门诊注射室工作中的安全隐患及防护措施

门诊注射室担负着全院门诊病人的注射工作.门诊病人多,流动性大,病情复杂,各种医嘱没有相对固定的查对制度和治疗流程,因为对护理人员的要求较高.本文通过对门诊注射室的注射环境、药品因素、患者流动性大、护患沟通不畅等客观因素和护士每天面临的职业危害、护士的责任心问题、护士的专业技术水平、护士的法律观念意识等主观因素容易造成的各种不同安全隐患进行深入的剖析,提出护理人员应如何提高自身素质,规范各项规章制度,改进注射流程,认真做好相应的各项安全防护措施,从而提高门诊注射室的护理服务质量,保证门诊注射室的护理安全.     

心内科护理工作潜在不安全因素调查分析

目的：探讨心血管内科护理工作中的不安全因素及对策.方法：回顾分析我科存在不安全因素的住院患者58例,对其护理过程不安全因素进行总结分析.结果：58例存在不安全因素住院患者中,存在医护人员责任心不强、护士业务技术水平缺陷、护患沟通缺陷、法律意识淡薄、患者及家属因素.结论：心内科护士强化法制观念,增强服务意识,提高自身素质和业务水平,加强护患沟通等,可保障护理安全.     

脑卒中患者发生误吸的护理风险及防范对策

总结脑卒中患者发生误吸的护理风险因素及防范对策.回顾78例误吸患者的资料,常见风险因素包括患者、护士、照顾者中存在的问题;提高护士对误吸护理风险的防范意识,从吞咽功能的评估、正确的饮食指导、鼻饲的护理、加强气囊管理、注重护患沟通等方面入手,可减少误吸并发症的发生.     

护士在基层医院人群用药安全中的责任

在基层医院工作中，护士在临床第一线，接触患者的机会多，交流沟通时间长。护士不仅是各种药品治疗的使用者，也是药品使用前后的监护人。在基层医院药品安全使用中，护士是最后也是最重要的一环，如果护士业务知识差，工作责任心不强。容易造成药品安全使用的隐患，不仅影响疾病恢复，甚至可能给病患者造成更大的伤害。     

安全文化在急诊护理风险管理中的应用

探讨安全文化在急诊风险管理中的意义。对急诊护理工作中的主要风险因素进行分析,提出将安全文化作为一种新的管理思路运用到风险管理中。加强护士培训教育、树立安全意识;落实安全措施,规避护理风险;完善管理制度,加强风险干预。患者的满意度提高。认为运用护理安全文化到急诊风险管理中能有效规避护理风险,降低护理差错率及纠纷发生率。     

风险隐患防范护理在老年科病房的应用及效果分析

老年科属于综合性科室,是医院重要组成部门,其收治的患者存在年龄大、疾病多样且复杂、病程长、自理能力差等特点,护理安全事故发生风险大。因此,有效识别老年科病房存在的护理风险因素、实际安全隐患并制定具有针对性的风险隐患防范护理以降低护理不良事件的发生、促进患者康复进程、提高老年患者舒适度及对护理工作的满意度至关重要。老年科病房护理风险隐患主要与护理人员、患者自身等因素相关,通过健全、完善老年科病房管理相关规章制度、规范各项护理操作、提高护理人员业务能力、加强病房环境管理、做好安全防护、加强护理沟通等针对性防范护理措施,能有效规避风险因素,降低护理不良事件发生率。     

门诊手术室护理安全与对策

目的 观察医院门诊手术室护理的安全与管理对策.方法 本文中笔者收集2011年1～6月期间在我院门诊就诊的200例门诊手术患者,并且对门诊手术患者的心理状态及护理过程进行统计分析.结果 200例门诊手术患者均顺利完成手术治疗,没有医疗护理差错发生.通过加强语言沟通、微笑服务、不断改进等工作可以建立起良好的护患关系.结论 通过了解门诊手术患者的心理状态,有针对性地对患者进行心理干预,稳定患者的情绪,让患者主动配合手术,保证了手术室护理工作的安全.     

门诊输液室职业安全现状调查与分析

目的 调查门诊输液室护士职业安全现状并分析其发生原因,探讨有效的防护措施.方法 采用问卷调查法,对门诊输液室24名护士职业暴露现状进行分析.结果 护士职业暴露发生率为100.00％;近1年内有95.83％的人接触过患者的血液,91.67％的人有安瓿割伤史,针刺伤发生率为45.83％;针刺伤后仅有7.4％上报医院.结论 门诊输液室护士职业暴露发生率高,报告率低,存在职业安全风险;医院应加强职业安全教育,提高防护意识,合理调配人力资源,保障门诊输液室护士的职业安全.     

妇产科护理安全隐患调查

目的了解妇产科护理存在的安全隐患,保证护理安全。方法回顾性调查在我院接受治疗的90例患者所存在的护理隐患。结果妇产科护理中的隐患主要存在于护患沟通、护士、患者、管理、医疗护理技术、药物因素及消毒隔离等方面。结论妇产科护理安全隐患数量颇多,要想提高妇产科的护理水平,需要培养高素质的护理人员,且要提高护理安全管理,才能有效防范安全隐患的发生,保障护理质量和护理安全。     

安全注射现状分析与管理对策研究

安全注射是指对接受注射者无害、实施注射操作的医务人员不暴露于可避免的风险及注射后的废弃物不对环境和他人造成危害;长期以来,全球范围内因不安全注射导致的感染问题一直存在,不安全注射行为可以导致医务人员发生血源性病原体职业暴露,注射后医疗废物处理不当可导致环境安全存在隐患;本综述旨在分析不安全注射产生的相关因素,从安全注射认知水平、注射器材生产安全、消毒安全、注射方式安全及医疗废物和损伤性废物使用后处理安全等五个方面,进一步指出安全注射应加强重点环节的管理。     

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.