老年住院患者安全风险管理及对策

目的:提高护理质量,降低护理风险系数,为老年住院患者提供安全、优质有效的护理服务。方法:通过识别与分析老年病房现存的和潜在的护理风险,结合老年患者的特点,提出有效的安全风险管理及对策,指导临床规避和化解护理风险。结果:护理人员提高了风险防范意识,促进病房护理管理质量,风险事件发生率降低。结论:老年病房实施护理风险管理十分必要;在实施过程中,健全管理机制和提高护理人员风险防范意识及对风险因素评估能力很重要。     

住院糖尿病患者安全风险管理

目的提高护理质量,降低护理风险系数,为住院糖尿病患者提供安全、优质、有效的护理服务。方法通过识别与分析住院糖尿病患者现存的和潜在的护理风险,结合糖尿病患者的特点,提出适合糖尿病专科的有效安全风险管理,指导临床规避和化解护理风险。结果护理人员提高了风险防范意识,促进病房护理管理质量,风险事件发生率降低。结论糖尿病患者实施护理风险管理十分必要;在实施过程中,健全管理机制和提高护理人员风险防范意识及对风险因素评估能力很重要。     

老年内科住院患者安全护理对策

随着社会的进步及医疗卫生水平的不断提高，人类社会逐渐趋向老龄化。老年住院率逐年增加，为加强和保障住院老年患者的护理安全，现将笔者多年护理老年内科住院患者的体会报告如下。     

开展优质护理服务对住院患者护理服务满意度的影响

目的比较开展优质护理服务工作前后住院患者对护理服务满意度的情况。方法采用便利抽样的方法,选取开展优质护理服务工作的10个试点病房的住院患者,采用纽卡斯尔护理服务满意度量表（NSNS）调查患者的满意度。结果患者对护理服务整体评价满意度由工作开展前的91．99％上升到开展后的95．94％,差异有统计学意义（X^2=13．165,P〈0．05）。护理服务满意度的各个方面也均有显著性提高。结论优质护理服务工作的开展有效提高了患者对护理服务的满意度。     

优质护理服务对老年住院患者抑郁和焦虑情绪的影响分析

目的：探析优质护理服务对老年住院患者抑郁和焦虑情绪的影响。方法选取2015年4-10月秦皇岛市第一医院老年住院患者200例,随机分为两组,每组100例,分别行常规护理（对照组）和优质护理（观察组）。结果观察组的SAS、SDS评分和护理满意度数据均优于对照组（P＜0．05）。结论对老年住院患者实施优质护理服务可改善其焦虑、抑郁情绪,且可提高护理满意度。     

老年住院患者护理安全预防新进展

护理安全是护理工作的重要内容,是提高护理质量的基础,是改善护理关系的关键,本文通过分析影响护理安全的原因,提出应对措施,取得了较好效果。老年患者在住院期间环境的突然改变,容易发生摔倒、跌伤等意外损伤; 加之亲属对患者的情感忽略、照顾不周,长期疾病折磨部分老年患者易发生自伤甚至自杀。因此,在诊治及护理过程中必须加强护理安全管理。     

优质护理服务在老年患者安全管理中的应用效果

目的 在开展优质护理服务基础上加强老年患者安全管理,提升患者满意度,保障医疗护理质量.方法 学习领会“优质护理示范工程”精神实质,开展优质护理服务,进行护士能级划分,改变排班模式,合理利用护理人力资源,落实患者包干责任制护理,责任护士对患者进行精细、温馨、全程、无缝隙的安全优质护理.比较优质护理服务实施前后患者护理不良事件的发生率.结果 优质护理服务实施后护理不良事件发生率较实施前显著减少.结论 护理人员清楚地认识到影响老年患者安全的各种因素,结合优质护理示范工程的实施,做好基础护理,采取积极有效的预防措施,能够减少老年患者意外事件的发生,促进健康,提高老年患者的生活质量.     

风险管理对老年手术患者护理安全的影响

目的探讨风险管理对老年手术患者护理安全的作用与效果。方法以风险管理知识为指导,通过识别老年患者围手术期护理工作中存在或潜在的护理风险制订风险管理预防,指导临床规避和化解护理风险,确保护理安全。结果风险管理的实施提高了护理质量,减少了护理缺陷的发生,提高了病人的满意度。结论风险管理对老年患者围手术期的应用不仅可降低护理风险,也提高了护理质量。     

对住院择期手术患者开展优质护理服务的效果观察

目的 探讨对住院择期手术患者开展优质护理服务的效果。 方法 落实责任制护理,责任护士提供全程、连续、无缝隙的护理,注重人文关怀。 结果 开展优质护理服务,提供全程优质的护理服务,未发生1例护患纠纷,患者满意度98.1%,护士满意度94.1%,医生满意度为97.5%。 结论 对住院择期手术患者开展优质护理服务,提高了医生、护士患者的满意度及护理质量。     

老年内科住院患者安全护理对策

随着社会的进步及医疗卫生水平的不断提高，人类社会逐渐趋向老龄化。老年住院率逐年增加，为加强和保障住院老年患者的护理安全，现将笔者多年护理老年内科住院患者的体会报告如下。     

Harmonization of Pharmacovigilance Regulation in Brazil: Opportunities to Improve Risk Communication

Brazilian pharmacovigilance regulations involve 3 spheres: health services, Marketing Authorization Holders (MAHs), and sanitary agency. Drug tolerability began to be effectively assessed in Brazil after the founding of the National Agency of Sanitary Surveillance, which developed the Sentinel Network Project. The objective of the Sentinel Network Project is to increase the adverse drug reaction (ADR) reporting rate by health care professionals in the hospital setting. Pharmacovigilance practices became mandatory for MAHs, and patient tolerability issues were considered in drug policy in Brazil only as recently as 2000. However, despite recent events, the regulatory advancements in pharmacovigilance in Brazil are only equivalent to international practices (ie, those of the European Union). The pharmacovigilance system in the European Union integrates the national authorities, the European Commission, and the European Medicines Agency, which is responsible for the scientific evaluation, supervision, and safety monitoring of medicines for human and veterinary use in the European Union. Furthermore, ADR patient reporting is included in the new EU pharmacovigilance regulations. Numerous possible ways are available to improve the Brazilian pharmacovigilance system, mainly through regulations of biosimilar, nanotechnology, and veterinary medicines or by training health care professionals and patients to report nonserious cases and quality deviations. It is necessary to encourage and develop strategies for decentralizing pharmacovigilance actions in the whole country, as is common practice in several EU countries. Motivating and considering ADR reports by patients and improving feedback and audit practices in health care services and MAHs are also necessary measures. With the inclusion of Brazil as a member of the International Conference of Harmonization, significant changes in pharmacovigilance regulation are expected; these updates, which will consider international standards, will improve signal detection and risk communication.     

院前急救中的风险因素分析及管理

目的了解院前急救中的风险因素,提出管理对策。方法自设院前急救风险问卷调查表,对浙江省内从事院前急救工作的137名医生和护士进行问卷调查。结果不同工作年限的医护人员均认为位居前3位的风险因素有2项:患者信息不准确;疾病的严重性、复杂性。另外,工作年限1～3年的医护人员较多地强调客观或他人因素带来的风险;4～6年及7年以上的医护人员有较多的共识,他们能意识到自身原因带来的风险。院前急救流程中的重点风险环节有:电话受理环节1项;现场救护环节6项;出车环节2项;管理环节6项。结论管理者要规范院前急救流程,加强重点风险环节管理;让院前急救人员学会识别风险,提高对风险的预见性,针对不同工作年限的医护人员分别组织学习培训,增强医护人员对重危患者病情的评估能力和预见性;主动与患者及家属沟通交流,及时履行告知义务,从而得到患者及家属的信任、理解与合作。     

The Use of Physical Restraints in Elder Care in Relation to Fall Risk

Physical restraints are a frequently used but disputed method to prevent falls. The aim of the present study was to investigate how the use of restraints in institutional elder care relates to previous falls and to the estimated fall risk of the individual patient. A total of 1 142 patients, mean age 82 years, were included in the study. A questionnaire, the Multi-Dimensional Dementia Assessment Scale (MDDAS), was used to measure motor function, vision, hearing, ADL performance, behavioral symptoms, psychiatric symptoms, cognitive impairment and use of medication. Questions concerning the use of physical restraints and known previous falls were added to the instrument. Based on data from the questionnaire (MDDAS), a score on the Downton Fall Risk Index was calculated for each patient. All in all, 248 (22%) of the patients had been subject to restraints and for 155 of them (14%) such measures had been taken to prevent falls. Only weak connections were found between the restraining of patients to prevent falls and the prevalence of known previous falls during hospital stay (? = 0.05), and estimated fall risk (? = 0.07). The results indicate that the use of physical restraints is poorly connected with the estimated fall risk. Therefore, this study may point to a possible overuse of these measures.     

老年住院患者康复中的心理护理

目的 探讨心理护理在老年住院患者躯体疾病康复中的作用。方法 老年住院患者60例随机分为2组。治疗组采用常规药物治疗和心理护理,对照组采用常规药物治疗,连续观察4周,分别进行全面量化测定。结果 2组治疗前后MOSES、SDSS、ADL、HAMD、HAMA总分经统计学处理t检验,差异有显著性。结论 心理护理能促进老年患者全面康复和生活质量的提高。     

识别高危风险因素，做好老年髋部损伤的围手术期护理

目的 探讨老年髋部损伤患者围手术期的高危风险因素，做好患者围手术护理工作。方法 对我院自1991年-1999年收治的172例髋部损伤的患者进行回顾性调查，对调查结果进行多元回归分析比较，并进行统计检查。结果 老年髋部损伤患者发生并发症的患者中，伤前活动能力差，血色素及总蛋白较低，有较大的手术风险，围手术期针对性预防护理有意义。结论 在老年髋部损伤的围手术期护理中，注意识别高危风险因素，有效预防并发症的发生，提高护理质量。     

老年人服务与管理专业安宁疗护课程教学实践及启示——以濒死期症状照护为例

摘 要：目的 探索中职院校安宁疗护课程教学方法,分析教学效果,总结其对我国职业院校安宁疗护课程教学的启示,以期推动我国老年人服务与管理专业安宁疗护教育的发展提供参考依据。方法 选取参加2019年秋季学期开设《安宁疗护》课程学习的中职老年人服务与管理专业60名学生为研究对象,采用案例视频、小组讨论与情景体验教学方法相结合的方式讲授主题为濒死期症状照护内容,并测试学生知识掌握情况;问卷调研教学满意度及学生对濒死期照护的态度。结果 (1)成绩：平均分（92.25±5.77）,优良率91.70%,不同性别、生源等无差异性（p>0.05）;(2)教学方法满意度：① 案例视频法,班级和性别不同均无差异性(p>0.05),但接触过濒死期患者的满意度显著高于没有接触过濒死期患者（p<0.05）。②小组讨论法：上海班的满意度显著高于云南班（p<0.05）,性别与是否接触濒死患者没有差异性(p>0.05)。③情境体验法：上海班的满意度显著高于云南班（p<0.05）,性别与是否接触濒死患者没有差异性(p>0.05)。(3)课程设计满意度:上海班在趣味性、互动性两个方面的满意度分别高于云南班（p<0.05）,其他无差异性(p>0.05).(4)对濒死期照护工作的态度: 75.00%的学生表示有责任对安宁疗护病房濒死期照护任务;66.67%认为应更早实施对安宁疗护病房濒死期患者的临终关怀;46.67%认为自己有足够的知识对濒死期患者进行安宁疗护。结论 以案例视频教学法为主的多种教学方法相结合的方式适合在安宁疗护课程中使用。     

住院老年患者家属对护理需求的调查

目的 了解住院老年患家属对护理的需求。方法 采用自制问卷对123例家属作相关需求的调查。结果 家属最担心的问题是患病情会突然加重(占53．7％)；最希望得到重视的是夜间多关心、照看老人(82．1％)；最希望提供的护理服务是能经常与老人交流(77．2％)。结论 通过护理心理需求调查，有助于调整、改进老年护理工作的结构和提高临床护理质量。     

Utilizing Academic–Service Partnerships to Advance the Care of Veterans

Challenges encountered in both advanced practice registered nursing (APRN) education and veteran health care include an aging workforce, limited resources, and faculty/staff shortages, which ultimately affect patient outcomes. Academic–service partnerships (ASP) address these challenges by increasing workforce capacity and engagement, promoting interprofessional collaboration and evidence-based practice, creating educational opportunities for nursing students to work with underserved populations, and offering a mechanism for recruitment and retention. This article outlines the systematic approach a large doctor of nursing practice (DNP) program in the southwestern United States used to develop and deploy an ASP program with 2 sizeable veteran-serving community partners.