士官护士卫勤保障救援综合能力调查

目的 探讨士官护士卫勤保障救援能力的培养方法.方法 采用个人访谈、问卷调查、素质测试等方法对10省（市）武警部队医院的162名士官护士分类调查.结果 士官护士卫勤保障救援能力薄弱.表现在37.50％的士官护士对现阶段承担的卫勤保障救援任务不明确,不了解具体工作,对保障救援任务自我认知程度不够;应急处置方面表示“知识欠缺”的102名占62.96％;现场救援的动手能力方面表示“知识欠缺”的79名占48.77％;急救知识和急救技能测试合格率偏低,急救技术理论成绩优秀率最低,仅为7.27％;军事体能素质下滑.结论 士官护士急救技术不过硬,缺乏对突发事件的应对能力,有必要采取多样化继续培训等方式提升士官护士卫勤保障救援综合能力.     

依托院前急救平台提高卫勤保障能力的实践

目的:探讨依托院前急救平台增强来自地方的卫生人员卫勤保障能力的可行性。方法:采用自行设计的卫勤保障知识认知调查表,对本院来自地方的卫生人员45例在轮转急诊科前后进行调查分析,并对轮转前后5大战地救护技术及急救仪器使用操作的考核情况进行比较。结果:卫生人员在急诊科轮转训练后对各类卫勤保障知识、5项急救技能及急救仪器使用操作得分均非常显著高于轮转前(P<0.01)。结论:急诊科轮转培训是提高卫生人员卫勤保障能力的有效途径。     

武警广西总队与广西壮族自治区卫生厅举行警地联合卫勤应急救援演练

本刊讯为加强总队卫勤应急保障力量建设,提高突发事件卫生应急处置水平和综合协调能力,4月2日,武警广西总队卫勤应急保障分队与广西壮族自治区各大医院应急救援队在总队后勤基地举行警地联合卫勤应急救援演练。广西总队副司令员钟全义、自治区卫生厅副厅长夏宁及卫生厅应急办有关领导出席活动。     

依托武警医院急救优势发展院前急救

 目的 建设具有武警特色的现代化院前急救系统,适应处置突发事件卫勤保障的需要.方法 对武警总医院院前急救系统进行改造:建立三级指挥机构,完善组织;增加三个要素的经费投入,改进装备;实行三个环节循环培训人才,改进技术;制定三级质量监控体系,完善制度.做到"组织、装备、技术、制度"四落实.结果 建成了具有快速反应能力、大量人才储备、能将院内急救直接延伸到院前急救的医疗服务体系,提出了应进一步加强呼救系统建设、急救知识普及方面的工作.结论 通过加强院前急救系统的医院管理,提高了武警总医院处理突发事件卫勤保障能力.     

形成多样化军事任务卫勤保障综合能力探讨

随着军事斗争准备进入实质性备战阶段,我们结合“如期就绪”要求,着眼战时,狠抓人才综合能力、装备保障能力、应急处置能力建设,全面提高了机动卫勤分队遂行多样化军事任务卫勤保障的综合能力.     

武警医院应急卫勤分队训练中存在的问题及对策

新形势下武警医院如何提高应急卫勤保障能力,一直是卫勤保障工作的一个难点。近年来,我们以总部要求为依据,着眼遂行紧急、突然、复杂情况下的应急保障任务;着眼从实战出发;着眼最大化抽组,围绕“拉得出、上得去、展得开、救得下”的总体目标,紧贴部队担负的任务特点及自身情况,通过实兵、实地、实装的综合应急卫勤分队训练,提高了应急卫勤保障能力,取得了满意的效果。     

练技能 砺硬功

为做好军事斗争准备、提高卫勤人员的野战保障水平，前不久，沈阳军区65571部队将医护人员及卫生装备拉到训练场．模拟实战进行了野战化训练。训练中他们根据高技术条件下局部战争的战伤特点设置各种险情、伤情，重点锤炼卫勤人员的战场救护、战术防护、战场机动和应急处置能力，有效地提高了卫勤人员的综合保障水平。     

武警山东总队医院应急卫勤保障掠影

武警山东总队医院应急卫勤保障分队自组建以来，始终以总部、总队关于加强卫勤保障力量建设意见为指导，以提高医院应急卫勤保障能力为目的，以实战需求为导向，创新管理理念，完善物资装备，加强机制建设，建立起“平战一体”的应急卫勤保障模式，医院平战时应急卫勤保障能力不断提高，多次圆满完成了特大灾难的抢险救灾及应急救援卫勤保障任务，受到了总部、总队及地方政府的一致好评。     

灾害应急救援卫勤评价初探

为了不断提高部队卫勤力量参加灾害应急救援的能力,确保灾害救援卫勤应急处置过程的科学性和处置结果的可靠性,必须对卫勤力量参与灾害救援的所有阶段和环节,对影响救援效果的所有因素进行科学的评价。应急救援评价包括卫勤评价和救援技术、装备的评价等,笔者重点探讨卫勤评价。     

突发公共事件对军队医院合同护士卫勤保障能力培训的启示

目前,各种突发公共事件日趋增多,严重危害人类生命和健康,破坏人类生存、生产和生活设施,影响社会经济发展,破坏社会稳定,危害生态环境,当今已引起世界各国政府和公众的高度重视。军队护理人员成为突发公共事件中医疗队重要的组成人员,随着军队编制体制的改革,合同护士已经成为军队医院护理队伍的重要组成部分,合同护士的应急能力关系着军队非战争军事行动卫勤保障能力。本文就此谈谈军队医院合同护士培训的一些启示,以切实提高我军护理人员的卫勤保障能力。     

二维码在创伤数据录入中的应用效果观察

目的研究二维码(quick response,QR)在创伤数据录入中的应用效果。方法30名护理人员前瞻性对2016年1月—2018年6月急诊科收治的创伤患者数据(包括患者基本信息、院前信息、急诊科、放射科/实验室检查、手术/ICU处置、咨询、出院信息、财务)分别进行手动录入(手动录入组,n=15)和二维扫码录入(扫码录入组,n=15),对比两组的录入时间、准确性以及系统可用性量表(SUS)评分。结果15例患者创伤数据:扫码录入组录入用时间(53.7±1.4)min显著少于手动录入组(75.0±1.8)min;25例患者创伤数据:录入时间,扫码录入组vs.手动录入组:(83.7±1.7)min vs.(106.4±10.7)min;30例患者创伤数据:录入时间,扫码录入组vs.手动录入组:(98.5±2.8)min vs.(128.1±2.8)min;差异均有统计学意义(P<0.05)。手动录入和扫码录入的准确率随录入人数的增加呈降低趋势,但两组录入的准确率差异无统计学意义。扫码录入组SUS评分(78.4±9.1)分,显著高于手动录入组(61.5±8.3)分(P=0.002<0.05)。结论通过二维码扫描可以完成创伤数据录入工作,并能提高创伤数据录入效率,且更容易被工作人员接受。     

The effect of an in-flight, emergency training program on crew confidence

INTRODUCTION: Despite some progress, the air medical transport profession continues to experience widely publicized accidents that result in injuries and death to crew members and patients. An air medical crew member's experience, training and confidence may affect his or her ability to deal effectively with an in-flight emergency, and may also affect his or her behavior before and after the emergency. SETTING: A hospital-based, rural rotor- and fixed-wing program flying approximately 890 flights per year. Seventy-seven percent of these flights are interfacility. METHODS: A pretraining survey evaluated the experiences of air medical crew members and pilots. A 20-question assessment tool based on a 5-point Likert scale evaluated how confident the individuals were in their ability to react to in-flight emergencies. An extensive in-flight emergency training program was then conducted. Personnel were asked to complete the same questionnaire one month and six months after the training. RESULTS: On the pretraining questionnaire, flight crew members with neither prior training nor actual experience in in-flight emergencies showed the lowest level of confidence. Those with prior training, actual in-flight emergency experience or both, responded with higher levels of confidence. The mean confidence scores of the study participants increased from 82 pretraining to 89 at one month post-training and remained at the increased level six months after training. CONCLUSIONS: A training program focusing on in-flight, aircraft-related emergencies can increase the crew's confidence during such situations. This increase in confidence is most noticeable in those without previous training or experience and is maintained for at least six months. Several other benefits occur from the training program.     

N1级护士规范化培训方法和效果

 目的 探讨N1级护士在职规范化培训的方法和效果。方法 将2011-2014年使用《N1级护士培训考核手册》、接受在职规范化培训的护士设为研究组,将2007-2010年采取原传统带教考核方式培训的护士设为对照组,对两组技术操作、理论考核,综合素质测评及护理岗位胜任情况等进行比较。结果 护士技术操作、理论考核及综合素质测评年度平均成绩,研究组分别为(93.43±4.11)分、(92.19±4.26)分、(93.26±3.67)分,对照组分别为(91.06±5.82)分、(87.03±7.48)分、(84.12±8.02)分,研究组各项得分均高于对照组,差异有统计学意义(P均＜0.05)。N1级护士护理岗位平均胜任时间,研究组为(109.6±30.1)d,对照组为(175.0±29.6)d,前者比后者明显缩短,差异有统计学意义(P＜0.05)。研究组护士对培训认可率达到100%,对照组护士对培训认可率为84.4%,两组比较,差异有统计学意义(P＜0.05)。结论 通过对N1级护士早期有计划、有目标、有针对性的规范化培训,能够明显提高其基本素质和执业能力,有利于新毕业护士尽快适应临床岗位,促进其专业成长。     

Use of High-fidelity simulation training for radiology healthcare professionals in the management of acute medical emergencies

Objectives:Life-threatening emergencies are relatively uncommon in the radiology department, but when encountered, require timely intervention. With an increasing number of critically unwell patients visiting the radiology department each year for both diagnostic and interventional procedures, it is vital that radiology staff are trained to provide basic resuscitation before further assistance arrives. Simulation training is a well-validated, effective method for rehearsing low-frequency, high-acuity events in a supportive and safe environment. The aim of our study was to investigate whether the introduction of a focussed, multidisciplinary simulation course would improve healthcare professional’s knowledge and confidence when managing common medical emergencies; including cardiac arrest, anaphylaxis and airway obstruction.Methods:A multidisciplinary group of radiology staff attended a dedicated simulation teaching course. Participants completed a pre- and post-test questionnaire which assessed a range of knowledge domains and their perceived confidence with dealing with the clinical scenarios. The delegates were then asked to repeat this questionnaire 6 months after taking part in the course to assess their retention of skills and knowledge.Results:Knowledge scores increased by a mean difference of 4 points (p < 0.001). The mean pre- and post-course perceived confidence scores were 4.4/10 and 8/10, respectively.Advances in knowledge:This study suggests that embedding simulation training into the radiology curriculum improves healthcare professional’s knowledge and perceived confidence when dealing with common medical emergencies. Although previous studies have looked at the use of simulation training for radiology trainees in the management of selected medical emergencies, to the authors’ knowledge, this is the first study to demonstrate these benefits across a range of clinical scenarios, within an interprofessional environment.     

醒脑开窍法结合康复训练对脑卒中偏瘫康复疗效的观察

 目的 探讨醒脑开窍法配合康复训练对脑卒中偏瘫患者肢体运动功能康复效果.方法 将126例脑卒中偏瘫患者随机分为观察组和对照组各63例.观察组采用醒脑开窍法配合康复训练进行康复治疗,对照组单纯进行醒脑开窍法治疗,以Fugl-Meger评分法,Barthel指数进行治疗前后的功能评价.结果 观察组在肢体运动功能,日常生活能力(ADL)方面治疗后有明显改善,与对照组相比差异有非常显著意义(P＜0.01).结论 醒脑开窍法配合康复训练更有助于脑卒中患者尽快恢复功能.     

Radiation disaster response: preparation and simulation experience at an academic medical center

OBJECTIVES: A mass casualty disaster drill involving the simulated explosion of a radiation dispersal device (dirty bomb) was performed with the participation of multiple hospitals, emergency responders, and governmental agencies. The exercise was designed to stress trauma service capacities, communications, safety, and logistic functions. We report our experience and critique of the planning, training, and execution of the exercise, with special attention to the integrated response of the Departments of Nuclear Medicine, Health Physics, and Emergency Medicine. METHODS: The Health Physics Department presented multiple training sessions to the Emergency Medicine Department, Operating Room, and ancillary staff; reviewing basics of radiation biology and risk, protection standards, and detection of radiocontamination. Competency-based simulations using Geiger-Müller detectors and sealed sources were performed. Two nuclear medicine technologists played an important role in radiation discrimination-that is, assessment of radioactive contamination with survey meters and radionuclide identification based on gamma-spectroscopy of wipe smears from patients' clothing, skin, and orifices. Three Health Physics personnel and one senior Nuclear Medicine staff member were designated the radiation control officers for assigned teams triaging or treating patients. Patients were triaged and, when indicated, decontaminated. RESULTS: Within a 2-h period, 21 simulated victims arrived at our institution's Emergency Room. Of these, 11 were randomized as noncontaminated, with 10 as contaminated. Decontamination procedures were implemented in a hazardous materials (HAZMAT) decontamination trailer and, for the 5 patients with simulated serious injuries, in a designated trauma room. A full debriefing took place at the conclusion of the exercise. Staff largely complied with appropriate radiation protection protocols, although decontamination areas were not effectively controlled. The encountered limitations included significant lapses in communications and logistics, lack of coordination in the flow of patients through the HAZMAT trailer, insufficient staff to treat acute patients in a radiation control area, additional personnel needed for transport, and insufficient radiation safety personnel to control each decontamination room. CONCLUSION: Nuclear Medicine personnel are particularly well qualified to assist Health Physics and Emergency Medicine personnel in the preparation for, and management of, mass casualty radiation emergencies. Simulation exercises, though resource intensive, are essential to an institution's determination of response capability, performance, and coordination with outside agencies.     

一站式复合手术的护理管理

回顾性分析“一站式”复合手术室的护理管理,并进行经验总结.“一站式”复合手术室成功实施管理重点,在于复合手术室设置、术中护理配合及专业护理人才培养,旨在构建灵活的护理人力资源弹性配备机制及专业护理人员“小轮转”的人才培养新模式.“一站式”复合手术是治疗复杂疾病的微创方法,科学的护理管理是“一站式”复合手术成功的有力保障.     

Joint service training for medical readiness

Medical Readiness Training is of major importance in preparing to meet the challenge of medical care during wartime and national emergencies or disasters. As an alternative to simulated casualty training, the U.S. Public Health Service and the U.S. Army joined forces to provide "real world" medical care for troops during training. Although simulated training provides insight into casualty and trauma medicine, it is felt that many aspects of real medical care are often ignored or taken for granted. Providing medical care under austere field conditions provides a realistic environment and presents situations that can not be evaluated by simulated training.     

Annual training medical support for a Reserve Separate Infantry Brigade (Mechanized).

The authors have combined their experience of recent changes in the Health Service Support of a separate mechanized infantry brigade during 10-day field training exercises conducted by the same population, in the same geographical area, and in the same season in 4 consecutive years. The development of Health Service Support and the reasons necessitating its evolution are discussed. The impact of MedForce activities on training effectiveness is highlighted. The intensive use of health care providers in the most forward field medical treatment facilities, to include the nursing pool from the training support reserve hospital and Army Medical Department augmentation pool doctors, can alleviate unit medical staff shortfalls and provide exceptional training for unit medics "in house." The deployment of medical assets far forward and the maximization of "in situ" treatment of casualties prevents significant loss of training time and can prevent loss of life in combat. The authors recommend changing the medical care doctrine of Vietnam, from the life-threatening "scoop and run" doctrine to the life-preserving "doc in the box" doctrine presented in this article.     

基层医院手术室医护协调性配合访视分析

目的了解手术医生对手术护理服务满意度,制定有效的改进措施,提高手术护理服务的质量和水平。方法选择本院2007年10月至2009年12月间手术室医护协调性配合的手术医生56人为访视对象,有效问卷3640份。结果手术医生对手术护士服务态度、责任心方面满意度较高（〉90%）;对基础护理、护理管理方面满意度高低不均衡（81.35%～90.08%和70.38%～93.93%）;对应急处理、新业务新技术领悟力等专科技术方面满意度较低（〈80%）。结论应提高基层医院手术护士的基础护理质量,强化危机意识和学习紧迫感,更新思想观念、完善知识结构,加强专科知识和技能培训,优化手术护理服务工作流程;注重手术室医护协调性配合访视,充分利用访视信息,不断改进手术护理服务质量。