加强护患沟通 推进“优质护理服务示范工程”活动

我院在实施卫生部"优质护理服务示范工程"活动(以下简称"示范工程"活动)中,通过对两组不同年龄病人交流沟通的经验总结,进一步掌握了更好的护患沟通技巧,构建了良好的护患关系,减少了护患矛盾与纠纷,保障医疗安全,全面提高了医院临床护理工作水平,推进了"示范工程"活动的深入开展。     

Children at birth,children growing up. Integration between healthcare and family educational care

This research is based on the assumption that in order to improve the quality of life of children with major health problems in the early stage of their life, especially in the case of disability, it is necessary to ensure the continuity and proper two-way integration of early childhood educational planning and health care, both provided by the adults involved, that is parents and professionals. Therefore, we tried to explore and piece together the complex set of family support experiences, both in the process of forming an attachment and affiliation to the newborn and in the construction of a common evolutionary history, aimed at the well-being of the entire family unit. We considered the context and actors of the first few days and months in the lives of children with a difficult life course, in a city of Northern Italy. By means of qualitative investigation, we carried out observations in the neonatal intensive care units of hospitals over a period of 10 months. Our observations continued in the local healthcare, social, and educational services, entrusted with providing care to children and support to parents after hospital discharge. We also carried out observations in nursery schools, in order to highlight early forms of individualised educational planning, drawn up by the educators together with the family.     

PRACTICE GUIDELINES IN PEDIATRIC HEMATOONCOLOGY: Implementation and Survey. A Possible Way for Medical Quality Assurance

The Hungarian Pediatric Oncology Working Group intended to change the practice of prescribing diagnostic tests as well as to examine the possibility of introducing indicators about the time factors of medical care. A nationwide accepted protocol was established for these tests. The examined time factors were the length of elapsed time from admittance to treatment and the length of hospital stay for different reasons (diagnosis, treatment, complications). Included in to this study are the new cases of 5 common groups of malignancies (acute lymphoblastic leukemia and non-Hodgkin lymphoma, osteosarcoma, soft tissue sarcoma, Wilms tumor, neuroblastoma) for a study period of 1 year. The follow-up data of 152 patients were examined; the length of survey was 1-12 months, depending on when the patients entered the study. As a continuous clinical audit, a system of survey was set up for each follow-up test, using a questionnaire about the conformity of physicians to the protocol, evaluating the principal reasons of deviation from the protocol. Using the data provided by this questionnaire, a renewal of the protocols for each disease was made three times during the whole study period. The principal reasons of nonconformity to the protocol were (1) complications, (2) the nonuse of the protocol, (3) nonacceptance of the protocol, and (4) technical problems. The authors intended to use their time indicators for benchmarking, to make a comparison possible between centers concerning the length of treatment, occurrence of complications, and delays in chemotherapy. However, the examination of the time indicators in the most frequent disease (acute lymphoblastic leukemia, n = 73) showed inverse correlation between the numberof admissions per year per center and the length of time elapsed up to the beginning of treatment. This points to a need for better cooperation in small centers at the initial phase of the diagnosis. The main result of this study is the successful elaboration and implementation of practice guidelines by information linked to performance (the feedback) in daily practice: Compliance during the first 3 months of the study was 28%, and compliance during the last 3 months was 61%.     

What Can Health Communication Science Offer for ACA Implementation? Five Evidence-Informed Strategies for Expanding Medicaid Enrollment

Context: Implementing the Affordable Care Act (ACA) in 2014 will require effective enrollment and outreach efforts to previously uninsured individuals now eligible for coverage.Methods: From 1996 to 2013, the Health Communication Research Laboratory conducted more than 40 original studies with more than 30,000 participants to learn how to improve the reach to and effectiveness of health information for low-income and racial/ethnic minority populations. We synthesized the findings from this body of research and used them to inform current challenges in implementing the ACA.Findings: We found empirical support for 5 recommendations regarding partnerships, outreach, messages and messengers, life priorities of low-income individuals and families, and the information environment. We translated these into 12 action steps.Conclusions: Health communication science can inform the development and execution of strategies to increase the public''s understanding of the ACA and to support the enrollment of eligible individuals into Medicaid or the Health Insurance Marketplace.     

Touch,the essence of caring for people with end-stage dementia: A mental health perspective in Namaste Care

This article presents the mental health aspects of ‘touch’ associated with a funded research project: Avoiding ‘high tech’ through ‘high touch’ in end-stage dementia: Protocol for care at the end-of-life. These mental health aspects highlight the human need for touch that continues up until and inclusive of the final stages of life. This study was informed by Simard's (2007) ‘high touch’ protocol based on the End-of-Life Namaste Care programme for people with dementia. The article is situated in relation to the research project which used a three-phase mixed methods approach. Data explored in this article are derived from focus groups conducted at three residential aged care facilities located in metropolitan and regional areas of NSW, Australia. The exploration of touch vis-a-vis mental health fell under two broad themes: touch by others and touch by the person. Sub-elements of these themes comprised touch towards a physical objective, touch towards an emotional objective, touch of objects and touch of others. The overarching outcome of interconnectedness embraced environmental awareness and human and life awareness. These two broad themes, with their accompanying elements, express the essential nature of mental health as a reciprocal connectedness, with reciprocal impacts on both those people with advanced dementia and their carers.     

What about doctors? The impact of medical errors

Medical error is a distressing event to the patient and the health care providers. The impact of such events has been well studied on patients but poorly on health professionals. These events are still considered as a taboo in the medical culture and hence missed as great learning opportunities. They have negative impact on doctors' emotional wellbeing, general quality of life, and their professional practice and conduct. Medical errors and adverse events also affect the quality and cost of the health service. Health service administrations should provide healthcare professionals involved in such events with professional support and counselling services, and should consider and treat them as second victims.     

胃、十二指肠溃疡出血的临床观察及护理体会

目的探讨胃、十二指肠溃疡出血的有效护理措施,为临床护理提供切实的参考依据。方法将我院近年来收治的108例胃、十二指肠溃疡出血患者随机平均分为对照组和实验组,对照组的患者采取常规护理措施,实验组的患者在常规对症护理的基础上加上护理干预。结果实验组的患者比对照组的患者住院时间短,并发症发生率低,溃疡愈合状况良好。两组的各项指标有显著差异,p<0.05,有统计学意义。结论精心的治疗和科学有效的护理干预能促进患者的痊愈,对患者的早日康复有着重要的意义。