三方监控身份识别流程在新生儿监护室中应用效果

目的探讨三方监控身份识别流程在改进新生儿监护室中的应用效果。方法本科自2016年1月在新生儿监护室实施身份识别改进措施,执行三方监控身份识别操作流程,比较流程改进前后新生儿身份识别的安全性和护理质量。结果三方监控身份识别后,新生儿腕带缺失、信息错项与改进前比较,差异有统计学意义(P0.05);家属对护理的满意度高于改进前,差异有统计学意义(P0.05)。结论三方监控身份识别措施改进能够有效提高新生儿身份识别的安全性和护理质量,改善家属的佩戴腕带的安全性、责任性和护理满意度。     

脑血管意外的早期识别和处理

早期和超早期的识别和正确处理是处理脑血管意外的重中之重。脑血管意外的早期识别和处理有三个层次,即患者家属或目击者的识别和应对、急诊科医师的评价和处理及神经专科医师的诊断和处理。     

患者身份识别管理在妇科门诊手术室的应用

目的：探讨患者身份识别管理在妇科门诊手术室的应用效果。方法：对2011年12月～2012年11月妇科门诊手术室的患者进行身份识别管理,采用手腕识别带和手术安全核查表对患者进行有效的身份识别。结果：妇科门诊手术室采用手腕识别带和手术安全核查表对患者进行身份识别管理1年的时间,未发生身份识别错误及手术错误。结论：对妇科门诊手术室患者进行身份识别管理能提高医务人员对患者身份识别的准确性,是妇科门诊手术安全管理的有效措施。     

指纹识别技术在精神病患者身份识别管理中的应用效果

目的：探讨使用指纹识别仪对住院精神病患者身份识别管理质量及满意度的影响。方法精神病患者在入院时通过便携式指纹比对机器录入相关信息,当各种诊疗护理操作时,不需要患者或家属提供信息的情况下,直接通过指纹比对,快速准确地确认患者身份信息。比较使用指纹识别仪前后精神患者对身份识别依从率、身份识别的缺陷率、腕带材料成本节约率、护理人员对身份识别的满意度。结果使用指纹识别仪前后精神患者对身份识别依从率分别是82％,98％;身份识别的缺陷率分别是36％,6％;腕带材料成本节约率分别是5％,45％;护理人员对身份识别的满意度分别是86％,99％,差异均有统计学意义（χ2分别为7．11,13．56,21．00,46．89;P＜0．05）。结论使用指纹识别仪,提高精神病患者身份识别的依从性,降低精神患者身份识别的缺陷率,节约成本及提高护理人员满意度．从而提高精神病患者身份识别管理质量。     

患者身份和标本识别的准确性

患者身份识别和标本识别的准确性是临床实验室全面质量管理中要求的重要内容。为了提高识别过程的准确性,查阅美国临床和实验室标准化研究院和美国检验医学质量学会等相关文件,就临床工作中识别准确性关键过程进行讨论,并提出改进方案。规范识别程序,加强所有医护人员对患者身份识别准确性的重视,对于减少医疗差错和保障患者安全是非常重要的。     

新生儿无陪护病房在身份识别流程改进中的应用效果

目的：探讨新生儿无陪护病房身份识别流程改进的应用效果。方法我科自2014年6月以来在新生儿无陪护病房实施身份识别流程改进,执行身份识别操作流程,比较流程改进前后新生儿身份识别的安全性和护理质量。结果流程改进后,新生儿的孕周、皮肤、性别、体重等方面的记录正确率高于改进前,差异有统计学意义( P<0.05);新生儿腕带缺失、病历分离的发生率低于改进前,差异有统计学意义( P<0.05);家属对护理的满意度高于改进前,差异有统计学意义( P<0.05)。结论身份识别流程改进能够有效提高新生儿身份识别的安全性和护理质量,改善家属的护理满意度。     

纤溶酶原激活剂的糖基侧链对体内清除率和溶栓活性的影响

tPA和uPA这两类溶栓药物都是糖蛋白,其上的糖基侧链对其半减期和生物活性有一定的影响。它们在体内的清除主要通过肝脏,而肝细胞对它们的识别一部分是通过识别糖基侧链完成的;位于活性中心附近的糖基侧链则会对它们和底物的结合造成一定的空间障碍,从而影响酶的生物活性。     

摇头丸中毒者的急救与护理

收集并复习有关文献 ,重点介绍摇头丸的药理作用 ,以期使医护人员对摇头丸有初步了解。虽然摇头丸中毒不多见 ,一旦遇到这类病例如果不及时识别进行确诊和抢救 ,这对中毒者将是致命的     

全方位护理安全管理在急诊科的应用体会

护理安全管理是指为保证患者的身心健康,对各种不安全因素进行有效的控制[1]。我院急诊科自2002年开始实施以防为主的全方位护理安全管理,效果满意,现报告如下。1急诊护理工作中的风险识别和风险评价风险识别是安全管理的第一步,其主要任务是分析、识别急诊护理工作中可能出现的风险事件。我们通过对近年来急诊护理工作中易发生投诉、纠纷的主要项目进行调查分析,掌握可能发生风险事件的信息,并对可能产生的后果进行评价。通过风险识别和风险评价,有针对性地进行以防为主的风险管理。2方法2.1定期进行护理风险教育,培养急诊护士防范风险意识…     

双重身份识别在儿科住院患者护理安全管理中的应用

目的 评价双重身份识别在儿科住院患者护理安全管理中的应用效果.方法 回顾性分析本科2011年11月~2013年3月住院患儿在执行各项治疗和护理操作时使用双重身份识别对住院患儿进行身份识别,即以患儿姓名和住院号作为患儿有效的识别标志,统计因身份识别不当原因所致护理差错.结果 使用双重身份识别后未发生患者身份识别错误,与未使用双重身份识别发生患者身份识别护理差错发生率比较差异有统计学意义（P〈0.05）.结论 双重身份识别方法能提高护理人员识别住院患儿身份正确性,确保住院患儿安全,减少护理差错发生,值得在临床护理中推广使用.     

Hypertensive emergency and severe hypertension: what to treat, who to treat, and how to treat

Remember to treat patients, not numbers. Use fast acting shortterm medicines only when convincing evidence of rapidly evolving end-organ damage is present. For all patients, emergent or asymptomatic, the treatment goal is long-term control of hypertension. Potent IV agents for the im-mediate control of elevated blood pressure need to be used cautiously,bearing in mind both the side effects and the hazards of overly rapid control of hypertension. Conventional oral medication regimens demonstrated to modify the risks of chronic hypertension should be used whenever possible and as early as is practical to promote gradual control of hypertension.Whenever a patient presents for the evaluation of severe hypertension in an emergent setting, take the opportunity to encourage appropriate ongoing follow-up; after all, hypertension is not a single episode, it is an ongoing threat to good health.     

Susceptibilities of Mycoplasma hominis, M. pneumoniae, and Ureaplasma urealyticum to GAR-936, dalfopristin, dirithromycin, evernimicin, gatifloxacin, linezolid, moxifloxacin, quinupristin-dalfopristin, and telithromycin compared to their susceptibilities to reference macrolides, tetracyclines, and quinolones

The susceptibilities of Mycoplasma hominis, Mycoplasma pneumoniae, and Ureaplasma urealyticum to eight new antimicrobial agents were determined by agar dilution. M. pneumoniae was susceptible to the new glycylcycline GAR-936 at 0.12 microg/ml and evernimicin at 4 microg/ml, but it was resistant to linezolid. It was most susceptible to dirithromycin, quinupristin-dalfopristin, telithromycin, reference macrolides, and josamycin. M. hominis was susceptible to linezolid, evernimicin, and GAR-936. It was resistant to macrolides and the ketolide telithromycin but susceptible to quinupristin-dalfopristin and josamycin. U. urealyticum was susceptible to evernimicin (8 to 16 microg/ml) and resistant to linezolid. It was less susceptible to GAR-936 (4.0 microg/ml) than to tetracycline (0.5 microg/ml). Telithromycin and quinupristin-dalfopristin were the most active agents against ureaplasmas (0.06 microg/ml). The new quinolone gatifloxacin was active against M. pneumoniae and M. hominis at 0.12 to 0.25 microg/ml and active against ureaplasmas at 1.0 microg/ml. The MICs of macrolides were markedly affected by pH, with an 8- to 32-fold increase in the susceptibility of M. pneumoniae as the pH increased from 6.9 to 7.8. A similar increase in susceptibility with increasing pH was also observed with ureaplasmas. Tetracyclines showed a fourfold increase of activity as the pH decreased 1 U, whereas GAR-936 showed a fourfold decrease in activity with a decrease in pH.     

Older People and Attachment to Things, Places, Pets, and Ideas

A model of older adult to environment interactions is proposed that moves beyond the perspective of environment as safety hazard to environment as supportive resource the framework encourages health professionals to look for ways to incorporate positive environmental influences into individualized plans of care with older adults. Research is reviewed on the attachments formed by older adults to things, places, companion animals, ideas, and beliefs— which alongside people-to-people attachments comprise the "attachment structure." Research on attachments of older people to environmental objects identifies important sources of security, belonging, and self-identity. Further research is needed to define the nature of environmental connections in later life, their developmental characteristics, and their potential to influence the health of older people.     

Coagulation, inflammation, and responses to injury

Several mechanisms contributing to the development of post-traumatic alterations in organ function are reviewed. The importance of interactions between clotting and inflammatory mediators is detailed. A discussion of management strategies emphasizes the role of early recognition and aggressive treatment of organ dysfunction.     

Susceptibilities of Mycobacterium marinum to gatifloxacin, gemifloxacin, levofloxacin, linezolid, moxifloxacin, telithromycin, and quinupristin-dalfopristin (Synercid) compared to its susceptibilities to reference macrolides and quinolones

The susceptibility pattern of Mycobacterium marinum was determined. Quinupristin-dalfopristin and telithromycin were less active than clarithromycin. Linezolid showed good antimicrobial activity at clinically achievable concentrations. Gatifloxacin, levofloxacin, and moxifloxacin displayed activities similar to those of ciprofloxacin. Gemifloxacin was less active. The Etest method showed variable agreement with the reference method.     

Physical, personal, and cognitive responses to trauma

This article has presented an overview of important physical, personal, and cognitive responses to trauma that are necessary to provide enlightened critical care for the multiple trauma patient. The nurse who understands the full range of responses to trauma is better able to harness the patient's natural healing ability and promote optimal recovery. The unique pattern of responses that characterize the critically ill trauma patient provides a special challenge for the critical care nurse.     

Perfectionism,stress, and vulnerability to depression

The relation between stressful life events, perfectionism, and relative depression in a university sample was studied. Results indicated that the relationship between stressful events and depression was significant only for participants who scored above the median on a scale of perfectionistic attitudes. Additional regression analyses indicated that later depression was significantly predicted by prior depression and current perfectionistic attitudes. On the other hand, stressful life events and prior perfectionistic attitudes did not significantly predict later depression. Taken together these findings suggest that perfectionistic attitudes are a concomitant of depression and that they may mediate the relationship between stress and depression. Although strong evidence of cognitive vulnerability was not obtained, the need for controlled experimentation with clinical samples was discussed.This article is based on part of an honour's thesis by the first author under the direction of the second author. The study was supported by the Natural Sciences and Engineering Research Council of Canada, Grant #A9941. The authors thank Linda Wilson, Myles Genest, and David Burns for assistance in completion of the research.     

Self awareness: conceptual influences, contribution to nursing, and approaches to attainment

The paper examines the concept and dimensions of 'self', and the notion of self-awareness. It discusses the questions raised by the issues involved, and the central relationship of the concept of self-awareness to nursing, and some specific therapeutic models. It suggests that awareness of 'self', including the incorporation of the models described, makes a predominantly positive contribution to both general and psychiatric nursing. The use of some current teaching approaches is discussed, and congruence and balance are urged for nurse teachers involved in facilitating the development of the skills involved. (Solely for ease of reading all persons are referred to throughout by a single gender, however, in order to redress the conventional imbalance, the feminine pronoun is chosen).     

Tendon and ligament adaptation to exercise, immobilization, and remobilization

This study provides a theoretical and computational basis for understanding and predicting how tendons and ligaments adapt to exercise, immobilization, and remobilization. In a previous study, we introduced a model that described the growth and development of tendons and ligaments. In this study, we use the same model to predict changes in the cross-sectional area, modulus, and strength of tendons and ligaments due to increased or decreased loading. The model predictions are consistent with the results of experimental exercise and immobilization studies performed by other investigators. These results suggest that the same fundamental principles guide both development and adaptation. A basic understanding of these principles can contribute both to prevention of tendon and ligament injuries and to more effective rehabilitation when injury does occur.     

Susceptibility of penicillin-susceptible and -resistant pneumococci to dirithromycin compared with susceptibilities to erythromycin, azithromycin, clarithromycin, roxithromycin, and clindamycin.

Agar dilution with incubation in air and CO2 was used to determine the MICs of erythromycin, dirithromycin, azithromycin, clarithromycin, roxithromycin, and clindamycin for 79 penicillin-susceptible, 72 penicillin-intermediate, and 74 penicillin-resistant pneumococci (158 erythromycin-susceptible and 67 erythromycin-resistant pneumococci). MICs obtained in air were usually 1 to 3 dilutions lower than those obtained in CO2. In air, the respective MICs at which 50% (MIC50s) and 90% (MIC90s) of penicillin-susceptible, -intermediate, and -resistant strains are inhibited were as follows: erythromycin, 0.016 and 0.5, 0.03 and > 64, and 2 and > 64 microg/ml; dirithromycin, 0.03 and 0.5, 0.06 and > 64, and 8 and > 64 microg/ml; azithromycin, 0.03 and 0.5, 0.06 and > 64, and 2 and > 64 microg/ml; clarithromycin, 0.016 and 0.06, 0.03 and > 64, and 2 and > 64 microg/ml; roxithromycin, 0.06 and 2, 0.06 and > 64, and 2 and > 64 microg/ml; and clindamycin, 0.03 and 0.06, 0.06 and > 64, and 0.06 and > 64 microg/ml. The MICs of erythromycin, azithromycin, and dirithromycin were very similar; however, clarithromycin MICs were generally 1 to 2 dilutions lower and roxithromycin MICs were 1 to 2 dilutions higher than those of the other compounds tested. Strains resistant to one macrolide were resistant to all macrolides; however, not all macrolide-resistant strains were resistant to clindamycin, and 32 macrolide-resistant (MICs, > or = 28 microg/ml), clindamycin-susceptible (MICs, < or = 0.25 microg/ml) strains were encountered. Time-kill testing of six strains showed similar killing kinetics for all compounds, with 99.9% killing of all strains observed with the compounds only at or above the MIC after 24 h.