PBL教学法在个案护理查房中的应用

目的为适应新的医疗护理模式,探索合适的护理查房形式,提高护理人员专科业务水平,提高临床护理查房质量。方法将以问题为中心（problem—basedl earning,PBL）教学法应用于护理查房中,查房后进行效果评价。结果以问题为中心的教学方法,规范了护理查房,拓宽了护理查房内涵,激发了护理人员的学习兴趣。结论个案护理查房中运用PBL,有利于提高护理人员分析和解决患者临床问题的能力,能提高护理查房的效果,可以在护理查房中应用。     

浅谈精神科护理查房的管理

现代护理事业的发展，引人注目的护理查房在临床中的应用，尤其是在精神科的应用，更有其特殊地位，通过查房可提高护士长业务管理水平，提高群体意识。总之，做好护理查房工作，为提高医疗质量提供了保障。     

全院性护理大查房在提升护理管理质量中的作用

目的探讨开展全院性护理大查房的方法,为临床解决实际问题,提高护理管理质量及效率。方法由医院护理部根据各临床科室的重点,开展全院护理大查房。结果帮助解决临床科室在护理管理中的难点问题,保障了全院护理管理的有序、平稳、安全、有效。结论开展全院性护理大查房,是提升护理管理质量的有效方法,使护理队伍的管理水平有显著提升。     

床边护理查房在临床护理中的应用

目的：为了适应现代护理模式的转变,探索更实用的护理查房形式。方法：于2008年1月开始,逐步采用床边护理查房的方式,并与传统护理查房相比较,采用整体护理查房质量评分标准进行评分。结果：床边护理查房明显优于传统护理查房（P〈0.001）。结论：床边护理查房,给临床护士锻炼的机会,提高了护士的主观能动性和临床思维能力,为解决临床实际问题起到很好的作用。     

移动医疗系统在临床护理查房中应用的研究

目的：探讨移动医疗系统应用于临床护理查房中的积极效果。方法将移动医疗系统应用于临床护理查房,采用问卷调查和抽查相结合的方式对移动医疗系统应用于临床护理查房的效果进行评价、数据分析及统计处理。结果经移动医疗系统ipad护理查房后患者对疾病认知度、患者满意度、医护配合程度、医生对护理工作满意度,护士对护理查房流程评价、护士工作量减轻、护士对疾病认知度、健康教育执行率较实施前均有显著提高。结论将移动医疗系统应用于护理查房中,患者满意度、疾病认知程度、医生对护士工作满意度、健康教育执行情况、护理查房质量、护理查房流程、疑难护理问题解决情况,医护配合程度均明显提高。差异有统计学意义（P<0.05）。     

以整体护理观指导临床护理查房的体会

护理查房是护理管理中评价护理程序实施效果和了解护士工作性质的一种最基本、最常用、最主妾的方法。根据护理查房的性质可分为临床业务性查房、教学指导性查房、常规评价性查房。我院护理部根据基层医院的具体情况选择了常规评价性查房。     

改进护理查房形式 加强护理质量管理

护理查房是护理管理最基本、最重要的活动之一，它能够解决护理工作中的难点、疑点问题，是提高护士业务能力，全面考核护士素质的重要途径。随着人民群众物质文化生活水平的不断提高，患者对护理服务的要求也越来越高。加之医学模式的转变，以往功能制的护理查房已经不能适应新的形势。近年来，本院在护理查房方面作了一些改进，收到良好效果，在一定程度上促进了护理质量的提高。     

整体护理查房的实践与体会

目的在新的护理模式下，为了检验整体护理的效果，实施了整体护理查房。方法从查房的目的、应遵循的原则、组织管理、方法和步骤等追行分析。结果提高了护理工作满意度；激发了护士学习的积极性；使护士能够根据患病的个体，有针对性地应用护理程序进行护理；是发现人才、培养护理骨干的有效途径；是科室护理人员继续教育的好方法。结论整体护理查房是检验整体护理效果的重要方法．宜大力推广。     

护理组长查房对低年资护士临床护理能力的影响

目的探讨在新生儿科实施常态化护理组长查房对低年资护士临床护理能力的影响。方法随机抽取实施护理组长查房前后的130例早产儿,其中对照组患儿未实施护理组长查房,观察组患儿实施常态化护理组长查房,主查低年资护士。分析护理组长查房的实施效果。结果实施护理组长查房后低年资护士的护理评估准确性评分,护理措施落实及时性评分,护理记录准确性评分,患儿家属对护士沟通指导满意度评分均显著高于实施前,差异有统计学意义(P<0.05)。结论实施常态化护理组长查房能提高低年资护士的临床护理能力,促进低年资护士的成长,提高护理质量,保障护理安全。     

PBL教学模式在产科教学查房中的应用

目的探讨以问题为基础的教学法（PBL）在产科临床护理教学查房中的应用及效果。方法将2011年6月至2012年6月在产科进行护理专业临床实习的学生80名,按照学校实习分组随机分为实验组和对照组,实验组采取PBL教学模式进行护理教学查房,而对照组采用传统的教学方法进行教学查房。通过对两组护生从临床综合能力、专科理论、操作能力及护理病历的书写等方面进行效果比较,以及两组护生对护理查房效果满意度进行评价,对比两种不同临床护理查房模式的效果。结果实验组学生对护理查房教学的满意度为92．51％,对照组的满意度为55．13％,差异有显著性（χ2=8．37,P〈0．05）;实验组护生的专科理论、临床综合技能均较对照组高,差异均有统计学意义（t值分别为5．37、7．21,P〈0．05）。结论应用PBL教学模式进行护理查房,有助于护生临床综合能力的提高,并促使临床教师进一步提升自身素质,值得在临床教学中推广。     

Structuring ward rounds for learning: can opportunities be created?

This paper explores the ways in which ward rounds can be conducted to maximize educational opportunities, as part of a project to improve the effectiveness of on-the-job training (OJT) for hospital doctors. Ninety ward rounds taken by 24 trainers in the Anglia region were observed. Each observation produced a note of the ward round's structure and routines and of the contributions made to it by trainers and trainees. Teaching was a feature of all ward rounds and different types of round were valued for different reasons. A range of ward round structures was observed and, within each, a range of routines for conducting the round. Ward round structures fell into four categories, with almost three-quarters of trainers making no use of either pre- or post-ward round meetings. Where such meetings took place, however, opportunities for OJT were created and, in some cases, optimized through routines to encourage trainee contributions. Discussion time away from patients structured into ward rounds enabled trainers and trainees to take advantage of many opportunities to learn from service. Although unplanned and unsystematic opportunities for OJT do arise, far more reliable are those created through systematic planning and preparation. Trainers have choices to make about how they conduct ward rounds and by choosing to make use of pre- and/or post-ward round sessions, valuable opportunities for OJT can be created.     

院感专职人员开展日常临床查房对提升院感管理质量的作用

目的 分析医院感染管理专职人员参与日常临床查房的实施流程和效果评价,及时发现和解决工作中存在的感染隐患问题,降低医院感染的发生.方法 2018年7月—2019年6月开展院感专职人员参与的日常临床查房,由院感专职人员于查房前收集被查科室近3日内的手术及危重患者、发热患者、带管患者等,设定查房的重点目标,对重点患者、重点环...     

护生主查式教学查房模式在心胸科的应用实践

目的探讨护生主查式教学查房模式对提高护理教学查房的效果。方法对2009年5月至2011年4月64名护理本科及大专实习护生实施护生主查式教学查房并进行问卷调查,了解护生对查房前准备、查房安排、查房效果的满意度。结果查房前准备护生满意度96.9%,查房安排护生满意度98.4%,查房效果护生满意度95.3%。结论护生主查式教学查房模式增强了护生查房的主动参与意识,提高了护生分析解决问题的能力,提高了查房的效果,值得在护理查房教学中应用。     

Why patients need leaders: introducing a ward safety checklist

The safety and consistency of the care given to hospital inpatients has recently become a particular political and public concern. The traditional 'ward round' presents an obvious opportunity for systematically and collectively ensuring that proper standards of care are being achieved for individual patients. This paper describes the design and implementation of a 'ward safety checklist' that defines a set of potential risk factors that should be checked on a daily basis, and offers multidisciplinary teams a number of prompts for sharing and clarifying information between themselves, and with the patient, during a round. The concept of the checklist and the desire to improve ward rounds were well received in many teams, but the barriers to adoption were informative about the current culture on many inpatient wards. Although the 'multidisciplinary ward round' is widely accepted as good practice, the medical and nursing staff in many teams are failing to coordinate their workloads well enough to make multidisciplinary rounds a working reality. 'Nursing' and 'medical' care on the ward have become 'de-coupled' and the potential consequences for patient safety and good communication are largely self-evident. This problem is further complicated by a medical culture which values the primacy of clinical autonomy and as a result can be resistant to perceived attempts to 'systematize' medical care through instruments such as checklists.     

应用护理行政查房以提高管理水平和护理质量

目的探析护理行政查房在提高管理水平和护理质量中的应用效果。方法选取160例本院住院患者,入选时间2018年4月-2019年5月,随机分为两组,对照组80例行常规护理管理,观察组80例行护理行政查房管理。对两组满意度、护士能力评分、护理质量、管理水平进行对比观察。结果观察组满意度97.50%、护士能力(86.53±4.15)分、健康教育(16.24±1.24)分、病房管理(75.42±3.25)分、护理技术操作(97.46±2.75)分、专科护理(95.82±5.86)分、基础护理(95.65±5.40)分、管理水平(41.64±3.15)分均高于对照组81.25%、(75.52±11.90)分、(13.89±1.29)分、(66.23±3.09)分、(91.32±3.03)分、(87.72±5.82)分、(84.37±5.02)分、(36.43±5.51)分,对比差异有统计学意义(P <0.05)。结论实施护理行政查房后,各科室人员自我素质有所提升,管理水平有所改善,服务认可度、护理质量有所提升。     

Evaluation of a new course to teach the principles and clinical applications of epidemiology to medical students

A new short course to teach clinical medical students the principles of epidemiology and their applications to clinical practice was introduced at St. Thomas's Hospital Medical School. During the first year one half of the students took the new course. All the students also received the previous epidemiological teaching which was performed on the wards in the context of individual patients with a particular disease. In the next year all students were given only the new course. One year after attending these courses, students completed a questionnaire designed to test how well the course objectives had been met. A comparison was made between those who had received the new course and those who had received only ward round teaching. Students exposed to both the ward rounds and the course were more satisfied with the latter and had a greater appreciation of the importance of epidemiology to clinical practice than students receiving only ward rounds. This improvement was maintained in the subsequent year when the ward rounds were dropped. Students who had the new course also performed relatively better than the others in the Community Medicine multiple choice questions in the Medicine Finals examination, and the marks improved in the subsequent year. This evaluation was also useful in identifying those aspects of the course that need further development.     

The effectiveness of ethanol gauze for hand disinfection in surgical wards

The effectiveness of ethanol gauze in removing transient bacteria on the hands was investigated in a surgical ward during clinical nursing rounds. Two nurses with similar duties were selected as subjects for each round; one disinfected her hands with ethanol gauze when moving between patients while the other immersed her hands in 0.05% aqueous chlorhexidine gluconate when aware of contaminating her hands. Hand samples were taken after preliminary disinfection before the round, and again after the round on 37 occasions. Pseudomonas aeruginosa and Staphylococcus aureus were not detected in nurses using ethanol gauze, except in one nurse where S. aureus was isolated from both the pre- and postround hand culture. Both organisms were detected on four occasions from the postround hand cultures in the chlorhexidine group. Acinetobacter anitratus was not removed by pre-round disinfection, and was found on five and 11 occasions from the postround hand cultures in the ethanol gauze and chlorhexidine groups, respectively.     

某院三级查房考核质量分析

目的了解三级查房中各级医师存在问题,提出改进策略。方法由7名具有高级职称的临床专家,按照统一评分标准进行观摩并打分,利用词云图分析存在问题。结果一级医师存在辅助检查解读不全面、疑难点报告不清晰、病历陈述缺项、查体手法不规范及查体前后未执行手卫生等问题;二级医师存在解答疑难问题不全面、临床思维讲解不透彻及查体纠正不到位等问题;三级医师存在对国内外最新知识进展讲解不全面及对查房内容点评不到位等问题。结论各级医师查房中都存在一定问题。医院管理者应针对不同级别医师提供个性化培训,促其努力提升医疗服务能力。同时,树立优秀科室榜样,充分发挥榜样带动作用。此外,还应充分利用人工智能技术辅助。     

“三科一室”联合业务查房的做法与体会

"三科一室"联合业务查房是将业务查房与医疗质量管理相结合的查房形式。由主管业务院长带队,医务科、质控科、护理部、临床药学室主要负责人参与,到临床科室现场查房,全面把握医疗质量管理情况,进一步规范了医疗行为,提高了医疗质量,保障了医疗安全。     

Validation of a checklist to assess ward round performance in internal medicine

BACKGROUND: Ward rounds are an essential responsibility for doctors in hospital settings. Tools for guiding and assessing trainees' performance of ward rounds are needed. A checklist was developed for that purpose for use with trainees in internal medicine. OBJECTIVE: To assess the content and construct validity of the task-specific checklist. METHODS: To determine content validity, a questionnaire was mailed to 295 internists. They were requested to give their opinion on the relevance of each item included on the checklist and to indicate the comprehensiveness of the checklist. To determine construct validity, an observer assessed 4 groups of doctors during performance of a complete ward round (n = 32). The nurse who accompanied the doctor on rounds made a global assessment of the performance. RESULTS: The response rate to the questionnaire was 80.7%. The respondents found that all 10 items on the checklist were relevant to ward round performance and that the item collection was comprehensive. Checklist mean-item scores differed between levels of expertise: junior house officers 1.4 (1.0-1.9); senior house officers 2.0 (1.5-2.9); specialist trainees 2.5 (1.8-2.8), and specialists 2.7 (2.3-3.5); median (range) (P < 0.001). A significant correlation was found between global observer scores and nurse scores (r = 0.56, P < 0.001). CONCLUSION: The checklist, developed for assessing trainees' performance of ward rounds in internal medicine, showed high content validity. Construct validity was supported by the higher scores of experienced doctors compared to those with less experience and the significant correlation between the observer's and nurses' global scores. The developed checklist should be valuable in guiding and assessing trainees on ward round performance.