高等护理教育实验教学存在的问题及对策

随着社会的发展,对高等护理教育人才培养模式提出了更高的要求,护理专业是一门应用性强的学科,理论与实践结合紧密,实验教学是学生掌握专业技能的重要环节,因此,专业技能培养可直接检验高等护理教育人才培养目标实现的程度以及护理理论与实践结合的差距。目前中国高等护理教育实验教学还存在着很多问题,制约着对学生综合素质的培养,因此,进一步深化护理实验教学改革势在必行。     

新时期高等护理教育实验教学改革初探

随着社会的发展人类对健康的需求不断提高,对高等护理教育人才培养模式提出了更高的要求,护理实验教学是高等护理教育体系的重要组成部分,是学生掌握专业技能的重要环节,可反映护理院校本科教育实践性方面的质量和效果,并直接检验学校护理本科人才培养目标实现的程度及护理教育理论与实践结合的差距.目前我国高等护理教育实验教学还存在着很多问题.制约着对学生综合素质的培养,因此,进一步深化护理实验教学改革势在必行.     

《护理学基础》实验教学存在问题与改进方法初探

护理学专业是一门应用性强的学科，理论与实践结合紧密，实验教学是护生掌握专业技能的重要环节，因此，专业技能培养可直接检验高等护理教育人才培养目标实现的程度以及护理理论与实践结合的差距。目前我国高等护理教育实验教学还存在着很多问题，制约着对护生综合能力的培养，我校在总结目前《护理学基础》实验教学的现状及存在问题的基础上，于2003年逐步进行护理专业课程设置、教学方式、教学内容等的综合改革。经过5年多的探索与实践，取得了一定的成效，现报道如下。     

护理专业实验教学管理中存在的问题分析与对策

护理学是以实践为基础的学科，要求学生熟练掌握各项护理技能并将所学的知识运用于实践。实验教学是护理人才培养的重要环节，在实验教学中应充分体现“以学生为主体”的教育理念，从高等护理院校的学生出发，培养学生的动手能力，让学生熟练掌握护理操作技能，达到培养技能型、创新型护理人才的目标。因此，实验教学的综合管理对保证实验教学质量至关重要，而目前我国多数院校护理专业实验教学仍存在管理方法滞后，如教学手段单一、训练机会少、只注重学生专业技能训练而忽视其他能力培养等问题。     

构建高等护理教育实验教学新体系的思考

]随着社会的发展,医学模式的转变,教育全球化进程的加快和护理专业人员跨国进行学术交流及从业活动的增加,对我国高等护理教育人才培养模式提出了更高的要求.护理实验教学是高等护理教育体系的重要组成部分,是学生掌握专业技能的重要环节,可反映护理院校本科教育实践性方面的质量和效果,并直接检验学校护理本科人才培养目标实现的程度及护理教育理论与实践结合的差距.目前我国高等护理教育实验教学还存在着很多问题,制约着对学生综合素质的培养,因此,必须进一步深化护理实验教学改革构建高等护理教育实验教学新体系.

Abstract：

With the development of society and the transformation of medical mode and with the increase of the education of globalization and the international academic exchange activities of nursing professionals.We put forward higher requirement of the cultivation modde of higher talent.The nursing experiment teaching is an important part of education system, and it is the important link of student's professional slills.It can reflect the nursing education undergraduate colleges in practical quality and effect.Also It can inspect the cultivation mode of higher talent and the level of completion and the gap betwenn the nursing education theory and the combination with practice.At present,there are many problems still exist in higher nursing education experimental teaching, and it restricts the cultivation of students'comprehensive quality.Thererfore, It must be further deepening experiment teaching reform of higher nursing education to build new experiment teaching system.     

护理本科生实践能力的多元化培养

护理学是一门应用性、实践性很强的学科,培养和提高护生的实践能力和创造性思维能力始终是护理教学的根本要求.我国高等护理教育经过二十余年的努力,人才培养质量不断提高,当前护理本科生的现状是理论知识扎实,思维活跃,但也存在重理论、轻实践的现象,缺乏理论与实践有机结合的能力[1].因此在教学改革中注重学生能力的培养和素质的提高不容忽视.     

护理本科生实践能力的多元化培养

护理学是一门应用性、实践性很强的学科，培养和提高护生的实践能力和创造性思维能力始终是护理教学的根本要求。我国高等护理教育经过二十余年的努力，人才培养质量不断提高，当前护理本科生的现状是理论知识扎实，思维活跃，但也存在重理论、轻实践的现象，缺乏理论与实践有机结合的能力。因此在教学改革中注重学生能力的培养和素质的提高不容忽视。     

高等护理教育与临床实践衔接的影响因素与对策

目的：针对高等护理教育与临床实践脱节的情况，分析并探讨对策。方法：采用自设问卷以方便抽样方法，向102家不同等级医院护理部以及354名临床护士进行问卷调查。问卷内容包括32个项目，以下4个方面：目前高等护理教育与临床实践的适合程度;存在问题;应当如何加强护理教育与实践的联系;应当加强学生哪些方面能力的培养。结果：医院方面和临床护士对高等护理教育与临床实践的适合程度认识差异无统计学意义（P〉0.05）;有24.51%的医院和21.75%的临床护士认为高等护理教育与临床实践有部分或完全脱节现象，在原因方面，双方各项认识的差异均无统计学意义（P〉0.05），认同程度依次排列顺序基本一致;在加强护理教育与临床实践联系的措施、高等护理教育应加强学生能力培养方面重视程度的顺序上，医院和临床护士的认识基本一致，其中基础知识、专业技能、临床实践被置于最重要的位置。结论：把握临床护理发展动态，优化教学过程各环节，建设校内外实践教学基地和一支与临床紧密结合的师资队伍，加强学生专业技能和实践能力培养，以利于高等护理教育健康持续地发展，保证学校专业建设和人才培养始终与社会需求相吻合。     

构建“强实践与重人文”护理人才培养模式的探讨

目的：构建“强实践与重人文”护理人才培养模式，为社会培养富有人文精神的高素质应用型护理人才。方法：对高等护理教育人才培养现状进行分析，明确指导思想、确定培养目标、优化课程设置、完善实践教学机制、注重人文素质教育。结果：构建“强实践与重人文”护理人才培养模式，促进了实践教学改革，学生的人文关怀意识明显增强。结论：该人才培养模式适应我国社会发展对高等护理教育人才培养的需求，可推广。     

建设规范化护理实训中心提高护生操作能力

护理操作是护理人员最基本也是最主要的专业技能.＂十二五＂期间,中国护理事业发展规划纲要提出：＂进一步加快护理教育的改革与发展,坚持以岗位需求为导向,促进理论与实践相结合,大力培养临床实用型人才,注重护理实践能力的提高.＂护理实践技能的培训是护理专业教学中的重要组成部分,而护理专业实践技能训练中心是完成学生实践技能培训和考核的重要载体,在护理教育中发挥着关键性作用,它不仅仅是培养学生理论联系实际、动手实践能力、临床思维能力、创新能力及提升综合素质的重要基地,也是学校教学、科研、学科建设和管理水平的重要标志.2012年我校护理学院实训中心被评为省级实验教学示范中心,现从硬件建设、团队结构、改革措施、成果应用、教学效果等方面介绍实训中心的规范化建设情况.     

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.     

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.     

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.     

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.     

Prospects for the control of neglected tropical diseases by mass drug administration

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

Bacterial meningitis: an update of new treatment options

The outcome of bacterial meningitis critically depends on the rapid initiation of bactericidal antibiotic therapy and adequate management of septic shock. In community-acquired meningitis, the choice of an optimum initial empirical antibiotic regimen depends on the regional resistance patterns. Pathogens resistant to antibacterials prevail in nosocomial bacterial meningitis. Dexamethasone is recommended as adjunctive therapy for community-acquired meningitis in developed countries. In comatose patients, aggressive measures to lower intracranial pressure <20 mmHg (in particular, external ventriculostomy, osmotherapy and temporary hyperventilation) were effective in a case–control study. Although many experimental approaches were protective in animal models, none of them has been proven effective in patients. Antibiotics, which are bactericidal but do not lyse bacteria, and inhibitors of matrix metalloproteinases or complement factor C5 appear the most promising therapeutic options. At present, vaccination is the most efficient method to reduce disease burden. Palmitoylethanolamide appears promising to enhance the resistance of the brain to infections.     

Imaging choices in occult hip fracture

Background: Hip fracture is a common injury, with an incidence rate of > 250,000 per year in the United States. Diagnosis is particularly important due to the high dependence on the integrity of the hip in the daily life of most people. Objectives: In this article we review the literature focused on hip fracture detection and discuss advantages and limitations of each major imaging modality. Discussion: Plain radiographs are usually sufficient for diagnosis as they are at least 90% sensitive for hip fracture. However, in the 3–4% of Emergency Department (ED) patients having hip X-ray studies who harbor an occult hip fracture, the Emergency Physician must choose among several methods, each with intrinsic limitations, for further evaluation. These methods include computed tomography, scintigraphy, and magnetic resonance imaging. Conclusion: We present an evidence-based algorithm for the evaluation of a patient suspected to have an occult hip fracture in the ED. Also outlined are future directions for research to distinguish more effective techniques for identifying occult hip fractures.