夜间配备二线班护士对提高夜间护理工作质量的探讨

目的 探讨临床各科建立二线值班护士制度对夜间护理工作质量的影响。方法 建立二线值班（二值）护士夜间值班制，参与夜间护理质量监控。结果 二值护士解决了夜间护理工作问题，并得到了一线护士、医生的高度评价。结论 二值护士值班制保证和提高了夜间护理工作质量，为夜间护理工作提供了优质的护理服务。     

急诊科护理工作对护士的素质要求

结合临床实践分析急诊科工作的基本特点，提出了对急诊科护理人员的素质要求：即要求护士要有良好的心理素质．扎实的理论知识和熟练的操作技能，要有很强的沟通能力和风险意识，同时还要不断加强慎独修养，从而提高急诊护理质量，及时挽救患者的生命和促进患者康复．     

提高急诊科护理质量探讨

急诊科的护理是护理工作的重要内容之一，它要求护理人员具有丰富的急诊工作经验，对各种常见病，多发病的主要临床表现要有所了解及掌握其相应的护理措施，在遇到问题就会迎刃而解。经验不是一朝一夕就能总结出来的，“积累”就在于朝朝夕夕，更重要的是在平日工作中学习，这就要求急诊     

急诊科实施二线护士节假日值班制的作用与效果

目的探讨某院急诊科实施二线护士节假日值班制以来对完善护理质量控制的作用.方法主要是国家法定节假日、周六和周日,由急诊科主管护师值班,采用8 h在班,24 h值班的原则指导并参与急危重症患者的抢救,解决护理疑难问题,协助应急事件的处理,协助护患工作的调解等.急诊科实施二线护士节假日值班制节假日护理考核与实施前的得分情况以及急诊科实施二线护士节假日值班制节假日满意度与实施前进行比较.结果急诊科实施二线护士节假日值班制节假日护理考核与实施前得分比较,差异有统计学意义(P<0.05),急诊科实施二线护士节假日值班制节假日满意度与实施前比较差异有统计学意义(P<0.05).结论急诊科实施二线护士值班制,对急诊科在节假日期间加强环节质量监控、确保护理安全、及时合理进行人员调控、及时解决护患矛盾、减轻护士心理压力、培养护士操作技能等方面起到了重要的作用.     

护理二线值班对夜间护理质量的影响

组建护理二线值班小组,解决了夜间儿科护理中发生的疑难问题和异常情况,减少了护理纠纷与投诉,减轻了值班护士心理压力和科室护士长的工作压力.护理二线值班小组夜间会诊有利于提高夜间护理质量,提高抢救成功率,利于护理管理者不断提高管理水平.     

夜间急诊科护士护理纠纷原因分析及防范对策

2001年1月～2005年7月，我们对16件夜间急诊科护士护理纠纷进行分析，以针对各项原因采取防范对策。现报告如下。     

实施护士二线双重值班制的探讨

[目的]探讨护士二线岗位24 h值班对夜间、节假日等薄弱环节护理工作质量的影响.[方法]建立护士二线24 h岗位值班,指导危重病人的护理及抢救,解决病区护理疑难问题,指导协助高难技术操作及突发事件的处理,同时以病房医生、住院病人及低年资护士为调查对象,对实施护士二线岗位值班制前后各项满意度进行比较.[结果]实施护士二线24 h岗位值班前后比较,医生对二线护士工作满意度、病人对护士工作满意度及低年资护士对二线护士工作满意度明显提高,差错发生率明显降低.[结论]实施护士二线岗位24 h值班是确保护理质量和护理安全的重要举措.     

科室设立总值班护士对提高护理质量的初探

设立科室总值班护士1名,协助中、夜班护理工作。设立夜班总值班护士后,及时解决了夜间护理工作中的疑难问题,减轻了夜班护士的心理压力,减少了护患纠纷,提高了护理质量。     

如何提高急诊科护理质量

急诊科是医院诊治急症病人的场所，是抢救病人生命的第一线。急诊质量的高低直接关系病人的安危；同时也反映医院的医疗技术水平、管理水平和医护人员的基本素质。我们常说“时间就是生命”，当危急情况发生时，必须分秒必争，在最短的时间内争取最大的抢救效果，以减少致残率和死亡率。这     

内科设总值班护士长对护理质量的控制效果

目的探讨内科总值班护士长制度对护理质量的控制效果。方法设立总值班护士长,负责内科各个护理单元晚夜班及节假日的护理质量管理,督导护理工作落实情况,协助科室进行危重患者的抢救并解决各类疑难护理问题,实现护理质量24h无缝隙管理。对总值班护士长制度实施前(2005年)和实施后(2010年)的效果进行比较。结果实施总值班护士长制度后,各项护理质量指标达标率逐年提高,且实施后与实施前比较,差异有统计学意义(P<0.05);按照住院患者对护理工作满意率≥90%的标准,实施前后内科护理工作满意度达标率分别为81.25%、97.73%,两者比较差异有统计学意义(P<0.05);实施5年来,共协助科室完成125次危重患者抢救,解决102例疑难护理问题。结论总值班护士长能够有效提高特殊时段的护理质量和护理安全,提高医院整体护理水平。     

Critical Clinical Events and Resilience Among Emergency Nurses in 3 Trauma Hospital-Based Emergency Departments: A Cross-Sectional Study

IntroductionEmergency nurses experience occupational stressors resulting from exposures to critical clinical events. The purpose of this study was to identify the critical clinical events for emergency nurses serving 3 patient populations (general, adult, pediatric) and whether the resilience of these nurses differed by the patient population served.MethodsThis study used a cross-sectional survey design. A total of 48 emergency nurses were recruited from 3 trauma hospital-based emergency departments (general, adult, pediatric). Clinical Events Questionnaire, Connor-Davidson Resilience scale, and an investigator-developed demographic questionnaire were used to collect data from respondents.ResultsAll respondents were female (n = 48, 100%), and most were White (n = 46, 96%). The average age of participants was 39.6 years, the average number of years as a registered nurse was 12.7 years, and the average number of years as an emergency nurse was 8.8 years. Clinical events considered most critical were providing care to a sexually abused child, experiencing the death of a coworker, and lack of responsiveness by a colleague during a serious situation. The least stress-provoking event was incidents with excessive media coverage. Nurses were less affected by the critical events they experienced more frequently at work. Nurses in the 3 trauma settings had high level of resilience, with no statistically significant differences between groups.DiscussionThe occupational stress from exposure to significant clinical events varied with the patient population served by emergency nurses. It is important that interventions be adopted to alleviate the effect of work-related stressors and promote the psychological health of emergency nurses.     

护理人员睡眠状况调查以及夜班工作对睡眠的影响

目的调查护理人员的睡眠状况,以及夜班工作对睡眠的影响.方法对348名护理人员、50名通讯值班员,100名夜勤人员进行匹兹堡睡眠质量指数测查和睡眠特征分析,采用DSM-Ⅳ标准进行失眠症诊断.结果护理人员中睡眠状况差者占71.86%,符合DSM-Ⅳ中原发性失眠诊断者占38.22%;通讯值班员该两项比例分别为74%和48%;夜勤人员分别为26.76%和7%.护理人员睡眠状况差与年龄、从事夜班年限有关;护理人员与通讯值班员的睡眠状况相似（ P〉0.05）,与夜勤人员的睡眠状况有非常显著性差异（ P＜0.01）.结论轮班工作方式对护理人员的睡眠状况影响较大,使其在入睡时间、睡眠时间、睡眠效率、日间功能等方面普遍存在一定障碍,但对此不倾向于使用药物治疗,可采用非药物疗法如穴位按摩、自我保健等.     

Verification of Endotracheal Tube Position by Emergency Nurses Using Ultrasound: A Repeated Measures Cadaver Study

IntroductionEndotracheal intubation is a lifesaving procedure frequently performed in emergency departments. It is associated with some potential risks. Rapid and reliable confirmation of endotracheal tube placement during intubation is critical. Nurses play an important role in the care of patients in various settings. Ultrasound can be performed and interpreted not only by physicians but also by nurses. The aim of this study was to evaluate how well nurses without previous ultrasound experience can determine both esophageal and tracheal localization of endotracheal tubes in cadavers after a short ultrasound training.MethodsThis was a repeated measures study with an educational intervention and no control/contemporaneous comparison group. The study was performed to evaluate the ability of emergency nurses to confirm correct endotracheal tube placement and identify esophageal intubations. A total of 7 emergency nurses were given theoretical education and hands-on training about ultrasound. They diagnosed tracheal or esophageal intubation using ultrasound.ResultsFour cadavers were used 8 times each for the study. A total of 32 intubation procedures were evaluated with ultrasound by each nurse. In the analysis based on 224 responses, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and overall accuracy of ultrasound applied by nurses to detect tracheal intubation were 95.61% (90.06%-98.56%), 97.27% (92.24%-99.43%), 35.06 (11.48-107.10), 0.05 (0.02-0.11), and 96.43% (93.08%-98.45%), respectively. The mean time to evaluate the tube location by ultrasound was 6.57 seconds.DiscussionThe results support that ultrasound can be performed by nurses for the confirmation for esophageal and tracheal intubations quickly and accurately.     

急诊护理质量与临床实践

如何加强和提高急诊护理质量,我院急诊科进行了一系列积极探索如建立各区护士岗位职责、建立晨交班理论查房与操作考核制度、建立突发事件应急处理预案、拟定各区常见问题解答、建立护士长24h值班制,使急诊护理质量有了明显提高。     

急救模拟训练对提高手术室护士急救技能的作用

目的通过对急救模拟训练前、后手术室护士急救技能水平的比较,探讨手术室急救技能教学方法的改进。方法对在手术室工作1-3年的护士进行急救模拟训练,由过去的单纯理论讲课改为和医生一起对急救的各个阶段进行综合模拟训练,并对训练前、后手术室护士急救技能水平进行比较。结果模拟训练后手术室护士掌握急救知识和操作技能均较训练前水平有明显提高(P<0.01)。结论(1)急救模拟训练可以明显增加手术室护士对急救知识的了解,并能够主动配合手术医生应对手术室的各种急救;(2)使手术室教学由抽象变为实际,更加易于理解和掌握。     

An Assessment of Emergency Nurses’ Perspectives on Nurse-Driven Human Immunodeficiency Virus Testing in the Emergency Department

IntroductionEngaging emergency clinicians in universal human immunodeficiency virus screening is paramount to achieving goals of reengaging human immunodeficiency virus–positive persons into care, identifying new human immunodeficiency virus cases, and linking them to care. The study aim was to identify beliefs and barriers towards opt-out human immunodeficiency virus testing among emergency nurses.MethodsA cross-sectional study used Qualtrics software to deliver a survey on a tablet device to emergency nurses in a private Level 1 trauma hospital in Houston, Texas during downtimes of their clinical shifts. The survey evaluated perspectives on human immunodeficiency virus screening and knowledge relative to rapid screening and human immunodeficiency virus prevalence rates locally and nationally.ResultsFifty emergency nurses were enrolled. Few nurses accurately identified human immunodeficiency virus prevalence rates at the local hospital and city level (10% and 42%, respectively). Most (54%) of nurses correctly estimated human immunodeficiency virus prevalence rates nationally. Nearly half of the nurses (42.0%) correctly predicted the cost of a rapid human immunodeficiency virus test with accuracy and most were willing to offer rapid human immunodeficiency virus testing all the time (60.0%). Eighty-eight percent of nurses were supportive of facilitating universal human immunodeficiency virus screening. However, 92.0% strongly supported human immunodeficiency virus testing for high risk patients only when compared to 80.0% support of testing for all eligible patients. Qualitative data revealed time constraints and follow-up concerns as barriers.DiscussionEmergency nurses reported barriers that sometimes prevented application of Centers for Disease Control and Prevention recommendations to human immunodeficiency virus screening. Strategies to overcome these barriers are instrumental to programmatic success. Solutions can corroborate the importance of emergency nurses to the nation’s Ending the HIV Epidemic plan.