护理过程中影响“知情同意”落实的原因及对策

目的 本文就目前病人知情同意权在护理环节落实中存在的问题及产生根源进行了分析，并提出对策建议，供护理人员借鉴。方法 分析目前病人知情同意在护理环节落实中存在的问题；分析病人知情同意在护理环节中落实不力的原因。结果 提出护理环节过程中落实“知情同意”的对策和建议：重视护理环节过程中落实“知情同意”，重视告知义务与病人知情内容。结论 转变观念，加强知情权和同意权是病人生命权的重要保证，这种权利不单指书面形式的签字同意，还包括其他方式的知情同意，护士有责任弄清楚病人是否真的理解治疗与护理的目的、方法和其它相关问题，护理人员必须认真告知和记录病人的一切相关内容。     

护理过程中影响"知情同意"落实的原因及对策

目的本文就目前病人知情同意权在护理环节落实中存在的问题及产生根源进行了分析,并提出对策建议,供护理人员借鉴.方法分析目前病人知情同意在护理环节落实中存在的问题;分析病人知情同意在护理环节中落实不力的原因.结果提出护理环节过程中落实"知情同意"的对策和建议:重视护理环节过程中落实"知情同意";重视告知义务与病人知情内容.结论转变观念,加强知情权和同意权是病人生命权的重要保证,这种权利不单指书面形式的签字同意,还包括其他方式的知情同意,护士有责任弄清楚病人是否真的理解治疗与护理的目的、方法和其它相关问题,护理人员必须认真告知和记录病人的一切相关内容.     

病人的“知情同意权”与护士的义务

随着社会的发展，医学的进步，医学界逐渐强调尊重病人的自主权，医患之间也从传统的主动——被动型关系模式发展成共同参与型关系模式，共同参与医疗决定和实施。病人对自己的病情、诊疗方案、预后、潜在危害等有知情同意的权利，护士有充分的告知义务，让病人知道住院时的规章制度、检查及手术目的、医疗费用、康复知识等，以使病人能更好的配合治疗护理，促进病人康复。但在告知过程中应注意处理好病人知情权与医疗保护的关系以及医护告知内容的一致性，以增加病人对医生护士的信任，促进医总和护患关系融洽，有利于病人恢复健康。     

精神科护理文件中存在的纠纷隐患及对策

目的 为提高精神科的护理记录质量，使之适应新的《医疗事故处理条例》实施的要求，减少护理记录缺陷引起的纠纷，加强护理人员自我保护的意识。方法 通过对本院2003年5月～2004年4月出院患者的护理记录书写质量的评审。结果 分析护理记录存在的缺陷有5类：1）护理记录与医疗记录不一致；2）未能科学客观地记录病情或护理记录前后不一致；3）护理记录不准确、不及时、不完整、表达不清；4）记录欠连续性和护理效果评价不及时，存在可能引起争议的记录；5）忽视了患者及家属的知情权。结论 针对存在问题，提出相应的干预对策：1）护理记录内容要准确，与医疗病历记载及客观实际一致；2）认真观察，准确记录。3）加强对护士的业务培训，提高书写质量；4）强化护理行为中的法律意识，加强自我保护；5）尊重患者及家属的知情同意权；6）实施全程、全员参与质控。     

临床护理实践教学过程中医疗纠纷的伦理分析

针对临床护理实践教学过程中医疗纠纷现状,从病人利益、隐私保护、知情同意、医疗服务平等方面对临床护理实践教学过程中医疗纠纷的发生进行了伦理分析,并提出不伤害原则、尊重原则和公正原则等伦理学对策。     

临床护理实践教学过程中医疗纠纷的伦理分析

针对临床护理实践教学过程中医疗纠纷现状,从病人利益、隐私保护、知情同意、医疗服务平等方面对临床护理实践教学过程中医疗纠纷的发生进行了伦理分析,并提出不伤害原则、尊重原则和公正原则等伦理学对策。     

护理中的知情同意

现代护理与传统护理相比其本质区别之一是 :与病人进行有效的沟通和交流、获得病人的知情同意 ,已成为护理工作的组成部分和护士的职责。自 2 0世纪 90年代起各国护理界对知情同意的关注和研究已形成国际化趋势。1　知情同意的由来首先把知情同意 (Informedconsent)这一概念作为医学术语的是美国。 1 957年美国法院在一个案例的判决中将知情同意在法律上引进了医疗领域 ,判决规定医生有义务将诊疗利弊告诉病人〔1〕。之后人们开始注意这一问题 ,医务工作者也开始探讨哪些诊疗问题应该充分地告诉病人 ,怎样获得病人的理解和同意并尊重病人的…     

履行病人知情同意权的实践与体会

护士在为病人提供护理服务时,告知医疗护理措施实施的原因及方法、医院环境与制度、医疗风险、病人的病情及自我护理方法并征得病人的同意,减少了医疗纠纷的发生,保护了护患双方的合法权益;培养护士的法律意识,建立良好的护患关系,建立护理告知监督制度是履行告知义务、病人知情同意的基本素质。     

护士在履行患者告知义务中的体会

随着近几年医疗改革的深入以及人们法律意识的增强，患者的知情权常成为医疗纠纷中的突出矛盾。《医疗事故处理条例》和《中华人民共和国护士管理办法》中早已明确规定了护理人员的告知义务，同时也赋予了患者知情权。护士在工作中充分履行告知义务，保障病人的知情同意权，对于提高护理质量，保护自己，减少医患纠纷，建立相互信任与理解的医患关系有着至关重要的意义。     

临床护士对患者知情同意执行情况调查分析

摘要：目的 了解临床护士对知情同意的认知及应用情况。方法 从某三甲和二甲医院各随机抽取１００名临床护士，采用自制临床护士知情同意问卷进行调查。结果 知情同意总得分为４４.８３±５.４７，其中知情同意相关知识平均得分为１５.６７±３.２１，知情同意的临床实施情况得分为２９.９６±１.７９。不同医院之间比较，差异有显著性意义（Ｐ＜０.０１）。知情同意实施中最难的是知情同意的度量把握，其次为与保护性医疗制度相冲突，沟通障碍，认为是医生的事等。结论临床护士对知情同意有一定的认识并能在实际工作中执行，但还需进一步学习，加深认识，以把握知情同意的度量和提高沟通的有效性。关键词：临床护士；　患者；　知情同意；　权利；　义务中图分类号：Ｒ４７；Ｃ９３１．２　　文献标识码：Ｃ　　文章编号：１００１-４１５２（２００７）０３-００６１-０３     

从"知情同意"谈患者的权利

在近几年繁多的医疗纠纷中,围绕知情同意权的纠纷不在少数,本文主要围绕患者的知情同意权 进行分析,并介绍了患者在诊疗护理过程中享有的主要权利。保护患者的权利,不仅要加强医护人员的法律意识, 而且要加强医护人员与患者之间的沟通和交流,如在患者的知情同意权的实现中,医护人员加强语言社会化,使之 能与患者更好的沟通,使得患者对相关事宜有更好的了解,也是减少医患纠纷的措施之一。     

知情同意告知书的设计与应用

为减少医疗护理纠纷,维护病人就医的知情同意权,增强医患之间的理解和信任,我科自2000年1月起,自行设计知情同意告知书,在临床实际应用中收到满意效果。     

耳鼻咽喉科22起医疗护理纠纷的原因分析及对策

笔通过分析耳鼻咽喉科22起医疗护理纠纷,认为发生在耳鼻咽喉科的医疗护理纠纷与专科的自身特点,社会问题．医患关系紧张．医护人员依法自我保护意识薄弱,医疗护理服务不到位,没有严格执行医疗护理的规章制度等因素有关。提出不断加强法制教育．强化医护人员的法律法规意识：提高医疗护理服务和管理水平;深入开展围手术期健康教育;增强服务意识,尊重患的隐私权和知情同意权：建立新型的医患合作关系是防范耳鼻咽喉科医疗护理纠纷的重要途径。     

Autonomy and clinical practice. 3: Issues of patient consent

In this, the last in a three-part series considering how the concepts of autonomy, privacy and informed consent are articulated in nursing and the related literature, the authors focus on the notion of consent. Definitions of consent are considered, as are the legal elements of valid consent. Obtaining a patient's consent to treatment has several important functions. This article looks at some of these functions, such as safeguarding patient autonomy and encouraging patient participation in health care. Finally, a number of the difficulties in obtaining an informed consent from patients are considered. Some empirical studies which consider patients' understanding of the information and consent process are also discussed. From a review of the literature it appears that the issue of informed consent is very much tied up with the perceived power struggle between doctors and nurses and doctors and their patients.     

医患双方对医疗知情同意书意见的调查

目的探讨医患双方对医疗知情同意书的意见,以期为修改医疗知情同意书提供参考依据。方法收集不同等级医院的医疗知情同意书进行分析。采用自制的调查问卷对某医院100名医生和100名患者进行医疗知情同意书意见的调查。结果医患双方在医疗知情同意书的性质、过程、签署及改进方面的差异均有统计学意义(均P<0.05)。结论临床现行医疗知情同意书仍有许多方面不能达到医生及患者的要求,且绝大部分的医生及患者均认同知情同意书应采取全国统一格式。     

The meaning of autonomy in Chinese culture: obtaining informed consent for operation

The purpose of gaining the patient's informed consent is ethical, lying in respect for his or her autonomy, and such consent forms the foundation for the performance of clinical medical treatment. In order to respect the patient's autonomy, for example, during decisions about operations, doctors have the obligation to clearly explain that patient's medical condition to him/her. A thorough briefing should be given prior to the obtaining of the patients' consent. In fulfillment of their duties as medical professionals, both doctors and nurses should be involved in clinically informing patients as well as in obtaining their signature for operation and anesthesia. Although informing patients about their physical state is not the responsibility of nurses, it remains absolutely necessary for nurses to understand how people in Asian cultures understand autonomy. This paper begins with a discussion of autonomy in ethics, and then outlines the differences between the Eastern and Western concepts of autonomy, before discussing the obtaining of the signature of consent, a process performed by the nursing staff during clinical treatment, and resulting in the provision of such signatures by patients with the legal capacity to provide them.     

临床护理科研中的伦理学问题分析及对策

阐述了临床护理科研中涉及的伦理学问题,包括病人利益第一原则、知情同意原则、有利无害原则、公平公正原则。并提出要建立健全相关的伦理审查委员会,加强临床护理科研人员医学伦理学知识培训,更好地保护病人的权益。     

Perceptions of autonomy,privacy and informed consent in the care of elderly people in five European countries: comparison and implications for the future

This article discusses nurses' and elderly patients' perceptions of the realization of autonomy, privacy and informed consent in five European countries. Comparisons between the concepts and the countries indicated that both nurses and patients gave the highest ratings to privacy and the lowest to informed consent. There were differences between countries. According to the patient data, autonomy is best realized in Spain, privacy in the UK (Scotland), and informed consent in Finland. For the staff data, the best results tended to concentrate in the UK. The conceptual and methodological limitations of the study are identified and discussed. Implications of the results are divided into three areas: nursing practice, education and research. In practice, the analysis of patients' values and the ethical sensitivity of nurses are important as part of ethically good care. In nurse education, students should learn to recognize ethical problems, generally and particularly, among vulnerable groups of patients. Multicultural international research is needed in this area. This is the last of a set of five articles published together in this issue of Nursing Ethics in which the results of this comparative research project are presented.     

The competency quagmire: clarification of the nursing perspective concerning the issues of competence and informed consent

Selected issues involved in informed consent and the patient's competence to give it are examined. A discussion of tests of competence reveals some of the problems encountered in using them. There are differences in medical and nursing functions and responsibilities in the informed consent process. One nursing framework, self care, is used to discuss whether informed consent should be obtained from patients when they receive specific nursing care.     

Nursing and medical student attitudes towards nursing disclosure of information to patients: a pilot study

The American Hospital Association 'Patient's Bill of Rights' encourages greater disclosure of medical information to patients. However, the 'Bill of Rights' and conventional hospital practice centre responsibility for disclosure on physicians. The standing of nurses with regard to disclosure of information remains unclear. Many features of the nursing role indicate nurses could participate more fully in disclosure. A questionnaire exploring issues of disclosure by nurses was circulated to senior nursing students and fourth-year medical students. The 28 nursing respondents and 28 medical respondents differed significantly on 20 of the 87 items. In 15 of these, nursing students clearly showed more support than medical students for an active nursing role in disclosure, informed consent, expressing professional opinions, and patients' decision-making. A more active role by nurses in disclosing information may support increased patient participation in decision-making.