整体护理路径在乳腺癌围手术期的临床应用

目的 提高临床护士开展整体护理、应用护理程序的能力。方法 设计整体护理路径，将要实施乳腺癌根治术或改良根治术的98例病人分为对照组和实验组，由责任护士分别按原来的方法和整体护理路径进行整体护理。结果 73．3％病人表示掌握了乳腺自查知识和出院后如何保持健康；82％．95％．91％护士认为护理评估路径使其对病人的生理、心理以及家庭和社会状况的了解更有针对性和更为全面，73％护士认为病人的心理、社会方面的护理诊断已经不难以确定，73％护士认为通过健康教育，病人已建立了健康行为；71％的护士对乳腺癌围手术期整体护理路径表示满意，93％护士认为路径对实施护理程序有帮助，98％认为路径值得推广，80％认为路径能推广。结论 整体护理路径能体现整体护理理论，是提高护士应用护理程序的有效途径。     

糖尿病患者家庭护理评估路径的设计与应用

目的 探讨家庭护理评估的方法,提高社区护士护理评估能力.方法 设计糖尿病患者家庭护理评估路径,社区护士根据路径逐一进行客观、真实的护理评估程序.结果 社区护士进行护理评估时间明显缩短、评估资料的完整性较前有明显提高,92%的护士认为护理评估路径的应用使其对患者的了解更有针对性和全面性,对实施护理程序有极大的帮助,有效提高工作效率.结论 护理评估路径为社区护士提供全面而规范的工作指引,提高护理评估的规范性、有效性、预见性和完整性.     

情绪晴雨表在老年干部病房整体护理工作中的应用

目的探讨情绪晴雨表在老年干部病房整体护理工作中的应用。方法设计制作情绪晴雨表,包含患者床号、性格颜色、当日情绪、不良情绪原因分析和沟通策略栏。对护士进行相关培训,提高责任护士对老年患者情绪变化的关注及掌握正确护理干预策略的能力。结果应用情绪晴雨表提高了患者对护理服务的满意度;护士认为情绪晴雨表使用简便、易操作;提高了护士对患者不良情绪和沟通策略的知晓率。结论应用情绪晴雨表利于记忆、交接患者情绪状态及沟通策略,能够有效引导和帮助护士开展整体护理工作。     

整体护理查房在儿科临床实践中的应用

目的 探讨整体护理在儿科查房中的应用效果.方法 2008年1月～2010年1月对本院52例儿科患儿进行整体护理查房,观察儿科15名护士整体护理查房前后整体护理程序运用能力、理论考核和操作考核得分变化.结果 实施查房后,护士整体护理程序运用能力测评、理论及操作的考核成绩显著优于实施前(均p＜0.05);患者满意度、患儿及家属的遵医行为均有明显改善(均p＜0.05).结论 通过整体查房,使护士的求知欲、分析问题的能力、沟通能力,高年资护师的组织能力和教学能力均得到了提高,护理查房能有效提高护士的综合素质,从而提升患者的满意度.     

新护士规范化培训的实践体会

总结了本院对新护士上岗前进行规范化培训的实践体会,培训内容包括成立规范化培训组织,重视素质培养;加强基础理论,专业知识与实践技能的培训;树立整体护理观,能运用护理程序开展工作;加强安全教育,强化责任意识;组织急救演练,提高急救能力;加强语言技巧培训,提高沟通能力。认为高素质、高水平、技术精湛的护理团队,是保证病人安全、提高护理质量的基础。     

临床护理路径与护士层级管理在神经内科的应用

目的 探讨临床护理路径与护士分层级管理在神经内科应用的效果.方法 利用现有资源,将科室常见病做出临床护理路径表格,重新制定各层级护士的工作职责,将临床护理路径表与护理记录单同时使用,实现护理活动的程序化和标准化.采用自行设计的问卷进行患者、医生、护士满意程度调查,统计平均住院天数.结果 将临床护理路径与护士层级管理在神经内科联合应用后,患者平均住院天数下降,护士、医生、患者满意度均显著提高.结论 将临床护理路径与护士层级管理联合应用,能有效控制医疗成本,提高护理质量,提升护士核心能力,有利于护理人才的培养,达到最佳的护理管理目标.     

老年患者心理护理路径表的设计与应用

目的探讨老年患者心理护理路径表的应用方法与效果。方法根据老年内科患者住院特点及心理需求设计开发临床心理护理路径表,分7个步骤指导责任护士开展心理护理。结果 100.00%的护士认为心理护理路径表能够有效帮助护士开展心理护理服务;观察组96.67%的患者认为责任护士能够积极关注自己的情绪变化;100.00%的患者感受到护士的心理支持,因而对护理服务满意度提高,与对照组比较差异具有统计学意义(P<0.01或P<0.05)。结论心理护理路径表有助于提高老年病房心理护理服务质量。     

实景案例模拟竞赛在工作2～5年内护士综合技能培训考核中的应用

为探讨实景案例模拟竞赛在工作2～5年护士综合技能培训考核中的应用，以某“三甲”医院51名2～5年护士作为参赛对象，采用“三站式”实景案例模拟：针对预设情景案例进行病情及安全风险评估→提出护理问题和措施并实施→判断并处理预设并发症及突发意外。全部选手认为竞赛提高了运用护理程序的能力；92.8%认为提高了安全风险评估及防范能力；90.7%认为提高了临床观察、评估、综合分析处理问题的能力；86.5%认为提高了评判性思维能力，82.7%认为提高了人文关怀及沟通交流能力。3个月后跟踪回访显示，91.2%的护士长、86.7%的护士、68.5%的医生认为提高了选手的临床安全风险观察、防范、分析等综合处理问题能力。实景案例竞赛能够有效提高2～5年护士临床综合素质及能力，值得借鉴及推广。     

外科病区护士循证护理技能的培训方法研究

目的 探讨外科病区护士循证护理技能的培训方法.方法 选择2个外科病区的护士共计43人作为培训对象,根据循证护理4个步骤,制订提出问题、寻找循证支持、进行循证观察、临床循证应用的培训流程,按照流程对护士进行循证护理能力的培训.评价培训后的护士循证护理技能;护士获取信息资源能力;护士满意度调查.结果 培训前后护士循证护理技能比较,差异有统计学意义(P＜0.01);培训前后护士获取信息资源能力比较,差异有统计学意义(P＜0.01);95%的护士认为经过培训后提高了自身循证护理能力.结论 通过对外科病区护士进行循证护理能力的培训,达到了提高护士循证护理技能;提高护士获取信息资源能力的目的,对促进循证护理的推广应用有一定的指导意义.     

护理程序培训对护理记录质量的影响

目的 为了提高护理记录质量,针对我院护理记录存在问题,探索护理程序对护士书写护理记录质量的影响.方法 随机抽取护理程序培训前后各200份护理记录,检查护理记录存在问题,应用护理程序有无缺陷.结果 护理程序培训前后护理记录质量差异有统计学意义(P＜0.01).护理程序培训后护士书写的护理记录质量明显高于培训前护理记录质量.结论 护理程序培训明显提高护士书写护理记录质量.     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

临床护理成本与效益分析

笔者根据临床护理服务价格偏离成本的事实,提出关注护理成本,改革现行的医疗护理服务收费制度和医疗费用结构比,提升护士的劳务价值,以期深入发展护理经济研究形成系统的护理成本核算体系,以低成本、高效益的优质护理服务来赢得市场。     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

涉外护理英语教学现状与思考

分析目前涉外护理英语的教学现状和存在的问题,从招生制度、课程定位与课程内容、教材选择、师资队伍建设、英语和涉外护理工作语言环境、考评方式、学生管理方面探讨提高涉外护理英语教学质量和涉外护理人才培养的对策。     

我院护理差错分析及对策

为了加强对护理安全的管理,对6年中发生的33起护理差错及与护理管理有关的主要因素进行分析,认为差错主要发生在护士,其中合同护士发生率较高;与护理管理相关的主要因素有:规章制度不健全占27.3%;业务知识欠缺占36.3%;与临床教学有关、未严格执行查对制度各占18.2%。通过建立健全各项护理规章制度,加强岗前护理安全教育、护士的规范化培训、对临床教学以及对合同护士的管理等综合措施,有力地保证了护理安全。     

我院专科护理门诊的实施与体会

目的探讨专科护理门诊的实施方法与体会。方法确定专科项目及服务内容、选拔护理门诊人员并明确工作职责、设置合理的诊室、制订相关制度,规范就诊流程,建立门诊护理日志,拓展服务功能。结果开设专科护理门诊以来,已接待门诊患者27000余人次,得到了患者、家属、医生及护士的认可。护理门诊就诊综合满意率为96．54％。结论开设专科护理门诊有利于提高护理专业地位,满足不同患者的健康需求,促进专科护士成长。     

口腔门诊患者专科护理评估表的构建与应用

目的探讨口腔门诊患者专科护理评估表的构建与应用情况。方法应用Cordon的FHPS理论,结合口腔专科的临床护理特点设计口腔专科护理评估表,运用改良的Delphi法进行专家咨询,并采用Likert 5点计分法,确定口腔门诊专科护理评估的内容。结果专科护理评估表包括5个一级指标和10个二级指标。通过专家的评定认为,85%一级指标和90%二级指标为重要和很重要。通过临床应用,85%～90%的护士认为采用专科护理评估表能准确了解患者的护理问题;能促进护患沟通。结论口腔门诊患者专科护理评估表所涵盖的评估内容全面、实用,能预见性地发现患者存在的护理问题,及时采取相应措施,促进护患沟通,提高患者满意度。     

Perceptions and expectations of Baccalaureate-prepared nurses in Jordan: Community survey

The overall purpose of this paper is to describe the process of utilizing community participation for curriculum design to develop a new school of nursing. A brief Community Needs Assessment Survey was carried out in order to explore community perceptions and expectations of Baccalaureate-prepared nurses in Jordan. The sample consisted of 152 participants who were staff nurses, nurse administrators, nurse supervisors, nurse educators, physicians, pharmacists and consumers of services. Data were collected through a self-administered survey form using open-ended questions. Participants were asked to describe their perceptions of nursing and nurses, the desired professional skills and personal characteristics of the Baccalaureate-prepared nurse, important curriculum contents and to provide suggestions or comments for improving the preparation of Bachelor of Science in Nursing (BSN) nurses. The findings indicated that nursing was viewed as a caring profession where nurses care for the person both in sickness and health. Several professional skills and personal characteristics emerged as being important for the BSN nurse, including clinical competence, the desire to continue learning, communication skills, ethical and moral character, critical thinking, assessment skills, and computer and English-language skills. The participants provided the desired curriculum contents and suggestions related to the expected skills. Implications for nursing education were discussed.     

优质护理服务示范工程的实践与体会

目的进一步强化护理质量建设,全面提升护理质量,为患者提供优质的护理服务。方法以优质护理服务示范工程为契机,通过优化护理质量管理运行机制、实行护士能级管理、改进工作模式及排班方式、强化护理信息化管理等措施强化护理质量建设。结果实施优质护理服务示范工程期间,全院出院患者对护理服务满意度达98.27%,较2009年同期提升2.18%;试点病房出院患者满意度达99.54%,较2009年同期提升3.45%;护理安全（不良）事件发生率较2009年同期下降50%;提升了护士的职业认同感。结论优质护理服务示范工程的实践,切实提高了护理服务质量,有力保障了护理安全,增进了护患关系,是提升护理质量的重要举措。