扇形培训对提升消化内科护理人员护理水平和护理质量的价值分析

目的观察扇形培训对提升消化内科护理人员护理水平和护理质量的影响,分析扇形培训在优质护理服务建设中的应用价值。方法为了提升护理核心服务能力,自2017年3月起我院消化内科在护理培训中开始采取扇形培训模式,本研究将实施扇形培训前(2016年2月～2017年2月)1年内消化内科护理指标考核情况作为对照组,实施扇形培训后(2017年3月～2018年2月)1年内消化内科护理指标考核情况作为观察组,比较两组护理质量评分、患者满意度和护理不良事件发生情况。结果观察组护理满意度(95.68%)、护理质量评分(95.43±1.57)分均明显高于对照组,差异具有统计学意义(P0.05);观察组护理投诉(1.44%)、护理差错(0.72%)、护理意外事件(0.72%)明显低于对照组,差异具有统计学意义(P0.05)。结论扇形培训能够提升消化内科护理人员的护理水平,提升护理质量,减少护理不良事件,有利于消化内科优质护理服务的建设。     

提高手术室护生教学质量与法律意识教育的探讨

手术室是为患者施行各类手术并进行抢救的重要技术部门,又是护生的实习基地.针对手术室护理工作潜在的法律问题,我们在对护生的实习带教中,实施理论宣教以强化护生的法律观念;结合手术室操作带教实践规范护理操作流程:严把查对病人,手术部位,输血关,准确清点手术物品,切实执行消毒灭菌常规.杜绝了护生在实习中出现差错事故以致触犯法律的事件,提高了教学质量和护生的法律意识.     

提高手术室护生教学质量与法律意识教育的探讨

手术室是为患者施行各类手术并进行抢救的重要技术部门，又是护生的实习基地，针对手术室护理工作潜在的法律问题，我们在对护生的实习带教中，实施理论宣教以强化护生的法律观念；结合手术室操作带教实践规范护理操作流程：严把查对病人，手术部位，输血关，准确清点手术物品，切实执行消毒灭菌常规，杜绝了护生在实习中出现差错事故以致触犯法律的事件，提高了教学质量和护生的法律意识。     

浅谈手术室差错事故的防范措施

目的 探讨防范手术室发生差错的护理措施,以减少差错发生,确保手术室护理工作的安全、准确和高效.方法 通过严格执行查对制度、职责明确、完善手术室管理制度等途径,总结手术室护理的工作常规.结果 与结论实施环节控制有效预防了手术室护理差错的发生.     

基层医院护理技术操作存在问题分析及对策

目的 探讨如何提高护士护理技术操作水平,改变护士操作中的不规范性,满足患者的护理安全需要.方法 通过三年来对我院127名在岗护理人员的基础护理操作考核,实行以科室为单位培训演练,院操作组全面考核,针对出现的问题,与<河南省医院管理综合评价细则>有关标准进行对照分析,采取当场指正和科室讨论纠正,使护士全面理解掌握.结论 采取科室培训,院方考核方式,是保证技术操作的规范性、统一性的有效手段,是提高护理质量、减少事故发生、保证患者安全的有效措施.     

神经内科实施风险管理的做法与体会

目的 探讨神经内科实施风险管理的做法与体会.方法 针对神经内科常见的风险因素,采取了一系列的风险管理措施:如制定神经内科安全制度,不定期组织学习等,完善查对制度与交接班制度等.结果 自2007年实施风险管理之后,差错事故明显减少,事故发生率从实施风险管理前的4.40%降至0.97%,患者及家属满意度显著上升.结论 实施有效的风险管理是减少临床差错事故的重要手段,是患者健康和安全的重要保障.     

69例护理差错相关因素分析及预防对策

目的探讨护理差错发生的原因、环节、时段、人群及防范对策.方法对69例护理差错进行回顾性分析.结果最常见的护理差错是药物治疗失误(79.7%),发生的直接原因多见于未认真执行查对制度52例(75.4%),未遵守操作规程和护理常规15例(21.7%),发生的环节多见于过医嘱环节20例(29.0%)、治疗环节20例(42.0%),发生时段多见于中夜班独立当班时、常规工作时(28.9%),工作繁忙时、节假日(21.7%),发生人群多见于低年资护士(59.1%)、护师(31.8%).结论加强风险意识教育,健全制度,认真执行查对制度和操作规程;提高护理人员素质和合理安排人力资源;是预防护理差错的有效措施.     

手术查对应注意方向性和顺序性以防止护理差错

手术查对是手术室日常护理工作的重要内容和必要环节,严格执行手术查对制度,把握好查对工作的基本要领和注意事项,是每个手术室工作者的职责所在,特别是在手术查对中注意方向性和顺序性可以较好地防止各种差错事故的发生.笔者从事手术室护理工作12a来,进行6421台手术查对,无一例差错发生,积累了一定的手术查对工作经验,对提升手术室护理质量管理具有一定临床意义.     

加强静脉输液治疗的环节管理提高护理服务质量

静脉输液是临床治疗中最常见的治疗方法,是基础护理操作中用得最多的技术,也是发生护患纠纷最多的治疗环节。因此。护士应做好静脉输液中的每一个环节,以减少护患纠纷。从而提高护理质量,更好地服务于病人^[1]。我院护理部自2007年1月起采取一系列措施。通过对全院护士进行综合素质培训,规范静脉输液过程中护士语言和操作行为;严格执行查对制度,责任到人;     

门诊输液室护理风险因素分析与防范措施

目的分析门诊输液室的护理风险因素并提出相应的防范措施,从而减少门诊输液室的护患纠纷。方法对门诊输液室所存在的风险因素进行逐个分析,包括从护理人员方面以及患者方面进行分析,并提出相应的防范措施。结果为了降低输液室护理风险,我院提出规范护理流程、增强护士责任心、加强护士技能培训、加强护患沟通等措施,以减少护理差错以及纠纷。结论采取相应的防范措施能够降低门诊输液室护理风险,同时优化输液护理。     

Asymmetry of the internal connections of the striate cortex of the cat in the projection zone of the center of the field of vision

Studies were carried out on the organization of the internal connections of the striate cortex in cats in the projection zone of the center (0–5°) of the field of vision by microintophoretic application of horseradish peroxidase to electrophysiologically identified orientational columns. The area containing neurons showing retrograde labeling in most cases extended in the mediolateral direction. Labeled cells were located in the upper (II, III) and lower (V, VI) layers of the cortex, and the shapes and orientations of the areas containing labeled neurons in these layers coincided. Spatial asymmetry was detected in the distribution of labeled neurons relative to the orientational column studied. Labeled cells were located predominantly medial to the columns, regardless of the distance from the projection of the area centralis. Considering the visuotopical map of field 17, the asymmetry detected here provides evidence that neurons in orientational columns have more extensive connections with neurons of the peripheral part of the cortex. An asymmetrical distribution of “silent” zones around the receptive fields of neurons in orientational columns is suggested, and that these appear to receive influences from the periphery of the visual field. Laboratory of Visual Physiology and Laboratory of Central Nervous System Morphology, I. P. Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Makarov Bank, 199034 St. Petersburg, Russia. Translated from Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 82, No. 12, pp. 23–29, December, 1996.     

Effects of the lesion of the postcommissural part of the septum on the behavior of the rat.

The effects of the lesion of the postcommissural part of the septum on behavior of the rat has been studied. Results may be summarized as follows. An increase in the exploratory behavior in the open field which decreases rapidly; a decrease in the number of defecations in this test and a decrease in time leaving a dark environment for exploration. In the shuttle box test, no facilitation of the acquisition, but a permanent and quite significant increase in the intertrial activity has been found. We conclude that the lesions tend to decrease the emotivity of the subjects. An interpretation on the basis of the species -- specific defensive reactions explains the transitory and permanent effects of the lesions on the spontaneous activity.     

Counterpointing the functional role of the forebrain and of the brainstem in the control of the sleep-waking system

This paper reviews the lifetime contributions of the author to the field of sleep-wakefulness (S-W), reinterprets results of the early studies, and suggests new conclusions and perspectives. Long-term cats with mesencephalic transection show behavioral/polygraphic rapid eye movement sleep (REMS), including the typical oculo-pupillary behavior, even when the section is performed in kittens prior to S-W maturation. REMS can be induced as a reflex. Typical non-rapid eye movement S (NREMS) is absent and full W/arousal is present only after a precollicular section. The isolated forebrain (IF) rostral to the transection exhibits all features of W/arousal and NREMS [with electroencephalographic (EEG) spindles and delta waves], arousal to olfactory stimuli, and including the appropriate oculo-pupillary behaviors. These features also mature normally after neonatal transection. REMS is absent from the IF. After deprivation there is NREMS pressure and rebound in the IF, but the decerebrate cat only shows pressure for REMS. Most IF reactions to pharmacologic agents are within expectations, except for the tolerance/withdrawal effects of long-term morphine use which are absent. In contrast, these effects are supported by the brainstem (i.e. seen in the decerebrate cat). In cats with ablation of the telencephalon, or diencephalic cats, delta waves are absent in the thalamus. EEG thalamic spindle waves are seen triggering S for only 4-5 days after ablation. Therefore, true NREMS is absent in chronic diencephalic cats although pre- and postsomniac behaviors persist. These animals are hyperactive and show a pronounced, permanent insomnia; however, a low dose of barbiturate triggers a dramatic REMS/atypical NREMS rebound. Cats without the thalamus (athalamic cats), initially show a dissociation between behavioral hyperactivity/insomnia and the neocortical EEG, which for 15-20 days exhibits only delta and slower oscillations. Fast, low-voltage W rhythms appear later on, first during REMS, but spindle waves and S postures are absent from the start, such that these cats also display only atypical NREMS. Athalamic cats also show barbiturate-sensitive insomnia. Cats with ablation of the frontal cortices or the caudate nuclei remain permanently hyperactive. They also show a mild, but significant hyposomnia, which is permanent in afrontal cats, but lasts for about a month in acaudates. The polygraphic/behavioral features of their S-W states remain normal. We conclude and propose that: (a) the control of the S-W system is highly complex and distributed, but is organized hierarchically in a well-defined rostro-caudal manner; the rostral-most or highest level (telencephalon), is the most functionally complex/adaptative and regulates the lower levels; the diencephalic/basal forebrain, or middle level, has a pivotal role in inducing switching between S and W and in coordinating the lowest (brainstem) and highest levels; (b) W can occur independently in both the forebrain and brainstem, but true NREMS- and REMS-generating mechanisms exist exclusively in the forebrain and brainstem, respectively; (c) forebrain and brainstem S-W processes can operate independently from each other and are preprogrammed at birth; this helps understanding normal and abnormal polygraphic/behavioral dissociations in humans and normal dissociations/splitting in aquatic mammals; (d) NREMS homeostasis is present in the IF, but only REMS pressure after deprivation persists in the decerebrate cat; (e) the thalamus engages in both NREMS and W; (f) insomnia in diencephalic cats is the result of an imbalance between antagonistic W- and S-promoting cellular groups in the ventral brain (normally modulated by the telencephalon); (g) the EEG waves, which are signature for each S-W state, appear to truly drive the concomitant behaviors, e.g. a hypothetical human IF could alternate between behavioral NREMS and W/arousal/awareness; (h) a role for REMS is to keep the individual sleeping at the end of the self-limiting NREMS periods. The need for accelerating research on telencephaling NREMS periods. The need for accelerating research on telencephalic S-W processes and downstream control of the lower S-W system levels is emphasized.     

The development of the ligament of the head of the femur

The hip joints of 30 human male and female fetuses and stillborns between 20 mm and 350 mm crown-rump length were studied by light microscopy. The ligament of the head of the femur developed in situ as a condensation of mesenchyme at the end of the second month of intra-uterine life (IUL), and was vascularized by branches of acetabular vessels early in the fourth month. In the majority of fetuses older than 5.5 months IUL, vessels in the ligament passed a short way into the femoral head within cartilage canals, to supply a small region around the fovea capitis. The remainder of the head was supplied by vessels in canals from around the upper part of the neck. The ligament changed from predominantly cellular to fibrous during the last 4 months of IUL. This increase in strength suggested significant mechanical functions in utero: limitation of adduction-flexion and opposition to postero-superior dislocation were the most likely.     

Topical organization of the projections of neurons of the substantia nigra and the ventral field of the tegmentum of the midbrain to the head of the caudate nucleus of the cat

Neuroscience and Behavioral Physiology -     

Involvement of the striatum in the central regulation of the hormonal functions of the gonads

Studies reported here show that intrastriatal administration of corticoliberin to rats decreases the blood testosterone level. However, in conditions of chemical deficiency of dopaminergic transmission in the dorsal striatum induced by injection of 6-hydroxydopamine, the effect of this neurohormone did not appear. It is concluded that extrahypothalamic corticoliberin is involved in regulating the hormonal reproductive system acting via dopaminergic mechanisms. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 85, No. 4, pp. 594–597, April, 1999.     

Ultrastructure of the endothelium of the drainage system of the eye

The endothelium of the ocular drainage system (Schlemm’s canal, collector tubules, and aqueous veins) in primary juvenile glaucoma undergoes degenerative dystrophic changes with compensatory hypertrophy and proliferation at the initial stages of the glaucomatous process and atrophy and desquamation at advanced and terminal stages. Progressive decrease in the pinocytous function of endotheliocytes, reduction of the protein-synthesizing and mitochondrial compartments of the cytoplasm, and formation of autophagosomes reflect the process of endotheliocyte degeneration in general. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 145, No. 5, pp. 574–577, May, 2008