精神科住院患者护理需求及满意度的相关分析

目的:分析精神科住院患者护理需求及满意度的相关影响因素。方法:选取精神病专科医院住院患者100例,对其发放调查问卷,回收有效问卷91份,对相关数据进行分析。结果:住院精神病患者的需求范围广泛。开放病房与封闭病房对患者生理舒适的需求方面有影响;不同病种的精神病患者对家属陪伴需求方面的满意度不同;住院精神病患者的满意度与护理需求的排序不一致。结论:护理工作需要满足精神科患者各个方面的需求,以促进其全面康复。     

精神科住院患者防跌倒护理管理

目的探讨精神科住院患者跌倒发生情况及其相关因素并提出护理管理的相应对策。方法选取本院发生院内跌倒的精神科住院患者90例,分析患者的基本资料、跌倒情况,根据研究结果提出针对性地护理对策。结果 60岁以上老年人发生跌倒的比例最高,0:00—8:00是发生跌倒的高危时段;院内跌倒主要发生在床旁、卫生间附近;跌倒患者中,受伤患者占42. 2%,受伤以头、面部破溃、血肿,四肢及躯干软组织损伤常见。结论精神科院内跌倒的发生受年龄、生理、药物、环境、护理质量等多种因素的影响,预防跌倒应改善病区环境,提高护理人员综合素质,加强患者健康教育。     

精神科住院患者发生跌倒事件分析与护理对策

通过对56例精神科住院患者跌倒事件的分析及护理,提出护理要点为针对夜间、起夜、老年、女性、服药后、有基础疾病的为跌倒发生的高发因素,加强护士对高发因素预见性护理的能力、规范其交接班及巡房内容;严格病房管理;加强基础护理及护患沟通,是预防跌倒事件发生行之有效的护理措施。     

精神科住院患者院内感染情况分析与对策

目的:调查和分析精神科住院患者发生院内感染的情况,并提出相应的护理对策。方法:对3 436例精神科住院患者进行院内感染情况调查,并对调查结果进行分析。结果:精神科住院患者中168例患者发生院内感染,感染率为4.9%,感染类型以呼吸道多见,其次为胃肠道、泌尿道、皮肤和软组织。结论:依据精神科住院患者发生院内感染的特点,在加强精神科病房的消毒管理的基础上,制订具有针对护理人员与住院患者的双重对策,以减少院内感染的易感因素,降低精神科住院患者的院内感染发生率,提高住院患者的医疗服务质量。     

老年精神科住院患者谵妄症状的护理

谵妄实质是一种意识障碍状态,常见于老年人,临床表现为意识、注意力、定向、睡眠- 觉醒、行为和情感等障碍.文献报道,老年住院患者谵妄发生率4%～10%[1].作者收集本院老年精神科2009 年1 月至2011 年1 月住院患者中发生谵妄32 例的临床资料,分析其基础疾病及采取的护理措施.结果报告如下.     

精神科住院患者护理巡回单在临床中的应用

1999年我院开始应用新设计的护理巡回单对一级护理的精神病患者进行观察记录 ,使患者在住院期间得到了更为完善、连贯、详细地治疗和护理[1] 。现将应用体会总结如下。1　资料与方法1 1　临床资料　随机将 1999年 9月至 2 0 0 2年 7月收住我院的一级护理精神病患者 15 6例分为试验组和对照组各 78例。试验组中男 4 0例 ,女 38例 ,18～ 5 9岁 ,采用护理巡回单进行护理观察 ;对照组中男 4 8例 ,女 30例 ,17～ 6 0岁 ,采用传统护理方式进行观察。 15 6例患者均无严重躯体疾病。1 2　方法　值班护士每 15min床前观察 1次患者状态并记录 ,作为责…     

住院精神科患者死亡的相关因素分析及护理

目的 通过分析住院精神科患者的死亡资料,探讨死亡原因及相应护理对策,为精神科临床护理和医疗服务安全提供依据.方法 回顾性调查128例精神科住院死亡患者的病历,并对其进行统计学分析.结果 128例精神科住院死亡患者中,死亡原因以躯体疾病、意外事故和猝死为主,分别占50.8%、19.5%和19.5%;首次住院死亡91例占71.1%;住院10 d内死亡60例占469%;死亡多发生在夜间、午休和三餐时间.结论 躯体疾病、意外事故和猝死是精神科住院患者死亡的主要原因,护理人员应高度重视首次住院、住院10 d内的精神科患者,并加强特殊时间段护理.     

精神科住院患者的心理护理与接触方法分析

应用心理护理，对调动患者主观能动作用，提高疗效，增强战胜疾病的信心至关重要。现根据不同的患者心理与行为特征，采取相应的心理护理与接触方法的临床实践，具体阐述如下。     

精神科住院患者上呼吸道感染回顾分析及对策

目的 了解精神科住院患者发生上呼吸道感染的特点并提出预防、控制对策.方法 对我院2005年1月-2007年12月的出院病例中发生上呼吸道感染的临床资料进行回顾分析.结果 2005-2007年中,发生上呼吸道感染的患者中,老年患者最多,分别占43%、44%、44%,其感染发生率最高,分别为4.08%、3.89%、3.24%;住院天数>900 d者的感染率最高,分别为3.98%、3.06%、3.19%;精神分裂症患者的人数最多,分别占68%、56%、56%,其感染率最高,分别为3.24%、2.50%、2.33%;男性人数比例和发病率高于女性;每年发生上呼吸道感染多在春季和秋季.结论 在春、秋季节,年龄大、住院天数长、精神分裂症的住院患者易发生上呼吸道感染,提示应针对该特点积极采取有效的控制和预防措施.     

精神科住院患者医院感染调查分析

目的:探讨住院精神患者医院感染的发生率及预防控制措施。方法:对我院2003年1月~2005年12月住院精神患者的医院感染情况进行调查分析。结果:5614例住院患者医院感染495例,医院感染率8.82%。2003年、2004年、2005年医院感染率分别为9.67%、7.15%、9.58%(P<0.05),医院感染例次率分别为11.50%、7.53%、10.22%(P<0.05)。感染部位以上呼吸道(38.72%)、胃肠道(19.63%)和下呼吸道(18.72%)为主,以精神分裂症和情感性精神病为主,分别占54.95%和31.52%,重性精神病区的医院感染率较神经症病区的感染率明显增高。结论:封闭式管理、抗精神病药物副作用及精神疾病的严重程度与医院感染有关,建议应加强病区环境管理,重视重性精神患者的护理,合理选用抗精神病药物,以有效控制医院感染的发生。     

住院精神病患者219例次攻击行为的特点及护理干预

目的:了解住院精神病患者攻击行为的发生原因、攻击方式、攻击对象等特点和发生攻击行为的患者人群特点,给临床护理提供帮助。方法:对某精神病院1年来的住院患者病历资料和护理交班报告进行回顾性调查和分析。结果:男性、年轻、文化程度低、病程相对较短、新发病患者等是住院精神病患者攻击行为的危险因素。结论:及时正确的诊断和治疗,加强病房管理,是预防攻击行为的有效措施。     

精神病住院患者对环境的需求调查与分析

目的:为精神病住院患者创造温馨和谐的住院环境。方法:采用自行设计调查表对168例住院精神病患者进行住院环境需求的调查。结果:病区宜男女患者混合收治,病室的大小以2～3床为宜,病室的设置尽量家庭化为大多数患者所需求,患者及工作人员按照自己喜爱选择服饰也深受住院精神病患者欢迎。结论:精神科护理管理者应打破传统观念的束缚,为住院精神病患者营造温馨和谐的住院环境,才能保护患者的隐私与满足患者社会性的需求,减轻住院患者的压抑和戒备心理。     

Reconstructing normality: characteristics of staff interactions with forensic mental health inpatients

Forensic psychiatry is an area of priority for the Danish Government. As the field expands, this calls for increased knowledge about mental health nursing practice, as this is part of the forensic psychiatry treatment offered. However, only sparse research exists in this area. The aim of this study was to investigate the characteristics of forensic mental health nursing staff interaction with forensic mental health inpatients and to explore how staff give meaning to these interactions. The project included 32 forensic mental health staff members, with over 307 hours of participant observations, 48 informal interviews, and seven semistructured interviews. The findings show that staff interaction is typified by the use of trust and relationship-enabling care, which is characterized by the establishment and maintenance of an informal, trusting relationship through a repeated reconstruction of normality. The intention is to establish a trusting relationship to form behaviour and perceptual-corrective care, which is characterized by staff's endeavours to change, halt, or support the patient's behaviour or perception in relation to staff's perception of normality. The intention is to support and teach the patient normal behaviour by correcting their behaviour, and at the same time, maintaining control and security by staying abreast of potential conflicts.     

住院患者临床检测低血钾而无低钾症状的原因分析

目的探讨住院患者实验室检测低血钾而无临床低钾症状的原因,为消除临床诊断和治疗误区提供新思路及实验依据。方法对2010年3月至2011年2月该院750例血钾小于3.0mmol/L的住院患者进行回顾性分析。根据患者当时是否有低钾症状分为两组,对6个临床相关因素进行分析比较;另就高温下（30℃）肝素钠抗凝血对检测结果的影响做实验分析。结果 750例患者中495例有临床低钾症状,其发生率为66.0%;255例无低钾症状,发生率为34.0%,两组患者在年龄、季节、病区、心电图检查及血钾水平比较差异均有统计学意义（P〈0.05）;高温下肝素钠抗凝血放置2h即对离子选择性电极间接法检测钾离子有负干扰,且超出允许总误差。结论住院患者实验室检测低血钾而无临床低钾症状发生的原因与多种因素有关,临床应加强对有重病、慢性病的老年患者血钾的监测,早期诊断和治疗,预防患者发生无症状低血钾,夏季住院患者使用离子选择性电极间接法检测肝素钠抗凝血浆钾离子标本应及时送检,并使标本始终处于22～25℃,以确保检验结果对临床诊断的有效性。     

产妇产褥初期低钾血症临床观察及护理

目的了解产妇产褥初期(产后2周)低钾血症发生率、临床特点及观察方法。方法统计2003年3月～2004年1月在我院分娩的462例产妇产褥初期低钾血症的发生率,并回顾性分析发生低钾的原因及总结护理的方法。结果121例(26.2%)产妇产褥初期发生低钾血症,经治疗1～5d后均恢复正常。结论产褥初期产妇低血钾发生率高,护理人员应了解产褥初期产妇低钾血症发生的原因,分娩后严密观察产妇是否出现低血钾相关的症状,并及时根据病情采取不同补钾方式,可减少产褥初期产妇低钾血症漏诊、误诊,减少由于低钾引起的不良反应。     

住院病人对护理服务评价情况的分析

[目的]了解住院病人对我院护理服务的评价,查找出护理服务中的问题环节,以便有针对性地加以改进。[方法]采用自行设计的调查表,每季度调查1次入院3d以上的住院病人,分析住院病人对护理技术、服务态度、提供帮助等护理服务的评价情况。[结果]住院病人对护理服务总体满意度为94．86％,对服务态度的评价不满意例次最多,主要是入院有护士相迎并作入院介绍和使用请、对不起等服务敬语方面还不能令病人满意。[结论]护理人员还要进一步改善服务态度,加强主动、热情服务和文明用语。     

The attitudes of mental health professionals towards patients with mental illness in an inpatient setting in Palestine

Culture plays a vital role in shaping public and professional attitudes towards mental illness. In Arab cultures negative attitudes toward patients experiencing mental illnesses are common. There is a lack of studies that investigate the attitudes of professionals towards patients in inpatient mental health settings. This study aimed to assess the attitudes of professionals towards patients with mental illnesses in the only psychiatric hospital in Palestine. A survey was undertaken using the Attitudes Toward Acute Mental Health Scale (ATAMHS 33). The scale was distributed to a variety of professionals at the only psychiatric hospital in Bethlehem. Data was managed and analysed by using SPSS 15 (a statistical package for social sciences). The participants (mostly nurses) expressed both negative and positive attitudes toward patients, however, results revealed more negative than positive attitudes, particularly in relation to alcohol misuse, medication, patients' ability to control their emotions, and genetic predisposition to mental illness. This paper provides baseline data about the attitude of mental health professionals towards patients experiencing mental illnesses. Education and direct contact with patients with mental illness may not be enough to foster positive attitudes towards them. This may indicate the need to revise educational curriculum at the Palestinian universities and offer more training for mental health professionals in order to change their attitudes.     

The realities of mental health nursing in acute inpatient environments

ABSTRACT:  The purpose of this ethnographic study was to understand how nurses construct their practice in an acute inpatient psychiatric unit in light of the current challenges, demands and influences brought about by service reform. During a 5-month period, fieldwork observations, interviews and discussion groups occurred in a 22-bed acute inpatient mental health facility in New South Wales, Australia. The findings demonstrate how the current role of acute care has resulted in nurses working in increasingly complex environments characterized by competing priorities and new demands. Nurses struggled to fit the changed service philosophy with traditional models of practice within this fluid and changing environment. The findings are relevant within the context of current debates and can be used to enhance the understanding of contemporary acute mental health nursing practice and inform the continued development of mental health nursing in these settings.     

The reality of practice development for nurses working in an inpatient service for people with severe and enduring mental health problems

Nursing practice development is a growing priority for the British National Health Service. However, the nature of practice development remains poorly articulated. Despite the growing number of papers on practice development in nursing, there is insufficient guidance in the literature for the practical day-to-day management of the role, particularly in the inpatient environment. This paper explores the tensions experienced by practitioners engaged in practice development within a service for people mainly with a diagnosis of psychosis. The entrenched culture of the environment is described, which was resistant to change therefore did not easily embrace practice development. Within such a culture it is important to balance effective management with team development and support. Although this balance is essential for positive change, it is the maintenance of the balance that often leads to the tensions experienced by practice development practitioners. The paper describes numerous tensions including the competing agendas, influencing 'hearts and minds' rather than forcing change and working where people are at. Each tension is explored alongside possible survival strategies. The material presented aims to be realistic and although it may not be generalizable to other settings and staff groups, the authors hope to stimulate debate about similar or contrasting experiences of practice development.     

住院精神病人发生猝死的相关因素

精神科病人猝死率高于综合医院住院病人。从猝死时间、季节、形式以及与病种、年龄、药物的关系方面对精神病人猝死的相关因素进行了综述