护理告知在临床的应用

护理安全是保证护理质量的前提,有效的护患沟通可以防范护理安全隐患,减少医患纠纷。沟通的实质是院方是否完整地履行了告知义务,患者是否有知情同意权。沟通交流是非常重要的。由于护士与患者接触多,因此护士在医疗告知实施过程中承担着十分重要的作用。我科2009-06～2011-07对住院患者全面实施了护理告知制度,收到了较好的效果,现报道如下。     

加强沟通 促进医患和谐的几点思考

加强医患沟通、促进医患和谐,是构建和谐医院、和谐社会的关键,是确保社会稳定的基础.如何加强医患沟通,促进医患和谐,是全社会面临的一项紧迫课题. 1医患沟通的突出问题 目前,患者对就医环境不满意,"看病难"、"看病贵"问题突出,而医务人员对日益恶化的行医环境也很忧虑,医患之间面临信任危机,关系日益紧张,医疗纠纷不断,医师被打、医院被砸、医院大门被堵等屡见不鲜.有统计表明,在已经发生的医疗纠纷中,由于医患沟通不够、关系不和谐导致的纠纷约占总量的2/3[1].     

搭建医患交流平台减少医疗纠纷

在已经发生的医疗纠纷中,大约占总量的2/3的纠纷是由于医患沟通不够造成的。医患关系变得紧张,患者在受到伤害的同时,不可避免地让医方也受到了伤害。减少医疗纠纷就必须加强医患之间的交流。用医患交流平台搭起医院与患者之间交流的桥梁,构建和谐的医患关系,减少因医患间缺少交流引发的医疗纠纷。     

浅谈有效医患沟通能力在医务部门人员综合能力构成中的重要性

有效医患沟通是减少医疗纠纷、缓解医患关系的必要手段,有效医患沟通能力则更是医务部门人员综合能力构成中的重要组成部分。因此,只有让医务部门人员认识到有效医患沟通能力在自身综合能力构成中的重要性,才能改善医务人员的态度,从而更好地让医院贯彻＂以病人为中心＂的新型诊疗理念和＂临床路径＂等新型诊疗模式,最终为医院的＂服务型＂文化建设做出贡献。     

从可避免压疮的发生分析护理注意义务

根据《侵权法》的解读，注意义务是护士最基本的义务，要求护士在诊疗活动中认真履行注意义务。临床上发生压疮后的追责是护理工作中常见的管理问题，判断护士是否存在过错并承担责任，前提是对注意义务内容的界定，关键在于护士是否尽到注意义务。只有加强法律、法规的学习，提升综合能力，加强护理管理，才能履行好注意义务，保证护理安全。     

风险管理在医院门诊服务中的应用

门诊是医院的重要窗口,是满足患者需求的关键环节,门诊管理是衡量医院管理水平的重要标志。在门诊服务中,由于医患沟通不到位、就医流程不合理等,导致医患矛盾时有发生。为此,我们在门诊医疗服     

浅谈出院回访中的新技巧

如何提高医院服务质量是医院发展中面临的重大考验,采取有效方法及沟通技巧做好出院回访,可以增强医患关系,搭建护患沟通桥梁,收集患者反馈信息,为服务缺陷管理提供依据,改善医院形象,提升服务质量,提高医院经济效益和社会效益。     

加强干部门诊医患沟通的做法和体会

干部门诊既是体现医院形象的重要窗口,也是检验服务质量的主要门户之一。作为担负特殊医疗任务的服务性保健机构,如何为患者提供优质、周到的诊疗服务,是每位医务人员都必须认真思考的问题;加强医患沟通,是坚持以人为本、构建和谐医患关系的重要环节。良好的医患沟通技巧能使患者更加满意,治疗效     

医患沟通有学问

医生与患者是一对亲密的合作伙伴,二者共同面对的是疾病这一敌人。在医患关系较为紧张的今天,信任危机使得医患沟通显得更加重要。若医患之间不能良好沟通,很容易耽误病情。没有良好的沟通,就难有真正的信任;没有信任,矛盾就会产生。其实,大部分情况下医生说的往往都是事实,只不过患者却无法理解,进而引起医患纠纷。那么,怎样通过沟通来建立和谐的医患关系呢？要做到这一点,不仅需要医方具备一定的能力技巧,同时也需要患方进行积极的配合.     

关注肿瘤病人心理 倡导医患沟通文化——肿瘤病人医患沟通现状调研及对策

良好的医患沟通能帮助肿瘤病人这一特殊群体完成对肿瘤的心理适应过程,帮助患者减轻对疾病的恐惧,提高患者对治疗的满意度。以问卷调查、座谈会形式对医院肿瘤病人医患沟通现状开展调研,分析现状及存在问题,从关注肿瘤病人心理出发,提出五个方面的应对措施,倡导“只要有心,沟通就无处不在,无时不在”的医患沟通文化。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

我国医用辐射防护研究概况

医学放射学技术的迅速发展及介入放射学在临床广泛应用，使更多的人受到电离辐射的照射，同时也促进了医疗照射防护工作的发展。文中重点综述了我国医用辐射防护工作者近年来在Ｘ射线ＣＴ的医疗照射防护、对介入放射学工作者的剂量监测以及应用医疗照射防护体系，降低医疗照射剂量等方面所作出的成绩和研究进展     

新时期军医学院人才培养的思考

在新的历史条件下 ,军医学院迎接未来高技术局部战争的挑战 ,适应部队武器装备的不断更新以及医学科技、社会发展对人才素质提出的新要求 ,必须在更为广阔的时空背景下找准人才培养的着眼点 ,科学确立人才培养方向 ,提高人才培养质量。现就人才培养思考如下 :1　改变教育观念 ,     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。