住院患者跌倒时间与地点的分析及护理对策

目的探讨住院患者跌倒时间与地点的规律,提出预防及护理对策。方法对37例住院患者跌倒事件进行回顾性分析。结果发生跌倒最多的是午夜12点到清晨8点的大夜班班次,跌倒率为51．35％,患者跌倒的地点多发生在病房床旁及洗手间,跌倒率分别为56．76％及29．73％。结论合理安排护理人力,提供安全环境,做好患者、家属及陪人的健康教育,可有效预防跌倒的发生。     

运用项目管理防范住院患者跌倒的效果评价

目的探讨项目管理在预防住院患者跌倒中的应用效果。方法通过项目管理的方法,制定跌倒项目整改进度表,培训并在全院各科室开展实施,定期收集结果、总结。观察实施前后住院患者跌倒发生率及伤害率。结果项目管理实施前后,住院患者跌倒率由之前的2.93%降至1.54%,伤害率由之前的79.17%降至53.33%,前后差异有统计学意义(P<0.05)。结论项目管理为护理管理人员提供了先进的管理方法,可以有效预防患者跌倒的发生,提高护理质量。     

综合护理干预在预防住院患者跌倒中的作用

目的探讨综合护理干预预防住院患者跌倒的作用及成效。方法选取2011年10月至2012年9月在我院住院的患者作为干预前观察对象,采取常规预防跌倒措施。选取2012年10月至2013年9月的住院患者为干预后观察对象,实施综合护理干预。比较干预前后患者跌倒人数、跌倒率及跌倒损伤等情况。结果实施综合护理干预后,住院患者跌倒人数由48例下降到27例,跌倒率由2.8‰下降到1.5‰,跌倒损伤率由85.4%下降到33.3%,差异均有统计学意义(P<0.05)。结论综合护理干预能有效降低住院患者跌倒发生率和跌倒损伤率,减少对患者的伤害,确保患者住院安全,避免医疗护理纠纷。     

精神科73例住院患者跌倒事件的分析及护理干预

目的探讨预防精神科住院患者跌倒的有效护理干预措施,提高精神科患者住院护理安全性。方法对73例精神科住院患者发生医院内跌倒的患者年龄、跌倒的时间、地点、原因、后果进行分析,制定相应的护理干预措施。结果 60岁以上的老年精神病患者是跌倒的高危人群;4:00至8:00、12:00至16:00是跌倒发生的高峰时段;跌倒的地点主要在卫生间、床旁、浴室;跌倒发生的原因主要与护理人员因素、环境因素、疾病因素、药物因素有关。结论要加强护理安全管理,改进护理流程,提高精神科患者的住院安全。     

脑卒中患者急性期跌倒的调查与护理体会

目的了解脑卒中患者跌倒的发生情况及危险因素,为采取有效的护理措施提供依据。方法对21例住院期间发生跌倒的脑卒中患者跌倒的发生时间、地点、下肢肌力、患者依从性等进行评定。结果患者跌倒在床边的居多（57．1％）,住院前10d和晚上易发生跌倒。结论加强对卒中跌倒的风险评估并采取针对性的预防措施,对于预防跌倒有重要意义。     

持续质量改进在普通外科住院患者跌倒风险评估管理中的应用

目的制定出完善的风险评估表和防范措施，有效地控制及减少跌倒风险，完善预防住院患者跌倒工作流程，提高服务质量。结果患者在住院期间发生跌倒率为零。结论持续质量改进方法在普通外科住院患者跌倒护理中的应用，有效减少住院患者跌倒发生率，提高了护理工作质量。     

跌倒不良事件现状与影响因素分析

目的探讨护理管理在防范住院患者跌倒安全对策。方法回顾性我院2012-2015年间125例病人发生跌倒不良事件为研究对象,分析其发生跌倒例数、年龄结构、伤害严重度等级、跌倒地点。结果住院患者跌倒以年龄大于65岁患者为主体。跌倒地点频率最高依次是卫生间、病室、走廊。跌倒事件逐年上升,伤害严重度等级中1级伤害程度及所占比例逐年增多,2伤害程度有下降趋势,3级伤害程度所占比例逐年降低。结论应用护理质量管理方法,制定对策,协同跨部门合作,才能有效地、致力地降低跌倒/坠床的伤害程度,预防跌倒/坠床的发生,降低住院患者跌倒/坠床发生率。     

107例住院患者跌倒原因分析

目的通过107例住院患者跌倒原因的分析,为住院患者防跌倒工作提供参考依据。方法采取根本原因分析法(RCA)分析住院跌倒患者所在护理片区、年龄、跌倒时间、地点、疾病、陪护情况及损伤程度构成比。结果内科、脑系科及老年科是全院跌倒的高发片区,占全院75.70%;发生跌倒的患者年龄≥60岁的占81.31%;跌倒高发时段为夜间(47.66%);病房及洗手间为主要跌倒区域;发生跌倒患者的疾病以脑梗塞、高血压、冠心病、糖尿病为主,占47.67%;在跌倒患者中有陪护的占71.96%;一级损伤占49.35%。结论住院患者发生跌倒的主要原因与患者疾病、年龄、用药,医护人员风险评估不足,环境,管理及陪护因素有密切关系。     

骨科肿瘤患者预防跌倒的全程护理管理

目的:探讨预防骨科患者跌倒的全程护理方法,保证患者安全。方法:回顾性分析对234例骨科下肢肿瘤患者实施预防跌倒的管理流程,包括全面评估、高危跌倒标识醒目、对高危跌倒患者采取有效预防措施、加强对患者及家属的健康教育、制订住院患者应急预案等。结果:实施预防跌倒管理流程后骨科患者跌倒率为0.4%。结论:预防性跌倒管理流程可以有效地预防骨科下肢肿瘤患者的跌倒。     

防跌倒护理在呼吸内科住院患者中的应用效果

目的观察防跌倒护理风险管理在呼吸内科住院患者中的应用效果。方法选取天津市海河医院呼吸内科2018年1月—2019年12月收治的老年患者108例,将患者随机分为观察组和对照组各54例,观察组患者实施临床防跌倒护理风险管理,对照组患者实施常规护理干预,比较两组患者在实施护理干预前后跌倒、坠床现象的发生情况以及对护理工作的满意率。结果护理干预后,两组患者跌倒率、坠床率均有所降低,观察组跌倒率和坠床率均明显低于对照组,差异均有统计学意义(P0.05)。观察组患者护理总满意率为98.15%,明显高于对照组的92.60%,差异有统计学意义(P0.05)。结论防跌倒护理风险管理在呼吸内科住院患者临床应用,能够有效降低跌倒和坠床事件的发生率,对患者跌倒和坠床现象起到预防的效果,同时提升患者对护理工作的满意率,值得临床推广应用。     

Linking of information from health and security databases on homicides

OBJECTIVE: Increased homicide rates in the city of Sao Paulo, Brazil, in the last two decades points out to the need for better understanding this subject. The purpose of the present study was to link information about homicide from different sources of data. METHODS: Homicide data from death certificates, medical examiners and police records of residents in the city of Sao Paulo was linked for the second semester of 2001. Variables about victims, risk factors and homicide circumstances were analyzed using absolute numbers, proportions and coefficients. Statistical differences were tested using Pearson's Chi-square test. RESULTS: Homicide crude rate was 57.2/100,000. Higher rates were observed among men aged 15 to 29 years (56.0% of all cases). The proportion of firearm-related homicides was 88.6%, higher among men than women. Most injuries were to the head (68.9%). Among the victims who underwent to drug screening, 42.5% had high blood alcohol concentrations (44.0% for men and 24.0% for women). Most events occurred at night during weekends and it was found a high correlation (74.6%) between the victim's place of residence and event location. CONCLUSIONS: The study findings highlight that linking information provides better quality of data and allows for better understanding of homicides.     

2004年中国疾病预防控制中心健康教育所“性病/艾滋病咨询热线”人工电话记录分析

目的 分析中国疾病预防控制中心健康教育所“性病/艾滋病咨询热线”人工电话记录资料,为今后开展艾滋病热线咨询服务及健康教育工作提供参考依据.方法 对该热线2004年人工原始咨询电话记录进行整理,由经过培训的录入员采用数据双录入法对咨询电话记录进行录入.结果 使用STATA 8.0及EXCEL软件进行统计分析.结果在2716例次咨询记录中,男性求询者占88.44%,女性求询者占11.56%;年龄以20～29岁组居首位,占54.38%;职业以职员居首位,占35.82%;受教育程度以大学文化程度居首位,占70.95%;求询者自述曾发生的高危行为中以嫖娼为首位,占80.00%;艾滋病知识信息42.19%来自网络媒体.咨询内容中涉及艾滋病问题比例最多,这其中涉及艾滋病病毒检测问题的占66.05%;其次是涉及艾滋病传播途径的占39.80%;涉及性病等问题的提问率较低.结论 本热线求询者以男性中青年为主,大部分文化程度较高,且多数有高危行为.利用咨询热线,对求询者实施有效地心理、行为干预,对于预防控制艾滋病具有积极作用.     

Carers' reflections on nursing home and NHS long-stay care for elderly patients

The aim of this study was to compare the perceptions of carers of elderly long-stay care patients who are now in nursing homes in three health districts in a former Regional Health Authority and in remaining long-stay geriatric National Health Service (NHS) wards. One hundred and ninety-eight nursing home carers (78%) and 128 NHS carers (83%) were interviewed by telephone, using a semi-structured questionnaire and open questions. The impact of caring at home was shown to be greater on NHS than on nursing home carers. Most were satisfied with the care, staff and atmosphere of the nursing home or hospital. Nursing homes were perceived to offer better ‘hotel’ facilities and a more pleasant environment. They were seen as better at respecting patients' privacy. The NHS was regarded as superior in offering clinical and rehabilitative services. Most participants thought the institution was the right place for their relative, although in general, it was thought to be better to care for elderly people at home. ‘Care in the community’ was supported, but carers were realistic about alternatives when informal care ceased to be a reasonable option. There was little ‘choice’ between public and private sector care. For many patients, entry into the institution followed directly from an acute hospital admission. The only choice was between care in a long-stay facility or remaining at home, with the patient becoming increasingly dependent and the carer becoming increasingly unable to cope. The formal aspect of community care should be to be organized rationally and accepted as a valid response to the needs of some dependent elderly patients and their carers.     

福建省469例健康咨询热线电话记录分析

目的了解福建省接受健康咨询热线的主要对象的特征以及求询的主要内容,为今后开展健康教育和行为干预提供依据。方法选取2004年1月至2005年2月接受电话咨询者469例资料进行分析,按咨询内容(性病艾滋病、寻医问药、生殖生育和心理卫生)进行分类整理,数据采用SPSS 11.5统计软件包进行统计分析。结果求询者中,男性占66.74%,女性占33.26%;年龄以29岁以下青年人居多,占49.89%;职业以工人(打工族)居首位,占48.83%;文化程度主要是初中以下人员,占60.77%;咨询内容涉及性病艾滋病问题最多,占45.42%。结论本热线求询者以男性中青年为主,大部分文化程度偏低,且多数有高危行为。利用咨询热线,对求询者进行心理、行为等健康教育具有积极意义。     

273例医疗纠纷原因分析

目的探讨医疗纠纷发生的原因,提出相应的防范对策和建议,以期提高医院的管理水平。方法采用回顾性流行病学调查方法,对上海市某综合性医院2011—2013年的273例医疗纠纷进行分析。结果医疗纠纷涉及的主要人员中副高职称以上者占56.8%;外科医疗纠纷发生的比率最高,为40.3%,其次是内科,为27.8%;医源性投诉的比例最高,为72.2%,其中因服务态度导致的医疗纠纷比例为34%;医疗纠纷的处理以选择协商途径的比例最高,为89.7%。结论医源性投诉是医疗纠纷的主要原因,其中服务态度引发的医疗纠纷比率最高。为有效预防医疗纠纷的发生,应加大科室管理力度,健全和落实各项医疗规章制度,引入人民调节机制,积极借鉴国外相关医患矛盾处理制度,提高医疗技术水平和服务质量。     

鱼骨图法分析神经外科患者跌倒原因

目的分析神经外科患者跌倒的原因,为防范神经外科患者跌倒提供对策依据。方法通过查阅本病区16例发生跌倒患者的相关资料,查找跌倒原因,分析后绘制鱼骨图。结果针对神经外科患者发生跌倒的原因建立跌倒的管理流程。结论鱼骨图用于神经外科患者跌倒原因的分析简便实用,为防范神经外科患者跌倒提供了对策依据,为进一步实现医疗安全持续改进提供了有力保证。     

Situating mental health work in place: Qualitative findings from interviews with Veterans in Southeastern Louisiana and Northern California

Most chronic illness management occurs outside clinics and hospitals, in the everyday lives of individuals. We use data from semi-structured interviews with 37 veterans from Southeastern Louisiana and Northern California to illustrate how “health work” for mental health concerns are shaped by place. Using health work as an orienting concept for analysis, we discerned variation between the two study sites in how Veterans used interacting with the natural environment, cultivating time alone, and religious practice to manage their mental health and well-being. Through these findings, we advocate for a situated notion of health work that is mindful of how health-related behaviors are shaped by place and the attributes that constitute place.     

淮南市2001年法定传染病流行病学分析

目的　了解淮南市法定传染病的流行特征 ,为制定防制措施提供依据。方法　按中国预防医学科学院的疫情规定 ,将 2 0 0 1年报告的法定传染病归纳为肠道、血源及性传播、呼吸道、自然疫源性及虫媒传染病四大类分类统计分析。结果　病毒性肝炎、痢疾、肺结核、疟疾 4种疾病是主要病种 ,占总发病数的 91.2 5 %,其中血源及性传播疾病占据首位。乙型肝炎以谢家集区、田家庵区为主 ,痢疾以谢家集区为主 ,肺结核以田家庵区最多 ,疟疾主要集中在潘集区。痢疾的发病以 6～ 10月为多 ,疟疾以 7～ 10月为多。传染病发病主要以 2 0～ 5 0岁、男性、工人和农民为主。另外 ,痢疾以 10岁以下儿童发病最多 ,肺结核以≥ 6岁发病为多。结论　提示应在不同地区、不同季节、不同人群中有侧重的开展防病工作。     

Health care consumers' preferences around health information exchange

PURPOSE Consumer buy-in is important for the success of widespread federal initiatives to promote the use of health information exchange (HIE). Little is known, however, of consumers' preferences around the storing and sharing of electronic health information. We conducted a study to better understand consumer preferences regarding the privacy and security of HIE. METHODS In 2008 we conducted a cross-sectional, random digit dial telephone survey of residents in the Hudson Valley of New York State, a state where patients must affirmatively consent to having their data accessed through HIE. RESULTS There was an 85% response rate (N = 170) for the survey. Most consumers would prefer that permission be obtained before various parties, including their clinician, could view their health information through HIE. Most consumers wanted any method of sharing their health information to have safeguards in place to protect against unauthorized viewing (86%). They also wanted to be able to see who has viewed their information (86%), to stop electronic storage of their data (84%), to stop all viewing (83%), and to select which parts of their health information are shared (78%). Among the approximately one-third (n = 54) of consumers who were uncomfortable with automatic inclusion of their health information in an electronic database for HIE, 78% wished to approve all information explicitly, and most preferred restricting information by clinician (83%), visit (81%), or information type (88%). CONCLUSION Consumers in a state with an opt-in consent policy are interested in having greater control over the privacy and security of their electronic health information. These preferences should be considered when developing and implementing systems, standards and policies.