护理安全在儿科病房的应用

目的探讨护理安全在儿科病房的应用。方法通过总结儿科病房存在的护理安全隐患,加强管理,执行有效的护理对策。结果护理人员提高了护理安全意识,把握了每一个护理环节,消除了不安全隐患,确保护理安全。结论重视儿科病房的护理安全,提高护理质量,为患儿提供安全、满意的优质服务。     

浅谈儿科病房护理安全管理及对策

目的：探讨护理工作中存在或潜在的风险因素及安全管理应对措施,以保证临床护理安全。方法回顾我院2011年5月~2014年5月在儿科病房中实施护理安全管理的基本方法;以风险管理为指导,完善相应工作制度、改进工作流程、制定专科风险防范措施与预案,加大风险监控。结果儿科病房实施护理安全管理3年来,儿科护士增强了护理风险意识,提高了儿科理专科技能,加强了护患沟通意识和技巧。结论在儿科病房中应用护理安全管理,护理质量得到提高,保证了护理安全,提高了患儿家属的满意度,增强了护士风险意识,护理缺陷明显下降,护理安全系数稳步提高。     

人性化护理在儿科病房中的应用

目的 评价在儿科病房采用人性化护理干预措施的效果.方法 选择在本院就诊的首次住院患儿100例为研究对象,随机分成观察组和对照组两组,其中对照组采用常规专业护理模式护理;观察组在常规专业护理的基础上联用人性化护理干预措施.结果 观察组总满意率为88.00%明显高于对照组总满意率58.00%,具有显著差异(P<0.01,见表1).结论 在儿科病房采用人性化护理干预措施效果可靠,可以建议基层医院进一步推广.     

基层医院儿科护理管理的体会

目的探讨基层医院儿科护理管理的方法,总结体会。方法通过对儿科病房实施病房环境管理、预防的管理、陪护的护理及对护理人员的管理等。结果护士对患儿关怀照顾及病房管理,总体满意度大幅提升。结论加强基层医院的儿科护理管理,对提高患者满意度及护理质量具有重要价值。     

整体护理方法应用于儿科病房方法与效果分析

目的：探讨整体护理方法应用于儿科病房方法及效果。方法在儿科病区实施整体护理方法,对患儿的护理重点应由治疗转变为预防和保健,做到全方位护理。结果运用整体护理法后,患儿的住院日明显缩短,患儿的治愈率有了明显的提高,其家属的满意度也非常高。结论整体护理法适用于儿科病房,能够提高治愈率和患者的满意度,整体护理法在临床上值得推广。     

加强细节管理在儿科护理管理中的应用和地位

目的对细节管理在儿科护理中的应用和地位进行分析和探讨。方法主要以我院2010年1月~2012年6月收治的300例儿科患儿为研究对象,分成对照组和实验组,对照组在护理方法上采用常规护理方法,实验组在常规护理基础上落实细节管理,对两组护理效果及满意度进行比较。结果实验组护理效果及对护理工作的满意度均明显高于对照组,两组在护理效果及满意度的比较上,差异有统计学意义,P<0.05。结论结果表明,细节管理能够有效提高护理质量及满意度,有较高的临床应用价值,值得推广和普及。     

风险防范式护理在儿科安全管理中的应用及效果观察

目的 探讨风险防范式护理在儿科安全管理当中的应用效果。方法 选取2016年4月~2017年9月在我院儿科就诊的140例患儿作为对象,将其随机分为研究组与对照组,每组70例。对照组给予常规护理措施干预,研究组在常规护理基础上给予风险防范式护理干预,对两组满意度,抑郁、焦虑评分,不良事件进行对比。结果 研究组患者对治疗性、心理、生活、健康教育等满意度评分,高于对照组,差异有统计意义（P＜0.05）。研究组患者抑郁、焦虑评分、不良事件发生率低于对照组,差异有统计学意义（P＜0.05）。结论 在儿科安全管理当中采取风险防范式护理干预,能够有效提高临床治疗效果,降低不良事故发生率,提高患者对护理满意度。     

浅谈家庭关怀在儿科护理中的应用效果分析

目的探讨小儿惊厥患者实施家庭关怀的护理效果。方法将58例小儿惊厥患者随机患儿分为观察组及对照组,观察组患儿实施家庭关怀护理,对照组患儿实施常规性护理,观察两组患儿临床护理效果。结果两组患儿临床护理效果即总有效率具有统计学意义（观察组的100%VS 对照组的79.3％）（P＜0.05）;两组患儿住院时间具有统计学意义（对照组的13.5±3.5d VS 观察组的8.5±2.5d）（P＜0.05）;两组护理满意率具有统计学意义（观察组的100％VS对照组的79.3％）（P＜0.05）。结论对小儿惊厥患者在护理过程中实施家庭关怀,有利于提高患儿治愈率,缩短患儿住院时间,提高护理满意度,有利于护患关系的建立。     

浅谈健康教育在儿科病房实施的体会

儿科病房护理工作中,将"健康教育"这一环节较好的实施会有促进患儿早日康复、构建和谐护患关系、减少医疗纠纷等作用。根据在儿科临床工作实践,总结得出影响儿科病房健康教育实施的因素主要为护士自身因素、患儿家属接受心理因素及客观因素。     

儿科护理存在的安全隐患和对策

目的：分析儿科护理存在的安全隐患,并制定相关的有效对策。方法抽取2013年3月~2014年3月我院60名儿科护士进行观察,对护理工作中存在的安全隐患进行分析,并对采取相关对策前后安全隐患发生情况进行分析比较。结果采取相关对策后安全隐患发生率(3.1%)明显低于采取相关对策前安全隐患发生率(12.9%),前后数据差异明显(P<0.05),有统计学意义。结论儿科护理存在的安全隐患主要是护理人员整体素质较低、与患儿缺乏有效的沟通交流、没有相应的管理制度等;因此,努力提升护理人员的整体素质、与患儿进行密切沟通、加强服务意识及并完善相关管理制度,才能够提升儿科护理质量,进而使护患之间维持和谐关系。     

Multimedia based health information to parents in a pediatric acute ward: A randomized controlled trial

Objective

To determine whether multimedia based health information presented to parents of children with breathing difficulties in a pediatric acute ward, is more effective than verbal information, to reduce parental anxiety and increase satisfaction.

Methods

This randomized controlled trial was conducted in a pediatric acute ward in Norway, from January to March 2011. Parents were randomly assigned to a multimedia intervention (n = 53), or verbal health information (n = 48). Primary outcome measure was parental anxiety, and secondary outcome measures were parental satisfaction with nursing care and health information.

Results

Parental anxiety decreased from arrival to discharge within both groups. At discharge the anxiety levels in the intervention group were no lower than in the control group. There was no difference in satisfaction with nursing care between the groups, but parents in the intervention group reported higher satisfaction with the health information given in the acute ward (p = .005).

Conclusion

Multimedia based health information did not reduce anxiety more than verbal information, among parents to children with breathing difficulties. However, after discharge the parents were more satisfied with the multimedia approach.

Practice implications

More research is needed to recommend the use of multimedia based information as a routine to parents in pediatric emergency care.     

Exploring collaboration between clinicians and parents to optimize pediatric weight management

Objective

To explore the understanding of collaboration between clinicians working in pediatric weight management and parents of overweight children.

Methods

Clinicians (n = 12) and parents (n = 8) seeking pediatric weight management care participated in semi-structured focus groups or individual interviews. A family-centered, collaborative model of care was used to frame the data and develop codes/themes for analysis. Member checking and external reviews were conducted to verify emergent themes.

Results

Analyses revealed that collaboration between clinicians and parents included a positive therapeutic relationship, negotiation of health care delivery, and regular monitoring and evaluation. These elements are consistent with a philosophy of family-centered care, emphasize the importance of tailoring health services to families’ needs, respect parents as experts, and identify clinician responsiveness as pivotal to partnerships with families. Parents described dissatisfaction with care and a lower likelihood of seeking future care when clinicians deviated from these principles.

Conclusion

Results suggest that pediatric weight management should be family-centered to give parents the opportunity to actively engage in health services and negotiate their family's care.

Practice implications

Clinicians may be able to optimize their interactions with families seeking pediatric weight management care by taking a family-centered approach that is individualized and responsive to families’ needs.     

SWOT分析法在SICU护理质量管理中的应用

目的：探索SWOT分析法在外科重症监护室（SICU）护理质量管理中的应用,以不断改进护理质量。方法：运用SWOT分析法评估2011年1～12月SICU护理质量管理的内部优势、劣势和外部环境的机会、威胁,从而制订相应策略。结果：与2010年1～12月相比,SICU在病区管理、基础护理、技能考核、护理文件书写、院感控制以及患者满意度方面均较实施前明显改善（P〈0．01）,差异具有统计学意义。结论：SWOT分析法用于指导SICU护理质量管理,可有效提高护理工作质量,提高护理安全。     

Heart transplantation in pediatric patients: twelve-year experience of the Asan Medical Center

Heart transplantation is a standard treatment for end-stage heart disease. Pediatric heart transplantation, however, is not frequently performed due to the shortage of pediatric heart donors. This is the first report of pediatric heart transplantation in Korea. Our retrospective study included 37 patients younger than 18 yr of age who underwent heart transplantation at Asan Medical Center between August 1997 and April 2009. Preoperative diagnosis was either cardiomyopathy (n = 29, 78.3%) or congenital heart disease (n = 8, 22.7%). Mean follow up period was 56.9 ± 44.6 months. There were no early death, but 7 late deaths (7/37, 18.9%) due to rejection after 11, 15, 41 months (n = 3), infection after 5, 8, 10 months (n = 3), suspicious ventricular arrhythmia after 50 months (n = 1). There was no significant risk factor for survival. There were 25 rejections (25/37, 67.6%); less than grade II occurred in 17 patients (17/25, 68%) and more than grade II occurred in 8 patients (8/25, 32%). Actuarial 1, 5, and 10 yr survival was 88.6%, 76.8%, and 76.8%. Our midterm survival of pediatric heart transplantation showed excellent results. We hope this result could be an encouraging message to do more pediatric heart transplantation in Korean society.     

重度烧伤患者人工气道护理管理的现状研究

目的 重度烧伤尤其合并严重吸入性损伤者,因体液急性渗出,短期内患者即可出现头面部、气道黏膜严重水肿.因此,快速建立人工气道并保持有效通气,是重度烧伤患者得以成功救治的重要前提之一.本文通过对国内外重度烧伤患者人工气道的并发症、气道湿化、雾化吸入、气囊管理、院感防控5个方面进行文献回顾并总结海军军医大学第一附属医院60年...     

Exploring the usability of the ISO reference terminology model for nursing actions in representing oriental nursing actions

Purpose

This study examined the extent to which the ISO reference terminology model for nursing actions represents oriental nursing actions in a computerized nursing documentation system to share data and foster communication between oriental nursing care and conventional nursing care.

Methods

The narrative nursing notes of 545 patients retrieved from a nursing documentation system in an oriental medicine teaching hospital were analyzed. Among 49,118 entries, 933 were recorded as nursing actions. Each entry was decomposed in a set of single statements. A total of 1209 nursing action statements were derived and mapped to the components of the model. These processes were reviewed and validated by two domain experts and a nursing terminology expert.

Results

All of the oriental nursing actions documented contained a word or phrase that described the Action and Target in the model. The Recipient of Care was expressed explicitly in 1.2% of statements. The most frequently used Action terms were ‘administering’ (19.7%), ‘teaching’ (16.5%), and ‘explaining’ (13.6%). The Target terms that indicated unique oriental nursing concepts included ‘Sasang constitution differentiation’, ‘removal of acupuncture needles’, ‘herb moxibustion’, ‘oriental massage’, and ‘oriental medication’.

Conclusion

The findings demonstrate that oriental nursing actions can be represented using the ISO reference terminology model for nursing actions. Further specification of the components of the model will be useful to achieve consistent mapping across different settings. The addition of component qualifiers should also be taken into consideration to describe nursing actions at a more granular level.     

A comprehensive microbial analysis of pediatric patients with acute appendicitis

BackgroundPathogenesis of pediatric acute appendicitis (AA) is yet to be elucidated. Therefore, we performed a comprehensive microbial analysis of saliva, feces, and appendiceal lumen of AA patients using 16S ribosomal RNA (rRNA) gene amplicon sequencing to elucidate the pathogenesis of pediatric AA.MethodsThis study included 33 AA patients and 17 healthy controls (HCs) aged <15 y. Among the AA patients, 18 had simple appendicitis, and 15 had complicated appendicitis. Salivary and fecal samples were obtained from both groups. The contents of the appendiceal lumen were collected from the AA group. All samples were analyzed using 16S rRNA gene amplicon sequencing.ResultsThe relative abundance of Fusobacterium was significantly higher in the saliva of AA patients as compared to that in HCs (P = 0.011). Bacteroides, Escherichia, Fusobacterium, Coprobacillus, and Flavonifractor were significantly increased in the feces of AA patients, as compared to that in HCs (P = 0.020, 0.010, 0.029, 0.031, and 0.002, respectively). In the appendiceal lumen, Bacteroides, Parvimonas, Fusobacterium, and Alloprevotella were the top bacterial genera with an average relative abundance >5% (16.0%, 9.1%, 7.9%, and 6.0%, respectively).ConclusionsThe relative abundance of Fusobacterium was high in the appendiceal lumen of pediatric AA patients. Moreover, the relative abundance of Fusobacterium was significantly higher in the saliva and feces of pediatric AA patients than in those of healthy children. These results suggest that ectopic colonization of oral Fusobacterium in the appendix might play an important role in the pathogenesis of pediatric AA.     

Structuring psychosocial care in pediatric oncology

The requirements for high quality psychosocial care for children with cancer and their families are steadily increasing. As an additional supplement to medical and nursing care, psychosocial work has to consider both the requirements of the medical treatment and the associated stress factors. It is essential to structure the different possibilities of intervention in a way which guarantees the practice of psychosocial care within the ongoing medical care. This requires a standardized psychosocial care manual. In July 1994, a ‘Manual for Psychological Care in Pediatric Oncology’ was put into practice and has been continually improved in the Department of Pediatric Hematology/Oncology of the University of Bonn. It contains special indications for different standards of psychosocial care, is oriented according to the phases and situations of medical treatment, and consists of a health education program as well as special care measurements. The latter are related to both the stressors primarily caused by the requirements of familial adherence to medical and nursing care and the stressors primarily caused by factors of the individual or the familial life circumstances. The theoretical basis of this manual and concrete information for its use are described in this paper.