Dimensions of perioperative nursing for a national specialty nomenclature

Dimensions of perioperative nursing for a national specialty nomenclature Before nurses can develop a clinical database capable of evaluating quality of care or validating their impact on health or illness, they must describe the basic dimensions of their specialty. The purpose of this study was to define the dimensions of clinical perioperative nursing practice. Experienced perioperative nurses (n=239) were mailed a survey and asked to rank the frequency with which specific patient diagnoses occurred in their daily practice (1=never occurs; 5=occurs almost all the time) and the priority of treatment each diagnosis required (1=never requires attention of the nurse; 5=demands immediate attention of the nurse). Completion of the form indicated consent to participate in the study. Following a principal component analysis and theoretical discussion by perioperative experts, four dimensions of perioperative practice were delineated: (a) patient and family behavioural responses to surgery (26.7% of variance, alpha=0.92); (b) perioperative patient safety (10.1% of variance, alpha=0.89); (c) perioperative physiological response to surgery (5.7% of variance, alpha=0.87); and (d) the health systems required to deliver perioperative care. Dimensions extracted in this analysis served as the domains for the new perioperative nursing nomenclature.     

急诊骨科手术围手术期护理对策的研究

目的：探讨急诊骨外科手术围手术期护理对策和护理效果。方法将吴川市人民医院急诊骨外科手术围手术期患者60例按随机数字表法分为观察组和对照组,每组30例。对照组给予常规护理措施,观察组给予优质护理,判定2组临床护理效果。结果观察组患者总满意度、健康知识知晓率及得分均明显高于对照组（P＜0.05）,观察组患者叫铃次数明显少于对照组（P＜0.05）。结论优质护理在急诊骨外科手术围手术期的护理效果明确,值得推荐。     

加速康复外科理念在髋关节置换围术期护理中的应用

目的:探讨加速康复外科理念在髋关节置换围术期护理中的应用.方法:选择2008年3月～2010年5月实施髋关节置换术患者24例为实验组,围术期护理采用 FTS理念指导的优化护理措施;调取以往住院同种手术患者病历,采用传统的围术期护理方式的患者24例为对照组;比较两组患者术后开始下床活动时间、平均住院时间和并发症的发生率等.结果:实验组术后拔尿管时间、开始下床活动时间及平均住院时间均明显短于对照组(P<0.01).结论:ITS理念指导的围术期护理缩短了术后平均住院时间,不增加并发症发生率,可以促进患者快速康复.     

亲情式关怀联合激励式护理在食管癌患者围术期中的应用

目的:探讨亲情式关怀联合激励式护理在食管癌患者围术期中的应用效果.方法:将2020年5月1日～2021年1月30日胸外科收治的76例食管癌患者随机分为对照组和实验组各38例;对照组实施胸外科常规护理干预,实验组在对照组基础上实施亲情式关怀联合激励式护理干预;比较两组干预前后焦虑情况[采用焦虑自评量表(SAS)]、护理满...     

Caring for older patients at an emergency department -- emergency nurses' reasoning

Aim. The aim of the study was to use the experiences of emergency nurses to illuminate what constitutes good nursing care for patients 75 years or older transferred to emergency departments. Background. Emergency departments have a medical technical character and the number of visits there increases dramatically as people age. Older patients require increased healthcare services in terms of nursing care, interventions and hospitalizations due to an increased complexity of their problems. For these reasons it is important to study what good nursing care of the older patients consists of at an emergency department from the emergency nurses’ point of view. Method. Ten emergency nurses from a university hospital emergency department in Sweden were interviewed. A thematic content analysis was performed. Results. The study showed that it was necessary to be knowledgeable, to be understanding of the older patients’ situation and to take responsibility for them in order to be able to provide good nursing care. The emergency nurses shifted focus from describing the central aspect of good nursing care to describing what hinders the provision of it. Their experience was that prioritizing medical procedures, everyday tasks and routines threatens good nursing care of older patients in emergency departments. The emergency nurses held that the older patient is often sent to an emergency department where the level of care is not appropriate to their needs. Conclusions. The result can be seen as a challenge for the organization and the nurses in the future; to prioritize differently, thereby maintaining a balance between good nursing and medical/technical tasks when treating older patients. Relevance to clinical practice. The present day healthcare system is not organized to appropriately meet the needs of the older patients. Nurses themselves hold they can better serve the older patient. By sharing their experiences, both can be accomplished.     

运用Delphi法完善腰椎间盘突出症围手术期护理服务内容的研究

目的:完善腰椎间盘突出症围手术期护理服务内容,并探讨其意义。方法:拟定腰椎间盘突出症围手术期患者护理服务内容,运用Delphi法进行两轮专家咨询,了解专家的意见和建议。结果:两轮咨询问卷有效回收率分别为89%和94%;专家权威系数均数分别为0.79和0.88;两轮术前、术中、术后咨询专家总的协调系数分别为0.265、0.305、0.359和0.435、0.316、0.425,且P值均小于0.01,差异有统计学意义。结论:确立了术前5个分类指标及35个护理项目,术中4个分类指标及25个护理项目,术后5个分类指标及41个护理项目的服务内容,规范了该疾病护理流程,适应临床护理实践的发展。     

围术期舒适护理在择期手术患者中的应用

目的:探讨择期手术患者围术期舒适护理的方法及临床效果。方法:将104例择期手术患者随机分为观察组与对照组各52例。对照组实施常规护理,观察组在对照组基础上给予舒适护理,观察比较两组心理状态、手术耐受性、护理满意度及血压、心率情况。结果:两组护理后焦虑和抑郁评分、护理满意度、手术耐受性比较差异有统计学意义(P<0.05),两组麻醉前心率、血压情况比较差异有统计学意义(P<0.05)。结论:围术期加强舒适护理可缓解择期手术患者紧张、焦虑情绪,增强手术耐受性,提高护理满意度,稳定血压、心率,保证麻醉及手术安全性。     

12例腹腔镜辅助远端胃癌根治术围手术期护理

目的:探讨腹腔镜辅助远端胃癌根治术围手术期护理经验.方法:总结2006年3月至2007年3月我科12例腹腔镜辅助远端胃癌根治术的围手术期护理措施.结果:无1例并发症发生,所有患者均痊愈出院,平均住院日为11天.结论:除腹腔镜微创手术术后常规护理措施外,多种形式的心理护理、病员术后活动及饮食的具体指导和管道护理等是腹腔镜辅助远端胃癌根治术围手术期积极有效的护理措施.     

循证护理在前列腺癌患者围术期护理中的应用

目的:探讨循证护理在前列腺癌患者围术期中的实施的效果.方法:将70例患者随机分为观察组与对照组各35例.对照组采用常规护理模式进行护理,包括饮食、休息、治疗配合、健康宣教、术后护理、心理护理等;观察组实施循证护理,先给予患者针对性的综合评估,了解其机体素质、疾病状况等,然后根据评估结果进行护理程序及细节的制订,并对可能发生的问题进行预见性护理程序的制订及预防性措施的实施.结果:与对照组比较,观察组住院时间更短,治疗依从性和护理满意度更高,并发症发生率更低,EORTC QLQ-C30评分更理想(P＜0.05).结论:对前列腺癌手术患者实施循证护理效果好,可显著改善其生存质量.     

骨科手术750例围术期舒适护理

目的:探讨对骨科手术患者围术期进行舒适护理的方法.方法:对750例患者进行术前访视,术中做好环境准备、舒适体位安置、心理护理、基础护理,术后进行镇痛、健康教育等护理.结果:患者术中均未发生压疮,对手术室护理工作满意度达99%,无护理投诉或纠纷事件.结论:对骨科手术患者围术期开展舒适护理,可缓解其恐惧和焦虑情绪,提高对手术室护理工作的满意度.     

预见性护理在糖尿病性白内障患者围术期护理中的应用

目的探究预见性护理在糖尿病性白内障患者围术期护理中的应用效果。方法从2018年5~11月聊城市第三人民医院收治的糖尿病性白内障手术患者中选出92例,随机分成两组,对照组采取常规护理,观察组采取“常规护理+预见性护理”,各46例。比较两组患者的并发症发生率、生活质量。结果观察组患者的并发症发生率显著低于对照组,生活质量评分显著高于对照组,差异均有统计学意义(均P<0.05)。结论预见性护理可显著降低糖尿病性白内障患者并发症发生率,提高患者生活质量。     

先天性腹壁缺损膀胱外翻患儿整形修复围手术期护理

目的总结先天性腹壁缺损膀胱外翻患儿整形修复术围手术期护理措施及临床效果,为临床该类患儿规范化护理方案的制定提供借鉴。方法运用整形修复外科原则对11例天性腹壁缺损膀胱外翻患儿的缺损范围及程度进行充分评估,采用腹壁局部肌筋膜瓣、阔筋膜张肌皮瓣、阴股沟皮瓣及髂腹股沟皮瓣修复缺损腹部并对外翻膀胱实施内翻修复治疗,并给予系统化围手术期护理干预。结果所有先天性腹壁缺损膀胱外翻患儿均一期修复成功,皮瓣存活良好,缺损腹壁均一期愈合,所有外翻膀胱均得到还纳修复,排尿功能正常,术后形态良好,患儿家属对整形修复效果及护理措施满意。结论根据不同腹壁缺损范围及膀胱外翻程度,运用整形修复皮瓣尽早闭合修复腹壁缺损膀胱外翻,效果显著,实施围手术期科学护理干预是保证整形修复良好疗效的基础,可降低术后并发症发生率,提高整形修复效果,提升护理质量。     

运用关怀护理理念作好巡回护理

基于对“关怀伦理”理论的认识，通过分析心外科病人围手术期的心理需求，阐述关怀理论在临床心理护理中的积极作用。结合手术巡回护理的工作内容，详细介绍了将关怀理念转化为护理行为的具体做法，提出发展护理关怀文化，培养护士良好的道德责任感和人性价值观是现代护理发展的必然需要。     

舒适护理在计划生育手术患者中的应用及效果观察

目的:探讨舒适护理在计划生育手术患者中的应用效果.方法:将120例行计划生育手术的患者随机分为对照组与观察组各60例,对照组患者实施传统护理模式,观察组患者实施心理舒适护理、术前舒适护理、术后舒适护理等护理措施.应用焦虑自评量表(SAS)和抑郁自评量表(SDS)对两组患者干预前后负性情绪进行评估,比较两组干预前后SAS评分、SDS评分、术后VAS疼痛评分及患者满意度.结果:护理干预后观察组SAS评分、SDS评分及VAS疼痛评分均显著低于对照组(P<0.01),观察组患者满意度显著高于对照组,差异有统计学意义(P<0.01).结论:舒适护理可显著减轻计划生育手术患者心理负担,促进患者早日康复.     

糖尿病性白内障56例围术期护理

目的:探讨糖尿病性白内障围术期的护理方法.方法:对56例糖尿病性白内障患者进行围术期的护理,如心理护理、血糖监测、饮食指导等.结果:本组患者经过精心护理,术后视力均较术前明显提高,且无并发症的发生.结论:充分的术前准备、周密的术后护理是保证手术顺利进行的关键.     

Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department

This study examined the emergency nurse practitioner candidate (ENPC) scope of practice in a Victorian emergency department (ED). The emergency nurse practitioner (ENP) role is relatively new in Victoria and the scope of the ENP(C) practice is yet to be defined. International research literature regarding the ENP role has focused on outcomes such as patient satisfaction, waiting times and/or ED length of stay, accuracy and adequacy of documentation, use of radiography, and patient education, health promotion and communication issues. A prospective exploratory design was used to conduct this cohort study. There were 476 ENPC-managed patients between 14 July 2004 and 31 March 2005 with an average age of 29 years. The majority (77.2%) of ENPC-managed patients were discharged from the ED. The majority of the ENPC time was devoted to clinical practice (55%) and development of clinical practice guidelines (25%). Of patients managed by the ENPC, 49.6% required medications, 51% required diagnostic imaging and 8.6% required pathology testing during their ED stay. The most common discharge referrals were made to local medical officers (73.5%) and the most common referrals made for patients requiring admission were made to the plastic surgery (37.3%) and orthopaedic (35.5%) units. Extensions to the current scope of emergency nursing practice are pivotal to effective management of specific patient groups by ENP. The ENP model of care is an important strategy for the management of increased service demands in Victoria; however, little is known about the scope of the ENPC practice and many outcomes of the ENP care are yet to be defined. Further research to better understand the relationships between ENP outcomes is required if the contribution that ENPs make to emergency care is to be accurately quantified.     

应用胸外科术后呼吸道观察与护理记录表实施专科护理的临床实践

目的：制定并应用自行设计的胸外科呼吸道观察与护理记录表对患者实施专科护理,并进行效果评价。方法：在分析既往出现呼吸道并发症的病例的基础上,明确影响呼吸道护理质量的因素,完善人员培训及健康宣教,制定并应用胸外科呼吸道观察与护理记录表,比较应用该表前后,术后肺不张的发生情况。结果：应用前肺不张的发生率为3.93%,应用后的发生率为0.49%,较应用前有所降低,且差异有统计学意义（P〈0.05）。结论：胸外科呼吸道观察与护理记录表可以起到规范专科护理并促进信息沟通的作用,提高了护理质量。     

护理干预对老年胸外科患者围术期心理状况的影响

目的:探讨护理干预对老年胸外科患者围术期心理状况的影响.方法:将120例胸外科手术患者随机分为实验组65例和对照组55例,实验组给予围术期护理干预,对照组给予常规护理.比较两组患者手术前后HAMA、HAMD评分.结果:实验组HAMA、HAMD评分明显低于对照组(P＜0.05),患者发生心理问题程度明显轻于对照组(P＜0.05),患者满意度明显高于对照组(P＜0.05).结论:实施护理干预可有效降低老年胸外科患者围术期心理问题,提高患者预后及满意度.     

人性化护理在老年骨科患者中的临床应 用

目的 探讨老年骨科患者围术期的人性化护理.方法 将200例老年骨科围术期患者按随机数字表法分为对照组和观察组,每组100例.对照组采用传统的护理（以完成各项医嘱和常规的基础护理为主要工作内容）,观察组在人院时、围术期、功能锻炼、语言及对患者家属等5个方面实施优质的人性化护理.对2组患者的心理状态（恐惧焦虑,对手术效果、家庭影响及治疗费用的担心）及患者对护理工作满意度的情况进行比较.结果 2组患者手术均顺利完成,安全返回病房,无并发症发生.观察组的恐惧焦虑、对手术效果担心、对家庭影响担心及对治疗费用担心分别为43.0％、48.0％、30.0％、25.0％;对照组分别为72.0％、80.0％、54.0％、46.0％,观察组各项指标均明显低于对照组（均P＜0.05）.观察组对护理工作满意度明显高于对照组（60.0％比30.0％,P＜0.05）.结论 采用人性化护理可使患者对护理工作的满意度及护士的专业素质大幅度提高.