医院到家庭连续护理干预对持续植物状态出院患者的效果

目的探讨对持续植物状态出院患者实施医院到家庭连续护理干预的效果。方法将47例持续植物状态出院患者按照不同社区分为对照组(23例)和观察组(24例)。对照组采用常规出院康复指导及电话随访,观察组建立一个微信群实施医院到家庭的持续护理干预。干预1年后对两组患者的并发症发生率及再住院、急诊、门诊就诊次数进行统计。结果观察组干预1年后并发症发生率及再住院次数显著低于对照组(P<0.05,P<0.01)。结论医院到家庭连续护理干预可降低持续植物状态出院患者并发症发生率及再住院率。     

协同护理模式对妊娠糖尿病患者家庭功能和妊娠结局的影响

目的探讨协同护理模式对妊娠糖尿病患者家庭功能和妊娠结局的影响。方法选择妊娠糖尿病患者128例,采用随机数字表法分为对照组(64例)和观察组(64例)。对照组实施常规护理,观察组实施协同护理模式。以家庭功能评定量表(FAD)评价干预前和干预后家庭功能及比较两组的妊娠结局。结果干预后观察组家庭功能各维度得分显著高于对照组(P<0.05,P<0.01)。观察组剖宫产、早产、胎膜早破、羊水过多、产后出血感染、糖尿病急性并发症发生率较对照组显著降低(P<0.05,P<0.01)。观察组巨大儿、宫内窘迫、新生儿低血糖发生率较对照组显著降低(P<0.05,P<0.01)。结论应用协同护理模式能提高患者的家庭功能,降低围生期不良并发症,提高自然分娩率,改善母婴预后。     

照顾者同步随访对老年髋部骨折患者术后康复的影响

[目的]探讨照顾者同步随访干预对老年髋部骨折患者术后康复的影响。[方法] 2019年2～12月入住骨科一病区的42例患者及主要照顾者为干预组,同期入住骨科二病区的40例患者及主要照顾者为对照组,干预组在常规出院指导基础上,对患者及主要照顾者进行为期3个月的同步随访干预,对照组仅接受常规出院指导。[结果]术后3个月内,干预组并发症发生率为7.14%;对照组为27.50%;两组间比较差异有统计学意义(P0.05)。干预3个月后干预组SF-36评分显著优于对照组(P0.05)。干预3个月后干预组主要照顾者自我效能评分显著高于对照组(P0.05);而干预组主要照顾者SAS评分显著低于对照组(P0.05)。[结论]基于医院随访平台对患者及主要照顾者实施同步随访干预,能够增加主要照顾者的自我效能感、缓解焦虑情绪,有效降低患者术后并发症发生率,改善生活质量。     

以家庭为中心的赋权模式在PICC化疗患者中的应用

目的探究以家庭为中心的赋权模式对PICC化疗患者家庭照顾者照顾能力和照顾准备度的影响。方法将122例行PICC置管化疗的恶性肿瘤患者及其家庭照顾者随机分为对照组与赋权组各61例。对照组给予肿瘤科常规护理,赋权组实施以家庭为中心的赋权模式护理。结果干预后赋权组患者家庭照顾者照顾能力及照顾者准备度显著优于对照组(均P<0.01)。结论以家庭为中心的赋权模式可提高家庭照顾者的照顾能力和照顾准备度。     

家庭护理干预对晚期老年痴呆患者家居安全及并发症的影响

目的探讨提高晚期老年痴呆患者家居安全,减少并发症发生率的有效方法。方法将47例晚期老年痴呆患者随机分为观察组24例,对照组23例。对照组采用常规出院指导,出院后不进行护理干预;观察组对患者、家庭照顾者进行为期1年的老年痴呆相关知识和护理技能、家居安全等家庭护理干预,指导照顾者为患者进行预防肺部感染、泌尿系感染、压疮,肢体功能锻炼,并对照顾者进行心理疏导等。比较两组干预1年期间全身并发症及家居安全意外发生率。结果观察组肺部感染、泌尿系感染、压疮发生率及家居安全意外发生率显著低于对照组(P0.05,P0.01)。结论充分有效的家庭护理干预可减少晚期老年痴呆患者并发症的发生,延缓病情进展,提高其家居安全。     

首发脑卒中患者照顾者家庭抗逆力干预方案的构建及应用

目的 构建首发脑卒中患者照顾者家庭抗逆力干预方案,并评价其应用效果。方法 通过文献研究、德尔菲专家函询及预试验构建首发脑卒中患者照顾者家庭抗逆力干预方案。将首发脑卒中患者照顾者按入院时间分为对照组41人和观察组40人;对照组实施常规护理,观察组在此基础上实施首发脑卒中患者照顾者家庭抗逆力干预方案。比较两组干预前、干预后1、3个月家庭抗逆力、脑卒中照顾者综合照顾能力及照顾者负担评分。结果 干预后,观察组照顾者家庭抗逆力、综合照顾能力评分显著高于对照组,照顾者负担评分显著低于对照组(均P<0.05)。结论 首发脑卒中患者照顾者家庭抗逆力干预方案能显著提高照顾者家庭抗逆力和综合照顾能力,降低照顾负担。     

出院准备计划在长期卧床患者压力性损伤管理中的应用

目的探讨出院准备计划在长期卧床患者压力性损伤管理中的应用效果。方法将60例长期卧床患者随机分为对照组和干预组各30例。对照组按照常规护理,出院后实施电话随访,干预组在此基础上实施出院准备计划干预。出院3个月后比较两组患者压力性损伤发生率及照顾者照顾行为的差异。结果患者出院3个月后,干预组压力性损伤发生率显著低于对照组,照顾者照顾行为得分显著高于对照组(P0.05,P0.01)。结论实施出院准备计划干预可改善照顾者的照顾行为,从而降低长期卧床患者压力性损伤发生率。     

中国期刊全文数据库核心期刊肿瘤护理文献评析

目的了解居家老年留置导尿患者家庭护理的现状,为护士开展家庭护理与指导提供依据。方法采用问卷调查法,对93例家庭老年留置导尿患者及其照顾者进行调查。结果62．4％的患者更换导尿管的时间为1个月及以上,24．7％的患者每日消毒会阴及尿道口,74．2％的患者集尿袋的使用时间超过1周以上;100％的患者发生泌尿系感染,49．5％的患者出现尿路刺激症,39．8％的患者出现漏尿现象。结论居家老年留置导尿患者家庭护理现状不容乐观,家庭照顾者护理患者往往带有盲目性和随意性。需加强对照顾者和患者出院健康教育,社区护士提供相应的护理指导及信息支持,以有效降低居家老年留置导尿患者并发症的发生,提高其生活质量。     

居家老年留置导尿患者家庭护理现状调查

目的了解居家老年留置导尿患者家庭护理的现状,为护士开展家庭护理与指导提供依据。方法采用问卷调查法,对93例家庭老年留置导尿患者及其照顾者进行调查。结果62.4%的患者更换导尿管的时间为1个月及以上,24.7%的患者每日消毒会阴及尿道口,74.2%的患者集尿袋的使用时间超过1周以上;100%的患者发生泌尿系感染,49.5%的患者出现尿路刺激症,39.8%的患者出现漏尿现象。结论居家老年留置导尿患者家庭护理现状不容乐观,家庭照顾者护理患者往往带有盲目性和随意性。需加强对照顾者和患者出院健康教育,社区护士提供相应的护理指导及信息支持,以有效降低居家老年留置导尿患者并发症的发生,提高其生活质量。     

居家老年留置导尿患者家庭护理现状调查

目的了解居家老年留置导尿患者家庭护理的现状,为护士开展家庭护理与指导提供依据。方法采用问卷调查法,对93例家庭老年留置导尿患者及其照顾者进行调查。结果62．4％的患者更换导尿管的时间为1个月及以上,24．7％的患者每日消毒会阴及尿道口,74．2％的患者集尿袋的使用时间超过1周以上;100％的患者发生泌尿系感染．49．5％的患者出现尿路刺激症,39．8％的患者出现漏尿现象。结论居家老年留置导尿患者家庭护理现状不容乐观,家庭照顾者护理患者往往带有盲目性和随意性。需加强对照顾者和患者出院健康教育,社区护士提供相应的护理指导及信息支持,以有效降低居家老年留置导尿患者并发症的发生,提高其生活质量。     

首诊责任护士家庭跟进照料对老年卧床患者出院指导依从性的影响

目的 探讨首诊责任护士家庭跟进照料模式对老年卧床患者出院指导依从性及护理满意度的影响.方法 将出院后回归家庭的120例老年卧床患者分为对照组与观察组各60例.对照组为轮班制责任护士按常规登记资料及评估患者情况,访视及实施护理干预措施;观察组则为首诊责任护士从入院首次接诊到患者回归家庭全程负责该患者的访视及护理干预.比较两组患者对出院指导依从性及护理满意度.结果 观察组在系统治疗、康复锻炼、并发症预防、生活方式、按时复诊方面依从性显著高于对照组（P＜0.05,P＜0.01）,护理满意度显著高于对照组（P＜0.01）.结论 采用首诊责任护士家庭跟进照料模式可密切护患关系,提高患者对出院指导的依从性和护理满意度,改善老年卧床患者健康预后.     

脑卒中患者出院后的亲情化延续护理

目的探讨亲情化延续护理对脑卒中患者日常生活能力(ADL)、遵医行为及满意度的影响。方法将105例临床治愈出院的脑卒中患者随机分为观察组(54例)和对照组(51例),均于出院后第7、14、30天各随访1次,以后每月随访1次,连续6个月。对照组采取电话回访或返院咨询方式;观察组采取成立亲情延续护理中心,上门访视与指导、制作亲情卡等亲情延续护理方式。结果观察组Barthel指数、4项遵医率及满意度显著高于对照组(P<0.05,P<0.01)。结论亲情化延续护理可提高脑卒中患者的ADL,提高遵医率,提高满意度。     

系统化护理干预对人工肛门患者排便习惯的影响

目的 观察系统化护理干预对改善直肠癌术后人工肛门患者排便习惯的效果.方法 将76例患者按住院时间分为观察组(53例)和对照组(23例).观察组采用系统化护理干预,包括术前的心理护理和排便指导、术后针对性的护理干预指导以及出院后的追踪护理指导;对照组采用常规护理.结果 观察组对人工肛门心理上完全接受的时间为(2.3±0....     

Midnight removal of urinary catheters — Improved outcome after gynecological surgery

By convention, most indwelling urethral catheters are removed in the morning. The authors carried out a randomized prospective study of 101 patients with postoperative urethral catheters and compared midnight removal with the more usual practice of morning removal. Patients were randomized into two groups: group A (n=46) had their catheters removed at 6:00 am and group B (n=49) had their catheters removed at midnight. Six patients were excluded from the study (1 patient on distigmine and 5 with preexisting urinary tract infections). The groups were comparable in age, use of night sedation, operative procedures and incidence of postoperative urinary tract infections. Patients in group B passed urine a median of 1 hour 40 minutes earlier, with a median volume 175 ml greater than group A (P=0.012 and <0.001); 13 patients in group A subsequently required recatheterization for urinary retention, compared to only 6 patients in group B. Patients in group B were also discharged significantly earlier from hospital (median of 2 days earlier from removal of catheter) than those in group A (P=0.032). Midnight removal of indwelling catheters after gynecologic surgery significantly decreases hospitalization and improves bladder function in terms of time and volume of first void.     

多学科合作干预对广泛性全子宫切除术后患者膀胱功能恢复的影响

目的探讨多学科合作干预促进广泛性全子宫切除术后患者膀胱功能恢复的临床效果。方法将150例广泛性全子宫切除术患者按住院时间分为对照组与观察组各75例。对照组实施常规护理,观察组在对照组的基础上给予多学科合作干预。比较两组术后尿管留置时间、泌尿系感染发生率;术后1个月进行膀胱功能评估量表评分、残余尿测定及尿动力学检测。结果观察组术后尿管留置时间显著短于对照组,泌尿系感染发生率显著低于对照组(P0.05,P0.01);术后1个月观察组膀胱功能恢复程度、最大尿流率、逼尿肌收缩力、最大膀胱容量显著优于对照组,膀胱功能评分显著低于对照组(P0.05,P0.01)。结论多学科合作干预可促进广泛性全子宫切除术后患者膀胱功能恢复。     

Chronic indwelling catheter replacement before antimicrobial therapy for symptomatic urinary tract infection

PURPOSE: We determined whether routine replacement of a chronic indwelling catheter before instituting antimicrobial therapy leads to an improved bacteriological or clinical outcome when treating symptomatic urinary tract infection in elderly nursing home residents. MATERIALS AND METHODS: We performed a prospective randomized open clinical trial at 2 long-term care facilities. Patients were randomized to indwelling catheter replacement before initiating antimicrobial therapy or no replacement. Urine and blood cultures were done before antimicrobial therapy began. Clinical and microbiological outcomes were assessed after 3 days of therapy, and 7 and 28 days after therapy was complete. RESULTS: Enrolled in our study were 21 male and 33 female nursing home residents with a mean age of 72.6 years, a chronic indwelling catheter and a clinical diagnosis of urinary tract infection. A total of 27 cases were randomized to either catheter replacement and no replacement before antimicrobial therapy. Polymicrobial bacteriuria significantly decreased 3 days after therapy was initiated, and 7 and 28 days after it was discontinued in 24 versus 8 (p = 0.002), 18 versus 9 (p = 0.01) and 13 versus 5 (p = 0.02) patients with and without catheter replacement, respectively. Catheter replacement was also associated with a shorter time to afebrile status, improved clinical status 72 hours after the initiation of therapy in 25 versus 11 patients (p <0.001) and a lower rate of symptomatic clinical relapse 28 days after therapy in 3 versus 11 (p = 0.015). CONCLUSIONS: Clinical and bacteriological outcomes are improved when long-term indwelling catheters are replaced before initiating antimicrobial therapy for symptomatic urinary tract infection.     

出院患者短信息随访系统的创建与应用

目的寻找最佳的出院患者健康教育方法。方法将2008年出院的32330例患者采用传统随访方法(对照组),对2009年出院的36099例患者采用短信息随访系统实施随访及健康教育(观察组)。结果观察组患者表扬医护人员次数及患者提合理化建议数显著高于对照组(均P<0.01);实施短信息随访系统后,住院患者满意度显著提高(P<0.05)。结论建立短信息随访平台实施出院患者随访及健康指导能及时有效解决出院患者的护理问题,增加患者对医院及医护人员的信赖,提高患者满意度,减少医护人员外出随访,减轻临床工作量,提高工作效率和社会效益。     

Initial bladder management in spinal cord injury: does it make a difference?

We classified 204 patients with acute spinal cord injury into 1 of 5 groups according to the initial form of urological management. Group A patients were placed on an intermittent catheterization program within 36 hours of injury, group B received a suprapubic trocar within 36 hours of injury, group C had urethral catheters in place for more than 36 hours before intermittent catheterization was begun, group D was on indwelling urethral catheter drainage throughout the hospitalization and discharged from the hospital with indwelling catheters, and group E was placed on intermittent catheterization in a community hospital. There were no statistically significant differences among the groups in the incidence of chills and fever, rate of urinary infections (excluding group D), incidence of upper tract changes, genitourinary complications or frequency of urological procedures at 1 year after injury. We conclude that the method of initial bladder management is relatively unimportant in determining the urological prognosis after spinal cord injury.     

Clamping short-term indwelling catheters: a systematic review of the evidence.

OBJECTIVE: The objective of this review is to determine the effects of clamping short-term indwelling urethral catheters before removal on the incidence of urinary tract infection, time to first void, voiding dysfunction, incidence of recatheterization, and the length of hospital stay. MATERIALS AND METHODS: Published and unpublished randomized and quasi-randomized controlled trials, completed between January 1966 and July 2004, in English and other languages that compared the effects of clamping short-term indwelling urethral catheters, were systematically reviewed using multiple electronic databases. Determination of eligibility of trials for inclusion in the review, assessment of methodological quality, and data extraction were undertaken independently by 2 reviewers. Relative risks for dichotomous data and a weighted mean difference for continuous data were calculated with 95% confidence intervals. Where synthesis was inappropriate, a narrative overview has been undertaken. RESULTS: Three trials that investigated the effect of clamping the indwelling urethral catheter compared to free drainage before removal were eligible for inclusion. Two trials reported no significant difference in the incidence of urinary tract infection (UTI), number of patients who developed urinary retention or required recatheterization, and the length of hospital stay between the 2 groups. Another reported that the postvoid residual urine volume for patients who did not receive reconditioning of the bladder increased from 4.25 mL at baseline to 42.25 mL after removal of the indwelling urethral catheter, whereas the residual urine volume for patients who received reconditioning increased from 17.25 mL at baseline to 22 mL at follow-up. CONCLUSIONS: The evidence for clamping indwelling urethral catheters before removal remains equivocal. Given the current state of evidence, procedures relating to clamping of indwelling urinary catheters should not be initiated. Until stronger evidence becomes available, however, practices relating to clamping indwelling urethral catheters will continue to be dictated by local preferences and cost factors.     

基于智慧病房系统的智慧护理在呼吸与危重症医学科的实施

目的 探讨基于智慧病房系统的智慧护理在呼吸与危重症医学科的实施效果.方法 将呼吸与危重症医学科的一病区161例患者分为常规护理组,二病区160例患者分为智慧护理组;两组护士均为14人.常规护理组行常规护理;智慧护理组优化实施输液管理、健康教育、医嘱核对、诊疗护理信息查询、结构化护理文书书写、智能化护理质量管理等.实施2...