新型冠状病毒肺炎暴发期间儿科病房护理防控策略

2019年12月以来，新型冠状病毒肺炎（coronavirus disease-2019, COVID-19）迅速在国内外传播，受感染人群短期内大幅增加，不仅包括成年人，还包括不同年龄段儿童，甚至新生儿。儿童因免疫系统发育不成熟、抵抗力低下，成为COVID-19易感人群之一，尤其是COVID-19流行期间住院患儿更易受感染。因此，做好儿科病房疫情期间的防控工作，采取切实可行措施对于预防和控制儿童感染新型冠状病毒显得尤为重要。本文根据国家卫生部门关于COVID-19疫情最新管理规定，结合本医院COVID-19防控经验，从护理角度探讨综合性医院儿科病房感染防控措施，为国内其他医院儿科病房疫情防控与护理工作提供参考。     

院长业务查房的做法及对医疗质量的影响

实行了业务院长带领与医疗有关的职能科室负责人和临床医疗、药学专家进行综合性业务查房。这种具有前馈质控、环节质控的查房模式,强化和完善了院长查房在医疗质量控制中的作用,是全面、及时了解临床科室业务工作,落实三级医师负责制,全面控制医疗质量,培养和考核各级医护人员、进行病历环节质控和医疗安全监控的有效方法。     

母婴同室新生儿安全隐患分析及防范对策

目的：了解母婴同室的新生儿安全隐患情况,探讨降低母婴同室新生儿安全问题发生率的方法。方法：采用回顾性调查方法,对本院母婴同室10 253例新生儿安全隐患相关因素进行分析。结果：该组新生儿发生安全问题80例,发生率为0.78%。安全隐患以院内感染为主（32.5%）,其次为呛奶窒息、低血糖、暑热综合症等（分别为22.5%、15.0%、和10.0%）。结论：重视母婴同室新生儿安全问题的管理,严格无菌操作,严格执行消毒隔离制度,加强新生儿护理工作,有效地控制新生儿安全事故的发生。     

Aggression and violence in psychiatric hospitals with and without open door policies: A 15-year naturalistic observational study

Aggressive behavior and violence in psychiatric patients have often been quoted to justify more restrictive settings in psychiatric facilities. However, the effects of open vs. locked door policies on aggressive incidents remain unclear. This study had a naturalistic observational design and analyzed the occurrence of aggressive behavior as well as the use of seclusion or restraint in 21 German hospitals. The analysis included data from 1998 to 2012 and contained a total of n = 314,330 cases, either treated in one of 17 hospitals with (n = 68,135) or in one of 4 hospitals without an open door policy (n = 246,195). We also analyzed the data according to participants' stay on open, partially open, or locked wards. To compare hospital and ward types, we used generalized linear mixed-effects models on a propensity score matched subset (n = 126,268) and on the total dataset. The effect of open vs. locked door policy was non-significant in all analyses of aggressive behavior during treatment. Restraint or seclusion during treatment was less likely in hospitals with an open door policy. On open wards, any aggressive behavior and restraint or seclusion were less likely, whereas bodily harm was more likely than on closed wards. Hospitals with open door policies did not differ from hospitals with locked wards regarding different forms of aggression. Other restrictive interventions used to control aggression were significantly reduced in open settings. Open wards seem to have a positive effect on reducing aggression. Future research should focus on mental health care policies targeted at empowering treatment approaches, respecting the patient's autonomy and promoting reductions of institutional coercion.     

病房噪声的暴露现状及干预研究

目的:了解病房噪声的来源,实施合理的干预措施,评价其对病房噪声的控制效果。方法:应用噪声测量仪连续72h监测病房的各种噪声及病房整体环境噪声水平,分析病房噪声的来源及暴露现状,并对其实施为期8周的干预,比较干预前、后病房整体环境噪声水平及各种噪声源强度的差异。结果:干预前,病房昼间与夜间的噪声水平均超过规定标准;干预后,病房昼间、夜间噪声水平及各种噪声源强度均低于干预前,差异具有统计学意义(P<0.05)。结论:病房中存在多种来源的噪声,通过对病房的噪声源实施具体可行的干预措施,可有效降低病房的噪声水平。     

连续性排班及层级管理模式在外科护理中的应用

目的 探讨连续性排班结合层级管理在外科护理管理中的应用效果.方法 对外科病区实行层级管理联合连续性排班,实行护士长-责任护士层级管理模式,重建各层级各班人员的工作职责,比较实施前后护理质量,患者对护理质量的满意度,医生的认可度及护士的自我满意度.结果 实施后患者对护理工作的满意度,医生对护士的认同度及护士自我满意度得到很大提高;实施后护理质量明显提高,护理意外及缺陷发生例次明显降低.结论 实施层级管理联合连续性排班有助于提高护理质量,提高工作效率,激发护理人员的积极性.     

儿科病房多重耐药菌的分布特点与防控对策

目的了解儿科病房多重耐药菌的分布特点,制定预防控制措施。方法对本院2011年1月～2012年6月儿科患者分离出的多重耐药菌进行统计分析。结果在1283例患儿中分离出细菌348株,其中多重耐药菌124株,占总细菌35．6％。在多重耐药菌中,产ESBLS的大肠埃希菌最多占39．5％,其次为产ESBLS的解鸟氨酸克雷伯菌占16．9％;多重耐药菌主要分布于呼吸道和胃肠道。结论儿科病房多重耐药菌发病率高．应采取切实可行的措施加以防控。