安全文化在手术室护理管理中的应用探析

目的探讨安全文化在手术室护理管理中的应用效果。方法选取实施安全文化的我院手术室,全面加强安全文化在护理管理中的应用,对实施安全文化前后医生、患者满意度和危急患者抢救情况以及护理差错和护理纠纷发生率分别予以统计分析。结果实施安全文化后,医生、患者满意度和危急患者抢救成功率均明显提高,护理差错及护理纠纷发生率明显降低,差异均具有统计学意义(P0.05)。结论手术室通过实施安全文化教育和管理后,医疗服务质量明显提高,值得临床推广应用。     

护理安全干预模式在手术室安全管理中应用的效果评价

目的探讨护理安全干预模式在手术室安全管理中应用的效果。方法选择我院收治的800例手术患者,随机分为观察组和对照组。对照组患者实施常规手术室安全管理:手术室及器械消毒、遵守手术室规章制度、做好相关记录。观察组引入护理安全干预模式实施手术安全管理。观察两组护理差错和护理纠纷发生情况,调查两组患者的护理满意度。结果观察组护理差错发生率为8.5%,观察组护理纠纷发生率为2.7%;对照组护理差错发生率为24.0%,对照组护理纠纷发生率为16.7%;观察组护理差错发生率和护理纠纷发生率均低于对照组,差异有统计学意义(P<0.05)。观察组护理满意度高于对照组,差异有统计学意义(P<0.05)。本组护理人员护理干预后业务考核分数显著高于干预前考核分数,差异有统计学意义(t=21.1462,P<0.05)。结论护理安全干预模式能够降低护理差错和护理纠纷发生率,提高患者护理满意度,效果显著。     

手术室患者的安全管理

目的探讨手术室患者的安全管理方法与效果。方法手术室患者进行安全管理,强化安全观念,加强安全教育,分析手术室的常见风险因素,并根据不同的风险因素,制订相应的有效防范措施。加强与患者的交流沟通,建立护理差错主动报告制度,提高护士的护理能力和防范意识。结果手术室患者进行安全管理后,护理缺陷及差错的发生率均得到了降低,且提高了患者对护理工作的满意度。结论手术室患者的安全管理,能够提高护理人员安全意识,降低手术室护理缺陷的发生率,提高护理人员防范风险的能力,保证了手术的护理质量。     

放射科护理中风险管理的应用效果观察

目的:对放射科护理中风险管理的应用效果进行观察分析。方法:选取2016年4月~2017年4月某院放射科收治的200例患者作为此次研究对象,随机分为常规组和风险组,常规组患者实施常规护理管理,风险组患者实施风险管理,对两组患者护理满意度及护理纠纷及护理差错发生率进行比较。结果:风险组患者护理纠纷及护理差错发生率明显低于常规组患者,数据差异具有统计学意义(P0.05)。结论:放射科护理中实施风险管理有效的降低了护理纠纷及护理差错发生率,极大的提高了患者的护理满意度,值得推广。     

手术室护理安全干预机制在安全管理中的应用分析

手术室是医院中不可缺少的一个部分,是医院用来对患者实施手术治疗,进行检查、诊断、对紧急患者进行抢救的重要场所。手术室护理包括无菌技术操作、皮肤护理、穿刺注射、输液输血等工作[1]。手术室是风险较高的岗位,容易发生事故差错而引起医患纠纷。所以在手术室安全管理中应用护理安全干预机制,能减少医疗事故差错的发生,提高护理质量,降低手术     

手术室规范化管理的实践体会路径探讨

目的探讨实施手术室规范化管理,提高手术室工作效率,保证手术安全。方法分析影响手术效果的原因,制订相应管理措施,完善和落实各项制度,加强手术人员、手术室布局、物品、设备及环境监测管理。结果实行规范化管理后,手术周转时间加快,护理缺陷发生率明显下降,手术医师满意度提高。结论实行手术室规范化管理,不仅能提高手术室的工作效率,降低护理缺陷发生率,提高医师满意度,保证手术的顺利进行,更为重要的是为患者的手术安全提供保障。     

护理安全文化在综合外科护理安全管理中的应用

目的研究分析护理安全文化用于外科护理安全管理中的应用价值。方法将未提倡和实施的护理安全文化期间的40名外科手术医师对手术室护理工作的满意满意度的问卷调查表、半年1560台次的手术室护理缺陷108次当作对照组;提倡及实施护理安全文化期间的40名外科手术医师对手术室护理工作的满意满意度的问卷调查表、半年1592台次的手术室护理缺陷45次当作研究组给予研究比较。结果研究组的护理满意度明显高于对照组(P<0.05),护理缺陷发生率明显低于对照组(P<0.05)。结论将护理安全文化运用于外科护理安全管理中,可以明显提高护理工作的满意度,降低手术室的护理缺陷,提升护理质量。     

安全管理在手术室护理中的运用体会

目的：探讨在手术室护理中应用安全管理的临床效果。方法选取本院2011年11月—2013年11月收治的112例行手术治疗的患者,随机分为试验组56例和对照组56例。对照组患者仅给予常规手术室护理,而试验组患者将安全管理应用于常规护理中。观察两组患者术中护理差错率、护理纠纷发生率及患者对护理的满意度,同时进行护理质量评分观察应用安全管理后的护理效果。结果试验组患者护理差错率和护理纠纷发生率均低于对照组,护理总满意度和护理质量评分均高于对照组,差异均有统计学意义（ P〈0.05）。结论安全管理应用于手术室护理中可有效改善手术室护理效果,降低护理差错率和护理纠纷发生率,提高护理质量。     

新生儿病区护理风险管理的方法与效果

目的分析新生儿病区护理风险管理的方法与效果。方法 160例新生儿对其实施护理风险管理。对实施前后患儿的护理缺陷总发生率以及产妇及家属满意度、护理差错、护理纠纷投诉和护理的质控评分等各项质控指标进行观察比较。结果护理风险管理实施后,护理缺陷的总发生率为5.63%,明显低于护理风险管理实施前的22.50%,差异有统计学意义（P〈0.05）;护理风险管理实施后的产妇及家属满意度为96.88%,无护理差错发生,护理纠纷发生率为1.25%,明显优于实施前,差异有统计学意义（P〈0.05）。结论在新生儿病区实施护理风险管理后,能有效降低护理缺陷总发生率,提高服务质量,提升产妇及家属的满意度。     

安全文化在手术室护理管理中的应用

目的探讨安全文化在手术室护理管理中的应用效果,以供临床工作参考。方法本院自2013年1月起在手术室护理管理中加强安全文化建设,对比加强安全文化建设前后1年内医师、患者对手术室护理工作满意度的变化。结果与加强手术室安全文化建设前1年对比,加强安全文化建设后1年内医师、患者对手术室护理工作满意度均有所提高,差异经卡方检验后发现有统计学意义(P<0.05)。结论手术室护理安全文化建设有助于减少护理缺陷、提升护理质量、保障医疗安全,使医师、患者对手术室护理工作满意度提高,有利于构建和谐的医护关系和护患关系。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.