重视开展应急模拟演练提高护士综合素质

目的探索提高护理人员抢救与应急等综合素质的培训方法。方法对21名护理骨干进行院内急救模拟演练考核暴露出的大量问题进行分析、整改,重点推进各项急救处置演练。结果1年多来,通过层层演练促使护士提高了抢救与应急处置能力,抽组18名护士进行考核,综合能力有了明显提升。结论强化对应急预案的模拟演练与考核,提升了护理培训效果,同时也是提高护士综合素质的有效途径。     

临床情景模拟应急演练在低年资护士应急能力培养中的应用

目的:探讨临床情景模拟应急演练在低年资护士应急能力培养中的应用效果.方法:对我院52名低年资护士开展临床情景模拟应急演练,演练前后对各项急救技能、应急能力进行考核评分,并进行对比分析.结果:通过临床情景模拟应急演练,低年资护士在急救技能与综合能力方面较演练前显著提高(P＜0.01).结论:情景模拟演练可有效提高低年资护士应急能力和急救技能.     

应用急救情景模拟演练提高产科病房低年资护士的急救能力

目的探讨应用急救情景模拟演练对提高产科病房低年资护士急救能力的效果。方法组建教学培训小组,确定妇产科急救病种,对12名低年资护士在疾病理论知识、操作技能培训后进行急救情景模拟演练。培训前后分别对受训护士进行考核。结果通过6个月培训,产科低年资护士的理论知识、操作技能、应急能力明显提高。结论急救情景模拟演练可提高低年资护士的急救水平。     

预案演练教学法在儿科低年资护士培训中的应用

目的探讨预案演练教学法在儿科低年资护士专科知识培训中的效果。方法利用医院迎接"三甲"强化培训的契机,科室成立应急预案演练培训小组,结合儿科常见意外、突发事件撰写模拟情景,对科室毕业后独立上班3年内的低年资护士进行应急预案培训,培训后由低年资护士进行模拟演练,演练时培训考核小组对每个角色进行考核,符合应急预案要求,能现实解决专科应急问题方能过关。结果实施强化应急预案演练教学法1年后,低年资护士的专业理论知识、基础操作技能、突发事件的应急和综合能力考核比培训前提高,前后比较差异有统计学意义(P0.01)。结论应急预案演练教学法使儿科低年资护士更快地掌握专科知识而胜任儿科专科护士工作,提高护士的综合能力、护理质量及患者的满意度。     

应用角色扮演及情景模拟演练培养护士应急能力

目的探讨角色扮演及情景模拟演练培训提升护士应急能力的效果。方法我院2010年3月~2011年3月采用"角色扮演、情景模拟"演练模式对13个护理单元170名临床护士进行突发事件应急能力培训。结果培训后护士应急知识与急救技能考核成绩、护士自我评价和医生对护士应急处置满意度评价较培训前均明显提高(P<0.01)。结论 "角色扮演、情景模拟"演练有助于短时间内提高护士应急能力。     

情景模拟演练在提高疗养院文职护士野战救护技能中的应用

目的探讨情景模拟演练在提高疗养院文职护士野战救护技能中的应用效果。方法成立训练考核小组,制订培训方案,在理论培训基础上,对文职护士进行流程式演练和应急式演练,在动态演练中培训救护流程及护理要点。结果文职护士野战救护理论知识、操作技能及应急能力考核成绩提高(P0.05)。结论情景模拟演练可以提高文职护士野战救护技能水平。     

情境模拟演练在低年资护士应急能力培训中的应用

目的探究在低年资护士应急能力培训中应用情境模拟演练的效果。方法以医院编制的《护理应急预案与安全告知》教材为基础,根据脑血管病专科发生的突发事件频率,设计8项情境模拟病例,选择医院脑血管病科21名低年资护士进行培训。结果培训后护士急救相关理论知识及操作技能考核均合格,应急能力及各维度得分高于培训前(t=8.797,P<0.05)。结论通过情境模拟演练方式对低年资护士进行培训,可有效提升护士的应急能力。     

实景模拟演练在提高儿科低年资护士综合技能培训中的应用

目的:探讨实景模拟演练在提高儿科低年资护士综合能力中的应用效果。方法:根据本专科特点,安排护士进行专业理论知识、抢救仪器使用、技术操作示范、急救药品知识、病情观察和评估、沟通协调能力等方面的培训,并结合实际病例,采用医护配合的方法,开展应急预案学习及现场实景模拟演练,演练结束后进行分析、总结。结果:随着模拟演练次数的增加,护士各项考核指标达标率均明显提高。结论:新入科低年资护士通过理论培训考核结合现场实景模拟演练,能快速提高急救应急能力、整体综合素质、医护配合满意度,护理服务质量得到明显改善。     

精神科开展自缢患者应急处置模拟演练的实践与效果

目的通过模拟演练提高护理人员安全意识及临床观察与应急综合处置能力。方法制订详细演练方案,以现场解救、报告、心肺复苏、简易呼吸器使用、转运患者等主要内容制订应急处置程序,根据医院科室设置特点及值班情况,分阶段培训、考核、模拟演练。结果护理人员急救知识与技能考核成绩及医生对护士急救处置满意度均明显提高（P〈0．05或P〈0．01）。结论模拟演练能提高护理人员应急综合处置能力及护士长带教能力。     

团队合作应急演练在肾脏科ICU护理人员应急能力中的效果评价

目的 针对肾脏科ICU中突发事件,通过团队合作应急演练,提高肾脏科ICU护理人员应急能力 方法 设置肾脏科监护病房突发抢救事件的模拟场景,采用团队合作的培训方式,根据提供病情,设计科学、规范的救护过程和角色分工,演练具有肾脏科专科性的抢救案例,通过理论和实践技能考核及医护满意度测评以评价演练效果。结果 团队合作应急演练前后,护士理论知识、临床操作考核成绩均提高（P<0.05）;在团队应急培训及演练后,护士总分及各维度得分均高于培训前,差异均有统计学意义（P<0.01）。 结论 通过团队合作应急演练应对突发抢救事件,护士的应急理论知识和急救实践技能、应急及团队合作等综合能力明显提高,医护满意度测评显著提高。     

我院住院药房抗生素应用分析

目的:了解我院5个科室抗生素应用情况。方法:随机抽查我院普外、骨科、妇科、儿科、呼吸内科5个临床科室的住院病例360份,统计每个科抗生素的应用例数,应用天数,平均天数。结果:5个临床科室抗生素应用各有特点。结论:抗菌药物种类繁多,临床应用广泛,应提倡安全、合理、有效地应用。     

培训者培训模式在护士心肺复苏技能培训中的应用

目的 探讨培训者培训模式在护士心肺复苏技能培训中的应用效果.方法 应用培训者培训模式对护士心肺复苏技能进行培训,对培训前后护士的考核合格率和操作技术失误率进行评价.结果 经培训,教师培训者操作考核合格率由61.90％提高至100％,理论考核合格率由64.29％提高到100％;被培训人员操作考核合格率由56.71％提高到89.48％,理论考核合格率由67.30％提高到96.40％;按压部位错误发生率、按压深度错误发生率、按压频率错误发生率、胸廓充分回弹问题发生率均有所下降;被培训人员CPR技术的平均分和合格率均高于传统的培训方法(均P<0.01).结论 培训者培训模式对护士CPR技能的培训效果明显优于传统的培训方法,值得推广应用.     

B超对壶腹部肿瘤诊断价值初步探讨

目的：探讨Ｂ超对壶腹部肿瘤术前诊断价值。方法：回顾性分析３１例经病理和（或）手术证实的壶腹部癌。结果：术前Ｂ超检查诊断为壶腹癌２７例（８７．１％）,误诊胰头癌２例,误诊壶腹结石、总肝管结石各１例。本组定位诊断正确率９０．３％。壶腹部肿瘤声像图表现：１．直接征象：在壶腹部显示肿块回声;２．间接征象：肝内、外胆管扩张至胰头水平,胰腺正常或虽显示不清但在胰头区未探到肿块。结论：Ｂ超对壶腹部肿瘤诊断有很大的实用价值。     

全血黏度测定质控品的适用性研究

Objective To exlore the influence of internal quality control and external quality control assessment(EQA) resulting from applicability of control samples in measurement of whole blood viscosity (WBV) through the analysis and comparison of applicability of 1 non-Newtonian fluid internal quality control sample in 3 viscometers. Methods Viscometer B, C and D were used to measure WBV of 30 blood samples in parallel under the shear rate(SR) of 1 s-1,30 s-1 and 200 s-1, then the blood SR-WBV curves of 3 viscometers were drawn according to the results. At the same time, viscometers B, C and D were used respectively to determine the WBV of control A 10 times in one day, then the control A SR-WBV curves were mapped. Three viscometers were used to measure the manufactory control samples and control A 5 times in one day for 4 days. Four groups of daily values of manufactory control samples and control A of each instrument were used to carry out F test to calculate whether 4 daily values are difference. Finally, the control A was dispensed in 49 laboratories nationwide chosen for measurement. On the basis of viscometer used, 20 laboratories were classified as group B, 20 laboratories were classified as group C and 9 laboratories were classified as group D. Then the data under SR of 1 s-1 were analyzed to calculate the coefficient of variation (CV) in the group. Results There was significant difference among the WBV of blood samples measured by the viscometers B, C and D. The results under SR of 1 s-1 declined in turn, and they were highest under SR of 30 s-1 followed by the values of viscometer D and B and they were (8.14±0.75), highest under SR of 30 s-1 followed by the values of viscometer B and D, and they were (7.35±0.07), daily values of manufactory control and control A of each instruments in four groups were compared. Under SR of 1 s-1, there was no difference between daily values of manufactory control and control A in viscometer B (F = 2.63, 1.37, P > 0.05), and there was no difference of daily values of manufactory control among viscometer C and D (F = 0.33,3. 14, P > 0.05), but significant daily difference existed when control A was tested by viscometer C and D (F = 5.76, 8.00, P < 0.05). Under SR of 30 s-1, there was no difference of daily values of manufactory control among 3 viscometers(F =0.31, 0.18, 2.26, P >0.05), and there was no difference of daily values of control A among 3 viscometers' (F = 1.03, 1.83, 2.40, P > 0.05); Under SR of 200 s-1, there was no difference of daily values of manufactory control among 3 viscometers (F =2.59, 0.68, 2.96, P > 0.05), and there was no difference of daily values of control A among 3 viscometers (F=2.31, 3.01, 2.28, P>0.05). When control A was tested under SR of 1 s-1 in 49 laboratories nationwide, the WBV values in groups of viscometer B, C and D were (18.47±1.30), (11.17±2.38), viscometer D and C were 63.75% and 21.3%. Conclusions Control A could fully mimic the properties of whole blood steadily on viscometer B, but partially mimic viscometer C and D, so the control A is most appropriate for viscometer B. Because current non-Newtonian fluid internal quality control could mimic rheological properties of whole blood under specifically conditions, laboratories should evaluate the consistent degree between control and whole blood, only the candidates which can mimic the properties of whole blood approximately could be chosen as quality control of WBV. When third-party control is chosen to be samples of EQA, its applicability should be in consideration. Pretest should be performed adequately to define applicability of third-party control, so as to reduce the difference among laboratories due to applicability of control and reflect detection quality of laboratories exactly.     

超声心动图在经导管封堵主动脉窦瘤破裂中的应用价值

目的 探讨超声心动图评价经导管封堵主动脉窦瘤破裂疗效的应用价值.方法 对11例行经导管封堵主动脉窦瘤破裂患者的超声心动图进行回顾分析.评价术前窦瘤破口的位置、形态、大小等,术中监测封堵器置入,术后随访评价其疗效.结果 11例患者术前超声诊断均为单纯主动脉窦瘤破裂,超声测得破口直径2～13 mm.11例患者均封堵成功,10例采用动脉导管封堵器,型号较破口直径大约1～5 mm.3例患者术后即刻少量残余分流于术后1月内复查消失,其中1例患者术后32月随访时再次出现少量残余分流;所有患者未见主动脉瓣反流加重等并发症.结论 经导管封堵主动脉窦瘤破裂是治疗主动脉窦瘤破裂安全有效的方法,远期疗效需进一步观察,超声心动图在其中发挥重要作用.     

护理干预对预防未足月胎膜早破感染的效果分析

目的 探讨护理干预对预防未足月胎膜早破感染的效果.方法 将131例未足月胎膜早破的产妇分为对照组65例和实验组66例,分别采取常规护理方法和护理干预,比较2组孕期、围生儿情况以及实验室感染指标监测情况.结果 2组在年龄、入院孕周、分娩孕周、距分娩时间、新生儿体质量方面比较差异无统计学意义;新生儿Apgar评分、新生儿死亡2组间比较差异显著.结论 在未足月胎膜早破的积极护理治疗中,必须对感染指标进行监测,做好预防感染的护理,一旦出现感染先兆必须终止妊娠.     

急诊科量化经济管理的实践及成效

目的探索急诊科量化个人收入的有效途径。方法核算每日个人收入,工资分配实行多劳多得,并且与档案工资双轨并行。结果科室收入年增长率为24.38%,职工个人收入年增长率为23.72%,职工工资年增长率为24.00%。结论合理有效地应用量化个人收入的方法,可提高经济效益和社会效益。     

全程护理干预对高龄股骨颈骨折患者术后生活质量的影响

目的:探讨全程护理干预对高龄股骨颈骨折患者术后生活质量的影响。方法:将60例高龄股骨颈骨折患者随机分为实验组和对照组各30例,对照组给予常规护理,实验组由责任护士负责从入院到出院至术后随访的全程护理干预。结果:实验组生活质量满意度、患肢功能恢复、心理适应能力明显高于对照组(P<0.05)。结论:全程护理干预能明显提高高龄股骨颈骨折患者术后生活质量。     

护理干预对预防未足月胎膜早破感染的效果分析

目的探讨护理干预对预防未足月胎膜早破感染的效果。方法将131例未足月胎膜早破的产妇分为对照组65例和实验组66例,分别采取常规护理方法和护理干预,比较2组孕期、围生儿情况以及实验室感染指标监测情况。结果2组在年龄、入院孕周、分娩孕周、距分娩时间、新生儿体质量方面比较差异无统计学意义;新生儿Apgar评分、新生儿死亡2组间比较差异显著。结论在未足月胎膜早破的积极护理治疗中,必须对感染指标进行监测,做好预防感染的护理,一旦出现感染先兆必须终止妊娠。