护理专业学生对工学结合订单式培养真实体验的研究

目的深入了解护理专业学生对工学结合订单式培养的真实感受,为探索院校联合订单式培养的新模式提供依据。方法对20名订单式培养的护理专业学生进行访谈,将获得的资料进行编码、分析、整理、提炼主题。结果在进入订单式培养时,学生表达出认同感、自豪感和紧迫感;进入订单式培养后,学生有归属感、主人翁意识、压力感、收获感和感恩感,并提出文化认同培训、增加教学内容、教学方法多样化等需求,以及护理价值感和成就感等职业新感受。结论工学结合订单式培养得到了学生广泛认可,今后应强化用人单位文化价值的引领作用,不断丰富教学内容,优化和改进教学方法。     

严重皮肤撕脱伤患者的护理体会

目的探讨严重皮肤撕脱伤发生的原因，采取有效的救治及护理措施。方法总结2009～2013年发生严重皮肤撕脱伤共7例的临床资料与护理措施。结果经采取有效的抗休克、创面换药、植皮等护理，6例患者愈合良好。结论皮肤撕脱伤是严重而复杂的创伤，其创面大，常合并有深部组织损伤，病情危重、复杂，创面组织渗出多，感染率高，需要护理人员熟练的急救技术配合救治。     

Integrating psychology with interpersonal communication skills in undergraduate nursing education: Addressing the challenges

The inclusion of the social, behavioural and bio-sciences is acknowledged as essential to the development of the art and science of nursing. Nonetheless, the literature highlights on-going debate about the content and delivery of these subject areas in undergraduate nursing education. The bio-sciences and social sciences in particular have received much attention but more recently the inclusion of psychology in nursing curricula is gaining momentum. Studies conducted on nursing students' views of these supporting sciences have also highlighted problems with their understanding, relevance and application to nursing practice.Although broad guidelines are given as to what should be included, no detail is given as to how much detail or at what level these subjects should be taught. Subsequently, approved institutions are responsible for their own course content. This has resulted in inconsistent and varied approaches to integrating the sciences in undergraduate nursing curricula.Following a recent review of the undergraduate nursing curriculum in one university in the Republic of Ireland a decision was made to combine the teaching, learning and assessment of Applied Psychology with Interpersonal Communication skills. This paper will describe the developmental process and evaluation of the integrated module.     

Achieving graduate outcomes in undergraduate nursing education: following the Yellow Brick Road

Nursing practice is a dynamic and constantly changing field within healthcare, with well-documented challenges to maintaining a suitably skilled workforce to meet the needs of the community it serves. Undergraduate nursing education provides the mandatory minimum requirements for professional registration. Each nursing program has clearly stated graduate attributes, qualities that their graduates will possess on graduation. The aim of this paper is to stimulate discussion about graduate attributes for nurses, a transferrable set of specific attributes that make nursing graduates work ready. This paper focuses on identifying specific attributes, the embedding of those attributes in nursing education, particularly through role modelling, with the aim of producing a future workforce that is knowledgeable, compassionate and confident. The graduate attributes are likened to the qualities sought by the characters in ‘The Wizard of Oz’; brains, heart and courage and the learning process as the ‘Yellow Brick Road’. There is a relative lack of discussion about role modelling by nurse educators for nursing students, a potentially undervalued learning experience that we believe must be brought to the forefront of discussions pertaining to undergraduate nursing education and achieving graduate outcomes.     

新生儿个体化发育支持护理及评估在极低出生体重儿中的应用

新生儿个体化发育支持护理及评估（Neonatal Individualized Developmental Care and Assessment Program ，NIDCAP）自1986［1］年Dr ．Als 推广以来，已在国外很多医院实施于新生儿监护病房内的早产儿及高危新生儿。该项目以神经发育和心理发育为基础，强调对患儿的行为反应进行观察评估，采用个体化干预方案。我院2012年5月始，在新生儿重症监护病房设立了特殊照护（Special Care Nursery ， SCN）病房，对极低出生体重儿运用NIDACP模式进行护理，取得一定效果，现报告如下。     

普外科手术患者术后疼痛相关因素研究

目的观察和分析年龄、性别和护理干预与普外科患者手术后疼痛分级的关系。方法以我院普外科2010年10月～2011年10月住院进行手术的528例患者作为研究年龄、性别与术后疼痛关系的观察对象，按患者年龄分为少年组、青年组、中年组、老年组；按性别分为男性组和女性组；将我院2011年11月～2012年7月进行手术的305例患者随机分为观察组和对照组，观察护理干预对术后疼痛的影响。观察组给予综合性护理干预，对照组给予普外手术一般护理；按照主诉疼痛分级法，将患者术后的疼痛感觉分为四组：无疼痛组、轻度疼痛组、中度疼痛组、重度疼痛组。运用分级资料的统计学分析方法（Kruskal—WallisH检验、Spearman秩相关分析），分析普外科手术后疼痛程度分别与患者年龄、护理干预的相关性。结果普外科手术后疼痛程度与年龄之间有明显相关性（疼痛程度与年龄的比较结果Y。=9．341，P〈0.05，Spearman相关系数为rs=0．128，P〈0.05。普外科手术后疼痛程度与性别无明显关系（X^2=3．184，P=0．364〉0．05），普外科手术后疼痛程度与护理干预之间有明显相关性（x^2=3．184，P=0．364〉0．05），Spearman相关系数rs=0．177，P〈0.05。结论普外科患者手术后疼痛程度与年龄有明显关系，年龄越大，手术后疼痛程度越高；性别与术后疼痛程度之间无相关性；术后进行系统护理干预，可以明显减轻患者的疼痛程度。     

腹膜透析短管腰袋的设计与使用

持续性不卧床式腹膜透析，是终末期肾脏病的主要治疗手段之一。腹膜透析管路分体内部分和体外部分，体外部分是通过腹部皮下10 cm的皮下隧道，有20 cm 留在体外，由腹膜透析导管体外部分（约长20 cm ）、钛接头及短管（约长20 cm ）组成，称腹膜透析短管，是患者进行腹透换液操作治疗的通路，连接短管末端污染是引起腹膜炎的重要原因。腹膜相关性感染是腹透技术失败的主要原因，由于操作不当、无菌观念不强，腹膜透析短管污染引起的感染也是引起腹膜相关性感染的原因之一，故连接短管的妥善保管十分重要。以往的腹膜透析袋不能按病人腰部大小随意调整，给护理操作和患者带来诸多不便。为了方便腹透导管的放置及患者操作，我科自行改良设计了腹膜透析腰袋，经50例患者的临床使用，效果满意，现介绍如下。     

中西医结合护理对膝骨关节炎关节功能及疼痛影响的研究

目的探讨中西医结合护理对膝骨关节炎（KOA）关节功能及疼痛的影响。方法300例KOA患者，分为观察组和对照组。观察组150例患者，在常规护理基础上接受中西医结合护理措施；对照组150例患者给予常规护理。结果各项观察指标比较观察组明显优于对照组（P〈0．01）。结论对KOA患者采取中西医结合护理，可以减少其不良情绪的产生，改善关节功能，缓解疼痛，减少并发症，提高患者的满意度。     

先天性心脏病术后小儿无痛支气管镜吸痰的护理

目的探讨先天性心脏病术后小儿无痛支气管镜吸痰的护理经验。方法对65例先天性心脏病术后小儿无痛支气管镜吸痰的护理配合进行分析。结果65例患者经纤维支气管镜检查吸尽气道分泌物后，患者呼吸状态明显好转，脉搏血氧饱和度上升5％～12％，肺部湿哕音较检查前明显减轻；其中32例肺不张患者经纤维支气管镜诊疗后，不张的肺叶次日胸部x线片复查明显复张，其中8例次日需再行纤维支气管镜检查和治疗后，肺叶亦完全复张，无1例严重并发症发生。结论无痛气管镜检查是比较安全的方法，并发症低。严格遵守操作规程，熟练的操作和术中密切医护配合及良好的术后护理，可降低并发症的发生，保证纤维支气管镜检查的安全、有效。     

一例体外膜肺氧合成功抢救碘帕醇对比剂致过敏性休克的护理体会

体外膜肺氧合（Extra corporeal membrane oxygenation,ECMO）又称体外生命支持系统,是指将患者的静脉血引流至体外,经人工肺（氧合器）氧合后再输回患者动脉或静脉的中短期心肺辅助治疗,使心肺得到充分休息,为心肺功能的恢复赢得时间[1]。而非离子型造影剂因其渗透压低,没有阳离子的生物学作用,不良反应少,具有良好的血管内皮和神经系统的耐受性,已广泛用于影像检查及介入治疗。