护理人员现代护理观与基础护理认识现状及两者之间的相关性分析

目的了解护士对现代护理观和基础护理认识现状,探究两者之间的关系,正确评价护理人员在认识上的问题,以便采取有效对策,进一步推动基础护理工作的落实。方法采用问卷调查法,以北京市3所三级甲等综合医院182名临床护士为研究对象。调查其对现代护理观及基础护理的认识状况,并分析此2者之间的相关性。结果(1)护士对现代护理观及基础护理的认识存在严重不足;(2)护士对基础护理与现代护理观的认识成正相关关系,r=0.516,P<0.01,其中护士对职能扩延观的认识更大地影响其对基础护理的认识;(3)临床上存在部分基础护理依靠家属或护工的状况。结论护士对现代护理观认识的不足,导致了对基础护理认识上的偏差,从而阻碍了基础护理工作的落实。     

护理人员对基础护理现状的认识及思考

目的了解护理人员对基础护理现状的认识及基础护理不到位的原因，为进一步推动基础护理的落实，寻找管理对策。方法采用自制问卷调查，以本院165名临床一线护士为对象，了解对基础护理现状的认识情况，分析原因，探究认识与原因两者之间的关系。结果部分护士对基础护理现状的认识存在不足及偏差；27个临床常用基础护理工作70％是护士完成的，30％基础护理工作是由病人家属及陪护完成的；基础护理不到位的原因分析最主要的是临床护士不足，单位时间内基础护理时间太少，基础护理设施落后；护士对基础护理现状的认识与基础护理不到位的原因之间呈正相关关系（r=0．708，p〈0．01）。结论护士对基础护理内涵认识上的误区及在基础护理中职责认识的不足，这种有缺陷的认识和处理问题，阻碍了基础护理的到位，管理者应审视差距，改变现状。     

临床护士执行基础护理意愿及影响因素分析

目的了解临床护士执行基础护理意愿及其影响因素，以便采取有效的对策，进一步贯彻执行卫生部相关文件。方法自行设计问卷．采用便利抽样的方法．对249名临床护士进行基础护理意愿及其影响因素调查。结果本组护士对基础护理的认识严重不足并存在误区；基础护理意愿量表评分为（95．4&#177;2．5）分；排在前3位的影响因素是护士数量不足，忙于治疗、输液、接瓶等工作。基础护理收费低。结论临床护士对基础护理概念、内涵及在临床中的重要性缺乏正确认识，对患者实施基础护理意愿不高，应强化基础护理各项认识，合理配置人力资源，增设基础护理收费项目，加强护理管理，以改善基础护理的落实情况。     

基础护理操作难度评价及执行人员资质的调查

目的了解临床护士对各项基础护理操作难度的评价，为探索与各项基础护理难度相适应的护理人员配置方式提供依据。方法采用自行设计的基础护理操作难度评价调查表，便利选取北京市4家三级甲等综合医院230名临床护士进行调查。结果临床护士对基础护理操作难度的评分为（1．90±0．89）-（3．40±1．05）分。临床普通护士对压疮的预防及护理、协助患者翻身及有效咳嗽两项操作难度评分分别为（3．35±1．08），（2．57±0．99）分，低于护士长的（3．72±0．86），（2．97±1．06）分，差异有统计学意义（t=-2．359，-2．328；P〈0．05）。目前各项基础护理的护理人员配置方式与临床护士认定的人员配置方式差异均有统计学意义（P〈0．01）。结论基础护理操作的整体难度较低，但临床普通护士仍需要对部分基础护理操作提高认识，目前执行基础护理操作的护理人员配置方式也需要改进。     

病人入院护理服务现状调查

[目的]了解医院护理人员对病人入院护理服务的现状，分析其存在的问题，以提高病人入院护理服务质量。[方法]采用自行设计的问卷，对3所三级甲等医院和4所二级甲等医院从事临床护理工作的448名护士进行问卷调查。[结果]61．2％护理人员重视入院护理工作，31．0％护士把入院护理服务看成常规的工作内容来完成，7．8％的人不重视，不同护龄的护理人员对其重要性的认识差异有统计学意义（P〈0．01）；就目前的入院护理服务内容和方式，52．6％的护士认为不完善；护士常做入院护理评估的占62．6％；81．8％护士所在科室有自行设计的入院护理评估表，但很少应用；了解和收集心理状况资料的占57．9％。[结论]目前临床入院护理服务工作还处于相对滞后的状态，护理管理者应加强入院护理服务质量控制，入院护理服务的内容、形式应满足病人需要。     

健康教育中存在的问题与对策

健康教育是护理工作的重要组成部分，它贯穿于护理工作的全过程，根据临床体会及护理文献，归纳出临床健康教育中存在的问题是：（1）对健康教育认识不足；（2）知识缺乏；（3）不能充分利用有效时间；（4）缺乏沟通交流技巧，教育方法不当。建议：（1）改变护士的健康教育观；（2）加强健康教育的相关知识培训；（3）合理安排健康教育时间；（4）重视健康教育投资。     

临床护士基础护理认知状况分析

目的分析临床护士对基础护理的认知状况，以便采取相应措施促进基础护理工作的落实。方法对某院住院部442名临床一线护士和实习护生进行基础护理认知情况问卷调查。结果实习护生与正式护士对基础护理是属于护工或家属工作的认知差异有统计学意义；不同职称护士对基础护理是属于护士工作的认知差异有统计学意义。结论临床护士对基础护理的性质和分工认识不足，建议通过抓好护生的培养和使用，转变临床护士的观念意识，争取医院最大支持等方式做好基础护理的组织管理工作，以促进基础护理工作的有效持续开展。     

基础护理项目执行单的应用效果

目的应用并探讨基础护理项目执行单在指导并落实临床基础护理工作中的效果。方法选择2011年1—6月经巴塞尔指数评分依赖型患者228例作为观察组，2010年1—6月经巴塞尔指数评分依赖型患者214例作为对照组，对照组采用传统方法进行护理；观察组采用自行制定的基础护理项目执行单来确定患者需执行的项目，护理人员根据指定的项目来实施基础护理，护士长对质量进行检查。结果对照组基础护理质量为95．05％观察组基础护理质量为99％，两组比较差异有统计学意义（X2=7．03，P〈0．01）；对照组陪护率30．8％，观察组陪护率19．7％，两组比较差异有统计学意义（x2=7．24，P〈0．01）；对照组基础护理满意度为95．3％，观察组基础护理满意度为99．1％，两组比较差异有统计学意义（x2=6．02，P〈0．05）。结论基础护理项目执行单能针对患者的生活自理能力进行有效的补偿，对临床基础护理工作的有效实施有指导意义。     

手术室护士心理状况和压力的调查及对策

目的 了解手术室护士的心理状况和压力。方法 采用以中国成人常模作比较和护士工作压力源量表，对2所三级医院和3所二级医院的手术室护士采取方便抽样的方法发放调查问卷。结果 手术室护士SCL-90各因子分均低于健康成人（p〈0．05）。手术室护士工作压力状况显示，二级医院与三级医院在工作量及时间方面（p〈0．01）和压力总分（p〈0．05）有显著性差异。手术室护士心理健康状况与护理专业及工作方面相关性不大；在工作量、时间分配、工作环境及资源、病人护理及管理和人际关系等方面具有显著相关性（p〈0．01）。结论 手术室护士心理健康状况较好，但在工作压力的一些方面存在问题，对手术室的护理管理者提供重要的参考价值。     

基础护理服务落实情况与病房患者满意度的相关性研究

目的了解病房基础护理服务落实情况与患者护理服务满意度的关系。方法选取创伤骨科住院患者60例患者及护理人员30人，分别进行问卷调查。结果患者对护理工作的总体满意度为（4．20±0．55）分；病房患者满意度与基础护理服务落实情况呈正相关（P〈0．05）。结论基础护理服务落实情况与患者满意度密切相关，加强基础护理服务能提高患者满意度。     

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     

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.

     

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。     

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.     

人性化护理理论及其应用

从理论形成背景、理论框架、理论的主要概念、护理的4个基本概念及理论评价等方面,介绍了Paterson和Zderad的人性化护理理论及其应用。     

人性化护理理论及其应用

从理论形成背景、理论框架、理论的主要概念、护理的4个基本概念及理论评价等方面,介绍了Paterson和Zder-ad的人性化护理理论及其应用。     

临床护理成本与效益分析

笔者根据临床护理服务价格偏离成本的事实,提出关注护理成本,改革现行的医疗护理服务收费制度和医疗费用结构比,提升护士的劳务价值,以期深入发展护理经济研究形成系统的护理成本核算体系,以低成本、高效益的优质护理服务来赢得市场。     

社区护理中存在的问题及对策

3年的社区护理实践,发现社区护理中存在的问题有：受社会经济环境影响,护理工作量日益增加;护理人员严重不足,护理工作超负荷运转;社区护理仪器设备不配套,护理整体水平与医疗发展不适应;工作量与奖金分配不成比例。采用相应的对策：护理人员角色转换;加强对护理人员的时间管理;提高社区护理人员的政治觉悟,树立无私奉献的思想;加强护理业务技术及其质量管理;加强科室间协调工作,保证仪器设备到位。收到了明显的效果,提高了社区护理质量。     

30种内外科常见病整体护理路径的研究和应用

目的 探索整体护理路径的应用,提高护士运用护理程序的能力.方法 设计30种内外科常见病的整体护理路径,选择4所三级甲等医院作为实验医院,培训80名责任护士,将设计好的整体护理路径在临床上应用,重点验证整体护理路径的结构、内容和使用效果等,并对整体护理路径进行修改和完善,以及评价整体护理路径.结果 完成了30种内外科常见病整体护理路径的设计和完善.分别有92%、95%和96%的护士认为整体护理路径对实施护理程序有帮助,能够发挥护士的能力,值得推广;44%的护士认为使用整体护理路径不能得心应手.结论 整体护理路径是一种较理想的护理工作模式,能够提高护士运用护理程序的能力,但仍需要加强对护士的培训,特别是要着力提高护士的评估能力.