探讨重症监护室护士的综合素质

随着医疗技术的不断提高，重症监护室(Intensive Care U．nit，ICU)在现代医院中的地位越来越显得重要。ICU收治了各种高危手术及术后重症，脏器移植及脏器功能衰竭的患者，而ICU的设备和工作人员的素质为抢救成功做出了根本保证。ICU是医院“高”、“精”、“尖”医疗设备较集中的地方。护士素质的优劣是ICU救治工作成败的关键因素之一。为     

谈重症监护室护士的素质

重症监护室（ICU）是以救治各类重症和多系统功能衰竭病人为主的诊疗体系,我国卫生部已把医院建立ICU作为医院等级评审的条件之一。由于ICU是危重病人集聚的科室,具有病人病情变化快、突发事件多、先进医疗仪器集中、病人生活不能自理、护理工作劳动强度大等特点,这些应激源易导致护士生理和心理的双重压力,因此要求ICU护士具备高素质、健全人格、宽广知识面、较强应变能力等。     

谈重症监护室护士的素质

重症监护室(ICU)是以救治各类重症和多系统功能衰竭病人为主的诊疗体系,我国卫生部已把医院建立lCU作为医院等级评审的条件之一.由于IC[J是危重病人集聚的科室,具有病人病情变化快、突发事件多、先进医疗仪器集中、病人生活不能自理、护理T作劳动强度大等特点,这些应激源易导致护士生理和心理的双重压力,因此要求lCU护士具备高素质、健全人格、宽广知识面、较强应变能力等.     

心脏重症监护室护士的素质要求

心脏重症监护室(CCU)是医务人员利用先进的监护仪器和抢救设备对病情危重的急性心肌梗死病人、不稳定的心绞痛病人、严重的心律失常病人及心脏介入手术需要监护的病人进行全方位连续监护治疗的病房,是医务人员守在病人身边,密切观察和记录病人的生命体征和病情变化,及时正确为病人施治,确保病人安全,使病人顺利度过危险期的病房.由于CCU病房复杂的仪器和监护设备、陌生的环境、死亡对病人的威胁、医护人员紧张的工作节奏等会使病人心理上产生很大的压力,在意识上、情绪上、行为上产生各种变化,影响其生理、病理的变化,并最终影响病人病情的转归和治疗效果,故要求CCU护士应具备较高素质.现将CCU护士的素质要求介绍如下.     

浅谈重症监护室护士应具备的素质和能力

本文论述了重症监护室（ICU）护士应具备的素质和能力，认为崇高的职业道德、良好的心理素质和身体素质、坚强的意志和团队合作的意识是ICU护士应具备的素质，而全面丰富的理论知识、扎实娴熟的操作技术、敏锐的感知观察能力和广博的人文知识是ICU护士应具备的主要能力，并提出了相应的建议。     

国外重症监护室护士处方权及国内护士处方权发展现状

概括国外部分国家重症监护室专科护士处方权现状以及国内护士处方权研究发展现状,以期挖掘国内护士处方权下一步可研究的领域。     

省市级重症监护室护士科研能力水平调查分析

[目的]调查重症监护室(ICU)专科护士科研能力水平现状,分析探讨影响ICU护士科研能力的主客观因素,为制定有针对性的护理科研培训方案、提高ICU护士的科研能力水平、推动医院护理科研工作提高有价值的参考。[方法]使用护理人员科研能力自评量表对15家省市级医院218名ICU护士进行问卷调查。[结果]ICU护士科研能力总分为51.47分±22.64分。各维度中文献查阅能力得分最高(2.07分±0.73分),其次为问题发现能力、论文写作能力、科研实践能力、科研设计能力、资料处理能力。多元回归分析显示,所有变量中,只有英语水平能力能明显预测15.7%的护士科研能力。[结论]ICU护士科研能力水平中等偏低,医院护理管理者应加强ICU护士科研能力知识培训,并且培训要有针对性,主要培训内容为资料的处理、科研设计和英语知识的学习,以期有效快速提高临床护理科研水平。     

神经外科重症监护室护士工作压力分析及对策

本文就神经外科重症监护室（NICU）护士所面临的工作压力进行分析并探讨，工作压力会导致工作疲惫感，出现体力、情绪和精神上的疲倦感，导致护理质量下降，护理差错及护患纠纷增多，并影响护士的身心健康。因此，应通过各种组织措施和护士自身的努力，使工作压力减轻，维持高水平的护理服务质量和保持身心健康。     

重症监护室护士心理压力分析及对策

从工作环境、工作时间、工作强度、人际关系、噪声、意外损伤、放射和化学损害、心理素质等方面分析了导致重症监护室（ICU）护士产生心理压力的原因,针对原因,采取了改变工作环境及时间、建立和谐的人际关系、加强沟通等相应的对策,以减轻ICU护士的心理压力。     

重症监护室护士应对方式的调查分析

[目的]调查重症监护室护士的应对方式。[方法]选取外科ICU护士62人，采用一般资料问卷及应对量表进行调查。[结果]重症监护室护士多用积极的应对方式，少用消极的应对方式，常用的应对策略有“集中注意力，考虑下一步该怎么办”“向自己尊敬的亲友或朋友征求意见”“和某些人交谈以便了解更多的信息”等，较少用的应对策略有“吃东西、吸烟、喝酒、用药或吸毒等使自己感觉好些”“拒绝相信已经发生的事情”“做一些冒险的尝试”等。[结论]ICU护士在面对压力源时能积极地面对问题，努力寻求社会支持，获取更多的信息和采取有效的行动来减轻压力源所带来的压力。     

品管圈活动在呼吸重症监护病房的应用与效果

目的在呼吸重症监护病房应用品管圈实施持续的护理质量改进,以提高护理工作质量。方法组建了压疮管理、静脉治疗、气道管理、药品安全及低年资护士技能培训5个品管圈,各品管圈组织专项学习与督导,对存在的问题进行原因分析,制订并落实质量改进措施。结果提高了护理工作质量及患者对护士服务的综合满意度。结论开展品管圈活动,可以增进护士的团队精神,充分发挥其工作积极性,提高护理质量。     

急诊重症监护病房患者的护理管理

目的探讨急诊及重症监护病房（ICU）监护患者的护理管理。方法对514例急诊ICU监护患者的临床护理管理进行回顾性分析。结果514例急诊ICU监护患者在护士的密切观察和严格护理管理下，家属满意度为99％。结论加强急诊ICU监护患者的护理管理，是减少患者在住院期间护理差错和纠纷的关键，值得临床推广。     

Correlation between the TISS‐28 and NEMS indicators in an intensive care unit

Cross‐sectional study aimed at to analyse and compare the correlation between the Therapeutic Intervention Scoring System (TISS)‐28 and Nine Equivalents of Nursing Manpower Use (NEMS) indicators with a sample of 725 patients, for which data was collected from the computerized system of a university hospital. The findings of the present study well demonstrated a strong correlation between the TISS‐28 and NEMS, both at the time of patient admission and discharge (0.888 and 0.885; P < 0.001), although there is a dispersion of 21% in the data and established cut‐off points to discriminate with greater power the death and no death scenarios. Further research is still necessary to confirm the possibility of replacing the TISS‐28 scoring instrument with NEMS.     

Person-centred care among intensive care unit nurses: A cross-sectional study

ObjectivePractising person-centred care is crucial for nurses in the intensive care unit, as patients have high physical and psychological care needs. We aimed to identify the predictors of person-centred care among nurses working in intensive care settings.MethodsIn this cross-sectional study, 188 intensive care unit nurses at four tertiary hospitals in two cities of South Korea were included. They completed self-reported questionnaires on emotional intelligence, compassion satisfaction, secondary traumatic stress, burnout, and person-centred care. Emotional intelligence was measured using the Korean version of the Wong and Law’s emotional intelligence scale. Compassion satisfaction, secondary traumatic stress, and burnout were measured by the Professional Quality of Life questionnaire (version 5). Person-centred care was measured using the person-centred critical care nursing scale.ResultsMultiple regression identified compassion satisfaction (β = 0.49, p <.001) as the most powerful predictor of person-centred care, followed by emotional intelligence (β = 0.21, p =.004) and intensive care unit career length (β = 0.17, p =.021). These three variables accounted for 31.0 % of the variance in person-centred care.ConclusionsThis study highlights the importance of career length, emotional intelligence, and compassion satisfaction in the promotion of person-centred care among intensive care unit nurses. Nursing management should contemplate specific measures to reduce turnover among experienced intensive care unit nurses and to enhance the factors that promote person-centred care, such as compassion satisfaction and emotional intelligence.     

全国30个省市三级医院重症监护病房医护人员呼吸治疗工作现状的问卷调查

目的 调查我国三级医院重症监护病房(ICU)呼吸治疗的仪器装备、工作内容和完成人等,为规范和发展呼吸治疗工作提供依据.方法 在2006年8月国内召开的三次大规模会议上发放问卷,调查30个省264家三级医院320个ICU的491名医护人员.结果 有创、无创呼吸机数与床位数之比分别为0.52: 1(2 189/4 185)和0.16:1(672/4 185).320个ICU中,超声、喷射式以及定量雾化吸入器的配用率分别为55.9%(179/320)、33.8%(108/320)和12.1%(39/320);机械通气中呼吸机设置、撤机、拔管主要由医师完成的ICU占92.1%、93.1%、83.5%,更换管路、吸痰、雾化、湿化主要由护士完成的ICU占83.7%、93.9%、91.6%、90.2%.491名回答者中撤机前行自主呼吸试验者占40.9%,不知道或从来不做者占26.2%;有创通气时未监测气道开口端温度者占27.1%;对撤机未拔管患者应用气管内持续滴入/泵入盐水湿化者占34.4%;55.6%的人员使用前检测呼吸机;管路更换频率依次为每周1次占48.1%,1～3 d和3～5 d更换1次者为25.0%、14.7%.结论 目前国内三级医院ICU的呼吸机数量较前已大幅增加,但对其他实用装置的应用尚不足;呼吸治疗工作主要由医生和护理人员共同承担,尚缺少专业的呼吸治疗师;机械通气、气道管理和呼吸机管理等呼吸治疗工作差异较大,缺乏统一的规范.     

呼吸加强医疗病房患者预后因素研究

目的 探讨影响呼吸加强医疗病房患者预后的危险因素，为制定相应防治措施作参考。方法 回顾性分析216例呼吸加强医疗病房危重患者临床资料，采用Logistic回归分析，筛选和分析相关危险因素。结果急性生理和慢性健康评分Ⅱ(acute physiology and chronic health evaluationⅡ，APACHEⅡ评分)、免疫抑制状态和氧合指数(PaO2／FiO2)对评价患者预后有重要作用；APACHEⅡ评分OR值为1．135，P值为0．00；氧合指数OR值为0．997，P值为0．092；免疫抑制OR值为6．583，P值为0．013。结论 升高的APACHEⅡ评分和降低的氧合指数以及合并免疫功能受损将使患者死亡风险升高，医务人员应高度重视。     

Rotating shift-related changes in hormone levels in intensive care unit nurses

Title.  Rotating shift-related changes in hormone levels in intensive care unit nurses.
Aim.  This paper is a report of a study to investigate if an irregular rotating shift system, including night shifts, can cause changes to the secretion of hormones in nurses.
Method.  In 2006, 32 healthy intensive care unit nurses completed the Standard Shiftwork Index (SSI) and blood samples were collected from each participant at the beginning and end of each shift. Change in hormone levels between the beginning and end of morning shifts were examined and compared between nurses on morning only and rotating shifts. Correlations between change in hormone concentrations and scores from the SSI are presented.
Results.  The mean reduction of cortisol level between the two measurements was statistically significantly greater for the 'rotating' than 'morning' shift group ( P  = 0·032). There were no statistically significant differences between the two groups in overall mean change from the first to the second measurement of prolactin, triiodothyronine and thyroid-stimulating hormone. Levels of thyroxine increased statistically significantly in the 'rotating' group ( P  = 0·049) but not in the 'morning' group. The morningness scale score was greater for the 'rotating' group, while greater job satisfaction levels were found in the 'morning' group. Statistically significant correlations were found between thyroid-stimulating hormone, triiodothyronine, thyroxine and prolactin changes and specific scales of the SSI questionnaire.
Conclusion.  Ergonomic shift schedules sympathetic to the body clock and nurses' preferences should be adopted to mitigate the adverse effects on health.