评判性思维在NICU护理带教中的效果观察

目的 观察评判性思维在NICU护理带教中的效果.方法 将60名护生随机分为对照组和观察组各30名,对照组按传统的带教方法进行教学,观察组通过以问题为基础的学习,反思性教学法,病例讨论法及以护理程序为框架的临床教学法等措施,逐渐培养和提高提高护生的评判性思维能力.结果 两组护生出科时的理论考核、操作考核以及评判性思维能力的认知评估比较,均P〈0 05,差异有统计学意义.结论评判性思维教学法值得在临床上推广的护理教学方法.     

220例经大隐静脉置入PICC导管术在新生儿监护病房中的应用

[目的]探讨经大隐静脉置入中心静脉导管（PICC）导管在新生儿监护病房中（NICU）的应用效果。[方法]对住NICU的220例患儿经大隐静脉置入PICC导管,并对其临床资料进行总结、分析。[结果j220例患儿中成功置管于下腔静脉217例,3例因导管末端异位于腹壁下静脉拔管;一次穿刺成功196例,成功率89．1％;留置时间4d～98d（23．94d±13．73d）;置管期间导管堵塞13例次,发生静脉炎19例次,导管因渗液脱出l例,导管体外断裂1例;206例拔管后行导管末端培养,结果导管末端细菌培养阳性2例。[结论]经大隐静脉置入PICC导管技术一次穿刺成功率高、异位率低、并发症少。     

The impact of the Covid‐19 pandemic on North American milk banks

This study aims to understand the impact of the Covid‐19 pandemic on human milk banking services in North America, with a focus on the United States. We triangulated questionnaire data with interviews and text‐based website data. Of the 30 human milk bank services from which data were obtained, the majority faced substantial internal organization change in terms of staffing and protocols and experienced financial hardship in particular because of decreases in donor human milk orders. At the same time, most banks reported an increase in their numbers of donors and in the volume of milk collected. These results show that the pandemic significantly affected the way in which many North American milk banks operate, some lactating mothers donate their milk and, at least during the first few months of the crisis, certain hospitals'' donor human milk ordering patterns changed. It suggests in particular that stay‐at‐home orders and the turn to remote work created the potential for a surge in human milk available for donation as a number of parents no longer needed their surplus for their own children. Legal and policy reform should focus on replicating the positive effects of the pandemic on breastfeeding by guaranteeing paid parental leave and flexible work conditions. Initiatives should also aim at counteracting its negative effects by mandating the insurance coverage of donor human milk, supporting milk banks financially and, more generally, integrating lactation and human milk banking services within the health system.     

患者转出交接核查表在神经外科重症监护室的应用

目的 探讨NICU转出交接核查表在NICU的应用效果.方法 对2009年12月～2010年8月采用传统口头式交接的323例NICU住院患者(对照组)与2010年9月～2011年5月采用转出交接核查表的298例NICU住院患者(观察组)的交接耗时、交接问题发生率、患者满意度方面进行比较.结果 观察组较对照组交接耗时缩短,交接问题发生率降低,住院患者满意度明显提高,差异有显著意义(P＜0.05).结论 运用“患者转出交接核查表”后,患者转出交接过程趋于标准化,减少交接环节中的薄弱点,提高了护理质量,保证了患者的安全,增加了患者及家属对护士的信任感.     

NICU患儿再入院原因分析及护理干预

目的:分析新生儿重症监护病房(NICU)患儿再入院原因,并提出针对性护理干预措施.方法:回顾性分析239例NICU再入院患儿的临床资料及护理措施,对其再入院原因、出院至再入院间隔时间进行描述性分析,并提出针对性护理干预措施.结果:本组患儿再入院原因包括喂养(48.95%)、感染(34.31%)及其他(16.74%);本组患儿出院至再入院间隔时间为(5.370±5.028)d,其中0～24 h再入院91例(38.08%),0～3 d再入院132例(55.23%),4～10 d再入院64例(26.78%),11～19 d再入院43例(17.99%).结论:NICU患儿转出后实行母婴同室,早期加强新生儿喂养指导、预防感染、适当保暖等护理干预措施有助于降低再入院率.