吉林省护理人力资源现状研究

目的了解吉林省护理人力资源现状,为建立科学合理的护理人力资源配置提供依据。方弦查阅吉林省统计年鉴收集吉林省人口总数、医疗机构总体状况,采用横断面调查法对吉林省150家二级以上医院的护理人力资源情况进行统计描述。结果2006年吉林省每千人口的护士数为0.665人,明显落后于0．993人的全国平均水平：护士人数占卫生技术人员总数的31．30％,略高于28．55％的全国平均水平,县级以下卫生所的护理人员仅占全省护理人员的11.20％,远低于全国平均水平。护士数与床位数之比是0.443：1,与全国平均水平0.4：1基本持平：医生与护士的人数比是1：0.80,略低于1：0.97的全国平均水平：对吉林省150家二级以上医院调查结果显示,护士年龄段主要集中在35～44岁,与全国平均水平趋于一致：护士整体学历层次好于全国平均水平,高级职称占6、56％,中、初级职称占93．20％;在编不在岗的护理人员所占比例平均高达5．41％;聘用合同护士占26．30％。结论吉林省护理人力资源配置有待进行调整,使之逐步趋于合理,以满足人民群众对护理的需求。     

优质护理工程重在创新

据统计,截至2009年底,我国注册护士已经达到218万人,护士不足问题正在得到扭转。据对全国28个省（区、市）280所医院的调查,医院普通病房床护比平均为1：0．41,其中省部级医院普通病房平均床护比为1：0．44。日前,在卫生部召开的新闻发布会上,卫生部医政司护理处处长郭燕红指出,我国护士工作的重点将转向护理队伍的能力建设。为此,卫生部今年在全国卫生系统开展了“优质护理服务示范工程”活动。     

军队医院聘用护士睡眠质量及其影响因素调查

目的：调查军队医院聘用护士的睡眠情况及其影响因素,为改善护理人员的睡眠质量,提高工作绩效提供参考。方法随机抽取某三甲军队医院220名聘用护士,采用匹兹堡睡眠质量指数量表（ pittsburgh sleep quality index , PSQI）调查睡眠质量,用自制的调查表进行基本情况调查,分析其对睡眠质量的影响。结果①军队医院聘用护士PSQI总分为7．63±3．85;②军队医院聘用护士PSQI各因子中,以入睡时间延长为最高,占32．1％,以日间功能影响为最低,占15．7％;③职务、护龄、身体不适、环境因素和不良认知是影响军队医院聘用护士睡眠质量的最主要因素（P＜0．05或P＜0．01）。结论军队医院聘用护士存在不同程度的睡眠质量问题,加强心理健康教育,提高护理人员主人翁意识,有利于改善其睡眠质量。     

部队医院开展整体护理面临的问题与对策

系统化整体护理是护理史上的一场变革，这种新型的护理模式强调的是以病人为中心，护理程序为核心，系统的躯体和心理的整体护理。发达国家一些医院早已对患者进行整体护理，我国护理工作如何实现与国际先进护理接轨，护理管理者必须充分认识实现这种护理模式不相适应的问题，并采取相应措施，才能逐步得以实现。一、与整体护理不相适应的问题1．护理力量不足我国各医院的床护比例明显低于西方发达国家，军队医院受编制限制，加之医院发展，展开床位比实际编制床位增加，所以矛盾更为突出，北京某部队医院的床护比例外科为1：0．25，内科为1…     

非现役文职护士对军护的心理压力及对策

医院根据中央军委下发《关于加强军队专业技术人才队伍建设的意见》,面向社会公开招聘非现役文职护士。非现役文职的到来一方面为军队护理队伍注入了新鲜活力,另一方面也给现役军护带来了心理压力,成为护理队伍的一个不稳定的因素。分析非现役文职护士对军护带来的心理压力,调动军护工作的积极性,加强军护同非现役文职护士的协作,是贯彻优质服务,保证护理质量的有力保证。1非现役文职护士对军护的心理压力1.1综合因素的压力医院招聘的首批24名非现役文职护士,平均年龄24.2岁,均为大专以上学历,有学士学位者占43.5%,大大超出了军队护理人员的…     

我国医院感染管理组织的人员结构

对全国医院感染监控系统的７６所不同规模的医院，进行了医院感染管理组织的人员结构现状调查。结果看出不同规模医院的专职人员与床位数之比波动在１３７～２２１床／人（平均１９３床／人）；兼职人员波动在１５．２～２７．３床／人）；专职人员的职称分布为副高与副高以上医（护）师∶主管医（护）师∶医（护）师∶医（护）士为２∶４∶３∶１；兼职人员中医、护分布为医占４５．５％、护占５４．５％。     

广东省三级医院护理人力资源配置现状及对策研究

目的了解广东省三级医院护理人力资源的配置现状,探讨更合理的配置对策。方珐自行设计问卷,对广东省21个地市的76所三级医院护理人力资源数量、护理人力资源内部结构、人员流失、支持保障系统情况等现状进行研究分析。结呆8所（13．33％）医院未成立临床支持中心：23所（38．33%）医院普通病房实际床位总数与普通病房护士总数比不达标;职业性别比例严重失衡,男性仅占2．61％;34岁及以下护士占76．38％;大专及以下学历占78,61％;高级职称占4．65％;近年离职比由3．62%上升至5．08％。结论广东省三级医院护理人员非护理工作负担较重：人力资源总量相对不足,队伍结构欠合理：护士人力流失逐年增长。建议优化三级医院护理人力配置,重视临床服务指标,建立并完善后勤保障系统,积极开展护士岗位改革等是适应社会高速发展需求和护理学科专业化的重要举措。     

湖州市乡镇、农村社区临床医学与护理学人力资源现状调查分析

目的了解湖州市农村社区临床医生及护理人员的现状，为区域医护人力的合理配置提供理论依据。方法对湖州市乡镇医院和村卫生室的临床医生和护理人员进行普查，数据以软件SPSS12．0．1进行统计分析。结果农村平均每千农业人口拥有临床医生数为1．25，护医比为0．5，并且村卫生室无护理人员，乡镇医院医生学历中专以下者占66．1％，护士中专以下者占84．1％。村卫生室学历均在中专以下。乡镇医院医生职称初级以下者占77．4％，初、中、高级职称之比为38：9：1，护士职称初级以下者占86．8％，护士初、中、高级职称之比为7：1：0。结论湖州市乡镇、农村社区服务站人员总数配置严重不足，学历水平明显偏低；具有较高职称者比重明显偏小，职称结构不合理。建议：本区域积极做好临床医生及护理人才引进工作；加强在职人员的继续教育和知识进修培训；加大本区域内高等医学院校对专科以上临床医生及护理人才的培养；科学制定本区域卫生规划。     

钦北区护理人力资源现状调查与分析

目的：了解钦北区医院护理人力资源现状,为卫生局制定符合实际情况的护理发展规划提供依据。方法：采用自制调查表对钦北区13家医院进行调查。结果：13家医院的护理人员占卫技人员数35．02％,低于部顾标准;医生与护士人数比是1：0．868;护士数与床位数比是0．319：1明显低于部颁标准的0．4：1;护士年龄段主要集中在26～34岁,过于年轻;学历层次低主要是中专毕业;职称主要是低级职称,没有高级职称。结论：为了提高医疗质量,合理的护理人力资源配置是有关卫生部门值得关注的亟待解决的问题。     

陕西省护理人力资源现状调查与分析

目的了解陕西省护理人力资源现状,探讨护理人力资源与护理质量的关系。方法于2011年1月-2012年6月,应用护理人力资源问卷、护理差错问卷、病人满意度问卷,分别对陕西省二级及以上（专科医院及中医医院除外）的20家医院的1080名临床护士和620名住院病人进行调查。结果20家医院的平均医护比均低于国家标准;平均床护比基本达国家标准;护理人员编制严重不足,需要大量聘请合同制护士;高学历护理人员严重匮乏。相关关系分析显示,总护理差错与医护比未见相关,与床护比成正相关,与编制比和学历比成负相关;病人总满意度与医护比和编制比未见相关,与床护比成负相关,与学历成正相关。结论护理人力资源可对护理质量产生较大影响,加强护理人力资源配置并优化其结构可促进护理质量持续提高。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.