野外急救多功能气道防护屏的研制

研制一种适合野外急救使用的多功能气道防护屏,以解决气道相关操作时患者呼吸道分泌物喷溅的问题。多功能气道防护屏由一个底部为直角"目"型框架,两个体部为直角"∏"形不锈钢支架,一个双层开放气道体位调节垫和一个透明塑料罩组成,具有可拆卸、可折叠及视野清晰的多功能呼吸道防护装备;防护屏设计具有可调节头颈后仰卧位,能充分显露气道提高气管插管成功率,可提高医护人员安全性和满意度;在防护屏内建立人工气道、实施各种气道护理,可防止患者呼吸道分泌物喷溅,使周围环境处于相对安全状态,有效避免职业暴露及交叉感染。     

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。     

General vaccination willingness and current vaccination status in relation to clinical and psychological variables in patients with multiple sclerosis

BackgroundInfections can have a significant impact on morbidity and mortality in multiple sclerosis (MS) patients. Therefore, vaccinations are of immense importance. If vaccination willingness is to be increased, possible influencing factors should be identified. The aim of the present study was to investigate the status of active immunisation in MS patients in association with sociodemographic, clinical-neurological, psychopathological and personality variables using the NEO-Five Factor Inventory, the Temperament and Character Inventory-Revised and the Hospital Anxiety and Depression Scale.MethodFour hundred and four MS patients from two German neurological hospitals were examined for their vaccination attitudes, in detail, the general willingness to vaccinate and the current vaccination status of mumps, measles and rubella (MMR) as well as tetanus and influenza. We also looked at the current level of disability in relation to the current vaccination status, as well as possible associated personality and psychopathological variables.ResultsPatients with a complete MMR vaccination status were significantly younger and those with a complete influenza vaccination status were significantly older than those with related incomplete vaccination status. Tetanus vaccination status completeness did not differ depending on age and did not show substantial association with personality scores. However, influenza vaccination completeness was associated with differences in personality and psychopathological variables; extraversion, openness, novelty seeking, harm avoidance and anxiety. A reported general vaccination willingness was significantly correlated with the current completeness of tetanus and influenza vaccinations. Novelty seeking, persistence, extraversion, agreeableness, conscientiousness and neuroticism were found associated with an increased vaccination willingness. Anxiety and depression were not related to general vaccination willingness.ConclusionsNo specific personality trait could be defined on its own in relation to general vaccination willingness or complete vaccination status. Younger patients should be made more aware of influenza vaccination. Reasons for rather low vaccination rates need to be further investigated.     

优化急诊护理对急性心肌梗死患者抢救效果的影响

目的评价急性心肌梗死(心肌梗死)患者抢救期间配合应用优化急诊护理干预对抢救效果的影响。方法选择本院收治的急性心肌梗死患者,总计80例。除抢救治疗外,给予患者随机分组进行护理干预,对照组40例急性心肌梗死患者采取常规急诊护理,试验组40例急性心肌梗死患者采取优化急诊护理干预。比较对照组与试验组急性心肌梗死患者组间分诊评估时间、急救总时间、住院时间、救治成功率、护理满意度。结果经优化急诊护理的试验组急性心肌梗死患者的分诊评估、急救以及住院时间均少于对照组,护理满意度高于对照组(P<0.05)。另外,组间救治成功率比较(P>0.05)。结论急性心肌梗死患者抢救中运用优化急诊护理可以缩短患者抢救时间、提高抢救成功率。     

结构化病情交班模式在急诊抢救室的应用

【】目的：探讨结构化病情交班模式在急诊抢救室的应用。方法：成立结构化病情交接班模式专案小组,通过结构化理论知识培训、组织工作坊形式的实战演练、临床推广实践等方式,使护理人员的交接班流程更加规范。结果：研究组护理人员交班质量评分明显优于对照组(P＜0.05)；研究组护理人员接班质量评分明显优于对照组(P＜0.05)；研究组护理人员交接项目完整率明显优于对照组(P＜0.05)；研究组护理人员不良事件发生率明显低于对照组(P＜0.05)。结论：采用结构化病情交接班模式,使护理人员交接流程变得更规范,减少不良事件发生率,使工作效率得到提高,临床上应当进一步推广应用。     

急诊急救护理对有机磷农药中毒患者的效果观察

目的探讨急诊急救护理对有机磷农药中毒患者的效果。方法将2016年3月-2019年3月我院收治的74例有机磷农药中毒患者按随机数字表法分为观察组(n=37)和对照组(n=37)。对照组患者给予常规的急救护理,观察组在对照组的基础上给予高效一体化急救护理。比较两组患者的洗胃时间、洗胃液体容量、胃内容物溢出率以及抢救成功率。结果观察组的洗胃时间、洗胃液体容量、胃内容物溢出率均要明显低于对照组;观察组患者抢救成功率明显高于对照组(P<0.05)。结论对有机磷农药中毒患者应用高效的急诊急救护理,能够明显减少患者的洗胃时间、洗胃液体容量、胃内容物溢出率,提高抢救成功率,值得临床应用。     

多院区综合医院应对新冠肺炎救治策略研究

大型多院区综合医院一般都具有较强的空间集中性、人口密集性和影响辐射性,在新发重大传染病暴发的情况下,大型多院区综合性医院必然成为新发重大传染病救治的前沿部门和关键环节,其救治策略直接对新发重大传染病的最后结果造成很大的影响。以泰州市某三甲多院区综合医院救治新冠肺炎为例,总结出多院区综合医院"集中患者、集中专家、集中资源和集中救治"的管理策略,供相关单位参考借鉴。     

乡镇卫生院卫生技术人员现况研究*

目的分析乡镇卫生院卫生技术人员的基本情况、工作负担、收入水平、满意度以及离职意愿等。方法通过自制调查表对五个区县1 112个卫生技术人员进行调查。使用SPSS 20.0软件对定量数据进行描述性统计分析。结果约1/3的乡镇卫生院卫生技术人员每周加班2次以上;近一半卫生技术人员每周工作41~50小时;调查卫生技术人员年收入均值为4.7万元,满意度均值为7.3分;卫生技术人员认为目前工作三大劣势是收入低、职称晋升困难和工作负担重;超过一半的卫生技术人员认为职称晋升困难,收入和职业发展空间有限;22.8%的卫生技术人员有离职意愿,其中有一半想进入县级公立医疗机构。结论乡镇卫生院卫生技术人员工作负担较重;收入和满意度不高,对职业发展的前景持消极态度;人才有向县级公立医疗机构流动的趋势。