护士长督导式检查在优质护理服务中的作用

目的探讨实施护士长督导式检查在提高患者优质护理知晓率和满意度中的作用。方法护士长在了解患者基本信息后对患者实施"督导式"检查,与所有住院患者进行面对面交流,询问患者对护理质量和服务的感受,检查护理日常运作,根据督查中发现的护理工作中的低效、缺陷、服务风险和潜在问题指导护士及时纠正。结果实施护士长督导式检查后,患者优质护理知晓率和满意度较实施前显著提高(均P<0.01)。结论实施护士长督导式检查,有利于护士长对护理质量进行监控,增强了护理服务的针对性,是行之有效地提高患者优质护理知晓率和满意度的方法。     

温馨服务承诺的实施与评价

目的探讨对患者实施温馨优质服务的方法，以提高护理质量及患者满意度。方法制定“温馨服务承诺”活动条例，下发到每位护理人员．同时进行相关培训及督促检查．在活动开展前及开展3个月后分别用自编的“患者对病区护理服务质量评价表”和“患者对病区责任护士满意度评价表”对70例住院患者进行问卷调查。结果“温馨服务承诺”活动实施后患者对护理服务质量及责任护士的满意度显著高于活动前（P〈0．05，P〈0．01）。结论护士在“温馨服务承诺”活动中重视对患者进行人性化服务，既加强了自身素质又有利于提高护理质量和患者满意度。     

人文关怀护理在合作医院的推进及成效

目的 探讨合作医院人文关怀护理推进策略及效果.方法 选派护理专家至合作医院进行驻点指导,建立人文关怀护理组织架构,制定人文关怀护理标准和制度,强化护理管理和服务理念,实施人文关怀培训、试点病房人文关怀护理,督导推进人文关怀护理规范化,全面推进合作医院人文关怀护理.结果 合作医院建立首批人文关怀试点病房12个,实施后护士关怀能力显著高于实施前(P＜0.01),患者对关怀护理满意度及护士工作满意度逐步提升.结论 人文关怀护理推进策略在合作医院的推进,促进了护士对患者的关怀、护理管理者对护士的关怀,可有效提高患者满意度、护士的关怀能力和工作满意度.     

责任护士转盘的制作及在优质护理服务中的应用

目的 提高住院患者对责任护士知晓率,提升患者、护士满意度.方法 设计责任护士转盘(下称转盘),于内科10个护理单元应用3个月后调查患者和护士满意度.结果 转盘应用后患者对责任护士、护士长知晓率及对优质护理服务满意度显著升高(均P＜0.01).结论 转盘的应用有利于提高患者满意度和有利于责任制整体护理工作深入持续地开展.     

温馨服务承诺的实施与评价

目的探讨对患者实施温馨优质服务的方法,以提高护理质量及患者满意度.方法制定"温馨服务承诺"活动条例,下发到每位护理人员,同时进行相关培训及督促检查,在活动开展前及开展3个月后分别用自编的"患者对病区护理服务质量评价表"和"患者对病区责任护士满意度评价表"对70例住院患者进行问卷调查.结果"温馨服务承诺"活动实施后患者对护理服务质量及责任护士的满意度显著高于活动前(P＜0.05,P＜0.01).结论护士在"温馨服务承诺"活动中重视对患者进行人性化服务,既加强了自身素质又有利于提高护理质量和患者满意度.     

专科小组主导的“互联网+护理服务”实践及效果

目的 探索以专科小组为主导的“互联网+护理服务”实施效果。方法 2022年7-12月由58名网约护士实施常规“互联网+护理服务”(实施前),2023年1-6月由103名网约护士实施以专科小组为主导的“互联网+护理服务”(实施后),评价比较实施前后网约护士接单量、接单行为及服务患者的满意度。结果 专科小组为主导的“互联网+护理服务”实施前后分别开展“互联网+护理服务”179例次和409例次。实施后网约护士接单行为及患者对“互联网+护理服务”满意度显著优于实施前(均P<0.05)。结论 以专科小组为主导的“互联网+护理服务”有利于增强网约护士的接单行为意愿，改善患者接受“互联网+护理服务”的体验。     

首诊责任护士家庭跟进照料对老年卧床患者出院指导依从性的影响

目的 探讨首诊责任护士家庭跟进照料模式对老年卧床患者出院指导依从性及护理满意度的影响.方法 将出院后回归家庭的120例老年卧床患者分为对照组与观察组各60例.对照组为轮班制责任护士按常规登记资料及评估患者情况,访视及实施护理干预措施;观察组则为首诊责任护士从入院首次接诊到患者回归家庭全程负责该患者的访视及护理干预.比较两组患者对出院指导依从性及护理满意度.结果 观察组在系统治疗、康复锻炼、并发症预防、生活方式、按时复诊方面依从性显著高于对照组（P＜0.05,P＜0.01）,护理满意度显著高于对照组（P＜0.01）.结论 采用首诊责任护士家庭跟进照料模式可密切护患关系,提高患者对出院指导的依从性和护理满意度,改善老年卧床患者健康预后.     

扁平化排班责任包干制在优质护理实践中的成效

目的 探讨在“优质护理服务示范工程活动”中实施扁平化排班模式结合责任护士包干制护理患者的成效.方法 对骨科病区30名护士按扁平化排班模式优化排班、责任包干制护理患者,分别于实施前后对患者、护士、医生进行满意度调查.结果 实施后患者对责任护士满意度、护士对自身工作满意度、医生对护士满意度显著高于实施前(P＜0.05,P＜...     

护士分层分组管理在优质护理临床管理中的应用

目的:探讨病房护士分层分组管理在优质护理临床管理中的应用及对护理质量、满意度的影响.方法:自2010年5月起开展并成立优质服护理示范病区,采取护士分层分组管理,设立责任组长、责任护士和辅助护士三个层次,分组包干制,以病人为中心,围绕患者需求为导向的分工方式,分为两个护理小组,每组每个护士分别负责6～8名患者的治疗和护理工作,制定了责任组长、责任护士、辅助护士岗位职责.在责任组长的负责下,通过质控检查,现场改进,保证基础护理、专科护理以及心理护理工作落实到位.结果:通过分层分组管理,提高了护理工作质量和患者、医生对护理工作的满意度.结论:护士分层分组管理制度的实施,提高了护理人员的自身价值,加强了高年资护士对年轻护士的带教和支持作用,护理人员合理应用, 工作更贴近患者需求,减少了护理缺陷和医患纠纷,提高了护理工作质量和患者满意度.     

实施责任制护理对护士工作责任感的影响

目的探讨实施责任制护理对提高护士工作责任感及患者满意度的影响。方法选取2个病区开展责任制护理实践,包括分组按层级排班、责任制包干及加强支持性管理等,并以自制的护理人员的责任感问卷和住院患者满意度问卷进行评价。结果实施1年后,护士工作责任感及住院患者满意度显著提高(P<0.05,P<0.01)。结论开展责任制护理改革,可明显提高护士的工作责任感,进而提高患者的满意度。     

老年人和青年人胃癌的特点对比分析

目的探讨老年人与青年人胃癌不同的临床特点。方法收集本院1981年—1996年住院手术治疗,经病理检查确诊的胃癌1086例,按年龄不同分为老年组(≥60岁)373例,青年组(≤35岁)52例,比较两组的临床病理指标。结果老年组男:女为3.22:1,青年组为1:1.89;老年组肿瘤位于胃窦部以上占66.5％,青年组肿瘤多位于胃窦部,占78.8％;老年组中高分化腺癌占62.2％,而青年组中低分化、未分化及粘液腺癌居多,占73％;老年组手术切除率为75.5％,青年组为59.6％;老年组5年生存率为49.8％,青年组为15.4％。结论老年人和青年人胃癌具有不同的临床特点,应加以区别对待;但由于青年人胃癌较老年人胃癌发病年龄早,预后更差,应引起重视。     

The acceptability of pig organ xenografts to patients awaiting a transplant

Abstract: As the waiting lists for allotransplants of heart, kidney, and liver continue to grow, alternative sources of organs for transplantation are being sought: xenografts from pigs to humans could be a solution. However, is this solution acceptable to patients? To answer this question, we sought opinions, using a questionnaire, from 277 patients on a waiting list for a cadaver transplant for either a kidney (207), heart, or heart/lung transplant (70); there was a 65% (188) response rate. Approximately 75% of respondents had heard of xenografting; 50% would accept a xenograft for themselves and 43% for a relative; and 10% found a xenograft to be unacceptable and 40% were unsure and wanted more information. The most acceptable donor animal was the pig (27%), but 24% would accept organs from any animal; 68% had no objection to breeding animals as a source of organs and considered that the most appropriate use of animal tissue to be when no human organs were available. Thus, a minimum of 50% and a maximum of 90% of patients awaiting an allograft would accept a xenograft, although most would prefer a human rather than an animal donor.     

As others see us. The patient''s view of the anaesthetist

One hundred hospital patients were given a questionnaire, designed to assess their beliefs about the anaesthetist in relationship to other workers in the United Kingdon national health service. The results of this survey, and the comments passed at a simultaneous interview, are discussed.     

An appraisal of the anaesthetist-patient relationship

A questionnaire was used to obtain information from 100 patients about their knowledge of the anaesthetist and his work. The results are presented and discussed.     

Is it More Difficult to Cannulate the Right Internal Jugular Vein in Morbidly Obese Patients than in Nonobese Patients?

BACKGROUND: The placement of an internal jugular vein (IJV) catheter is considered to be more difficult in morbidly obese patients. The objective of this study was to compare the success of simulated IJV puncture between morbidly obese patients and a nonobese control group. METHODS: Thirty-four morbidly obese patients with body mass index (BMI, kg/m(2)) >/=40 were compared with 36 patients with BMI < 30. Right IJV puncture was simulated using an ultrasound probe directed towards the sternal notch at the midpoint between the sternal notch and the mastoid process. The investigator placing the probe was blinded as to the image being created on the ultrasound machine. Success rate was assessed at three different head rotation angles from midline; 0 degrees , 30 degrees , and 60 degrees . RESULTS: There was no statistically significant difference in successful simulated IJV puncture between two groups for any of the head positions. However, there was a higher incidence of the carotid artery (CA) puncture in the morbidly obese patient group when the head rotation was advanced from neutral position to 60 degrees (p < 0.05). In addition, the ultrasound showed significantly more overlapping of the IJV over the CA in morbidly obese patients at 0 degrees (p < 0.05) and 30 degrees (p < 0.05). Our results show no statistically significant difference in success rate of IJV puncture between morbidly obese patients and nonobese patients. Keeping the head in a neutral position in morbidly obese patients minimizes the overlapping of the IJV over the CA and the risk of CA puncture. CONCLUSION: However, due to the fact that even in the neutral position there is a significant increase in overlap between IJV and CA, we recommend the use of ultrasound guidance for IJV cannulation in obese patients.     

瑞芬太尼应用于老年患者的研究进展

瑞芬太尼是一种新型的阿片μ受体激动剂,可迅速被广泛存在于血液和组织中非特异性酯酶水解.瑞芬太尼具有独特的药理学特性,起效迅速,超短效,清除率快且不依赖于肝肾功能,长期静脉输注不产生明显蓄积作用.因此瑞芬太尼适用于老年患者全麻诱导插管、麻醉维持及门诊麻醉,有利于术后认知功能的早期恢复.然而,对于瑞芬太尼所产生的心动过缓、低血压、呼吸抑制和肌肉僵直等副作用,应积极采取预防和补救措施.     

右美托咪定在小儿患者的临床应用进展

背景 盐酸右美托咪定(dexmedetomidine hydrochloride,DH)是一种新型α2肾上腺素能受体激动剂,具有镇痛镇静和抗焦虑抑制交感神经的作用.它以起效迅速,清除率快且几乎对呼吸无影响的优点被国内外医学工作者广泛地应用于小儿患者.目的 了解DH在小儿患者的应用进展,可为临床用药提供参考.内容 概括DH的小儿药代学特点及对呼吸循环的影响,重点论述小儿临床常见领域如影像学检查,临床麻醉和重症监护室(ICU)的应用情况,它不仅在小儿非创伤性操作时的镇静具有独特的优势,而且对预防和治疗术后苏醒期激动和烦躁的患儿有肯定的疗效.趋向 DH在小儿临床麻醉辅助性应用和镇静镇痛抗焦虑等方面具有一定作用.