系统性护理干预对重度宫颈糜烂Leep刀手术治疗的应用分析

探讨系统性护理干预对重度宫颈糜烂LEEP刀手术治疗效果的影响。按照随机数字表法将收治的78例重度宫颈糜烂患者分为干预组(系统性护理干预)与对照组(常规护理),所有患者均采用LEEP刀手术治疗。对比两组护理效果。干预组、对照组并发症发生率分别为5.1%(2/39)、20.5%(8/39),差异显著(P0.05);两组手术时间、术中出血量差异显著(P0.05)。重度宫颈糜烂采用LEEP刀手术治疗过程中,实施系统性护理干预的效果显著,值得进行深入研究和推广。     

阴道给药结合宫颈环形电切术治疗中重度宫颈糜烂

中、重度宫颈糜烂患者200例随机分为两组每组各100例。宫颈环形电切术(LEEP)联用宫颈炎康栓局部用药者为治疗组,宫颈LEEP术后自然修复者为对照组。比较两组临床疗效、术中出血情况、宫颈痂膜脱落情况及宫颈创面伤口愈合情况。结果两组治愈率均达100%,治疗组术中出血量、脱痂期出血量少于对照组(P0.01),创面愈合时间较对照组缩短(P0.01)。     

LEEP刀手术治疗宫颈糜烂38例临床护理

目的:探讨利普刀(LEEP刀)手术治疗宫颈糜烂患者的临床护理方法。方法:将76例宫颈糜烂患者随机分为观察组和对照组各38例,对照组给予常规护理干预措施,观察组实施针对性护理干预措施。比较两组临床疗效及并发症发生情况。结果:观察组总有效率为89.47%,对照组总有效率为68.42%,两组比较差异有统计学意义(P0.05)。观察组患者术后阴道排液量月经量人数显著多于对照组(P0.05),术后排液时间7 d的人数显著多于对照组(P0.05);观察组术后阴道出血量月经量人数显著多于对照组(P0.05),术后阴道出血时间10 d的人数显著多于对照组(P0.05)。结论:对宫颈糜烂行LEEP刀手术治疗患者采用针对性临床护理,能够促进患者术后创面康复,提升手术治疗效果,值得临床推广应用。     

整体护理干预对宫颈糜烂行 LEEP电波刀术患者的疗效分析

目的：研究分析整体护理干预对宫颈糜烂行LEEP电波刀术患者的临床疗效。方法将在我院采用LEEP电波刀术治疗宫颈糜烂的62例患者随机分成实验组和对照组,每组平均31例患者。进行常规护理的患者为对照组,进行整体护理的患者为实验组。分析两组患者的临床疗效、术中出血量、手术时间及并发症。结果实验组患者的总有效率（90.32％）明显高于对照组患者的总有效率（64.52％）,差异具有统计学意义（ P＜0.05）;实验组患者手术时间、术中出血量及并发症明显少于对照组患者,差异具有统计学意义（ P＜0.05）。结论整体护理干预对宫颈糜烂行LEEP电波刀术患者有显著的临床疗效,有效地提高了治疗效果,术后并发症明显减少,患者的身心健康得到促进,生活质量得到提高。     

循证疼痛护理对痔疮手术患者术后疼痛及创面愈合的影响

目的探讨循证疼痛护理对痔疮手术患者术后疼痛及创面愈合的影响。方法将本院2018年1—4月收治的120例痔疮手术患者分为观察组和对照组。对照组60例围术期采用常规护理,观察组60例在常规护理基础上采用循证疼痛护理。比较2组的术后疼痛及创面愈合情况。结果观察组术后24、48 h疼痛评分、术后最高疼痛评分低于对照组,术后首次换药、首次排便时的疼痛评分低于对照组,差异均有统计学意义(P 0. 05)。观察组术后24、48 h水肿评分低于对照组,出院前的创面评分低于对照组,创面愈合时间短于对照组,差异均有统计学意义(P 0. 05)。结论循证护理能够减少痔疮手术患者的术后疼痛程度,减轻创面水肿,促进愈合。     

LEEP术联合重组人干扰素α2b阴道泡腾胶囊治疗重度宫颈糜烂的疗效观察

目的 探讨LEEP术联合重组人干扰素α2b阴道泡腾胶囊(辛复宁)治疗重度宫颈糜烂的疗效.方法 将146例重度宫颈糜烂患者随机分为实验组73例和对照组73例,术后2组患者均采用常规抗生素预防感染3～5d,实验组在常规抗生素治疗的基础上加用重组人干扰素α2b阴道泡腾胶囊(辛复宁)治疗,治疗12周后比较2组患者的疗效和治愈时间.结果 2组患者在治疗12周后实验组治愈率(93.15%)高于对照组(80.82%),治愈时间显著缩短(均p＜0.05).结论 LEEP术联合重组人干扰素α2b阴道泡腾胶囊(辛复宁)治疗重度宫颈糜烂疗效好.做好治疗前心理护理、治疗中的病情观察及注意操作事项和健康教育,对提高治疗效果,减少并发症的发生,缩短疗程具有积极的意义.     

微波加云南白药治疗宫颈糜烂的效果观察

目的 探讨微波配合云南白药治疗宫颈糜烂的治疗效果.方法 选择妇科宫颈糜烂患者120例,随机分为观察组与对照组各60例.观察组采用微波治疗后创面涂抹云南白药药粉的方法;对照组采用微波治疗后创面涂抹红霉素眼膏的方法.比较观察2组创面脱痂后的出血情况、治疗效果及患者满意度.结果 与对照组比较,观察组非重度出血率明显高于对照组,而中度、重度出血率明显低于对照组,有显著性差异(P值均＜0.01);观察组治疗有效率及病人满意度明显高于对照组,有极显著性差异(P值均＜0.01).结论 说明采用微波加用云南白药外敷方法治疗宫颈糜烂效果确切,具有阴道出血量明显减少、创面愈合时间缩短的优点,其有效率及病人满意度比微波后加用红霉素眼膏方法治疗者明显提高,值得临床推广应用.     

LEEP治疗重度宫颈糜烂的临床效果探讨

随机抽取妇科门诊收治的重度宫颈糜烂患者70例,随机分成对照组和观察组各35例,评价两组手术指标和临床治疗有效率。(1)对照组治疗时间和阴道排液时间长于观察组,差异显著(P0.05),两组术中出血量无差异(P0.05)。(2)对照组总有效率为80%(28/35),低于观察组的97.14%(34/35),组间差异显著(P0.05)。LEEP刀治疗重度宫颈糜烂可以缩短治疗时间和术后恢复时间,降低手术风险,同时明显提高治疗效果,具有较高的临床推广价值。     

重度宫颈糜烂的微创高频电刀环切术

249例重度宫颈糜烂的患者随机分成观察组125例,采用高频电刀环切术(LEEP)治疗;对照组124例采用激光治疗。观察两组疗效和手术时间、术中出血量、术后出血情况。结果两组有效率分别为96.80%和84.67%,有显著差异(P<0.01);两组手术时间、术中出血量有显著差异(P<0.01),术后出血无差异。LEEP用于重度宫颈糜烂患者的治疗,具有手术时间短、术中出血少、创伤小、术后恢复快、操作简单安全、患者痛苦小、治愈率高、不需住院且不损伤宫颈机能、对妊娠分娩无影响等优点,是目前治疗重度宫颈糜烂的最佳方法。     

两种不同手术方法治疗宫颈糜烂的效果观察及护理

目的探讨高频电波刀(loop electrosurgical excision procedure,LEEP)和微波治疗宫颈糜烂的效果及总结护理要点。方法将2013年1~12月在本院治疗的150例宫颈糜烂患者,随机分为观察组和对照组,每组各75例。观察组患者采用LEEP进行治疗,对照组患者采用微波进行治疗。比较两组患者手术时间、术中出血量及疗效情况。结果观察组患者术中出血量明显少于对照组,手术时间明显短于对照组,疗效明显优于对照组,两组比较,差异具有统计学意义(均P0.05)。结论 LEEP治疗宫颈糜烂效果优于微波治疗宫颈糜烂,且治疗时间缩短,出血量减少。护理方面,应做好术前准备工作,治疗过程做好心理护理及相关知识指导。     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

Structure and content in Norwegian nursing care documentation.

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two-fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.     

提升护理服务综合价值的研究

目的:研究护理综合价值的提升。方法:分析护理价值研究背景,阐述护理价值研究进展结果:提出护理价值研究途径。结论:有利于达成一种共识,使广大护理人员认识护理价值、研究护理价值、开发护理价值,重视护理综合价值研究和提升。 护理服务价值是护理服务劳动产品的价值和服务本身所创造的价值的总和,即使用价值与价值的统一。目前日本、美国、德国和中国都在加强护理价值研究的探索,但仍存在使用价值与价值研究分离问题。因此,我们应不断加强护理综合价值研究,以适应卫生事业改革对护理管理的挑战。本研究主要在分析国内外护理价值研究的基础上,提出综合护理价值研究途径,以达到合理评价护理价值的目的。     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

我国护理行业的改革与发展

从我国护理行业的现状、卫生体制改革以及基本国情出发 ,着重探讨护理管理、护理教育、护理环境、护理经济与管理体系、护理立法等方面的发展途径     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

Innovations in United States genetics nursing: Practice and research

Aim: Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics‐related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods: The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics‐related health services, research, education, and public policy. Results: Genetics nurses in the US have developed innovative responses to genetics‐related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health‐care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics‐related research; and (vi) participation in high‐level genetics advisory groups. Conclusions: The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses’ organization known as the International Society of Nurses in Genetics (ISONG) has provided this base.     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

Towards an aesthetics of nursing

Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader approach to aesthetics and proposes a way in which a theoretical approach to nursing aesthetics could be developed. The paper concludes that nursing is a fit object of aesthetic appreciation and that aesthetic quality is a necessary attribute of good nursing practice.     

晨间护理缺陷分析及对策

目的提高晨间护理质量。方法通过向住院病人和护士发放问卷调查及每周不定期检查各病区晨间护理质量,了解晨间护理工作中存在的缺陷,提出整改的措施。结果晨间护理工作中存在的主要缺陷:51.8%的病人认为护士与病人的沟通少,进病房时未向病人问好,整理病房时未向病人解释,口腔清洁率70.3%,头发清洁率45.3%,皮肤清洁率69.5%,病房安静整洁率67.3%,床单位整洁率86.5%,病情关注情况67.9%,健康教育执行情况48.6%,协助生活不能自理的病人进食、入厕、更衣、床上排便等占75.4%,时间安排满意度75.6%,护士认为晨间护理重要的占30%,晨间护理内容知晓率占60.9%,认为工作量大来不及做的占56.7%。结论提高护士对晨间护理的认识,规范晨间护理内容和程序,加强与病人的沟通,提供符合个体化需要的晨间护理,合理安排护理人员、工作重点和时间,持续质量改进,有助于提高晨间护理质量。