Preliminary Studies on the Relationship betweenAutoantibodies to Heat Stress Proteins and Heat Injury of Pilots during Acute Heat Stress

Organismsrangingfrombacteriatohu-mansrespondtoheatbyinducingthesyn-thesisofagroupofproteinsknownasheatshockorstressproteins(HSPs)andinhibit-ingthesynthesisofnormalproteins['J.Be-causethesynthesisofHSPsisinducednotonlybyheatbutalsoavarietyofotherstress(theadverseconditionsofphysiologi-calstress:ischemia,hyperthermia,lowpHetc.andenvironmentalstress:ethanol,aminoacidanalogs,heavymetals,freerad-icals,virusinfectionetc.)[l'2J.HSPsmayhavesuchimportantbiologicalfunctionsasraisingtheresistancetohe…     

新生儿监护病房实施住院总护士岗位培训的效果与评价

目的：评价在新生儿监护病房实施住院总护士岗位培训的方法及其效果。方法我院自2010年1月至2013年1月对11名护士进行住院总护士岗位培训上岗,比较住院总护士上岗前后科室护理质量、患儿家属满意度、护士个人能力以及夜班护士工作压力的情况。结果实施前新生儿监护病房护理质量评分为（88.9±1.3）分,实施后为（96.3±1.9）分;实施前患儿家属满意度评分为（90.1±1.8）分,实施后为（97.6±1.6）分。实施住院总护士岗位后科室护理质量和家属满意度均明显提高,差异均有统计学意义（P〈0.05）。11名接受住院总护士岗位培训的护士岗前急救技能考核合格4人,合格率为36.36%;人际沟通考核合格3人,合格率为27.27%;处理纠纷考核合格2人,合格率为18.18%;组织协调考核合格2人,合格率为18.18%;综合素质考核合格3人,合格率为27.27%。培训后所有护士均通过个人能力考核,合格率为100%。培训后护士个人能力考核合格率均高于培训前,比较差异均有统计学意义（P〈0.05）。自实施住院总护士岗位后,对新生儿监护病房36名夜班护士进行工作压力调查,实施前26人自觉工作压力大,占72.22%;实施后6人自觉压力大,占16.67%。实施住院总护士岗位后自觉压力大护士所占比例明显降低,比较差异有统计学意义（P〈0.05）。结论新生儿监护病房实施住院总护士岗位培训能明显提高科室护理质量和患儿家属满意度,提升护士个人能力,减轻夜班护士的工作压力,值得推广。     

Alcohol-related admissions to an intensive care unit in Dublin

Background  

Excessive alcohol consumption is ingrained in Irish society and is known to have significant adverse health consequences, including adverse outcomes for critically ill patients. Previous assessments of alcohol-related intensive care unit (ICU) admissions were felt to have underestimated the scale of this problem.     

新疆多民族地区重症医学专科护士培训效果分析与改进措施

目的探讨重症医学科病房专科护士培训的实施效果,提出相应的改进措施,提高重症医学(ICU)专科护士培训基地的教学质量。方法由新疆医科大学第一附属医院护理部对112名学员组织实施ICU专科护士培训,在培训结束时进行结业考试并填写基地教学质量反馈表。结果理论与临床实践考核成绩分布不均衡,其中理论与技术操作考核以良好居多,分别占42.9%和53.6%,临床实践优秀居多,占53.6%;学员对基地建设的满意度最高,对理论授课的满意度最低。结论 ICU专科护士的培训提高了学员的业务水平,加强了我院与各地州医院的合作与交流。还需要对ICU课程设置、培训模式及师资队伍的培养方面进行持续的改进与提高。     

重症监护病房的静脉血栓栓塞症问题

静脉血栓栓塞症（VTE）是住院患者特别是危重症患者一种严重的并发症，主要包括深静脉血栓形成（DVT）和肺血栓栓塞症（PTE）。重症监护病房（ICU）的患者由于自身的特殊性很容易发生DVT—PTE，其潜在的多系统性病变经常会掩盖DVT-PTE的症状和体征，导致诊断困难，成为ICU患者致死和致残的突出原因。     

重症监护室中的胸膜合并症

据报道 ,美国内科重症监护病房 (MICU) 6 2 %患者伴胸腔积液[1] ,机械通气者并发气胸亦较常见。但由于收入MICU的患者病情均较重 ,其胸膜疾病的临床表现和胸部X线片征象均不典型 ,故易漏诊。了解MICU患者伴发胸膜疾病的特点 ,有利于早期发现病情变化 ,及时治疗。一、MICU病人胸     

Depression in intensive cardiac care unit

Depression is known to occur in patients with heart disease and the intensive cardiac care unit (ICCU) environment adds to their worsening symptoms. The objective of the study was to determine depression in patients admitted to ICCU. A total of 30 patients admitted to ICCU with heart disease were taken for the study and were compared to patients with heart disease admitted in general medicine wards (except ICCU). The tool used was Beck's depression inventory (BDI). This study showed depression as assessed on BDI was statistically highly significant. The results showed that the patients in ICCU suffered from depression.     

Nosocomial infections in an intensive care unit in a private hospital

The nosocomial infection rate in the intensive care unit (ICU) of a private hospital was assessed during an 18-month survey. From 629 admissions to the ICU, 139 hospital-acquired infections were identified. The rate was 22.1% compared to the overall nosocomial infection rate of 15.3% for the entire hospital. In the ICU, the main infections occurred in the respiratory tract, 41 (29.5%), followed by surgical wounds, 35 (25.2%), urinary tract, 28 (20.1%) and the blood stream, 24 (17.3%). From 165 bacterial isolates, 80% of isolates were gram-negative rods, with P aeruginosa, 48 (36.6%), being the predominant gram-negative isolate followed by Klebsiella pneumoniae, 27 (20.6%), and Enterobacter sp, 22 (16.8%). The main gram-positive isolates were S aureus, 23 (41.8%), coagulase-negative Staphylococci, 17 (30.9%), and Enterococci, 11 (20.0%). Of the 23 S aureus strains, 15 (65.2%) were methicillin-resistant (MRSA), (8 MRSA were from surgical wounds, 5 from the respiratory tract and 2 from infected urine). Only 2 of the 17 (11.8%) coagulase-negative staphylococci were methicillin-resistant, and both were isolated from wounds. Resistance to ampicillin and augmentin (amoxicillin-clavulanic acid) was high, 81.9% and 55.4%, respectively. Gentamicin, aztreonam, piperacillin and piperacillin-tazobactam showed resistance rates of less than 15%. Infection control measures aimed at reducing nosocomial infections at the hospital are often frustrated by apathy of hospital administrators who apparently are insensitive to the high nosocomial infection rate. Effort by the infection control team through seminars, lectures and newsletters have begun to show improvements in attitude and awareness of staff to infection control and preventative measures within the institution.     

某ICU病房内铜绿假单胞菌交叉感染调查分析

目的 调查ICU病房铜绿假单胞菌医院交叉感染发生的危险因素和传播规律。方法 应用生物、血清、耐药谱和质粒谱等分型方法对某ICU病房从患者和周围环境分离到的7株铜绿假单胞菌进行同源性分析。结果 铜绿假单胞菌的四种分型结果显示,质粒谱分型和血清分型的一致性较好,7株菌具有相同的血清型和质粒谱型,说明此次医院内铜绿色假单胞菌感染来源于氧气湿化瓶液体,并通过患者周围物品及陪护人员手接触发生交叉感染的同一克隆菌株。结论 质粒分型和血清分型用于铜绿假单胞菌医院感染流行病学调查追溯传染源,是一种较实用的方法,生物分型和耐药谱分型有不足,但作为实验室的常规方法对早期发现流行株和抗菌药物的合理应用具有重要参考价值。本次调查结果显示,加强医疗器具及周围环境消毒和陪护人员管理是预防医院交叉感染的重要措施。     

A nurse-associated epidemic of cardiac arrests in an intensive care unit

Review of 2219 admissions to an intensive care unit at a large urban hospital from 1983 to 1985 revealed an epidemic of cardiac arrests during the evening shift from January 1984 to March 1985. Of the 88 evening-shift cardiac arrests during this time, one specific nurse (Nurse 14) was the care giver for 57 (65%). Eight of ten epidemic-period patients who experienced shift-specific circadian recurrences of cardiac arrests were patients of Nurse 14. No therapeutic intervention and no other health care provider was as strongly associated with evening-shift cardiac arrests as was Nurse 14. Multiple logistic regression analysis demonstrated that when risk of cardiac arrest was adjusted for age, sex, severity of illness, and postoperative status, patients of Nurse 14 were 47.5 times more likely to experience arrest than were other nurses' patients. An expert determined that, compared with other nurses, the cardiac arrests among Nurse 14's patients were more likely to be consistent with unexplained hyperkalemia, to be unexpected in timing, and to be inconsistent with the clinical course. The epidemic ceased when Nurse 14 left employment at the intensive care unit in March 1985. Epidemiologic surveillance of adverse outcomes in health care settings is recommended.