早期护理干预对预防早产儿高胆红素血症的效果研究

目的探讨早期护理干预对预防早产儿高胆红素血症的效果。方法将转入NICU的110例早产儿作为研究对象,随机分为观察组(早期护理干预组)55例和对照组(非干预组)55例。观察组在转入NICU 6h内给予温生理盐水洗肠通便,然后给予母乳胃肠内营养及抚触护理。对照组按传统的方法实施常规护理,对生后48h内不能哺乳、未排胎便者给予针对性对症护理。比较2组患儿腹胀情况、体重增长情况及高胆红素血症的发生率。结果观察组患儿黄疸持续时间、消退时间显著短于对照组(P<0.01),观察组高胆红素血症发生率显著低于对照组(P<0.01)。结论早期护理干预对预防早产儿高胆红素血症效果显著。     

护理干预对预防早产儿高胆红素血症的效果观察

目的：探讨护理干预对预防早产儿高胆红素血症的效果。方法将91例早产儿随机分为对照组和观察组，对照组45例，给予常规护理，对出生后48 h内不能哺乳、未排胎便者给予针对性对症护理。观察组46例，在给予常规护理的同时，入院6h内给予温生理盐水灌肠通便，配合腹部按摩、抚触及给予早期母乳胃肠内营养等综合护理干预。比较两组患儿黄疸及高胆红素发生情况。结果观察组胎便排尽时间、经皮胆红素（T BC ）均值、T BC峰值、黄疸消退时间、高胆红素血症发生率均明显低于对照组，差异有显著意义（P＜0．05）。结论早期综合护理干预，对预防早产儿高胆红素血症效果显著。     

不同护理干预方式对早产儿病理性黄疸的影响

目的 探讨早期护理干预对早产儿病理性黄疸的影响.方法 将转入NICU的110例早产儿作为研究对象,随机分为观察组（n=55）和对照组（n=55）.观察组在出生后6 h内给予温生理盐水洗肠通便、生理盐水洗胃、胃肠减压,建立母乳胃肠内营养及抚触疗法.对照组按传统的方法实施常规护理,对出生后48 h内不能哺乳、腹胀、未排胎便者给予针对性对症护理.比较两组患儿腹胀情况、喂养耐受情况、体重增长情况及高胆红素血症的发生率.结果 两组患儿黄疸出现时间（4.37±1.23）d、黄疸持续时间（5.74±1.32）d、消退时间（8.74±2.07）d、黄疽指数（9.05±2.72）μmol/L、血清胆红素值（118.60±28.42）μmol/L;对照组患儿黄疸出现时间（2.17±1.02）d、黄疽持续时间（11.62±2.57）d、消退时间（11.35±3.72）d、黄疽指数（15.62±3.51）μmol/L、血清胆红素值（210.49±30.27）μmol/L;两组比较差异均有统计学意义（P＜0.01）;观察组患儿腹胀、喂养不耐受、呼吸暂停、高胆红素血症发生率低于对照组（P＜0.01）;腹胀缓解时间、吸吮吞咽功能建立时间、体重增长及达足量喂养时间优于对照组（P＜0.01）;观察组患儿住暖箱时间、住院时间、医疗费用均少于对照组（P＜0.01）.结论 早期护理干预减少了早产儿病理性黄疸的发生率,达到了预期效果.     

综合护理对预防早产儿高胆红素血症的影响

目的:探讨综合护理对预防早产儿高胆红素血症的影响。方法:将184例早产儿随机分为对照组和观察组各92例,对照组给予常规护理,观察组在常规护理基础上给予综合护理,比较两组胆红素均值、首次排便时间、胎便排尽时间、黄疸消退时间、高胆红素血症发生率、中重度黄疸发生率、家长满意度。结果:观察组首次排便时间、胎便排尽时间、胆红素均值、黄疸消退时间均低于对照组(P0.05),高胆红素血症、中重度黄疸发生率低于对照组(P0.05),满意度高于对照组(P0.05)。结论:早期综合护理干预可有效预防早产儿高胆红素血症的发生。     

基于循证实践的早期口腔干预在NICU早产儿护理作用分析与探讨

目的 探讨基于循证实践的早期口腔干预在新生儿重症监护病房（NICU）早产儿护理中的作用。方法 选择 2021 年 1 月 至 2022 年 12 月期间本院 NICU 收治的早产儿 180 例作为研究对象。采用随机数字表法将研究对象分为对照组和观察组，每组 90 例。对照组用常规护理，观察组用基于循证实践的早期口腔干预。分析对比两组的喂养进程、喂养效率、胃肠功能障碍发生 情况、血清胆红素水平及护理满意度。结果 观察组早产儿喂养进程显著快于对照组（P＜0.05）。观察组喂养效率显著优于对照 组（P＜0.05）。观察组胃肠功能障碍发生率显著低于对照组（P＜0.05）。观察组血清胆红素水平显著低于对照组（P＜0.05）。 观察组护理满意度显著高于对照组（P＜0.05）。结论 对 NICU 早产儿采用循证实践的早期口腔干预，能促进喂养进程，改善喂 养效率与胃肠道功能，降低血清胆红素水平，提高护理满意度。     

早期护理干预对预防早产儿呕吐的效果与观察

目的：探讨早期护理干预预防早产儿呕吐的效果。方法：对我院NICU收治的80例早产儿随机分成干预组和对照组。干预组在出生后开奶前予1%碳酸氢钠洗胃后禁食6 h喂配方奶;施加抚触按摩每日3次,在喂奶前实施;对照组不洗胃,在出生后24 h直接喂配方奶,观察二组在出生后10 d内呕吐的发生率。结果：干预组呕吐的发生率为7.5%,对照组为25%,差异具有统计学意义（P〈0.05）。结论：早期护理干预可减少早产儿呕吐的发生率,促进患儿的早日康复。     

早期抚触对新生儿高胆红素血症的影响

[目的]探讨早期抚触对新生儿高胆红素血症的影响。[方法]将100例正常足月新生儿随机分为对照组50例和干预组50例，对照组与干预纽在常规预防的同时，干预组增加抚触。[结果]新生儿高胆红素血症干预组发生率为34％，对照组发生率为58％，干预组发生率较对照组低（P〈0．05）。[结论]早期抚触对预防新生儿高胆红素血症有一定效果。     

早产儿高胆红素血症早期干预的临床观察

目的 :探讨早期干预对早产儿高胆红素血症的影响。方法 :将 12 5例早产儿随机分为两组 :①干预组 :6 4例 ;②对照组 :6 1例。干预组 2 4h内采用苯巴比妥、尼可刹米治疗 ,对照组未采取早期干预。并观察两组的总胆红素值变化。结果 :干预组总胆红素值在 96h、14 4h明显低于对照组 (P <0 .0 1)。结论 :对早产儿早期干预 ,可有效地降低早产儿高胆红素血症发生率。     

鸟巢式护理联合穴位按摩在预防早产儿高胆红素血症中的疗效观察

目的探讨鸟巢式护理联合中医穴位按摩早期干预在预防早产儿高胆红素血症的临床效果。方法 76例早产儿随机分为观察组和对照组,各38例。2组早产儿分娩后均安置于暖箱中,常规蓝光治疗和护理。观察组早产儿进入暖箱后睡在医院自制"鸟巢"式襁褓中,给予穴位按摩。比较2组早产儿出生后首次排便时间、大便转黄时间、蓝光治疗次数以及娩出后48、72、96 h经皮测胆红素水平。结果观察组首次排便时间、大便转黄时间均显著早于对照组(P0.01),蓝光治疗次数低于对照组(P0.05);观察组48、72、96 h经皮测胆红素水平低于对照组(P0.05)。结论实施鸟巢式护理联合中医穴位按摩早期干预,可以降低早产儿高胆红素血症发生风险,对预防新生儿胆红素脑病具有重要意义。     

早期护理干预在新生儿黄疸治疗中的应用及疗效分析

[目的]探讨早期护理干预对新生儿黄疸的影响。[方法]将120例新生儿黄疸患儿随机分为对照组与观察组。对照组患儿给予常规护理,观察组患儿接受游泳、光照、抚触等早期干预措施,比较两组患儿血清胆红素值、胎便转黄时间、体重、治疗总有效率等指标。[结果]干预后观察组患儿血清胆红素值低于对照组、胎便转黄时间早于对照组、体重重于对照组（P均〈0.01）;观察组与对照组治疗总有效率分别为95.0%和81.7%,差异有统计学意义（P〈0.01）。[结论]对新生儿黄疸患儿早期进行护理干预可减轻高胆红素血症,增加患儿体重,促进患儿康复。     

我国姑息护理教育现状及需求的调查

目的了解姑息护理教育的现状、开展方式及护士态度。方法采用自行设计的调查问卷,对参加2006年6月杭州姑息护理理论与技术国际研讨会的150名护理人员进行调查,并对调查结果进行归纳总结。结果46%的护理人员表示对姑息护理不了解,90%以上的护理人员认为有开展姑息护理教育的必要。结论姑息护理教育尚未引起普遍重视,有必要开展系统的姑息护理教育,以适应现代护理发展的需要。     

Exploring the views of nurse prescribing among Macmillan nurses

Nurse prescribing is a key government initiative which aims to enhance patient care. The aim of this study was to investigate the prescribing practice of specialist nurses working in cancer and palliative care and to explore the benefits of and barriers to uptake of nurse prescribing training. A national postal survey of 2252 Macmillan nurses was undertaken using a structured questionnaire with open-ended questions. Data were analyzed using thematic content analysis for 1575 respondents (70% response rate). Only 13% (203) had undergone prescribing training and of these 105 provided responses to the open questions concerning training and of the 87% (1372) who had not undergone the training, 423 provided details on barriers to nurse prescribing training. The data presented in this paper draw from this data. The findings indicate that those who prescribed gave the prospect of improving care as the main reason for undertaking nurse prescribing training. The main reasons why these specialist nurses did not undertake training were: resource issues particularly with respect to backfill while training, lack of medical support and mentorship, concerns about the relevance of prescribing as a nursing role and prioritizing other courses. If nurse prescribing is to be more widely available for cancer and palliative care patients it is important in both primary and secondary care to address the resource and support issues.     

Patient approaches to clinical conversations in the palliative care setting

AIM: The aim of this paper is to report a study exploring patients' understanding of their discussions about end-of-life care with nurses in a palliative care setting. BACKGROUND: It is assumed that nurses are central players in patients' major decisions about their care, yet minimal information is available about the complexity of patient-nurse interaction in palliative care, and patients' views of the impact of such interactions on decisions that are made. METHOD: A modified version of grounded theory was used to collect and analyse interview data collected in 2001-2002 with a convenience sample of 11 patients in a palliative care setting. Interviews focused on each patient's selection of two decisions they had made in the past 6 months that had involved nurses in the decision-making process. FINDINGS: Processes were identified between nurses and patients that facilitated or blocked open discussion and discernment of patients' preferences for care. Six approaches that patients used in their conversations with nurses about their care: wait and see, quiet acceptance, active acceptance, tolerating bossiness, negotiation and being adamant. These approaches are described in terms of how they assisted or impeded autonomous decision-making. CONCLUSION: Palliative care patients often adopt passive roles and tend not to engage in important decision-making, for various reasons. Professionals need to be made aware of this, and should facilitate an open, trusting relationship with patients in order to ensure that important information passes freely in both directions. Professionals should learn to prioritize patient participation and negotiation in their work. With further research, it should be possible to identify the factors that will allow patients to take a more pro-active role in making decisions about their care, where desired.     

Critical caring. Promoting good end-of-life care in the intensive care unit.

Changing the culture in the ICU to include palliative care interventions along with curative interventions is already underway. Further work is needed, however. This is a role for the critical care nurse. Critical care nurses can be involved in research and education to enhance their future practice in end-of-life care. Research to establish evidence-based protocols for use in patients who require palliative care in the ICU needs to be done. Critical care nurses can prepare themselves for carrying or dying patients by attending palliative care seminars and continuing education courses or by taking a short clinical sabbatical or internship in a local hospice to observe and help give end-of-life care. Hospice nurses can be invited to the ICU to give inservice sessions and to help nurses and other staff understand the transition to dying, including the services that need to be offered to the patient and the family. Nurses from the hospital palliative care team can consult and be available for follow-up. Promoting good end-of-life care should be a goal for all intensive care nurses and critical care units. This goal is reached one patient at a time.     

31省份儿科护士安宁疗护知识与态度现状调查

目的 调查31个省份儿科护士安宁疗护知识与态度现状,为培养儿科安宁疗护专科护士提供依据.方法 2020年10月,选取31个省份74所医院的儿科护士370名为研究对象,采用安宁疗护知识及态度问卷对其进行调查,并分析其影响因素.结果 儿科护士安宁疗护知识和态度得分分别为54.55(39.77,81.82)分和72.44(6...     

The importance of funding palliative care education: a look to the future

This article outlines the position statement agreed by the Midlands Palliative Care Teachers' Professional Forum. Written by a member of the group, it includes suggestions from other members and was submitted for publication before the recent announcement of funds being available for palliative education for district nurses. The article highlights the challenges facing the adequate funding of specialist palliative care education and, in particular, for education departments within independent hospices. The statement recognizes the sensitive nature of subjects that ought to be included in palliative care education. Emphasis is placed on the provision of holistic multiprofessional and uniprofessional courses dedicated to enhancing the quality of palliative care. The article confirms the commitment of palliative care educationalists to this end and looks to continued commitment of adequate funding from NHS trusts and regions in supporting existing palliative care education and its ongoing development in response to clinical need.     

Effects of a postqualification course in palliative care

AIM: This paper reports a study to determine the effectiveness of a postqualification course in palliative care in terms of increased knowledge, insight and self-efficacy among Registered and Licensed Practical Nurses. BACKGROUND: The importance of measuring the effectiveness of postqualification courses in palliative care for nurses is widely recognized. The benefits of such courses are often merely described in terms of satisfaction of the course participants. METHOD: A convenience sample of nurses was studied. The effect measurement comprised a pretest/post-test quasi-experimental design. Two instruments were used: a comprehensive variant of the Palliative Care Quiz for Nurses and an especially developed domain specific self-efficacy instrument for palliative care. These were used before and after the course. FINDINGS: The course had a positive effect on knowledge and insight level as well as on level of self-efficacy. The main improvements were related to pain and symptom management. Participants seemed to be able to increase the effects of the course by implementing certain products on the wards, such as clinical lessons, a pain assessment scale and relaxation massage. CONCLUSIONS: Palliative care courses can make a significant contribution to nurses' knowledge and insight, as well as their self-efficacy in providing palliative care.     

Nurses' attitudes to palliative care in nursing homes in Western Australia

Nursing homes are one of the care settings in Western Australia where older people may spend their final years. Residents should be able to receive palliative care where appropriate, but this type of care is not always available at some nursing homes in the state. This study investigated nurses' attitudes to palliative care in nursing homes by examining their cognitive, affective and behavioural information. A sample of 228 nurses working in nursing homes completed a questionnaire, using a free response methodology. Results showed that participants had either a positive or negative attitude to palliative care. Cognitive and affective information significantly and independently predicted the attitudes of nurse, whereas knowledge of palliative care did not contribute significantly to these attitudes. Nurses currently working in palliative care were more positively disposed towards such care, but this disappeared when they ceased working in the area. There is an emphasis on education in the literature which does not take into account the beliefs and emotions of the nurse. Therefore, there is a need to consider these in undergraduate and postgraduate training for nurses. Current experience is also important in palliative care education. The results obtained from nurses in this study should be incorporated into policy for introducing palliative care into nursing homes and used to provide support and assistance to nurses working in this field.     

"Pain talk" in hospice and palliative care team meetings: an ethnography

BACKGROUND: Specialist palliative care nurses have considerable expertise in pain management and this expertise can contribute to tension in the boundary between specialist nurses and non-specialist doctors. OBJECTIVES: This article reports on how specialist palliative care nurses contribute to team talk about pain and the rhetorical strategies they use to develop their reputation and credibility in pain management. DESIGN AND SETTINGS: This is an ethnographic study involving the collection of naturally occurring data from eight palliative care team meetings. The study is concerned with team meetings in hospice, community and hospital palliative care settings. METHODS: Data was collected by audio recording eight team meetings in hospice, hospital and community palliative care settings. The data were analysed using a grounded theory approach followed by application of the tools of discourse and conversation analysis. RESULTS: The findings indicate that specialist palliative care nurses use rhetorical strategies such as contrastive rhetoric, telling atrocity stories, veiled criticism and neutralism as a platform for building a reputation in managing pain. Furthermore they situate their expertise in pain management by direct contrast with problems related to non-specialist practice in pain management. CONCLUSIONS: The team meetings are a safe place, a collegial setting for specialist nurses to challenge non-specialist medical practice and to manage the specialist/non-specialist boundary. The findings have implications for further research related to the specialist nurse/non-specialist doctor boundary and for education of specialist nurses and GPs.