急诊科护士专业水平及培训现状调查分析

目的　了解急诊科护士对急救知识、技能的获取途径、掌握现状及学习需求 ,探讨对急诊科护士开展专业培训的意义和实施方法。方法　采用问卷调查法对上海市 9所医院 2 82名急诊科护士进行调查 ,统计处理用Excel和SAS软件包进行。结果　急诊护士的专业知识平均得分为 71 .95± 1 0 .75分 ,但作为急诊中坚力量的年轻护士平均得分不尽人意。结论　有必要开展急诊科护士专业培训 ,培训内容和形式应结合我国实际、针对薄弱环节开展     

急诊科护士急救知识技能掌握情况的调查研究

目的　了解急诊科护士急救知识、技能的获得途径和现阶段的掌握情况 ,探讨影响其业务素质的因素。方法　采用问卷调查法对上海市 9所医院 2 82名急诊科护士进行调查 ,统计处理用Excel和SAS软件包进行。计量资料用t检验和方差分析 ,计数数据以百分比表示 ,知识得分影响因素的分析运用多元逐步回归的方法。结果　急诊科护士的平均知识得分为 71.95± 10 .75 ;知识得分 =62 .3 67+0 .5 2 5护龄 +2 .15 6职务。护龄、职务对护士知识得分的影响差异显著 ,不同级别医院知识得分差别不显著。结论　急诊科护士急救知识技能的全面素质需进一步提高 ,低护龄护士毕业后教育工作应引起高度重视 ,充分发挥高年资护士的业务专长。对急救业务影响因素的分析研究和怎样进一步提高护士急救水平的研究尚需继续深入。     

襄阳市5所医院急诊科护士急救知识和技能水平的调查

目的了解急诊科护士对急救物品相关知识及急救技能的掌握情况,为提高急诊科护士急救水平提供依据。方法采用问卷调查法对我市5所医院111名急诊科护士的急救物品及药品相关知识掌握情况进行调查;采用现场考核法考核护士的急救技术。结果 107名急诊科护士的急救知识得分为(71.48±10.22)分,不同护龄、职称和学历的急诊科护士的急救知识得分差异有统计学意义(P<0.05);对急救物品管理合格率为92.52%、用法合格者率为86.92%,急救药品知识的合格率为73.83%、用法合格率为71.96%;心肺复苏、除颤仪操作、呼吸机的使用、洗胃术、气管插管术及创伤患者的急救等各项急救技术的合格率分别为76.64%、71.03%、42.06%、85.98%、28.04%及62.52%。结论急诊科护士急救知识掌握较欠缺,急救技术与急救药品知识合格率也较低,护理管理者应为急诊科护士尤其是低年资护士提供有针对性的急救知识与技能培训,强化全体护士的急救技术和药品知识。     

门诊护士急救知识和技能水平现状及影响因素分析

目的调查北京某三甲医院门诊护士急救知识和技能水平现状,并分析其影响因素。方法采用方便取样于2019年4月对北京某医院门诊90名护士进行问卷调查,内容包括一般情况、急救知识测试、CPR技能操作得分和急救知识学习现状与需求,并分析影响门诊护士急救知识和技能水平现状的因素。结果门诊护士急救知识平均得分为(90.93±10.64)分,CPR技能操作平均得分为(91.92±2.49)分,其中不同工作年限的门诊护士急救知识得分差异具有统计学意义(P0.05)。结论门诊护士急救知识和技能水平需进一步提高,低年资的护士应重点加强培训。     

山西省急诊护士继续教育现状及需求调查

[目的]调查山西省急诊护士继续教育现状及需求,为更好地开展继续教育服务。[方法]采用便利抽样法,自设问卷对山西省11个地级市中92所医院共146名急诊急救专科护士进行问卷调查,了解急诊护士的一般情况、继续教育现状和需求。[结果]31.5%的急诊护士表示参加继续教育的频率在1年以上;56.2%的急诊护士通过短期培训班参加继续教育;69.2%的急诊护士认为工作繁忙影响他们参加继续教育;急诊护士对继续教育内容需求排在前5位的分别是：急救复苏相关技能、现场急救技能、创伤病人的急救护理、急危重症病人护理的相关理论知识和急诊各种抢救设备、物品及药物的应用和管理。[结论]急诊护士的继续教育需要加强;继续教育的内容应在学习急诊理论知识的同时注重培养护士抢救相关的实用技能。     

山区急诊护士急救技能培训最佳方式的选择

目的调查山区一、二级医院急救状况及急诊护士急救技能掌握情况,选择最佳的培训方式,以提高山区基层医院急诊护士急救技能水平。方法通过问卷调查、技能测试、实地考查等方法,了解到一、二级医院急救资源及经费不足、急诊护士急救技能偏低,采用送教上门、骨干护士短期培训班进行培训。结果培训前一、二级医院急救技能水平考核平均分为（45．35±3．62）分,培训后平均分为（89．66±1．85）分,培训前后比较,差异有统计学意义（P〈0．05）。结论送教上门、骨干护士短期培训班能提高基层医院急诊护士急救技能水平,是基层医院急诊护士培训的最佳选择。     

急诊科护士急救技能培训研究进展

急救技能是医护人员为患者提供医疗护理服务必须掌握的基本技能.随着社会的发展,生活节奏的加快以及交通运输多样化等因素的影响.急症抢救护理工作的重要性越来越突现出来.急症抢救护理工作质量是衡量医院整体水平、服务质量、应急能力的一个重要标准,要求急诊护士必须具备专业的急救知识、精湛的急救技能,才能适应快速多变的急救要求.如何增强医护人员专业急救意识和提升其技能,建立一支训练有素的专业队伍,是医疗界当前需要思考和面临的重要课题之一[1].现将急诊科护士急救技能培训研究进展报告如下.     

构建急救技能培训体系 提高区域急救护理水平

目的构建不同等级医院三位一体化的急救技能培训体系,提高区域急救护理水平。方法以三级医院急救中心为培训基地,以适应一、二、三级医院急救的护理技能为培训内容,分级别对10所医院的150名急诊护士进行统一培训。结果一、二、三级医院急诊护士的急救理论与急救技能培训前后比较差异均有统计学意义(P均0.01)。结论实施不同等级医院三位一体化的急救技能培训体系,能缓解基层医院急诊护士培训难和培训不到位的状况,提高区域整体的急救护理水平。     

军队医院护士急救技能培训的探讨

目的探讨军队医院护师和急诊科护士急救技能培训的方法。方法2005年4月至9月,对91名护理人员（所有科室的护师65名,急诊科护士26名）实施急救护理技能的专科培训,并比较培训前后的考核成绩。结果专科培训前后,护理人员急救理论知识及急救技能的考核合格率有显著性差异（P＜0．01）。结论加强岗位培训、巩固专科护理知识、建立抢救流程有助于提高护士的救护水平,适应现代急救技术及现代战场的需要。     

急诊护士急救技能培训方法及效果

[目的]探讨对急诊护士进行急救技能培训的方法及效果。[方法]成立急救技能培训及考核小组,制定培训目标,采用发放急救知识手册,集中急救理论授课、急救流程培训,急救技术、急救仪器操作培训,模拟急救情景演练,带班护士随机指导等方法,制定考核细则,每季进行考核与评价。[结果]培训后,急诊护士急救理论知识、急救技术、急救仪器操作、急救技能应用较培训前有较大提高,差异有统计学意义(均P<0.01)。[结论]加强急诊护士急救技能培训,可以提高急诊护士应激能力、提高急救知识理论及急救技术水平,确保急诊护理工作质量和急诊病人的生命安全。     

应急管理路径在急诊手术护理中的应用

目的 运用应急管理路径,提升急诊手术护理水平,提高急救护理质量.方法 调查分析手术室急诊护理中的相关危险因素,制定科学的应急管理路径,启动专项应急管理,观察与评价急诊手术的护理质量.结果 实施与应用各种应急管理路径后,手术室护士急救意识提高,应急应变能力增强,急救护理质量明显提高.结论 应急管理路径的实施有助于提高手术...     

Application of emergency severity index in pediatric emergency department

BACKGROUND:

The purpose of triage is to identify patients needing immediate resuscitation, to assign patients to a pre-designed patient care area, and to initiate diagnostic/therapeutic measures as appropriate. This study aimed to use emergency severity index (ESI) in a pediatric emergency room.

METHODS:

From July 2006 to August 2010, a total of 21 904 patients visited the International Department of Beijing Children’s Hospital. The ESI was measured by nurses and physicians, and compared using SPSS.

RESULTS:

Nurses of the hospital took approximately 2 minutes for triage. The results of triage made by nurses were similar to those made by doctors for ESI in levels 1-3 patients. This finding indicated that the nurses are able to identify severe pediatric cases.

CONCLUSION:

In pediatric emergency rooms, ESI is a suitable tool for identifying severe cases and then immediate interventions can be performed accordingly.KEY WORDS: Pediatrics, Emergency Department, Triage, Emergency severity index     

急诊急救护理路径对急性冠脉综合征紧急介入治疗的影响

目的：探讨急诊急救护理路径对急性冠脉综合征紧急介入治疗的影响。方法将2010年1月～2011年12月收治的50例急性冠脉综合征患者作为观察组,按急诊急救护理路径进行救治,与2008年1月～2009年12月未应用急诊急救护理路径的47例患者相关资料进行对比,比较两组患者在急诊科的滞留时间、就诊至首次球囊扩张时间（Door-to-Ballon）、住院时间、患者或家属及接诊医护人员满意度。结果两组患者在急诊科的滞留时间、就诊至首次球囊扩张时间（Door-to-Ballon）、住院时间,患者或家属及接收科室满意度比较,差异有显著意义（ P＜0．05）。结论急诊急救护理路径的实施,缩短了患者在急诊科滞留时间、就诊至首次球囊扩张时间（Door-to-Ballon）及住院时间,提高了患者、家属及接诊医护人员满意度。     

Rural emergency nurse: A true story

The risk rural emergency nurses who practice in their own community face is that they one day may have to care for someone close to them or a member of their own family. My journey involved several presentations to the Emergency Department by people I loved, sometimes with devastating results, while still being stricken with grief from the sudden loss of my mother. Altogether, I attended eight funerals in ten months.Seeking professional help was a crucial step in the healing process.     

The influence of crowding on clinical practice in the emergency department

Background

This study aimed to clarify the association between the crowding and clinical practice in the emergency department (ED).

Factors associated with refractory pain in emergency patients admitted to emergency general surgery

BACKGROUND: Oligoanalgesia in emergency departments (EDs) is multifactorial. A previousstudy reported that emergency providers did not adequately manage patients with severe paindespite objective findings for surgical pathologies. Our study aims to investigate clinical andlaboratory factors, in addition to providers’ interventions, that might have been associated witholigoanalgesia in a group of ED patients with moderate and severe pains due to surgical pathologies.METHODS: We conducted a retrospective study of adult patients who were transferred directlyfrom referring EDs to the emergency general surgery (EGS) service at a quaternary academic centerbetween January 2014 and December 2016. Patients who were intubated, did not have adequaterecords, or had mild pain were excluded. The primary outcome was refractory pain, which wasdefi ned as pain reduction <2 units on the 0–10 pain scale between triage and ED departure.RESULTS: We analyzed 200 patients, and 58 (29%) had refractory pain. Patients with refractory painhad signifi cantly higher disease severity, serum lactate (3.4±2.0 mg/dL vs. 1.4±0.9 mg/dL, P=0.001), and lessfrequent pain medication administration (median [interquartile range], 3 [3–5] vs. 4 [3–7], P=0.001), whencompared to patients with no refractory pain. Multivariable logistic regression showed that the number of painmedication administration (odds ratio [OR] 0.80, 95% confi dence interval [95% CI] 0.68–0.98) and ED serumlactate levels (OR 3.80, 95% CI 2.10–6.80) were signifi cantly associated with the likelihood of refractory pain.CONCLUSIONS: In ED patients transferring to EGS service, elevated serum lactate levelswere associated with a higher likelihood of refractory pain.     

The 911 emergency telephone number: Impact on emergency medical systems access in a metropolitan area

The telephone number 911 is designated for public use in requesting emergency assistance. It is thought to reduce response time by reducing the interval between the decision to call for assistance and the notification of an agency that can dispatch the appropriate services. The experience of the Twin Cities metropolitan area of Minneapolis-St. Paul provides a unique opportunity to examine this assumption. Prior to the introduction of the 911 emergency telephone number on December 1, 1982, the area was serviced by over 100 different seven-digit emergency telephone numbers. Before the introduction of 911, 347 callers who activated the emergency medical services (EMS) system were interviewed, and after 911 was introduced, 305 callers were interviewed. Activation of the EMS system by making one call in less than 1 minute was achieved by 219 of 347 callers (63%) in the pre-911 phase and by 251 of 305 callers (82%) in the post-911 phase (P < 0.001). Compliance (use of an appropriate emergency number for the first call) was demonstrated by 139 of 347 callers (40%) in the pre-911 phase, and 225 of 305 callers (74%) in the post-911 phase (P < 0.001). Rapid activation of the EMS system was rarely achieved by calling a hospital or physician first. Overall, 911 was found to be a more efficient means of activating the EMS system.     

Violence toward emergency physicians: A prospective-descriptive study

BACKGROUND: The highest rate of workplace violence occurs in the health sector, although most cases remain unreported. Emergency services face the majority of these incidents for many reasons, such as the patient profile, long waiting time, and overcrowding. We aimed to determine the characteristics and causes of violence toward emergency physicians.     

Demand for hospital emergency departments: a conceptual understanding

BACKGROUND:

Emergency departments (EDs) are critical to the management of acute illness and injury, and the provision of health system access. However, EDs have become increasingly congested due to increased demand, increased complexity of care and blocked access to ongoing care (access block). Congestion has clinical and organisational implications. This paper aims to describe the factors that appear to influence demand for ED services, and their interrelationships as the basis for further research into the role of private hospital EDs.

DATA SOURCES:

Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) and relevant journals were searched using terms related to EDs and emergency health needs. Literature pertaining to emergency department utilisation worldwide was identified, and articles selected for further examination on the basis of their relevance and significance to ED demand.

RESULTS:

Factors influencing ED demand can be categorized into those describing the health needs of the patients, those predisposing a patient to seeking help, and those relating to policy factors such as provision of services and insurance status. This paper describes the factors influencing ED presentations, and proposes a novel conceptual map of their interrelationship.

CONCLUSION:

This review has explored the factors contributing to the growing demand for ED care, the influence these factors have on ED demand, and their interrelationships depicted in the conceptual model.KEY WORDS: Emergency department, Demand, Crowding, Risk factors, Emergency services, Emergency medicine, Emergency room