硝酸灼伤合并吸入性呼吸系统损伤患者的护理

目的总结硝酸灼伤合并吸入性呼吸系统损伤患者的呼吸道护理经验。方法针对1 2例硝酸灼伤合并吸入性呼吸系统损伤患者的特点,早期抢救护理及时正确,密切观察病情变化,对气管切开患者加强气道护理,保持呼吸道通畅,防治肺感染。结果 1 2例硝酸灼伤合并吸入性呼吸系统损伤患者,有7例做了气管切开术,经有效的治疗和护理,患者全部治愈出院,效果满意。结论硝酸灼伤合并吸入性呼吸系统损伤患者的呼吸道护理对治疗吸入性呼吸系统损伤和预防气管切开后并发症非常重要,直接影响伤情与预后。     

烧伤吸入性损伤的呼吸道护理

目的探讨烧伤吸入性损伤患者的气道管理,以减少并发症,提高吸入性损伤病人的救治成功率。方法保持呼吸道通畅,做好吸痰、气道湿化的管理,合理氧疗;改善肺循环,防治并发症。结果本组严重烧伤并发吸入性损伤108例,治愈91例,中途放弃治疗5例,死亡12例,治愈率84.3%。结论早期认真观察,正确分析,科学、细致的呼吸道护理,可减少并发症的发生,提高吸入性损伤的治愈率。     

硝酸灼伤合并吸入性呼吸系统损伤患者的护理

目的总结硝酸灼伤合并吸入性呼吸系统损伤患者的呼吸道护理经验。方法针对12例硝酸灼伤合并吸入性呼吸系统损伤患者的特点,早期抢救护理及时正确,密切观察病情变化,对气管切开患者加强气道护理,保持呼吸道通畅,防治肺感染。结果12例硝酸灼伤合并吸入性呼吸系统损伤患者,有7例做了气管切开术,经有效的治疗和护理,患者全部治愈出院,效果满意。结论硝酸灼伤合并吸入性呼吸系统损伤患者的呼吸道护理对治疗吸人性呼吸系统损伤和预防气管切开后并发症非常重要,直接影响伤情与预后。     

高温水泥致呼吸道烧伤20例的早期观察护理

高温水泥烧伤患者常伴有呼吸道烧伤,而合并有吸入性损伤的病人,休克和败血症的发病率高,病势严重,呼吸系统并发症多且发生的早,因而成为当前烧伤病人的主要死亡原因。高温水泥所致的吸入性损伤又属特殊类型的吸入伤,故早期注意呼吸道的观察极为重要。我们总结20例观察护理体会如下。     

吸入性损伤患者的护理

吸入性损伤是热气或烟雾引起的呼吸道以至肺实质的损害。吸入性损伤的主要因素为热气和化学刺激性物质,即热气损伤和化学性损伤,有时两种损伤同时存在。目前,随着对烧伤的了解和治疗措施的改善,烧伤休克和感染的发病率和病死率均明显下降,吸入性损伤已成为当前烧伤病人的重要死亡原因。因此,保持呼吸道通畅,及时清除患者呼吸道分泌物,是吸入性损伤治疗过程中的有效措施。1吸入性损伤伴休克患者的护理1.1吸入性损伤后肺含水量增加,伤后12～28小时达高峰,而吸入性损伤伴有体表中等面积以上烧伤时,往往在一定时间内输液量较多,特别是在伤后8小…     

对头面部烧伤并吸入性损伤患者的护理

通过对我院接受治疗的45例患有头面部烧伤并吸入性损伤患者的护理,包含对患者实施的急救处理,呼吸道不同程度烧伤的护理措施进行探讨,提出了一些护理措施,比如对患者实施常规的支气管纤维镜的检查,要能够及时发现患者的呼吸道吸入性的损伤,尤其是对呼吸道深度烧伤的患者尽早施行气管的插管或者是切开等操作,这在临床上具有很重要的意义。     

经面罩无创正压通气治疗烧伤合并吸入性损伤患者的临床护理分析

目的：探讨烧伤合并吸入性损伤在无气道梗阻情况下使用经面罩无创机械通气患者的护理措施。方法：回顾性分析18例烧伤合并吸入性损伤在无气道梗阻情况下使用无创机械通气患者的临床资料与护理情况。结果：本组18例患者,15例经过积极的救活和护理痊愈出院;3例治疗过程病情加重进行气管切开后痊愈出院。结论：大面积烧伤合并吸入性损伤患者在无气道梗阻情况下可先采用无创机械通气纠正缺氧,应采取正确的护理措施,早期加强病情观察,积极对创面进行处理,控制感染,并加强呼吸道管理是提高患者治愈率、促进创面修复的重要保证。     

重度烧伤合并呼吸道损伤患者呼吸道的管理

目的:回顾总结37例重度烧伤并呼吸道损伤患者呼吸道管理的经验.方法:加强对患者呼吸症状的监护,加强气道湿化,保持呼吸道通畅,预防感染,维持有效的呼吸.结果:37例患者,无1例由于呼吸道并发症而导致死亡.结论:实施正确的护理措施,保持呼吸道通畅,维持有效的通气,预防感染是重度烧伤并吸入性损伤患者呼吸道管理的关键.     

业界动态

目的探讨纤维支气管镜在吸入性损伤合并面部烧伤中的应用及时机。方法对本院8年来43例吸入性损伤合并面部烧伤病人的资料进行分析与对比。结果43例病人均顺利恢复，肺部症状1周左右消失，无死亡，未遗留肺部并发症。结论纤维支气管镜在吸入性损伤合并面部烧伤中早期应用可明显缩短病程，降低病死率。     

大面积烧伤伴重度吸入性损伤的气道护理体会

近年来,本院收治了10例大面积烧伤伴重度吸入性损伤病人。现将呼吸道烧伤护理体会归纳如下。1 临床资料本组患者均为男性,体表烧伤面积最小为40％,最大为98%,其中水泥烧伤7例,沥青烧伤1例,石灰烧伤1例,化学烧伤1例。3例死亡,2例自     

重症颅脑损伤气管切开患者的护理管理分析

目的观察重症颅脑损伤气管切开患者实施护理管理的临床效果。方法选择该院40例重症颅脑损伤气管切开患者实施该次研究,时间为2018年1月-2019年1月,所有患者均实施护理管理措施,观察护理管理效果。结果40例重症颅脑损伤气管切开患者中,显效29例(72.50%),有效10例(25.00%),无效1例(2.50%),总有效率为97.50%。肺部感染1例(2.50%),气管食管瘘1例(2.50%),无窒息、皮下气肿等症状,并发症发生率为5.00%。结论将护理管理措施用于重症颅脑损伤气管切开患者中,可提升临床治疗效果,降低并发症发生率,临床应用及推广价值极高。     

Prioritizing back injury risk in hospital employees: application and comparison of different injury rates

To identify high risk areas for back injury in a large teaching hospital, we calculated standard injury rates and newly developed composite statistics for nursing and non-nursing work groups. Data were extracted from the hospital's workers' compensation database. The hospital-wide total injury rate was 4.6 reports per 100 full-time equivalents (FTE); Compensation Case Rate, 1.4 cases per 100 FTE; Compensation Severity Rate, 76 days lost per 100 FTE; and the Cost Rate, $3742 per 100 FTE. The Total Injury Reports Rate for nursing varied from 14.2 per 100 FTE for Intensive Care Unit (ICU) Nursing to 3.8 per 100 FTE for Pediatric Nursing. Non-nursing areas also demonstrated increased rates for back injury. Individual statistical rates ranked areas differently in risk, whereas composite statistical measures consistently ranked ICU Nursing, Buildings and Grounds, and Orthopedics/Neurological Nursing as the top three. Patient handling was the precipitating event in the majority of nursing back injuries, indicating the need for ergonomic intervention. The use of combined statistical measures provided a more integrative measure for describing and following back injury risk over time.     

急性颅脑损伤的急救及护理

目的探讨急性颅脑损伤的急救及护理。方法回顾性分析90例急性颅脑损伤病人的护理方法,主要包括保持呼吸道通畅,防止呼吸道阻塞;快速建立静脉通道;严密观察病情;并发症的护理。结果收治颅脑损伤患者90例,痊愈58例;好转30例;死亡2例。结论认为正确而娴熟的护理措施是抢救成功的关键,在抢救过程中,护理人员急救技能的熟练程度对于保证抢救的顺利进行,减少并发症,降低死亡伤残率,改善预后及提高患者生存质量有密切关系。     

下肢外伤患者人工皮肤封闭式负压引流的护 理简

目的：观察人工皮肤封闭式负压引流治疗下肢外伤手术患者的临床护理疗效。方法：使用人工皮肤封闭式负压引流对35例下肢外伤手术患者进行治疗和护理。结果：29例患者Ⅰ期愈合，6例行Ⅱ期植皮后愈合。结论：人工皮肤封闭式负压引流是下肢软组织严重损伤简单、有效的治疗方法，人工皮肤精确封闭和维持负压状态是治疗成败的关键。     

康复干预应用于脊髓损伤的恢复效果观察

目的：观察并分析脊髓损伤患者应用康复干预的临床效果。方法资料随机选自2011年8月-2014年1月在本院诊治的60例脊柱损伤患者,随机分为对照组和研究组,28例对照组患者给予常规护理,32例研究组患者在对照组基础上给予康复干预,比较两组患者护理前后相关数据。结果护理后,研究组的并发症发生率25.00%比对照组发生率71.43%低,差异明显（P＜0.05）;研究组患者运动评分增加值、针刺觉评分增加值、轻触觉增加值均比对照组高,差异明显（P＜0.05）;研究组患者WHOQOL-100量表中的心理功能、独立性与社会关系评分均比对照组高,差异明显（P＜0.05）。结论康复干预应用于脊髓损伤的恢复效果显著,可以提高患者的生活自理能力,具有临床应用价值。     

责任包干制的护理模式在消化内科的应用

目的探讨消化内科落实责任包干制护理服务模式在临床护理中的应用效果。方法改变分工方式与排班形式,以责任小组的形式承包一定数量的病床,每名责任护士负责组内8～9例病人的全部护理工作,包括入出院护理、基础护理、治疗、病情观察、护理记录、心理护理、康复治疗、健康教育、病房管理等,应用相同的满意度调查表及护理质量评价标准进行回顾性分析比较。结果护理质量、病人满意度较落实前高,p<0.05,差异具有统计学意义。结论落实责任小组包干制使护士分工更加明确,基础护理更加到位,护患关系更加融洽,不仅病人得到全程、连续、无间缝护理,病人满意度、护理质量得到提高,而且护士觉得自我价值得到了体现,对工作热情也提高了,值得临床推广。     

Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012‐2015

Background

Workplace violence is a substantial occupational hazard for healthcare workers in the United States.

Methods

We analyzed workplace violence injury surveillance data submitted by hospitals participating in the Occupational Health Safety Network (OHSN) from 2012 to 2015.

Results

Data were frequently missing for several important variables. Nursing assistants (14.89, 95%CI 10.12‐21.91) and nurses (8.05, 95%CI 6.14‐10.55) had the highest crude workplace violence injury rates per 1000 full‐time equivalent (FTE) workers. Nursing assistants' (IRR 2.82, 95%CI 2.36‐3.36) and nurses' (IRR 1.70, 95%CI 1.45‐1.99) adjusted workplace violence injury rates were significantly higher than those of non‐patient care personnel. On average, the overall rate of workplace violence injury among OHSN‐participating hospitals increased by 23% annually during the study period.

Conclusion

Improved data collection is needed for OHSN to realize its full potential. Workplace violence is a serious, increasingly common problem in OHSN‐participating hospitals. Nursing assistants and nurses have the highest injury risk.

     

Sexual functioning of women with complete spinal cord injury: Nursing implications

The Human Sexual Response Cycle and the neurological alteration in physiological sexual functioning of women following complete spinal cord injury is discussed. Nursing implications regarding current theoretical knowledge, its foundation in research and practical considerations for patient education is reviewed. Specific suggestions are also provided for the sexual concerns of birth control, lubrication issues, elimination problems, loss of motor and sensory control and changes in orgasmic function.     

Fluid management: a nursing intervention for the patient with fluid volume excess

The objective of this research is to identify which nursing activities contained in the fluid management intervention proposed by the Nursing Intervention Classification (NIC) are realized and considered important by nurses, to attend patients who received fluid volume excess as a nursing diagnosis, as proposed by the North American Nursing Diagnoses Association (NANDA). Data were collected in three hospitals. The sample included 77 nurses, who chose the best alternative on a Likert scale, to indicate the realization of which of those actives they considered important and which activities are realized in their daily care practice. It was concluded that most of the nursing activities were always considered important and were always performed by the nurses. These activities were classified as independent and dependent.     

实习护士发生锐器伤的现状调查与分析

目的了解实习护士发生锐器伤的相关因素,探讨其有效的职业防护对策。方法采用自行设计的问卷调查表,随机对101名实习护士进行调查。结果实习护士对锐器伤的认知不足,且专科实习护士在玻璃类及针刺伤是否危险性大、戴手套是否有防护作用及套护针帽的手法是否为单手4个方面的认知率明显低于本科生,差异有统计学意义(P<0.05);锐器伤发生率89.11%,其中以实习时间在<3个的实习护士发生频率最高,其在调查日前1个月发生锐器伤的频率明显高于实习即将结束组,差异有统计学意义(P<0.05);发生锐器伤的科室以输液室、普外科等为多,分别占14.41%、12.16%。结论高发生率的实习护士锐器伤应引起高度重视,在防护对策中,学校课程设置上充实医院感染的相关知识是前提,而建立规范的职业防护制度,加强3个重点的管理是关键。