我国飞行护士培养目标的探讨

目的：探讨我国飞行护士培养目标的具体内容,为未来选拔及培训飞行护士提供理论依据。方法采用文献分析法、专家访谈法形成专家咨询问卷,对不同领域的15名专家进行两轮Delphi专家咨询。结果构建了我国飞行护士培养的总体目标和具体目标,其中具体目标包括3个一级指标和22个二级指标。两轮专家咨询的问卷回收率均为100%,专家对一、二级指标的权威系数均在0.87以上,两轮咨询的所有肯德尔协调系数差异均有统计学意义（均P＜0.01）。结论专家的积极性和权威程度高,意见协调性好,所形成的培养目标合理,具有可操作性。     

重大地震灾害军队机动医疗分队医学救援能力评价指标体系的构建

目的旨在研究和评价重大地震灾害军队机动医疗分队医学救援能力,为提高军队机动医疗分队执行重大地震灾害等非战争军事行动的应急救援能力提供理论依据。方法运用文献检索和德尔菲法,构建军队机动医疗分队重大地震灾害医学救援能力的评价体系,使用Excel 2007建立数据库并计算得出各指标综合权重。结果建立4个一级指标、14个二级指标和32个三级指标,其中“组织指挥能力”权重为0.183,“医疗后送能力”权重为0.368,“医疗保障能力”权重为0.167,“应急机动与适应能力”权重为0.282。结论重点提高机动医疗分队的医疗后送、应急机动与适应能力,有侧重地建设组织指挥和医疗保障能力。     

创伤专科护士岗位职责核心指标体系的初步构建

目的构建符合我国创伤救治体系架构特征的创伤专科护士岗位职责核心指标体系, 为创伤中心设置创伤专科护士岗位提供参考。方法通过文献研究法和小组讨论法构建创伤专科护士岗位职责核心指标体系初稿。应用Delphi专家咨询法对来自全国7个省(市)的15位专家进行两轮咨询, 确定指标体系终稿。计算两轮咨询专家的积极系数、权威系数(Cr)、肯德尔协调系数(Kendall′sW)、各级指标的重要性赋值均数及变异系数(CV)。结果两轮咨询专家的积极系数均为100%, Cr为0.953。第2轮咨询的Kendall′sW为0.188(χ2=155.29, P<0.001), 所有指标的重要性赋值均数范围为4.27～5.00分, CV均<0.25分。最终构建的创伤专科护士岗位职责核心指标体系包含7项Ⅰ级指标和49项Ⅱ级指标。结论创伤专科护士岗位职责核心指标体系科学合理、内容全面, 可以为我国创伤专科护士岗位设置提供参考依据。     

介入专科护士理论知识体系的构建

目的通过构建介入专科护士理论知识体系,为介入专科护士培养和理论课程设置提供参考。方法应用德尔菲法对16名专家进2轮函询,确立理论知识大纲要点。结果 2轮专家函询的积极性均为100%,专家咨询的权威系数为0.89,判断系数0.89,熟悉程度0.89,均>0.7。最终确定的理论知识体系包括5项一级指标,21项二级指标。结论介入专科护士理论知识体系专家意见集中,可信度高,能为介入专科护士理论课程培训的设置提供参考依据。     

门诊医疗质控重点指标的构建与实践

目的 构建门诊医疗质控重点指标体系，以提高门诊医疗质量和患者满意度。方法 通过文献研究和专家访谈，形成咨询问卷，运用德尔菲法对17名专家进行两轮专家咨询，确立构建门诊医师医疗质控重点指标。提取医院HIS系统相关数据和移动终端满意度调查结果。结果 两轮专家函询的回收率均为100%,专家权威系数大于0.7,筛选后门诊医师质控重点指标体系包括3个一级指标、12个二级指标，指标问卷调查的克朗巴赫系数为0.728。从指标体系实践结果来看，预约挂号率增高了29.09%,基本药物占比增加了2.75%,门诊病历打印率增加了28.28%,出诊考勤合格率和患者满意度均有明显提升。结论 构建的医疗质控重点指标定位准确、导向性强，数据可量化，可用于门诊医疗质控，提升患者满意度。     

机动卫勤分队特诊模块岗位胜任力评价指标体系构建

 目的 构建科学、系统、实用的机动卫勤分队特诊模块岗位胜任力评价指标体系,为训练和考评提供参考。方法 结合胜任力特征理论,通过文献分析法和小组访谈法初步拟定机动卫勤分队特诊模块岗位胜任力指标体系框架,采用德尔菲专家咨询法对21名专家进行2轮咨询,确定各级指标及权重分值,构建机动卫勤分队特诊模块岗位胜任力评价指标体系。结果 两轮咨询的有效回收率分别为95.2%、100%,两轮咨询的专家的权威程度为0.87、0.90,一、二级指标的重要性赋值均大于4.0,变异系数0.0382~0.1280,咨询专家积极性、权威程度及可信度高。构建的机动卫勤分队特诊模块岗位胜任力评价指标体系涵盖一级指标6项,二级指标49项。结论 本研究构建的机动卫勤分队特诊模块岗位胜任力评价指标体系具有较好的科学性、系统性和实用性。     

军队核化医学救援能力评估指标体系的构建

目的构建军队核化医学救援能力评估指标体系。方法综合运用文献调研、实地调研、专家咨询和序关系分析（G1法）等方法,对军队核化医学救援能力要素构成进行研究。结果提出了军队核化医学救援能力评估指标体系。结论本研究通过对核化医学救援能力构成要素的分析研究,为指导建立具有军队特色的核化医学救援能力评估体系,切实提高核化医学救援能力提供参考和依据。     

我国空运后送专业护士培训课程体系的构建研究

目的结合我国飞行护士能力标准指标体系、飞行护士培训知识需求调查和飞行护士核心知识体系,探讨我国空运后送专业护士的培训对象、培养目标、课程模块及学时设置、具体课程内容和考核要点,以尝试构建我国空运后送专业护士的培训课程体系。方法通过国内外文献回顾和专家访谈法制定出专家咨询问卷,运用德尔菲法对15名专家进行两轮函询,并对数据进行分析处理。结果在两轮问卷中,93.3%的专家认同空运后送专业护士培训对象的要求,专家对具体培养目标、课程模块和考核要点的权威系数分别在87.0%以上、79.0%以上和85.0%以上,所有肯德尔协调系数均有统计学意义(P0.01)。结论构建的空运后送专业护士培训课程体系具有较高的科学性,对未来空运后送专业护士的培训与考核提供了重要理论依据。     

灾难医学救援体系和机制的构建设想

灾难和突发事件已成为当今社会一个重要的公共问题，我国急需开展灾难医学理论体系的系统研究，以有效应对各种灾难和突发事件。本研究在查阅文献、专家访谈和实地调查的基础上，运用系统分析、专家咨询、统计分析等理论和方法，依据军队所担负的任务及编制序列，提出了灾难医学救援体系和机制的构建设想，供参考。     

我国空运后送护理安全管理评价指标体系的构建研究

目的 初步构建我国空运后送护理安全管理评价指标体系,旨在降低空运后送伤病员护理安全隐患,有效减少不良事件的发生.方法 通过文献回顾法、专家议题小组法初步拟定专家咨询问卷;采用德尔菲法对不同专业的15位专家进行两轮专家咨询;使用Excel 2010、SPSS 23.0软件和yaahp层次分析软件对数据进行汇总分析,筛选指标并确定指标权重.结果 两轮咨询专家积极系数均为100％,专家权威系数均在0.912以上,肯德尔和谐系数差异均有统计学意义(P<0.05).最终确定包含5项一级指标、16项二级指标、85项三级指标的我国空运后送护理安全管理评价指标体系.结论 初步构建的我国空运后送护理安全管理评价指标体系具有较高的科学性和实用性,专家意见较为集中,经进一步验证后可作为空运后送护理安全评价工具.     

某大型舰船护理核心技术体系研究

目的 构建某大型舰船护理核心技术体系。方法 采用文献研究法、专家会议法、德尔菲法和层次分析法对20名专家进行两轮函询,选用SPSS 17.0、yaahp 10.3软件进行统计分析。结果 两轮问卷有效回收率均为100%,专家权威系数为0.88、0.90,协同系数0.216~0.416。最终确定包括舰船一般护理技术、急救技术、特殊护理技术、战创伤护理技术4个方面的某大型舰船护理核心技术体系,权重依次为0.093、0.305、0.143、0.459。结论 专家积极性和权威程度高,意见协调性较好,构建的护理核心技术体系可为开展护理技术培训提供理论参考依据。     

印尼海啸救援中亚齐机场的伤病员医疗转运模式

目的 探讨印尼海啸救援中亚齐机场伤病员医学转运模式,为合理利用救援资源提供依据.方法 回顾总结在印尼海啸灾难救援中,中国国际救援队首次与其他国家救援队在灾区亚齐机场联合转运伤病员的过程.结果 在航空医疗救援组织上,由美国国际开发总署、国际移民组织及美国军方共同发起,成立亚齐机场联合医学转运中心.由美国军方、印尼政府、澳大利亚和新加坡空军使用直升机飞赴交通不便的难民营及岛屿,将伤病员转运到亚齐机场,再由中国、美国、澳大利亚等多个国家的医务工作者或志愿者提供急救医疗服务:检伤分类,快速处置并后送分流到市内各级医疗机构.由该中心进行检伤分类、快速处置并转运的急危重伤病员共217名,其中居前3位的伤病分别为外伤(伤口)感染、急性呼吸系统疾病、急性消化系统疾病.结论 联合医学转运中心建立了一种从灾难现场到医院的医疗救援模式:现场→直升机→机场转运中心→后方医院,极大地提高了救援效率.在联合医学转运中心基本框架下,多国救援队、军队及多个国际组织共同参加的伤病员转运工作,最大限度地实现了救灾资源的整合利用.强大的垂直空运能力对于救灾快速反应具有至关重要的作用,有效解决了交通瓶颈问题.     

Preliminary assessment of computed tomography and satellite teleradiology from Operation Desert Storm

Computed tomography at military transportable hospitals was used for the first time during the recent Operation Desert Storm in the Saudi Arabian desert. Scan quality was excellent and the scans proved clinically important in patient management. A teleradiology link via satellite to the U.S. mainland was also successfully employed. The objectives of the teleradiology link were to validate the concept distant interpretation of images obtained on the battlefield and to provide specialty radiology consultation. This technology shows great promise for future applications, both for combat casualty care and for civilian disaster medical support operations.     

突发公共卫生事件军队卫勤应急反应能力要素构成指标体系的探讨

本文运用文献调研法、实地调研法、专家咨询法（Delphi法）、系统分析法和多指标综合评价法等方法，对军队卫勤应对突发公共卫生事件的反应能力要素构成进行了研究。研究提出了突发公共卫生事件军队卫勤应急反应能力要素构成指标体系；并在对各指标赋予权重系数的基础上进行指标优化排序。     

Activities of an ethics consultation service in a Tertiary Military Medical Center

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center.     

Iranian military forces in the Bam earthquake

The earthquake that struck Bam, Iran, in December 2003 was one of the most catastrophic natural disasters in recent years. Medical and assistance activities conducted by Iranian military forces in this event are discussed in light of the special capabilities of the military forces in search and rescue missions. Among the most significant activities of the Iranian military forces in this event are the following: reporting the first news about the event, starting search and rescue missions in the first hour after the disaster by the 1st Brigade of Bam as the first assisting force, setting up two field hospitals as the first Iranian field hospitals in the disaster area, transporting 937 assistance, medical, and health care personnel to the disaster area in the first day, setting up 23 field emergency and 13 field assistance centers in the area, running 8 post-hospital care centers throughout the country, and playing a significant role in airlifting 11,792 casualties to different hospitals around the country. Based on the recent experience and the exclusive abilities of military forces, a special role for these forces in search and rescue missions should be considered.     

Experience in organizing epidemic control work in catastrophes

Maintenance of preventive medicine measures is one of the main part of national system of emergency health service in disasters. The priority in this activity belongs to the mobile autonomous units, which take measures for protection of population disaster regions and military personnel from infections diseases.     

An innovative medical civil-military operation training program

The San Antonio Military Pediatric Center has developed an innovative humanitarian civic assistance (HCA) program. Many medical HCA programs focus on short-term medical interventions and provide transient benefit. To have a more lasting impact, this program focuses on public health surveillance. U.S. military medics conduct random household nutritional surveys and train in austere settings and on rounds in Honduran hospitals. Since 2001, >200 military medics have been trained in population assessment, primary medical care in developing nations, and other skills critical for medical civil-military operations. All activities are coordinated with the host nation. Public health data are collected and reported to Honduran public health leaders, the U.S. Agency for International Development, and nongovernmental organizations, to assist with program and policy development. This innovative project is a potential model to improve both military training and host nation benefit from HCA programs.     

Designing a Medical Humanitarian Assistance Course for advanced practice nurses in the uniformed services

The U.S. uniformed services frequently respond to natural and man-made disasters worldwide. Disaster management and humanitarian assistance has been a major focus of military medicine for well over a decade. Training for these missions is a priority for the U.S. military, specifically as a result of the Gulf War. The Medical Humanitarian Assistance Course for advanced practice nurses is a course available to train advanced practice nurses in disaster management and humanitarian assistance. This article will describe the evolution, design, format, and implementation of the Medical Humanitarian Assistance Course.