老年眼科患者的护理安全隐患分析及预防对策(附74例)

目的?探讨老年眼科患者护理安全隐患及相应预防对策.方法?选取老年白内障住院手术患者140例,随机分为2组,对照组66例,观察组74例,2组患者有可比性.分析老年眼科患者存在的护理安全隐患.对照组患者采取常规护理,观察组患者在对照组基础上给予针对安全隐患的全面护理.对2组患者安全问题发生情况以及护理满意度进行统计和比较.结果?老年眼科患者主要存在的安全隐患包括摔伤碰伤、错用药品、慢性疾病引起猝死、术眼错误或感染、人工晶体突出或术眼出血.经过针对性的护理后观察组患者安全问题发生情况明显低于对照组,观察组约有91.89%的患者未发生安全问题,明显高于对照组56.06%的比例;约有59.46%和93.24%的观察组患者对护理感到非常满意,明显高于对照组39.39%和83.33%的比例.上述比较两组差异有统计学意义(P<0.05).结论?安全护理在老年眼科患者中进行推广应用是十分必要的,在日常工作中,护理人员应对患者安全风险进行恰当评估,将危险因素消灭于萌芽中,保证患者的安全,提高护理质量,融洽护患关系.     

浅谈基层医院护理管理中的安全隐患与对策

目的 分析基层医院影响护理质量的因素,制定相应对策,防止护理差错事故的发生.方法 通过对护理安全隐患的分析,认为主要原因是职能科室和规章制度不健全,护理人员的职业倦怠,流动性大,业务水平低,护理记录不规范等.结果 采取健全科室和规章制度,加强责任心和业务技术的培训,合理调配人力资源,加强护理人员法制观念的教育等措施.提高了护理人员的整体水平,提高了病人的满意度,稳定了护理队伍.结论 通过有效的干预措施,促进了基层医院护理安全,全面提高了护理质量.     

Knowledge,attitudes, and practices regarding seasonal influenza vaccination during pregnancy in Costa Rica: A mixed-methods study

BackgroundInfluenza increases stillbirth risk, morbidity and mortality in pregnant women. Vaccination protects pregnant women against severe disease and indirectly protects their infants, but coverage among pregnant women remains low worldwide. We aimed to describe knowledge, attitudes, and practices (KAP) regarding seasonal influenza vaccination among postpartum women and prenatal care physicians in Costa Rica.MethodsWe conducted cross-sectional KAP surveys to women one to three days after childbirth at Costa Rican Social Security Fund maternity hospitals, and obstetricians and general practitioners who provided prenatal care in 2017. Principal components analysis, multiple imputation, and logistic regression were used to examine associations between influenza vaccination and demographics, prenatal care, and sources of information—separately for postpartum women and physicians. We also held two focus groups of six healthcare workers each to further describe vaccination KAP.ResultsWe surveyed 642 postpartum women and 146 physicians in maternity hospitals in five Costa Rican provinces of whom 85.5 % (95 % CI: 82.6 %-88.0 %) and 57.9 % (95 % CI: 49.6 %-65.7 %) were vaccinated for influenza, respectively. Factors associated with influenza vaccination for postpartum women included tetanus vaccination (aOR: 3.62, 95 % CI: 1.89–6.92); received vaccination recommendations from clinicians during prenatal check-ups (aOR: 3.39, 95 % CI: 2.06–5.59); had other children in household vaccinated for influenza (aOR: 2.25, 95 % CI: 1.08–4.68); and secondary/university education (aOR: 0.15–0.31) with no formal education as reference. For postpartum women, reasons for vaccination were perceived benefits for mother and infant, whereas not being offered vaccines was most cited for non-vaccination. Most prenatal care physicians recommended influenza vaccines during prenatal check-ups but believed vaccination causes flu-like symptoms.ConclusionVaccination campaigns and provisions of free vaccines effectively increased knowledge and coverage among women in Costa Rica. To improve access, women should be offered vaccines during prenatal care appointments. Educating healthcare workers about vaccine benefits for themselves and patients is needed to mitigate safety concerns.     

家兔右室流出道细胞双孔钾通道电流特性的分析研究

目的已知特发性室速主要起源于右室流出道(RVOT),由于技术上的困难,目前对特发性右室流出道室速(RVOT-VT)的离子通道机制研究很少,本实验意在探索右室心室肌(RV)和RVOT的双孔钾通道电流(IK2p)的特性及其在RVOT-VT发生机制中可能参与的作用。方法采用全细胞膜片钳技术记录右室和右室流出道心肌细胞的单细胞电流。结果 RVOT的稳态外向电流较右室的小。对稳态电流进一步研究发现,右室流出道和右室心肌细胞上均存在IK2p。右室流出道细胞的IK2p电流密度明显小于右室细胞。结论首次在电生理水平上,证实了家兔右室心肌细胞上存在IK2p,RVOT心肌细胞的IK2p电流密度小于RV心肌细胞,是构成右室流出道APD离散度增大及外向电流降低的基础,从而易出现EAD,进而促进RVOT-VT的发生。     

Impact of scanning density on spectral domain optical coherence tomography assessments in neovascular age‐related macular degeneration

Purpose: To determine the effect of optical coherence tomography (OCT) B‐scan density on the qualitative assessment of neovascular age‐related macular degeneration (AMD). Methods: Data were collected from 59 patients imaged with Topcon 3D OCT‐1000 (128 B‐scans × 512 A‐scans). Custom software was used to generate less dense subsets of scans: 1/16 (eight B‐scans), 1/8 (16 B‐scans), 1/4 (32 B‐scans) and 1/2 (64 B‐scans). At each B‐scan density, scans were assessed for cystoid spaces, subretinal fluid (SRF), subretinal tissue (SRT) and pigment epithelium detachment (PED). For each sampling density, sensitivity, specificity and predictive values were calculated using the full volume scan (128 B‐scans) as the reference standard. Results: For cystoid spaces, the detection sensitivity was 76.3% at 1/16 density; this rose to 89.5% with a 1/4 density. For SRF, the detection sensitivity was 75.0% at a 1/16 density; this increased to 91.1% with 1/4 density. For PED, even at the lowest sampling density (1/16) the detection sensitivity was 86.4%; this rose to 94.9% at 1/4 density. For SRT, detection sensitivity at a 1/16 density was 64.7% and only rose above 90% with the densest sampling subset (1/2). Conclusions: Use of scanning protocols with reduced sampling densities resulted in decreased detection of key features of neovascular AMD; despite this, a sampling density reduced to 1/4 appeared to allow accurate assessment for most features. Current management of neovascular AMD is dependent on qualitative assessment of OCT images; with the recent proliferation of OCT systems, optimization and standardization of scanning protocols may be of value.     

Switchable hardening of a ferromagnet at fixed temperature

The intended use of a magnetic material, from information storage to power conversion, depends crucially on its domain structure, traditionally crafted during materials synthesis. By contrast, we show that an external magnetic field, applied transverse to the preferred magnetization of a model disordered uniaxial ferromagnet, is an isothermal regulator of domain pinning. At elevated temperatures, near the transition into the paramagnet, modest transverse fields increase the pinning, stabilize the domain structure, and harden the magnet, until a point where the field induces quantum tunneling of the domain walls and softens the magnet. At low temperatures, tunneling completely dominates the domain dynamics and provides an interpretation of the quantum phase transition in highly disordered magnets as a localization/delocalization transition for domain walls. While the energy scales of the rare earth ferromagnet studied here restrict the effects to cryogenic temperatures, the principles discovered are general and should be applicable to existing classes of highly anisotropic ferromagnets with ordering at room temperature or above.     

实现医院X光片共享信息系统的安全策略

随着医院信息化建设的深入发展,为保证医院数据的连续性、完整性和准确性,信息系统需要24h不间断运行。因此,如何保证信息系统正常运行及信息安全,就成为一个重要问题,涉及到网络、环境、人等各方面因素。