开展优质护理服务提升专科监护病房患者满意度

目的研究重症监护病房推行优质护理服务模式对患者满意度的影响。方法心胸外科重症监护病房实行优质护理服务模式,包括增进护患沟通、争创特色专科护理、延伸护理服务、增加直接护理时间和提高护士工作积极性等,比较分析优质护理服务模式推行前、后的患者满意度。结果患者满意度由模式推行前的84．54％上升至推行后的90．02％,两者差异显著（P〈0．05）。结论优质护理服务模式的推行能有效提高重症患者满意度,应在重症监护病房深入推广。     

全面推进优质护理服务提高患者的满意度

目的探讨全面推进优质护理服务对提高患者满意度的影响。方法随机选取该院于2012年1月—2014年6月收治的518例住院患者作为观察组,推行优质护理服务;另随机选取该院于2012年1~12月收治的365例住院患者作为对照组,未开展优质护理服务。结果开展优质护理服务后的住院患者满意度为98.65%,显著高于开展优质护理服务前的71.78%,有统计学意义（P〈0.05）。结论全面推进优质护理服务,能有效提高护理人员的专业服务技能与积极性,有利于提高护理服务质量及提高患者对护理工作的满意度,减少护患纠纷的发生。     

优质护理服务在老年病区临床护理工作中的应用效果

目的推行优质护理服务,改革护理工作模式,提高患者满意度与护理服务质量。方法 2013年9月至今在我院老年病区全面推行"以病人为中心"的责任制整体护理工作模式,从确立护理理念、创立工作模式、创建护士管理方式等方面开展基础护理、专项护理等优质护理服务活动。结果开展优质护理服务后患者满意度、护理质量均高于优质护理服务前(P﹤0.05),陪护率明显下降(P﹤0.05)。结论优质护理服务能够显著提高护士的主动服务意识,提高患者对护理服务质量的满意度,可以推动护理质量持续改进。     

优质护理服务对神经内科住院患者满意度的影响

目的探讨优质护理服务与神经内科住院患者满意度的关系。方法随机抽取优质护理服务前后神经内科住院1周的患者各100例作为调查对象,将其分为试验组和对照组,采用医院统一设计的患者满意度问卷调查表进行比较,观察两组患者满意度。结果经过9个月优质护理服务的实施,患者无护理投诉。刚开始实施优质护理服务时,患者对护理工作的满意度均为90%以上,实施优质护理服务9个月后,患者对护理工作的满意度明显提高（P〈0.05）,其中一项患者对护士的操作技术满意度P〉0.05无统计学意义。护士在患者入院接待,患者疾病、用药、治疗、检查、饮食等方面相关知识的健康教育,主动巡视病房,主动加液等方面工作做得出色,患者满意度高。试验组患者满意度明显高于对照组。结论优质护理服务可提高神经内科住院患者满意度,值得推广。     

浅谈优质护理在产休区的应用

目的探讨在产科病房的产休区实施优质护理服务,为母婴和家属提供个性化服务,整体提高产科住院患者满意度,促进医院和谐发展提供必备的基础。方法实施24 h床边责任制护理,转变以往的服务理念,改变陈旧的工作模式,对产休区住院的母婴患者提供全方位的责任小组制的优质护理服务。统计在产休区实施优质护理后在纯母乳喂养率、产后24 h出血量、产后3 d子宫收缩情况、住院满意度等方面进行了比较,运用SPSS统计软件,计数资料采用χ2检验,计量资料采用t检验,P〈0.01或P〈0.05则有统计学意义。结果在产休区实施优质护理后,纯母乳喂养率提升到96.94%;产后24 h出平均血量明显优于实施前;住院满意度调查显示上升至94.90%;患者和家属对实施优质护理的评价情况比实施前具备明显的优势。结论产休区实施优质护理服务后,大大提升纯母乳喂养率;减少产后出血量;促进子宫的收缩;提高患者住院期间的满意度。同时还提升了产科护士的整体素质,提高了护理人员工作质量及工作积极性,减少护患纠纷,产休区实施优质护理是起到正能量的作用。     

优质护理对提高急诊观察室患者满意度的调查

目的:研究实施优质护理对急诊观察室患者护理工作满意度的影响方法:采用医院统一使用的患者满意度调查表对急诊观察室的护理工作进行问卷调查,比较开展优质护理前和优质护理服务后患者对护理工作的满意度.结果:开展优质护理之前患者满意度76%,开展后为96%,两者差别有统计学意义(P<0.05),开展优质护理服务后患者满意度明显提高.结论:在急诊观察室实施优质护理后,能为患者提供人性化,整体化,专业化,连续性的优质护理服务,从而提高了急诊观察室的护理质量.     

优质护理服务对慢性病患者满意度的影响调查

目的探讨优质护理服务对慢性病患者满意度情况的影响。方法培训学习,提高认识,提升素质,转变理念,规范管理,实施临床护理责任组工作模式等;调查比较实施前、后慢性病患者对护理工作满意度。结果开展优质护理服务前后慢性病患者对护理工作满意度差异具有统计学意义(P0.05)。结论开展优质护理服务,可以提高护理服务质量,有利于提高慢性病患者对护理工作的满意度。     

人性化护理在优质护理服务中的应用

目的研究人性化护理服务在优质护理示范病房创建中的作用,提高护理质量和住院患者满意度。方法加强培训,转变护理工作人员服务观念,优化就医环境,完善患者需求评估表及个性化健康教育单,强化基础护理、注重细节护理,对护士施行人性化管理等。结果开展人性化护理服务后住院患者对优质护理服务满意度达98%以上,优质护理示范病房创建符合验收标准,被授予全市示范病房称号。结论坚持"以人为本,以患者满意为目标"的服务宗旨,强化人性化服务理念,重视人员内涵建设,推行优质护理服务是医院提高护理服务质量的重要途径。     

如何做好神经内科的优质护理服务

目的:总结优质护理服务在神经内科的应用体会.方法:针对神经内科危重患者较多,基础护理工作繁重的特点,将神经内科作为我院优质护理服务示范工程的先行试点,开展怎样做好优质护理服务的探讨和实践.结果:实施优质护理服务后住院患者及家属满意度由95.6%提高到98.9%.结论:开展优质护理服务,可以极大地提高护理人员的责任心,提升护理水平,提高患者及家属的满意度.     

优质护理服务模式在肿瘤内科的应用研究

目的 探讨优质护理服务模式在肿瘤内科住院病房的应用效果.方法 根据优质护理服务模式的要求和原则,对现有护理系统进行整改,通过加强业务培训,合理配制人力资源,强化护理质量控制管理等措施促进护理质量的提高.比较优质护理服务模式实施前后肿瘤内科护理缺陷发生率、患者住院期间护理相关并发症的发生率,以及患者满意度.结果 实施优质护理服务模式后,肿瘤内科护理缺陷、护理相关并发症的发生率明显降低,组间比较差异具有统计学意义(P＜0.05),医生对护理满意度以及患者满意度提高.结论 优质护理服务模式促进了肿瘤内科护理人员业务素质的提高,有效降低了护理缺陷的发生率,提高了患者满意度,值得临床推广.     

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.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

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.     

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.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.