应用美国用药安全自我测评量表改进用药安全

目的评估用药安全问题,改进用药安全。方法应用美国用药安全自我测评量表(2000版),开展用药安全自我测评,发现用药安全问题,制定改进措施,降低用药安全风险。结果通过改进薄弱环节,相比2010年测评结果,2018年测评总得分权重比由56%提升至73%,19项核心特征得分权重比不同程度提高(3.1%~120.0%)。结论该用药安全自我测评量表可在改进患者用药安全方面发挥重要作用。     

影响护理人员报告给药错误的相关因素分析

目的 描述护理人员给药错误的报告率;识别影响护理人员报告给药错误的因素.方法 运用描述性研究设计,自制"影响护理人员报告给药错误的因素"问卷,共23个条目,CVI为0.84,Cronbach's α为0.83.运用方便抽样的方法,对210护理人员进行问卷调查.结果 22.4%的护理人员认为,给药错误的报告率在60%以下.护理人员报告给药错误的主要障碍是害怕报告后带来不良后果、害怕医生的责备、害怕患者及家属的反应.护士长对于给药错误的处理方式是报告给药错误的预测因子.结论 鼓励护理人员报告给药错误的有效策略是营造不责备、无惩罚的工作环境,改进给药错误的报告流程和沟通方法,加强对护理人员有关意外事件报告流程及重要性的培训,建立一支能够发现和分析复杂系统问题的护理管理团队.     

肝移植受者服药依从性现状及其影响因素分析

目的:对肝移植受者服药依从性现状及其影响因素进行观察。方法:组建专人调查小组采用Mofisky-Green测评表对37例接受肝移植手术的患者进行随访调查,并对调查结果与可能的影响因素进行统计分析。结果:37例患者中,依从性不佳者29例(78.38%),依从性良好者8例(21.62%);在肝移植受者服药依从性具有差异性的影响因素中,年龄、文化程度、职业、居住地、术后服药时间、服药次数、对药物了解程度、是否定期复诊为保护因素(OR1),是否担心不良反应为危险因素(OR1)。结论:肝移植受者服药依从性现状不容乐观,应着重开展对肝移植患者关于疾病、药物、不良反应及其应对方法的教育工作,提高受者的自我护理意识,进而达到改善其服药依从性现状的目的。     

Establishment and application of medication error classification standards in nursing care based on the International Classification of Patient Safety

ObjectiveTo standardize the classification, reporting and analysis of medication errors in nursing in order to improve patient safety management by achieving real-time monitoring and systemic analysis.MethodsA system of classifying nurse-related adverse drug effects into four category grades was developed based on the framework provided by the International Classification of Patient Safety. Three investigators used the system to classify 1343 nursing-related drug adverse events reported between January 2006 and December 2010 at 15 tertiary medical institutions in Shanghai.ResultsThe classification standard incorporated all relevant information provided in the reporting system and revealed that the greatest frequency of drug adverse events resulted from staff-related factors. In particular, the largest number of events resulted from routine violations, followed by technology type errors of negligence and fault.ConclusionApplication of this classification system will help nursing administrators to accurately detect system- and process-related defects leading to medication errors, and enable the factors to be targeted to improve the level of patient safety management.     

Patient adherence to warfarin therapy and its impact on anticoagulation control

Warfarin is a commonly prescribed oral anticoagulant in Saudi Arabia and yet patient adherence to warfarin therapy and its impact on anticoagulation control have not been well researched here. A cross-sectional survey was conducted over 6 weeks at the outpatient anticoagulant clinic on patients who were receiving warfarin. Adherence was assessed using the translated Arabic version of the Morisky Medication Adherence Scale (MMAS-8). Levels of adherence were classed as low (score ⩽ 7), or high (score = 8) based on the scores. Good anticoagulation control was defined as percent Time INR in Therapeutic Range (TTR) ⩾ 75% using the Rosendaal method. A total of 192 patients completed a questionnaire with a response rate of 68.1%. It was established that no association was found between adherence to warfarin therapy and INR control groups. Among the 89 (46.4%) patients who had high adherence, only 34 (38.2%) had an acceptable INR control. This was versus 103 (53.6%) patients who had low adherence but also 34 (33.0%) had good INR control. Multivariate logistic regression (MLR) analysis showed that when studying females and occupational status of unemployment, they were independently associated with poor INR control with an OR 2.31, 95% CI 1.10–4.92, and OR 2.71, 95% CI 1.12–6.61 respectively. MLR analysis also showed that age <50 years alongside no formal education was independently associated with low adherence to warfarin therapy with an OR 2.67, 95% CI 1.29–5.52 and OR 2.63, 95% CI 1.01–6.93 respectively. The demographic background influences adherence and INR control, but no association was found between adherence and anticoagulation control.     

胃食管反流病相关影响因素分析及应对策略

胃食管反流病是消化系统的常见病,病因多样,发病机制尚不十分明确。现结合临床实践及查阅古今文献,发现其发病原因与饮食、情绪、体质量、服药史等有较大关系,并对本病的中西医结合应对策略作一综述,以期对临床诊治提供一定指导意义。     

COVID 19 pandemic challenges and their management: A review of medicines,vaccines, patents and clinical trials with emphasis on psychological health issues

The SARS‐CoV‐2 (COVID 19) paroxysm is a dominant health exigency that caused significant distress, affecting physical and mental health. Increased mortality, a stressed healthcare system, financial crisis, isolation, and new living and working styles enhanced societal commiseration leading to poor health outcomes. Though people try to maintain good physical health but unfortunately the mental affliction is still ignored. Poor psychological health has emerged as a burgeoning social issue and demands attention. Henceforth, the fundamental objective of this review article is to collate information about COVID-linked physical and psychological agony in diverse population groups with related symptoms and accessible diagnosis techniques. Recent studies have unraveled the fragile mental states of people who have either contracted COVID 19 or had near and dear ones falling prey to it. The impact of the epidemic on the human mind both in short and long-term, with possible risk and preventive factors together with suggested solutions for maintaining good health have also been discussed here. It also enlists the available medications, vaccines and investigational research in the form of patents and clinical trials. This article can be taken as an updated information sheet for COVID 19, accompanied by its management techniques with special emphasis on coping strategies for mental health. Further, it may also assist the policymakers to devise approaches that could enable the public to overcome the pandemic-driven adversity not only in the given situation but also futuristically.