新型冠状病毒肺炎期间护士职业认同感与抗疫 认知水平状况及相关性研究

目的 了解新冠肺炎期间护士职业认同感和抗疫认知水平的情况，并分析二者之间的相关性。方法 采取便利抽样法于2020年1月至3月对安徽省4所三甲医院的724名注册护士进行一般资料、抗疫认知水平和护士职业认同调查，对结果进行统计描述、单因素分析和Pearson相关性分析。结果 疫情期间护士抗疫认知水平总分为（40.33±9.11）分；护士职业认同感总分为（109.14±16.65）分，处于中等偏上水平；不同性别、年龄、婚姻状况及临床工作年限的护士职业认同感之间差异有统计学意义（P<0.05）；护士职业认同感与抗疫认知水平之间呈正相关。结论 新冠肺炎期间护士抗疫认知水平较高。护士职业认同感影响其抗疫认知水平，社会应提高对护理职业价值的认可，同时护理人员也需不断提升职业素养，增强抗疫应急能力。     

家属支持的主观感知水平对抗疫人员心理压力的预测作用

目的 调查抗疫医护人员主观感知的家属支持程度,并探讨其对压力水平的预测作用。方法 应用自编问卷,对连续纳入的173名抗疫医护人员进行在线问卷调查。结果 回收有效问卷168份,有效问卷回收率为97.11%。抗疫医护人员感知的家属支持中,来自主要家属持“支持”态度的比例在67.96%~88.98%之间,持“反对”态度的比例在0.85%~2.98%之间,持“无意见”态度的比例在6.55%~11.65%之间。79.17%的抗疫医护人员感到抗击疫情工作有压力,年龄越大、学历越高,队员的压力水平越低;在压力来源方面,受调查的抗疫抗疫医护人员最常见按的压力来源是“自己被感染”、“子女照顾问题”、“老人照顾问题”;年龄、父母的支持程度与队员的压力大小显著负相关（p＜0.05）;父母支持水平能有效预测抗疫医护人员的压力水平,父母越支持,队员的压力水平越低。结论 抗疫医护人员感知的家属支持总体较好,管理者应尽可能更多关注抗疫医护人员的家属状况,尤其是其父母的态度,这有助于降低抗疫医护人员的压力水平。     

抗疫临床一线护士的灾害护理能力与压力负荷的相关分析

目的 调查援沪抗疫临床一线护士的灾害护理能力和工作压力负荷的现状,分析其相关性,为提高其灾害护理能力提供参考。方法 采用整群抽样法,于2022年5月选取洛阳市某三级甲等医院参加支授上海抗疫的154名护士为研究对象,采用问卷星方式进行一般资料、灾害护理能力评估工具和压力负荷量表调查。结果 抗疫护士灾害护理能力总分为(207.25±34.65)分,工作压力负荷总分为(56.98±15.60)分;单因素分析结果显示,不同职称、职务、是否听说过灾害护理、是否参加过灾害护理培训以及是否参加过灾害救援的抗疫护士灾害护理能力得分比较差异有统计学意义(P<0.05);Pearson相关性分析结果显示,抗疫护士灾害护理能力与工作压力负荷呈负相关(r=-0.163,P<0.05);多元线性回归分析结果显示,灾害护理培训、压力负荷是影响抗疫护士灾害护理能力的主要因素。结论 抗疫临床一线护士的灾害护理能力处于中高水平,工作压力负荷处于中等水平,一线护士压力负荷越高,灾害护理能力越低,护理管理者应加强灾害护理能力教育和培训,及时提供心理疏导,进而提高其灾害护理能力。     

同伴支持在抗疫护士群体中应用体验的质性研究

目的探讨苏州地区抗疫护士在同伴支持中的真实体验。方法采用质性研究方法,选取2020年1-4月参与当地抗疫的护士112名,对23名同伴支持中的护士进行半结构式访谈,并用Colaizzi七步法分析抗疫护士参与同伴支持的真实体验。结果苏州本土抗疫护士同伴支持的体验归纳出3个主题:(1)多维度的支持内容,给予抗疫护士全方位的支持关怀。(2)特殊情境下的同伴支持体验。(3)抗疫护士对同伴支持的建议。结论提供多维度的同伴支持方案可以传递关怀力量,缓解抗疫护士压力,增强抗疫信心和防护经验,优化护理质量。     

抗疫精神思政工作坊对高职护生职业认同、职业自我效能及应急态度的影响

目的 分析基于抗疫精神的主题思政工作坊对护生职业认同、职业自我效能及应急态度的影响。方法 基于抗疫精神设计思政工作坊方案，选取86名高职护生为研究对象，分为观察组和对照组，观察组护生全程参与工作坊，对2组研究对象在工作坊前后进行应急态度、职业认同、职业自我效能调查。结果 2组护生在实施研究后职业认同量表总分、职业自我效能总分、应急态度总分及观察组上述指标研究前后测量结果比较差异具有统计学意义（P<0.01），自主选择护理专业、参加工作坊、职业自我效能、职业认同进入对护生应急态度预测的回归方程。结论 疫情防控常态化背景下基于抗疫精神的思政工作坊对护生职业认同、职业自我效能及应急态度有积极影响。     

试论医院思想政治工作与文化建设的互动性

医院文化是医院文明的基础。是以人为中心，以调动职工积极性为目标，运用文化的力量和方式对医院进行管理的一种管理形式，其特征与医院思想政治工作颇有相通之处。认识和探讨医院文化建设与思想政治工作的内涵特征，发挥两者在医院工作中的相互渗透、优势互补的作用，对推动医院改革和发展，加强医院精神文明建设具有十分重要的现实意义。     

罕见的抗E、抗Kpa混合抗体1例

Kp^a抗原(KEL3)属于Kell系统的低频抗原，抗Kp^a非常罕见，可能引起严重的急性[1]、迟发性溶血性输血反应[2]和胎儿贫血[3]、水肿[4]。抗E、抗Kp^a混合抗体更未见报道且极易漏检，近期本实验室发现1例，现报告如下。1对象与方法1.1研究对象患者，女，32岁，骨髓增生异常综合征，无妊娠史，有5次输血史，最近输注红细胞为2月前。血红蛋白43 g/L，申请输注红细胞，医院输血科检测不规则抗体筛查阳性，送检至本实验室。     

导医护士素质的培养及管理

随着医疗卫生改革的深入，以病人为中心的人性化服务已成为全社会的共同心声。良好的导医服务不仅能树立医院窗口服务的新形象，还是协调医患关系的桥梁，在医院服务文化建设和推动医德建设中起着重要的作用。     

加强医院文化建设、推进公立医院改革

医院文化建设是医院发展战略的重要组成部分,这项工作的有效开展,有利于支持和推动公立医院改革的顺利实施。当前新的医改方向已经确定,目标已经确立,能否保证新的一轮医改航船顺利驶向、成功彼岸？在探索和推进体制、机制、人事和分配制度一系列改革过程中,更需要一种精神激励和智力支持,需要一种先进的价值理念和服务理念,需要一种强大的凝聚力和公信力,因此,要围绕医院改革的中心工作,不断加强医院文化建设,以推动医院实现跨越式发展。     

抗-Mur在闽南地区人群分布频率及其导致新生儿溶血病的临床研究

目的:了解本地区抗-Mur的分布频率以及引起新生儿溶血病的特点,为指导临床安全输血提供依据。方法:回顾性分析本院2020年11月至2021年12月备血或输血病例中检出的抗-Mur,并对患者的实验室检测数据和相关临床资料进行统计学分析。结果:39 069份备血或输血病例检出不规则抗体345例,其中抗-Mur 23例,男性7例,4例有输血史;女性16例,9例仅有妊娠史,2例仅有输血史,5例既有输血史又有妊娠史;抗-Mur检出者中位年龄为59(19-78)岁,高于同期其他抗筛阳性患者的中位年龄[45(1天-93岁)岁](P<0.05),而组间性别比较无统计学差异(P>0.05)。1例高胆红素血症的患儿,其红细胞放散液和母亲血清中检出抗-Mur,确诊为Mur新生儿溶血病。结论:抗-Mur在闽南地区是有重要临床意义的同种抗体,抗-Mur的产生与免疫史密切相关,抗-Mur检出者年龄高于其他抗筛阳性患者。抗-Mur引起的新生儿溶血病患儿贫血症状重,容易漏检,应引起重视。     

互联网医院在新型冠状病毒肺炎防控中的作用

目的:通过开通互联网医院新型冠状病毒肺炎义诊团队在线服务,为患者在疫情期间提供必要的防范指导,降低一线门急诊接待压力和线下人群集中交叉感染风险。方法:自2020年1月新型冠状病毒肺炎疫情暴发以后,四川省绵阳市中心医院迅速反应,组建了抗击新型冠状病毒肺炎的互联网义诊项目工作组,根据实际情况,分析需求,按需设置线上专科门诊,对义诊专家实施针对性的培训,优化患者端智能导诊,简化流程后通过互联网医院紧急上线。结果:互联网医院专家义诊团队于2020年1月26日上线,截至2020年2月1日,7 d时间义诊专家团队完成线上问诊4120人次,其中咳嗽、咳痰、发热等呼吸道症状咨询2489人次,占60.4%。598人次咨询新型冠状病毒肺炎相关知识,425人次咨询焦虑、恐惧相关心理问题。筛查出发热及(或)有新型冠状病毒肺炎流行病学史患者共622例,其中既有发热又有流行病学史患者5例。结论:通过互联网医院帮助患者区分普通感冒和新型冠状病毒肺炎,排查疑似病患并进行心理干预,减少社会恐慌,在医院诊治之前,构建了第一道抗疫防线。     

Exploration of transmission chain and prevention of the recurrence of coronavirus disease 2019 in Heilongjiang Province due to in-hospital transmission

The coronavirus disease 2019 (COVID-19) epidemic is a major public health emergency characterized by fast spread, a wide range of infections, and enormous control difficulty. Since the end of December 2019, Wuhan has become the first core infection area of China's COVID-19 outbreak. Since March 2020, the domestic worst-hit areas have moved to the Heilongjiang Province due to the increased number of imported COVID-19 cases. Herein, we reported the major COVID-19 outbreak, which caused a rebound of the epidemic in Harbin, China. After the rebound, different levels of causes for the recurrence of COVID-19, including city-level, hospital-level, and medical staff-level cause, were investigated. Meanwhile, corresponding countermeasures to prevent the recurrence of the epidemic were also carried out on the city level, hospital level, and medical staff level, which eventually showed the effect of infection control function in a pandemic. In this study, we described the complete transmission chain, analyzed the causes of the outbreak, and proposed corresponding countermeasures from our practical clinical experience, which can be used as a valuable reference for COVID-19 control.     

新型冠状病毒肺炎疫情下医疗转运工作的管理研究

目的 探讨新型冠状病毒肺炎疫情下医疗转运工作的应对管理措施,为医疗转运部门在传染病疫情下医疗运送工作提供参考.方法 针对新型冠状病毒肺炎突发事件,成立转运管理小组、制订转运流程、开展专项培训、动态调配人力及物力、严格消毒管理、加强防控督导.结果 截至2月22日,协助检查发热患者2970例次,转运入院218例次,运送标本...     

SAA、 CRP在新型冠状病毒肺炎诊断中的价值

目的:探讨血清淀粉样蛋白A (SAA)、C反应蛋白(CRP)在新型冠状病毒肺炎(COVID-19)诊断中的价值.方法:回顾性分析2020年1月～6月本院COVID-19患者的临床资料,包括基本人口学特征、实验室检查结果和影像学检查结果,并与甲流组、疑似组、健康组进行比较分析.结果:COVID-19组患者SAA和CRP明...     

COVID-19 related callback in blood donors; Outcomes in blood donors and patients

Call back as a procedure to report post donation symptoms or illness by donors has been established since 2009 in Iranian Blood Transfusion Organization (IBTO). During the first phase of COVID-19 outbreak, all blood donors were requested to report any respiratory infection symptoms after donation. The study investigated the callback data of COVID-19 in Tehran Blood Center during the first 3 months of the outbreak in Iran. The purpose of this study was to estimate the frequency of post donation COVID-19 related call back reports and determine its implications for blood donors and patients.A telephone interview was conducted with donors who had reported COVID-19 symptoms. Some questions were asked to evaluate donor′s health at the time of blood donation. The donors categorized into three groups: laboratory-confirmed, suspected, and COVID-19 irrelevant based on their answers. In cases that the blood component obtained from a laboratory-confirmed donor had been released, the hospital was notified and asked to follow up the recipient for COVID-19.The results showed 30 donors (0.08 %) had callback related to COVID-19 and 76.63 % of the obtained component was disposed. The results also showed that only one donor had a laboratory-confirmed result with the RBC unit processed from her whole blood released for transfusion. The RBC unit recipient did not show any signs or symptoms of infection during a 46-day follow-up.Concluded that callback system was effective to remove most of the components obtained from the donors who reported to be COVID-19 suspected or confirmed. Moreover, the result did not support virus transmission through blood transfusion.     

Effect of short-duration,limited rehabilitation on maintenance of the activities of daily living in patients with acute phase of COVID-19

[Purpose] To determine whether short-duration, limited rehabilitation is effective in patients with COVID-19. [Participants and Methods] Single-center, retrospective, observational study. Thirty-six inpatients were classified into the three groups: a close contact (CC) group with a negative polymerase chain reaction (PCR) test (n=14); a PCR–positive (PP) group (n=15); and a PCR–positive and transfer (PT) group with severe COVID-19 patients who were transferred to an acute care hospital for treatment and then returned to our hospital (n=7). Short-duration, limited rehabilitation was provided to the CC and PP groups in isolated rooms by a therapist wearing full personal protective equipment, and we assessed the changes in their activities of daily living. [Results] The patients’ clinical characteristics at baseline were similar among the three groups. Functional Independence Measure scores in the CC, PP, and PT groups were not different at baseline (69 ± 29, 53 ± 26, and 63 ± 32), but differed after control of COVID-19 (63 ± 25, 47 ± 24, and 32 ± 19). Multivariate regression analysis showed that the implementation of a customized self-exercise program and the Mini Nutritional Assessment Short-Form at baseline were independently associated with Functional Independence Measure score after control of COVID-19. [Conclusion] These results suggest that even short-duration, limited rehabilitation may be effective for preventing decreases in activities of daily living in patients with COVID-19.     

Convalescent plasma to aid in recovery of COVID-19 pneumonia in a child with acute lymphoblastic leukemia

The natural history of COVID-19 infection in children is still evolving as the pandemic unfolds. Few cases of severe and often fatal COVID-19 have been reported although the infection is mild in the large majority. Children with cancers are recognised as a high risk group for all infections. Since there aren’t any definite treatment guidelines established in children with severe COVID, treatment is guided by adult recommendations which too are often not evidence based. We report the case of a 4-year-old girl with severe COVID-19 associated pneumonia who presented to us as febrile neutropenia. The use of convalescent plasma along with steroids and IVIG showed dramatic results in this child and she recovered without the need for any specific treatment. This is highlighted as one of the earliest cases that is reporting the use of convalescent plasma in a child; the first ever in a child with underlying malignancy.     

Application of refined management in prevention and control of the coronavirus disease 2019 epidemic in non-isolated areas of a general hospital

ObjectiveThis article summarizes the experience in the prevention and control of coronavirus disease 2019(COVID-19) epidemic in non-isolated areas in a general hospital.MethodsBased on refined management theory, we professionally developed the standards for prevention and control of COVID-19 in non-isolated areas, systematically implemented various prevention and control measures, performed gridding audits, effectively communicated among teams and between medical staff and patients assisted by information techniques, and reported results for quality improvement.ResultsThere was no hospital-acquired COVID-19 infections among staff in the hospital. The rates of mask-wearing, epidemiological history screening, and the medical supplies disinfection were all 100% in the hospital. The accuracy rate of mask-wearing of patients and their families was 73.79% and the compliance rate of their hand hygiene was 40.78%.ConclusionRefined management strategies for the prevention and control of COVID-19 infection in non-isolated areas of the general hospital are effective. The accuracy rate of mask-wearing and hand hygiene compliance of patients and their families need to be further improved.     

Experience of 101 patients with coronavirus infectious disease 2019 (COVID-19) at a tertiary care center in Japan

IntroductionClusters of novel coronavirus infectious disease of 2019 (COVID-19) have spread to become a global pandemic imposing a significant burden on healthcare systems. The lack of an effective treatment and the emergence of varied and complicated clinical courses in certain populations have rendered treatment of patients hospitalized for COVID-19 difficult.MethodsTokyo Metropolitan Tama Medical Center, a public tertiary acute care center located in Tokyo, the epicenter of COVID-19 in Japan, has been admitting patients with COVID-19 since February 2020. The present, retrospective, case-series study aimed to investigate the clinical course and outcomes of patients with COVID-19 hospitalized at the study institution.ResultsIn total, 101 patients with COVID-19 were admitted to our hospital to receive inpatient care. Eleven patients (10.9%) received ECMO, and nine patients (8.9%) died during hospitalization after COVID-19 was diagnosed. A history of smoking and obesity were most commonly encountered among patients with a complicated clinical course. Most patients who died requested to be transferred to advanced palliative care in the early course of their hospitalization.ConclusionsOur experience of caring for these patients demonstrated a relatively lower mortality rate and higher survival rate in those with extracorporeal membrane oxygenation placement than previous reports from other countries and underscored the importance of proactive, advanced care planning in the early course of hospitalization.     

新型冠状病毒肺炎整建制救治模式下的护理协同管理实践

目的探讨新型冠状病毒肺炎定点医院在整建制救治模式下的护理协同管理实践。方法分析疫情突发后整建制救治模式下护理工作面临的挑战,从完善护理组织架构、科学设置护理岗位、合理调配人力资源、规范排班模式、落实工作例会制度、落实质量管理、开展全员全方位培训等方面统筹、协调护理管理工作。结果我院光谷院区被确定为新冠肺炎患者定点救治医院后,24 h内与17支国家援鄂医疗队有效对接,协助其整建制接管隔离病区并顺利开展救治工作,未发生护理不良事件,同时实现医务人员"零感染"。截至2020年3月31日24:00,累计收治患者1462例,治愈出院患者1282例,治愈率87.68%。根据疫情防控指挥部统一部署,光谷院区隔离病区全部关舱,需进一步治疗的患者按要求转至其他救治医院继续治疗。结论新冠肺炎整建制救治模式下的护理协同管理实践,可为突发公共卫生事件救治中的护理管理提供参考与借鉴。