以家庭为中心的医疗护理模式在儿科急诊中的实施效果

目的探讨“以家庭为中心”的医疗护理模式在儿科急诊中的实施效果。方法在儿科急诊开展以家庭为中心的医疗护理模式,采取营造温馨的人文环境、APN排班、医护同管患者、开展人性化主题活动等优质护理方法,通过实验性研究方法比较干预措施实施前后患儿或家属对急诊护士工作和急诊就医服务的认同度。结果实施后患儿及家长对急诊护士工作、急诊就医服务满意度优于实施前（P=0.01）。结论实施以家庭为中心的医疗护理模式后,急诊护理工作质量显著提高,护理效果明显,患儿及家长满意度明显提高,值得临床推广应用。     

以家庭为中心的儿科优质护理模式的应用效果评价

目的评价以家庭为中心的儿科优质护理模式的应用效果,以提高临床护理质量,提高患儿家长护理满意度。方法将本院2012年5月~2014年5月儿科1病区及2病区收治的136例住院患儿,按照入院先后顺序随机将患儿分为观察组和对照组,每组68例,对照组患儿给予常规功能制护理服务,观察组患儿给予以家庭为中心的优质护理服务,比较两组的护理质量及患儿家长护理满意度。结果观察组护理质量及患儿家长护理满意度较对照组有显著提高,组间差异有统计学意义(P0.01)。结论以家庭为中心的儿科优质护理模式在儿科护理工作中具有较好的应用效果,不仅能够提高整体护理质量,加快儿科医护团队的发展,还能够进一步提高患儿家长的满意度,值得临床护理工作中进一步推广使用。     

以家庭为中心的护理模式在儿科门诊中的应用

目的探讨以家庭为中心的护理模式在儿科门诊分诊中的应用效果。方法选取2014年2月~2014年7月在我院儿科门诊就诊的600例患儿家长,按照患儿入院时间将前3个月(2月到4月)入院患儿的家长作为对照组,实施常规护理;后3个月(5月到7月)入院患儿的家长定为实验组,按照以家庭为中心的护理模式进行护理,比较两组患儿家长对就诊环境、就诊秩序以及对护理工作的满意度。结果通过实施以家庭为中心的护理模式,实验组患儿家长对就诊环境、就诊秩序以及对护理工作满意度明显高于对照组,两组比较差异有统计学意义(P0.01)。结论在儿科门诊中实施以家庭为中心的护理模式,强调与患儿家长有效的沟通,从而拉近了护患之间的距离,减少了护患矛盾,改善了就诊秩序的环境,提高了患儿家长的满意度。     

以家庭为中心的护理对CCF石膏术后护理效果及家长满意度的影响

目的:探讨以家庭为中心的护理对先天性马蹄内翻足(CCF)石膏术后护理效果及家长满意度的影响。方法:将2016年1~12月收治在我科CCF手术治疗的26例患儿作为对照组,实施常规护理;将2017年1~12月收治在我科CCF手术治疗的27例患儿作为观察组,采用以家庭为中心的护理模式。比较两组患儿护理效果,评价家长满意度。结果:观察组患儿湿疹发生率低于对照组(P0.05),患儿家长满意度评分高于对照组(P0.05)。结论:对CCF患儿行石膏术后实施以家庭为中心的护理模式,可加强护理效果,提高家长满意度。     

护理人员分层管理在儿科病房中的应用效果

目的:探讨护理人员分层管理模式在儿科病房中的应用效果。方法:分别选取我院儿科实施护理人员分层管理模式前后的各100例患儿、家长为对照组和观察组。观察两组患儿家长健康知识知晓率以及对护理工作的满意度,并比较护理分层管理前后护士的护理质量达标率。结果:护理分层管理前后护士的护理质量达标率及两组患儿家长的健康知识知晓率、对护理工作满意度比较,均有统计学意义(P0.05)。结论:护理人员分层管理能更好地落实对患者的基础护理,可以提高护理人员护理质量,并且提高患儿家长的满意度,具有积极的临床价值,值得推广。     

以家庭为中心的护理模式在发热患儿护理中的应用

目的：探讨以家庭为中心护理模式应用于发热患儿护理的安全性和可行性。方法将2012年11月~2013年11月期间本科收治的发热患儿215例随机分为常规护理组（C组,n=110例）和以家庭为中心的护理组（F组,n=105例）,比较两组患儿平均住院天数、家长对两种护理模式的总体满意度及住院期间的不良事件的总体发生率。结果两组患儿平均住院天数无统计学差别（P>0.05）;F组总体满意度显著高于C组（P<0.01）;与C组比较,F组不良事件发生率更低（P<0.05）。结论以家庭为中心护理模式应用于发热患儿护理是安全可行的。     

以家庭为中心的护理模式在儿科病房的实践

[目的]探讨以家庭为中心的护理(FCC)模式对儿科病房护理管理的影响。[方法]2010年10月—2012年10月,选择消化内科病房作为观察组,按FCC模式实施护理;呼吸内科病房作为对照组,按功能制护理模式实施护理,比较两组护理质量评分、不良事件的发生率及患儿家属、病房医师对护士工作的满意度。[结果]两组护理质量检查月平均总分、家属对护理工作的满意度以及医师对护士工作的满意度比较差异有统计学意义(P<0.05)。[结论]开展以家庭为中心的护理模式,有效提高了护理工作质量,提升了病人家属和医师对护士工作的满意度。     

柔性化管理模式在儿科护理管理中的应用

目的：探讨柔性化管理模式在儿科护理管理中的应用效果。方法在儿科护理管理中运用护理标准修订、护理人员培训、护理质量检查结果反馈等柔性化管理模式。评价和比较实施柔性管理前后儿科护理人员心理状况、公益满意度和患儿护理质量差异。结果实施柔性护理模式后儿科护士负性情绪极显著低于实施前（P＜0.01）,护理人员的工作满意度和护理质量显著提高（ P＜0.01）。结论实施柔性护理管理模式在提高护理质量和护理人员工作满意度的同时改善了护理工作人员的心理状况。     

人性化服务在儿科分诊护理管理中的应用

目的：探讨人性化管理理念在儿科门诊分诊护理管理中的应用效果。方法：对2010年5月～2011年5月在儿科门诊就诊的354例患儿家长实施人性化服务,并调查家长对护理服务的满意度情况。结果：通过1年的实施,患儿家长对护士行为举止、服务态度、就诊环境、护士总体满意度、护士的仪表仪容的满意度为95%以上。结论：人性化管理理念在护理管理中的应用,对提高患儿及家长满意度及医院的社会、经济效益具有积极的作用。     

以家庭为中心的护理模式在小儿扁桃体切除术中的应用

目的探讨以家庭为中心的护理模式在临床小儿扁桃体切除术中的应用价值。方法将320例行扁桃体切除术的患儿随机分为常规护理组与观察组,各160例。常规护理组以普通儿科护理模式进行护理,观察组执行以家庭为中心的护理模式,比较两组护理质量,术后并发症发生率和患儿家属满意度有无差别。结果观察组的护理质量、患儿家庭满意度均高于常规护理组,术后并发症发生率低于常规护理组,差异均具有统计学意义(均P0.05)。结论以家庭为中心的护理模式符合人性化护理的原则以及儿童的特点,具有一定的先进性和积极的社会意义,值得在临床中推广运用。     

The parent-nurse relationship from the perspective of parents of children with cancer

Research to date has overlooked the specific relationship between parents and nurses, particularly in the context of family-centered care for a hospitalized child with cancer. The purpose of this study was to describe how parents perceive the relationship with the pediatric staff nurse necessitated by the hospitalization of their child with cancer. Using a symbolic interactionist framework and a modified grounded theory methodology, this study explored the parent-nurse relationship when a child with cancer is hospitalized. A purposive, theoretical quota sampling method was used to recruit 16 parents. Both parents' and nurses' care were examined from the parents' perspectives; mothers and fathers were interviewed separately. Analysis of the data led to the development of a substantive theory describing parent care (Making it Better), nursing care (Going Through the Motions, Caring Incompletely and Caring Completely), and the parent-nurse relationship (Working Together). Conditions influencing the care provided by parents and nurses and in turn the parent-nurse relationship were also identified. This research describes strategies nurses use to enhance the family-centered care they provide and reveals the effect nursing care has on parents' hospital experiences. Recommendations are made for nursing research, practice, and education.     

Parents' report of children's hospital care: what it means for your practice

PURPOSE: To determine the aspects of nursing practice that are predictive of parent satisfaction with their child's hospitalization. METHOD: A sample of 3,299 families whose children were hospitalized in a tertiary pediatric teaching hospital between 1995 and 1998 were surveyed. The survey covered their experiences during the child's hospitalization and their overall satisfaction with care. FINDINGS: Survey questions that were most strongly associated with overall satisfaction were questions about caring practices that are collaborations between nurses and parents. Satisfied parents reported nursing care that was tailored to their needs and preferences. CONCLUSIONS: These findings are consistent with Curley's model for nursing practice, which predicts better patient outcomes when nursing care is synergistic with patient characteristics.     

Development of a family liaison model during operative procedures.

The essence of family-centered care is the provision, by all health professionals, of psychosocially supportive care that fosters family integrity and functioning. Data from a hospital-based satisfaction survey at The Children's Hospital of Philadelphia (CHOP) indicated that the primary reason for parents being "less than completely satisfied" was lack of communication. A search of recent literature suggests also that breakdown in family-centered care in intensive care units is neither new nor unique. The purpose of this article is to describe how efforts to improve communication with parents and families led to the development of a family liaison program and an expanded role for staff nurses in the Cardiac Intensive Care Unit (CICU). The goals of this family liaison program were three-fold: to facilitate establishment of a relationship between CICU nursing staff, parents, and families at the earliest possible point in time; to ensure communication with parents and families at regular intervals during their child's surgery; and to promote practice that incorporates principles of family-centered care within the CICU. The design and implementation of such a program presented nurses in the CICU with both a challenge and an opportunity to take an innovative approach to meeting the fundamental need for information reported by parents and families, and echoed throughout nursing literature. This family liaison program serves to educate parents and families, communicate updates, provide physical and emotional support, and establish continuity of care for the patient and family. Additionally, nurses involved in the program have given positive feedback regarding their expanded role in this family-centered care model.     

医护合作型责任制护理模式的实践及效果

目的：探讨医护合作型责任制护理模式在深化优质护理服务活动中的实施效果。方法：在深入开展优质护理服务活动中,实施医护合作型责任制护理模式,采用自行设计的调查表,对病人满意度、医生满意度和护士满意度进行问卷调查,同时采集护理质量检查结果和护理服务质量相关数据,与实施医护合作型责任制护理模式前的调查结果进行比较。结果：实施医护合作型责任制护理模式后,病人对护理工作满意度、医生对护理工作满意度均明显提高,差异具有统计学意义（P〈0．05）。护士对自身工作满意度也有所提高,但差异无统计学意义（P〉0．05）。特级护理和一级护理质量、基础护理质量、病区管理质量明显提高,差异具有统计学意义（P〈0．05）。最满意护士的人次数、病人感谢信中点名表扬护士的人次数明显增多。结论：实施医护合作型责任制护理模式,能有效地密切医、护、患关系,充分发挥高级责任护士的作用,促进初级责任护士的成长,提高工作效率和护理质量,达到“病人满意、医生满意、护士满意”的目标。     

The nursing shortage: dynamics and solutions. A supportive clinical practice model

In a large VA teaching hospital, the primary nursing care delivery model is established with an all-RN staff. Several new initiatives and incentives have been implemented to maintain nurse satisfaction during this period of nurse shortage, but the primary nurse's relationship with her or his patient is the most satisfying and rewarding opportunity in this setting. The professional profile of the nurse staff reflects high academic preparation, certification in clinical area of practice, and involvement in nursing organizations. Primary nursing is successful because of the availability of support services, which enable the nurse to remain with the patient on the nursing unit. The primary nursing care delivery model and staffing were evaluated and revised to include licensed vocational (practical) nurses as associate nurses. Nurses on staff affirm their authority and autonomy to make and carry out clinical decisions about the nursing care of their primary patients. Physicians recognize nurses as the co-primary care provider in a clinical practice atmosphere of mutual respect and collaboration. New opportunities for professional growth and self-actualization enrich the work environment.     

Family-centered care: current realities in parent participation

Family-centered care is currently one of pediatric nursing's most dynamic and challenging philosophies. The concept of parent participation in family-centered practice has become a central tenet of pediatric nursing for the 21st century. Inhospital and home health care interventions have shifted now to recognize families' involvement in care as central to a child's care. Despite roots dating as early as the 1950s, the family-centered care approach still carries with it a myriad of challenges related to parental participation, including issues of role stress, negotiation failure, and power struggles. Although the application of theory in family-centered care practice has been discussed in the literature, implementing parent participation in family-centered care still needs to be refined. Case examples provide an educational strategy for nurses to discuss facilitating effective practice of family-centered care. This strategy also includes developing expertise in communication using models such as the LEARN framework to promote collaborative nurse-family relationships.     

县级医院护士层级管理实践

目的：探讨护士层级管理模式在县级医院护理管理中的应用效果.方法：实施护士长、护理组长、护士层级管理,APN排班模式,充分合理利用现有护理人力资源,质控前移,保证护理安全,提高护理质量.结果：实施前后患者的满意度及健康教育水平、护理质量指标得到提高.结论：护理人员层级管理能充分合理利用现有的护理人力资源,保证护理安全,提高护理质量,达到最佳的护理管理目标.     

Evaluation of a model of nursing care for older patients using participatory action research in an acute medical ward

Aims and objectives. The main aim of this study was to improve the quality of nursing care for older acutely ill hospitalized medical patients through developing, implementing and evaluating a new model of care using a participatory action research process. Background. One of the challenges of nursing today is to meet the health‐care needs of the growing older population. It is important to consider what quality of nursing care means to older patients if nurses are to address gaps between their own perceptions and those of older patients themselves and to consider conceptual models of care appropriate for older patients care in order to improve the quality of care provided. Design. This study is a mixed method triangulated study, involving the use of both quantitative and qualitative methods through participatory action research methodology to establish an evidence‐base for an evolving model of care. Methods. The model was tested on 60 acutely ill patients aged at least 65 years. The medical ward nurses selected a key reference group including the researcher to facilitate the participatory action research process to develop, implement and evaluate a new model of care based on Orem's self‐care model incorporating the Nurses Improving Care to Health System Elders Faculty (Am J Nurs 1994; 94:21) medication protocol to improve the nursing care provided for acutely ill older patients. Results. The participatory action research process resulted in improved heath‐care outcomes for the patients, such as significant improvements in activities of daily living capabilities between admission to discharge, significant improvements in knowledge levels regarding their medication regimes, as well as increased satisfaction with nursing care activities as perceived by older patients and nursing staff. The implementation of educational sessions during the model of care improved the older patient's functional activities and knowledge levels of their medication regime prior to discharge. In addition, by repeatedly explaining procedures, nurses became more involved with their individual patient's care, developing a patient‐centred care relationship based on Orem's self‐care model. Conclusions. This study demonstrates the efficacy of a new model of nursing care in improving the quality of nursing care for older patients in the acute medical ward setting. Relevance to clinical practice. This study is significant because of its evidence‐base and demonstrates how the participatory action research process empowered nurses to make sustainable changes to their practice. The nurses in the study wanted to affect change. The planned change was not dictated by management, but was driven by the clinical nursing staff at the ‘grass roots’ level. Therefore, being involved in the decision‐making process provided an incentive to actively implement change.