护士对患者安全文化的感知调查

目的 了解护士对患者安全文化的感知,为进行干预性试验提供描述性资料.方法 采用自制护士对患者安全文化的感知调查表,对2008年11月参加广东省护理学会举办骨科护理新技术学习班的学员67人进行调查.结果 护士感知医院患者安全文化的水平低22人(占32.84%),中等40人(占59.70%).高5人(占7.46%);总分31.48±10.04.58.21%护士认为自己医院处于安全文化发展的反应性时期,26.86%护士认为处于病态时期.结论 护士感知组织患者安全文化处于初级阶段,要建立起科学的患者安全文化,必须领导重视,建立保密、自愿、非惩罚性上报系统.     

A Review of Common Tanning Methods

Tanning in the United States has become an increasingly popular activity in our culture. Tanning methods have evolved through the years to become more readily accessible and easier to use for all consumers, regardless of geographic location. With the rising incidence of skin cancer, the demand for safe and efficient tanning methods remains high. There are currently many different tanning methods being utilized, and still more are being researched. This article serves to summarize some of the most common tarining methods used in the United States today as well as some potential methods currently under study.Tanning remains an incredibly popular activity in our society despite the well-known risks. Many people view tan skin as more aesthetically pleasing. In fact, 90 percent of women perceive tan skin as being more attractive than non-tan skin.1 As such, approximately 10 percent of the US population uses indoor tanning salons, the majority of which are female.2 Studies have shown that the high prevalence of tanning is because the perceived aesthetic benefits outweigh the risks and is not due to lack of knowledge about the dangers of tanning with ultraviolet radiation (UVR).3 Aside from UVR tanning, which includes both sunbathing and the use of indoor tanning salons, there are forms of sunless tanning that are popular as well. While these have traditionally been viewed as safer than UVR tanning, some concerns have been raised about the safety profile of these methods. This article serves to summarize the various methods of tanning that are used today, as well as some new potential tanning options that are being researched and explored.     

Treatment of Acute Achilles Tendon Rupture in Scandinavia Does Not Adhere to Evidence-based Guidelines: A Cross-sectional Questionnaire-based Study of 138 Departments

The best treatment of acute Achilles tendon rupture has been discussed for decades. During the past half decade, evidence has increased in favor of nonoperative treatment and dynamic and weightbearing rehabilitation. We hypothesized that the treatment strategies would show great variation and that adherence to evidence-based recommendations would not be as good as desired. The purpose of the present study was to investigate how acute Achilles tendon rupture is treated in Scandinavia. A questionnaire was distributed to all orthopedic departments treating acute Achilles tendon ruptures in Denmark, Sweden, Norway, and Finland. The questionnaire was returned by 138 of 148 departments (response rate 93%). Two-way tables with Fisher’s exact test were used for statistical analysis. In Denmark, Norway, Sweden, and Finland, 19 of 23 (83%), 44 of 48 (92%), 26 of 40 (65%), and 8 of 27 (30%) departments recommended surgical treatment (p < .001). Dynamic rehabilitation was used significantly less often in Denmark (5 of 23 [22%]), Norway (17 of 45 [38%]), and Sweden (11 of 40 [28%]) than in Finland (15 of 26 [58%]; p = .015). A significant difference was found among the countries in the educational level of the performing surgeons (p < .001). Surgical treatment was the treatment of choice in Danish, Norwegian, and Swedish hospitals regardless of the increasing evidence favoring nonoperative treatment. Although increasing evidence has favored dynamic rehabilitation, it has gained limited use across Scandinavia. Weightbearing was used in most hospitals. Surgery was performed by junior surgeons in most hospitals across Scandinavia. Treatment algorithms showed considerable variation and often did not adhere to the clinical evidence.     

Mohs Tissue Mapping and Processing: A Survey Study

BACKGROUND: Mohs micrographic surgery (MMS) is the most reliable, conservative, and tissue-sparing approach to the management of cutaneous malignancies. The concept of MMS is simple, but its technique, which involves a series of suboperations, is complex. OBJECTIVE: To define which techniques of Mohs tissue mapping and processing are presently employed by members of the American College of Mohs Micrographic Surgery and Cutaneous Oncology. METHODS: Five hundred eighty surveys of eight questions regarding different techniques used in Mohs tissue mapping and processing were mailed out to Mohs micrographic surgeons registered with the American College of Mohs Micrographic Surgery and Cutaneous Oncology. A total of 310 responses (53%) were collected between October and December 2002. The results were tabulated and analyzed. RESULTS: Most Mohs micrographic surgeons personally prepare the map of the tissue in relationship to the patient (66.5%). A hand-drawn picture with standard orientations is most frequently used to map and orient a tissue specimen (69.4%). Histotechnicians usually prepare the tissue specimen for cryostat processing (63.5%). A heat extractor and/or tissue cuts or "slits" are the preferred methods used to flatten tissue by 52.9% of respondents. Hematoxylin and eosin is the stain that is most commonly used (82.6%). Approximately 50% of Mohs micrographic surgeons cut the excised specimen from the first stage into two separate pieces. Each tissue piece is then commonly processed into three to six representative serial sections per glass slide (68.1%). These sections are most commonly cut at 5 to 6 microm (53.9%) and less frequently at 4 microm (21.9%). CONCLUSION: There is variability in mapping and processing techniques employed Mohs micrographic surgeons and their histotechnicians. As long as the integrity of each step of Mohs tissue mapping and processing is preserved, the high cure rate of the technique should be maintained.     

合同制护士职业主观幸福感调查分析

目的 了解合同制护士群体主观幸福感的现状,为临床护理管理者对合同制护士的有效管理提供依据.方法 采用主观幸福感指数量表对110名合同制护士进行调查.结果 合同制护士的生活满意度平均得分为5.64±1.32,群体主观幸福感指数的平均值为10.65;学历越高幸福感指数越低(P<0.01);未婚护士幸福感指数显著高于已婚护士(P<0.05);外科护士幸福感指数显著高于内科护士(P<0.01).结论 合同制护士主观幸福感指数与医院对合同制护士的管理制度、自身期望值、科室环境以及社会支持等有一定关联,对于不同类可别合同制护士应区别对待.     

手术室护士工作压力源调查分析

目的 了解手术室护士工作压力的来源,探讨减轻手术室护士工作压力及保障其身心健康的方法.方法 采用自行设计的手术室护士压力源量表,对聊城市5所手术量较大医院的100名手术室护士进行问卷调查.结果 手术室护士工作压力较大的依次为担心工作中出现差错事故[(3.32±1.12)分]、工作量太大[(3.27±1.02)分]、经常加班[(3.25±1.20)分]、护理工作的社会地位太低[(3.25土1.00)分]等.结论 手术室护士的压力来源广泛,影响其身心健康.主管部门应积极采取有效措施,减轻手术室护士的工作压力.     

Perception and Awareness of Bariatric Surgery in Canada: a National Survey of General Surgeons

Background

The objective of this study was to assess Canadian general surgeons’ knowledge of bariatric surgery and perceived availability of resources to manage bariatric surgery patients.

Methods

A self-administered questionnaire was developed using a focus group of general surgeons. The questionnaire was distributed at two large general surgery conferences in September and November 2012. The survey was also disseminated via membership association electronic newsletters in November and December 2012.

Results

One hundred sixty-seven questionnaires were completed (104 practicing surgeons, 63 general surgery trainees). Twenty respondents were bariatric surgeons. Among 84 non-bariatric surgeons, 68.3 % referred a patient in the last year for bariatric surgery, 79 % agreed that bariatric surgery resulted in sustained weight loss, and 81.7 % would consider referring a family member. Knowledge gaps were identified in estimates of mortality and morbidity associated with bariatric procedures. The majority of surgeons surveyed have encountered patients with complications from bariatric surgery in the last year. Over 50 % of surgeons who do not perform bariatric procedures reported not feeling confident to manage complications, 35.4 % reported having adequate resources and equipment to manage morbidly obese patients, and few are able to transfer patients to a bariatric center. Of the respondents, 73.3 % reported residency training provided inadequate exposure to bariatric surgery, and 85.3 % felt that additional continuing medical education resources would be useful.

Conclusions

There appears to be support for bariatric surgery among Canadian general surgeons participating in this survey. Knowledge gaps identified indicate the need for more education and resources to support general surgeons managing bariatric surgical patients.

     

Relatives' Perception After Tissue Donation Experience: Results of a Postdonation Phone Survey

Introduction

Postmortem tissue donation (TD) requires the establishment of strategies for family approach to clearly explain the characteristics of multi-tissue donation. In a tertiary university hospital with a long tradition of tissue generation, we designed a survey to be applied to tissue donor families to evaluate global hospital care, care from Transplant Coordinators (TC), quality and content of information given about TD, experience, and motivations after TD process.

Threshold of Tactile Perception After Nipple-Sharing: a Prospective Study

Reconstruction of the nipple-areola complex is the final procedure of a breast reconstruction. The method of choice in our department for nipple reconstruction is nipple-sharing and tattooing of the areola. Some patients are reluctant to use a part of the healthy nipple, as it is not fully known how the sensibility in the remaining donor nipple is affected by surgery. Twenty patients admitted to the hospital for nipple-sharing were invited to participate in the study. The tactile perception threshold of the donor nipple was assessed using von Frey monofilaments preoperatively, and 1, 6, and 12 months postoperatively. The patients' subjective impressions one year postoperatively were also evaluated. The donor nipple had regained sensibility to touch six months after nipple-sharing. All patients reported that the nipple felt the same as before surgery and could become erect. We therefore recommend the nipple-sharing technique for completion of a breast reconstruction.     

Improving the Recruitment and Retention of Organ Procurement Coordinators: A Survey Study

Organ procurement coordinators (coordinators) employed by organ procurement organizations (OPOs) are critical to the success of organ donation. However, their high turnover rates may threaten the success of organ donation. This cross-sectional study examined employment satisfaction and factors contributing to job turnover among 326 coordinators representing 52 of 58 OPOs (90%) who completed an online survey. Most (93%) respondents reported high levels of job satisfaction, although 26% reported considering leaving their OPO, and 61% perceived a high turnover rate at their OPO. Considerations of leaving the OPO were most likely to emerge at 2 years of employment. To secure coordinator job satisfaction, it is essential that prospective coordinators be adequately prepared and informed about negative as well as positive aspects of this line of work. In hiring, OPOs should recruit more proactively, using their staff as contacts, and seek experience in critical care, intensive care, or other on-call work. To retain satisfied employees, OPOs should offer more education and advancement opportunities and focus on such issues as call and hours, rather than salary per se . OPOs should consider a variety of alternative pay structures, particularly separate on-call pay, whether or not coordinators are actually called into service.     

Choosing a Femoral Head: A Survey Study of Academic Adult Reconstructive Surgeons

Background

Our aim was to examine how academic adult reconstructive surgeons have interpreted evidence on femoral head material in total hip arthroplasty (THA).

慢性盆腔炎患者疾病相关知识认知调查

目的 了解慢性盆腔炎患者对疾病相关知识的认知,为护士有效实施健康教育提供参考.方法 采用自行设计调查表对60例慢性盆腔炎患者进行疾病相关知识认知调查.结果 80.0%患者对保持经期卫生有较好认知,35.0%对正常分娩、流产及妇科手术有正确认知,65.0%患者对正确的会阴清洁方法了解不确切或方法错误,仅5.0%患者了解影响疾病的因素.不同文化程度、家庭收入及年龄患者疾病相关健康知识认知得分比较,差异有统计学意义(P<0.05,P<0.01).结论 慢性盆腔炎患者对经期卫生有较好的认知,但其总体健康知识水平仍普遍偏低,尤其欠缺对治疗措施的了解、疾病预后及疾病影响因素的认知.护士临床工作中可根据患者健康知识水平,加强有针对性的健康教育指导,帮助其获取健康知识.     

Knowledge and Perception of Bariatric Surgery Among Primary Care Physicians: a Survey of Family Doctors in Ontario

Purpose

The primary objective of this study was to identify Ontario family physicians’ knowledge and perceptions of bariatric surgery.

Methods

The study population included all physicians practicing family medicine in Ontario who were listed in the Canadian Medical Directory. A self-administered questionnaire consisting of 28 questions was developed and validated using a focus group of seven primary care physicians. The questionnaire was distributed to 1328 physicians.

Results

One hundred sixty-five surveys were completed. 8.8 % of physicians did not have any bariatric surgical patients, and 71.3 % had no more than five in their practice. 70.2 % referred no more than 5 % of their morbidly obese patients for surgery. Only 32.1 % had the appropriate equipment and resources to manage obese patients. 92.5 % of physicians would like to receive more education about bariatric surgery. Physicians with no history of referral (n?=?21) were earlier into their practices and had less morbidly obese patients than physicians with previous referrals (n?=?141). They were also less likely to discuss bariatric surgery with their patients (30 vs. 79.3 %; p?<?0.001) and less likely to feel comfortable explaining procedure options (5.6 vs. 33.9 %; p?=?0.013) and providing postoperative care (26.7 vs. 64.2 %; p?=?0.005). 55.6 % would refer a family member for surgery, compared to 85.4 % of physicians with previous referrals; p?=?0.002.

Conclusion

There appears to be a knowledge gap in understanding the role of bariatric surgery in the treatment of obesity. There is an opportunity to improve education and available resources for primary care physicians surrounding patient selection and follow-up care. This may improve access to treatment.