工作方法,贯彻＂以人为本＂的护理理念,全面提高护士的整体素质。方法对护理交接班的现状作出分析,探讨新的交接班流程和管理对策。强化交接班制度,具体规范交接班流程。结果实施规范化交接班流程后,护理质量和患者满意度明显提高,护士责任心加强。结论规范化交接班流程的实施,提高临床护理质量和患者满意度,促进整体护理的发展,树立良好的护士职业形象。     

层级护理管理模式在ICU护理管理中的应用

目的分析层级护理管理模式在ICU护理管理中应用效果,保证了ICU护理质量。方法使用层级护理管理,将ICU护士按照N0 N1、N2、N3、四个层级进行划分,实施层级护理管理模式,完善了管理制度,明确了工作职责和工作内容。利用护士评分平台以及互评《ICU护理床边交接班质量考核表》和《ICU护理质控检查评分结果汇总表》,对实施层级护理管理模式后的评价结果与之前进行对比。结果通过使用层级护理管理模式前后数据对比分析,护理质量比为实施前有了大幅度提高,实施后,护理质量逐年提高,夜班护理抽查抽检的不达标率由原来的两位数降到了2%,降低效果显著。结论分析层级护理管理模式在ICU护理管理中应用,提高了护理质量,直接提高了护理的亲情性和安全性。     

护理交接单结合医护一体化在心脏术后晨间交接班中的应用

探讨护理交接单结合医护一体化在心脏术后晨间交接班中的应用及其实施效果。选取心脏术后患者99例,将其分为两组, 2013年10月至2015年1月未实施医护一体化的46例为对照组,应用传统口头晨间交接班;2015年2月至2017年1月实施医护一体化的53例为观察组,应用护理交接单结合医护一体化进行晨间交接班。比较两组每日晨间交接班时间、医生下达医嘱时间、护理质量、出院患者满意度、护士满意度。观察组与对照组交接班时间无显著性差异（P＞0.05）,但观察组医生下达医嘱时间缩短了7.21 min（P＜0.01）,护理质量、出院患者满意度、护士满意度均显著提高（P＜0.05或P＜0.01）。护理交接单结合医护一体化可规范交接班内容,提高医护工作效率,明显提高护理质量和护士、患者满意度,值得临床推广应用。     

Shift of pH-absorption curves

The conditions for deviations of thepH-absorption curve from the course predicted by the simplepH partition theory are investigated theoretically. The deviations are an elevation of the asymptotic section usually approaching zero and/or a shift of the intermediate section, more exactly of the inflection point, in the direction of the abscissa and/ or the ordinate. In the absence of a specialpH at the surface of the barrier (microclimatepH), the elevation of the asymptotic section can be attributed to a permeability of the barrier to the ionized form of the permeating substance. A shift of the inflection point to the right for acids and to the left for bases can be explained by a significant unstirred layer at the surface of the barrier or-only when the concentration in the well- stirred bulk phase is decreasing with time-by a high distribution ratio of the substance between barrier and bulk phase. A variable microclimatepH influenced by bulk phasepH can also produce the described deviations.     

Paradigm Shift in Toxicity Testing and Modeling

The limitations of traditional toxicity testing characterized by high-cost animal models with low-throughput readouts, inconsistent responses, ethical issues, and extrapolability to humans call for alternative strategies for chemical risk assessment. A new strategy using in vitro human cell-based assays has been designed to identify key toxicity pathways and molecular mechanisms leading to the prediction of an in vivo response. The emergence of quantitative high-throughput screening (qHTS) technology has proved to be an efficient way to decompose complex toxicological end points to specific pathways of targeted organs. In addition, qHTS has made a significant impact on computational toxicology in two aspects. First, the ease of mechanism of action identification brought about by in vitro assays has enhanced the simplicity and effectiveness of machine learning, and second, the high-throughput nature and high reproducibility of qHTS have greatly improved the data quality and increased the quantity of training datasets available for predictive model construction. In this review, the benefits of qHTS routinely used in the US Tox21 program will be highlighted. Quantitative structure-activity relationships models built on traditional in vivo data and new qHTS data will be compared and analyzed. In conjunction with the transition from the pilot phase to the production phase of the Tox21 program, more qHTS data will be made available that will enrich the data pool for predictive toxicology. It is perceivable that new in silico toxicity models based on high-quality qHTS data will achieve unprecedented reliability and robustness, thus becoming a valuable tool for risk assessment and drug discovery.     

Anomalous Particle Size Shift During Post-milling Storage

Purpose To investigate the anomalous phenomenon of particle size shift during post-milling storage. Materials and Methods Crystallised and ball-milled adipic acid were stored under different humidity conditions. Analyses were carried out to characterise changes in particle size distribution (laser diffraction), morphology (SEM), bulk flow properties (annular shear tester), surface adhesion forces (AFM) and crystallinity (PXRD and DVS). Results It was observed that the particle size distribution of milled adipic acid can shift to finer fractions, remain unchanged, or even shift to coarser fractions depending on storage conditions. SEM analysis showed that milled adipic acid is composed of agglomerates, which can undergo de-aggregation or further agglomeration via re-crystallisation. Empirical analysis ruled out the effects of electrostatic charges on the particle size shift. In addition, an improvement in powder flow in terms of bulk tensile strength was seen for milled adipic acid stored under high relative humidity but not under low humidity. Conclusions Storage of milled adipic acid below the critical relative humidity led to localised disintegration from the agglomerate surface and particle size reduction, which was not influenced by moisture sorption or loss. This evidence supports that “stress relaxation” mechanism behind particle breakage of post-milled particles. Appropriate storage conditions are important in maintaining the stability of milled powders.     

工作强度计算法在优化门诊调剂工作排班中的应用

目的:探索并推广一种适合门诊药房调剂工作的排班方法。方法:对传统的固定排班方法进行调研,利用图表形式直观反映出调剂人员工作强度的波动,针对传统方法排班的弊端,采用数学换算后调整排班。结果:排班调整后,调剂人员工作强度波动明显减小,工时有明显降低。结论:采用工作强度计算法能合理调配及利用现有的人力资源。     

Addiction: The Urgent Need for a Paradigm Shift

Severe addictions to drug use and to countless other habits are causing enormous harm around the globe. Massive expenditures and dedicated efforts of police, doctors, addiction therapists, and self-help groups have failed to bring the problem under control, although many individual addicts have been helped. What can society do when our best efforts continue to fail and a menacing problem continues to grow? This paper proposes that a major paradigm shift is required. The currently dominant paradigm assumes that addiction is either an individual disease or an individual moral breach. But this individually oriented paradigm has failed. Instead, addiction needs to be understood socially, as a way that large numbers of people adapt to the breakdown of psychologically sustaining culture under the global influence of free-market society. This new paradigm is based on the social thinking of Karl Polanyi and other social scientists rather than on the individual thinking of neuroscientists, doctors, or psychologists.     

均值漂移在背景像素模态检测中的应用

自适应背景更新是视频序列运动分割中的重要步骤,而背景像素分布的不规律性是对背景进行更新的困难所在.本文首先对背景像素值分布的模态性特点进行描述,然后提出采用均值漂移(Mean Shift)方法检测背景像素的模态数量,从而为背景建模提供依据,可以针对不同模态数量的背景像素采用不同的建模方法.这种基于背景像素模态分类的方法能够实现背景更新在精度和速度上的折中.     

高危型HPV在宫颈癌前哨淋巴结微转移中的研究

目的通过检测早期宫颈癌患者前哨淋巴结中的高危型HPV16/18的表达,探讨高危型HPV16/18与早期宫颈癌前哨淋巴结微转移的相关性及其临床意义。方法选择Ia2-Πa期宫颈癌患者42例;所有的患者均行广泛性子宫切除加双侧盆腔淋巴结清扫术;采用放射性核素联合亚甲蓝方法识别宫颈癌患者前哨淋巴结;应用聚合酶链反应(polymerase chain re-action,PCR)方法,检测早期宫颈癌患者前哨淋巴结中HPV16/18DNA的表达,计数资料采用χ2检验。结果 42例宫颈癌患者共检出82枚前哨淋巴结。用常规病理组织学方法检测有11枚前哨淋巴结有癌转移,阳性率为13.4%(11/82);经PCR法检测有26枚HPV16/18表达阳性,阳性率为31.7%(26/82)。病理阳性淋巴结经PCR法检测HPV16/18的表达均阳性。病理组织学证实无癌转移的71枚前哨淋巴结,经PCR方法检测有15枚HPV16/18表达阳性,阳性率为21.3%(15/71)。结论与传统的病理组织学比较,采用PCR法检测宫颈癌前哨淋巴结中HPV16/18的表达能显著提高微转移的检出率。HPV可作为检测宫颈癌微转移的特异性标志物。