护理研究生临床带教方式探讨

目的:以护理硕士临床专业学位培养目标为依据,探索科学的护理研究生临床培养模式,培养和提高学生的临床护理、管理、教学和科研能力,提高护理硕士研究生临床指导老师的教学能力、保证硕士研究生培养质量。方法:对2001年9月~2004年3月在我科实习的7位研究生,根据其研究方向和职业生涯规划,制定详细的带教计划,采用自学辅导、精讲点拨教学、参与项目管理与护生的临床带教等方法,着重从临床护理操作技能、临床护理综合技能、临床护理教学能力、临床护理科研能力及临床护理管理能力进行培养,带教过程中加强监督检查,确保计划的顺利完成。结果:7位学生均顺利完成实习计划,学生的临床护理操作技能、临床护理综合技能、临床护理教学能力、临床护理科研能力及临床护理管理能力以及指导老师的临床带教水平得到提高。     

我国护理研究生临床实践模式探讨

护理硕士研究生教育是我国目前护理教育体系中培养层次较高的教育形式，是培养高级护理管理、教学、科研及临床高级人才的主要渠道。由于我国研究生教育起步较晚，发展还不完善，实现培养高素质、高水平、具有全面技能的护理研究生，目前尚在探索之中。临床实践是研究生教育不可缺少的重要部分，如何合理地安排研究生进行临床实践，是护理硕士研究生教育所面临的重要课题。     

我国护理学硕士研究生培养能力的研究

目的本研究旨在探讨培养适合我国国情的护理专业硕士研究生的方案。方法采用Delphi技术。结果“科研型”硕士研究生培养能力按照百分比从高到低依次为：专业基础知识、临床知识、科研能力、社会适应能力、教学能力、管理能力、社区护理能力；“临床型”硕士研究生培养能力依次为：专业基础知识、临床知识、社会适应能力、管理能力、科研能力、教学能力和社区护理能力。结论根据我国目前的情况，专家认为护理专业硕士研究生的能力培养不可忽视专业基础知识、临床知识和技能。     

护理学研究生教育设置专业学位的调查研究

目的调查医院护理管理者及本科护士对设置护理学研究生专业学位的态度和需求。方法采用问卷调查结合访谈法,对北京大学12家附属及教学医院的20名护理部主任和(或)副主任、32名副主任护师及371名具有本科学历的护士进行调查。结果90%以上的护理部主任和(或)副主任、副主任护师及80%的本科护士认为有必要开设专业学位护理研究生教育。他们认为应优先设置的专业为重症监护、急救护理、糖尿病护理、肿瘤护理等,认为应该培养的能力是科研能力、专科知识和技能、教学能力和管理能力,认为临床导师有待提高科研能力、教学能力和专科知识与技能。结论在我国有必要开设专业学位护理研究生教育,需要充分利用学院导师与临床导师相结合的优势,共同培养专业学位硕士研究生。     

我国护理专业学位硕士培养现状的调查与分析

目的:了解我国护理专业学位研究生培养状况,为开展老年护理专业学位研究生培养方案的构建提供依据。方法:以能力本位理论为理论基础,采用自编问卷以方便抽样方法,对全国15所高校的84名护理专业学位研究生和26名护理研究生导师进行问卷调查。结果:调查对象中,88.1%护理专业学位研究生和96.2%的护理研究生导师认为护理研究生在临床实践中最应具备的能力是护理专科技能,84.5%护理专业学位研究生和88.5%导师认为其次是沟通与协调能力;护理专业学位研究生和导师在临床实践期间应具备的主要素质中选择专业素质、人文关怀、思想道德分别占比94.1%、90.5%、86.9%和100%、100%、100%;仅有26.2%的护理专业硕士希望将来从事临床高级护理实践工作;有9.5%的护理专业学位研究生有专职的临床指导医生。结论:护理专业学位研究生应该重视思想道德、人文关怀方面的培养,在临床护理实践中要着重培养学生的专科技能和沟通与协调能力,具备条件的医院要配备专门的高水平临床指导教师以提高学生专科技能,做到专业技能和人文关怀同步发展。     

护理专业学位硕士研究生临床实践能力评价指标体系的构建

目的：构建一套客观、全面的护理专业学位硕士研究生临床实践能力评价指标体系,为评价护理硕士研究生临床实践能力提供依据。方法：运用Delphi法,对来自华东地区35位专家进行两轮函询,建立护理专业学位硕士研究生临床实践能力评价指标体系。结果：最终确立的护理专业学位硕士研究生临床实践能力评价指标,包括8项一级指标及41项二级指标,一级指标包括专业基础知识、临床综合技能、评判性思维能力、临床科研能力、临床教学能力、护理管理能力、外语能力、社会反映。结论：本构建方案过程严谨、可靠,结果具有较强的理论与实践意义,对护理学硕士研究生的培养、临床实践能力的评价具有指导作用和参考价值。     

我国护理研究生临床实践模式探讨

护理硕士研究生教育是我国目前护理教育体系中培养层次较高的教育形式,是培养高级护理管理、教学、科研及临床高级人才的主要渠道[1]。由于我国研究生教育起步较晚,发展还不完善,实现培养高素质、高水平、具有全面技能的护理研究生,目前尚在探索之中。临床实践是研究生教育不可缺少的重要部分,如何合理地安排研究生进行临床实践,是护理硕士研究生教育所面临的重要课题。1我国护理硕士研究生临床实践特点1.1临床实践未突出个性护理学既有其独立的内容,又具有与医学密不可分的一面。因此,要求护理专业的研究生在掌握医学知识基础上还应具备护…     

护理学硕士研究生专业承诺的研究进展

护理研究生教育是培养护理管理、教学、科研及临床高级人才的主要手段.护理研究生的专业承诺能力和水平是增强研究生对专业学习的热情、兴趣,提高专业学习绩效,加深专业思想稳定性的重要因素.因此,加强护理研究生专业承诺的相关研究,提高护理研究生的专业承诺能力和水平,显得尤为重要,现报道如下.     

强化护生技能培训 提高护理教学质量

护理专业是一门实践性与技能性很强的学科，护理技能是护理教学的重要组成部分，其在加强理论联系实践，培养学生动手能力，创新能力和科研能力方面具有理论教学所不能取代的独特作用Ⅲ，我们在多年的教学实践中，深深地体会到，只有强化护理技能培训，才能有效地提高护理教学质量。     

临床护理研究生的科研能力现状调查

目的:了解临床护理研究生科研能力现状并探讨其影响因素,为护理管理者采取针对性的管理措施提高护理硕士研究生的科研能力提供依据。方法:抽取42名护理研究生作为研究对象,采用临床护理硕士研究生科研能力自评量表和客观因素评价量表进行问卷调查。结果:临床护理研究生的科研能力处于中等水平,参与护理科研经历、阅读文献情况和参与学术会议交流情况对临床护理研究生科研能力有影响;影响临床护理研究生参与科研能力活动及科研能力的客观因素为领导支持,科研环境及文献查阅能力。结论:临床护理研究生的科研能力有待进一步提高,护理研究生应加强自身学习,积极参与科研活动,多查阅文献,多参加学术会议与交流;护理管理者应为护理研究生提供良好的科研环境及科研时间,以便提高临床护理研究生的科研能力,让其充分发挥其科研能力,发现临床问题和运用科研的方法解决临床护理的实际问题。     

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.     

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.     

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.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.     

自动化酸碱平衡图在急诊社区获得性肺炎诊治中的应用

目的 探讨自动化酸碱平衡图在急诊科社区获得性肺炎(CAP)患者诊断中的价值.方法 根据病史、肺功能测定结果、慢性阻塞性肺疾病(COPD)诊断标准,将111例CAP患者分为单纯CAP组(56例)和COPD合并CAP组[即慢性阻塞性肺疾病急性加重(AECOPD)组,55例].询问患者病史后即刻抽取动脉血测血气并进行自动化酸碱平衡图分析.结果 血气分析结果显示,AECOPD组动脉血二氧化碳分压(PaCO2,kPa)、HCO3- (mmol/L)、剩余碱(BE,mmol/L)均显著高于CAP组(PaCO2:7.714±2.414比5.896±1.308,HCO3-:30.767±7.185比25.014±3.043,BE:4.345±5.371比-0.354±3.180,均P＜0.01).自动化酸碱平衡图分析结果显示,AECOPD组患者酸碱平衡紊乱高达89.1％,CAP组为66.1％.将AECOPD组和CAP组患者中正常(10.9％、33.9％)、急性呼吸性酸中毒(急性呼酸,12.7％、14.3％)、慢性呼吸性酸中毒(慢性呼酸,49.1％、10.7％)、呼吸性碱中毒(呼碱,7.3％、14.3％)、代谢性酸中毒(代酸,12.7％、17.9％)、代谢性碱中毒(代碱,12.7％、8.9％)综合进行x2分析,差异有统计学意义(x2=24.421,P=0.001),而将正常、急性呼酸、呼碱、代酸及代碱进行x2分析,差异无统计学意义(x2=5.280,P=0.260),提示AECOPD患者慢性呼酸的发生率较单纯CAP患者显著增加.结论 自动化酸碱平衡图能帮助急诊科医师快速识别CAP患者是否存在多重酸碱平衡紊乱,并可快速识别急、慢性呼吸系统疾病.