优化手术配合专业组轮转流程的实践及效果

目的:探讨手术配合专业组轮转流程及成效。方法:根据外科手术专科特点进行分组,实行相对固定制,每年轮转一次。各专科组设立一名组长,以护士长—组长—专科护士—专业护士—护士为各分组体系管理。实行优化手术配合专业组流畅式轮转及"一对一"手术配合方式,以理论授课、业务学习、分组训练及转组前集中训练相结合为轮转流程,采取自我评价、组长评价、外科医生评价反馈及理论考试等评价方式进行考核。结果:手术护士专科技术和手术配合技能均有所提高,从而提高了医生对手术护士的满意度。结论:通过优化手术配合专业组轮转流程的管理,缩短了轮转过程中存在的空档期,增加配合熟练度,同时使护理活动更规范,管理更科学,提高了手术室护理质量。     

综合性医院手术室护士的专科化训练

目的探讨培养手术室专科护士的方法.方法通过专科护士的设立、责任制手术间的设置与管理,以及分层次、分阶段的培训等,对手术室护士进行专科化训练.结果综合性医院手术室的专科护士手术配合达到了专科医院的配合水平和能力.结论综合性医院手术室护士的专科化训练,可以使综合性医院手术室护士的配合水平提高.     

综合性医院手术室护士的专科化训练

目的探讨培养手术室专科护士的方法。方法通过专科护士的设立、责任制手术问的设置与管理，以及分层次、分阶段的培训等，对手术室护士进行专科化训练。结果综合性医院手术室的专科护士手术配合达到了专科医院的配合水平和能力。结论综合性医院手术室护士的专科化训练，可以使综合性医院手术室护士的配合水平提高。     

建立手术室骨科系统护理亚专业组的模式探讨

目的探讨建立手术室骨科系统护理亚专业组模式在提高手术配合质量及专科发展中的作用。方法将手术室骨科专科护士分为创伤、脊柱和关节3个亚专业组,按照亚专业组固定人员和手术间,设亚专业组组长,试行亚专业组负责制度。结果医护配合默契,手术配合医生满意度从78.63%提高到97.31%;专科器械和仪器能得到及时维护和保养;与病房护士沟通良好,提高了围手术期的护理质量;护士业务和学术科研水平明显提高,发表论文由2006年的2篇增加到2009年的9篇,获专利2项,申报科研课题1项。结论手术室骨科系统亚专业组的建立,利于提高手术配合质量和工作效率,是培养高度专业化的现代手术室护士的有效模式。     

手术室护士分层次培养及使用的实践

[目的]探讨对手术室护理人力资源实行分层培养及使用的管理。[方法]根据我院手术专科的配置,结合我科护理人力资源结构情况,按专科需要分别设置为相应的10个专科组,护士长根据护理人员级别与岗位设置需要,分别设置专科组长、专科护士和专科轮转护士、助理护士等不同的角色。[结果]手术医生对护士的手术配合满意度有较大幅度的提高,有利于形成激励机制,实现人力资源的充分利用。[结论]对手术室护理人力资源实行分层培养及使用的管理,对培养手术室护理人员的专业才能,使护理人员朝着专科化的方向发展具有一定的意义。     

手术室护士分层次培养及使用的实践

[目的]探讨对手术室护理人力资源实行分层培养及使用的管理。[方法]根据我院手术专科的配置,结合我科护理人力资源结构情况,按专科需要分别设置为相应的10个专科组,护士长根据护理人员级别与岗位设置需要,分别设置专科组长、专科护士和专科轮转护士、助理护士等不同的角色。[结果]手术医生对护士的手术配合满意度有较大幅度的提高,有利于形成激励机制,实现人力资源的充分利用。[结论]对手术室护理人力资源实行分层培养及使用的管理,对培养手术室护理人员的专业才能,使护理人员朝着专科化的方向发展具有一定的意义。     

手术室护士相对专科化分组管理的做法与效果

目的:探讨手术室护士相对专科化分组管理的做法与效果,提高医护质量,增强手术室的整体功能。方法:根据各医疗专业组成立专科小组及培训体系,建立护士长—专科护士组长—组员,纵向层面的管理体系。将100台骨科手术配合的护士随机分为对照组和实验组,每组50台,分别采用传统的通科配合方式和成立专科小组进行管理,经过培训后进行比较。结果:成立专科小组后提高了医师对手术配合护士的满意度,缩短了手术时间,提高了工作效率。结论:成立专科护理配合小组可提高手术室医疗护理质量,增强手术室的整体功能,构建和谐的医护关系。     

专科组长在综合性医院手术室管理中的作用

目的:探讨专科组长在综合性医院手术室护理管理中的作用。方法:选择在手术室工作8年以上、能力较强、具有护师及护师以上职称的护士通过竞争上岗成为专科组长,协助护士长进行二级管理。结果:设立专科组长后手术房间的管理,仪器、器械的养护和手术室护士的专科业务技能都有了很大的提高(P0.05),医生满意度提高了11.96%。结论:充分发挥专科组长的管理作用,使手术室管理上了一个新台阶,形成了协调、有序、高效的管理机制。     

快速康复外科理念下手术室亚专科的构建与实践

目的探讨快速康复外科(ERAS)理念下手术室亚专科建设的构建与实践。方法选取福建医科大学附属闽东医院手术室护士52名作为对象,设置手术室亚专科组长和亚专科护士岗位,制定岗位说明书,形成以亚专科组长为核心,全面管理临床手术配合、质量安全、教学培训、物资供应、护理科研等。选择2019年5月至2021年3月手术室治疗患者92例作为对象,采用随机数字表法分为两组,各46例。对照组采用常规护理,观察组进行ERAS理念下手术室亚专科建设,比较两组护理满意度和手术配合质量。结果ERAS理念下手术室亚专科建设后手术配合、质量安全、教学培训、物资供应、护理科研评分高于ERAS下手术室亚专科建设前,观察组ERAS下手术室亚专科建设实践后患者护理方法、沟通技巧、健康宣教、手术效果、服务态度满意度高于对照组,观察组护理后手术配合药物供应、器械准备、器械传递、麻醉配合及抢救配合评分高于对照组,差异均有统计学意义(均P<0.05)。结论ERAS理念下手术室亚专科建设的构建有助于提高护士管理质量,用于手术治疗患者中可提高护理满意度和手术配合质量,值得推广应用。     

手术室亚专科护理岗位管理体系的构建与临床实践

目的:建立手术室亚专科护理岗位管理体系并应用于临床。方法:设置亚专科组长和亚专科护士岗位,制定岗位说明书,形成以亚专科组长为核心,对各亚专科的临床手术配合、质量安全、教学培训、护理科研、物资供应等各方面进行全面管理。结果 :手术室亚专科护理岗位管理体系的构建,促进了各专科的专业化发展。结论 :手术室亚专科护理岗位管理体系的实施,既提高了手术配合质量,又提高手术室护理管理的专业化水平,并使护士明确未来职业发展方向,值得推广。     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Rosamicin in Urethral and Vaginal Secretions and Tissues in Dogs and Rats

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.     

Similarities and differences in clients treated and in medications prescribed by APRNs and psychiatrists in a CMHC

This study is part of a larger study comparing prescribing practices of psychiatrists and advanced practice psychiatric nurses (APRNs) using the following three groups of patients: patients treated by psychiatrists, those treated by APRNs, and those treated by both APRNs and psychiatrists at different times in 1 year. Demographics for 5507 patients were examined. A subsample of APRNs and psychiatrists prescribed similar total numbers of medications. Psychiatrists prescribed more types of antidepressant medications other than the SSRI antidepressants, and they prescribed more than twice the number of benzodiazepines. APRNs prescribed more SSRIs and spent more time with clients during medication visits.     

Postural strategies and falls in elderly and in parkinsonism]

OBJECTIVE: To use a posture analysis to show the evolution of postural pattern connected with falls.MATERIAL AND METHOD: It is a prospective study on two groups of 16 persons of more than 60 years. A group concerns 16 small disability off drug parkinsonian patients, a group concerns 16 healthy witnesses. All the persons benefited from a posture recording by means of a force platform and were followed during 1 year. RESULTS: Data analysis underlines three groups of persons corresponding to three postural patterns, independently of the presence of Parkinson disease. A group (n = 18) did not contain fallers, the second (n = 10 ) contained 20% of fallers, the third (n = 4) contained 100% of fallers. Differences between the groups were identified on 16 posturographic parameters. DISCUSSION: A group has a good functional value and one does not record any fall. Its characteristics, which correspond to a category of persons who compensate well for the phenomena of ageing, are found in the literature. A group has an intermediate functional value and regrets 20% of fallers. Kinetic profile reveals a tendency to the stiffness of the posture. This group is going to operate rather ankle strategies. A group has an inferior functional value and regrets 100% of fallers. Kinetic profile seems disrupted and not to be able to adapt itself in a satisfactory way to the situation otherwise than by stereotypical reactions. This group is going to operate systematically much less stabilizing hip strategies. CONCLUSION: A close determinism between physiological neuromotor ageing and Parkinson disease does exist. We showed with a prospective follow-up, the arisen of fall and showed the evolution of postural patterns related to fall. It appears as well that evolution mainly follows three stages leading from a small risk of fall gait pattern to a major risk of fall gait pattern.     

Racial differences in oxidative stress and inflammation: in vitro and in vivo

African American race is an independent risk factor for enhanced oxidative stress and inflammation. We sought to examine whether oxidative-stress and inflammatory markers that are typically measured in humans also differ by race in cell culture. We compared levels between African American and Caucasian young adults and then separately in human umbilical vein endothelial cells (HUVECs) from both races. We found heightened oxidative stress and inflammation in the African Americans both in vitro and in vivo. African American HUVECs showed higher nitric oxide (NO) levels (10.8 ± 0.4 vs. 8.8 ± 0.7 μmol/L/mg, p = 0.03), Interleukin-6 (IL-6) levels (61.7 ± 4.2 vs. 23.9 ± 9.0 pg/mg, p = 0.02), and lower superoxide dismutase activity (15.6 ± 3.3 vs. 25.4 ± 2.8 U/mg, p = 0.04), and also higher protein expression (p < 0.05) of NADPH oxidase subunit p47phox, isoforms NOX2 and NOX4, endothelial nitric oxide synthase (NOS), inducible NOS, as well as IL-6. African American adults had higher plasma protein carbonyls (1.1 ± 0.1 vs. 0.8 ± 0.1 nmol/mg, p = 0.01) and antioxidant capacity (2.3 ± 0.2 vs. 1.1 ± 0.3 mM, p = 0.01). These preliminary translational data demonstrate a racial difference in HUVECs much like that in humans, but should be interpreted with caution given its preliminary nature. It is known that racial differences exist in how humans respond to development and progression of disease, therefore these data suggest that ethnicity of cell model may be important to consider with in vitro clinical research.