消毒供应中心护士操作技能培训效果评价

目的 探讨消毒供应中心护士的操作技能培训与考核方法,以提高护士的专业知识及操作技能水平,完善消毒供应中心护士的培训制度.方法 对科室22名年轻护理人员进行理论知识培训和专业操作技能培训,制定考核细则及各专项操作考核评分标准,培训结束后进行操作技能考核,＞85分为合格,对考核成绩进行统计分析.结果 两组护士在正颌手术器械识别、手术衣折叠包装、手术敷料包装、手术器械包装、气管切开包包装5项操作技能考核全部合格;工作3～10年护士的操作时间、考核成绩均高于工作＜3年护士.结论 通过对护士有计划、有目标地进行专业知识及操作技能培训,使考核更加规范,完善了护士培训管理制度,提高了护士消毒供应专业知识及操作技能.     

我院ICU专职仪器设备管理岗位的设置及实践

探讨我院通过设立ICU专职仪器设备管理岗位,由该岗位专职护士负责ICU仪器的维护质控、使用的培训和考核以及床旁使用督导等工作。岗位的设立保证了仪器管理的一体化和规范化,仪器故障发生率、维修率较实施前6个月分别降低了16.3%和28.9%。仪器维护完好率由83.8%提高到了97.8%,仪器相关不良事件发生率较前降低了18.4%,最大限度地提高ICU仪器设备的有效使用率与完好率。     

对急诊科护士定期抢救技能培训的实践与效果

目的使急诊科护士具备娴熟的抢救技能,提高急救患者的抢救成功率。方法以急诊科22名护士为对象,对8项常见抢救技能掌握的现状进行调查,发现急诊护士抢救操作技能及心理应对能力有待提高,及时制订了定期培训计划,对培训前后护士技术操作进行了考核。结果经过1个月的培训,急诊护士的常见抢救技术操作考核合格率及急救意识都比培训前有显著提高。结论定期对急诊护士进行抢救技能的培训,能使护士具备较好的应对能力,为抢救急救患者赢得更多的救治时间和机会。     

应用情景模拟演练提高口腔科护理人员急救技能培训效果

目的：探讨应用急救情景模拟演练对提高口腔病房护士在颌面部创伤性大出血案例中急救能力的效果。方法组建教学培训小组,确定情景模拟演练培训方案,对15名护士在疾病理论知识、临床操作技能及应急能力在培训前后分别对受训护士进行考核。结果通过3个月培训,口腔科病房护士在创伤性大出血患者急救的理论知识、操作技能、应急能力上有显著提高（ P＜0．01）。结论实施情景模拟演练培训方法,可以提高口腔科病房护士的应急能力,使其更好地胜任临床护理工作,降低患者死亡的风险。     

基于护士岗位管理的分层培训考核改革研究

目的探索与护士岗位管理相适应的分层培训及考核模式,通过培训及考核有效提高护士岗位胜任力。方法拟定与岗位分级管理要求相适应的护士分层培训方案,根据不同层级岗位胜任力要求制定评价标准,采取不同的考核方式,多角度、多途径开展护士培训工作,对比培训效果。结果改革前后护士技能培训成绩与理论培训成绩相比具有统计学意义(P <0. 05),其中95%的护士认为分层培训及考核提高了个人综合素质,促进岗位胜任力的提升,37. 14%的护士认为科研能力得到提升,护士对培训考核改革整体满意度为86. 43%。结论立足岗位管理的护士分层培训及考核模式改革,适应了当前护士岗位管理工作的需要,但在提高护士科研能力及培训考核效能方面还有待完善。     

定期培训在改善手术室工作人员感染知识掌握的效果研究

目的 观察定期培训在改善手术室工作人员感染知识掌握及意识中的效果,从而提高手术室工作人员感染知识掌握率.方法 对医院手术室员工定期培训后,培训前后统一参加考试,统计合格率,技能操作采用先培训后现场随机抽考.结果 培训前参加考试共82人,理论操作考试合格57人,合格率为69.5％;培训后参加考试共82人,理论操作考试合格78人,合格率为95.1％;技能操作考试合格76人,合格率为92.68％;培训后较培训前合格率明显提高,差异有统计学意义(P＜0.05).结论 定期培训可提高手术室工作人员感染知识掌握率,加强业务操作技能,降低医院感染率.     

护理部改进护士培训考核方式的实践与思考

目的 探讨改进护士培训考核的思路和方式,以提高护士培训效果.方法 根据人力资源状况,构建培训架构和模块,做到知识、技能系统化;选师资,抓质量,注重效果;改变培训考核方式,提高学习兴趣.结果 经过2年的系统培训,入职3年内护士考核成绩,与培训前对比(P＜0.05),参加南京市护理规范化培训考试合格率,与培训前对比(P＜0.05).结论 护理部要根据各层级护士的特点,改进培训方式,才能提高培训效果.     

医疗仪器管理及维修模式的新探讨

目的：探讨医疗仪器管理和维修的新模式,提高医疗仪器的使用效率和使用寿命。方法：对我院的医疗仪器进行普查登记,给每台医疗仪器建立档案,对我院的相关人员进行培训,采用多种维修模式相结合的方式对医疗仪器进行维修,对比分析各种维修模式的利弊。结果：经过培训之后,医疗仪器的故障率降低,维修率升高、故障排除及时。结论：加强医疗仪器的管理、设置合理的医疗仪器维修模式可以提高医疗仪器的使用效率和使用寿命,同时加快故障的排除效率。     

低年资护士急救能力培训及效果分析

目的:探讨对低年资护士(3年以内)实施急救能力培训的方法及效果.方法:成立急救能力培训考核小组,采用理论授课、急救流程培训、急救技能操作训练、急救模拟情景训练等方法.制订考核项目细则,每月进行考核与评价.结果:培训后护士的急救理论知识、急救操作技能、急救综合能力均较培训前有较大的提高.结论:对低年资护士急救能力培训,可以强化急救意识及急救操作技能,增强临床判断能力和急救能力,确保护理质量和患者安全.     

浅析分组式培训在儿科护理人员急救能力的应用分析

目的分析儿科护理人员急救能力的培训方法及效果。方法建立急救能力培训考核小组,对护理人员进行分组式包干培训,并按期进行急救能力考核。结果培训后,护士的急救理论知识、急救综合能力、急救操作技能均较前有很大提高,差异有统计学意义(P值0.01)。结论儿科护士的急救能力培训,可强化护士的急救操作技能,增强临床判断能力、病情观察和急救能力,提高儿科护理质量,有效地保障患儿生命安全。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.