绩效考评在手术室护理管理中的应用

目的:对绩效考评在手术室护理管理中的应用效果进行分析.方法:选取我院2015年-2016年26名手术室工作人员作为研究对象,对护理人员素质考核、能力考核、任务量考核、奖惩考核和患者满意度等方面每月进行一次考评.结果:通过研究可知在使用绩效考评后工作人员在素质考评、能力考评以及患者满意度等方面均明显提高(P<0.05),具有统计学意义.结论:绩效考评在手术室护理管理中的应用效果比较明显,工作人员在素质、能力以及患者满意度方面均有所提高,并且工作较为积极,值得临床推广使用.     

上海市金山区临床护士灾害护理能力现况调查及影响因素研究

目的调查上海市金山区临床护士的灾害护理能力及灾害应急知识掌握现状,探讨临床护士灾害护理能力的影响因素。方法通过便利抽样法,选取金山区5所二级及以上医院及11家社区卫生服务中心的1270名临床护士作为研究对象,采用一般资料调查表、临床护士灾害护理能力评估工具及灾害应急知识量表进行问卷调查,采用多元线性回归模型分析灾害护理能力的影响因素。结果收到有效问卷1263份,回收率为99.44%。1263名临床护士的灾害护理能力总分为(204.64±43.88)分,其中备灾能力均分最高,减灾/预防能力均分最低;临床护士灾害应急知识总分(134.97±30.60)分,其中事故指挥系统均分最高,特殊护理及隔离、去污均分最低。多元线性回归分析结果显示:相比三级医院,社区医院的护士灾害护理能力得分较低(β=-5.966,P=0.017);相比其他科室,急诊/ICU护士的灾害护理能力得分较高(β=5.765,P=0.029);护士灾害应急知识总分越高者,其灾害护理能力得分越高(β=1.000,P<0.001)。结论上海市金山区临床护士灾害护理能力、灾害应急知识储备整体处于中等偏上水平,在减灾/预防能力及恢复/重建能力上仍有待进一步提升。护理管理者可通过提升护士灾害应急知识水平、加强对急诊和ICU以外科室的护士以及三级医院以下护士的培训,提升临床护士的灾害护理能力。     

360度绩效考评对护理质量的影响

目的:探讨护士绩效考评对护理质量的影响.方法:根据护理岗位职责制定绩效考评标准,每季度考评,比较绩效考评前后护理质量的变化.结果:2008(实施前)与实施后的2009年护理工作质量进行比较,安全护理、院内感染、病情观察、应急能力、病人满意度分别经方差检验,P＜ 0.05,有显著差异性.结论:通过实施护理人员绩效考评,提高了护理人员的业务水平,提高了医院的护理质量.     

军队医院护理组长心身健康状况调查

目的为了解军队医院护理组长的身心健康状况,为探讨砺练其综合素质、提高其主观工作能动性的方法提供依据。方法采用康耐尔身心健康问卷(Cornell Medical Index,CMI),对41名军人护理组长及42名非现役文职护理组长进行调查,并进行组间比较。结果军人护理组长及非现役文职护理组长CMI全项目和心理项目,均分在筛查界值标准参考分以下;军人护理组长躯体症状项目,均分高于非现役文职护理组长且比较差异有统计学意义(P<0.001);非现役文职护理组长心理项目,均分高于军人护理组长且比较差异有统计学意义(P<0.001);军人护理组长的A、C、D、E、I、L 6项,均分高于非现役文职护理组长,且比较差异有统计学意义(P<0.001或P<0.05);非现役文职护理组长的M、P、Q、R 4项,均分高于军人护理组长,且比较差异有统计学意义(P<0.001或P<0.05)。结论军队医院各级管理部门要关注护理组长身心健康,采取相应的对策,塑造护理管理队伍良好的工作状态,有效地提高临床护理管理质量。     

甲状腺专科护理人员护理能力及影响因素研究

目的研究甲状腺专科护理人员对甲状腺疾病患者的护理能力,分析其影响因素。方法选择某院2016年1月至2018年6月甲状腺专科工作的护理人员78人进行问卷调查,护理能力测评各条目得分均用Likert 5级赋分法(0～4分);对其护理能力进行评分,并进行单因素及多因素线性回归分析。结果 7个维度得分比较,法律及伦理实践维度条目平均得分最高,达(2.88±0.47)分,而批判性思维及科研维度条目平均得分最低,仅(2.38±0.42)分;护理人员的甲状腺疾病护理能力测评量表总分(150.58±21.52)分;较高职称、较长工作年限及较高薪酬,是护理人员护理能力的独立保护因素。结论某院甲状腺专科护理人员对患者的护理能力处于中等水平,医院需要考虑护理人员特点,分层次进行培训及继续教育,以提高甲状腺专科护理人员的护理能力。     

宫颈癌患者健康促进生活方式现状及影响因素分析

目的调查宫颈癌患者健康促进生活方式的现状,分析其影响因素,探讨与自我管理效能感的相关性,以期为临床宫颈癌患者的健康促进干预提供依据。方法采用便利抽样法,选取2019年6月—2020年6月南昌大学第一附属医院妇产科收治的宫颈癌患者120例,采用自行设计的一般资料量表、中文版癌症自我管理效能感量表(SUPHH)及健康促进生活方式量表Ⅱ(HPLP-Ⅱ)进行问卷调查,回收有效问卷110份,对结果进行分析。结果SUPHH量表总分为(78.38±20.78)分,HPLP-Ⅱ量表总分为(124.96±22.20)分,健康责任维度条目均分(2.23±0.51)分,自我实现维度条目均分(2.50±0.53)分,压力管理维度条目均分(2.43±0.46)分,身体活动维度条目均分(2.02±0.58)分,人际关系维度条目均分(2.56±0.47)分,营养维度条目均分(2.56±0.53)分。单因素分析结果显示:文化程度(F=3.787,P<0.05)、家庭人均月收入(F=3.224,P<0.05)、家人对待治疗的态度(t=2.838,P<0.05)影响HPLP-Ⅱ量表总分。SUPHH量表总分及各维度得分均与HPLP-Ⅱ量表总分及各维度得分呈正相关(均P<0.05)。多元线性回归分析结果显示:宫颈癌患者HPLP-Ⅱ量表总分的影响因素包括文化程度、家庭人均月收入、自我管理效能感。结论宫颈癌患者的健康促进生活方式水平与患者的文化程度、家庭人均月收入水平及自我管理效能感有关,可以这3个独立影响因素为着手点制定相应的干预策略,改善宫颈癌患者健康促进生活方式,进而改善生活质量。     

护理人员心理健康水平及与医院情境因素的相关分析

目的:探讨护理人员的心理健康水平及与医院情境因素的相关性;方法:采用症状自评量表和医院情境因素问卷对116名护理人员进行测评;结果:护理人员的SCL-90总分和强迫症状、人际关系敏感、焦虑、敌意、精神病性因子均分低于全国常模(P<0.05～0.01),精神科护理人员与综合科护理人员相比,前者的SCL-90症状总分和强迫症状、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他9个因子均低于后者(P<0.01),医院情境因素中的工作激励、待遇满意度、医院保健、心理保健、集体精神、信息沟通6个因素与SCL-90总分及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他10个因子呈不同程度的负相关;结论:护理人员的心理健康水平高于一般正常人群,尤其是精神科护士;优化医院情境因素有利于护士心理健康水平的提高。     

双因素理论护理管理用于肿瘤外科病房护理满意度的影响

目的:探讨肿瘤外科病房采用双因素理论护理管理对护理满意度的影响;方法:选取2017年3月至2018年1月该院肿瘤外科病房的20名护理人员作为主要观察对象,采用双因素理论进行护理管理,对比干预前后的患者对护理人员的满意度及医生对护理人员的满意度、护理职业能力;结果:经过双因素理论模式干预后,医生对护理人员的满意度及患者对护理人员的满意度均显著高于干预前,(P0.01);护理人员职业能力评分总分为(99.76±2.44)分显著高于干预前评分(87.56±3.81)分(P0.05);结论:经过双因素理论护理管理,肿瘤外科病房的护理满意度得以提高,护理人员护理职业能力得以加强,值得临床推广。     

上海市护理人员情绪智力与工作绩效相关性研究

目的了解上海市护理人员情绪智力水平和工作绩效现状,探讨两者之间的关系。方法采用问卷调查法,随机抽取上海市两家三级综合性医院和一家二级综合性医院共260名临床一线护理人员进行调查。结果护理人员整体情绪智力水平呈中等偏上程度（3.63±0.37）,护理人员工作绩效的自评得分略高于护士长的他评,但其差异没有统计学意义（P〉0.05）,情绪智力与工作绩效各维度呈正相关（P〈0.05）。结论护理人员情绪智力水平的提高可促进护理工作绩效。     

绩效考评应用于产科护理管理中的优点

目的调查研究绩效考评在产科护理管理中的应用效果。方法采用图示式的评估方法,建立起产科护理工作绩效量化综合评估体系,做到人人参与管理,并通过护理部、护士长考核,进行反馈。结果对比2009年和2010年护理工作、服务质量,实施绩效考评后患者满意度由89%上升为98%,且差异性具有统计学意义(P<0.05),护理绩效由(89±1.2),上升为(93±2.5),护理质量出现显著性的提高。结论将绩效考评纳入产科护理管理中提高了管理工作的科学性,调动了护理人员工作的积极性,提高了产科护理服务质量和患者满意度。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.