强化管理 搞好临床护理带教

我院是一所拥有500张床位的综合性三级医院,担负着几所护校的教学任务。为顺利完成临床教学任务,让护生在我院学到更多的护理理论和实践知识,为社会培养出优秀的护理专业人才,我院领导从上到下严抓教学管理,建立健全科学的管理系统,制订周密的临床护理教学计划,并认真组织实施。在提高护理带教人员素质的基础上,以言传身教带动护生整体素质的提高,圆满完成了使护生到护士的过渡工作,受到委托学校的普遍好评。我们的主要做法是:     

落实《中国护理事业发展规划纲要（2005～2010年）》，有效促进护理事业发展

为促进护理工作持续协调发展,全面提高护理质量,满足人民群众的健康需求,卫生部于2005年颁布了《中国护理事业发展规划纲要（2005～2010年）》。为认真落实纲要目标,我院结合工作实际,制订了护理工作规划与目标,并通过一定措施,完善制度标准,健全工作机制。经过3年的努力,我院护理事业得到全面、协调、可持续的发展,基本完成和达到《规划纲要》2008年阶段性任务和目标,为下一步任务和目标的完成打下了坚实的基础。现将具体护理工作总结如下：     

临床路径管理在提高护理质量和安全中的应用与效果

目的 探讨临床路径管理在提高护理质量和安全的效果和作用.方法 对我科2011年3月-2013年6月收治的实施临床护理路径管理的130例患者进行调查,并随机抽取我院同期收治的实施常规护理活动的130例进行对比.结果 两组患者均完成护理,路径组患者能很好按临床护理路径制定内容完成各项治疗和护理,提高了患者的依从性,平均住院天数及住院费用均明显低于常规护理组,有显著差异性（P＜0.05）.路径组患者满意度为97.1％,常规组患者满意度为92.5％,两组比较有显著差异性（P＜0.05）.结论 临床护理路径使护士在执行护理任务时以更简便、更科学、更规范的护理程序对患者进行各方面综合护理,最大限度满足患者各方面的需求,也为和谐护患关系,提高护理治疗和安全提供有利条件,具有十分重要的意义.     

融入"护理程序"的护理《药理学》教学改革实践和探讨

根据高职高专护理专业的人才培养目标,通过导入临床案例实行任务驱动教学,融入用药护理程序完成任务实施,使学生对用药护理有一个全面的、系统的了解,提高学生药理学学习兴趣和效果,树立学生以患者为中心的护理理念,提高护理服务质量.     

儿科护理差错事故发生的原因及其防范措施

目的:探讨儿科护理差错事故发生的原因及其防范措施。方法:回顾性分析我院差错事故发生的原因,进行分析并寻找防范措施。结果:儿科护理差错事故的发生与儿科护理工作任务繁重、护理操作水平不高、护士责任心不强、护患沟通不足等有关。有效的防范措施为严格查对制度、提高业务素质、加强护理管理、加强护患沟通等。结论:出现差错有很多原因,但实施积极的预防措施可避免其差错的发生。     

内科实施“创优质护理服务活动”中的不利因素分析与对策

为贯彻落实2010年全国卫生工作会议精神及深化医药卫生体制改革各项重点任务,加强医院临床护理工作,落实基础护理,为人民群众提供安全、优质、满意的护理服务,我院率先在内科开展"优质护理服务示范工程"活动。自实施以来,通过护理部调查,各项基础护理落实不佳,病人满意度上升幅度不大。为彻底落实文件精神,提高我院护理质量,做到社会满意、政府满意、患者满意,特分析了我院内科"创优"中的不利因素,并制订了对策。鼓励和促进医院加强基础护理,借"创优"之机深化专业内涵,改善服务质量,推动护理事业的发展。     

5s理论在基层医院门急诊输液室的应用体会

我院为企业基层医院，门诊输液室在承担输液任务的同时兼顾急诊室的职责，工作琐碎，繁忙，突发事件多，工作常处于无序状态，容易发生不良事件和护理纠纷，为规范工作秩序，提高护理质量，体现优质护理服务工程的价值，满足病人对护理服务的需求，我院自2010年以来，将5S理念导入门急诊输液室的管理，开展5S活动，对提高护理质量，提高病人满意度，取得了良好效果，现报道如下.     

心里护理对心脏病患者护理效果的影响分析

目的:探讨心里护理在心脏病患者护理中的效果及其影响.方法:在我院2012年1月~2013年6月进行护理的50例心脏病患者,在进行常规护理的同时给予这50例心脏病患者心里护理,统计给予心里护理前后心脏病患者对我院护理的满意程度并进行对比,分析心里护理对心脏病患者护理效果的影响.结果:给予心里护理后心脏病患者对护理的满意度明显比给予心里护理前的满意度高,(P<0.05)为差异具有统计学意义.结论:心里护理对心脏病患者的护理效果显著,能够有效提高对心脏病患者护理工作的质量,值得临床护理的推广及应用.     

浅谈当代护士长的素质

目前,我国护理事业正处在发展、振兴、急起直追国际先进水平的阶段,加强护理队伍的管理、培养是迫在眉捷的任务.     

优质护理在手术室护理的应用及评价

目的:探讨优质护理在手术室护理中的应用,并评价其效果.方法:回顾性分析在我院手术室接受治疗的部分患者,对照组患者给予常规护理,观察组患者在对照组的基础上从术前宣教护理、术中护理及术后监测护理等方面开展优质护理,结论:优质护理可以有效提高手术室的护理质量,缓解患者手术全过程中出现的焦虑、抑郁情绪,提高患者及家属对于护理工作的满意度,值得应用与推广.     

L.I.F.E. and D.E.A.T.H

In this short, rhetorical article, I offer a thought experiment that seeks to make an analogy between ‘life’ and ‘disease’. This article was written whilst under the influence of Nietzsche, and I hope that readers will not mistake the polemical style and the occasional nod towards humour for flippancy. This is a serious subject, and this article attempts to ask, inexplicitly, a serious question. If we do suspend our subjective value judgements about life, and strip away what might be considered the ‘dogma’ of value in life, what effect might this have on our feelings towards voluntary euthanasia, and what can our reaction to that thought experiment tell us?     

A.S.P.E.N. Clinical Guidelines

Background: Children with severe intestinal failure and prolonged dependence on parenteral nutrition are susceptible to the development of parenteral nutrition–associated liver disease (PNALD). The purpose of this clinical guideline is to develop recommendations for the care of children with PN‐dependent intestinal failure that have the potential to prevent PNALD or improve its treatment. Method: A systematic review of the best available evidence to answer a series of questions regarding clinical management of children with intestinal failure receiving parenteral or enteral nutrition was undertaken and evaluated using concepts adopted from the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group. A consensus process was used to develop the clinical guideline recommendations prior to external and internal review and approval by the American Society for Parenteral and Enteral Nutrition Board of Directors. Questions: (1) Is ethanol lock effective in preventing bloodstream infection and catheter removal in children at risk of PNALD? (2) What fat emulsion strategies can be used in pediatric patients with intestinal failure to reduce the risk of or treat PNALD? (3) Can enteral ursodeoxycholic acid improve the treatment of PNALD in pediatric patients with intestinal failure? (4) Are PNALD outcomes improved when patients are managed by a multidisciplinary intestinal rehabilitation team?     

A.S.P.E.N. Clinical Guidelines

Background: Due to the high prevalence of obesity in adults, nutrition support clinicians are encountering greater numbers of obese patients who require nutrition support during hospitalization. The purpose of this clinical guideline is to serve as a framework for the nutrition support care of adult patients with obesity. Method: A systematic review of the best available evidence to answer a series of questions regarding management of nutrition support in patients with obesity was undertaken and evaluated using concepts adopted from the Grading of Recommendations, Assessment, Development and Evaluation working group. A consensus process, that includes consideration of the strength of the evidence together with the risks and benefits to the patient, was used to develop the clinical guideline recommendations prior to multiple levels of external and internal review and approval by the A.S.P.E.N. Board of Directors. Questions: (1) Do clinical outcomes vary across levels of obesity in critically ill or hospitalized non?intensive care unit (ICU) patients? (2) How should energy requirements be determined in obese critically ill or hospitalized non‐ICU patients? (3) Are clinical outcomes improved with hypocaloric, high protein diets in hospitalized patients? (4) In obese patients who have had a malabsorptive or restrictive surgical procedure, what micronutrients should be evaluated?