运用护理程序对急诊科实习护生的带教体会

临床实习是护生从单纯的学生向临床护士转变的过渡阶段，是理论联系实际的实践性操作。带教质量的高低直接关系到护理人才的培养，让护生把学到的理论知识在临床实践中得到强化，这与临床护理管理密切相关。急诊科专业性强，其工作环境、性质及所涉及的相关急救护理技术等与病房有较多不同。护生在校期间急救理论学习较少，刚进入急诊科实习时深感陌生、紧张、胆怯或恐惧感，     

部队住院患者护理服务模式探讨

为进一步明确“创官兵满意医院”的服务目标,牢固树立部队医院“姓警为兵”的服务思想,我院护理工作根据新时期部队伤病员的心理、疾病需求特点,不断探索新形势下部队住院患者的护理服务模式,在为部队患者服务过程中,更加注重严格管理与以人为本的接合,整体护理与亲情服务的接合,在院服务与跟踪服务的接合,收到了较好的实践效果。     

住院精神病患者的护理安全分析

目的 研究住院精神病患者的护理安全方法.方法 选取我院2015年6月至2016年12月期间入院接受陪护治疗的精神病患者80例,对患者的疾病诊断和护理的干预关系,以及患者的病情好转情况等,进行观察分析.对护理期间的有效防范措施进行分析,探究在现代医疗行为管理中的安全执行效果和对策.结果 在精神病患者的护理干预中,使用BPRS量表和NOSIE量表进行评价,可以有效确定患者的精神状态,同时为治疗提供安全治疗保障.对患者以及家属满意度的信息反馈,有了极大的提升.结论 住院精神病患者在临床中的暴力行为发生率较高,其危险性较大.在临床中通过护理措施来进行干预,可以降低住院暴力行动的发生率,同时提升患者家属对护理工作的满意度,在临床中,有较高的推广应用价值.     

心理护理干预在住院患者中的应用

住院患者的心理活动与疾病的严重程度、家庭经济状况及个人心理素质息息相关。笔者收集2008-10至2012-10住院患者1200例进行心理分析和护理干预,旨在对临床护理有一定的借鉴作用,现报告如下。1临床资料1200例住院患者,涉及心内、呼吸内科、普外科、神经外科等临床科室六个病区,男540例,女660例,年龄15～90岁,平均48.4岁,其中,心内科200例,诊断高血压、冠心病148例,心律失常52例;呼吸内科150例,肺肿瘤21例,支气管肺炎97例,肺心病32例;神经内科350例,脑出血186例,脑梗塞144例,帕金森症20例;神经外科112例:脑外伤90例,脑肿瘤10例,脑出血12例;普外科264例:急腹症4例,胆道结石186例,消化道肿瘤74例;泌尿外科120例:泌尿系结石100例,泌尿系肿瘤20例。患者住院时间3～280 d。精     

循证护理在1例重症破伤风患者中的实践

破伤风是由破伤风杆菌经伤口侵入人体生长繁殖,产生外毒素引起局部和全身性肌肉痉挛和抽搐为特征的一组症状[1].患者常因严重的感染、呼吸衰竭、窒息而死亡.平均病死率20％～30％,重型者可达70％.破伤风多发生在生活条件及卫生状况较差的偏远山区和农村[2].护理工作在重症破伤风患者的康复过程中起着重要的作用.本研究查阅有关文献,运用循证思维,探讨重症破伤风患者的护理.     

循证护理在高龄患者全膝关节置换术后护理工作中的应用

循证护理学由加拿大Alba Di-censo教授于1991年提出,是循证医学的重要分支,意为＂遵循证据的护理学＂,同时结合护理专业技能和多年临床经验,考虑患者的价值和愿望,将三者完美的结合,制定护理措施〔1〕。     

循证护理在鞍区肿瘤视功能障碍患者护理中的应用

目的对循证护理在鞍区肿瘤视功能障碍患者护理中的应用效果进行分析。方法随机选取2012年10月～2013年10月进行治疗的68例鞍区肿瘤视功能障碍患者,并将其随机分成两组,其中对照组患者实施常规护理,观察组患者实施循证护理。最后对两组患者的术后并发症和患者护理满意度进行对比分析。结果观察组患者术后并发症发生率为26．5％,对照组为38．2％,其差异显著,比较具有统计学意义（P〈0．05）;观察组患者护理满意度为97．1％,对照组为85．3％,其差异显著,比较具有统计学意义（P〈0．05）。结论鞍区肿瘤视功能障碍患者实施循证护理,可以有效的对患者视力进行改善,同时提高患者护理满意度,值得推广。     

住院患者药物不良反应的调查分析及护理对策

目的:对2011 -O1 ～2011 - 12在我科接受药物治疗的18例药物不良反应报告分析,探讨护理应对措施,以减少住院患者药物不良反应的发生率,将患者的损伤减低到最低水平.方法:采用问卷调查的方法对2011 -01～2011 - 12出现的18例药物不良反应进行分类统计分析,将出现药物不良反应的患者年龄、性别、疾病名称、所用药物名称和出现不良反应症状及发生不良反应的心理进行统计分析.结果:老年患者发生药物不良反应的比例明显高于其他年龄,药物不良反应的临床表现.结论:护理对策:(1)提高护理人员对药物不良反应的认知度及监测工作的重视度.(2)加强老年患者用药的安全管理建立良好的护患关系.(3)护士对用药全过程要严密进行观察.(4)帮助患者恢复心理平衡.     

高原地区上消化道出血患者的循证护理

目的　探讨循证护理在高原地区上消化道出血患者临床护理中的应用方法和效果 ,为高原地区上消化道患者的临床护理工作提供理论依据。方法　根据高原地区上消化道出血患者的病因 ,临床表现进行循证分析 ,研究临床护理方法 ,并作动态监测。结果　实施循证护理以后 ,患者一周内上消化道出血控制率由原来的为 81%上升到 96 % ,而死亡率、肺水肿或脑水肿的发生率分别由原来的 7.1% (11/ 15 6 )、8.9% (14 / 15 6 )下降到 1.5 % (3/ 175 )、1.1% (2 / 175 )。经统计学分析 ,两组病例的三个指标之间均有显著性差异 ,P <0 .0 5。结论　开展循证护理以后 ,上消化道出血患者的治疗成功率已明显增高 ,而死亡率和不良反应发生率已明显下降。实践表明循证护理较以往的经验护理具有明显的科学性和优越性     

肿瘤科实施风险管理的探讨

 目的 探讨风险管理在防范肿瘤科医疗纠纷和投诉中的作用.方法 树立正确的风险意识,正确鉴别和评估风险,制定风险管理制度和健全质量监控体系,同时进行临床业务和安全知识培训,协调好肿瘤科与相关科室部门的工作.结果 实施风险管理1年多,护患、医患关系明显改善,变被动服务为主动服务,降低了纠纷和投诉的发生率.结论 实施有效的风险管理是提高肿瘤科服务质量和医疗水平、减少纠纷和投诉的重要手段.     

Biomechanical basis of common shoulder problems

Balancing mobility and stability, the biomechanics of the shoulder provides optimal use of the thumb and hand. More than a glenohumeral joint, the shoulder complex consists of four joints and numerous muscles and ligaments. Injuries to the shoulder result from overuse, extremes of motion, and excessive forces. This review describes basic shoulder biomechanics, their role in impingement and instability, and how imaging can detail shoulder function and dysfunction.     

Clinical audit of a new radiation oncology department in the first 20 months of establishment

This audit was carried out to examine the workload statistics of the Radiation Oncology Department at Liverpool Hospital in its first 20 months of operation, and their implications for the delivery of radiation oncology services in the Southwestern Sydney Area Health Service (SWSAHS). Data on patient demographics, primary diagnosis and radiotherapy treatment details from April 1995 to December 1996 were analysed. In this time period, 1329 new patients were seen; 90.6% of them lived in the local area health service and approximately 30% came from a non-English-speaking background. The most common primary tumour sites were breast (25%), prostate (17%) and lung (15%). Nine hundred and ninety-eight of the new patients (74%) proceeded to have radiotherapy. Fifty-seven per cent were treated radically with curative or adjuvant intent, the remainder were treated palliatively for symptom control or local control. The most commonly used fractionation schedules were 31-35 fractions for radical treatment and 1-5 fractions for palliative treatment. Forty patients (4%) did not complete the treatment course as planned. Eighty-nine patients (9%) were retreated in the same time period. These workload statistics were helpful in determining ongoing workload and planning future expansion.     

Skeletal complications in pediatric oncology patients.

Pediatric oncology patients are at risk for the development of numerous skeletal complications, and radiologic studies are important in the identification and evaluation of these conditions. Methotrexate osteopathy manifests as osteopenia, dense provisional zones of calcification, pathologic fractures, and sharply outlined epiphyses. Hypertrophic osteoarthropathy may occur with nasopharyngeal carcinoma or tumors of the lungs or pleura and manifests as cortical thickening, lamellar periosteal new bone formation, and soft-tissue swelling. Biomechanical abnormalities are often seen at bone scintigraphy in patients who have undergone surgery for bone tumors. Growth plate injury may manifest as marked deformity, sclerotic metaphyseal bands, metaphyseal fraying, and longitudinal striations. Radiation "osteitis" is seen as an initial decrease in bone density with subsequent development of a mixed radiolucent and sclerotic appearance. Ischemic necrosis of the femoral heads is best demonstrated at magnetic resonance (MR) imaging and has low signal intensity on T1-weighted images and a high-signal-intensity rim on T2-weighted images. Bone infarcts are seen as well-demarcated, often ring-shaped areas of decreased signal intensity on T1-weighted MR images and as areas of increased signal intensity on short-inversion-time inversion recovery images. Radiographic signs of infection include bone destruction, periosteal new bone formation, and sclerotic changes. Short-inversion-time inversion recovery MR imaging is particularly useful in evaluating posttherapy changes in bone marrow. Osteochondroma may demonstrate a cartilaginous cap at MR imaging, whereas the most important finding in radiation-induced sarcoma is a soft-tissue mass. Radiologists who work with children with cancer need to be familiar with these complications and their imaging appearances.     

投稿规范解读及常见问题简析

科技论文的撰写与发表是科研工作的一项重要组成部分,论文的质量也是衡量科研工作者成就的一项重要指标。论文的质量主要包括学术质量和写作质量,但部分研究者大多精于实践而疏于文字,致使来稿中仍然存在许多写作方面的问题。笔者通过解读投稿规范,就本刊来稿中存在的常见问题进行总结及说明,以供参考。     

Radiological placement of chest ports in pediatric oncology patients

A single centers procedural and follow-up results of radiological chest port placement in pediatric oncology patients are presented. Between July 2002 and December 2003, 37 children (20 boys, 17 girls; age range, 4 months to 16 years; mean 6.7 years) underwent chest port placement. All patients received only one port through the internal jugular vein access, and all of the implantations were performed in the interventional radiology suite. Our database and electronic charts were retrospectively reviewed to obtain follow-up data. All chest ports were successfully implanted. The mean catheter life was 223 days (range: 15–450 days), with a total of 8,258 catheter days. Twenty-eight ports are still in use, four patient deceased, one port was prematurely removed because of a late infection, and four patients were lost to follow-up. Infection rate was 2.7% (0.12/1,000 catheter days). Malfunction due to partial catheter thrombosis and fibrin sheath formation was observed in three patients (8.1% or 0.36/1,000 catheter days), and all were relieved with rt-TPA dwell. None of the ports were revised or removed because of blockage, malposition or difficulty accessing the port. The peri-procedural complication rate was 0%. Chest ports in children can be inserted in interventional radiology suites under imaging guidance with high rates of technical success. The rates of infection and complications are comparable to that of surgically placed ports.     

Radiobiology and the role of the radiobiologist in the context of a teaching-oriented radiation oncology department.

This discussion concerns the function of a radiobiologist in the radiation oncology department of a hospital which maintains a radiation oncology training program. This involves teaching and research, both of which contribute to the oncology residents' total learning experience. The teaching commitment emphasizes the radiobiological basis of clinical problems, and makes use of both lectures and clinical experience to generate the teaching situations. As a part of the research commitment, the radiobiologist acts as an interface between clinical experience and research. He accomplishes this by maintaining a research program oriented toward clinical problems and organizing a research rotation during which the oncology trainees are able to participate in a specific research project. Radiobiology teaching and research must be relevant to the clinical experience of the oncologist.