个案护士在多学科整合式治疗管理模式中的作用

目的:探讨多学科整合式治疗管理模式中个案护士护理的选择、培训管理及效果评价。方法:选拔培训一批有资质的护理骨干作为个案护士,以特定工作流程为指导,在管理团队领导下开展工作。个案护士通过评定患者、参加多学科小组会议、健康宣教等职责,最终采用患者及家属满意度调查表对个案护士进行评定。结论:个案护士在多学科团队中起到了重要作用,促进了患者康复,减轻了患者心理负担,提高了患者和家属满意率。     

情景模拟与实践结合的手术室带教模式探讨

目的　探讨手术室各层次护生带教模式的最佳运用方式 ,以便更好地使护生得到各方面能力的培养。方法　将 2 0 8名护生分 2组运用不同的带教模式。第 1组 10 2名护生运用常规带教方法“一对一”跟班带教模式 ,第 2组 10 6名运用新的情景模拟与实践结合互动式带教模式。结果　两组比较有显著差异性 (P <0 .0 1)。结论　情景模拟与实践结合的带教模式不仅能提高手术室的带教质量 ,更能使护生得到更多实践的锻炼 ,巩固了理论知识 ,加强了动手能力     

Assistive technology training: Diverse audiences and multidisciplinary content

Purpose.?This study surveyed US programmes that train professionals in assistive technology (AT). Surveys contained questions regarding programme characteristics, audiences, training content, and approaches.

Method.?This multi-method, longitudinal study gathered information from 55 programmes in 27 states concerning their courses, curricula, and training audiences in 2002 and again in 2004. The study focused on 45 unique programmes conducting AT training for formal credit, which included graduate or undergraduate credit or degrees, continuing education units (CEUs), and/or AT credential.

Results.?Twenty-five programmes at universities and colleges (average age 10 years) trained mainly graduate students, and typically offered five or six three-unit AT courses. Twenty community-based programmes (average age 7 years) offered mainly 1- or 2-day workshops. Special educators represented the largest group of trainees. Thirty-two training directors and 135 instructors described training barriers, curriculum issues, distance and hands-on learning methods, and future AT training directions.

Conclusions.?Multidisciplinary AT training not only reaches core audiences of disability-related professionals, but has expanded to include new audiences. Special and general educator training may be a model for inclusion. Although distance learning can reach diverse audiences, faculty in training programmes also emphasised hands-on training. AT training programmes experience considerable turnover and remain vulnerable to funding losses.     

涉外护理人才培养模式的研究进展

从涉外护理教育产生的背景和科学意义、涉外护理人才培养模式发展现状等方面进行综述,重点分析了国内涉外护理发展现状。     

Kalevala or Keats: poetic traditions as a model for multidisciplinary miscommunication and team splitting

Attention is drawn to the oral tradition in poetry and some ways in which it differs from written, literary poetry. Some of these differences mirror differences between the oral communication typical of a psychiatric ward nursing handover and the writing-based communication styles of psychiatrists. In particular, the oral tradition tends to involve an interactive and participatory style, stewardship (rather than authorship) of the message, a less linear approach to time and valuing the use of familiar formulae. Neither style is intrinsically superior or inferior. The two styles have significant differences in context, intent and rules (i.e. in linguistic 'pragmatics'). In mental health practice, the apparently shared vocabulary and setting conceals these differences. The fact that these variations are hidden increases the risks of miscommunication and of team splitting. The use of an analogy from poetry is intended to make the differences more explicit, and thus generate awareness, discussion and problem solving.     

Encopresis in a multihandicapped child: Rapid multidisciplinary treatment

An 8-year-old child with cognitive, behavioral, and speech and language impairments presented to a multidisciplinary diagnostic and treatment center with long-standing secondary encopresis. The medical and behavioral literature is reviewed. The case is used to illustrate how: (1) secondary encopresis is often unreported because parents and some health professionals assume it is a natural part of the syndrome of disabilities of a multiply handicapped child; (2) it can present as a social emergency when community agencies are inconvenienced by this symptom; (3) a multidisciplinary team, using community resources, can successfully treat this symptom in the face of a number of factors which generally point toward a poor prognosis for rapid elimination of this symptom. Health professionals are urged to routinely inquire about secondary encopresis to insure that this symptom is not ignored.     

分层次多元化培训模式在护理人员临床护理培训中应用效果

目的探讨分层次多元化培训模式在临床护理培训中的应用效果。方法选取2018年1月—2019年1月在浙江省淳安县第二人民医院参与临床护理培训的102名护理人员,将2018年1—6月参加培训的51名护理人员作为对照组,将2018年7月—2019年1月参加培训的51名护理人员作为观察组。对照组采用传统护理培训模式,观察组在此基础上采用分层次多元化培训模式,比较两组培训人员的技能考核评分及培训人员对培训过程的满意度、患者对护理工作的满意度。结果观察组培训人员培训后的护理知识、临床技能操作、应急处理、护理质量等相关技能考核评分,对培训工作的总满意度,患者对观察组的护理工作总满意度均高于对照组,差异均有统计学意义(P<0.05)。结论分层次多元化培训模式能提高护理人员的临床护理能力及操作考核成绩,并能增强培训人员对培训工作满意度,有利于临床护理质量及护理效率的不断提升,也有助于构建良好的医患关系,安全性更高,值得临床推广应用。     

A narrative review of the effectiveness of aggression management training programs for psychiatric hospital staff

Workplace violence, including patient-perpetrated violence in healthcare settings, is increasingly being recognized as preventable. Staff training has been identified as a necessary component of any initiative aimed at preventing or reducing incidents of aggression and violence in the workplace. This narrative review of the literature evaluates the effectiveness of staff training programs designed to prevent and manage violence and aggression in psychiatric hospitals. An exhaustive review of the literature was performed on all articles published in English between January 1, 1990 and April 1, 2007 that evaluate an aggression management training program. Twenty-nine studies met the inclusion criteria for a full review and were summarized using a qualitative narrative approach. Aggression management training has been proven effective in some areas, such as reducing the use of restraints and other coercive control devices, but more methodologically rigorous research is needed to firmly establish whether it is effective in reducing aggression and staff injuries.
Implications: The findings of this study suggest that relying too heavily on aggression management staff training will have limited effect on addressing the range of issues related to patient-perpetrated violence in psychiatric hospitals. Mental healthcare organizations must look beyond staff training if they are to achieve meaningful reductions in aggressive incidents and staff injuries.     

层级培训管理模式的实施效果分析

目的：探讨有效的培训模式,以提高护理队伍的整体素质。方法：采用层级培训管理模式,对125名护理人员进行一对一的护理培训,注重工作过程中的培训,定期进行效果评估和反馈。结果：培训后护士的专科护理技能、对下级护士的培训能力、对病人的评估能力、沟通能力、护理文件书写能力评价总均分显著高于培训前（P〈0.05）。结论：层级培训管理模式可有效提高护理人员的综合素质。     

Outcomes of a headache-specific cross-sectional multidisciplinary treatment program

Aim.— Chronic headache is a disabling disorder that is frequently poorly managed in general clinical practice. Objectives.— To investigate primary (headache frequency in days/month) and secondary (headache‐related disability, lost work/school time, anxiety and depression, amount and intake frequency of acute medication) 12‐month outcomes of a headache‐specific cross‐sectional outpatient and inpatient multidisciplinary treatment program using a dedicated computer system for data collection and corresponding between integrated care team in a tertiary headache center and practicing headache specialists. Background.— A need for integrated headache care using comprehensive and standardized assessment for diagnosis of headache, psychiatric comorbidity, and burden of disease exists. There are little published data on long‐term efficacy of multidisciplinary treatment programs for chronic headache. Design.— A prospective, observational, 12‐month, follow‐up study. Subjects and Methods.— Prospectively recruited consecutive patients with frequent difficult‐to‐treat headaches (n = 201; 63 migraine, 11 tension‐type headache, 59 combined migraine/tension‐type headache, and 68 medication overuse headache) were enrolled. Outcome measures included prospective headache diaries, a medication survey, Migraine Disability Assessment, 12‐item short form health survey, and the Hospital Anxiety and Depression Scale. Results.— The primary outcome of a reduction of ≥50% of headache frequency (days/month) was observed in 62.7%. Mean headache frequency decreased from 14.4 ± 8.2 to 7.6 ± 8.3 days/month, P < .0001. Secondary outcomes improved significantly in the total cohort and all headache subgroups. Predictors for good outcome were younger age, few days lost at work/school, and familiarity with progressive muscle relaxation therapy at baseline. Conclusions.— The present analysis provided support for a cross‐sectional multidisciplinary integrated headache‐care program.     

Efficacy of multidisciplinary treatment in a tertiary referral headache centre

Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. We set out to describe the procedures, characterize the patients and evaluate the treatment results in Danish Headache Centre. All clinical records for patients discharged in 2002 were systematically reviewed. Diagnoses were classified in accordance with ICHD-II. Outcome results were analysed with respect to headache diagnoses, frequency, intensity, absence from work and medication use. Five hundred and five patients were included and 336 were eligible for the study. Mean age was 46 years and male/female ratio 1:2.4. For patients without medication overuse headache (MOH) a reduction in headache frequency (P<0.01) and intensity (P<0.05) was seen for frequent episodic and chronic tension-type headache (TTH), migraine, cluster and other headaches. No reduction was seen in post-traumatic headache. Absence from work decreased significantly for migraine (P<0.001) and frequent episodic TTH (P<0.05). For patients with MOH a reduction in headache frequency was seen for TTH and migraine (P<0.001). A specialized headache centre is valuable in treatment of patients with complex headache disorders.     

Nurses' perceptions of multidisciplinary team work in acute health-care

Multidisciplinary teamwork is viewed as one of the key processes through which care is managed in the British National Health Service, and yet is often viewed as one of the most problematic. Working in a multidisciplinary team requires many skills, which involves understanding not only one's own role but also the role of other professionals. The aim of this study was to explore nurses' perceptions of multidisciplinary teamwork in acute health-care. Nineteen nurses were interviewed using the critical incident approach to obtain their perceptions of multidisciplinary teamwork. Direct observation was conducted to record interactions between nurses and health-care professionals in multidisciplinary teams. In total, 14 meetings were attended in elder care and orthopaedics and seven in acute medicine. The findings of this study identified three barriers that hindered teamwork: (i) differing perceptions of teamwork; (ii) different levels of skills acquisitions to function as a team member; and (iii) the dominance of medical power that influenced interaction in teams. Thus, education establishments and nursing managers need to ensure that the acquisition of team-playing skills is an integral part of continued professional development.     

A small animal model for laparoscopic microsurgery training

Summary

Training of the surgeon is one of the main factors in avoiding technical problems and complications during laparoscopic procedures. Because of the demands on skill and restriction of instrument movement within pneu-moperitoneum and the need for 2-dimensional videoendoscopic vision, participation in a training course is recommended. Simulation trainers cannot completely simulate pneumoperitoneum and only represent part of the laparoscopic procedure and therefore pigs are the preferred animal model for surgical laparoscopy because standard instruments can be used and visceral anatomy of the pig is familiar to the surgeon. We report on an inexpensive training concept using the rat model which requires less logistic effort than the comparable course on a large animal would do. Laparoscopic procedures are performed with an increasing degree of difficulty first on an ‘open’ then on the ‘closed’ model simulating all laparoscopic conditions.     

多学科护理照顾模式对青少年癫痫患者术后应激及生活质量的影响

目的 探讨多学科护理照顾模式的应用对青少年癫痫患者术后应激、遵医行为、自我护理能力及生活质量的影响.方法 将90例手术治疗青少年癫痫患者按随机数字表法分为两组,每组45例.对照组采取常规护理干预,研究组采取多学科护理照顾模式开展护理干预,观察住院全程.比较干预前后两组患者应激指标、遵医行为、自我护理能力及生活质量.结果...     

难治性局灶性癫痫的多学科团队模式诊疗策略

目的:探讨难治性局灶性癫痫的多学科团队模式(multidisciplinary team,MDT)诊疗策略.方法:介绍1例药物难治性颞叶癫痫,头皮脑电图监测示患者双侧颞区不同步放电,常规磁共振序列扫描未见明显异常,初步评估为患者病灶位置和侧向性不明.进行MDT讨论和后续进一步术前评估,明确患者致痫灶和治疗方法.结果:患...     

采取跨越式方法培养新护士的探索

目的 :探索迅速提高新护士综合素质的途径。方法 :将在职培训与护理程序的各个环节密切结合 ,使护士职业道德培养、基础护理基本功训练与本科护理理论和技能训练融为一体。结果 :新护士综合知识和技能在较短时间内得到全面提高。结论 :采取科学、快捷的方法对新护士加以强化培训 ,可以起到事半功倍的效果     

'New to Forensic'; implementing a problem-based introductory educational programme for forensic practitioners in Scotland

The New to Forensic educational programme has been developed for use across all forensic services in Scotland. It is designed to meet the needs of all staff who are both new to and already working within forensic mental health services. Its objectives are targeted to both clinical and non-clinical staff. The programme follows the patient's journey through the mental health and criminal justice systems. It covers mental disorder, legislation, psychiatric defences, assessment and treatment, risk of harm to others, services, attitudes and boundaries, multidisciplinary working, users and carers, community, learning disability, and prison services. It is self-directed and practice based, and uses a problem-based approach. Over a 3-year period, trainers and mentors have been trained to deliver the programme by members of the School of Forensic Mental Health http://www.forensicnetwork.scot.nhs.uk/ and all services have adopted the programme as a core educational initiative. Initial findings from the programme evaluation indicate a significant improvement in learning following engagement in the initiative.