Nursing management of soft tissue sarcomas of the extremities

Soft tissue sarcomas of the extremities are uncommon malignancies that require combined modality treatment. Treatments include extensive surgical procedures, usually radiation therapy, and, in some cases, chemotherapy. Nursing care requires an understanding of surgical and reconstructive procedures, brachytherapy implants, radiation safety regulations, and chemotherapeutic agents. The combination of extensive surgery and radiation has greatly reduced the need for amputation, but the complexity of the treatments requires skilled and knowledgeable nursing care.     

新型冠状病毒肺炎疫情期间综合医院护理应急人员储备库的建立与管理

目的 总结新型冠状病毒肺炎疫情期间,综合医院基于信息网络技术建立与管理护理应急人员储备库的经验。 方法 调整组织管理架构;基于组建原则及流程建立护理应急人员储备库;基于医院信息平台实施应急人员基本信息的维护、新冠肺炎知识及相关技能的培训、实施多方位的心理支持及人文关怀,做好人员的应急储备工作。 结果 截止至2020年2月15日,共有553名护理人员入库,其中备岗260人,293人参与一线疫情防控工作。 结论 基于信息网络技术建立护理应急人员储备库,确保了疫情时期高效的人力调度及人员的动态管理,为后续灾害救援工作积累了经验。     

Understanding stereotactic radiosurgery for intracranial tumors, seed implants for prostate cancer, and intravascular brachytherapy for cardiac restenosis

Our 21st century has moved us into a world of technology never imagined. The aim of our article is to move oncology nurses beyond the realm of external beam radiation therapy. We chose to present 3 modalities of high precision that are infiltrating the everyday world of radiation therapy. Stereotactic radiosurgery for intracranial brain tumors and brachytherapy for prostate cancer require an expanded knowledge base for nursing to deliver excellent patient care. Cardiac patients receiving radiation seeds is new in the world of oncology nursing. These patients are unique but they are now a part of our world. Expanding our knowledge base to include a radiation procedure in cardiac care does bring us beyond the world of external beam radiation. Patients often seek information from nurses. Having an understanding of the basic principles and techniques will enable oncology nurses to educate patients. The purpose of this article is to explain the procedure of stereotactic radiosurgery, brachytherapy for prostate cancer, and intravascular brachytherapy for cardiac restenosis. Our discussion will include selection criteria, potential sides effects and risks, and nursing care.     

Promote Radiation Safety for Nurses: A Policy Perspective

Radiologic and imaging nurses (RINs) continue to be exposed to radiation at the workplace. However, many studies identified that most health care systems do not have policies on radiation safety training for RINs; the less educated they are on radiation safety, the more fear they have with radiation and the less comfortable they are with assisting patients while receiving medical imaging procedures. This policy perspective will identify gaps in radiation protection training, and development of education training, and suggest strategies for compliance with annual radiation training. We recommend that radiology or nursing departments should develop and enforce a policy mandating annual radiation safety training for RINs and that The Joint Commission should evaluate the institutional adherence to that policy.     

超声造影规范化护理专家共识

为了实现超声对比剂（也称超声造影剂）高效、合理、安全、规范化输注，国内相关医护专家总结了国内外文献证据及临床经验，按照循证医学原则充分讨论后，制订了该共识，旨在为我国超声对比剂安全输注的规范化和标准化提供参考意见。共识介绍了超声对比剂的应用现状和安全性、相关法规与流程，造影前、中、后的规范化护理，并提出16条推荐意见。提出目前国内批准上市使用的超声对比剂安全性高，建议医护人员根据最新说明书或专家共识进行配药和给药，并从造影室管理、风险预案、人员资质等方面予以规范。     

无缝隙模式护理在神经外科护理中的应用

[目的]探究分析无缝隙模式护理对神经外科护理安全、护理质量以及护理满意度的影响。[方法]选取神经外科接受住院治疗的146例病人作为临床研究对象,采用随机数字表法将其分为试验组和对照组各73例,对照组采用常规护理干预,试验组病人给予无缝隙模式护理,比较两组病人住院期间护理风险事件发生情况以及护理质量评分、护理满意度评分情况。[结果]试验组病人住院期间出现坠床、跌倒、压疮、擅自外出、意外拔管以及投诉等护理风险事件的几率均明显低于对照组(P0.05),行无缝隙模式护理的试验组护理人员一级护理、基础护理、重症护理、病区护理、医院感染等护理质量评分明显优于对照组(P0.05),且试验组病人对护理管理、病区环境、健康教育、人文氛围、服务主动性等护理满意度评分也较对照组具有明显优势,组间差异具有统计学意义(P0.05)。[结论]在神经外科护理中采用无缝隙护理模式可有效降低护理风险,减少不良预后反应的发生,同时可明显提高病人满意度。     

The requirement for informed consent prior to nursing care procedures

AIM OF THE PAPER: The aim of this paper is to examine the extent to which there is a requirement to obtain informed consent prior to nursing care procedures. RATIONALE: The requirement for nurses to obtain consent prior to nursing care procedures is addressed in various nursing policy documents. It is important that nurses understand the legal and ethical rationale behind the principles of informed consent so that the principles are applied appropriately to the particular context of nursing care. ARGUMENT: The ethical and legal rationale behind the concept of informed consent and its relevance to nursing practice are examined. In this paper, it is argued that the function of informed consent is to protect patient autonomy and to promote meaningful decision-making. Given the potential for nursing care procedures to infringe patient autonomy, consent is clearly a relevant concept in nursing. Furthermore, in law, any touching without consent is a potential battery. Informed consent is often associated as a rigid procedure, only relevant to surgical or research procedures. Consent should be obtained prior to nursing care procedures whenever patient autonomy is at stake. However, information-giving should be determined by the needs of the patient and approached in such a way as to facilitate meaningful decision-making. Given the individual nature of infringements to patient autonomy, it is difficult to predetermine all those care procedures that require consent; any list of procedures would fail to be comprehensive. CONCLUSIONS: The principles of informed consent should underpin our approach to nursing care procedures, which should not be mechanistic but determined by the needs of individual patients.     

^125I放射性粒子种植治疗恶性肿瘤的围手术期护理

目的总结^125I放射性粒子植入治疗恶性肿瘤围手术期的护理方法及放射防护措施。方法对36例行^125I放射性粒子植入治疗的患者进行全面细致的护理，包括术前的心理护理，术后加强并发症的护理和放射防护措施。结果全部患者都能积极配合手术和护理，患者和陪护家属及医护人员均无出现放射性疾病。结论做好心理护理、并发症的护理，加强放射防护措施，是保证治疗成功和医疗安全的关键。     

Conscious sedation of pediatric oncology patients for painful procedures: Development and implementation of a clinical practice protocol

Pain during treatment procedures is often identified as the most distressing aspect of the entire cancer experience for a child with cancer. The use of conscious sedation may reduce this procedure-related pain and distress. A clinical practice protocol is necessary to maximize the efficacy and safety of conscious sedation use. In this article, the processes of developing and implementing a conscious sedation protocol for pediatric oncology patients undergoing painful procedures are presented. The protocol itself is included. A review of the literature on conscious sedation is presented, and implications for pediatric oncology nursing practice are discussed.     

Safety Planning for Intraoperative Magnetic Resonance Imaging

An intraoperative magnetic resonance imaging (MRI) suite (ie, a type of hybrid OR) is a high-risk zone that requires well-defined safety procedures to avoid adverse events related to magnetic forces. At one facility, the opening of an MRI suite necessitated the creation of a safety plan to establish guidelines, procedures, education, and nursing care specific to the use of MRI technology in the operative environment. Formation of a steering committee enabled a multidisciplinary approach to planning and implementation. The addition of two new perioperative nursing roles (ie, MRI control room monitor, MRI safety nurse) addressed staffing challenges related to strictly enforcing MRI safety procedures and delineating duties different from those of the RN circulator. Benefits of a safe approach to an MRI-integrated operative setting included the elimination of an entire surgical experience for patients who underwent additional resection of the tumor during their initial surgical procedure instead of postoperatively or during a subsequent return to the OR.     

151例无陪护住院老年患者围手术期的护理管理

对医院外科系统9个科室需要手术的151例无陪护住院老年患者实施了围手术期无陪护护理管理.包括护理安全评估、护理照顾分级、设定无陪护患者围手术期临床路经、建立护理小组、进行护理质量控制等.解决了无陪护住院老年患者围手术期的安全与舒适问题,提高了患者及其家属的满意度.     

Protection procedures and preventions against the spread of coronavirus disease 2019 in healthcare settings for nursing personnel: Lessons from Taiwan

BackgroundSince coronavirus disease 2019 was first discovered, at the time of writing this article, the number of people infected globally has exceeded 1 million. Its high transmission rate has resulted in nosocomial infections in healthcare facilities all over the world. Nursing personnel account for nearly 50% of the global health workforce and are the primary provider of direct care in hospitals and long-term care facilities. Nurses stand on the front line against the spread of this pandemic, and proper protection procedures are vital.ObjectivesThe present study aims to share the procedures and measures used by Taiwan nursing personnel to help reduce global transmission.Review methodsCompared with other regions, where large-scale epidemics have overwhelmed the health systems, Taiwan has maintained the number of confirmed cases within a manageable scope. A review of various national and international policies and guidelines was carried out to present proper procedures and preventions for nursing personnel in healthcare settings.ResultsThis study shows how Taiwan's health system rapidly identified suspected cases as well as the prevention policies and strategies, key protection points for nursing personnel in implementing high-risk nursing tasks, and lessons from a nursing perspective.ConclusionsVarious world media have affirmed the rapid response and effective epidemic prevention strategies of Taiwan's health system. Educating nurses on procedures for infection control, reporting cases, and implementing protective measures to prevent nosocomial infections are critical to prevent further outbreaks.     

人工种植牙患者围手术期感染的危险因素及护理管理对策

目的 探讨人工种植牙患者围手术期感染的相关危险因素及护理管理对策.方法 选择医院2018年3月—2019年9月收治的人工种植牙患者90例为研究对象,根据患者围手术期是否感染分为病例组(感染组)与对照组(未感染组).通过单因素、多因素Logistic回归分析筛选人工种植牙围手术期感染的危险因素,据此制定护理管理对策.结果...     

浅谈我院护理安全管理的措施及体会

目的 探讨护理安全管理的方法,规避护理风险,保证护理安全。 方法 加强安全教育,强化安全意识;进一步完善和落实护理安全管理的相关制度;成立护理安全管理小组,加强护理风险的监测;进一步完善规章制度和工作流程;不断加强护理安全防范措施;加强对年轻护士的专业基础知识的培训及考核等方法。 结果 护理缺陷及护理差错明显减少;护理质量、患者满意度均提高。 结论 加强护理安全管理可以有效规避护理风险,确保护理安全,提高护理质量和患者满意度。     

居家护理指导对血液透析病人液体摄入依从性的影响

目的探讨以协议护理理论为指导的居家护理指导对提高血液透析（HD）病人液体摄入依从性的效果。方法将48例液体摄入不依从的HD病人随机分为观察组与对照组各24例。对照组给予常规护理与健康教育,观察组在此基础上实施以协议护理理论为指导的居家护理指导1个月,随后随访3个月。评价干预后第4个月HD病人的液体摄入依从性,家庭支持与透析问期体重增长（IDWG）的相对值。结果干预后观察组病人IDGW／干体重显著低于对照组,依从性和家庭支持水平显著高于对照组,家庭支持与IDGW／干体重呈负相关。结论以协议护理理论为指导的居家护理指导有利于指导家属向病人提供有效的家庭支持,提高病人液体摄入的依从性,使透析间期体重增长控制在理想范围。     

护理人员对围手术期护理项目风险性认知状况调查

目的:了解护理人员对围手术期护理操作项目风险性的认知状况,为护理管理者有针对性地加强围手术期护理风险管理提供依据。方法:采用方便抽样法,选取某市5所综合医院外科和手术室工作1年以上的196名护士为调查对象。结果:护理人员认为给药和病情观察相关的内容是围手术期的高风险护理项目。此外,术中还需重点关注物品准备、查对、输血、引流管理及病理标本管理;术后还应关注输血查对和一些专科护理项目。结论:护理管理者应重视护理人员风险意识的教育,有针对性地加强高风险护理项目的管理,以保证围手术期护理安全。     

Intracranial interstitial radiation

Primary malignant brain tumors are fatal, with 90% of patients having these tumors dying within two years following diagnosis. Cranial interstitial radiation therapy, a technique under investigation to control these tumors, involves implantation of radioactive iodine 125 seeds into the tumor bed by stereotaxic technique. The interstitial radiation technique, monitoring of radiation, and nursing care of patients are discussed. Case histories are presented, along with discussion of results attained using this therapy, and its future.     

Effect of two oral care protocols on the incidence of stomatitis in hematology patients

Research-based oral care protocols for the control and treatment of stomatitis secondary to cytotoxic therapy are scarce in the nursing literature. The purpose of this pilot study was to determine the efficacy of two different oral care protocols in decreasing the incidence of stomatitis in patients with hematologic malignancies receiving chemotherapy and radiation therapy. It was hypothesized that patients with hematologic malignancies using oral care protocol A would have a lower incidence of treatment-induced stomatitis than patients using oral care protocol B. Eighteen subjects with hematologic malignancies treated with high doses of chemotherapy alone or in combination with radiation therapy were randomly assigned to one of two specific oral care protocols. Protocols differed in the type of lip lubricant, toothette, and mouthwash used. The Oral Assessment Guide (21) was used to assess oral status five times a week for the duration of each subject's hospitalization. A t test for independent samples was used to determine if the difference in the condition of the oral cavity was related to the different oral care treatments. A statistically significant difference was not found between the mean oral assessment scores of the two groups. A trend emerged, however, of a lower incidence of stomatitis in the subjects using the experimental oral care protocol. A serendipitous finding was that reinforcement of oral care instructions and nursing assessments of the oral cavity seemed to promote patient compliance with the oral care regime. A supplementary analysis revealed a statistically significant (r = -0.7177) negative correlation between the degree of stomatitis and the peripheral white blood cell count.     

The nurse's role in delivery of radioisotope for ictal SPECT scan.

The Medical College of Georgia Hospital and Clinics (MCG) was one of the first centers in the United States (US) to institute a video electroencephalography (EEG) epilepsy monitoring unit and epilepsy surgery program. In order to surgically remove the area in the brain giving rise to seizures, the epileptogenic zone must be identified and localized. One of the newer methods used to identify the epileptogenic seizure focus is the ictal Single Photon Emission Computed Tomography (SPECT) scan, which MCG began performing in 1993. The nurses staffing the six bed Epilepsy Monitoring Unit (EMU) are trained by the Nuclear Radiology Department and Radiation Safety Officer to bandle the radioisotope during mixing, calibration and injection. The bedside nursing protocol developed assures patient and staff radiation safety and efficacious injection. Over 300 patients have been injected by nurses with a high degree of safety to patients and staff. This has resulted in positive scans that aid diagnosis. The success of the ictal SPECT protocol can be attributed to the active collaboration of our multidisciplinary team.