急诊危重度指数在儿科急诊中的应用

目的 例证急诊危重度指数(ESI)在儿科急诊室的应用.方法 通过收集2006年7月至2010年8月,北京儿童医院国际部急诊21 904人次患儿的ESI分级资料,应用x2检验方法,回顾性对比分析医生和护士的分诊结果.结果 ESI容易掌握,护士分诊结果与医生矫正分诊结果有较好一致性.结论 ESI分诊系统适合儿科急诊分诊,能够迅速分检危重病例,有效利用临床资源.     

快速分诊评估系统在急诊患者中的应用

目的 研究针对急诊患者的快速分诊评估系统,建立评估模式及方法,筛选评估指标和内容,帮助分诊护士准确快速辨识急危重患者,使其得到及时救治,优化使用急救医疗资源.方法 筛选目标人群,采集相关资料研究分析,设计建立研究模型,采集涵盖急诊患者危急重症主要表现和特征的评估指标及内容,选择确定急诊分诊评估指引系统的表达形式.结果 将研究选定的评估指标、评估内容采用表格化形式表达,建立急诊护士快速分诊指引评估表,指导护士分诊工作.结论 本研究设计的急诊护士快速分诊指引评估表,简洁直观、使用方便,能有效地提高护士分诊工作质量,具有一定实用性、科学性和创新性.兼顾到以有限的急救医疗资源取得优质的急诊医疗服务的结果,具有一定的社会效益和经济效益.

Abstract：

Objective To study the quick triage assessment system for emergency nurse, establish evaluation model and method, select indicators and contents, guide triage nurses to be accurate, fast, convenient and practical, and also to optimize the use of emergency medical resources. Methods Screening the target population to conduct the research, collecting main indicators and features covered with main symptom and characteristics of severe critical emergency patients, selecting manifestation form of triage assessment system. Results The selected indicators and contents were demonstrated by a table-based form, and the quick triage assessment form for emergency nurse was established to instruct triage work. Conclusions This established quick triage assessment form is simple, intuitive and can improve the quality of emergency triage work. It possesses feasibility, practicality and achieves the optimal medical services with the limited emergency medical resources, which shows both social and economic effect.     

柔性管理干预对缓解儿科输液中心护士压力效果的研究

目的 探讨柔性管理对缓解儿科输液中心护士压力的方法与效果.方法 调查分析儿科输液中心护士工作压力的来源,采取柔性管理干预措施,包括:深化内涵建设,提高实际工作能力;合理配置、弹性排班;加大管理者的支持力度,建立良好的支持系统;更新观念,满足患者需求;加强护士心理健康教育等.比较干预前后护士应对方式评分变化.结果 儿科输液中心护士普遍存在压力,柔性管理干预前、后护士应对方式评分比较有显著性差异(P＜0.01).结论 柔性管理干预是缓解儿科输液中心护士压力的有效措施.

Abstract：

Objective To discuss the methods and effects of flexible management for alleviating nurse'stress in pediatric infusion center. Methods The source of working stress of pediatric infusion center nurses were investigated and analyzed. The flexible management interventions was adopted, including deepening the building of connotation, improving the actual working capacity; rational allocation and flexible scheduling; increasing the manager's supporting strength, establishing a good supporting system, updating the conception, meeting patients'requirement, strengthening mental health education for nurses and so on. The evaluation score variation of nurses between before and after intervention was compared. Results Working stress of the nurses in pediatric infusion center was widespread. The evaluation score of nurses was significant difference between before and after flexible management interventions (P＜0. 01) . Conclusions The flexible management intervention is an effective measure for alleviating the pressure of nurses in pediatric infusion center.     

心肌梗死后患者恢复性行为的康复宣教

INTRODUCTION Recovery of normal sexual activity is the rehabilitation objective of patients with myocardial infarction.Guide to sexual activity should not be neglected for patients and their spouses.Health sexual life is necessary for improvement of quality of life and recovery to society.However,traditional culture made nurses and doctors shirk sexual education,patients and their spouses are reluctant to talk the sex to their doctors.Sex life had been neglected.Anxiety and fear for sex can be cleared by special staffs.Nurse,therefore especially circulation nurses should comprehend techniques and knowledge about health education of sex life.     

Analysis of status quo and research progress in nursing of postpartum fatigue: a literature review

Postpartum fatigue is an important issue that threatens women’s health.The incidence of postpartum fatigue is high.Failure to intervene in time may lead to adverse outcomes such as postpartum depression,premature termination of breastfeeding,child abuse,and low infant development.This article reviews the concepts,characteristics,related factors,adverse effects,and interventions of postpartum fatigue.The aim is to improve doctors’and nurses’awareness of on postpartum fatigue in pregnant women,enrich the research content and methods,stimulate the interest of nurses,and actively carry out targeted intervention research to prevent or reduce the occurrence of adverse outcomes.     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

Application of emergency severity index in pediatric emergency department

BACKGROUND:

The purpose of triage is to identify patients needing immediate resuscitation, to assign patients to a pre-designed patient care area, and to initiate diagnostic/therapeutic measures as appropriate. This study aimed to use emergency severity index (ESI) in a pediatric emergency room.

METHODS:

From July 2006 to August 2010, a total of 21 904 patients visited the International Department of Beijing Children’s Hospital. The ESI was measured by nurses and physicians, and compared using SPSS.

RESULTS:

Nurses of the hospital took approximately 2 minutes for triage. The results of triage made by nurses were similar to those made by doctors for ESI in levels 1-3 patients. This finding indicated that the nurses are able to identify severe pediatric cases.

CONCLUSION:

In pediatric emergency rooms, ESI is a suitable tool for identifying severe cases and then immediate interventions can be performed accordingly.KEY WORDS: Pediatrics, Emergency Department, Triage, Emergency severity index     

护理岗位动态调度法在缓解急诊科拥挤现象中的应用效果

目的探讨护理岗位动态调度法在缓解急诊科拥挤现象中的作用。方法选取2010年1—6月及2011年1—6月急诊科18：00～1：00班次的各80名护士作为对照组及观察组。对照组护士使用传统的排班模式,实验组护士采用岗位动态调度法。对两组护士在患者、医生、护士满意度及护理质量检查结果进行比分析。结果对照组患者满意度为90．6％,医生满意度为82．0％,护士满意度为85．0％,实验组患者满意度为97．2％,医生满意度为96．0％,护士为96．3％,两组比较差异有统计学意义（X2分别为9．862,5．005,5．959,8．636;P〈0．05或P〈0．01）。结论启用护理岗位动态调度法后,提高了抢救室、输液室和留观室的处置效率,减轻了护士的劳动强度,使患者、医生及护士满意度得到了提升,有效地缓解了急诊科拥挤现象。     

应用微技能培训法提高急诊年轻护士应急能力效果分析

目的：探讨微技能培训法对提高急诊年轻护士应急能力的作用效果。方法对31名急诊年轻护士使用微技能培训法进行专科培训,比较其培训前后应急能力考核成绩、急诊专科疾病知识得分、急诊抢救技能得分及急救护理过程的执行时间。结果培训前护士应急能力考核评分如监护理论、抢救技术、个案护理得分分别为（85．93±4．30）,（86．17±3．68）,（83．14±4．70）分;培训后相应得分分别为（90．74±4．72）,（92．55±4．21）,（90．25±4．58）分,差异有统计学意义（t 值分别为-2．484,-2．665,-2．956;P＜0．05）。培训后护士急诊专科疾病知识得分与培训前比较差异有统计学意义（t值为-2．848～-2．472;P ＜0．05）。培训后护士急诊抢救技能总分为（88．05±4．66）分,培训前为（74．50±4．74）分,差异有统计学意义（t＝-4．824,P＜0．05）。培训后护士在急救护理过程执行时间与培训前比较差异有统计学意义（ t值为2．470～2．662;P＜0．05）。结论微技能培训法运用积少成多的策略,实行每日限时教学、反复强化记忆的方法,有效提高了护士急诊理论知识及专科性操作技能,提高了年轻护士的应急反应能力。     

急诊护士工作压力源及身体健康状况调查分析

目的了解急诊护士与病房护士工作中的主要压力源和心理压力及身体健康状况,减少压力以便提高工作质量及身心健康水平。方法采用问卷调查法对87名急诊护士、83名病房护士进行工作压力源、心理压力和身体健康状况调查。结果在工作压力源中的病人护理方面存在差异(P<0.05);心理方面和身体方面均比病房护士差。结论建议管理者减少或消除护士压力源,并对护士进行业务培训和心理压力训练以减轻工作压力。     

急诊医护人员手套使用情况的调查研究

目的了解急诊医护人员手套应用的现状，探讨有效的干预方法。方法对在急诊工作的医护人员，在未干预、不知情的情况下进行观察，记录更换手套的应用情况。结果医生在接触病人时的手套使用正确率显著高于接触自身时的正确率；护士在接触自身时的手套使用正确率显著高于接触病人时的正确率；在接触自身时手套使用的正确率上，护士显著高于医生。结论急诊医护人员手套使用是职业防护的薄弱环节。     

急诊医护人员手套使用情况的调查研究

目的了解急诊医护人员手套应用的现状,探讨有效的干预方法。方法对在急诊工作的医护人员,在未干预、不知情的情况下进行观察,记录更换手套的应用情况。结果医生在接触病人时的手套使用正确率显著高于接触自身时的正确率;护士在接触自身时的手套使用正确率显著高于接触病人时的正确率;在接触自身时手套使用的正确率上,护士显著高于医生。结论急诊医护人员手套使用是职业防护的薄弱环节。     

福建省儿科护士突发公共卫生事件应急能力培训现状调查

目的 调查福建省儿科护士突发公共卫生事件应急能力培训现状,提出针对性的干预策略。 方法 采用自行设计的“福建省儿科护士突发公共卫生事件应急能力培训现状调查问卷”对全省134家医院3379名儿科护士进行横断面问卷调查。结果 全省2470名（73.10%）儿科护士接受了突发公共卫生事件应急能力相关培训,近5年平均培训次数为3.62次;培训内容主要聚焦儿童危重症护理（59.39%）及基础生命支持部分（66.48%）;接受系统、完整儿童突发公共卫生事件应急能力培训的只有218名,占比8.83%。结论 福建省儿科护士参与突发公共卫生事件应急能力培训比例相对较高,但培训内容参差不齐,以急危重症护理及基础生命支持培训为主,接受系统、完整公共卫生事件应急能力培训的比例较低,迫切需要建立科学化、标准化、多元化的应急培训体系并在全省推广培训,从而提升全省儿科护理队伍应对突发公共卫生事件的应急能力水平。     

改良早期预警评分管理模式在急诊留观患者中的应用研究

目的 探讨改良早期预警评分(MEWS)在急诊留观患者风险管理中的应用价值.方法 通过动态监测MEWS,决定患者处理策略和去向;比较不同流向患者评分的差异;调查医生、护士对实施MEWS管理模式的满意度.结果 评分无动态变化的245例患者MEWS为(2.6±1.2)分;有动态变化的44例中,直接收住院的32例患者评分为(4.6±1.7)分;转抢救室12例患者评分为(6.2±2.4)分.各组患者评分比较差异均有统计学意义(2.6±1.2 vs.4.6±1.7,t=3.44,P=0.003;2.6±1.2 vs.6.2±2.4,t=5.10,P=0.000;4.6±1.7 vs.6.2±2.4,t=2.79,P=0.007);医生、护士对实施MEWS动态监测前后的留观患者管理满意度分别为75.5%和94.3%,前后比较差异有统计学意义(χ~2 =7.36,P＜0.01).结论 MEWS可作为急诊留观患者风险管理和合理分流的有效工具,值得临床推广.