培养护士临床病情观察能力的实践与思考

临床病情观察是对病人病情进行全面了解作出综合判断的过程，最能体现护理工作的科学性和重要性。护士病情观察能力，是认知疾病的全过程。是护理程序中的基础。通过观察能及时发现问题，为治疗护理提供依据，甚至可以为患者赢得抢救生命的宝贵时间。临床病情观察直接体现了护士工作的责任心、业务水平和识别病情危重与转归的能力。     

培养神经内科专科护士病情观察能力的实践探讨

病情观察是护理工作的重要内容之一,是临床护士必须具备的基本技能,是护士综合素质的体现,是反映护士救治能力的重要指标。病情观察的目的就是预测疾病的发展趋向和转归,为临床救治提供诊断、治疗和护理依据。因此加强临床护士病情观察能力的培养至关重要,自2011-01开始我科采取多种形式对临床护士病情观察能力进行培养,取得了良好的效果,现介绍如下。     

“白杯”检查中所发现的护理交班报告存在的问题

护理交班报告是护理工作翔实的文字根据。报告直接反映出护士观察、分析、判断病情的能力,又可反映护理工作质量,也是护士业务素质和工作责任心的集体反映。为此,记录要连贯,上下班情况要衔接,以了解病情的动态变化。     

案例培训法在提高年轻护士病情观察能力中的应用研究

目的:为了弥补年轻护士观察能力不足的现状,探讨以案例为基础的护理培训法在年轻护士护理观察能力提高中的效果.方法:对我院127名年轻护士病情观察能力进行了案例培训,通过培训前后对年轻护士病情观察能力及护理评估能力考核对比分析,比较培训前、后的差别.结果:培训后年轻护士病情观察能力和护理评估能力较培训前有显著提高(P<0.01).结论:案例培训法对提高年轻护士病情观察能力有明显促进作用.     

加强老年二三级护理病人巡视的体会

按制度查房是护士了解患者病情、观察疾病变化、发现患者心理和生理疾苦的前哨。在临床工作中护士往往重视病危、一级护理病人的巡视,却忽视了对二三级护理病人的查看。老病病人大多同时患有多种、多器官疾病,突发病率及死亡率高,如不能及时发现这些患者病情突变,将导致失去抢救最佳时机,甚至引发医疗纠纷。因此,加强二三级护理病人的夜间查房是非常重要和必要的。     

护理记录存在缺陷分析及对策

护理记录是护理人员对患者病情现象和实施护理措施的原始文字记载,是临床护理工作的重要组成部分,无论在临床医疗、护理科研、教学上、法律上、护理行政管理上均有其特殊价值。本文对护理记录单书写缺陷进行了阐述．包括记录缺乏及时性、真实性、完整性和规范性,提出增强护士的法律意识,提升护士综合素质,加强质量监控体系等对策,以提高护理文书的质量。     

病情观察在护理工作中的重要性

有人认为临床护士工作的四分之三是观察[1] ,而观察质量是衡量护理的重要标志之一[2 ] 。因此 ,要做好病情观察必须要求护士有强烈的责任心 ,才能利用 2 4ｈ守护病房的职业特点 ,主动细心的巡视和察看患者 ,同时启动自己的感官和思维 ,方可能及时发现患者的病情变化[3 ] 。1　认真巡视病房 ,仔细观察病情变化1 1　注意观察疾病发作时间及症状　疾病的发生发展均有一个演变过程 ,有的病人入院时诊断不明确 ,很多症状是疾病所共有的。医生是通过查体辅助检查等手段获得确切的数据 ,为疾病提供诊断。而护士则是通过过硬的基本功观察来获取第一…     

护理记录内容新要求及主客观资料的探讨

2002年国务院颁发的《医疗事故处理条例》[1]以及《病历书写基本规范(试行)》[2],把护理记录作为客观资料归入病历,因此,对护理记录提出了新的要求。护理记录是护理人员根据医嘱和病情把病人住院期间发生的症状,病情变化动态以及护士为此按操作规程所执行的护理活动,病人接受护理后的反应结果,用医学术语表达出来。要求护士在记录中既要能如实体现病人病情变化及观察,指导康复,护理措施的连续性和护理效果,又能体现医生与护士之间,护士与护士之间,白、晚、夜各班之间的工作职责与法律责任等。同时又要有利于举证,有利于事故处理部门对事故的…     

急危重症留观患者的特点及护理对策

急症留院观察患者具有病情复杂且危重、病情发展瞬息万变、患者流动随机性大、病室易增加医院感染危险因素等特点,本文结合急症留观患者的病情特点提出了不断优化急诊护士素质,合理调配急诊护理力量,注重提高急诊护理质量,积极预防医院感染的护理对策。     

临床护理工作中差错事故防范浅析

临床护理工作中差错事故防范浅析武警云南总队保山医院杨仙兰，李常芬，覃霞（保山６７８０００）医院临床工作中，护士２４ｈ工作在病人身旁，观察病情变化，照顾病人在医疗、生活、心理等方面的需要，保证病人在住院期间得到妥善的治疗和护理。其工作的重要性直接体现在...     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.