专科护理延伸服务模式探讨

[目的]探讨专科护理延伸服务模式。[方法]由医院护理部组织成立社区延伸护理服务中心,由经过统一培训的专科护士利用业余时间深入社区为有延伸护理需求的病人提供服务。[结果]病人对延伸护理服务满意度较高,且延伸护理服务提高了专科护士的服务意识、专业知识和技能等,大多数专科护士认为延伸护理服务可行。[结论]专科护理延伸服务转变了护理服务模式,拓展了护理服务内容,可解决病人的紧急需求。     

专科护理延伸服务模式探讨

[目的]探讨专科护理延伸服务模式。[方法]由医院护理部组织成立社区延伸护理服务中心,由经过统一培训的专科护士利用业余时间深入社区为有延伸护理需求的病人提供服务。[结果]病人对延伸护理服务满意度较高,且延伸护理服务提高了专科护士的服务意识、专业知识和技能等,大多数专科护士认为延伸护理服务可行。[结论]专科护理延伸服务转变了护理服务模式,拓展了护理服务内容,可解决病人的紧急需求。     

我国二级、三级医院临床护士延伸护理服务认知情况的调查研究

[目的]调查我国临床护士对延伸护理服务的认知状况,为提高延伸护理服务质量、构建满足病人需求的延伸护理服务模式提供参考依据。[方法]对全国46所综合医院共1 941名临床护士进行问卷调查,内容包括对病人延伸护理服务需求的认知、对开展延伸护理服务意义的认知、对开展延伸护理服务的态度等,比较二级、三级医院临床护士对延伸护理服务认知的差异。[结果]二三级医院临床护士认为出院病人需求较高的延伸护理内容为用药指导(98.4%)、饮食指导(97.6%)、疾病相关知识宣教(97.5%)和提醒复诊(96.2%);护理方式为出院宣教(97.8%)、举办健康知识讲座(94.7%)和电话/短信随访(93.1%);执行者为社区护士(56.3%)和社区医生(55.0%);超过90%的护士认同延伸护理服务的意义,64.0%的护士认同护士在延伸护理服务中的责任,85.2%的护士认为延伸护理服务加重了护士的负担,82.2%的护士认为应有专业团队负责延伸服务的组织和实施。[结论]需加强临床护士对出院病人延伸护理需求的正确认识,培养临床护士在出院病人延伸护理服务中的责任感和延伸护理能力,设立专门机构和合作式跨学科团队负责延伸护理服务的组织和实施,促进医院-社区一体化延伸护理服务模式的建立,以保证延伸护理服务的顺利实施。     

产后延伸护理服务模式的临床应用

目的:探讨产后延伸护理服务模式的临床应用。方法:选取2011年2月～2012年2月在我院进行分娩的328例初产妇作为研究对象,随机分为对照组和观察组各164例,对照组接受传统的护理服务模式,观察组接受母婴保健延伸护理服务模式。出院后对两组研究对象进行问卷调查,了解产妇对医院护理服务满意度、产妇身体康复情况、新生儿健康状况、产妇对母婴保健知识的掌握情况。结果:观察组产妇对医院护理服务满意度提高,产妇产褥期感染、新生儿不良反应发生率低于对照组,产妇泌乳情况、对产褥期保健及新生儿护理方面的知识掌握程度均优于对照组,具有统计学差异(P<0.05)。结论:产后延伸护理服务模式的构建,拓展了优质护理的内涵,具有实际推广意义。     

福州市医疗机构延伸护理服务开展现状的调查研究

[目的]了解某市各级医疗机构延伸护理服务的开展现状,分析我市延伸护理服务现存的问题,为探索更适合某市群众的延伸护理服务模式提供可靠依据,并为卫生管理部门、医疗机构及行政机构对相关政策的制定提供参考依据。[方法]通过现场访谈及自制"医疗机构延伸护理服务现况调查表""护理人员延伸护理服务认知调查表"问卷对我市35家医疗机构共33名护理管理者及4 857名临床护理人员进行调查。[结果]29所已开展延伸护理服务,占87.88%,开展延伸护理服务过程中遇到的主要困难为人力资源不足、缺乏国家政策指导和相关法律法规支持等。[结论]延伸护理能够推进护理事业的发展,能够满足病人出院后的健康照护,减少再住院率。延伸护理是基于医院、社区、家庭三元联动的结果。     

无缝隙延伸护理服务模式在口腔门诊的构建与实践

目的探索"无缝隙"延伸护理服务模式在口腔门诊的实践效果。方法广州市某三甲口腔专科医院于2015年9月~2016年9月针对口腔门诊患者在就诊前、就诊中、就诊后这3个时间段内的需求特点,探索并实践了一系列全程、优质、无缝隙的延伸护理服务模式。结果实施"无缝隙"延伸护理服务后,护士服务患者的时间增加了(18.5±1.3)min;医护比由原来的1∶1.06提高至1∶1.3;椅护比由原来的1∶1提高至1∶1.2;患者失约率由33.3%降至8.3%;患者对护理工作的满意度由93.3%提高到99.4%;患者对诊位责任护士的知晓率由61.1%提高到96.7%。结论 "无缝隙"延伸护理服务模式把患者就诊前、就诊中、就诊后的护理服务进行有机的衔接,充分满足了口腔门诊患者的护理需求,体现了护理的专业价值和社会服务功能。     

关怀护理服务模式的实施与成效

目的：探索以人文关怀为特点的关怀护理服务模式,达到全程、优质、高效的服务目标。方法：以“五心”工作法为基础,实施从病人入院到出院后回访的全过程护理服务,体现亲情服务、感动服务和延伸服务的工作模式。结果：提高了病人的满意度,优化了护士团队整体素质,提高了护理科研水平和护理质量。结论：关怀护理服务模式的实施,有利于构建高品质的服务文化,提升病人满意度,形成良好的服务优势和品牌。     

基于微信平台的延伸护理服务对女性尿失禁病人生活质量的影响

[目的]探讨基于微信平台的延伸护理服务对女性尿失禁病人生活质量的影响。[方法]将124例女性尿失禁病人随机分为对照组和研究组各62例。对照组给予传统的社区健康教育,研究组在此基础上实施基于微信平台的延伸护理服务干预。比较干预前、干预6个月后两组病人生活质量,并调查研究组病人对基于微信平台的延伸护理服务模式的满意度。[结果]干预6个月后研究组病人的生活质量总分及各维度得分明显高于对照组(P0.05);研究组病人对基于微信平台的延伸护理服务模式满意度高。[结论]基于微信平台的延伸护理服务模式,宣教效果明显优于传统的社区健康教育法,有利于尿失禁病人的康复治疗,提高了其生活质量,是传统社区健康教育法的有益补充。     

我国44所综合医院延伸护理服务开展现状的调查分析

[目的]了解我国医院延伸护理服务的开展现状,分析延伸护理服务实践中面临的主要问题,为卫生部门及医疗机构制定延伸护理服务相关政策和流程提供参考依据。[方法]通过自设问卷对全国44所综合医院进行调查,内容包括开展延伸护理服务的时间、内容、形式、执行者等。[结果]43所(97.7%)医院已开展延伸护理服务,其中11所(25.6%)医院有专门的组织机构负责延伸护理服务的运营和管理,15所(34.9%)医院收取了相应的费用,23所(53.5%)医院进行了效果评价。开展率较高的延伸护理服务内容为用药指导(100.0%)、饮食指导(100.0%)、生活方式指导(95.3%)、疾病相关知识宣教(95.3%);形式为出院宣教(100.0%)、电话/短信随访(100.0%)、举办健康知识讲座(95.3%)。主要执行者为责任护士(90.7%)和专科护士(76.7%)。[结论]延伸护理服务在我国已初步开展起来,但仍处于初级阶段,需进一步探索符合我国医疗现状、能够满足我国病人需求、可持续发展的延伸护理服务模式,并制定相关政策,以推进延伸护理服务事业的发展。     

护理延伸服务在预防接种中应用的效果研究

目的 探索新的护理服务模式,延伸传统健康教育内涵,探讨护理延伸服务在预防接种中应用的效果。 方法 将2012.1----2013.1在本社区范围内300例预防接种儿童,用随机数字法随机分成试验组和对照组,对照组给予常规护理,试验组在此基础上加护理延伸服务,比较两组研究对象的家长满意度。 结果 对照组150例,未提供护理延伸服务,家长满意度86%;试验组150例,提供护理延伸服务,家长满意度100%,试验组家长满意度明显提高(P〈0.05)。 结论 护理延伸服务能有效提升家长的满意度,对提高社区卫生中心的服务质量有积极意义。     

阿尔茨海默病患者长期照顾模式研究进展

采用文献检索的方法，对阿尔茨海默病患者长期照顾模式的进展进行综述，旨在为国内开展适合阿尔茨海默病患者长期照顾的模式提供依据，让患者得到更好的护理照顾。本研究检索出31篇相关文章，主要包括家庭照顾模式、社区照顾模式、专业机构照顾模式。     

社区护士临终关怀知识和态度情况调查及其影响因素研究

目的:了解社区护士临终关怀知识和态度的情况,研究不同背景护士临终关怀知识与态度的差异。方法:通过问卷对6所社区卫生服务中心的211名护士进行调查。结果 :仅19.0%的社区护士对临终关怀知识的掌握程度达到良好;社区护士临终关怀态度的得分处于中等水平。社区护士临终关怀知识的掌握情况与其学历、职称、工作年限有关(P<0.05),而临终关怀态度则与其学历、工作年限、收入、宗教信仰、民族、职称有关(P<0.05)。结论:通过加强社区护士临终关怀基础教育及继续教育,可帮助其具备更专业的临终关怀知识、技能及良好的心理素质,以促进我国临终关怀的发展。     

Palliative care in non-malignant disease: a pragmatic response

With increasing requests for palliative care provision for all patients regardless of diagnosis, professionals within specialist palliative care services and palliative care nurse specialists need to consider how they will respond. Current palliative care is considered inequitable as the majority of palliative care services do not include those with non-malignant disease. This article examines a number of issues concerning the extension of palliative care to this patient population. It considers the needs of non-cancer patients, palliative care responsibilities, resource implications, professional knowledge and responsibilities, and possible action. Recommendations include the need for further research to explore these patients' needs and the role of specialist palliative care services. Suggestions regarding how Macmillan nurses could respond to the increased demand for palliative care services are offered. Within the current financial climate, the only realistic response for the Macmillan nurse is to act as a consultant working in collaboration with other health professionals outside the palliative care specialty.     

Models of bereavement care

After briefly reviewing the advantages and disadvantages of three approaches to bereavement care which are found in the United States of America (professional care, mutual help, and hospice care) this paper describes a fourth type exemplified by the British organization cruse. This provides both individual and group counseling through a national network of selected and trained volunteer counselors backed by professional caregivers.     

The impact of Alzheimer's disease on family caregivers

An understanding of the concerns and fears of caregivers of Alzheimer patients can help the health care professional provide home care management more effectively.     

Health ‘care’ interventions: making health inequalities worse,not better?

AIM: The aim of this paper is to present a model, the 'Effect of the Professional Ego', which provides a psychodynamically informed analytical framework for examining professional practice in arenas where issues of inequalities need to be addressed. BACKGROUND: There is a great deal of literature on the psychosocial aspects of inequalities in health care provision. However, the impact of intrapsychic and professional cultural elements has not been explored in this context. Moreover, the body of work which does explore these elements in relation to health care workers does not address how they might impact on health inequalities. DISCUSSION: Drawing on empirical work, we discuss ways in which intrapsychic and professional cultural elements feed into the dynamic between clients and health care professionals in a way which can subvert espoused, positive client health outcomes. Based on this discussion, we propose the Effect of the Professional Ego model, which identifies two main aspects of the professional ego - the grandiose self and self-preservation - and how they influence the professional/client dynamic. CONCLUSION: Systematic self-reflection on the part of professionals would be a valuable contribution to the development of professional practice. This applies particularly to conceptualizing the links between the actions of service providers and the adverse health of clients.     

Remote nursing training model combined with proceduralization in the intensive care unit dealing with patients with COVID-19

The shortage of personal protective equipment and lack of proper nursing training have been endangering health care workers dealing with coronavirus disease 2019 (COVID-19). In our treatment center, the implementation of a holistic care model of time-sharing management for severe and critical COVID-19 patients has further aggravated the shortage of intensive care unit (ICU) professional nurses. Therefore, we developed a short-term specialized and targeted nursing training program to help ICU nurses to cope with stress and become more efficient, thus reducing the number of nurses required in the ICU. In order to avoid possible human-to-human spread, small teaching classes and remote training were applied. The procedural training mode included four steps: preparation, plan, implementation, and evaluation. An evaluation was conducted throughout the process of nursing training. In this study, we documented and shared experiences in transitioning from traditional face-to-face programs to remote combined with proceduralization nursing training mode from our daily work experiences during the COVID-19 pandemic, which has shown to be helpful for nurses working in the ICU.     

Nursing and genetics: a feminist critique moves us towards transdisciplinary teams

Genetic information and technologies are increasingly important in health care, not only in technologically advanced countries, but world-wide. Several global factors promise to increase future demand for morally conscious genetic health services and research. Although they are the largest professional group delivering health care world-wide, nurses have not taken the lead in meeting this challenge. Insights from feminist analysis help to illuminate some of the social institutions and cultural obstacles that have impeded the integration of genetics technology into the discipline of nursing. An alternative model is suggested--the transdisciplinary model--which was developed initially by a nurse and introduced in the 1970s into the delivery of health care and social services for children with developmental disabilities. This holistic model enables all health care professionals to have an equal voice in determining how genetic health care will be globalized.     

Special needs of the deaf dying patient

Abstract

After briefly reviewing the advantages and disadvantages of three approaches to bereavement care which are found in the United States of America (professional care, mutual help, and hospice care) this paper describes a fourth type exemplified by the British organization cruse. This provides both individual and group counseling through a national network of selected and trained volunteer counselors backed by professional caregivers.     

Stress in families with medically fragile children

The literature related to the stress experienced by families who care for medically fragile children is analyzed. A model is generated from themes identified in the research literature. Four core themes were identified under which most of the stressors identified in the literature could be grouped. These are role conflict, financial burden, care burden, and independence. These are in turn arranged as a matrix in which the family, the child, the care professional, and health care system interact dynamically with the four core themes. The Family Stress/Task Matrix has the potential for facilitating research related to models that include a family-centered view among health professional and systems.