10例游离足趾移植手指再造围手术期护理

通过对10例游离足趾移植手指再造围手术期的护理,包括术前心理护理、术前准备及术后及时缓解疼痛,密切观察再造指以及供趾保留皮条的血液循环,加强动静脉血管危象及用药后不良反应的观察与护理,结果本组再造手指全部成活,功能良好.     

10例游离足趾移植手指再造围手术期护理

通过对10例游离足趾移植手指再造围手术期的护理,包括术前心理护理、术前准备及术后及时缓解疼痛,密切观察再造指以及供趾保留皮条的血液循环,加强动静脉血管危象及用药后不良反应的观察与护理,结果本组再造手指全部成活,功能良好.     

足趾游离移植手指再造术的系统护理

总结了102例122指拇手指缺损病人取足趾游离移植手指再造术护理观察要点,通过术前心理护理、术后疼痛护理、指体血运观察及对发生血管危象的病人给予针对性处理,成活120指,坏死2指,再造手指成活率98.0%。认为精心的术前准备和围手术期的观察和护理及功能康复锻炼指导,保证了病人再造手指顺利康复。     

手指全形再造的功能康复训练

对158例166指全形再造手指围手术期进行有计划的系统康复训练.第一阶段:保温、消炎、抗凝、制动,保证再造手指成活.第二阶段:更换支具,早期进行主动活动.第三阶段:软化瘢痕和关节,加强功能锻炼.第四阶段:开始进行再造指感觉及触觉训练.第五阶段:开始日常生活训练及职业前训练.经术后6个月至2年的随访,手部功能优良率达到98.20%.     

踇趾腓侧皮瓣联合第二足趾移植再造拇指的围手术期护理

总结踇趾腓侧皮瓣联合第二足趾移植再造拇指的围手术期护理。包括术前进行疾病知识宣教,让其了解再造拇指的知识及注意事项,术后护理人员密切观察患者全身和局部再造手指的变化。认为做好围手术期护理,密切观察病情变化,发现问题及时处理,可提高再造手指的成活率。     

游离足趾移植再造拇指和手指围手术期护理体会

目的:探讨游离足趾移植再造拇指和手指围手术期护理方法。方法:对我院11例行再造术的患者进行围手术期护理,自制观察表记录,对术后发生血管危象分析。结果:11例全部存活,2例发生术中危象,2例发生术后危象。结论:细致周密的护理观察,早期发现预防术后血管危象是提高再造指存活率的关键。     

手指再造成活及功能康复的护理

对121例168指再造手指围术期进行有计划的系统康复护理干预。第一阶段：保温、消炎、抗凝、制动，保证再造手指成活。第二阶段：更换支具，早期进行主动活动。第三阶段：软化瘢痕和关节，加强功能锻炼。第四阶段：开始进行再造指感觉及触觉训练。第五阶段：开始日常生活训练及职业前训练。经6个月至2年的随访，手指功能优良率达到98．2％。     

拇指V°缺损再造18例围术期护理

目的:探讨拇指V°缺损患者行游离足趾再造术的围术期护理。方法:对18例拇指V°缺损患者术前重视患者心理辅导,术后密切观察再造指血运,注意观察引起血管痉挛的因素并及时解决。结果:本组患者再造指无血管危象发生,再造指均存活。结论:积极的围术期护理结合术后早期功能锻炼有利于患者功能恢复,是手术成功的重要因素。     

足趾移植拇指再造术修复拇指缺损50例围术期护理

对50例拇指缺损患者行足趾移植拇指再造术,做好围术期的护理.结果术后4例发生血管危象,均发现及时,经积极手术探查后,3例危象解除;1例因动脉反复顽固性痉挛探查3次后,患者要求放弃治疗.成活58指(98.3%).认为围术期做好精心护理可提高再造指的成活率,促进再造指功能恢复.     

多手指离断再植的护理

报告了61例多手指离断患者行再植的术前及术后护理,包括:术前重视患者心理辅导,术后密切观察再植指血运,并处理引起血管痉挛的因素,使再植指顺利度过血管危象期外,更加注重术后心理护理及功能锻炼,帮助患者早期功能恢复.认为心理引导、围手术期的护理及合理功能锻炼是手术成功的重要因素之一.     

面中份骨骼中位牵引治疗中部后缩畸形的护理

目的探讨应用手术截骨和正畸牵引联合矫治的牵引成骨技术的护理方法。方法手术前详细讲解治疗的方法、过程，针对患者的顾虑进行心理护理，做口腔护理，准备牵引器具。手术后，将面弓的额托和颏托平稳置于额和颏部表面，用正畸橡皮圈连接面弓的横梁与牵引钩的外部连接体进行牵引，注意调整牵引力的大小和方向，做口腔和鼻腔的护理，防止感染，进行详细的出院指导。结果所有患者顺利康复，面容和咬和关系完全恢复正常。面部上、中、下各部的前后关系协调鼻梁，鼻下部挺拔。结论患者围手术期的护理是确保牵引成骨技术成功的重要环节。     

对电子胃镜检查病人实施全程护理干预的效果研究

目的探讨全程护理干预在电子胃镜检查中的效果。方法将121名初次接受电子胃镜检查的病人随机分为实验组和对照组,对照组采取常规护理,实验组在常规护理基础上采取指压穴位法、分心法、放松训练法等干预措施。结果实验组焦虑得分、血压、心率、呼吸及不适程度明显低于对照组,插入电子胃镜的时间少于对照组。结论全程护理干预可有效减轻电子胃镜检查病人的痛苦,并有利于检查的顺利完成。     

Nursing care of cognitively impaired, institutionalized elderly

Findings indicate the importance of many nursing staff behaviors in relation to the behaviors of demented elderly persons, especially when asking the elder to complete a care task, such as dressing. Nonverbal as well as verbal nursing staff behaviors were related to behaviors of demented elderly persons, especially smiling, eye contact, and manipulating the environment to avoid difficult encounters. The nursing staff's ability to remain relaxed and flexible when assisting with the elder's care was strongly related to the elder's ability to remain flexible, calm, and cooperative during the care procedure. Use of verbal distraction or redirection, praise, and light-hearted, playful approaches were often found to be helpful when the demented elder became upset or paranoid.     

微创技术Orthofix外固定架治疗儿童股骨干、胫骨干骨折的护理

目的:探讨Orthofix外固定架治疗儿童股骨干、胫骨干骨折的护理方法。方法:对39例用Orthofix外固定架治疗股骨干、胫骨干骨折患儿的护理进行总结分析。结果:39例均获得骨性愈合,优良率为100%。结论:Orthofix外固定架治疗儿童股骨干、胫骨干骨折是一种损伤小、对骨折处生理影响小、骨折愈合快、并发症少的手术,同时作好手术前后的护理以及科学合理的功能锻炼是患儿全面康复的重要保证。     

视觉分散和视听分散对接受结肠镜检病人焦虑和接受性的影响

目的通过在结肠镜检查中给患者看DVD,了解视觉分散和视听联合分散对受检者焦虑和接受性的影响。方法采用随机对照的研究方法,将180例准备行结肠镜检查的患者随机分为三组,每组60例,视觉分散组检查时看DVD但不听DVD里播放的声音,视听分散组检查时看DVD并戴着耳机听DVD里播放的声音,对照组检查时不看DVD,比较三组患者间的焦虑水平和接受性。结果视觉分散组和视听分散组检查后焦虑水平降低较对照组显著,但这种差异未达到统计学意义。视觉分散组和视听分散组的愿再检查率均较对照组高(P<0．05)。结论视觉分散和视听分散能增加结肠镜检查患者的接受性,对患者的焦虑水平无显著影响。     

Relaxing to the beat: music therapy in perioperative nursing.

1. Music therapy is a research-based nursing intervention that can be used in perioperative nursing to reduce anxiety and prevent postoperative complications. 2. Music therapy provides patients with some degree of control and the opportunity to participate in their own care. 3. The use of headphones allows the patient to listen to the music without the distraction of other sounds.     

Smartphone distraction during nursing care: Systematic literature review

AimTo investigate the impact of smartphone distraction on the quality and safety of care provided by the nursing population during work.BackgroundAbout 80% of nurses use the smartphone in the workplace both for personal purposes and as a useful support to improve the quality of care. Distraction from smartphones during care is a phenomenon that should be known and managed within each health service.MethodsA systematic review of the literature was conducted using the PRISMA methodology. The sources included in the review study were subjected to a qualitative assessment using the GRADE method.ResultsSixteen articles were included in the review. Studies included highlight the positive and negative consequences of using mobile devices during nursing practice. Findings identify the smartphone as a generator of stimuli capable of diverting the attention of the person from the priority activities and absorbing the cognitive resources useful for carrying out these activities. Some studies aimed to show the restriction policies and/or the strategies for reducing disruptions. This review highlights how the free and indiscriminate use of the smartphone can negatively affect patient safety and the nurse-patient relationship through the dehumanization and depersonalization of care.ConclusionsMobile technology can improve nurses' performance and the quality of care provided. However, the application of regulations and policies by healthcare facilities is desirable to avoid inappropriate use of these devices by nurses. The available data do not provide a precise estimate of the effect that distraction from smartphones has on the outcomes of nursing care.     

Impact of an education programme for staff working with children undergoing painful procedures

AIM: Needle phobia is very common in children, particularly in those with chronic illness who may have to endure many painful procedures. A programme developed to educate paediatric healthcare professionals working with children undergoing painful procedures was evaluated to identify: (1) whether the education programme led to an increase in participating clinicians' knowledge and confidence; and (2) the effectiveness of the education programme in changing practice for patient care. METHOD: Five senior house officers undertook the one-hour training provided by the hospital play specialist. Questionnaires were completed by the clinicians at the beginning and end of the programme. Nurses reported on the clinicians' adherence to best practice. Twenty-one children who had undergone painful procedures were interviewed with their parents to assess their levels of pain, distress, satisfaction and coping style. RESULTS: Participants had increased their knowledge of how to work with children undergoing painful procedures. The main changes in knowledge reported by the clinicians were involving the nurse and the play specialist, preparing the equipment out of sight of the child and using distraction techniques. Parents and children reported low levels of distress during painful procedures, high levels of satisfaction with the procedure and listed a number of coping strategies that helped the child, and the parent, to cope during the procedure. Staff reports indicated that the protocol for painful procedures and that techniques such as distraction were being used in the majority of cases to help the child to cope. CONCLUSION: There are useful pain control techniques that can be taught relatively quickly by nursing staff to paediatric healthcare professionals that do make a substantial difference to the care of children.     

Assessing pediatric patients for vascular access and sedation.

Central venous catheters have been established as a reliable source of vascular access since the 1970s. Peripherally inserted central catheters became a popular central catheter in the early 1990s for adults and children. The management of vascular access in children is an essential part of inpatient and outpatient care. Assessing and inserting the appropriate catheter for the pediatric patient is just a part of the component for central catheter care. Care providers also need to assess these children for sedation or distraction for the procedure. This article discusses factors for catheter choice and points for assessing children for sedation or distraction for vascular access insertion.