手术室外来器械管理存在的问题及对策

目的 探讨我院手术室外来器械管理中存在的问题及对策.方法 通过对手术室外来器械使用情况的跟踪及了解,发现外来器械对手术室的医疗安全管理具有较大的影响,并制订了有效对策.结果 通过针对外来器械存在的问题实施有效对策后,外来器械的清洗、消毒及灭菌质量得到了保证,完善了外来手术器械的清点、登记等管理措施,加强了术前、术中及术后对外来器械的管理,外来器械公司业务人员加强了对医院感染相关知识的掌握.结论 加强对外来器械及业务人员的管理,是降低手术室医疗安全隐患、确保患者手术安全的保障.     

手术室外来手术器械的质量管理

目的:探讨手术室外来手术器械质量管理的效果。方法:回顾手术室2011年9月~2013年11月完善外来器械管理制度和使用外来器械手术医师确认卡以来,应用外来手术器械6179例次手术的效果。结果:采用外来器械手术医师确认卡以来,加强了手术前后对外来器械的管理,未出现外来器械准备不足、配送失误,消毒灭菌质量合格,手术器械使用满意度提高。结论:实施质量管理,可督促器械公司准备合适的器械,有效提高手术室护士的工作责任心,加强团队合作,确保手术患者安全。     

手术室外来器械的规范化管理体会

目的探讨手术室外来器械管理的方法及其效果。方法了解手术室外来器械的使用情况,加强手术室外来器械的管理,以有效提高医疗安全,确保患者的手术安全。结果通过对手术室外来器械的规范化管理,术后感染率明显下降。结论加强对手术室外来器械及其业务人员的管理能够有效地减少医疗安全隐患,确保手术安全。     

手术室外来器械的零风险管理

目的探讨手术室外来器械零风险管理的方法及其效果。方法了解手术室外来器械的使用情况,加强手术室外来器械的管理,以有效提高医疗安全,确保患者的手术安全,依此制定了行之有效的管理措施。对2003年至2011年术后患者的感染率进行比较。结果2006年采取严格的管理措施以来,术后感染率明显下降。结论外来器械设计精良、针对性强,对患者的伤害小、预后效果好,有利于医院获得良好的社会与经济效益。加强对手术室外来器械及其业务人员的管理能够有效地减少医疗安全隐患,确保手术安全。     

手术室外来器械清洗灭菌效果监测管理

[目的]对手术室外来手术器械进行规范化管理,提高手术器械的清洗、灭菌质量,防止手术室医院感染。[方法]将外来手术器械统一到消毒供应室进行专业化的清洗、打包、灭菌后,送手术室备用,对规范化管理前后所使用的外来手术器械的清洗、灭菌质量进行统计。[结果]实施规范化管理前,手术室外来手术器械清洗质量不合格的发生率为3.0%,因清洗不合格而影响手术不能正常进行的发生率占清洗不合格器械的20.6%;实施规范化管理后,清洗质量不合格的发生率及影响手术正常进行的发生率均降至0。[结论]对手术室外来手术器械进行清洗、灭菌的规范化管理,能确保手术器械的清洗、灭菌质量,防止手术医院感染,保障手术医疗安全。     

手术室外来器械清洗灭菌效果监测管理

[目的]对手术室外来手术器械进行规范化管理,提高手术器械的清洗、灭菌质量,防止手术室医院感染.[方法]将外来手术器械统一到消毒供应室进行专业化的清洗、打包、灭菌后,送手术室备用,对规范化管理前后所使用的外来手术器械的清洗、灭菌质量进行统计.[结果]实施规范化管理前,手术室外来手术器械清洗质量不合格的发生率为3.0%,因清洗不合格而影响手术不能正常进行的发生率占清洗不合格器械的20.6%;实施规范化管理后,清洗质量不合格的发生率及影响手术正常进行的发生率均降至0.[结论]对手术室外来手术器械进行清洗、灭菌的规范化管理,能确保手术器械的清洗、灭菌质量,防止手术医院感染,保障手术医疗安全.     

外来骨科器械的管理实践

报告了手术室对外来骨科器械的管理实践.在手术室设立骨科专科组,对器械公司人员进行操作规范培训,实行准入制度,建立和完善了人员及器械的管理流程.通过加强人员管理和外来骨科手术器械的物流管理,保障了外来器械的安全使用.     

基层医院对外来器械的管理

目的针对外来器械在各医院间频繁流通的问题,改进传统的管理模式,以提高器械的清洗、消毒、灭菌及管理的有效性。方法对器械清洗、消毒、灭菌、发放至使用环节实施全程无缝隙管理:即细化外来器械清洗、消毒、灭菌环节管理,引入目视管理方法识别外来器械,科学调配器械保证手术供应,规范培训厂商跟台技术人员。结果使各种配套器械统筹、合理、有序地分配周转,有效地提高了对手术器械使用的管理,增加了急诊手术的应对能力。结论实施全程无缝隙管理,提高了外来器械质量,保证了患者安全。     

手术室外来器械的管理

【】 目的 有效控制手术室外来器械的清洗、灭菌质量,保证患者的手术安全。方法 参照卫生部2009年颁布的《医院消毒供应中心管理规范》,对医院手术室外来器械进行规范化化管理,对器械情况、手术医生的满意度及病人术后感染情况进行分析。结论 根据规范对外来器械进行管理, 有效提高了外来器械的完好率和消毒合格率, 进一步提高了手术医生的满意度, 降低了术后感染率。     

骨科术中外来器械与手术室器械污染监测对比分析

目的监测骨科术中外来器械和手术室器械污染情况,为外来器械管理提供参考.方法在骨科手术进行至2.5 h、3.5 h时由手术护士配合采集未使用的术中器械样本,其中外来器械98个,手术室器械75个.样本均置于37℃恒温箱中培养72 h后观察记录,肉汤混浊、变色、有生物膜生成视为阳性,肉汤透明清亮视为阴性.结果外来器械总体样本阳性率、3.5 h样本阳性率高于手术室器械,差异有统计学意义(P<0.05);外来器械组内比较,2.5 h和3.5 h间差异有统计学意义(P<0.05);手术室器械组内比较,2.5 h和3.5 h间差异无统计学意义(P>0.05).骨科手术中所用全部器械污染率2.5 h和3.5 h时比较差异有统计学意义(P<0.05).结论骨科术中外来器械污染率高于手术室器械,手术开始3.5 h时污染率明显高于手术室器械,外来器械的污染率随手术时间延长而升高;骨科手术器械整体采样阳性率偏高,且随手术时间延长呈升高趋势.     

医用锐器盒放置架的研制与应用效果分析

目的分析医用锐器盒放置架的临床应用效果,以改进锐器盒的使用效能。方法自行设计医用锐器盒放置架,对24名临床护士采用问卷法调查使用此装置前后的锐器伤发生率、锐器投放受伤率、护士满意度;采用观察法调查锐器投放的准确率、丢弃针头时弯腰发生率。结果临床护士锐器伤发生率由62.5%降至33.3%,锐器投放受伤率由1.42%降至0.53%,护士满意度由(46±5.9)分升至(92±4.3)分,锐器投放的准确率由80.00%升至98.78%,丢弃针头时弯腰发生率由80.00%降至10.20%。结论医用锐器盒放置架能有效提高护士操作时的易见性及可及性,降低锐器伤的发生,提高锐器投放的准确率及护士的满意度,显著改进锐器盒的使用效能。     

护理人员针刺与锐器伤现状的调查分析与预防对策

目的了解护理人员的针刺与锐器伤的情况,并探讨相应的防治对策。方法对我院12个病区护理人员进行为期8个月的针刺与锐器伤的调查分析。根据损伤情况对病员、护理人员进行包括HBV、HIV、梅毒螺旋体等相关指标的检测,并在24h内作必要防治,所有受伤者如实填写完整的调查表,并由EPINet软件进行数据处理。结果43例护理人员的针刺与锐器伤中,针头造成的损伤占83.7%,而其他锐器造成的损伤占16.3%。检查发现,针头与锐器受污染占88.4%,而未受污染仅为11.6%,两者有非常显著统计学差别(P<0.01)。结论应加强临床护理管理,减少针刺等造成的损伤,避免感染等继发职业伤害。     

Developing and testing instruments for improving cooperation and patient's participation in mental health care

The main purpose of the project was to develop computerized instruments that could be used by nurses and patients to assess their cooperation and mutual contributions to care. This paper presents a part of the project: the reliability and validity testing phase of a process of instrument development. To test the validity and reliability of the instruments, data were collected with questionnaires from nurses (n = 146) and patients (n = 286). The validity evaluated as construct validity and the reliability evaluated as internal consistency of the instruments were quite good. Construct validity was tested by factor analysis, and internal consistency was tested by Cronbach's alpha coefficient, which varied from 0.69 to 0.79. The instruments, which consisted of a software application that can be operated in a www environment, were meant to be used as tools in the psychiatric nursing context for assessing the cooperation between the nurses and patients and the patient's participation in his/her care. Furthermore, the computer programme can be used as a tool for developing and assessing the patient orientation in nursing.     

全员参与管理模式在ICU仪器管理中的应用

[目的]在重症医学科的仪器管理中应用全员参与管理模式,以更好地做好仪器的维护,提升病区仪器管理水平。[方法]建立树枝状分级的管理小组,全员参与仪器管理,建立完善的仪器管理规范,进行知识和技能培训。[结果]实施全员参与管理模式后,仪器的故障发生率由24.9%降至14.8%,护士使用仪器的满意度由59.9%升至91.2%,全科护士仪器使用理论和操作考核得分均有提高。[结论]实施全员参与仪器管理模式,确保了医疗质量和病人安全,提高了护士使用仪器的满意度,提高了全科护士的仪器使用技能,提升了护理质量,提高了对仪器等的管理能力。     

Nurses' views on the use, quality and user satisfaction with electronic medical records: questionnaire development

AIM: This paper is a report of the development of an instrument to measure nurses' views on the use, quality and user satisfaction with electronic medical records systems. BACKGROUND: Use of electronic medical records systems in hospitals is steadily increasing, yet no validated instruments have assessed the effectiveness of these systems from the viewpoint of nurses. METHOD: Items were designed following a literature review based on three main constructs: use, quality and user satisfaction with electronic medical records. Reliability and validity were examined based on responses from 1,666 nurses from 42 hospitals in Japan in February 2006. Exploratory factor analysis was conducted to determine the degree to which each item within a construct was associated. The reliability of each resultant factor was computed using Cronbach's alpha coefficient. Content validity was addressed by basing the items on previous surveys and review of the instrument by a panel of nurses experienced in nursing informatics. Construct validity was examined through factor analysis and correlational analyses. FINDINGS: Extent of 'use' of electronic medical records resulted into three factors with good factor loadings, but only two had acceptable reliability. 'Quality' of electronic medical records had two factors with good factor loadings and reliability. 'User satisfaction' with electronic medical records had three factors, but only one had acceptable reliability. 'Use' and 'quality' constructs were positively correlated with 'user satisfaction'. CONCLUSION: The final instrument incorporates 34 items from the original 44-item pool. Initial validity results were positive and therefore the instrument can be used in evaluating electronic medical records in hospitals.     

实习护生锐器损伤状况调查及对策

目的了解实习护生锐器伤情况,并探讨相关对策。方法采用问卷调查方法,对在本院实习的140名护生发生锐器伤情况进行调查。结果140名护生中,发生锐器伤的有112人次,其中针刺伤68人次,占60.7%;玻璃伤36人次,占32.2%;刀割伤5人次,占4.5%;其他3人次,占2.7%。发生的主要原因依次为：输液及注射结束拔针时、回收毁形时、手掰安瓿时、静脉加药时、抽血拔针时和其他原因。结论加强实习护生岗前相关职业防护知识的培训,严格遵守操作规程,加强带教老师的责任感,对降低实习护生锐器伤的发生具有积极的作用。     

Self-assessment of nursing competencies – validation of the Finnish NCS instrument with Italian nurses

Aim: Research focusing on competence assessment of practicing nurses has recently increased. However, few generic instruments are available for this purpose. This study reports cultural validation of the Italian version of the Nurse Competence Scale (NCS, English version) by exploring nurses’ perceptions of the use of the NCS instrument. Methods: Content validity of the Italian version of the NCS was assessed during the translation and back‐translation process. Thereafter, cultural validity was further explored by conducting self‐assessments and semi‐structured interviews with 10 nurses, who practise medicine, cardiology and intensive care wards. First, the Italian version of the 73‐item NCS was used to assess nurses’ competence levels and the frequency of using competencies in practice settings. Second, semi‐structured interviews were conducted to evaluate nurses’ perceptions of the use of the instrument. Results: The advanced beginners obtained a high overall competence level and the experienced nurses a very high overall competence level. These results are similar with the earlier findings of nurse competence levels with the NCS. The overall frequency of using NCS competencies in clinical practice indicated good cultural validity of the instrument. The instrument was considered easy to understand and to complete, and the Italian version was considered to express the domain of nursing. However, a need to make semantic specifications for some items for the Italian version was pointed out. Conclusions: This explorative pilot study reports a first phase cultural validation process. Carefully performed translation alone does not ensure validity of translated instrument. Interview method is recommended to deepen the understanding of concept in question and the content validity of the instrument. The results support previous research findings of the use of the NCS instrument and show that it could be very useful in competence assessment for Italian nurses.     

消毒供应中心与口腔科护士处理口腔器械的效果对比

[目的]探讨消毒供应中心统一处理口腔器械的效果.[方法]将2008年由口腔科护士处理的口腔器械抽样5 000件设为对照组,2009年由消毒供应中心人员按标准流程处理的口腔器械抽样5 000件设为观察组,进行清洗质量;不同包装,同一脉动真空压力蒸汽灭菌器灭菌的器械质量;口腔科医生和椅旁护士满意度比较.[结果]由消毒供应中心处理的口腔器械其清洗质量,包装、灭菌质量,口腔科医生和椅旁护士对器械质量的满意度均高于口腔科护士处理的口腔器械(P<0.001).l结论]口腔器械由消毒供应中心统一处理,能保证器械质量,有效控制医院感染,保证病人安全.     

肿瘤科护士锐器伤发生因为及预防对策

目的 探讨肿瘤科护士锐器伤发生原因及预防管理对策.方法 2006年6月-2008年5月,采用医疗锐器伤登记表收集护士锐器伤情况,并对相天数据资料进行统计分析.结果 24名护士(5.71人次/100张床)发生锐器伤,主要发生于护龄≤1年的护士(66.67%);发生时间多集中在上午8:30～11:00之间(41.67%);...     

护理人员锐器伤后心理状态与相关影响因素调查

目的:探讨护理人员发生锐器伤后的心理状态及其影响因素,为锐器伤教育干预提供基础依据.方法:采用自行设计的护理人员职业锐器伤调查表,对5所综合医院977名在岗护理人员的锐器伤发生情况进行回顾性问卷调查.结果:97.5%护理人员曾发生锐器伤,67.8%护理人员发生锐器伤后感到害怕;4.4%护理人员感到悲观;27.8%护理人员感到不怕.发生锐器伤后护理人员心理状况学历间、职称间无差异;职称越低、护龄越短者心理负担越重.结论:职业心态和心理素质是影响护理人员身心健康的主要因素,加强对护理人员锐器伤防护培训、教育干预,可缓解其心理压力,减少伤者心理伤害.