婴幼儿择期手术前禁饮食最佳时间的临床研究

[目的]探讨择期手术患儿术前禁饮食的最佳时间及长时间禁饮食对婴幼儿机体的影响。[方法]将156例择期手术患儿随机分为实验组和对照组,实验组患儿术前采用新的禁饮食方法,即母乳喂养的患儿术前禁食4h,其他患儿术前禁食6h,术前禁饮2h,对照组接受传统的术前禁饮食方法,即术前禁食12h,禁饮4h～6h,观察两组患儿术中呕吐或误吸,术后呕吐、饥饿、口渴、脱水哭闹情况。[结果]实验组患儿的术后饥饿、口渴、脱水及哭闹发生率低于对照组,差异有统计学意义(P<0.01)。[结论]婴幼儿择期手术在术前禁食4h～6h,禁饮2h可减轻患儿不适,满足其机体需要;禁饮食时间过长可导致患儿脱水及低血糖、哭闹等一系列不良反应的发生。     

择期手术患儿禁食禁饮时间现状及研究进展

通过中国知网（CNKI）和万方数据库等检索相关文献,对择期手术患儿术前禁食、禁饮时间的研究现状及进展进行综述,提出术前禁食、禁饮时间过长,会对患儿产生不良影响,建议适当缩短择期手术患儿术前禁饮时间,在术前禁食4～6 h,术前2h饮清液体可改善患儿自身感受,减轻患儿不适,满足其机体需要,缓解口渴感,同时降低患儿发生脱水的风险,且不会增加呕吐及误吸的发生率。     

缩短患儿术前禁食禁水时间的研究

目的探讨缩短患儿术前禁食、禁水时间的可行性及安全性。方法将206例在氯胺酮分离麻醉下行非胃肠道择期手术的患儿按入院顺序分为两组，观察组术前禁食6h、禁水2h，对照组术前禁食12h、禁水6h。结果两组患儿术前口渴饥饿、烦躁、疲乏无力等不适情况比较，观察组发生率低于对照组，差异比较有统计学意义；两组患儿发生术中误吸、术后恶心呕吐情况比较，差异无统计学意义。结论实施患儿术前禁食6h、禁水2h，可减少患儿不适。     

婴幼儿择期手术前禁食禁饮时间的临床研究

目的 探讨1～36个月择期手术患儿术前适当的禁食禁饮时间新方法的安全性、可行性及其影响因素，让患儿更加顺利地度过围手术期。方法 将1～36个月104例择期手术患儿随机分为实验组41例和对照组63例，实验组患儿接受新的术前禁食禁饮方法，对照组患儿接受传统的术前禁食禁饮方法。比较2组患儿术前口渴、饥饿、哭闹、家长焦虑状况及术中、术后患儿的呕吐或误吸情况。结果患儿术中、术后呕吐及误吸2组间比较差异无统计学意义，实验组患儿的术前口渴、饥饿、哭闹及家长焦虑程度低于对照组，差异有统计学意义（P〈0．01）。结论术 前禁食4～6h，禁水3h对择期手术患儿是安全可行的，可有效提高患儿的舒适度，保证手术的顺利进行。     

择期手术患儿术前禁食禁饮时间过长原因分析及对策

目的规范择期手术患儿术前禁食、禁饮的时间和方法。方法采用面对面访谈的方法,按照自行设计的调查表,询问200例择期手术患儿家长患儿实际禁食禁饮的起止时间;患儿是否出现禁食禁饮所致的不良反应,如口渴、饥饿、哭闹、脱水等,家长的焦虑程度。结果医嘱要求患儿术前禁食4～8h,禁饮4h。择期手术患儿术前实际禁食、禁饮的时间普遍过长,〈6个月患儿平均禁食8．11h、禁饮8．02h;～12个月的患儿平均禁食9．81h、禁饮9．38h;～3岁患儿平均禁食10．98h、禁饮10．21h;～7岁患儿平均禁食15．12h、禁饮14．12h。〈6个月的婴儿及新生儿均出现口渴、饥饿、哭闹等不良反应,6例有轻度脱水表现;～12个月患儿有64．0％出现口渴、饥饿、哭闹等不良反应,2例有轻度脱水表现;～3岁患儿有44．0％出现哭闹,60．0％诉饥饿口渴,2例有轻度脱水表现;～7岁患儿有12．0％出现哭闹,36．0％诉口渴,48．0％诉饥饿,没有患儿出现脱水表现。对家长的焦虑评价中,45．0％的家长〉4分。结论目前择期手术患儿术前禁食禁饮时间过长。择期手术患儿术前禁食禁饮时间过长的原因与以下几方面有关：医护人员及患儿家长认识上存有误区;医护人员工作流程不规范,工作不够细致;对家属宣教欠缺,家长配合欠佳。为避免择期手术患儿术前禁食禁饮时间过长造成患儿不适及出现不良反应,需要医护人员更新观念,规范工作流程,加强宣教,加强医患合作。     

婴幼儿择期手术前禁食禁饮时间的临床研究

目的 探讨1～36个月择期手术患儿术前适当的禁食禁饮时间新方法的安全性、可行性及其影响因素,让患儿更加顺利地度过围手术期.方法 将1～36个月104例择期手术患儿随机分为实验组41例和对照组63例,实验组患儿接受新的术前禁食禁饮方法,对照组患儿接受传统的术前禁食禁饮方法.比较2组患儿术前口渴、饥饿、哭闹、家长焦虑状况及术中、术后患儿的呕吐或误吸情况.结果 患儿术中、术后呕吐及误吸2组间比较差异无统计学意义,实验组患儿的术前口渴、饥饿、哭闹及家长焦虑程度低于对照组,差异有统计学意义(P＜0.01).结论 术前禁食4～6 h,禁水3 h对择期手术患儿是安全可行的,可有效提高患儿的舒适度,保证手术的顺利进行.     

儿童择期手术术前禁饮禁食时间的调查分析

目的调查儿童择期手术术前禁饮、禁食时间;禁饮、禁食时间过长对患儿造成的不良影响及预防. 方法随机对176例择期手术患儿或家长采取术后当日回访. 结果择期手术患儿术前禁饮、禁食时间分别为7～9 h、10～13 h;禁饮、禁食后出现口干、口渴的占94%;饥饿占77%;发热占1.1%;烦躁占37%.结论择期手术患儿术前禁饮、禁食时间延长,导致患儿出现不适和不良反应的发生.     

儿童择期手术术前禁饮禁食时间的调查分析

目的调查儿童择期手术术前禁饮、禁食时间;禁饮、禁食时间过长对患儿造成的不良影响及预防。方法随机对176例择期手术患儿或家长采取术后当日回访。结果择期手术患儿术前禁饮、禁食时间分别为7~9 h、10~13 h;禁饮、禁食后出现口干、口渴的占94%;饥饿占77%;发热占1.1%;烦躁占37%。结论择期手术患儿术前禁饮、禁食时间延长,导致患儿出现不适和不良反应的发生。     

小儿全麻术前禁食禁饮时间对比观察

目的 探讨小儿全麻术前禁食禁饮的时间和方法。方法 针对患儿术前禁食的需要和进食的要求，进行临床对照实验，对照组按常规术前12小时禁食，10小时禁饮；实验组术前6小时禁食，2小时前饮少量白开水。结果 对照组和实验组均在全麻下顺利实施手术，无1例术中和术后发生呕吐误吸，对照组惠儿出现口渴、饥饿、烦躁例数与实验组比较差异有显著性意义（P〈0．005）。结论 对患儿进行个性化术前饮食指导，缩短禁食时间。可减少其术前不适，满足机体需要，同样能保证手术顺利进行。     

缩短小儿心脏手术术前禁食禁饮时间的可行性探讨

目的探讨缩短小儿心脏手术术前禁食禁饮时间的可行性。方法将本院择期行心脏手术的患儿随机分为2组:对照组按常规术前禁食12 h、禁饮4~6 h;观察组于术前禁食6 h,麻醉前2 h可饮糖水或者无渣饮液100~150 mL。比较2组患儿有无口渴、饥饿、脱水,术中有无恶心、呕吐及误吸。结果观察组在缩短禁食、禁饮时间的情况下并未增加发生呕吐、误吸的危险,同时此期间患儿口唇干燥、泛白或出现哭闹不止现象,年长儿诉口渴、饥饿感低于对照组。结论适当的缩短术前禁食、禁饮时间是安全可行的。     

Allocation of Nursing Time

The purpose of the study was to examine the allocation of nursing time to various activities of registered and assistant nurses during the day shift. Twenty-three registered (RN) and eighteen assistant nurses (AN) working in medical and surgical wards of five large hospitals were studied. The findings have shown that the most frequent activities performed were: indirect care representing 35.6% of the time, direct care representing 23.8% of the time, personal activities representing 16.8% of the time, and direct nursing interventions representing 8.2% of the time. Cross-tabulation revealed that RNs provided direct care less frequently and indirect care more frequently than ANs (25.3 activities per RN and 27.5 per AN, 62.1 activities per RN and 32.6 per AN, respectively). Many indirect care activities were found to be the responsibility of the head nurse (64), secretary (465), and others (104). Less expected results were the minimal amounts of time spent on both education and research activities (1.3% and 0.0% respectively). Nurse managers have to free nurses from subsidiary work and to find mechanisms to distribute nursing valuable time more efficiently.     

冠状动脉硬化性心脏病患者死亡时间及其时间护理研究

目的分析冠状动脉硬化性心脏病（简称冠心病）患者死亡时间的分布趋势，讨论《内经》中关于冠心病患者死亡时间医学理论的科学性及其对时间护理的指导作用。方法采用多阶段整群抽样法，从湖南省123个县（区）级行政区所辖医院抽取345例冠心病死亡病例，调查患者死亡的具体时间，用圆分布统计方法分析数据的时间集中趋势。结果345例冠心病患者的死亡时间有集中在1月8日的趋势（P〈0．05）；具体死亡时点无集中趋势（P〉0．05）。春季死亡时间集中趋势不明显（P〈0．05）；夏季死亡时间有集中在12：52分的趋势（P〈0．05）；秋季死亡时间无集中趋势（P〉0．05）；冬季死亡时间有集中在0：32分的趋势（P〈0．05）。结论调查分析结果与《内经》心病死亡时间观点一致，可为预测冠心病死亡时间提供参考，可利用《内经》心病时间医学理论指导冠心病患者的时间护理。     

Time in hospital

? This article is based on research into patients' perceptions of being in hospital. ? Time, ordinarily taken for granted, becomes a significant problem for people in hospital. ? Patients seek control over time that they do not seem to have during their stay in hospital. ? They try to keep track of time and find ways of passing it, while believing that precious personal time is lost to them. ? The insight gained into differing perceptions of time and how patients coped with these can be used to reduce some of the tensions and negative aspects of the way time is experienced in hospital.     

等级护理标准操作时间与实际操作时间的测量与分析

目的 对目前临床等级护理项目工时进行定量分析.方法 选择上海市某三级甲等医院6个病区患者共计2 107例,使用EPIDATA3.0和EXECEL中文版对2 107例患者等级护理项目完成情况的资料建立数据库,运用SAS统计学软件对数据库进行统计学处理,分析对不同患者等级护理标准操作时间与实际操作之间的差异.结果 等级护理各项目实际操作时间与各项目的标准操作时间相比较,差异有统计学意义(P＜0.01);手术、留置尿管、氧气吸入患者等级护理各项操作所花费的时间比非手术、非留置尿管、无氧气吸入患者多,结果有统计学意义(P＜0.05);留置胃管、引流管患者与无胃管、无引流管患者相比较,结果无显著性差异(P＞0.05),表明等级护理各项操作所花费时间差异无统计学意义;不同手术日用于等级护理的直接操作时间不同;6个病区平均每天实际护理总工时数与平均每天标准护理总工时数不同.结论 目前临床护理人员编制不足,工作超负荷,为了完成各项护理工作,护理人员不得不加快操作速度、简化操作流程.相同护理等级的患者,因手术、留置尿管、氧气吸入等因素,需要投入更多的直接护理时间.     

Time and qualitative research

Qualitative researchers may bear a special obligation in relation to time, as the context they hope to preserve for the phenomena they study is, in large part, temporal. Temporal concerns are integral to qualitative research, whether the focus is on disciplines in which largely qualitative methods are used, paradigms of inquiry that are primarily associated with qualitative methods, or on qualitative methods themselves. Temporal factors play a critical role in purposive sampling, the content and structure of data collection and analysis techniques, and in the re‐presentation of data in the qualitative research report. Qualitative research designs may be oriented to synchronic and/or diachronic analyses. The Trajectory Model is a useful framework for sampling, data collection, and analysis. The Storyline Graph is a tool especially useful in narrative research. © 1999 John Wiley & Sons, Inc. Res Nurs Health 22: 79–87, 1999.     

深圳市市属医院护士时间管理倾向的现状分析

目的探讨深圳市市属医院护士时间管理倾向的现状。方法便利选取深圳市3所市属医院225名护士作为调查对象,采用一般情况问卷及时间管理倾向量表进行测量。对数据采用描述性分析、两独立样本t检验。结果深圳市市属医院护士时间管理倾向总分为(149.46±20.94)分;其中时间价值感维度为(37.10±6.44)分,时间监控观维度为(78.05±11.75)分,时间效能感维度为(34.32±5.47)分。深圳护士的时间管理倾向处于中等水平。深圳护士时间管理倾向得分与北京护士、高校辅导员、企业员工比较,差异均有统计学意义(P0.05),深圳护士得分高于北京护士,低于高校辅导员和企业员工。结论深圳市市属医院护士时间管理倾向处于中等水平,低于其他行业,提示管理者应加强护士时间管理能力的培训,从价值感、监控观、效能感各维度全面提升护士的时间管理水平。     

Time management strategies in nursing practice

BACKGROUND: With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. AIM: To explore how nurses organize and manage their time. METHODS: A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995-1999. FINDINGS: Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. CONCLUSIONS: Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.     

临床监测体温时间与体温单绘制时间模式的研究

目的了解临床实际监测体温时间与体温单绘制时间的差异,探讨对实际工作更合理、更适用的体温测量时间模式。方法采用问卷调查法分别对150名护理人员及100例住院患者进行调查,了解监测体温的时间及对不同监测体温时间模式的看法。结果护理人员认为4:00-8:00-12:00-16:00-20:00-24:00这种测体温时间模式,影响患者休息和进餐,影响交接班,临床实际工作中未按此时间模式进行体温监测,因此实际监测体温的时间与体温单上绘制的时间存在差异,影响了医疗护理记录的客观性和准确性;认为3:00-7:00-11:00-15:00-19:00-23:00这种测体温时间模式,与临床实际监测体温的时间相符。100例住院患者中,认为8:00和12:00监测体温影响进餐,认为24:00和4:00监测体温影响睡眠。结论体温单上的传统监测体温时间模式4:00-8:00-12:00-16:00-20:00-24:00不受住院患者及护理人员的欢迎,并且存在医疗纠纷隐患,修改体温单绘制时间模式使其与临床实际监测体温时间相符是非常必要的。     

Influence of Time of Sampling Onset on Parameters Used for Activation Time Determination in Computerized Intraoperative Mapping

The purpose of this work is to determine the sensitivity of the estimated time of peaks and maximum slopes, commonly used in activation time computations, to the instant at which sampling is initiated. Based on complex and quickly changing waveforms, 471 monopolar (MP) and bipolar (BP) epicardial responses in man were selected. These were decimated from 10 kHz to simulate sampling at frequencies ranging from 200 Hz to 2,000 Hz. The peak and maximum absolute slope for BP and the minimum slope for MP were computed repeatedly starting at successive 100 microseconds intervals extending throughout the sampling period and compared with these parameters computed from the waveform sampled at 10 kHz. Slopes were estimated using each of four different algorithms. The average greatest shift (AGS) due to variations in sampling onset ranged from 11.2 +/- 3.5 (200 Hz) to 0.3 +/- 0.2 msec (2,000 Hz). For bipolar algorithms, the peak performed better than the slope algorithms (AGS: 5.9 +/- 3.3 to 0.3 +/- 1.0 msec). For MP algorithms, 2 point linear, and 3 and 5 point Lagrange slope estimates performed similarly (AGS: 5.6 +/- 3.3 to 0.3 +/- 0.2 msec); a 5 point least square fit algorithm performed poorly. Sampling MP and BP electrograms below 500 and 400, respectively, often caused maximum shifts greater than 4 msec. Thus, the resolution of the peak and estimated slope is not limited to the sampling period, variations in initiation of sampling can cause significant outliers especially at low sampling rates, and MP electrograms should be sampled faster than BP electrograms for comparable accuracy.