急诊内科昏迷患者的紧急抢救及临床护理干预分析研究

目的探讨急诊内科昏迷患者的紧急抢救及临床护理干预措施。方法选择我院2018年6月～2019年6月收治的218例患者随机分为观察组(n=109)和对照组(n=109)。两组均给予紧急抢救,对照组给予常规护理干预,观察组给予综合护理干预。观察比较两组抢救成功率、病死率、住院时间及护理满意度情况。结果观察组抢救成功96例,抢救成功率88.07%;对照组抢救成功101例,抢救成功率92.66%;两组分别有13例(11.93%)和8例(7.34%)患者抢救无效死亡。两组患者抢救成功率比较差异无统计学意义(χ~2=1.317,P=0.251)。观察组住院时间(18.57±2.34)d,明显低于对照组的(22.15±2.89)d(t=-10.051,P=0.000);观察组护理非常满意48例(44.04%)、基本满意57例(52.29%)、不满意4例(3.67%),整体护理情况优于对照组(Z=-2.453,P=0.014);观察组护理满意度为96.33%,明显高于对照组的80.73%(χ~2=13.057,P=0.000)。结论对急诊内科昏迷患者,在紧急抢救的同时,应给予相关综合临床护理干预,医护密切配合,有效提高患者抢救成功率及护理满意度,改善患者预后。     

肝癌介入导管室应用精细化护理预防医院感染的价值

目的 探讨肝癌介入导管室应用精细化护理预防医院感染的价值。方法 选择2014年1月～2017年12月在我院放射科导管室接受介入治疗的820例肝癌患者作为研究对象,其中2014年1月～2015年12月行常规护理的患者作为常规护理组,2016年1月～2017年12月行精细化护理的患者作为精细化护理组。对比两组医护人员无菌接触戴手套和外科洗手情况,对比两组导管室物品无菌情况,对比两组患者医院感染和住院时间情况。结果 精细化护理组医护人员无菌接触戴手套和外科洗手检测的合格率均显著性高于常规护理组(P0.05);精细化护理组导管室空气、导管室物品表面、消毒剂以及无菌物品的无菌情况的合格率均显著性高于常规护理组(P0.05);精细化护理组患者的医院感染率和住院时间均显著性小于常规护理组(P0.05)。结论 导管室对肝癌患者行介入治疗时实施精细化护理可以显著降低医院感染的发生率,缩短住院时间,具有很高的临床价值。     

临床护理路径（CNP）在腹部CT增强扫描检查中的应用研究

目的 探究临床护理路径在行腹部CT增强扫描检查患者中的应用效果。方法 收集本院2017年7月～2018年6月收治的120例行腹部CT增强扫描检查患者的临床资料,依据不同的干预方法归纳为对照组和实验组,各60例。前者采取常规护理方法,后者采取临床护理路径。对照并分析两组患者的检查配合度、不良反应发生率、护理满意度及护理差错数。结果 实验组患者的检查配合度为93.3%,明显优于对照组的73.3%(P0.05);实验组患者的不良反应发生率为5.0%,明显低于对照组的18.3%(P0.05);实验组患者的满意度评分为(4.37±0.40)分,明显优于对照组患者的(3.26±0.73)分(P0.05);实验组护理差错共1次,明显少于对照组的8次(P0.05)。结论 临床护理路径在腹部CT增强扫描检查中应用效果较好,能够明显提升患者的依从性,进而更好地配合检查,提高患者的满意度,具有较高的临床实用性。     

Three opportunities for standardization: A literature review of the variation among pharmacists’ patient care services terminology

BackgroundVariation describing pharmacists’ patient care services exist, and this variation contributes to the prevalent misunderstanding of pharmacists' roles. In contrast, standard phraseology is a critical practice among highly reliable organizations and a way to reduce variation and confusion.ObjectiveThis work aims to identify and define pharmacists’ patient care service terms to identify redundancies and opportunities for standardization.MethodsBetween May to August 2018, terms and definitions were searched via PubMed, Google Scholar and statements/policies of professional pharmacy organizations. Two references per term were sought to provide an “early definition” and a “contemporary definition.” Only literature published in English was included, and data gathered from each citation included the date published, the term's definition, and characterization of the reference's source as either a regulatory or professional body. A five-person expert panel used an iterative technique to revise and verify the list of included terms and subsequent literature review results. Terms were then searched in the National Library of Medicine's Medical Subject Heading Database (MeSH) in July, 2019.ResultsThere are fifteen commonly misunderstood terms that refer to the patient care services provided by pharmacists. The appearance of these terms in the literature spanned nearly five decades. Nearly half of terms appeared first in regulatory, law or policy documents; of these, two terms had contemporary definitions appearing in the professional literature that differed from their early regulatory definition. Three opportunities to improve standardization include: (1) Implementation of standardized phraseology systems similar to nursing's Clinical Care Classification System; (2) Academics' adherence to standardized MeSH terms; and (3) Clarification of pharmacy education accreditation standards.ConclusionNumerous terms are used to describe pharmacists' patient care services, with many definitions of terms overlapping in several key components. The profession has made concerted efforts to consolidate and standardize terminology in the past, but more opportunities exist.     

药浴治疗寻常型银屑病护理干预临床观察

目的探究寻常型银屑病予以药浴治疗及护理干预的效果。方法抽取2016年1月—2017年12月收治的寻常型银屑病患者80例,按照随机数字表法分为2组,各40例,所有患者均予以麦饭石药浴治疗,对照组予以常规护理,观察组在对照组基础上予以护理干预,比较2组护理满意度、住院时间、药浴时间。结果观察组住院、药浴时间短于对照组,2组差异有统计学意义(P<0.05),观察组护理总满意度95.0%,高于对照组80.0%,2组差异有统计学意义(P<0.05)。结论寻常型银屑病予以药物浸浴治疗基础上联合护理干预,能缩短治疗时间,提高护理满意度,值得推广。     

Derivation and Validation of a Model to Predict 30-Day Readmission in Surgical Patients Discharged to Skilled Nursing Facility

ObjectivesTo identify factors associated with 30-day all-cause readmission rates in surgical patients discharged to skilled nursing facilities (SNFs), and derive and validate a risk score.DesignRetrospective cohort.Setting and participantsPatients admitted to 1 tertiary hospital's surgical services between January 1, 2011, and December 31, 2014 and subsequently discharged to 110 SNFs within a 25-mile radius of the hospital. The first 2 years were used for the derivation set and the last 2 for validation.MethodsData were collected on 30-day all cause readmissions, patient demographics, procedure and surgical service, comorbidities, laboratory tests, and prior health care utilization. Multivariate regression was used to identify risk factors for readmission.ResultsDuring the study period, 2405 surgical patients were discharged to 110 SNFs, and 519 (21.6%) of these patients experienced readmission within 30 days. In a multivariable regression model, hospital length of stay [odds ratio (OR) per day: 1.03, 95% confidence interval (CI) 1.02-1.04], number of hospitalizations in past year (OR 1.24 per hospitalization, 95% CI 1.18-1.31), nonelective surgery (OR 1.33, 95% CI 1.18-1.65), low-risk service (orthopedic/spine service) (OR 0.32, 95% CI 0.25-0.42), and intermediate-risk service (cardiothoracic surgery/urology/gynecology/ear, nose, throat) (OR 0.69, 95% CI 0.53-0.88) were associated with all-cause readmissions. The model had a C index of 0.71 in the validation set. Using the following risk score [0.8 × (hospital length of stay) + 7 × (number of hospitalizations in past year) +10 for nonelective surgery, +36 for high-risk surgery, and +20 for intermediate-risk surgery], a score of >40 identified patients at high risk of 30-day readmission (35.8% vs 12.6%, P < .001).Conclusions/ImplicationsAmong surgical patients discharged to an SNF, a simple risk score with 4 parameters can accurately predict the risk of 30-day readmission.     

地中海贫血孕妇产前诊断的护理效果评价

目的研究地中海贫血孕妇实施产科综合护理模式的护理配合措施及效果。方法选择78例于我院检查地中海贫血孕妇,纳入时间为2017年5月-2018年5月,采用随机数字表法将其分为综合护理组与对照组,每组均39例。其中对照组采用常规护理形式,综合护理组行产科综合护理模式,对比综合护理组与对照组护理前后心理状态评估指标及家属的护理满意度。结果护理前综合护理组与对照组患者心理状态评估指标差异无统计学意义(P>0.05),与对照组(76.92%)相比,护理后综合护理组焦虑指标、抑郁指标更低,综合护理组孕妇及家属的护理满意度(94.87%)较高(P<0.05)。结论通过综合护理模式可提升地中海贫血孕妇护理满意度,并改善其心理状态。     

中医康复护理对中风肢体功能障碍患者的疗效

目的分析脑卒中肢体功能障碍患者应用中医康复护理干预后,上下肢功能、生活品质以及神经功能损伤症状变化情况。方法选取本院2017年3月-2019年3月收治的160例脑卒中肢体功能障碍患者为研究对象,将其随机均分为采用传统康复护理的常规组,与采用中医康复护理的研究组。对比两组患者护理干预前后上下肢力指标、神经功能损伤评估分值以及生活品质评估分值。结果干预前,两组患者上、下肢肌力差异无统计学意义(P>0.05),干预后,两组患者上、下肢肌力全部明显增加,并且研究组增加幅度优于常规组,差异均具有统计学意义(P<0.05);干预后,研究组与常规组脑卒中患者神经功能缺损评分标准(CSS)评估分值均显著降低,且常规组降低幅度低于研究组;两组生活自理能力评估分值全部显著增加,且研究组提升幅度明显高于常规组,差异均具有统计学意义(P<0.05)。结论脑卒中肢体功能障碍患者应用中医康复护理干预,能够显著提高患者肢体肌肉能力以及生活品质,促进神经功能的修复。     

针刺联合优质护理干预对周围性面神经麻痹急性期患者的影响

目的分析针刺联合优质护理干预对周围性面神经麻痹急性期患者的影响。方法以2016年1月—2019年2月60例周围性面神经麻痹急性期患者为研究对象,患者按照护理方法不同,将其分为对照组、观察组各30例患者,对照组进行神经内科的常规护理,观察组进行针刺联合优质护理干预,对2组患者临床疗效和护理满意度等进行观察。结果对照组总有效率为70%,观察组总有效率为96.6%(P<0.05)。对照组护理满意度为63.3%,观察组护理满意度为96.6%(P<0.05)。结论周围性面神经麻痹急性期患者临床治疗中,针刺联合优质护理干预的应用,可以提升患者临床疗效,降低患者住院时间,实现其护理满意度的提升。