临床实习护生67名锐器损伤调查分析

目的:了解护生临床实习期间医疗锐器损伤发生情况,分析其主要原因,并探讨相应防护对策。方法:对某三级甲等医院67名护生进行实习前相关培训,并发放自行设计的问卷调查表便于护生进行实习记录,实习结束前进行收集统计。结果:67名护生中发生医疗锐器损伤有56名,占83.58%,共发生医疗锐器伤245人次,平均每人4.38次。其中玻璃安瓿划伤占66.94%,污染针头刺伤占24.49%。医疗锐器损伤好发于实习初期,占98.21%。结论:实习护生职业防护意识较薄弱,操作技能欠熟练,医疗锐器损伤的发生率较高。应加强职业防护知识教育及培训,规范护理操作行为,优化护理管理,是减少医疗锐器损伤的有效措施。     

手术室实习护生锐器损伤的原因调查及预防措施

目的探讨实习护生在手术室实习时发生锐器损伤的现状及防护对策。方法对2016年3月-2016年8月在浙江某市级三甲综合医院手术室实习过的160名护生进行问卷调查。结果 57.6%的实习护生有在手术室发生过锐器损伤的经历,大多数都是手受到伤害,并且78.1%的实习护生在进入手术室实习前未进行过操作技能加强训练,69.7%的实习护生未接受过自我防护教育。结论护士实习生的自我防范意识较差,操作技术不熟练,心理状态不佳,缺少岗前自我防护教育,均可引发实习护生的锐器损伤事件。应该加强手术室实习护生的自我防护教育、操作技能训练,重视实习护生的心理素质教育,以减少或避免发生锐器损伤事件的发生。     

中专临床实习护生锐器伤发生情况调查分析及对策

目的调查中专临床实习护生锐器伤发生情况,以便为预防及减少护生锐器伤提出针对性的对策。方法采用自行设计调查问卷对2012届121名中专实习护生进行调查,了解护生实习期间发生锐器伤的情况以及护生锐器伤发生的环节、锐器伤发生时间段和伤害器具分布情况。结果 121名护生发生锐器伤105名,发生率为86.8%。在操作过程,配药发生锐器伤占46.1%,其次为注射后拔出针头/针芯,占18.1%;操作后,重新将针头插回输液袋发生锐器伤占7.3%,双手回套针帽和整理锐器时各占5.6%;护生锐器伤发生率最高时间段为实习前3个月,占60.8%;伤害器具主要为玻璃安瓿,占47.8%,其次为头皮针,占24.1%,注射器针头,占15.1%。结论中专临床实习护生锐器伤发生普遍,配药时玻璃安瓿划伤发生率最高,操作不熟练和不规范是发生锐器伤的主要原因。学校应增加防护知识教育,提高护生的安全防护意识;医院应加强操作培训,并要求临床带教老师在实践中跟踪指导,反复纠正护生不正确的操作习惯,减少护生锐器伤的发生。     

实习护生锐器伤防护意识的调查分析

[目的]了解实习护生被锐器损伤的情况,为采取职业防护措施提供科学依据.[方法]采用问卷法调查183名实习护生锐器损伤的发生率和防护行为.[结果]97.3%的实习护生有锐器伤的经历,其中锐器损伤和安瓿玻璃割伤占首位.实习护生缺乏锐器伤的防护意识.[结论]实习护生要充分认识到锐器伤防护的重要性,增强锐器伤的防护意识,同时要加大职业防护的管理,以减少锐器伤的危害.     

实习护生锐器损伤状况调查及对策

目的了解实习护生锐器伤情况,并探讨相关对策。方法采用问卷调查方法,对在本院实习的140名护生发生锐器伤情况进行调查。结果140名护生中,发生锐器伤的有112人次,其中针刺伤68人次,占60.7%;玻璃伤36人次,占32.2%;刀割伤5人次,占4.5%;其他3人次,占2.7%。发生的主要原因依次为：输液及注射结束拔针时、回收毁形时、手掰安瓿时、静脉加药时、抽血拔针时和其他原因。结论加强实习护生岗前相关职业防护知识的培训,严格遵守操作规程,加强带教老师的责任感,对降低实习护生锐器伤的发生具有积极的作用。     

实习护生发生医疗锐器伤的现状分析

目的 了解临床实习护生医疗锐器伤的发生状况并探讨相应的对策.方法 对2005--2(107年在我院实习期间发生锐器伤的进行填表登记的58例实习护生受伤情况进行统计分析.结果 实习护生医疗锐器伤发生率为9.16%,锐器物中头皮针和注射器针头占72.42%;静脉输液占50.00%;拔针和用物整理环节占52.48%,受伤后伤口处理不规范占44.82%.结论 护生自我防护意识淡漠,防护知识匮乏.必须加强护生职业防护教育与管理.     

实习护生锐器伤发生状况调查及防护对策

目的 了解实习护生锐器伤发生情况,并探讨相关对策.方法 回顾性调查2003级实习的140名护生锐器伤发生情况,分析原因,制定相应措施应用于2004级护生的临床实习过程中,并调查其锐器伤的发生情况,与2003级的锐器伤发生情况进行比较,采用X2检验.结果 2004级实习护生锐器伤发生率较2003级实习护生明显降低.结论 实习护生安全意识薄弱,操作不熟练,临床经验缺乏,容易发生锐器伤,加强实习护生岗前相关职业防护知识的培训,严格遵守操作规程,加强带教老师的责任感,可以降低实习护生锐器伤的发生率.     

实习护生职业危害现状研究

目的调查实习护生发生职业危害的情况。方法选取某战区总医院的185名实习护生为研究对象,采用实习护生发生锐器伤情况调查表进行调查分析。结果实习护生锐器伤发生率为88.65%,平均锐器伤发生例次为2.81例次/人;实习护生锐器伤主动上报率为14.07%;锐器伤发生场所多在普通病房,占87.48%;发生时正进行的操作中,配置液体占65.90%,其次为处理医疗垃圾,占23.21%;发生部位均在手部。结论实习护生锐器伤发生率较高,应加强实习护生的职业防护教育,强化对实习护生主动报告锐器伤的教育与培训,积极构建主动上报锐器伤的安全文化氛围。     

护生锐器伤发生影响因素及伤口处理情况的调查

目的 了解实习护士实习期间发生锐器伤影响因素及伤口处理情况,为制定锐器伤的预防措施提供依据.方法 自行设计调查问卷,对完成10个月实习的168名护生进行实习期锐器伤后影.响因素及伤口处理情况调查.结果 83.33%护生发生锐器伤,护生发生锐器伤后10.13%未经消毒处理,经消毒处理护生中行规范消毒的仅占5.1%.结论 护生自我防护意识淡薄,伤口处理不规范,医学院校应高度重视护生的安全问题,须增强职业防护意识,加强教育和管理,减少锐器伤的发生率.     

手术室实习护生锐器损伤调查及防护对策

手术室是发生职业暴露的高危场所，手术室护士因其职业的特殊性易发生锐器损伤皮肤，因而导致血源性感染的危险性较高。近几年来，我国艾滋病、乙肝、丙肝发病率呈上升趋势，即使一次损伤也有可能导致感染，而手术室实习护生由于初次接触临床实践工作，环境生疏、技术操作不熟练、缺乏临床经验及相关专业知识，极有可能发生锐器损伤，她们是锐器损伤的高危人群。为了解实习护生手术室实习中所发生的锐器损伤情况，笔者进行了问卷调查，以便找出易致护生损伤的常见因素，     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

提升护理服务综合价值的研究

目的:研究护理综合价值的提升。方法:分析护理价值研究背景,阐述护理价值研究进展结果:提出护理价值研究途径。结论:有利于达成一种共识,使广大护理人员认识护理价值、研究护理价值、开发护理价值,重视护理综合价值研究和提升。 护理服务价值是护理服务劳动产品的价值和服务本身所创造的价值的总和,即使用价值与价值的统一。目前日本、美国、德国和中国都在加强护理价值研究的探索,但仍存在使用价值与价值研究分离问题。因此,我们应不断加强护理综合价值研究,以适应卫生事业改革对护理管理的挑战。本研究主要在分析国内外护理价值研究的基础上,提出综合护理价值研究途径,以达到合理评价护理价值的目的。     

我国护理行业的改革与发展

从我国护理行业的现状、卫生体制改革以及基本国情出发 ,着重探讨护理管理、护理教育、护理环境、护理经济与管理体系、护理立法等方面的发展途径     

Innovations in United States genetics nursing: Practice and research

Aim: Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics‐related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods: The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics‐related health services, research, education, and public policy. Results: Genetics nurses in the US have developed innovative responses to genetics‐related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health‐care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics‐related research; and (vi) participation in high‐level genetics advisory groups. Conclusions: The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses’ organization known as the International Society of Nurses in Genetics (ISONG) has provided this base.     

Structure and content in Norwegian nursing care documentation.

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two-fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

Towards an aesthetics of nursing

Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader approach to aesthetics and proposes a way in which a theoretical approach to nursing aesthetics could be developed. The paper concludes that nursing is a fit object of aesthetic appreciation and that aesthetic quality is a necessary attribute of good nursing practice.     

传承护理专业发展进程 开展“优质护理服务示范工程”

通过对近30年来护理专业发展进程的思考,剖析护理工作的内涵,从20世纪80年代初李士鸾引入责任制护理,到20世纪90年代中期推行整体护理,一直到今年开展"优质护理服务示范工程"。这一切变化充分体现了具有中国特色的护理专业发展的延续性,阐述了在医药卫生体制改革的形势下如何开展"优质护理服务示范工程"活动,促进整体护理进一步深化。